bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in anticoagulation practice in subjects admitted with stroke associated with atrial fibrillation, following introduction of direct oral anticoagulants over 2013–2021
Authors: Harbison Joseph , McCormack Joan , Brych Olga , Collins Ronan , O’Connell Niamh , Randles Mary , Kennedy Cormac , Kelly Peter J , Cassidy Tim
Published: September 2023

Background:

The adoption of direct oral anticoagulants (DOACs) has changed practice in prevention of stroke in atrial fibrillation (AF). We used Irish data national data on stroke and anticoagulation therapy over 9 years to investigate changes in anticoagulation practice and potential consequences on stroke prevalence and thrombolysis.

Methods:

AF, anticoagulation, thrombolysis, and stroke data from the Irish National Audit of Stroke (INAS) 2013–2021 were reviewed. The proportion of patients with ischemic stroke (IS) and intracerebral hemorrhage (IH) with known AF admitted on anticoagulation was determined. Effects on age distribution in the population and thrombolysis practice were assessed.

Results:

AF data were available on 34,630 of 35,241 individuals (98.3%) included in INAS; median age was 74 years and 56% were male. AF was found in 10,016 (28.9%, 9059 IS, 957 IH). 6313 had known AF prior to stroke (63.1%). The proportion all total IS due to AF decreased by 15.3% (31.3%−26.5%, chi-square = 24.6, p < 0.0001). The proportion of IH did not change significantly (21.6%–20.2%, chi-square = 1.8, p = 0.18). Over the 9 years, 3875 (38.6%) of the subjects with AF were recorded as receiving anticoagulants at admission. In 2013, 4.4% of AF-associated strokes were admitted on a DOAC and 21.4% on warfarin; by 2021, 44.1% were receiving a DOAC and 6.2% warfarin. There was a strong inverse correlation between the proportion of anticoagulated stroke patients and the total proportion of AF-associated strokes over time (r = −0.82, p = 0.006). In contrast, no correlation was found between increasing DOAC usage and IH (r = 0.14, p = 0.71). Increased anticoagulation usage correlated with a reduction in patients ⩾ 80 years (r = −0.83, p = 0.006) and also correlated with a relative reduction of 30.1% in subjects thrombolysed <4 h from onset (r = −0.89, p = 0.001)

Conclusion:

DOACs have led to increased use of anticoagulation, but warfarin use fell by two-thirds. There has been a reduction in the proportion of AF-associated IS without a noticeable increase in IH. Increased anticoagulation correlated with reduced numbers of strokes in those >80 years and in the proportion of patients thrombolysed.
Alterations of erythropoiesis in Covid-19 patients: prevalence of positive Coombs tests and iron metabolism
Authors: Schmitz Léa , Pirotte Michelle , Lebeau Alizée , Ernst Marie , Fillet Marianne , Devey Anais , Schmitt Justine , Cobraiville Gaël , Binsfeld Marilène , Gofflot Stéphanie , Beguin Yves , Vertenoeil Gaëlle
Published: September 2023

Background:

For more than 2 years medical practice has been dealing with the Covid-19 pandemic. Atypical symptoms, such as frostbites and acrosyndromes, have appeared, and autoimmune anemias (some of which with cold agglutinins) have been described.

Objectives:

We planned to study the prevalence of positive direct Coombs tests (DCTs) and hemolytic autoimmune anemia in patients infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and its correlation with complications, and then investigate the impact of the infection on iron metabolism.

Design:

This is an observational, cross-sectional, single-center, exploratory study.

Methods:

We obtained Coombs tests in a population of 179 infected patients at the CHU of Liège. We then studied iron metabolism in some of these patients, by measuring serum ferritin, erythropoietin (EPO), erythroferrone and hepcidin.

Results:

We did not identify any case of autoimmune hemolysis. However, there was a 20.3% prevalence of positive DCT, mainly with IgG (91.7%). These patients, compared to DCT-negative patients, were not only more anemic and transfused, but also required more transfers to intensive care units and had longer hospital stays and mechanical ventilation. The pattern of anemia was consistent with the anemia of inflammation, showing elevated hepcidin and ferritin levels, while EPO and erythroferrone values were lower than expected at this degree of anemia. Erythroferrone was higher and Hb was lower in DCT-positive patients. Finally, we identified a correlation between iron parameters and complicated forms of infection.

Conclusion:

Covid-19 patients suffered from inflammatory anemia with more severe forms of infection correlated to positive DCT status. This could potentially be of interest for future clinical practice.
Population-based assessment of the burden of COVID-19 infection in African countries: a first-year report card and public health implications
Authors: Mgbere Osaro , Nwabuko Ogbonna Collins , Olateju Olajumoke A. , Adepoju Omolola E. , Liaw Winston , Darkoh Charles , Essien Ekere James
Published: September 2023

Background:

The COVID-19 pandemic constitutes a global health threat and poses a major burden on the African continent. We assessed the real-world burden of COVID-19 infection in African Union (AU) member states to determine the distributional patterns of epidemiological measures during the first 1 year of the pandemic.

Methods:

This retrospective cross-sectional study utilized COVID-19 data from publicly available data repositories of the African Center for Disease Control and Prevention and Our World in Data for the period February 2020 to January 2021. AU member states were classified into low, medium, and high burdens based on COVID-19 morbidity. We conducted descriptive and inferential analyses of COVID-19-reported cases, deaths, recoveries, active cases, COVID-19 tests, and epidemiological measures that included morbidity and mortality rates, case fatality rate (CFR), and case ratios.

Results:

A total of 3.21 million cases were reported during the 1-year period, with 2.6 million recoveries, 536,784 cases remaining active, and 77,486 deaths. Most countries (49.1%, n = 26) in AU experienced a low burden of COVID-19 infection compared to 28.3% ( n = 15) with medium burden and 22.6% ( n = 12) with high burden. AU nations with a high burden of the disease were mainly in the northern and southern regions. South Africa recorded the highest number of cases (1.31 million), followed by Morocco with 457,625 and Tunisia with 175,065 cases. Correspondently, death tolls for these countries were 36,467, 7888, and 5528 deaths, respectively. Of the total COVID-19 tests performed (83.8 million) during the first 1 year, 62.43% were from high-burden countries. The least testing occurred in the medium-burden (18.42%) countries. The overall CFR of AU was 2.21%. A morbidity rate of 327.52/105 population and mortality rate of 5.96/105 population were recorded during the first 1-year period with significant variations ( p < 0.0001) across burden levels. Continental morbidity and mortality rates of 17,359/105 and 315.933/105 populations were recorded with significant correlation ( r = 0.863, p < 0.0001) between them and variations across selected epidemiological measures by COVID-19 burden levels.

Conclusion:

Understanding the true burden of the disease in AU countries is important for establishing the impact of the pandemic in the African continent and for intervention planning, preparedness, and deployment of resources during COVID-19 surges and future pandemics.
Understanding the use/non-use of an internet-based intervention complementing standard depression treatment: A qualitative study of user's experiences
Authors: Fernández Olga , Pérez J Carola , Fernández Sofía , Krause Mariane , Cáceres Cristián , Espinosa-Duque Daniel
Published: September 2023

Introduction

There is sufficient evidence about the effectiveness of internet-based interventions; however, the users’ level of adoption and utilization remains low, with this phenomenon requiring adequate explanation.

Objective

The aim of this qualitative study was to explore the users’ perceptions and experience of a web-based program (ASCENSO), designed to complement (usual) in-person depression treatment.

Method

Twelve participants of the ASCENSO program, comprised of adult individuals ( M = 44.3, SD = 13.4) of both genders (67% women) undergoing treatment for depression, were interviewed through semi-structured interviews. The data obtained from these interviews were analyzed utilizing a constructivist grounded theory approach. The interviews were transcribed and analyzed by trained coders. A constant comparative analysis of emergent themes was conducted.

Results

These show that users employ and appreciate the program when their interaction with it emulates a “humanized relationship,” that is, when the program is proactive in assisting users with their requests and when it responds in a pertinent and individualized manner to their emotional states and needs.

Conclusions

Our findings highlight the challenges associated with the development of algorithms capable of attracting different potential users. These should be designed to generate a virtual relationship that emulates human interaction and targets the characteristics of each user, for example, considering the specific phenomenology of their health condition, their present emotional states, and perceived needs. Elements that will vary as mental symptomatology evolve.
The irony of Indonesia's democracy: The rise of dynastic politics in the post-Suharto era
Authors: Kenawas Yoes C
Published: September 2023

This essay aims to study why politicians engage in dynastic politics within democratic institutions and how they reject institutional changes that may limit their ability to pass on political power to family members. While scholars have emphasized institutions as an enabling factor, it is unclear how the power struggle manifested to preserve the institutions that continually suit the interests of aspiring dynasts amidst the democracy shift and pressure. This study seeks to fill the gap by delving into how political players struggle to preserve the structures that allow them to form political dynasties. This study also presents an original empirical conclusion demonstrating that Indonesian political dynasties more than tripled between 2010 and 2018, or in only one election cycle. This study contends that the primary cause of the rapid growth of political dynasties in Indonesia is inextricably related to the gradual institutional changes following Indonesia's democratic transition in 1998. In the process, the parasitic symbionts—i.e. the aspiring dynasts—were able to make institutional drifts.
School Management and Education Development for Chinese Migrant Children: The Mediating Role of Assistance and Affective Support
Authors: Li Guangming , Pan Yuxi , Wen Haiying , Zhang Fadi , Yi Xiaoyan
Published: September 2023

The educational development level of migrant children is affected by many factors, and it is practical to study it. Based on the current situation of migrant children study in China, this study explored the multiple mediating effects of educational support and moderating effect of the age on the level of educational development by policy environment. The study sample was composed of 541 Chinese migrant adolescents aged 9 to 17. They completed educational development questionnaire, educational support questionnaire and policy environment questionnaire. Mediating and moderating effects analysis were used to examine the role of educational support between policy environment and educational development. The results show that the educational development level of Chinese migrant children was relatively high. However, there were significant differences among different schools and ages. It was found that school management played most important role in the educational development of migrant children. Also, it was found that assistance support played a partial mediating role between school management and academic condition, and affective support played a partial mediating role between school management and social behavior, and age played a moderating role between school management and social behavior. School management for Chinese migrant children should be further strengthened. Assistance support and affective support for Chinese migrant children should be further improved. In addition, the management of migrant children aged from 14 to 17 should be the focus of attention. In this study, some suggestions are put forward to improve these influence factors of education development for Chinese migrant children.
Mapping the Intellectual Structure of Mobile Payment Research: A Bibliometric Analysis
Authors: Sharma Prashant , Sharma Saurabh
Published: September 2023

Mobile payment has evolved over time and its adoption and usage have proliferated in the new normal subsequent to the COVID-19 pandemic. This study aims to (1) evaluate the performance and (2) map the body of knowledge in order to (3) chart the avenues to advance mobile payment research in the new normal. To achieve its aims, this study adopts and implements a bibliometric methodology on a corpus of 455 publications retrieved from the Web of Science to provide a retrospective and a prospective of mobile payment research. Using performance analysis, this study unpacks the productivity and impact of the contributors (i.e., journals, articles, authors, countries, and institutions) to mobile payment research. Using science mapping, this study reveals the foundational themes and topical trajectories in the extant literature dedicated to mobile payment research. The findings from the performance analysis and science mapping are subsequently used to inform the agenda for future research on mobile payment.
Assessment of Thresholds for Clinically Relevant Change in the Pediatric/Adolescent Shoulder Survey After Shoulder Instability Surgery: Factors Associated With Meaningful Improvement in Outcomes
Authors: Wallis-Lang Kendahl , Bastrom Tracey P. , Boutelle Kelly E. , Wagle Abigail , Pennock Andrew T. , Edmonds Eric W.
Published: September 2023

Background:

The pediatric/adolescent shoulder survey (PASS) score is a subjective measure of shoulder symptomology in younger patients.

Purpose:

To establish the minimal clinically important difference (MCID) and minimal detectable change (MDC) for the PASS score in adolescents after surgical treatment for shoulder instability.

Study Design:

Case series; Level of evidence, 4.

Methods:

Included were patients aged 12.5 to 23 years who underwent surgical treatment for shoulder instability and who had completed PASS forms preoperatively and at 3 months postoperatively. The MCID was established using an anchor-based approach, with the Single Assessment Numeric Evaluation (SANE) and shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) as anchors. Change in PASS score between anchor groups was determined using receiver operating characteristic curve analysis. MDC with 90% confidence (MDC90) was also calculated. Range of motion and strength data at 3-month follow-up were evaluated to identify the optimal postoperative PASS score. Factors associated with improvement in PASS score beyond the MDC90 and MCID were determined in a subset of patients with ≥6-month follow-up data.

Results:

A total of 95 patients were included. The mean PASS score improved significantly from preoperatively to postoperatively (57 ± 15 to 75 ± 16; P < .001). The anchor-based MCID ranged from 12.5 to 13.2 points, with an area under the receiver operating characteristic (AUC) curve of 0.87 for the SANE and 0.99 for the QuickDASH. The MDC90 was 16.5 points. The optimal PASS score at 3 months after surgery was ≥85 (AUC, 0.66). Shorter duration of symptoms, lower preoperative forward elevation, and higher preoperative external rotation were associated with improvement in PASS score above the MDC90 and/or MCID for the subset of patients (n = 25) with ≥6-month follow-up data. Increased number of suture anchors, less preoperative external rotation deficit, and number of previous dislocations had a moderate effect on improvement in outcomes.

Conclusion:

A postoperative increase in PASS score of ≥16.5 points had a 90% chance of being a true-positive change, while a score change of approximately 13 points was likely clinically relevant. The optimal PASS score after surgery was ≥85. Shorter duration of symptoms, preoperative range of motion, number of surgical anchors, and number of previous dislocations were associated with achieving a clinically relevant improvement in PASS score at minimum 6 months postoperatively.
Stabilization and Gap Formation of Adjustable Versus Fixed Primary ACL Repair With Internal Brace: An in Vitro Full-Construct Biomechanical Cadaveric Study
Authors: Bachmaier Samuel , Smith Patrick A. , Hammoud Sommer , Ritter Daniel , Hauck Oliver , Wijdicks Coen A.
Published: September 2023

Background:

A knotless, tensionable primary anterior cruciate ligament (ACL) repair system preloaded with an internal brace has been released. Currently, there is no biomechanical data on the stabilization and gap formation behavior of the adjustable system when compared with fixed repairs in human ACL tissue.

Hypothesis:

That knotless adjustable suture repair with an internal brace would provide overall higher construct stability and greater load share on the ACL with less gap formation compared with fixed repair.

Study Design:

Controlled laboratory study.

Methods:

Human cadaveric knees were utilized for internal braced ACL repair constructs (each group n = 16). Two fixed groups consisting of a single-cinch loop (SCL), cortical button (SCL group), and knotless suture-anchor (anchor group) were compared with an SCL-adjustable loop device (SCL-ALD) group. Testing was performed at 4 different peak loads (50, 150, 250, 350 N) over 4000 cycles at 0.75 Hz including suture repair preconditioning (10 cycles at 0.5 Hz) for SCL-ALD. Specimens were ultimately pulled to failure with a cut internal brace. The final loading situation of the construct and ACL repair with gap formation and ultimate strength were evaluated.

Results:

Peak elongation at various peak loads showed a significantly higher ( P < .001) stabilization of SCL-ALD when compared with both fixed groups. There was a significantly higher ( P < .001) load share of SCL-ALD, especially at lower loads (48% of 50 N), and the gap formation remained restricted up to 250 N. With only a little load share on the fixed constructs (<6%) at lower loads (50, 150 N), gap formation in these groups started at a load of 150 N, leading to significantly higher gaps ( P < .001). The ultimate failure load for SCL-ALD and anchor groups was significantly increased ( P < .001) as compared with SCL. The stiffness of SCL-ALD (62.9 ± 10.6 N/mm) was significantly increased ( P < .001).

Conclusion:

Internal braced knotless adjustable fixation for ACL repair with preconditioning of the suture repaired ligament increased the overall stabilization with higher load share on the ACL and restricted gap formation (<0.5 mm up to 350 N) compared with fixed suture repair. All internal braced repairs restored stability according to native ACL function.

Clinical Relevance:

Adjustable ACL repair improved the mechanical characteristics and reduced gap formation, but the overall clinical significance on healing remains unclear.
Comparison of EMG activity in the adductors during Copenhagen adductor exercise and Adductor slide in male ice hockey players
Authors: Olofsson Anton , Wörner Tobias , Eek Frida
Published: September 2023

Objectives:

The aim of this study is to estimate differences in muscle activity of the adductor longus- and adductor magnus muscle during the AS with different amounts of external resistance compared to CAE in male, adult, ice hockey players.

Methods:

This cross-sectional study compared muscular activity (EMG) during CAE and AS in a convenience sample of male ice hockey players. The players performed AS with different external loads and EMG readings was compared to the CAE. The main outcome was differences in mean %MVIC with CAE as a reference. Differences were compared using paired t-tests and standardized effect sizes (Cohen’s d) were calculated.

Results:

21 injury free male ice hockey players participated in the study. We found a statistically significant lesser muscle activation during AS compared to CAE (p<0.05), Differences in mean %MVC during concentric contractions had a range between -60% (95% CI:-82%; -37%) and -28% (-51%; -6%) for the adductor longus, and between -67% (-93%; -41%) and -36% (-53%; -19%) for the adductor magnus. Differences in mean %MVC during eccentric contractions had a range between -70% (-88%; -53%) ad -62% (-78%; -46%) for the adductor longus and between -78% (-101%; -55%) and -68% (-88%; -48%) for the adductor magnus. The effect size was moderate to high (0.45-1-85) for all differences in mean.

Conclusion:

The AS produces significantly less muscle activation than the CAE, concentrically and eccentrically as well as with and without external loads.
The effect of Post Activation Potentiation in children’s jumping performance
Authors: Hjortsberg Samuel , Mattson Jesper , Jansson Daniel , Theos Apostolos
Published: September 2023

Objectives:

The objective of the present study was to investigate a) the potential effect of PAP in children’s jumping performance and b) the optimal time frame of the potential PAP effects in the same population

Methods:

Ten healthy male children (age: 12.2 ± 1.2; n= 7, pre-PHV and n= 3, post-PHV) conducted a single set of heavy resistance training (3RM leg press) followed by five maximal counter-movement-jump (CMJ) at different passive rest periods (1 min, 2 min, 4 min, 6 min, 8 min). Baseline 3RM leg press strength test, countermovement jump (CMJ), and peak height velocity (PHV) were assessed. Primary outcome: jump height (cm) pre and post-PAP.

Results:

No significant differences were observed between jumping heights pre- and post-PAP at any of the selected rest periods (1 min ES: 0.0; 2 min ES: 0.25; 4 min ES: 0.09; 6 min: ES: 0.03; 8 min ES: 0.15, p = 0.99). Pre vs. post-PAP jumping heights did not differ significantly even when participants were grouped according to peak height velocity (PHV) (pre-PHV: p = 0.97, ES: - 0.07 to 0.26 and post-PHV: p = 0.99, ES: - 0.11 to 0.37).

Conclusion:

The results indicate that a single set of a heavy lower-body resistance training protocol induces no significant PAP effect in healthy male preadolescent children, irrespective of the rest period used. Future studies with larger sample sizes are needed to confirm the results.
The Metropolis and the Methars: The Struggle for Wage of Manual Scavengers in Colonial Calcutta
Authors: Thakur Parikshit
Published: September 2023

In the night of colonial Calcutta, soils were collected by the methars. As per Act VI of 1863 regulations, restrictions were imposed on methars. Thus, suitable depots were made and leased to the tollah methars. Since the 1870s, the disposing of the night soils in the river was stopped, and the duty of tollah methars was shifted to the municipality. Chandals was by profession an excluded social category. Even in prison chandals had to clear the night soils of the others. In protest of that prisoners specially methars declared a strike in the prison for months and hence formed a unique bonding that Putnam called ‘social capital’. This article discusses how methars of late colonial Calcutta while upholding the oppression gradually developed ‘social capital’ and started negotiating to establish their justified claims using party politics.
Clinical Outcome of Cystoid Macular Edema in Silicone Oil–Filled Eyes
Authors: Shaheen Abdulla , Lai James , Magraner Maria , Ashkenazy Noy , Flynn Harry W. , Sridhar Jayanth , Yannuzzi Nicolas A.
Published: September 2023

Purpose: To investigate the clinical outcome of cystoid macular edema (CME) in eyes undergoing silicone oil (SO) tamponade with subsequent SO removal (SOR). Methods: A retrospective case series of adult patients with CME treated with SO tamponade and SOR was conducted between January 2015 and January 2021. Exclusion criteria included eyes with a prior SO tamponade, those that did not undergo SOR, or those with infectious/inflammatory diagnoses. The primary outcomes were the incidence and resolution rates of CME in eyes with SO tamponade that had undergone SOR. The secondary outcomes included changes in best-corrected visual acuity (BCVA) and central field thickness (CFT). Results: Nineteen eyes of 19 patients (58% men) aged 52 years (interquartile range [IQR], 45-66 years) met the study inclusion criteria. The median (IQR) follow-up duration post SOR was 22 (8-35) months. The mean CFT decline for the CME-resolved cases was 13.1 µm/mo ( P = .257). CME resolved in only 10 eyes (53%), 7 (67%) of which occurred after SOR. The median (IQR) BCVA was 20/400 (20/200 to 20/1262) at CME diagnosis and 20/796 (20/252 to hand motions) after SOR, with 0.184 worsening in logMAR BCVA ( P = .340). Medical treatment was not associated with CME resolution compared with observation (50% vs 89%, respectively; P = .069). Eyes with proliferative vitreoretinopathy (PVR) had a higher rate of persistent CME compared with eyes with other diagnoses (78% vs 10%, respectively; P = .005). Conclusions: Nearly half had nonresolution of CME after SO was removed. The VA at the last follow-up was unaffected by CME resolution. Preoperative PVR may be a risk factor for unresolved CME.
Treatment of esophageal leakages with the Microtech®-VAC-Stent: a monocentric early experience of three cases
Authors: Klose Michelle A. , Walldorf Jens , Damm Marko , Krug Sebastian , Klose Johannes , Ronellenfitsch Ulrich , Kleeff Joerg , Michl Patrick , Rosendahl Jonas
Published: September 2023

Background:

Endoscopic approaches in the treatment of transmural esophageal defects, either after esophageal resection or due to perforation, have demonstrated convincing feasibility. Surgical options are limited and associated with high morbidity and mortality rates. Currently, internal endoscopic drainage with pigtail stents, self-expanding metal stent (SEMS), or endoscopic vacuum therapy (EVT) are options for first-line treatment. Here, we report the outcome of the recently developed combination of SEMS and EVT using the endoscopic Microtech®-VAC-Stent (EVS).

Methods:

Between June and July 2022, three consecutive patients (one female and two males) with esophageal transmural defects were treated with the Microtech®-VAC-Stent. Two patients suffered from an anastomotic leak after oncologic gastroesophageal surgery, and one patient presented with esophageal perforation due to Boerhaave syndrome.

Results:

Three consecutive patients were successfully treated with EVS. In one patient, one EVS treatment was sufficient, whereas the other two patients needed two and six EVS exchanges. Exchanges were scheduled every 7 days and no procedural adverse events were observed.

Conclusion:

In line with the former case series, EVS therapy is a promising new approach for the treatment of esophageal leaks. Exchange of the EVS seems feasible every 7 days reducing interventions for the individual patient. Prospective studies comparing EVS with other endoscopic therapies are needed to define the best therapeutic approach.
Analysis of the effectiveness of remote intervention of patients affected by chronic diseases: A systematic review and meta-analysis
Authors: Rezende Demetrius Ruben Borges de , Neto Isadora Andrade , Iunes Denise Hollanda , Carvalho Leonardo César
Published: September 2023

Objectives:

The aim of the study was to verify the effectiveness of telemedicine in randomized controlled trials (RCTs) in terms of its influence on physical conditioning, quality of life, and health conditions in adults/elderly people affected by chronic diseases.

Design:

This was a systematic review and meta-analysis.

Methods:

The search covered RCTs published from 2011 to 2021 and was conducted using the PubMed, Embase, PEDro, Lilacs, and Cochrane Library databases, on volunteers of both sexes, that were rehabilitated, and/or monitored, and/or evaluated, specifically, via remote care. The extraction, quality of studies, and risk of bias were assessed using the RoB2 (risk of bias) tool, for analysis of the strength of evidence, the GRADE (Grading of Recommendations Assessment, Developing, and Evaluation) method was used, and for the preparation of meta-analysis was used at RevMan 5.4 (Review Manager) was used.

Results:

The database search identified 3949 potential articles for screening, 13 of which were eligible for the present systematic review, involving 1469 participants with chronic diseases (chronic obstructive pulmonary disease (COPD), asthma, heart failure, diabetes mellitus, and fibromyalgia). Through the meta-analysis, an advantage was identified for the remote intervention on physical conditioning ( p = 0.001), with an estimated effect of 0.29 (0.11, 0.46) and on health conditions ( p = 0.0004), –0.30 (–0.47, –0.14), while for quality of life, no significant difference was identified ( p = 0.90), 0.01 (–0.13, 0.14).

Conclusion:

Telemedicine has clinical effectiveness for the outcome of physical conditioning and general health conditions in adults with chronic diseases when compared to usual care without face-to-face intervention.
Evaluating the Impact of Pharmacist Dual Verification of Anticancer Therapy in the Modern Era
Authors: Stonerock Devon S. , Clark Kaylee , Shah Vishal , Irvine Clayton C. , Draper Evan , Soefje Scott A.
Published: September 2023

Background: Pharmacist order verification is a critical step in ensuring medication safety for patients. While the second pharmacist verification (SPV) before dispensing anticancer therapies has been a longstanding practice, its continued necessity in the context of modern electronic health systems lacks robust evidence. Objective: This study aimed to assess the frequency of interventions performed by a second pharmacist to determine the ongoing effectiveness of the SPV process. Methods: This retrospective chart review was conducted at the Mayo Clinic, encompassing all anticancer therapy orders that necessitated an SPV. The study period extended from January 1, 2019, to June 30, 2021, and included inpatient and outpatient anticancer orders. The quantification and reporting of alterations made to discrete order fields subsequent to initial pharmacist verification of clinical significance were performed, utilizing the total number of anticancer therapy orders as the denominator. Results: Approximately 300 000 anticancer therapy orders were screened for inclusion criteria and 2.6% (N = 7634) of orders were modified on the SPV. Most changes were in the categories of rate (N = 1962), order start time (N = 1219), and pharmacy communication note (N = 777). Dosing changes greater than 10% accounted for 0.03% (N = 99) of the orders, with 10 anticancer therapies responsible for more than 50% of these changes. Conclusion and relevance: This study represents the largest report on the impact of SPV in a modern era. Our results suggest the SPV may be valuable for a small proportion of chemotherapy orders but raises questions about the necessity for broad application of this practice.
Simulation analysis of an adjusted gravity model for hospital admissions robust to incomplete data
Authors: Latruwe Timo , Van der Wee Marlies , Vanleenhove Pieter , Michielsen Kwinten , Verbrugge Sofie , Colle Didier
Published: September 2023

Background

Gravity models are often hard to apply in practice due to their data-hungry nature. Standard implementations of gravity models require that data on each variable is available for each supply node. Since these model types are often applied in a competitive context, data availability of specific variables is commonly limited to a subset of supply nodes.

Methods

This paper introduces a methodology that accommodates the use of variables for which data availability is incomplete, developed for a health care context, but more broadly applicable. The study uses simulated data to evaluate the performance of the proposed methodology in comparison with a conventional approach of dropping variables from the model.

Results

It is shown that the proposed methodology is able to improve overall model accuracy compared to dropping variables from the model, and that model accuracy is considerably improved within the subset of supply nodes for which data is available, even when that availability is sparse.

Conclusion

The proposed methodology is a viable approach to improve the performance of gravity models in a competitive health care context, where data availability is limited, and especially where a the supply nodes with complete data are most relevant for the practitioner.
Developing Family-Community Interactive program for the disabled older adults at home: a study protocol
Authors: Wang Peng , Niu Meilan , Chen Ying , Wang Shanshan , Wu Chuqiao , Zhao Di , Wang Panpan , Yang Huashan , Guo Panpan
Published: September 2023

Background

With an aging population and the influence of traditional culture, the number of disabled older adults at home is increasing. Meanwhile, their care needs are also increasing. The cooperation between family and community can effectively improve the quality of home care for the disabled older adults. At present, there is a lack of research on the interaction between family and community in home care for disabled older adults.

Methods

The aim of this study is to determine the experience and demands of the interaction for disabled older adults, family and community, construct an interaction program among disabled older adults, family and community, and improve the quality of life. From may 2022 to July 2022, This study will select disabled older adults families from seven communities in Henan provinces. The researchers, after training, will conduct semi-structured interview to collect research data. According to the integration results of qualitative research, the interactive program is constructed and revised using the Delphi expert consultation method. Then the participants will be selected to accept the intervention of the interactive program and evaluated through questionnaires.

Discussion

Both family and community play an important role in the care of the disabled older adults at home. There is some evidence indicating the benefits of cooperation between family and community on disabled older adults. This study will take a step further and constructs a interaction program about how to create a positive and interactive home-based older adults care environment.

Trial registration

Registered in the Chinese Clinical Trial Registry on April 19, 2021, number ChiCTR2100045584.
Turkish validity and reliability study of the nursing home adjustment scale
Authors: Varer Akpinar Ceren , Belice Tahir , Bolukbasi Selman , Mandiracioglu Aliye
Published: September 2023

Background

Adapting to a nursing home has a significant effect on facilitating the transition to a nursing home. However, a tailored nursing home adjustment scale for Turkish nursing home residents is not yet available. The purpose of this study was to translate the nursing home adjustment scale from English to Turkish and assess its reliability and validity in a sample of nursing home residents in Turkey.

Methods

A total of 202 older adults from four nursing homes were included in this study. The reliability of the Turkish nursing home adjustment scale was tested using Cronbach’s alpha values for internal consistency. Exploratory and confirmatory factor analyses were used to examine the factor structure, whereas correlation analysis was conducted for convergent validity.

Results

The Turkish version displayed satisfying internal consistency (Cronbach’s alpha = 0.88) and perfect convergent validity for life satisfaction (r = 0.482). The Turkish scale included five factors: difficulty fitting in, acceptance of new residence, emotional distress, depressed mood, and relationship development.

Conclusion

The findings indicate that the Turkish version of the scale is a valid and reliable tool for measuring the level of nursing home adjustment among older adults in Turkey.
Initial indicators for the prognosis of Acinetobacter Baumannii bacteremia in children
Authors: Hong Yi , Lin Xiaochen , Zhang Chunxu , Dong Xingqiang , Lu Meihua , Huang Saihu , Huang Lili , Su Chunmei , Bai Zhenjiang , Wu Shuiyan
Published: September 2023

Background

Risk factors related to mortality due to Acinetobacter baumannii (AB) bacteremia have been unveiled previously, but early clinical manifestations of AB bacteremia based on prognosis remain uncovered.

Methods

The demographic characteristics, clinical features, antibiotic susceptibility, and outcomes of 37 hospitalized children with laboratory-confirmed AB bacteremia from Suzhou, China, were collected and analyzed retrospectively.

Results

Of the 37 children with AB bacteremia included in this study, 23 were males and 14 were females, with a median age of 4.83 (0.60 to 10.15) years. Among the children, 18 died (48.65%, 18/37) and 19 survived (51.35%, 19/37). The dead group had a significantly higher incidence of respiratory failure (p = 0.008), shock (P = 0.000), MODS (p = 0.000), neutropenia (< 1.5 × 109/L) (p = 0.000) and serious neutropenia (< 0.5 × 109/L) (p = 0.000) than those in the survival group. The death group had significantly more invasive procedures (2 or more) than that in the survival group at 2 weeks before onset (p = 0.005). The proportion of MDR-AB in the death group was significantly higher than that in the survival group (p = 0.000), while the PICS score was significantly lower in the survival group than that in the death group (p = 0.000). There was no significant difference in effective antibiotic use within 24 h between these two groups (p = 0.295). Among the 37 children with bloodstream infection of AB, 56.76% (21/37) of the underlying diseases were hematological diseases and oncology. Among them, 17 (81.00%) were died in the hospital. The proportion of white blood cells (p = 0.000), neutrophils (p = 0.042), eosinophils (p = 0.029), the ANC (p = 0.000) and lymphocyte (p = 0.000), the NLR(p = 0.011), hemoglobin (p = 0.001), platelets (p = 0.000), prealbumin (P = 0.000), LDH (p = 0.017), blood gas pH (p = 0.000), and serum potassium (p = 0.002) in the death group were significantly lower than those in the survival group. However, CRP (p = 0.000) and blood glucose(p = 0.036) were significantly higher in the death group than those in the survival group. By further multivariate analysis, CRP [OR (95% CI): 1.022(1.003, 1.041), p = 0.021] and neutropenia [OR (95% CI): 21.634 (2.05, 228.313, p = 0.011] within 24 h of infection were independent risk factors for death in children with AB bacteremia. When CRP was higher than 59.02 mg/L, the sensitivity of predicting mortality was 88.9%, and the specificity was 78.9%. And the sensitivity and specificity of neutropenia for predicting mortality were 83.3% and 84.2%.

Conclusions

AB bacteremia has a high mortality in children, especially in patients with hematological diseases and oncology. Many early indicators were associated with poor prognosis, while elevated CRP and neutropenia were the independent predictors for the 30-day mortality of children with laboratory-confirmed AB bacteremia.
Wnt/β-catenin pathway is a key signaling pathway to trastuzumab resistance in gastric cancer cells
Authors: Kim Yuna , Bae Yoo Jin , Kim Jie-Hyun , Kim Hyunki , Shin Su-Jin , Jung Da Hyun , Park Hyojin
Published: September 2023

Background

Trastuzumab is the only approved target agent for the first-line treatment of human epidermal growth factor receptor-2 (HER-2) positive gastric cancer; however, trastuzumab resistance is a major problem in clinical practice. To comprehend the mechanism of trastuzumab resistance, we focused on the Wnt/β-catenin signaling pathway and its influence on the phenotypes and behavior of trastuzumab-resistant gastric cancer cells.

Methods

Trastuzumab-resistant NCI-N87R cells were established in vitro from the human gastric cancer cell line NCI-N87 by dose-escalating repeated trastuzumab treatment. We investigated the phenotypes of NCI-N87R cells, including Wnt signaling pathway activity. Gastric cancer organoid cells were incubated with complete medium and Wnt3a-depletion medium, and their resistance to trastuzumab was compared.

Results

NCI-N87R exhibited stemness and epithelial-mesenchymal transition (EMT)-like phenotypes, along with decreased levels of the epithelial marker E-cadherin and increased levels of the mesenchymal markers Vimentin and Snail along with an increased Wnt signaling pathway activity. When gastric cancer cells were incubated in Wnt3a-conditioned medium. Wnt signaling pathway activity and resistance to trastuzumab increased. Gastric cancer patient-derived organoids incubated in Wnt3a-depletion medium were more susceptible to dose-dependent inhibition of cell viability by trastuzumab than those incubated in complete medium.

Conclusions

Trastuzumab-resistant gastric cancer cells exhibited EMT-like phenotype, and trastuzumab resistance was promoted by the Wnt/β-catenin signaling pathway. The Wnt/β-catenin pathway is a key signaling pathway for trastuzumab resistance in gastric cancer cells.
Multifocal epithelial hyperplasia confined to the interdental papilla of an adult Chinese man: a rare case report and literature review
Authors: Wang Qianting , Xu Lehan , Li Xiaojun , Yu Mengfei , Chen Qianming
Published: September 2023

Background

Multifocal epithelial hyperplasia (MEH), or focal epithelial hypertension (FEH), or Heck’s disease, is an uncommon, benign oral mucosal disease associated with human papillomavirus infection. It is mostly observed in indigenous populations of the world, and has been rarely reported in China. However, previous research suggested there might be a greater prevalence of MEH in the Chinese population. While predominantly involves the lips, buccal mucosa and tongue, MEH was occasionally reported to affect the hard palate and gingiva as well.

Case presentation

This paper reports a case of extensive MEH lesions that confined to the interdental papilla of a Chinese male without detection of HPV, and summarizes the published gingiva-involved MEH reports from 1966 until present. The lesions were excised with an Er: YAG laser after scaling and root planning, no recurrence was observed after 6-month follow-up.

Conclusions

The present report illustrates the need for clinicians to be aware of rare presentations of MEH to facilitate a prompt diagnosis and proper management. More reports are encouraged to determine a correct prevalence rate of MEH in China.
A systematic review of menopause apps with an emphasis on osteoporosis
Authors: Paripoorani Deborah , Gasteiger Norina , Hawley-Hague Helen , Dowding Dawn
Published: September 2023

Background

Menopause can significantly hasten bone loss. Mobile phones provide an efficient way to manage, track and understand menopause using apps. A previous review of menopause apps found numerous apps designed to help women manage menopause. However, it did not use validated measures to assess the quality of the apps and did not focus on content related to osteoporosis.

Methods

This app review aligns with the updated Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The keywords used to search for the apps were “menopause” and “menopausal”. Apps were included if they were in English, for individuals or groups and had a lifestyle focus. Apps that looked at other aspects of women’s health, required external devices, cost to download, or were symptom-tracking were excluded. The quality and functionality were assessed using the Mobile App Rating Scale and IMS Institute for Healthcare Informatics Functionality score. Data were synthesised descriptively.

Results

Twenty-eight apps were selected and reviewed from the 236 apps screened from the Apple store and Google play store. Only 57% of the apps reviewed (n = 16) had content on osteoporosis which was educational in purpose. The readability of the apps was complex and best understood by university graduates. The average functionality score of the apps reviewed was 4.57 out of 11 and that of quality is 3.1 out of 5, both of which need improvement.

Conclusions

Existing menopause apps need more input from experts to improve the quality and functionality, using simple language. More emphasis on specific health problems during menopause, including osteoporosis, is required.

Trial registration

Not relevant.
The increased risk of colorectal cancer in the women who underwent hysterectomy from the South Korean National Health Insurance Database
Authors: Yuk Jin -Sung , Yang Seung-Woo , Yoon Sang-Hee , Kim Myoung Hwan , Seo Yong-Soo , Lee Yujin , Kim Jungbin , Yang Keunho , Gwak Geumhee , Cho Hyunjin
Published: September 2023

Background

Several population-based studies and observational studies have shown that oophorectomy is associated with an increased risk of colorectal cancer (CRC), and hormone replacement therapy has been associated with a reduction in the risk of colorectal cancer. This study was carried out to investigate whether hysterectomy, which may affect the levels of female hormones, is associated with a risk of cancer of the specific gastrointestinal tract.

Methods

This population-based retrospective cohort study was conducted using insurance data provided by the Health Insurance Review and Assessment Service (HIRA) from January 1, 2007, to December 31, 2020. The hysterectomy group included 40- to 59-year-old women who underwent hysterectomy with uterine leiomyoma or uterine endometriosis from January 1, 2011, to December 31, 2014. The control group included women aged 40 to 59 years who visited medical institutions for medical examination from January 1, 2011 to December 31, 2014.

Results

The hysterectomy and non-hysterectomhy groups comprised 66,204 and 89,768 subjects, respectively. The median ages in the non-hysterectomy group and hysterectomy group were 48 (range: 43–53) and 46 (range: 44–49) years, respectively. In the unadjusted results of the analysis, all colorectal cancer (CRC) increased in the hysterectomy alone group (HR 1.222, 95% confidence interval (CI) 1.016–1.47, p = 0.033), sigmoid colon cancer increased in the hysterectomy alone group (HR 1.71, 95% CI 1.073–2.724, p = 0.024), and rectal cancer increased in the hysterectomy with adnexal surgery group (HR 1.924, 95% CI 1.073–2.724, p = 0.002). The adjusted results showed that all CRC increased in the hysterectomy alone group (HR 1.406, 95% CI 1.057–1.871, p = 0.019), colon cancer increased in the hysterectomy alone group (HR 1.523, 95% CI 1.068–2.17, p = 0.02), and rectal cancer increased in the hysterectomy with adnexal surgery group (HR 1.933, 95% CI 1.131–3.302, p = 0.016). The all-cause mortality of GI cancer increased in the hysterectomy alone group (HR 3.495, 95% CI 1.347–9.07, p = 0.001).

Conclusions

This study showed that the risk of all CRC increased in women who underwent hysterectomy compared with women who did not. In particular, the risk of rectal cancer was significantly higher in the women who underwent hysterectomy with adnexal surgery than in the controls. There was no association between hysterectomy and other GI cancers.