bluuebunny/crossref_metadata_2025 huggingface dataset:
Vaping Opioids: Should We Be Worried?
Authors: Morris James D. , Pebley Kinsey , Little Melissa A.
Published: August 2023

The use of electronic cigarettes (i.e., e-cigarettes or vapes) has increased substantially among youth and young adults. While research has examined vaping cannabis and tetrahydrocannabinol (THC), little exists related to vaping other drugs, such as opioids, despite the fact that opioids are a leading cause of drug overdoses associated deaths in the U.S. The current study aimed to review the current state of the literature related to vaping opioids given our experience of learning about a youth overdose related to vaping opioids in a public high school in the U.S. while we were engaged in conducting community-based research. Peer-reviewed research publications related to vaping opioids are minimal, although there are several newspaper articles published related to vaping opioids, with most being about youth vaping opioids in school. This is concerning given that media often misconstrue substance use, particularly related to fentanyl, and may provide inaccurate information that perpetuates stigma. Thus, it remains unclear the scope of the issue of vaping opioids. Therefore, we propose a call to action for researchers and public health officials outlining recommendations for increased surveillance, interventions to address vaping-related opioid use, and measures to curb serious adverse consequences of vaping-related opioid use to determine whether this is a rising public health concern and offer mitigation strategies.
REBT for Depression in Teens
Authors: Khanolkar Swati
Published: August 2023

REBT is an evidence-based approach that helps people manage cognitive, emotional, and behavioral disturbances in sustainable, healthy ways. It takes a holistic view of emotional disturbances, including depression. In keeping with the concept of psychological interactionism, REBT views depression as a thinking-feeling-behaving pattern and not a diagnostic label alone.

Depressive thinking-feeling-behaving is a common consequence in teens in response to such adversities and can manifest in different ways. Some may want to resign to their fate and let others make these choices for them, some may want to gain more control by trying to make perfect choices, and some may want to escape the conflict by hurting themselves, overly consuming online content, binge eating junk food, and so on, and others may want to rebel and make extreme choices. Most of these ways prove to be short-term ways of coping with or managing these challenges and may be in fact harmful in the long term. REBT argues that therapy can teach teenagers to identify, practice, and internalize healthy, long-term ways of coping which they can eventually use independently across different situational contexts.
Hindfoot Arthrodeses and the Order of Joint Fixation Influence Tibiotalar Kinematics During Simulated Stance
Authors: Palma Joaquin , Kim Jaeyoung , Hoffman Jeffrey W. , Ellis Scott J. , Demetracopoulos Constantine A. , Steineman Brett D.
Published: August 2023

Background:

Although hindfoot arthrodeses relieve pain and correct deformity, they have been associated with progressive tibiotalar degeneration. The objective was to quantify changes in tibiotalar kinematics after hindfoot arthrodeses, both isolated subtalar and talonavicular, as well as double arthrodesis, and to determine if the order of joint fixation affects tibiotalar kinematics.

Methods:

Hindfoot arthrodeses were performed in 14 cadaveric mid-tibia specimens. Specimens randomly received isolated fixation of the subtalar or talonavicular joint first, followed by fixation of the remaining joint for the double arthrodesis. A 6-degree-of-freedom robot sequentially simulated the stance phase of level walking for intact, isolated, and double arthrodesis conditions. Tibiotalar kinematic changes were compared for the intact and arthrodesis conditions. A subsequent analysis assessed the effect of the joint fixation order on tibiotalar kinematics.

Results:

Isolated and double hindfoot arthrodeses increased tibiotalar plantarflexion, inversion, and internal rotation during late stance. Tibiotalar kinematics changes occurring after isolated arthrodesis remained consistent after the double arthrodesis for both the subtalar- and talonavicular-first conditions. The order of joint fixation influenced tibiotalar kinematics through some portions of stance, where the talonavicular-first double arthrodesis increased tibiotalar plantarflexion, eversion, and internal rotation compared to the subtalar-first double.

Conclusion:

Tibiotalar kinematics were modestly altered for all conditions, both isolated and double hindfoot arthrodeses. Changes in tibiotalar kinematics were consistent from the isolated to the double arthrodesis conditions and varied depending on which isolated hindfoot arthrodesis was performed first. Further research is needed to assess the clinical implications of the observed changes in tibiotalar kinematics, particularly as it pertains to the development of adjacent joint arthritis.

Clinical Relevance:

These findings may correlate with clinical research that has cited hindfoot arthrodesis as a risk factor for adjacent tibiotalar arthritis. Once either the subtalar or talonavicular joint is fused, avoiding the arthrodesis of the second joint may not necessarily protect the tibiotalar joint.
Digital divide or digital exclusion? Do allied health professionals’ assumptions drive use of telehealth?
Authors: Cook Renee , Haydon Helen M , Thomas Emma E , Ward Elizabeth C , Ross Julie-Anne , Webb Clare , Harris Michael , Hartley Carina , Burns Clare L , Vivanti Angela P , Carswell Phillip , Caffery Liam J
Published: August 2023

Introduction

Telehealth use within allied health services currently lacks structure and consistency, ultimately affecting who can, and cannot, access services. This study aimed to investigate the factors influencing allied health professionals’ (AHP) selection of consumers and appointments for telehealth.

Methods

This study was conducted across 16 allied health departments from four Australian hospitals. Semi-structured focus groups were conducted with 58 AHPs. Analysis was underpinned by Qualitative Description methodology with inductive coding guided by Braun and Clarke's thematic analysis approach.

Results

Six themes were identified that influenced AHPs’ evaluation of telehealth suitability and selection of consumers. These included the following: (1) ease, efficiency and comfort of telehealth for clinicians; (2) clear benefits of telehealth for the consumer, yet the consumers were not always given the choice; (3) consumers’ technology access and ability; (4) establishing and maintaining effective therapeutic relationships via telehealth; (5) delivering clinically appropriate and effective care via telehealth; and (6) external influences on telehealth service provision. A further theme of ‘assumption versus reality’ was noted to pervade all six themes.

Discussion

Clinicians remain the key decision makers for whether telehealth is offered within allied health services. Ease and efficiency of use is a major driver in AHP's willingness to use telehealth. Assumptions and pre-conceived frames-of-reference often underpin decisions to not offer telehealth and present major barriers to telehealth adoption. The development of evidence-based, decision-support frameworks that engage the consumer and clinician in determining when telehealth is used is required. Services need to actively pursue joint decision-making between the clinician and consumer about service delivery preferences.
Children of extremist parents: Insights from a specialized clinical team
Authors: Rousseau Cécile , Miconi Diana , Johnson-Lafleur Janique , Desmarais Christian , Hassan Ghayda
Published: August 2023

Background

Data on children who grow up with parents adhering to violent extremism is scant. This makes it extremely delicate to inform policies and clinical services to protect such children from potential physical and psychological harm.

Objective

This paper explores the predicament of children whose caretakers were referred to a specialized clinical team in Montreal (Canada) because of concerns about risks or actual involvement in violent extremism processes.

Methods

This paper uses a mixed methods concurrent triangulation design. Quantitative data was obtained through a file review (2016–2020). Qualitative data was collected through semi-structured interviews and a focus group with the team practitioners.

Results

Clinicians reported the presence of stereotypes in the health and social services network frequently representing religious extremist parents as potentially dangerous or having inappropriate parenting skills while minimizing the perception of risk for parents adhering to political extremism. Children displayed high levels of psychological distress, mainly related to family separation, parental psychopathology, and conflicts of loyalty stemming from familial or social alienation.

Conclusions

Training practitioners to be aware of their own personal and institutional bias may help them to understand the predicament of extremist parents’ children and implement systemic, trauma and attachment informed interventions.
Inheriting a dynasty: Family succession dramas and the moral economy of Downton Abbey
Authors: Kuusela Hanna
Published: August 2023

The role of inherited or family wealth in reproducing and even exacerbating wealth inequalities has been addressed in various studies in recent years. Bringing together representation studies with studies on cultural and moral economies, this article analyses how cultural norms indispensable to the preservation of dynastic wealth are negotiated through contemporary popular culture and television series. It introduces the concept of family succession drama, referring to television fiction that focuses on issues concerning intergenerational transmission of wealth and/or privileges and analyses the series Downton Abbey as a case study for interrogating the ambiguous affirmation of inherited wealth and dynastic privileges in a historical melodrama. By focusing on Downton Abbey, the article considers how hereditary rights and dynastic privileges are negotiated in a heritage drama in ways that also enable the legitimation of contemporary dynasty-making. While acknowledging the anxieties caused by class differences, Downton Abbey nevertheless affirms the necessity for various hereditary privileges and fortunes, thereby excluding any true alternatives for (contemporary) dynastic dynamics.
Feminist activists discuss practices of monetisation: Digital feminist activism, neoliberalism and subjectivity
Authors: Scharff Christina
Published: August 2023

This article explores the politics of ‘freelance feminism’ by drawing on 30 qualitative in-depth interviews with digital feminist activists. By documenting and analysing the different ways in which digital feminist activism can be monetised, the article shows that the potential to generate income is frequently discussed by, and contemplated among, activists. As this article argues, the monetisation of digital feminist activism goes beyond the application of market principles to political protest movements. When activism is monetised, activists’ emotional investments and passion become mobilised and tied to income generation. At the same time, and through emphases on self-branding and ‘authenticity’, activists’ selves are formed and rearranged in line with neoliberal values of entrepreneurialism and market competition. This article therefore shows that the workings of neoliberalism in digital feminist activism play out on an economic level, and also on the levels of affect and subjectivity.
Improving community health message reception through digital journalistic practices: Mixed-method evidence on health preventive behaviors and health podcast framing for emerging health issues
Authors: Raza Syed Hassan , Ogadimma Emenyeonu C , Shah Amjad Ali , Gorpe Serra
Published: August 2023

Health issues stemming from the public’s lack of access to scientific and health information prompted mounting concerns about public health responses. A growing amount of digital journalism scholarship has indicated the relevance of podcasts in health communication through reaching and engaging audiences in more significant preventive behaviors. Integrating digital journalistic practices in health podcasts as a practical and low-cost communication strategy can augment public adherence to addressing widespread health issues. However, the role of health podcasts in media framing in promoting preventive health behaviors is largely unknown. This study used a mixed-method approach (e.g., content analysis and quasi-experiments) to uncover the effectiveness of health podcasts’ framing practices (scientific vs. health frames). The content analysis results demonstrated that the health podcasts mainly used carrier and normal frames, while problem definitions and treatment were leading scientific frames. In a series of quasi-experiments comprising 640 respondents from the UAE and Pakistan, this research manipulated eight frames employed in health podcasts (i.e., two leading sub-frames for each scientific and health frame) to examine the causal mechanism that affects preventive health behaviors (hereafter PB). The findings established that the message-consistent effects of media frames manifesting scientific evidence and health orientation made audiences adopt PB. Theoretically, this research addresses the call for a more comprehensive “community digital journalistic practices model,” further delivering novel evidence on the health podcast framing approaches to offer more eloquent community health campaigns to raise public health issues.
Towards inclusive practice in Indonesian kindergartens: Evaluating the impact of Sign Supported Big Books
Authors: Sheehy Kieron , Budiyanto  , Widayati Sri , Rofiah Khofidotur
Published: August 2023

Indonesia is committed to creating an inclusive education system. Kindergartens have a key role to play in this endeavour. However, there are specific challenges that need to be addressed if this potential is to be fulfilled. It has been suggested that the use of keyword signs within Sign Supported Big Books (SSBB) as part of everyday story time activities might offer one way to begin to address some of these challenges. This research used a questionnaire method to evaluate the uptake and impact of SSBBs from 214 kindergartens across Indonesia. Analysis of teachers’ responses revealed the inclusive affordances of the approach. For the majority of teachers: the books were in regular use in their classrooms, teachers and children enjoyed using them, SSBBs made learning fun, the approach impacted positively on teachers’ classroom practice and they reported that it had benefits for children, including those with special educational needs. These results indicate that SSBBs can make a positive contribution towards creating an inclusive kindergarten pedagogy. Suggestions for further developments of the SSBB approach and future research are discussed.
Muscle Inflammation Susceptibility: A Potential Phenotype for Guiding Precision Rehabilitation After Total Hip Arthroplasty in End-Stage Osteoarthritis
Authors: Bridges S. Louis , Sun Dongmei , Graham Zachary A. , McAdam Jeremy S. , Mayo Elijah D. , Bamman Marcas M.
Published: August 2023

The progression of osteoarthritis of the hip to its end stage and ultimately to total hip arthroplasty (THA) is complex; the multifactorial pathophysiology involves myriad collaborating tissues in and around the diseased joint. We have named the heightened state of periarticular muscle inflammation at the time of surgery “muscle inflammation susceptibility” (MuIS) because it is distinct from systemic inflammation. In this review article, we discuss how MuIS and heightened atrophy-associated signaling in the periarticular skeletal muscles may contribute to reduced muscle mass, impaired muscle quality (ie, through fibrosis), and a muscle microenvironment that challenges regenerative capacity and thus functional recovery from THA. We also review directions for future research that should advance understanding of the key determinants of precision for optimized success of THA for each individual.
Simultaneous aortoiliac kissing Endovascular stenting for management of isolated monolateral common iliac artery aneurysm with no proximal landing zone
Authors: Gabrielli Roberto , Siani Andrea , Smedile Gianluca , Rizzo Anna Rita , Antonelli Roberto , De Vivo Gennaro , Accrocca Federico , Bartoli Stefano
Published: August 2023

Background

Isolated iliac artery aneurysm (IIAA) is an uncommon finding. It, accounts for 0.03% of all patients and 2% of all abdominal aneurysm. Endovascular approach represents the treatment of choice for most patients with IIAA. We reported our experience on iliac aneurysm with no proximal landing zone by simultaneous aortoiliac kissing endovascular (S.A.K.E.) covered stenting.

Methods

This is a retrospective analysis of nine consecutive patients with IIAA with no proximal landing zone, who underwent endovascular kissing covered stenting (Gore®Viabahn®VBX) The median aneurysm diameter was 4.1 cm, with a median 3-mm proximal neck length. In 3/9 aneurysms involving the internal iliac arteries the origin of the internal iliac artery was covered after its embolization and a stent graft extending to the external iliac artery (EIA) was placed. All stents were flared with semi-compliant balloon.

Results

Iliac aneurysm exclusion was obtained in all cases (100%), no graft migration or endo-leak were recorded. The median operative time was 28 min; the median fluoroscopy time was 9 min and a median 70 mL of contrast was used. At a median 24-month follow-up, all patients are alive, and no endo-leak or migration, infection, distal embolization, limb loss were observed. Moderate buttock claudication was experienced in 1/9 patients with internal iliac artery embolization. In 6/9 patients a shrinkage of the aneurysmal sac was recorded after 1 year.

Discussion

Endovascular management of IIAAs cases has been reported in literature and it was confirmed to be safe and successful. The IAA usually progresses into expansion which eventually leads into rupture. Adequate long proximal and distal landing zones were the most important feature related to better outcomes. Short proximal neck (˂10 mm) represents a real challenge for iliac aneurysm treatment and, nowadays, a classical bifurcated aortoiliac endograft deployment represents the treatment of choice. Endovascular repair of isolated CIA aneurysms with no proximal neck is safe and successful using the SAKE stenting technique with VBX adequately flared and it represents effective and minimally invasive alternative to aortobiliac endograft implantation in the treatment of these aneurysms. To the best of our knowledge, this is the first report which describes this approach in the treatment of IIAA with no adequate proximal landing zone. Our approach overcomes the need to aortic bifurcation graft implantation and reduces procedure time, contrast dose and radiation exposure. It also preserves relevant collaterals vessels thanks to inferior mesenteric artery and lumbar arteries sparing. A proximal aortic bifurcation endograft allows proximal sealing to be regained. Large population study with longer follow-up are needed to establish this approach as a new standard.
Novel hand hygiene promotion method in a pediatric and maternity hospital: A quality improvement pilot project using auditory feedback
Authors: Wang Chong Yu , Chan Mavis SH , Srigley Jocelyn A
Published: August 2023

A pilot quality improvement project was conducted to examine the effect of playing an applause sound effect at a busy hospital concourse for three consecutive days whenever hand hygiene behavior was observed. The immediate effect was documented. The project demonstrated observable interest among people passing by, and hand hygiene events triggered by the sound effect represented 10.1% of all hand hygiene events documented. This supports the possible utility of this intervention in generating public awareness and increasing hand hygiene behavior and demonstrates the feasibility of a longer trial utilizing audio devices.
Experimenting with ASL-based arterialized cerebral blood volume as a novel imaging biomarker in grading glial neoplasms
Authors: Senger Krishna Pratap Singh , Kesavadas C , Thomas Bejoy , Singh Ankita , Multani Gurpreet Singh , AN Deepti , Label Marc , Suchandrima Banerjee , Shin David
Published: August 2023

Background

Perfusion imaging is one of the methods used to grade glial neoplasms, and in this study we evaluated the role of ASL perfusion in grading brain glioma.

Purpose

The aim is to evaluate the role of arterialized cerebral blood volume (aCBV) of multi-delay ASL perfusion for grading glial neoplasm.

Materials and methods

This study is a prospective observational study of 56 patients with glial neoplasms of the brain who underwent surgery, and only cases with positive diagnosis of glioma are included to evaluate the novel diagnostic parameter.

Results

In the study, ASL-derived normalized aCBV (naCBV) and T2*DSC-derived normalized CBV (nCBV) are showing very high correlation (Pearson’s correlation coefficient value of 0.94) in grading glial neoplasms. naCBV and nCBF are also showing very high correlation (Pearson’s correlation coefficient value of 0.876). The study also provides cutoff values for differentiating LGG from HGG for normalized aCBV(naCBV) of ASL, normalized CBV (nCBV), and normalized nCBF derived from T2* DCS as 1.12, 1.254, and 1.31, respectively. ASL-derived aCBV also shows better diagnostic accuracy than ASL-derived CBF.

Conclusion

This study is one of its kind to the best of our knowledge where multi-delay ASL perfusion-derived aCBV is used as a novel imaging biomarker for grading glial neoplasms, and it has shown high statistical correlation with T2* DSC-derived perfusion parameters.
Injury, Musculoskeletal Symptoms, and Stress as a Function of Aging in Agricultural Operators in the Central United States
Authors: Beseler Cheryl L. , Rautiainen Risto H.
Published: August 2023

Background:

Studies show conflicting evidence on the association of age and occupational injury in agriculture, and few studies have addressed the effect of age on work-related chronic conditions or preventive practices among farmers.

Methods:

We examined the probability of injury, work-related stress, musculoskeletal symptoms (MSS), and preventive practices for MSS as a function of aging using surveillance data of 7,711 farm and ranch operators in the central United States.

Findings:

Segmented regression analyses of men (85% of sample) indicated that the probability of all four outcomes increased up to a certain age and then decreased; the changepoints in years of age being 59.6 for injury, 55.4 for work-related stress, 59.6 for MSS, and 67.9 for MSS preventive practices. Female operators had an increasing trend for stress up to age 29.7, while they showed no changepoints across their age spectrum in the proportion of injury, MSS, and prevention techniques.

Conclusion/Application to Practice:

These findings emphasize the need for preventive efforts particularly among younger and middle-aged farmers and ranchers, and the need to modify work duties to match work abilities at older ages.
Patient Values and Preferences for Managing Acute Dental Pain Elicited through Online Deliberation
Authors: Dawson T. , Pahlke S. , Carrasco-Labra A. , Polk D.
Published: August 2023

Introduction:

Patient values and preferences (PVP) are among multiple sources of information panelists synthesize when developing clinical practice guidelines (CPG). Patient and public involvement (PPI) can be critical for learning PVP; however, the methodology for engaging patients in CPG development is lacking. Deliberative engagement is effective for obtaining public views on complex topics that require people to consider ethics, values, and competing perspectives.

Objective:

Elicit comprehensive understanding of PVP concerning oral analgesics for managing acute dental pain consecutive to toothache and simple and surgical dental extractions, with consideration of associated outcomes, both desirable and undesirable.

Methods:

Multistage engagement involving 2 electronic surveys and a 90-min online small group deliberative engagement. Adults who have experienced acute dental pain deliberated about 3 hypothetical scenarios stratified according to expected pain intensity, completed a postdeliberation survey, and validated a PVP statement developed by researchers based on review of qualitative data from deliberations and quantitative data from surveys.

Results:

Participants affirmed the PVP statement reflected their small group deliberations and their individual views. Most indicated that pain relief is critical to deciding which pain relief medicine they would want regardless of expected pain level. Most also identify as critical concerns about substance abuse or misuse, although many believe it unlikely that they will experience these outcomes over the brief prescription timeframe for acute dental pain. Participants identified agency in decision-making, consultation including “better communication” of options, and treatment actions tailored to life circumstances as key values.

Conclusions:

Participants preferred nonprescription and nonopioid pain relief options. As expected pain levels increased, more participants expressed willingness to accept opioids, but more also mentioned rescue analgesia as a third outcome critical to decision-making. Online deliberative method provided opportunities for obtaining informed perspectives. Guideline developers and policymakers may find online deliberations useful for eliciting PVP related to health outcomes.

Knowledge Transfer Statement:

Study results informed the US Food and Drug Administration–funded clinical practice guideline on the management of acute dental pain. Findings may be a resource for clinicians in decision-making conversations with patients regarding expectations for pain relief and positive and negative outcomes of differing pain relief medications. Further research should pursue applicability of online deliberative engagement as a method to elicit patient values and preferences.
History of the terrestrial isopod genus Ligidium in Japan based on phylogeographic analysis
Authors: Harigai Wakana , Saito Aya , Zemmoto Chika , Karasawa Shigenori , Yokoi Touta , Nagano Atsushi J. , Suzuki Hitoshi , Yamamoto Masanobu
Published: August 2023

Background

Phylogeographical approaches explain the genetic diversity of local organisms in the context of their geological and geographic environments. Thus, genetic diversity can be a proxy for geological history. Here we propose a genus of woodland isopod, Ligidium, as a marker of geological history in relation to orogeny and the Quaternary glacial cycle.

Results

Mitochondrial analysis of 721 individuals from 97 sites across Japan revealed phylogenetic divergence between the northeastern and southwestern Japan arcs. It also showed repeated population expansions in northeastern Japan in response to Quaternary glacial and interglacial cycles. Genome-wide analysis of 83 selected individuals revealed multiple genetic nuclear clusters. The genomic groupings were consistent with the local geographic distribution, indicating that the Ligidium phylogeny reflects its regional history.

Conclusion

Ligidium DNA sequence analysis can provide insight into the geological, geographical, and paleoenvironmental history of the studied region.
Effect of erector spinae plane block with different doses of dexmedetomidine as adjuvant for ropivacaine on the postoperative quality of recovery after video-assisted thoracoscopic lobectomy surgery: a randomized controlled trial
Authors: Guo Yanxia , Wang Jingting , Jiang Pingping , Wang Dan , Fan Wenxi , Yang Xiaolin
Published: August 2023

Background

Erector spinae plane block (ESPB) improves postoperative analgesia and significantly enhances the quality of recovery (QoR) after video-assisted thoracoscopic lobectomy surgery (VATLS). However, it is not known whether the use of dexmedetomidine (Dex) as an adjunct for ropivacaine to ESPB affects the QoR after VATLS. The purpose of this study was to explore the effects of different Dex dosages as an adjunct for ropivacaine in combination with ultrasound-guided ESPB on the quality of postoperative recovery in patients with VATLS.

Methods

In this single-center, double-blind, randomized study, 120 patients between the ages of 18 and 65 who were scheduled for VATLS from december 2021 and october 2022 in our hospital under general anesthesia were randomly divided into three groups: ultrasound-guided ESPB with 30 mL of 0.5% ropivacaine (Group R), ultrasound-guided ESPB 0.5% ropivacaine plus 0.5 µg/kg Dex (Group RD1), and ultrasound-guided ESPB 0.5% ropivacaine plus 1.0 µg/kg Dex (Group RD2), ultrasound-guided ESPB was administrated at the T5 vertebral level before surgery. The primary outcome was the QoR-15 score 24 h after the surgery. The secondary outcomes included the QoR-15 scores at 12 h, 48 h, and 72 h after the operation, visual analogue scale (VAS) scores at 8 h, 12 h, 24 h, and 48 h after surgery, cumulative flurbiprofen consumption, postoperative nausea and vomiting (PONV), postoperative bradycardia, and hypotension.

Results

The QoR-15 scores were higher in group RD2 than the R and RD1 groups on postoperative day 1 (P < 0.05), in addition, no significant difference was found in the QoR-15 scores between groups R and RD1 on postoperative day 1. The VAS scores were significantly lower in group RD2 than in groups RD1 and group R 12–24 h after surgery (P < 0.05). No significant differences were observed in the QoR-15 and VAS scores at 48 and 72 h after surgery between the three groups. The cumulative flurbiprofen consumption was markedly reduced during the 72 h after surgery in the RD2 group (P < 0.05). The incidence of postoperative nausea and vomiting was lower in the RD2 group (P < 0.05).

Conclusions

The combination of 1 µg/kg dexmedetomidine as an adjunct with 0.5% ropivacaine 30 ml for erector spinae plane block significantly improved the postoperative quality of recovery and provided better postoperative analgesia on postoperative day 1 in patients undergoing Video-assisted thoracoscopic lobectomy surgery. However, dexmedetomidine (1 µg/kg) as an adjunct for ropivacaine combined with erector spinae plane block did not enhance the postoperative quality of recovery at 48 and 72 h postoperatively.

Trial registry number

The number of this clinical trial registry is ChiCTR2100053230, date of registration: 16/11/ 2021)
Real-time monitoring of vitamin C levels in trauma patients by electron-spin resonance spectrometry
Authors: Takenaka Ryuichi , Matsumoto Shigekiyo , Nureki Shinichi , Wada Shinsuke , Oyama Yoshimasa , Sakamoto Teruo , Kitano Takaaki , Shigemitsu Osamu
Published: August 2023

Background

In critically ill patients, healthy vitamin C levels are important to avoid an imbalance in reactive oxygen species. To achieve this, oxidative stress levels in emergency patients need to be accurately measured in real-time. However, normally, reactive oxygen/nitrogen species are short-lived, rendering measurement difficult; moreover, measurement of relatively stable antioxidants and other oxidative stress markers in real-time is challenging. Therefore, we used electron-spin resonance spectrometry (ESR) to assess vitamin C levels, clarify their relationship with patients’ severity, and establish more effective vitamin C therapy in critically ill patients.

Methods

We studied 103 severely ill emergency patients and 15 healthy volunteers. Vitamin C radical (VCR/dimethyl sulfoxide [DMSO]) values were analyzed in arterial blood samples by ESR at admission and once daily thereafter during the acute recovery phase. Severity scores were calculated. The relationship between these scores and VCR/DMSO values and chronological changes in VCR/DMSO values were analyzed.

Results

Serum VCR/DMSO values were significantly lower in critically ill patients than in healthy volunteers (0.264 ± 0.014 vs. 0.935 ± 0.052, p < 0.05), particularly in the severe trauma group and the cardiopulmonary arrest/post-cardiac arrest syndrome group. VCR/DMSO values and various severity scores did not correlate at admission; however, they correlated with SOFA scores from days 2–6. VCR/DMSO values remained low from the first measurement day through Day 6 of illness.

Conclusions

Vitamin C levels were low at admission, remained low with conventional nutritional support, and did not correlate with the initial patient’s severity; however, they correlated with patients’ severity after admission. Some patients had normal vitamin C levels. Therefore, vitamin C levels should be measured in real-time and supplemented if they are below normal levels.

Trial registration

Retrospectively registered.
Software-guided (PREVEDEL) cognitive stimulation to prevent delirium in hospitalised older adults: study protocol
Authors: Garrido Maricel , Álvarez Evelyn , Salech Felipe , Rojas Verónica , Jara Nicole , Farías José Ignacio , de la Vega Daniela Ponce , Tobar Eduardo
Published: August 2023

Background

Delirium is a clinical condition characterised by acute and fluctuating deterioration of the cognitive state, generally secondary to an acute pathology. Delirium is associated with negative outcomes in older adults, such as longer hospitalisations, higher mortality, and short and medium-term institutionalisation. Randomised clinical trials have shown that delirium is preventable through non-pharmacological prevention measures, decreasing its incidence by 30–50%. These interventions include promoting physical activity, facilitating the use of glasses and hearing aids, cognitive stimulation, and providing frequent reorientation of time and space, among others. These measures are currently seldom applied in hospitals in Chile and around the world for reasons including the heavy workload of clinical staff, the lack of trained personnel, and in general the absence of a systematic implementation processes.

We developed a software called PREVEDEL, which includes non-pharmacological strategies such as cognitive stimulation, early mobilisation, orientation, and pain assessment. We propose a randomised clinical trial to evaluate whether cognitive stimulation guided by PREVEDEL software prevents delirium status (full/subsyndromal delirium) in hospitalised older adults.

Method

A randomised controlled trial, with parallel, multicentre groups. We will recruite patients 65 years or older who have been hospitalised for less than 48 h in the general ward or the intermediate care units of four hospitals in Santiago, Chile. The participants in the intervention group will use a tablet with cognitive stimulation software for delirium prevention for five continuous days versus the control group who will use the tablet without the software.

We will evaluate the incidence, duration, density of delirium, subsyndromal delirium with the Confusion Assessment Method, cognitive with the Montreal Cognitive Assessment, and functional status with the Functional Independence Measure at discharge. Moreover, we will evaluate the adherence to prevention measures, as well as demographic variables of interest.

Discussion

The use of cognitive PREVEDEL software could increase and improve the implementation of non-pharmacological prevention measures for delirium in hospitalised older adults, thus reducing its incidence and contributing to patients and health professionals.

Trial registration

NCT05108207 ClinicalTrials.gov. Registered 4 November 2021.
Burden of human metapneumovirus infections among children with acute respiratory tract infections attending a Tertiary Care Hospital, Kathmandu
Authors: Lamichhane Jyoti , Upreti Milan , Nepal Krishus , Upadhyay Bishnu Prasad , Maharjan Urusha , Shrestha Ram Krishna , Chapagain Ram Hari , Banjara Megha Raj , Shrestha Upendra Thapa
Published: August 2023

Background

Acute respiratory infections (ARIs) are one of the most common causes of mortality and morbidity worldwide. Every year millions of children suffer from viral respiratory tract infections (RTIs) ranging from mild to severe illnesses. Human Metapneumovirus (HMPV) is among the most frequent viruses responsible for RTIs. However, HMPV infections and their severity among children have not been explored yet in Nepal.

Purpose

Therefore, the study was focused on HMPV infections and other potential viral etiologies or co-infections using multiplex PCR among children attending Kanti Children’s Hospital and assessed the clinical characteristics of the infections as well as found the co-infections. A hospital-based cross-sectional study was designed and a convenience sampling method was used to enroll children of less than 15 years with flu-like symptoms from both outpatients and inpatients departments over three months of the study period.

Results

HMPV infection (13.3%) was the most predominant infection among the different viral infections in children with ARIs in Kanti Children’s Hospital. The HMPV was more prevalent in the age group less than three years (21.8%). Cough and fever were the most common clinical features present in all children infected with HMPV followed by rhinorrhea, sore throat, and wheezing. HMPV-positive children were diagnosed with pneumonia (42.9%), bronchiolitis (28.5%), upper respiratory tract infections (14.3%), and asthma (14.3%). The prevalence of HMPV was high in late winter (14.3%) followed by early spring (13.5%).

Conclusions

This study provides the baseline information on HMPV and associated co-infection with other respiratory viruses for the differential diagnosis based on molecular methods and also the comparison of clinical presentations among the different respiratory syndromes.
Prevalence of and relevant factors for depression and anxiety symptoms among pregnant women on the eastern seaboard of China in the post-COVID-19 era: a cross-sectional study
Authors: Yang Haidong , Pan Yangyang , Chen Wanming , Yang Xu , Liu Bin , Yuan Nian , Zhang Xiaobin
Published: August 2023

Background

Antenatal depression and anxiety symptoms may have negative consequences for both mothers and offspring, and upward trends in the prevalence of these symptoms were especially apparent during the COVID-19 epidemic. The purpose of this study was to evaluate the prevalence of and relevant factors influencing depressive and anxiety symptoms in Chinese pregnant women in the post-COVID-19 era.

Methods

We conducted an online survey of 1,963 pregnant women in Jiangsu Province, using a cross-sectional design, and collected their general demographic data. The nine-item Patient Health Questionnaire 9 (PHQ-9) was used to evaluate depression symptoms, and the seven-item Generalized Anxiety Disorder 7 (GAD-7) was used to measure anxiety symptoms.

Results

The prevalence of reported antenatal depressive symptoms, anxiety symptoms, and depression combined with anxiety symptoms was 25.2%, 27.9%, and 18.6%, respectively. Of the respondents, the prevalence of moderate to severe depression, and anxiety was 7.9% and 7.7%, respectively. Binary logistic regression analysis demonstrated that age, low level of education, rural area, unemployment, pregnancy complications, poor marital relationship, and fair household income were positively association with both depressive and anxiety symptoms (all P < 0.05). The proportion of women reporting anxiety symptoms in the third trimester was 1.91-fold higher than in first trimester. Parity was a relevant factor for depression and anxiety symptoms (all P < 0.05).

Conclusions

In the post-COVID-19 era, the prevalence of depression and anxiety symptoms in pregnant women was higher than expected, and it is vital to establish hospital, community, and family psychological health screening systems based on relevant factors and enhance early preventive measures.
The prevalence of and perception toward mental illness: a cross-sectional study among Indonesian mental health nurses
Authors: Marthoenis Marthoenis , Sari Hasmila , Martina Martina , Alfiandi Rudi , Asnurianti Rini , Hasniah Hasniah , Safitri Siti Dara , Fathiariani Liza
Published: August 2023

Background

The emergence of the Coronavirus disease 2019 (Covid-19) pandemic has affected nurses’ mental and psychological health. This study investigates the prevalence of depression, anxiety, and stress among Indonesian mental health nurses and their perception of mental illness.

Methods

A cross-sectional study was conducted shortly before the height of the Covid-19 outbreak in Indonesia. The data were collected using the 21 items of the Depression, Anxiety, and Stress Scale (DASS-21), the questionnaire on perception toward mental illness, and demographic information.

Results

Approximately 2.5%, 6.5%, and 1.9% of the nurses had the symptoms of depression, anxiety, and stress, respectively. The vast majority of them perceive that society should treat well people with mental illness (94.8%) and that the government should protect them (94.8%). More than half also believe that they can eat anything but seldom get physically ill (62.1%) and that in Islam, people with mental illness are innocent and are destined for paradise (61.1%).

Conclusions

A considerably low prevalence of mental distress was discovered, which might be attributed to the nurses’ implementation of mental health skills and effective coping mechanisms. Further training and awareness-raising campaigns are needed to address their misconceptions about mental illness.
Factors affecting the effectiveness of the physical activity counselling intervention implemented in primary health care in adults with type 2 diabetes
Authors: Martiskainen Tuula , Lamidi Marja-Leena , Venojärvi Mika , Tikkanen Heikki , Laatikainen Tiina
Published: August 2023

Background

Type 2 diabetes (T2D) has become a major public health threat; physical inactivity and obesity are both independent risk factors. Increasing daily physical activity (PA) significantly benefits treatment. Individual PA counselling is helpful for people with T2D, especially those with previous inactivity or with diabetes complications. This study evaluated factors contributing to effectiveness of PA counselling in primary health care (PHC) patients with T2D in a real-world setting and using data elicited from electronic health records (EHRs).

Methods

All patients with T2D were offered the opportunity to participate in a PA program organized as part of basic PHC services in the Siun sote region in North Karelia, Finland, from October 2016 to December 2018. The study population consists of patients aged 19 to 87 years (n = 546). During the intervention information on possible other factors in addition to age and sex influencing the intervention effect such as amount of counselling sessions, changes in PA and patients´ motivation was gathered. Changes in the participants’ PA activity was generated by following the predefined rules from patient records and by assessing the descriptive documentation of activity patterns. The patients’ motivation level was assessed using a Likert scale.

Results

Over 60% of participants who attended PA counselling more than three times increased their PA compared with 1% of participants with one counselling session. Of the whole intervention group, the participants experiencing the largest weight loss were those with an increased level of PA (-1.36 kg vs. -0.63 kg among those with no change in PA). Age, sex, and baseline motivation did not affect the change the PA nor the main intervention outcomes.

Conclusions

Patients’ compliance with the intervention was reflected in the number of PA counselling sessions attended which in turn was seen as increased levels of PA as well as better treatment outcomes. In the implementation of lifestyle counselling interventions attention should be paid on sufficient amount and frequency of counselling sessions. The individually tailored PA counselling provided in PHC has similar effects regardless of sex and age.
The effect of water storage on nanoindentation creep of various CAD-CAM composite blocks
Authors: Alamoush Rasha A. , Salim Nesreen A. , Elraggal Alaaeldin , Satterthwaite Julian D. , Silikas Nikolaos
Published: August 2023

Background

To study the effect of water storage (3 months) on the creep deformation of various CAD-CAM composite structures at the nanoscale and compare it to that at the macroscale.

Methods

Seven CAD-CAM blocks were investigated: five resin-composite blocks (RCB), one polymer-infiltrated ceramic network (PICN) block, and one ceramic-filled polyetheretherketone (PEEK) block. Specimens of each material (n = 6) were separated into two groups (n = 3) according to their storage conditions (24 h dry storage at 23˚C and 3 months storage in 37˚C distilled water). Nano-indentation creep measurements were undertaken (creep depth measured in µm) using a nanoindenter (Nanovea) equipped with Berkovich three-sided pyramidal diamond tip. The machine was set for the chosen parameters: a load of 20 gf, a pause of 20 s, and the material type. Thirty indentations on 3 samples were made for each material for each test. Data were analysed using two-way ANOVA followed by one-way ANOVA and Bonferroni post hoc tests and independent t-test (< 0.05) for comparisons between the materials.

Results

The nanoindentation creep depth after 24 h storage ranged from 0.09 to 0.33 μm and increased after 3 months storage in distilled water to between 0.28 and 3.46 μm. There was a statistically significant difference in nanoindentation creep behaviour between the two storage conditions for each investigated material (independent t-test) and between all materials (Bonferroni post hoc). There was a non-significant negative correlation between nanoindentation creep (µm) and filler weight% at 24 h dry storage but a significant correlation at 3 months of water storage. A further non-significant positive correlation between nanoindentation creep (µm) and bulk compressive creep (%) was found.

Conclusion

The PICN material showed superior dimensional stability in terms of nanoindentation creep depth in both storage conditions. Other composite blocks showed comparable performance at 24 h dry condition, but an increased nanoindentation creep upon water storage.