bluuebunny/crossref_metadata_2025 huggingface dataset:
A Systematic Review of the Quality of Perpetrator Programs’ Outcome Studies: Toward A New Model of Outcome Measurement
Authors: Vall Berta , López-i-Martín Xavier , Grané Morcillo Jaume , Hester Marianne
Published: November 2023

This systematic review assessed whether studies on the outcomes of perpetrator programs comply with the model recommendations for outcome evaluation. Three databases (PsycINFO, Medline, and Scopus) were used to identify perpetrator program outcome studies from 1988 to 2021. The inclusion criteria were as follows: empirical studies with no time restriction; published in English or Spanish; evaluated interventions aimed at male perpetrators of any type of abuse toward women; evaluated the effectiveness of the intervention in a follow-up post-intervention; and provided an indicator of recidivism. The search and selection process resulted in 46 original studies. The results showed that studies did not include a thorough description of the study sample. Many approaches to psychological intervention are used, with cognitive behavioral therapy being the most widely used. Most studies did not describe the program content. Dropout rates varied greatly from one study to another (from 0% to 64%) and only eight studies provided dropout rates specified by each type of perpetrator. The follow-up period ranged from 3 months to 9 years. The recidivism rates (ranging from 5% to 72.5%), and their assessments were also very different. Only 12 of the 46 studies (26.1%) used more than one source to obtain recidivism rates. In terms of outcomes, few studies considered (ex-) partner accounts. Some studies had other measures of outcome, whereas a few included a pretest–posttest. In summary, these studies do not follow the recommendations of the model.
Association Between Adverse Childhood Experiences and Opioid Use-Related Behaviors: A Systematic Review
Authors: Regmi Sanjaya , Kedia Satish K. , Ahuja Nikhil A. , Lee Guijin , Entwistle Coree , Dillon Patrick J.
Published: November 2023

As opioid use-related behaviors continue at epidemic proportions, identifying the root causes of these behaviors is critical. Adverse childhood experiences (ACEs) are shown to be an important predictor of opioid initiation, opioid dependence, and lifetime opioid overdose. The purpose of this systematic review is to examine the association between ACEs and opioid use-related behaviors later in life and to discuss implications for policy, practice, and research regarding ACEs and opioids. Five databases (PubMed, PsycINFO, CINAHL, Medline, and Scopus) were used to identify studies investigating the association between ACEs and opioid use-related behaviors. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 20 studies out of the initial 428 met the inclusion criteria for this review. Among the included 20 studies, 15 focused on the relationship between ACEs and lifetime opioid use-related behaviors, and five focused on current opioid use-related behaviors. All studies found statistical associations between ACEs and lifetime or current opioid use-related behaviors. Five studies found a significant gradient effect; that is, as the number of ACEs increased, the risk of opioid use-related behaviors also increased. A significant dose–response relationship exists between ACEs and opioid use-related behaviors. Hence, it is essential for clinicians to screen for ACEs before prescribing opioid medications, for opioid treatment to incorporate trauma-informed methods, and for messaging around opioid use interventions to include information about ACEs. The current review points to a critical need to implement standardized ACE screening instruments in clinical and research settings.
Chronic Kidney Disease Predicts Adverse Major Cardiovascular Events and Adverse Limb Events in Patients With Diabetes and Peripheral Arterial Disease
Authors: Rerkasem Amaraporn , Mangklabruks Ampica , Buranapin Supawan , Sony Kiran , Inpankaew Nimit , Rerkasem Rath , Pongtam Sasinat , Phirom Kochaphan , Rerkasem Kitttipan
Published: November 2023

This study aims to explore the effect in each stage of chronic kidney disease (CKD) on the major adverse cardiovascular events (MACE) in diabetes mellitus (DM) patients with peripheral arterial disease (PAD). A total of 246 DM patients with diagnosed PAD were enrolled in this study. Of these, 86 patients (35%) died and 34 patients had non-fatal cardiovascular events occurred at the last 7 years follow-up. The baseline eGFR obtained from the first quantified eGFR value within 6 months from the date of enrollment estimated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Then, based on eGFR at entry, we defined CKD as an eGFR < 60 mL/min/1.73 m2, and stratified all patients into four groups: eGFR-1, normal eGFR (≥90 mL/min/1.73 m2); eGFR-2, mildly decreased eGFR (60-89 mL/min/1.73 m2); eGFR-3, moderately decreased eGFR (30-59 mL/min/1.73 m2); and eGFR-4, severely decreased eGFR (<30 mL/min/1.73 m2). The mean eGFR was 54.4 ± 28.9 mL/min/1.73m2, and more than 30% of all patients had CKD (eGFR <60 mL/min/1.73m2). The seven-year cumulative incidence of MACE was 29.8% (95% confident interval [95% CI] 15.5-35.7) for eGFR-1 group, 40.4% (95% CI 27.4-45.2) for eGFR-2group, 66.2% (95% CI 47.6-71.4) for eGFR-3 group, and 94% (95% CI 75.0-99.0) for eGFR-4 group. In addition, after adjustment, hazard ratio (HR) for MACE was 2.36 (95% CI 1.26-4.40) in the eGFR-3 group and 7.62 (95% CI 3.71-15.66) in the eGFR-4 group. Restricted mean survival time (RMST) for survival analysis was consistent with HR in this study. After adjusting confounders, relative to eGFR-1 group, an association between the eGFR group and MACE outcome was found only in eGFR-3 group and eGFR-4 group. The moderate to severe reduction in eGFR, was an independent risk factor for MACE among DM patients with PAD throughout a 7-year follow-up duration. Thus, early CKD screening might be essential in the management of diabetic patients with PAD.
Impact of Integrated Vascular Surgery Residency on General Surgery Resident and Vascular Fellow Operative Volume: A National Analysis
Authors: Kim Young , Cui Christina L. , Williams Zachary F. , Long Chandler A.
Published: November 2023

Background

The impact of integrated vascular surgery (VS) residency (0 + 5) programs on general surgery (GS) resident and VS fellow (5 + 2) operative volume has not been investigated on a national scale.

Methods

Accreditation Council for Graduate Medical Education (ACGME) case logs were reviewed for GS resident, VS resident, and VS fellow operative volume from 2001-2021. Integrated VS resident data was available from 2012-2021, corresponding with the introduction of the 0 + 5 paradigm. Trends in operative volume were evaluated via linear regression analysis.

Results

The national cohort of chief GS resident graduates increased from 1005 to 1357 per year. Total operative volume also increased from 932 to 1039 cases (+7.4 cases/yr, R2 = .80, P < .0001) among GS residents. Major vascular cases decreased among GS residents from 138 to 101 cases (−2.4 cases/yr, R2 = .58, P < .0001) with a decrease in proportion of chief-level vascular cases from 30.4% to 11.9% (−1.0%/yr, R2 = .92, P < .0001). Palliative procedures (amputations and hemodialysis access) comprised a significant proportion of GS cases (median 44.7%). Concurrently, integrated VS graduates increased from 11 to 37 per year, with an increase in major vascular case volume from 506 to 658 cases (+18.4 cases/yr, R2 = .63, P = .01). Total VS fellow major case volume also increased from 369 to 444 cases (+3.5 cases/yr, R2 = .73, P < .0001).

Conclusions

The introduction of the 0 + 5 intgrated VS residency paradigm has correlated with a significant decrease in GS operative experience in major vascular procedures on a national level. Traditional VS fellow case volume does not appear to be impacted by 0 + 5 integrated residents. Further analysis with program-level data may help to explain the causative relationship of these findings.
The Mediterranean Soul Food Diet Intervention After Stroke, a Feasibility Study in the Stroke Belt
Authors: Benameur Karima , Gross Phillip J. , Liu Star , Koneru Sitara
Published: November 2023

The Mediterranean diet has positive effects on primary and secondary prevention of cardiovascular disease including stroke, yet dietary counseling to stroke patients is under-utilized. This study aimed to develop a culturally adapted Mediterranean diet and introduce it to patients admitted to the hospital for acute ischemic stroke with at least one metabolic risk factor (type 2 diabetes mellitus [DM], hypertension [HTN], high low-density lipoprotein [LDL], low high-density lipoprotein [HDL], and/or body mass index [BMI] > 25). Dietary adherence and nutritional knowledge were measured at baseline and 30, 90, and 120 days post-stroke. Weight, hemoglobin A1C [HbA1C], and triglycerides [TG] were assessed at baseline and follow-up. The study enrolled 54 participants, 50 of whom had sufficient data for analysis. Dietary adherence and nutritional knowledge scores increased in 76.4% of participants, with a statistically significant median increase for each. Additionally, participants had significantly lower weight, HbA1C, and TG at follow-up than baseline. This study showcases the potential to introduce a culturally appropriate Mediterranean diet at the point-of-care, and significantly influence dietary adherence and nutritional knowledge and multiple stroke risk factors.
Assessing inter-rater agreement of the intellectual disability-frailty index short form: A descriptive pilot study
Authors: Hirst Heather , Campbell Jennifer , Chamberlin Samantha , Olagunju Ibukun , Bird Frank , Luiselli James K.
Published: November 2023

Frailty is a health concern for many adults with intellectual disability and should be measured to detect at-risk conditions, monitor disease, plan treatment, and gauge mortality. This descriptive pilot study evaluated measurement consistency (inter-rater agreement) of the Intellectual Disability-Frailty Index Short Form among multiple assessors with 20 adults ( M age = 48.3 years) who had intellectual and multiple disabilities. Agreement percentages were computed for (a) non-frail, pre-frail, and frail categories derived from total index scores, and (b) each of 17 deficits listed on the form. Low average inter-rater agreement (<85%) was obtained on the index frail categories, several of the assessed deficits had acceptable inter-rater agreement (84.2-100%), while the majority of deficits were associated with moderate-to-low agreement percentages. Though research supports the Intellectual Disability-Frailty Index Short Form as a valid and practical frailty assessment instrument, our findings suggest that full-scale inter-rater agreement must be improved by adding more specificity to the form, clarifying instructions for assessors, and providing competency-based training in assessment implementation.
Sino–Russian Partnership in the ‘Asian Supercomplex’: Choices and Challenges for India
Authors: Kapoor Nivedita
Published: November 2023

China’s relationship with Russia has been on an upward trajectory since the late Soviet period, with the strategic partnership growing steadily since the end of the Cold War. Built on political-economic-strategic convergences, the two sides benefit from their cordial engagement, both at the bilateral and multilateral level, without the obligations associated with an alliance relationship. This alignment has ensured that despite the asymmetric nature of this relationship characterised by China’s rise, the partnership has gone from strength-to-strength. This has particular implications for Indian foreign policy, which has been dealing with an increasingly aggressive China that is now considered a leading security challenge. The development of the Asian supercomplex has accelerated India’s already growing engagement within a regional security complex that is critical for its own security and its future positioning in the international system. Due to implications for India-China ties under conditions of Asian supercomplex, as the Sino-Russian partnership continues to gain strength, its ramifications will reverberate across the whole spectrum of Indo-Russian ties. The article will track the development of Sino-Russian relationship and how it reflects in the emergent regional security complex, before examining the challenges and choices for Indian policymaking in the context of its ‘special and privileged strategic partnership’ with Russia.
Investigating the Conceptual Model of Child–Nature Interaction in Architectural Spaces Using Grounded Theory
Authors: Soleimani Sara , Molanaei Salahedin , Khorshidi Babak , Nedaei Chakameh , Ghamari Hessam
Published: November 2023

Objectives:

To explore factors affecting the quality of child–nature interaction (CNI) based on the views and desires of children themselves and to offer solutions and strategies to provide this kind of spaces.

Background:

CNI is one of the most important needs of children which causes very profound effects on the psyche of children from different aspects. Space and context that have the ability and characteristics to provide opportunities to establish this interaction have an important role in the cognitive and social development of children.

Methods:

The qualitative data were collected by draw-and-write technique from a study of 119 children aged 2–6 years from five nursery schools located in the city of Hamedan, Iran. Then, the qualitative data were coded based on the grounded theory using three main steps of open, axial, and selective coding and a conceptual model of CNI is provided by the MAXQDA software.

Results:

The conceptual model developed from CNI consisted of seven core categories: “intertwining with nature,” “objective natural elements,” “nature conservation,” “colors,” “exaggerated plant perceptions,” “path perceptions,” and “nature-home similarity.”

Conclusions:

To reach an optimal CNI within architectural spaces, thus children should have a sense of belonging to nature, be engaged in it, and protect surrounding natural elements. It is of utmost importance to reflect on some points, such as colors, familiar signs, scales, natural elements, the boundary between natural environments and interior spaces, and natural element circulation and placement in designing and planning spaces made specifically for children.
Efficacy and safety of percutaneous cement discoplasty in the management of degenerative spinal diseases: A systematic review and meta-analysis
Authors: Grewal Sahibjot Singh , Hirsch Joshua A , Cancelliere Nicole M , Ghozy Sherief , Pereira Vitor Mendes , Dmytriw Adam A
Published: November 2023

Background

Percutaneous cement discoplasty (PCD) is a minimally invasive procedure. We aim to explore the efficacy and indication(s) of PCD in patients with degenerative disc disease (DDD).

Methods

The search was conducted across Ovid MEDLINE, Ovid Embase, and PubMed. Data on study design, patient demographics, pre- and post-procedure Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores, and complications were extracted. Inclusion criteria focused on adult patients with degenerative spinal diseases treated with cement discoplasty. The overall effect size was evaluated using a forest plot, and heterogeneity was assessed using the I2 statistic and chi-squared test.

Results

The search strategy yielded six studies, which included 336 patients (73.8% female, 26.2% male) with a mean average age of 74.6 years. VAS scores were reported in all studies, showing a significant difference between pre- and post-PCD pain scores (Weighted Mean Difference [WMD]: -3.45; 95% CI: -3.83, -3.08; I2 = 15%; P < .001). ODI scores were reported in 83% of studies, with a significant difference between pre- and post-PCD scores (WMD: -22.22; 95% CI: -25.54, -18.89; I2 = 61%; p < .001). Complications reported included infections, thrombophlebitis, vertebral fractures, disc extrusion, and the need for further operations.

Conclusions

The analysis showed clinically significant improvements in pain and functional disability based on VAS and ODI scores. However, due to methodological limitations and a high risk of bias, the validity and generalizability of the findings are uncertain. Despite these issues, the results provide preliminary insights into PCD's potential efficacy and can guide future research to address current limitations.
Enhancing the hospital at home experience
Authors: Towle Rachel Marie , Fan Peijin Esther Monica , Arba’in Juweita , Aloweni Fazila , Lim Siew Hoon , Ang Shin Yuh , Lim Su-Fee
Published: November 2023

Background

Hospital at Home programs have demonstrated to be safe, feasible and cost effective. However, challenges such as infection control, cleanliness, space constraints and insufficient resources may hamper the adoption and effectiveness of such programs.

Aims

To understand the challenges of providing and receiving healthcare in the community, design a solution to meet the challenges, and to pilot and evaluate the solution.

Methods

This is a three-phase mixed method study. Phase 1, nurses, patients and caregivers were surveyed to understand their challenges in providing or receiving healthcare at home. Results of the survey in Phase 1 were used in Phase 2 to design a solution. In phase 3, an integrated structure was designed and piloted for stakeholders’ evaluation.

Results

Twenty nurses and 50 patient-caregiver dyads responded to Phase 1 survey. Physical home environment was most cited by the nurses as their main challenge, particularly the lack of a dedicated and clean space to conduct nursing procedures. Medication management was the greatest challenge faced by the patient-caregiver dyads. Based on these findings, a prototype of an integrated structure was fabricated in Phase 2. Ten patient-caregiver dyads and nine community nurses tested the prototype in Phase 3. The participants found the structure useful to store and organize their healthcare items, and there was ample clean workspace to carry out nursing procedures.

Conclusion

An integrated structure that can fulfil the physical, spatial and interpersonal needs at an affordable price could be useful in facilitating the delivery of hospital care in the home setting.

Patient Contribution

Patient-caregiver dyads were key stakeholders in our study. They provided valuable feedback and suggestions on the prototype and design of the integrated structure.
Spleen stiffness determined by spleen-dedicated device accurately predicted esophageal varices in cirrhosis patients
Authors: Liu Jiqing , Xu Hangfei , Liu Weiyuan , Zu Hongmei , Ding Huiguo , Meng Fankun , Zhang Jing
Published: November 2023

Background:

The advantages of spleen stiffness in prediction of high-risk varices (HRV) in cirrhosis patients have been confirmed. Recently, a new device utilizing a 100 Hz probe dedicated to spleen stiffness measurement (SSM) was developed.

Objectives:

To validate the clinical applicability of SSM@100 Hz in predicting HRV by comparing it with other non-invasive tests (NITs).

Design:

A prospective cohort study.

Methods:

A total of 171 cirrhosis patients who underwent esophagogastroduodenoscopy (EGD) examination were included in this study. SSM using a 100 Hz probe and liver stiffness measurement using a 50 Hz probe were performed. Additionally, 22 healthy controls underwent spleen stiffness evaluation using the 100 Hz probe.

Results:

The failure rates of spleen stiffness examination in patients with cirrhosis and in healthy controls were 2.9% and 4.5%, respectively. The means of SSM values were 56.4 ± 21.6 and 13.8 ± 6.7 kPa in cirrhosis and controls. SSM increased proportionally with the severity of esophageal varices. The area under receiver operating characteristic (ROC) for spleen stiffness in predicting HRV was 0.881 (95% confidence interval 0.829–0.934), with a cutoff value of 43.4 kPa. The accuracy, false negative rate and EGD spare rate were 86.5%, 2.5% and 24.3%, respectively. For HRV prediction, SSM was comparable to expanded Baveno VI and VII and superior to other NITs. As to viral versus non-viral cirrhosis and compensated versus decompensated cirrhosis, the cut-off and performance of SSM were different.

Conclusion:

SSM@100 Hz demonstrates high accuracy in predicting HRV with a low missed HRV rate. Our findings suggest that SSM@100 Hz can be used independently due to its simplicity and effectiveness. However, further studies are needed to determine appropriate cutoff values based on the cause of cirrhosis and liver function.

Trail Registration:

ChiCTR2300070270.
Online focus groups as a tool to study policy professionals
Authors: Berkhout Joost , Crepaz Michele , Hanegraaff Marcel , Junk Wiebke Marie
Published: November 2023

Scholars interested in political elites and policy professionals only sporadically rely on focus group methods. In this article, we argue why this is a missed opportunity. Based on our own recent research experience, we suggest three innovations to the focus group method that should make it appealing for political scientists who study professionals active in the policy process. First, focus groups allow for the study of the interactions between political elites in ways other methods cannot. Second, the method can be used for hypothesis testing when focus groups are designed accordingly. Third, the option to conduct focus groups online has major advantages in terms of participant costs, ease of recruitment, and, potentially, research equity. We hope that our suggestions are useful for researchers wanting to build on any one—or all—of these innovations.
The hidden depths of suicidal discourse: Network analysis and natural language processing unmask uncensored expression
Authors: Lekkas Damien , Jacobson Nicholas C
Published: November 2023

Background

The socially unattractive and stigmatizing nature of suicidal thought and behavior (STB) makes it especially susceptible to censorship across most modern digital communication platforms. The ubiquitous integration of technology with day-to-day life has presented an invaluable opportunity to leverage unprecedented amounts of data to study STB, yet the complex etiologies and consequences of censorship for research within mainstream online communities render an incomplete picture of STB manifestation. Analyses targeting online written content of suicidal users in environments where fear of reproach is mitigated may provide novel insight into modern trends and signals of STB expression.

Methods

Complete written content of N = 192 users, including n = 48 identified as potential suicide completers/highest-risk users (HRUs), on the pro-choice suicide forum, Sanctioned Suicide, was modeled using a combination of lexicon-based topic modeling (EMPATH) and exploratory network analysis techniques to characterize and highlight prominent aspects of censorship-free suicidal discourse.

Results

Modeling of over 2 million tokens across 37,136 forum posts found higher frequency of positive emotion and optimism among HRUs, emphasis on methods seeking and sharing behaviors, prominence of previously undocumented jargon, and semantics related to loneliness and life adversity.

Conclusion

This natural language processing (NLP)- and network-driven exposé of online STB subculture uncovered trends that deserve further attention within suicidology as they may be able to bolster detection, intervention, and prevention of suicidal outcomes and exposures.
Published Articles on Deputy Principals From 1980 to 2020: A Systematic Literature Review
Authors: Tahir Lokman Mohd , Musah Mohammed Borhandden , Hassan Roslizam , Ali Mohd Fadzli
Published: November 2023

This article reports on the process and findings on a systematic review of published articles related to deputy principals on the area of educational leadership and management (EDLM). In achieving this purpose, quantitative and bibliometric content analysis methods were employed which studied 61 articles published in 24 international EDLM and educational-based journals. This review effort had examined general patterns of knowledge production, as well as research topics, production volumes, and methods employed by researchers in their deputy principals’ studies. Findings indicates that researchers from the United States, United Kingdom and Hong Kong have numbers of highest publication of articles on DPs’ knowledge production. Almost half of the topical foci covered on deputy principals are much related to roles and responsibilities, leadership and their professional and leadership development programs. Based on their methodological approach, qualitative case study with interviews, documents analysis and observation are the frequently used when studying deputy principals’ leadership, roles, and responsibilities and their career aspirations. Recommendations are forwarded for knowledge production development related to deputy principals.
Has a U.S. Developmental Education Reform for Academically Underprepared Students Affected College Enrollment?
Authors: Hu Pei , Mokher Christine G. , Zhao Kai , Park-Gaghan Toby J. , Hu Shouping
Published: November 2023

State policymakers in the United States have in recent years experimented with new initiatives to change the procedures used by public institutions to assess and assign academically underprepared students to non-credit developmental education (or remedial) courses. This study explores whether the most recent developmental education reform in Floridas—Senate Bill 1720 has affected student enrollment in the Florida College System (FCS) institutions and whether the enrollment effects vary by race/ethnicity and age. Through a difference-in-differences analysis, we did not find statistically significant effects of the reform on the college enrollment in Florida, neither on the racial or age compositions of the student population, compared to non-Florida institutions in the surrounding region. These null results provide valuable implications for policy and research consideration in Florida and beyond.
Why Do University Students From Australia, New Zealand, and Argentina Play Drinking Games? A Mixed-Method Cross-Country Study
Authors: Zamboanga Byron L. , Ford Kayla , George Amanda M. , Bacon Miller , Olthuis Janine V. , Wickham Robert E. , Pilatti Angelina , Van Hedger Kathryne , Dresler Emma
Published: November 2023

Qualitative work suggests that young people’s motives for playing drinking games (DGs) extend beyond those assessed in the Motives for Playing Drinking Games (MPDG) measure. Using a mixed-methods approach, we tested whether the 7-factor model of the MPDG would emerge among university students from Australia, New Zealand, and Argentina, and whether their open-ended responses regarding their reasons for playing would map onto the MPDG subscales. Students ( N = 895; ages = 18–30 yrs) completed the MPDG-33 measure and an open-ended-question regarding their reasons for playing DGs. We found support for the 7-factor model of the MPDG among students across sites. Open-ended responses revealed that students were motivated to play for a variety of reasons, some of which overlapped with the MPDG subscales while others did not. We present a conceptual model that considers motives specific to alcohol consumption in the context of a DG and reasons/possible motives for playing a DG given its specific features.
Comparison of 5-Item and 11-Item Modified Frailty Index as Predictors of Functional Independence in Patients With Spinal Cord Injury
Authors: Mouchtouris Nikolaos , Luck Trevor , Locke Katherine , Hines Kevin , Franco Daniel , Yudkoff Clifford , Sivaganesan Ahilan , Heller Joshua , Prasad Srinivas , Harrop James , Jack Jallo
Published: November 2023

Study Design

Retrospective Cohort Study.

Introduction

The 11-item modified Frailty index (mFI-11) by the ACS-NSQIP database was used to predict which patients are high risk for complications and inpatient mortality. ACS-NSQIP now has switched to the 5-item MFI. However, there are no studies on how these frailty indices fare against each other and their prognostic value of functional independence in patients with spinal cord injury (SCI).

Objective

To compare the mFI-5 and mFI-11 in order to standardize frailty assessment in the SCI population.

Methods

Retrospective analysis of 272,174 patients with SCI from 2010 to 2020 from the Pennsylvania Trauma Systems Foundation (PTSF) registry. Multivariable logistic regression was used to determine the predictive value of mFI for functional independence as determined by locomotion and transfer mobility.

Results

A total of 1907 patients were included with a mean age of 46.9 ± 15.1 years. The 3 most common MFI factors were hypertension (32.2%), diabetes mellitus (13.7%) and chronic obstructive pulmonary disease (8.5%). Multivariable logistic regression analyses using MFI-5 and MFI-11 showed that a higher frailty score in MFI-5 (OR 1.375, P < .001) and in MFI-11 (OR 1.366, P < .001) were each predictive of poor functional status at discharge. ROC curves for the MFI-5 (AUC = .818, P < .001) and MFI-11 (AUC = .819, P < .001) demonstrated excellent diagnostic accuracy.

Conclusion

The new MFI-5 is equivalent to its predecessor, the MFI-11, and predictive of functional outcomes in patients with SCI. MFI-5 can serve as the preferred frailty index at the point of care and in research contexts.
Understanding Pediatric Clinical Scaphoid Injuries: A Prospective Radiological Study
Authors: Cheung Kevin , Livock Holly , Rubin Zoe , Tang Ken , Smit Kevin , Carsen Sasha
Published: November 2023

Controversy exists in the management of children presenting with clinical suspicion of a scaphoid fracture but normal radiographs. The purpose of this study was to prospectively evaluate the potential role for advanced imaging in children with suspected scaphoid fractures. Participants with clinical suspicion of a scaphoid fracture but 2 sets of radiographs negative for fracture were casted and underwent both computed tomography (CT) and magnetic resonance imaging (MRI). The primary outcome was the prevalence of scaphoid fracture and other imaging findings. Twenty-five participants were enrolled. Nine participants (36%) were found to have a scaphoid fracture on either CT or MRI. Concordance of CT and MRI was found in 64% of cases. Future studies are required to better understand the clinical significance of these injuries, the role of advanced imaging, and the most appropriate treatment in children with suspected scaphoid fractures.
Efficacy, Safety, and Pain Level of Subcutaneous Catheter Use for Administration of Granulocyte Colony-Stimulating Factor (G-CSF) in Children With Cancer: A Randomized Pilot Study
Authors: de la Maza Verónica , Fuentes Valeska , Cabrolier Elisa , Fernández María Soledad , Saéz Sara , Concha Claudia , Nicklas Carolina , Castro Magdalena , Torres Juan Pablo
Published: November 2023

Background: The aim of this study was to explore the efficacy, safety, and pain level of granulocyte colony-stimulating factor (G-CSF) administration via a subcutaneous catheter compared with direct injection in children with cancer. Method: This was a pilot randomized controlled trial of standard G-CSF administration versus subcutaneous catheter administration. Children 2–15 years of age who were beginning G-CSF after their first chemotherapy cycle and anticipated to receive G-CSF following the next three cycles of chemotherapy were eligible. Efficacy, safety, and pain were as outcomes of the study. Results: Twenty-nine children with cancer (median age 12 years) were enrolled in the study (16 children in the subcutaneous catheter group and 13 children in the direct injection group). During Cycle 2, the median number of days to reach absolute neutrophil count (ANC) ≥ 500/mm3 was greater among those in the subcutaneous catheter group (12 vs. 10; p  =  .02). In Cycle 3, however, the subcutaneous catheter group received fewer doses of G-CSF (8 vs. 12; p  =  .004). No complications related to subcutaneous catheter use were observed. No differences in the visual analog scale pain score were observed between groups in Cycles 1 to 3; however, in Cycle 4, children in the subcutaneous catheter group had lower median pain scores than those in the direct subcutaneous injection group ( Mdn  =  0, [IQR]  =  0–2 vs. Mdn  =  1, IQR  =  0–6; p < 0.01). Conclusion: Results demonstrated administering G-CSF via a subcutaneous catheter enables ANC to recover with no pain or complications associated with its use. Thus, oncology teams may consider this administration method to be used in children with cancer.
Endophthalmitis caused by Burkholderia cepacia complex (BCC): clinical characteristics, antibiotic susceptibilities, and treatment outcomes
Authors: Beca Flavius A. , Sengillo Jesse D. , Robles-Holmes Hailey K. , Iyer Prashanth G. , Miller Darlene , Yannuzzi Nicolas A. , Flynn Harry W.
Published: November 2023

Purpose

To report the clinical characteristics, antibiotic susceptibilities, and review the literature of Burkholderia cepacia complex (BCC) associated endophthalmitis.

Study design

Retrospective, observational case series.

Methods

Clinical and microbiology records were reviewed for patients evaluated at the Bascom Palmer Eye Institute and diagnosed wisth culture-confirmed endophthalmitis due to BCC. Antibiotic susceptibility profiles were generated using standard microbiologic protocols via an automated VITEK system.

Results

Endophthalmitis associated with BCC was diagnosed in three patients. Infection occurred in the setting of post-penetrating keratoplasty (PKP), glaucoma filtering surgery, and suspected trauma. All isolates demonstrated in vitro susceptibility to ceftazidime and meropenem. Presenting visual acuity (VA) ranged from hand motion to light perception. Initial treatment strategies included intravitreal ceftazidime (2.25 mg/0.1 mL) and vancomycin (1.0 mg/0.1 mL) injections with fortified topical antibiotics in 2 patients, and surgical debridement of a corneoscleral melt with patch graft along with both topical fortified antibiotics oral antibiotics in the third patient. In all 3 patients, there was no VA improvement at last follow-up, as 2 eyes ultimately underwent enucleation and 1 eye exhibited phthisis bulbi at last follow-up. BCC related endophthalmitis was reviewed among 13 reports. Treatment outcomes were generally poor and antibiotic resistance was common. These BCC isolates cases demonstrated broad resistance patterns, with susceptibilities to ceftazidime (58%), ciprofloxacin (53%), and gentamicin (33%).

Conclusions

Endophthalmitis caused by B. cepacia is a rare clinical entity with generally poor visual outcomes despite prompt treatment with appropriate antibiotics.
Alterations in gut microbiota and host transcriptome of patients with coronary artery disease
Authors: Chen Liuying , Mou Xuanting , Li Jingjing , Li Miaofu , Ye Caijie , Gao Xiaofei , Liu Xiaohua , Ma Yunlong , Xu Yizhou , Zhong Yigang
Published: November 2023

Background

Coronary artery disease (CAD) is a widespread heart condition caused by atherosclerosis and influences millions of people worldwide. Early detection of CAD is challenging due to the lack of specific biomarkers. The gut microbiota and host-microbiota interactions have been well documented to affect human health. However, investigation that reveals the role of gut microbes in CAD is still limited. This study aims to uncover the synergistic effects of host genes and gut microbes associated with CAD through integrative genomic analyses.

Results

Herein, we collected 52 fecal and 50 blood samples from CAD patients and matched controls, and performed amplicon and transcriptomic sequencing on these samples, respectively. By comparing CAD patients with health controls, we found that dysregulated gut microbes were significantly associated with CAD. By leveraging the Random Forest method, we found that combining 20 bacteria and 30 gene biomarkers could distinguish CAD patients from health controls with a high performance (AUC = 0.92). We observed that there existed prominent associations of gut microbes with several clinical indices relevant to heart functions. Integration analysis revealed that CAD-relevant gut microbe genus Fusicatenibacter was associated with expression of CAD-risk genes, such as GBP2, MLKL, and CPR65, which is in line with previous evidence (Tang et al., Nat Rev Cardiol 16:137-154, 2019; Kummen et al., J Am Coll Cardiol 71:1184-1186, 2018). In addition, the upregulation of immune-related pathways in CAD patients were identified to be primarily associated with higher abundance of genus Blautia, Eubacterium, Fusicatenibacter, and Monoglobus.

Conclusions

Our results highlight that dysregulated gut microbes contribute risk to CAD by interacting with host genes. These identified microbes and interacted risk genes may have high potentials as biomarkers for CAD.
Alleviation of chromium toxicity in mung bean (Vigna radiata L.) using salicylic acid and Azospirillum brasilense
Authors: Ali Hafiz Haider , Ilyas Maimoona , Zaheer Muhammad Saqlain , Hameed Akhtar , Ikram Kamran , Khan Waqas ud Din , Iqbal Rashid , Awan Tahir Hussain , Rizwan Muhammad , Mustafa Abd El-Zaher M. A. , Elshikh Mohamed Soliman
Published: November 2023

Background

Chromium (Cr) contamination in soil poses a serious hazard because it hinders plant growth, which eventually reduces crop yield and raises the possibility of a food shortage. Cr’s harmful effects interfere with crucial plant functions like photosynthesis and respiration, reducing energy output, causing oxidative stress, and interfering with nutrient intake. In this study, the negative effects of Cr on mung beans are examined, as well as investigate the effectiveness of Azospirillum brasilense and salicylic acid in reducing Cr-induced stress.

Results

We investigated how different Cr levels (200, 300, and 400 mg/kg soil) affected the growth of mung bean seedlings with the use of Azospirillum brasilense and salicylic acid. Experiment was conducted with randomized complete block design with 13 treatments having three replications. Significant growth retardation was caused by Cr, as were important factors like shoot and root length, plant height, dry weight, and chlorophyll content significantly reduced. 37.15% plant height, 71.85% root length, 57.09% chlorophyll contents, 82.34% crop growth rate was decreased when Cr toxicity was @ 50 µM but this decrease was remain 27.80%, 44.70%, 38.97% and 63.42%, respectively when applied A. brasilense and Salicylic acid in combine form. Use of Azospirillum brasilense and salicylic acid significantly increased mung bean seedling growth (49%) and contributed to reducing the toxic effect of Cr stress (34% and 14% in plant height, respectively) due to their beneficial properties in promoting plant growth.

Conclusions

Mung bean seedlings are severely damaged by Cr contamination, which limits their growth and physiological characteristics. Using Azospirillum brasilense and salicylic acid together appears to be a viable way to combat stress brought on by Cr and promote general plant growth. Greater nutrient intake, increased antioxidant enzyme activity, and greater root growth are examples of synergistic effects. This strategy has the ability to reduce oxidative stress brought on by chromium, enhancing plant resistance to adverse circumstances. The study offers new perspectives on sustainable practices that hold potential for increasing agricultural output and guaranteeing food security.
The impact of eHealth on relationships and trust in primary care: a review of reviews
Authors: Ramachandran Meena , Brinton Christopher , Wiljer David , Upshur Ross , Gray Carolyn Steele
Published: November 2023

Background

Given the increasing integration of digital health technologies in team-based primary care, this review aimed at understanding the impact of eHealth on patient-provider and provider-provider relationships.

Methods

A review of reviews was conducted on three databases to identify papers published in English from 2008 onwards. The impact of different types of eHealth on relationships and trust and the factors influencing the impact were thematically analyzed.

Results

A total of 79 reviews were included. Patient-provider relationships were discussed more frequently as compared to provider-provider relationships. Communication systems like telemedicine were the most discussed type of technology. eHealth was found to have both positive and negative impacts on relationships and/or trust. This impact was influenced by a range of patient-related, provider-related, technology-related, and organizational factors, such as patient sociodemographics, provider communication skills, technology design, and organizational technology implementation, respectively.

Conclusions

Recommendations are provided for effective and equitable technology selection, application, and training to optimize the impact of eHealth on relationships and trust. The review findings can inform providers’ and policymakers’ decision-making around the use of eHealth in primary care delivery to facilitate relationship-building.
Developing and evaluating an interprofessional shared decision-making care model for patients with perinatal depression in maternal care in urban China: a study protocol
Authors: Xiang Defang , Xia Xian , Liang Di
Published: November 2023

Background

The majority of patients with perinatal depression (PND) in China do not receive adequate treatment. As forming a therapeutic alliance with patients is crucial for depression treatment, shared decision-making (SDM) shows promise in promoting patients’ uptake of evidence-based mental health services, but its impact on patient outcomes and implementation in real-world maternal care remain uncertain. Therefore, this study aims to develop and evaluate an interprofessional shared decision-making (IP-SDM) model for PND to enhance maternal mental health services.

Methods

This study contains four research phases: feasibility testing (Phase 1), toolkit development (Phase 2), usability evaluation (Phase 3), and effectiveness evaluation (Phase 4). During the development stage, focus group interviews will be conducted with expectant and new mothers, as well as maternal care providers for feasibility testing. A toolkit, including a patient decision aid along with its user guide and training materials, will be developed based on the findings of Phase 1 and syntheses of up-to-date evidence and appraised by the Delphi method. Additionally, a cognitive task analysis will be used for assessing the usability of the toolkit. During the evaluation stage, a prospective randomized controlled trial embedded in a mixed methods design will be used to evaluate the effectiveness and cost-effectiveness of the IP-SDM care model. The study targets to recruit 410 expectant and new mothers who screen positive for depression. They will be randomly assigned to either an intervention group or a control group in a 1:1 ratio. Participants in the intervention group will receive decision aid, decision coaching, and clinical consultation, in addition to usual services, while the control group will receive usual services. The primary outcome is the quality of decision-making process, and the secondary outcomes include SDM, mental health service utilization and costs, depressive symptoms, and health-related quality of life. In-depth interviews will be used to explore the facilitating and hindering factors of SDM.

Discussion

This study will develop an IP-SDM care model for PND that can be implemented in maternal care settings in China. This study will contribute to the understanding of how SDM impacts mental health outcomes and facilitate the integration of mental health services into maternal care.

Trial registration

ChiCTR2300072559. Registered on 16 June 2023.
Clinical features, treatments and prognosis of appendiceal bleeding: a case series study
Authors: Xing Xiao-cun , Yang Jin-lin , Xiao Xue
Published: November 2023

Background

Appendiceal bleeding is a rare cause of lower gastrointestinal bleeding, could be overlooked and diagnosed as obscure gastrointestinal bleeding. Due to limited real-world cases, the optimized management of appendiceal bleeding is unclear. We here shared our experiences in the past 20 years.

Methods

A retrospective study was conducted at West China Hospital of Sichuan University. We reviewed data of 28,175 colonoscopies from 43,095 gastrointestinal bleeding patients between June 2003 and June 2023. Six patients diagnosed as appendiceal bleeding were included. Data including symptoms, laboratory tests, imaging results, endoscopic findings, treatment and prognosis were collected and analyzed.

Results

Appendiceal bleeding accounts for 0.014% in gastrointestinal bleeding patients. Of the six patients, five were male, with a mean age of 48.5 years. Hematochezia was the most common symptom. The etiology included appendiceal angiodysplasia, appendicitis and appendectomy associated bleeding. Hemostasis was achieved by appendectomy, endoscopic therapy or medication according to different cases. One patient did not receive any treatment because of self-limiting bleeding.

Conclusions

The diagnosis of appendiceal bleeding is challenging, repeated flushing during endoscopy is helpful. Appendectomy is the priority option for treatment as well as the etiology clarification, therapeutic endoscopy and medication could be considered case by case.
L-shaped association of serum α-Klotho and frailty among the middle-aged and older adults: results from NHANES 2007–2016
Authors: Jiang Zewei , Wang Jiaxin , Cai Xingdong , Wang Ping , Liu Shengming
Published: November 2023

Background

Frailty is common and not limited to older age group. Serum α-Klotho works as a biomarker of anti-aging effect. However, there is limited research about the relationship between them in middle-aged and older people and controversy still exists.

Methods

Based on data from National Health and Nutrition Examination Survey (NHANES) 2007–2016, we constructed weighted logistic regression models and conducted sensitivity tests to investigate the correlation between frailty and α-Klotho among people aged 40 to 79. And then their relationship was visualized by Restricted Cubic Spline (RCS). Finally, the stratified analyses and interaction tests of covariables was presented in the forest plot.

Results

A total of 7052 individuals were involved in this study, with mean age of 62.76 ± 0.18 years and females accounting for 51.05%. 2554 of them were in “frailty”. After adjustment for relevant covariables, weighted logistic regression models showed that the odds ratio and 95% confidence interval [ORs (95%CI)] of correlation between frailty and Natural Logarithm(ln)-transformed α- Klotho[ln(α-Klotho)] was 0.63 (0.50, 0.79); we then performed a sensitivity analysis and found that the results remained stable. In model 3, individuals in quartiles 2, 3, and 4 showed statistical differences compared with the lowest ln(α-Klotho) quartiles, ORs (95% CI) were 0.74 (0.59, 0.93), 0.72 (0.57, 0.91), 0.71 (0.57, 0.87), respectively. Subsequently, non-linear associations were exhibited by RCS (p<0.001). The turning point for α-Klotho and ln(α-Klotho) were 785.7(pg/ml) and 6.67, respectively. Finally, analysis of the relationship between different levels of ln(α-Klotho) and frailty in different populations revealed differences between groups. The results of the interaction test showed that no other covariables had significant interaction with serum α-Klotho in our study.

Conclusion

The L-shaped and negative correlation was found between α-Klotho and frailty among people aged 40 to 79 in the NHANES from 2007 to 2016.