bluuebunny/crossref_metadata_2025 huggingface dataset:
Systematic Review of Ostomy Care Pathways
Authors: Nizum Nafsin , Jacob Greeshma
Published: April 2022

OBJECTIVE

To evaluate if ostomy care pathways improve outcomes for adults anticipating or living with an ostomy.

DATA SOURCES

In this systematic review, the authors searched the MEDLINE, CINAHL, Cochrane Central, and EMBASE databases.

STUDY SELECTION

Studies were included if they met the following criteria: written in English, targeted adults anticipating or currently living with an ostomy, evaluated the impact of two or more components of an ostomy care pathway, and included one or more of the pertinent outcomes (patient satisfaction, hospital length of stay, hospital readmission rates, and staff satisfaction).

DATA EXTRACTION

Details recorded included design, setting, descriptions of intervention and control groups, patient characteristics, outcomes, data collection tools, effect size, and potential harms.

DATA SYNTHESIS

Of 5,298 total records, 11 met the inclusion criteria: 2 randomized controlled trials and 9 nonrandomized studies. The overall quality of the studies was low. Of the four studies that examined patient satisfaction, all studies reported improvement or positive satisfaction rates. Of the six studies that evaluated hospital length of stay, five noted a decrease in length of stay. Of the eight studies that evaluated hospital readmission rates, five found a reduction in hospital readmission rates. No studies reported on staff satisfaction.

CONCLUSIONS

Ostomy care pathways included preoperative education and counseling, postoperative education and discharge planning, and outpatient home visits and telephone follow-ups. Ostomy care pathways may contribute to patient satisfaction and decrease both hospital length of stay and hospital readmission rates. However, higher-quality literature is needed to be confident in the effectiveness of ostomy care pathways.
Evaluating the Scales Used To Diagnose Incontinence-Associated Dermatitis: A Systematic Review
Authors: Tezcan Bilge , Eraydın Canan , Karabacak Bilgi Gülseven
Published: April 2022

OBJECTIVE

To investigate the scales used in the diagnosis of incontinence-associated dermatitis (IAD), including the risk factors included in the scales, their reliability and validity, and in which patient groups the scales have been applied.

DATA SOURCES

The relevant studies were screened retrospectively using five MeSH (Medical Subject Headings) keywords in various combinations. Seven international databases were screened between March and July 2019. In total, 2,908 studies published between 2009 and 2019 were evaluated.

STUDY SELECTION

Inclusion criteria for studies were as follows: written in English, published between 2009 and 2019, and investigated a scale developed to diagnose IAD (quantitative studies, randomized controlled studies, or meta-analyses). Studies were excluded if they did not examine scales for diagnosing IAD or were not in English. Nine studies were included in this review: five studies on scale development, one scale revision, one scale reliability study, and two Turkish validity and reliability studies.

DATA EXTRACTION

The study methods, sample characteristics, interventions, validity and reliability analyses, risk factors in the scales, and subdimensions of the scales were examined for each of the nine included studies.

DATA SYNTHESIS

Study samples were composed of nurses, healthcare professionals, patients, or individuals living in a nursing home and ranged in size from 9 to 823 participants. Most data were collected from hospital-wide clinics. The scales used investigated redness, rash, skin loss, incontinence type, infection symptoms, skin color, edema, patient experience, pain, and perineal care habits. Both validity and reliability of the scales were examined in eight of the studies; in one study, only reliability was examined because the scale validity was shown in previous research. Moreover, sensitivity and specificity were indicated in one study.

CONCLUSIONS

There are several competent scales in the literature with proven validity and reliability that can be used to diagnose IAD.
Reducing the Incidence and Prevalence of Pressure Injury in Adult ICU Patients with Support Surface Use: A Systematic Review
Authors: Bambi Adi Angriawan , Yusuf Saldy , Irwan Andi Masyitha
Published: April 2022

GENERAL PURPOSE

To provide information on the effectiveness of active and reactive support surfaces in reducing the incidence and prevalence of pressure injuries (PIs) in adult ICU patients.

TARGET AUDIENCE

This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES

After participating in this educational activity, the participant will: 1. Distinguish features of active and reactive support surfaces used in the ICU.2. Compare the PI incidence in patients using a variety of support surfaces.3. Synthesize recommendations for the use of support surfaces to reduce the risk of PI in adult ICU patients.

OBJECTIVE

To identify and analyze scientific evidence on the effectiveness of active and reactive support surfaces in reducing the incidence and prevalence of pressure injury (PI) in adult ICU patients.

DATA SOURCES

PubMed, ProQuest, ScienceDirect, Wiley Online Library, ClinicalKey for Nursing, Cochrane Library, and secondary searches.

STUDY SELECTION

Studies were included if they related to support surfaces, involved adult ICU patients aged ≥18 years, and the primary outcome measured was incidence or prevalence of PI. The initial search resulted in 8,357 articles; after exclusions, 31 complete texts were assessed for feasibility. A total of eight articles were included in this review. A bias risk assessment was performed using the Cochrane Risk of Bias Assessment Tool.

DATA EXTRACTION

Data were extracted by one reviewer and summarized in a table of study results that was examined and verified by two other reviewers.

DATA SYNTHESIS

Reactive (constant low pressure) support surfaces included viscoelastic foam mattresses, static air mattresses, and low-air-loss mattresses, whereas the active support surface consisted of alternating-pressure air mattresses. Alternating pressure mattress and viscoelastic foam mattress use both resulted in significantly lower PI incidence.

CONCLUSION

Support surface use is limited, and no particular type is proven to be superior to others. Clinicians should select support surfaces based on their therapeutic features and how well they meet the patient’s particular needs.
Revisiting Retake Policy: Analyzing the Success Rates of Examinees With Multiple Attempts on the United States Medical Licensing Examination
Authors: Rubright Jonathan D. , Ong Thai Q. , Jodoin Michael G. , Johnson David A. , Barone Michael A.
Published: April 2022

Purpose

A testing program’s decision making on retake policy considers a number of factors, including fairness to examinees, examination security, examination purpose, and classification accuracy. For high-stakes licensure and certification examinations charged with protection of the public, this includes balancing fairness issues inherent in the potential for false negatives with the public protection need to minimize false positives. Since 2012, the United States Medical Licensing Examination (USMLE) has maintained a policy of ≤ 6 attempts on any examination component. The purpose of this study was to empirically examine the appropriateness of existing USMLE retake policy.

Method

A sample of over 300,000 examinees who were administered each Step examination between 2008 and 2018 was examined to address how pass rates (per attempt and cumulatively) differed for examinees and examinee subgroups via graphic depictions of pass rates, the impact of restricting the number of attempts on examinees and examinee subgroups via logistic regression analyses, and the impact of restricting the number of attempts on classification error via classification error analyses.

Results

Repeaters displayed consistently lower pass rates on subsequent attempts. Regardless of Step, most passing examinees did so by their fourth attempt. Models predicting the log odds of examinees taking ≥ 5 attempts showed a significant effect of gender, race, and medical school status, although the associated sample sizes are small. Misclassification analyses showed that, as attempts increased, the percentage of false passers increased and percentage of false failers decreased.

Conclusions

These considerations led to the USMLE’s decision to reduce its attempt limit from 6 to 4 on any Step or Step component effective July 2021. This change balances the competing interests of fairness and examination access to the examinee population, while simultaneously maintaining a minimum standard consistent with the mission of the USMLE program to protect the public.
Association Between Exposure to Complementary and Integrative Therapies and Opioid Analgesic Daily Dose Among Patients on Long-term Opioid Therapy
Authors: Black Anne C. , Zeliadt Steven B. , Kerns Robert D. , Skanderson Melissa , Wang Rixin , Gelman Hannah , Douglas Jamie H. , Becker William C.
Published: April 2022

Objectives:

To describe the association between exposure to selected complementary and integrative health (CIH) modalities and the trajectory of prescribed opioid analgesic dose within a national cohort of patients receiving long-term opioid therapy (LTOT) in the Veterans Health Administration (VHA).

Materials and Methods:

Using national data from VHA electronic health records between October 1, 2017 and September 30, 2019, CIH use was analyzed among 57,437 patients receiving LTOT within 18 VHA facilities serving as evaluation sites of VHA’s Whole Health System of Care. Using linear mixed effects modeling controlling for covariates, opioid dose was modeled as a function of time, CIH exposure, and their interaction.

Results:

Overall, 11.91% of patients on LTOT used any of the focus CIH therapies; 43.25% of those had 4 or more encounters. Patients used acupuncture, chiropractic care, and meditation modalities primarily. CIH use was associated with being female, Black, having a mental health diagnosis, obesity, pain intensity, and baseline morphine-equivalent daily dose. Mean baseline morphine-equivalent daily dose was 40.81 milligrams and dose decreased on average over time. Controlling for covariates, patients with any CIH exposure experienced 38% faster dose tapering, corresponding to a mean difference in 12-month reduction over patients not engaging in CIH of 2.88 milligrams or 7.06% of the mean starting dose.

Discussion:

Results support the role of CIH modalities in opioid tapering. The study design precludes inference about the causal effects of CIH on tapering. Analyses did not consider the trend in opioid dose before cohort entry nor the use of other nonopioid treatments for pain. Future research should address these questions and consider tapering-associated adverse events.
Estimation of Occupational Noise–Induced Hearing Loss Using Kurtosis-Adjusted Noise Exposure Levels
Authors: Zhang Meibian , Gao Xiangjing , Murphy William J. , Kardous Chucri A. , Sun Xin , Hu Weijiang , Gong Wei , Li Jingsong , Qiu Wei
Published: April 2022

Objectives:

Studies have shown that in addition to energy, kurtosis plays an important role in the assessment of hearing loss caused by complex noise. The objective of this study was to investigate how to use noise recordings and audiometry collected from workers in industrial environments to find an optimal kurtosis-adjusted algorithm to better evaluate hearing loss caused by both continuous noise and complex noise.

Design:

In this study, the combined effects of energy and kurtosis on noise-induced hearing loss (NIHL) were investigated using data collected from 2601 Chinese workers exposed to various industrial noises. The cohort was divided into three subgroups based on three kurtosis (β) levels (K1: 3 ≤ β ≤ 10, K2: 10 <β ≤ 50, and K3: β > 50). Noise-induced permanent threshold shift at test frequencies 3, 4, and 6 kHz (NIPTS346) was used as the indicator of NIHL. Predicted NIPTS346 was calculated using the ISO 1999 model for each participant, and the actual NIPTS was obtained by correcting for age and sex using non-noise-exposed Chinese workers (n = 1297). A kurtosis-adjusted A-weighted sound pressure level normalized to a nominal 8-hour working day (LAeq,8h) was developed based on the kurtosis categorized group data sets using multiple linear regression. Using the NIPTS346 and the LAeq.8h metric, a dose-response relationship for three kurtosis groups was constructed, and the combined effect of noise level and kurtosis on NIHL was investigated.

Results:

An optimal kurtosis-adjusted LAeq,8h formula with a kurtosis adjustment coefficient of 6.5 was established by using the worker data. The kurtosis-adjusted LAeq,8h better estimated hearing loss caused by various complex noises. The analysis of the dose-response relationships among the three kurtosis groups showed that the NIPTS of K2 and K3 groups was significantly higher than that of K1 group in the range of 70 dBA ≤ LAeq,8h < 85 dBA. For 85 dBA ≤ LAeq,8h ≤ 95 dBA, the NIPTS346 of the three groups showed an obvious K3 > K2 > K1. For LAeq,8h >95 dBA, the NIPTS346 of the K2 group tended to be consistent with that of the K1 group, while the NIPTS346 of the K3 group was significantly larger than that of the K1 and K2 groups. When LAeq,8h is below 70 dBA, neither continuous noise nor complex noise produced significant NIPTS346.

Conclusions:

Because non-Gaussian complex noise is ubiquitous in many industries, the temporal characteristics of noise (i.e., kurtosis) must be taken into account in evaluating occupational NIHL. A kurtosis-adjusted LAeq,8h with an adjustment coefficient of 6.5 allows a more accurate prediction of high-frequency NIHL. Relying on a single value (i.e., 85 dBA) as a recommended exposure limit does not appear to be sufficient to protect the hearing of workers exposed to complex noise.
Advances in the clinical use of hydroxychloroquine levels
Authors: Chakrabarti Katherine , McCune W. Joseph
Published: April 2022

Purpose of review

This review summarizes the recent literature exploring hydroxychloroquine levels and their relationship with disease activity and risk of toxicity.

Recent findings

There is no clear correlation between weight-based dosing of hydroxychloroquine and the resulting blood levels of the medication. Recent studies have shown that increased hydroxychloroquine levels are associated with lower lupus disease activity and likely also increased risk of medication toxicity.

Mounting evidence supports use of hydroxychloroquine levels in clinical practice to document adherence and ensure safety.
Therapeutic advances in eosinophilic granulomatosis with polyangiitis
Authors: Ford Julia A. , Aleatany Yaseen , Gewurz-Singer Ora
Published: April 2022

Purpose of review

In recent years, therapeutic advances in eosinophilic granulomatosis with polyangiitis (EGPA) have changed our treatment paradigm. This review will summarize and discuss updates in management of EGPA, with a particular focus on biologic therapies.

Recent findings

The anti-interleukin (IL)-5 agent mepolizumab (the first FDA-approved drug specifically for EGPA) is effective in induction and maintenance of remission particularly in patients with predominantly asthma and allergic manifestations, though efficacy in ANCA-positive, vasculitic disease is unclear; additional anti-IL-5 agents are under study. Rituximab is currently recommended for remission induction in severe disease, particularly in ANCA-positive patients with vasculitic manifestations, though the supportive evidence is mostly observational. Evidence supporting use of traditional DMARDs and other biologic agents such as omalizumab remains limited and observational.

Although management of this heterogeneous disease remains challenging and unanswered questions remain, advances in biologics (particularly anti-IL-5 agents and an evolving interest in rituximab) have expanded our treatment armamentarium in EGPA.
Sympathetic modulation of tumor necrosis factor alpha-induced nociception in the presence of oral squamous cell carcinoma
Authors: Atherton Megan A. , Park Stella , Horan Nicole L. , Nicholson Samuel , Dolan John C. , Schmidt Brian L. , Scheff Nicole N.
Published: April 2022

Head and neck squamous cell carcinoma (HNSCC) causes more severe pain and psychological stress than other types of cancer. Despite clinical evidence linking pain, stress, and cancer progression, the underlying relationship between pain and sympathetic neurotransmission in oral cancer is unknown. We found that human HNSCC tumors and mouse tumor tissue are innervated by peripheral sympathetic and sensory nerves. Moreover, β-adrenergic 1 and 2 receptors (β-ARs) are overexpressed in human oral cancer cell lines, and norepinephrine treatment increased β-AR2 protein expression as well as cancer cell proliferation in vitro. We have recently demonstrated that inhibition of tumor necrosis factor alpha (TNFα) signaling reduces oral cancer-induced nociceptive behavior. Norepinephrine-treated cancer cell lines secrete more TNFα which, when applied to tongue-innervating trigeminal neurons, evoked a larger Ca2+ transient; TNF–TNFR inhibitor blocked the increase in the evoked Ca2+ transient. Using an orthotopic xenograft oral cancer model, we found that mice demonstrated significantly less orofacial cancer-induced nociceptive behavior during systemic β-adrenergic inhibitory treatment with propranolol. Furthermore, chemical sympathectomy using guanethidine led to a significant reduction in tumor size and nociceptive behavior. We infer from these results that sympathetic signaling modulates oral cancer pain through TNFα secretion and tumorigenesis. Further investigation of the role of neurocancer communication in cancer progression and pain is warranted.
Chronic pain domains and their relationship to personality, abilities, and brain networks
Authors: Pinto Camila Bonin , Bielefeld Jannis , Barroso Joana , Yip Byron , Huang Lejian , Schnitzer Thomas , Apkarian A. Vania
Published: April 2022

Chronic pain is a multidimensional pathological state. Recent evidence suggests that specific brain properties and patients' psychological and physical traits are distorted in chronic pain patients. However, the relationship between these alterations and pain dimensions remains poorly understood. Here, we first evaluated multiple dimensions of chronic pain by assessing a broad battery of pain-related questionnaire scores (23 outcomes) of 107 chronic low back pain patients and identified 3 distinct chronic pain domains: magnitude, affect & disability, and quality. Second, we investigated the pain domains relationship with measures of personality, social interaction, psychological traits, and ability traits (77 biopsychosocial & ability [biopsy&ab] outcomes). Pain magnitude (out-of-sample [OOS]

) is associated with emotional control, attention, and working memory, with higher pain scores showing lower capacity to regulate and adapt behaviorally. Pain affect & disability (OOS

associated with anxiety, catastrophizing and social relationships dysfunction. Pain quality did not relate significantly to biopsy&ab variables. Third, we mapped these 3 pain domains to brain functional connectivity. Pain magnitude mainly associated with the sensorimotor and the cingulo-opercular networks (OOS

). Pain affect & disability related to frontoparietal and default mode networks (OOS

. Pain quality integrated sensorimotor, auditory, and cingulo-opercular networks (OOS

). Mediation analysis could link functional connectivity and biopsy&ab models to respective pain domains. Our results provide a global overview of the complexity of chronic pain, showing how underlying distinct domains of the experience map to different biopsy&ab correlates and underlie unique brain network signatures.
Presentation, Management, and Outcome of Congenital Portosystemic Shunts in Children: The Boston Children’s Hospital Experience
Authors: Fahmy Doaa M. , Mitchell Paul D. , Jonas Maureen M.
Published: April 2022

Objectives:

Congenital portosystemic shunts (CPSS) are rare vascular malformations. We describe presentations, complications, associations, and outcomes of CPSS at Boston Children’s Hospital (BCH).

Methods:

This was a retrospective review of children with CPSS at BCH from 2000 to 2020.

Results:

Twenty-nine patients had CPSS (17 girls): 14 extrahepatic (EH) and 15 intrahepatic (IH). At diagnosis, 15 were ≤5 days, 7 <1 year, and 7 >1 year (range 1–19). Median follow-up duration was 5.2 years (interquartile range [IQR] 1.6–10.9) in EH and 2.2 years (0.2–4.2) in IH CPSS. The most common presentation was antenatal ultrasound 13 (45%) followed by hyperammonemia 10 (34%), whereas 6 (21%) were asymptomatic. Complications were noted in 17 (12/14 EH vs 6/15 IH, P = 0.008). Associated anomalies were present in 25 (14/14 EH vs 11/15 IH, P = 0.10). Spontaneous closure was observed in 8 (28%) patients with IH CPSS, all <12 months of age. Ten patients underwent shunt closure 3 (30%) by interventional radiology (IR) and 5 (50%) by surgery, whereas 2 (20%) required both. After therapeutic closure; 8 had improvement, 1 had portal hypertension, and 1 had sepsis and thrombosis. The remaining 11 patients, 8 (42%) were followed without closure: 6 of 8 (75%) EH versus 2 of 11 (18%) IH (P = 0.02), 2 lost follow-up and 1 with complicated EH CPSS died, unsuitable for therapeutic closure.

Conclusions:

CPSS may be asymptomatic or present with complications. Spontaneous closure of IH shunts may occur in infancy, thus therapeutic closure may be deferred until age ≥ 2 years. IR and surgical closure of CPSS are associated with improvement in the majority of cases.
Use of Cluster Analysis to Identify Subtypes of Pediatric Functional Nausea
Authors: Sullivan Erin C. , Fortunato John E. , Gray Elizabeth , Tarbell Sally E.
Published: April 2022

Objective:

The aim of the study was to evaluate whether there are clinical subtypes in children with functional nausea based on comorbidities and responses to the Nausea Profile questionnaire.

Methods:

Patients from the Neurointestinal and Motility Program clinical registry at Lurie Children's Hospital were included if they met Rome IV criteria for functional nausea. Patients completed the Nausea Profile, a multidimensional measure of nausea with gastrointestinal, emotional, and somatic subscales. Comorbidities were assessed by chart review and self‐report measures. Latent class analysis was used to identify patient groups based on comorbidities. To assess if model‐identified groups were predictive of differences in nausea quality, Nausea Profile subscale means were compared between groups and used to predict group membership. Conversely, k‐means analysis was used to divide the sample into groups based upon Nausea Profile subscale scores, to determine if identified groups had different comorbidities.

Results:

Seventy‐two patients (n = 53 girls) with a mean age (±SD) 14.5 ± 2.9 were included. Two clinical subtypes were identified based on comorbidities, with responses on the emotional subscale of the Nausea Profile predicting group membership (P < 0.04). When patients were grouped by nausea quality, the resulting clusters differed on psychiatric comorbidities (P < 0.001)

Conclusions:

Our findings support the existence of nausea subtypes within the broad diagnosis of functional nausea. One such subtype is an emotional predominant nausea supporting the notion that anxiety and depression constitute a subset of patients with nausea. Thus, patients may benefit from a treatment approach that integrates both GI assessment and psychiatric support in their care.
Insight Into the Adolescent Patient Experience With Nonalcoholic Fatty Liver Disease
Authors: Ley Sanita L. , Kidwell Katherine M. , Van Dyk Tori R. , Orkin Sarah , Odar Stough Cathleen , Howarth Taylor , Goetz Amy R. , Xanthakos Stavra A. , Bramlage Kristin , Mouzaki Marialena , Arce-Clachar Ana Catalina , Zeller Meg H.
Published: April 2022

Objectives:

Nonalcoholic fatty liver disease (NAFLD) is the leading chronic liver disease in youth, yet little is known about the adolescent patient’s experience with NAFLD, which is key for treatment engagement. We examined adolescents’ experiences with NAFLD diagnosis, thoughts on how NAFLD affects their daily life, understanding and perceptions of diagnosis and treatment, and impressions of how to improve care.

Methods:

Utilizing a mixed-method design, adolescents with NAFLD (N = 16; Mean
age
= 15.8 years; Mean
BMI
= 37 kg/m2) participated in focus groups. To supplement qualitative data, adolescents and their caregiver completed measures assessing illness perceptions, adolescent quality of life, and eating/activity behaviors.

Results:

Focus group themes suggested reactions to diagnosis varied from unconcerned to anxious. NAFLD diagnosis occurred within the context of other psychological/medical concerns and was not perceived to affect most adolescents’ daily lives. Although adolescents understood general contributors to NAFLD, comprehension of their diagnosis varied. Adolescents were more likely to make lifestyle changes when families were supportive, and they preferred tailored recommendations for health behavior change from the healthcare team. Notably, 62.5% of adolescents were more concerned about their weight than NAFLD. Almost half (43.8%) identified as food insecure.

Conclusions:

Adolescents with NAFLD may benefit from personalized treatment. Care could be enhanced by ensuring comprehension of diagnosis, problem-solving personal, and family barriers and increasing family support. Harnessing adolescents’ desire for weight loss may be a more salient driver for change in disease status. Interventions should also address systemic barriers such as food insecurity to ensure equitable care.
Qualitative analysis of randomized controlled trials informing recommendations for venous thromboembolism prophylaxis after distal lower extremity injuries
Authors: Folsom Aaron J. , Polmear Michael M. , Scanaliato John P. , Dunn John C. , Adler Adam H. , Orr Justin D.
Published: April 2022

Purpose:

The purpose of this study is to assess the quality of evidence to stratify recommendations for chemoprophylaxis following distal lower extremity trauma.

Methods:

Literature review identified primary studies investigating venous thromboembolism (VTE) chemoprophylaxis following traumatic injury distal to the knee. Inclusion criteria were randomized controlled trials in adult patients treated with and without operative intervention. Each primary study was assessed by the Consolidated Standards of Reporting Trials 2010 checklist and Modified Coleman methodology score.

Results:

Literature review resulted in 462 studies, of which 9 met inclusion and exclusion criteria. All studies included low molecular weight heparin as a treatment group with 2 (22%) also including a treatment group with a direct factor Xa inhibitor. Five studies (56%) used placebo as a control group. The mean Modified Coleman Methodology score was 63% (range 51%–72%), a categorical rating of Fair. The mean Consolidated Standards of Reporting Trials score was 78% (range 56%–97%). Most studies (89%) screened all asymptomatic subjects for deep venous thrombosis. Statistical significance in VTE incidence among prophylactic treatment groups was not achieved in 78%.

Conclusions:

Development of consensus for VTE prophylaxis recommendations following traumatic injury distal to the knee is complicated by heterogenous study populations, low incidence of VTE in study populations, and inconsistent definitions of clinically important VTE. Low molecular weight heparin is not consistently superior for preventing VTE. Chemoprophylaxis should be considered on an individual basis in the presence of additional risk factors, although an externally validated, evidence-based risk assessment tool does not currently exist.

Level of Evidence: IV, therapeutic
The methodological quality of physical therapy related trials published in open access and subscription journal: A cross sectional meta-epidemiological study
Authors: Ariie Takashi , Tsutsumi Yusuke , Taito Shunsuke
Published: April 2022

Objective

We aimed to compare the methodological quality of physical therapy-related trials published in open access with that of trials published in subscription-based journals, adjusting for subdiscipline, intervention type, endorsement of the consolidated standards of reporting trials (CONSORT), impact factor, and publication language.

Design

In this meta-epidemiological study, we searched the Physiotherapy Evidence Database (PEDro) on May 8, 2021, to include any physical therapy-related trials published from January 1, 2020. We extracted variables such as CONSORT endorsement, the PEDro score, and publication type. We compared the PEDro score between the publication types using a multivariable generalized estimating equation (GEE) by adjusting for covariates.

Results

A total of 2,743 trials were included, with a mean total PEDro score (SD) of 5.8 (±1.5). Trials from open access journals had a lower total PEDro score than those from subscription-based journals (5.5 ± 1.5 vs. 5.9 ± 1.5, mean difference [MD]: −0.4; 95% confidence interval: 0.3–0.5). GEE revealed that open access publication was significantly associated with the total PEDro score (MD: −0.42; P < 0.001).

Conclusions

In the recent physical therapy-related trials, open access publications demonstrated lower methodological quality than subscription-based publications, although with a small difference.
Estimating the Impact of Postamputation Pain
Authors: Liston Jared M. , Forster Grace L. , Samuel Ankhita , Werner Brian C. , Stranix John T. , DeGeorge Brent R.
Published: April 2022

Background

Neuromas, neuralgia, and phantom limb pain commonly occur after lower-extremity amputations; however, incidence of these issues is poorly reported and understood. Present literature is limited to small cohort studies of amputees, and the reported incidence of chronic pain after amputation ranges as widely as 0% to 80%. We sought to objectively investigate the incidence of postamputation pain and nerve-related complications after lower-extremity amputation.

Methods

Patients who underwent lower-extremity amputation between 2007 and 2017 were identified using a national insurance-based claims database. Incidence of reporting of postoperative neuroma, neuralgia, and phantom limb pain were identified. Patient demographics and comorbidities were assessed. Average costs of treatment were determined in the year after lower-extremity amputation. Logistic regression analyses and resulting odds ratios were calculated to determine statistically significant increases in incidence of postamputation nerve-related pain complications in the setting of demographic factors and comorbidities.

Results

There were 29,507 lower amputations identified. Postoperative neuralgia occurred in 4.4% of all amputations, neuromas in 0.4%, and phantom limb pain in 10.9%. Nerve-related pain complications were most common in through knee amputations (20.3%) and below knee amputations (16.7%). Male sex, Charlson Comorbidity Index > 3, diabetes mellitus, diabetic neuropathy, diabetic angiopathy, diabetic retinopathy, obesity, peripheral vascular disease, and tobacco abuse were associated with statistically significant increases in incidence of 1-year nerve-related pain or phantom limb pain.

Conclusions

Given the incidence of these complications after operative extremity amputations and associated increased treatment costs, future research regarding their pathophysiology, treatment, and prevention would be beneficial to both patients and providers.
Localization of Chronic Pain in Postmastectomy Patients
Authors: Shiraishi Makoto , Sowa Yoshihiro , Kodama Takuya , Numajiri Toshiaki , Taguchi Tetsuya , Amaya Fumimasa
Published: April 2022

Background

After breast surgery with or without immediate reconstruction, chronic pain can be a major problem for patients. However, few studies have examined the details of the sites of long-lasting postoperative pain. In this study, we specified the postoperative pain location after breast surgery, including reconstruction, to find ways to improve surgical procedures or provide effective pain relief.

Methods

The subjects were 205 Japanese women undergoing mastectomy or breast reconstruction with a tissue expander (TE)/implant or a deep inferior epigastric perforator (DIEP) flap. Patients were asked whether they had pain in different parts of the body at 1 year after surgery. Differences were assessed by cross-tabulation and χ2 statistics.

Results

Surveys were completed by 157 subjects. Deep inferior epigastric perforator flap cases had significantly more pain and TE/Imp cases had significantly less pain in the medial breast, upper breast, breast upper medial quadrant, and abdomen (P = 0.006, P = 0.006, P < 0.001, P < 0.001, respectively). In the neck area, pain in TE/Imp cases was significantly worse than that in all other patients (P = 0.025). There was no significant difference in chronic pain in any other body regions among the mastectomy only, TE/Imp, and DIEP flap groups.

Conclusions

The results of the present study revealed that the localization of prolonged postoperative pain after breast surgery differs depending on the surgical procedure. In DIEP flap reconstruction, there was a marked tendency for pain in the inner and upper chest and in the abdomen, whereas TE/IMP surgery resulted in pain around the neck of the affected side. These findings may help improve surgical methods and establish effective pain relief that focuses on the identified pain areas.
Square Flap Method for Reconstruction of Palmar and Dorsal Web Space Burn Contractures
Authors: Hifny Mahmoud A. , Ogawa Rei
Published: April 2022

Background

Postburn web space contractures can result in serious in hand function impairments along with cosmetic disfigurement. In our study, we introduce our experience with the use of the square flap method to release palmar or dorsal web space contractures.

Materials and Methods

From March 2019 to May 2021, the square flap method was conducted in 12 patients with 13 digital web space contractures.

Results

The average patient's age was 6 years old (range, 2.5–16 years old). The most common affected web space was the second web. Web contractures were palmar in 9 patients and dorsal in 4 patients. The average duration of scar maturity was 13.6 months (range, 8–24 months). All the square flaps were effective in releasing the web space contracture and healed uneventfully with no postoperative complications. The average follow-up period was 11 months (range, 2–24 months). All patients or their parents were satisfied with the procedure outcomes in terms of independent finger function and esthetic appearance.

Conclusions

The square flap technique is safe, reliable, and effective in management of both dorsal and palmar interdigital web scar contracture. It completely eliminates the contracture and restores commissural anatomy with good cosmetic outcomes.
Wide-range viscoelastic compression forces in microfluidics to probe cell-dependent nuclear structural and mechanobiological responses
Authors: Maremonti Maria Isabella , Panzetta Valeria , Dannhauser David , Netti Paolo Antonio , Causa Filippo
Published: April 2022

The cell nucleus plays a critical role in mechanosensing and mechanotransduction processes, by adaptive changes of its envelope composition to external biophysical stimuli such as substrate rigidity and tensile forces. Current measurement approaches lack precise control in stress application on nuclei, thus significantly impairing a complete mechanobiological study of cells. Here, we present a contactless microfluidic approach capable to exert a wide range of viscoelastic compression forces (10–10
3
µN)—as an alternative to adhesion-related techniques—to induce cell-specific mechano-structural and biomolecular changes. We succeed in monitoring substantial nuclear modifications in Lamin A/C expression and coverage, diffusion processes of probing molecules, YAP shuttling, chromatin re-organization and cGAS pathway activation. As a result, high compression forces lead to a nuclear reinforcement (e.g. up to +20% in Lamin A/C coverage) or deconstruction (e.g. down to −45% in Lamin A/C coverage with a 30% reduction of chromatin condensation state parameter) up to cell death. We demonstrate how wide-range compression on suspended cells can be used as a tool to investigate nuclear mechanobiology and to define specific nuclear signatures for cell mechanical phenotyping.
The role of procoagulant phospholipids on the surface of circulating blood cells in thrombosis and haemostasis
Authors: Protty Majd B. , Jenkins P. Vince , Collins Peter W. , O'Donnell Valerie B.
Published: April 2022

Phospholipids (PLs) are found in all cell types and are required for structural support and cell activation signalling pathways. In resting cells, PLs are asymmetrically distributed throughout the plasma membrane with native procoagulant aminophospholipids (aPLs) being actively maintained in the inner leaflet of the membrane. Upon platelet activation, aPLs rapidly externalize to the outer leaflet and are essential for supporting the coagulation cascade by providing binding sites for factors in the cell-based model. More recent work has uncovered a role for enzymatically oxidized PLs (eoxPLs) in facilitating coagulation, working in concert with native aPLs. Despite this, the role of aPLs and eoxPLs in thrombo-inflammatory conditions, such as arterial and venous thrombosis, has not been fully elucidated. In this review, we describe the biochemical structures, distribution and regulation of aPL externalization and summarize the literature on eoxPL generation in circulating blood cells. We focus on the currently understood role of these lipids in mediating coagulation reactions
in vitro
,
in vivo
and in human thrombotic disease. Finally, we highlight gaps in our understanding in how these lipids vary in health and disease, which may place them as future therapeutic targets for the management of thrombo-inflammatory conditions.
Discrete integrable equations on face-centred cubics: consistency and Lax pairs of corner equations
Authors: Kels Andrew P.
Published: April 2022

A new set of discrete integrable equations, called face-centred quad equations, was recently obtained using new types of interaction-round-a-face solutions of the classical Yang–Baxter equation. These equations satisfy a new formulation of multidimensional consistency, known as consistency-around-a-face-centred-cube (CAFCC), which requires consistency of an overdetermined system of 14 five-point equations on the face-centred cubic unit cell. In this paper, a new formulation of CAFCC is introduced where so-called type C equations are centred at faces of the face-centred cubic unit cell, whereas previously they were only centred at corners. This allows type C equations to be regarded as independent multidimensionally consistent integrable systems on higher dimensional lattices and is used to establish their Lax pairs.
Viscoacoustic wave equations for the power-law dependence of
Q
on frequency
Authors: Hao Qi , Greenhalgh Stewart
Published: April 2022

The power-law dependence of the quality factor

Q

on frequency (i.e.

Q
=

Q

0

|

f

/

f

0

|

γ

), which is called the power-law frequency-dependent

Q

for brevity, is a common phenomenological description of seismic wave attenuation in the interior of the Earth. The wave equation in differential form is essential to forward and inverse modelling of dissipative seismic waveforms in an accurate and efficient manner. However, all existing methods are seemingly unable to explicitly incorporate the exponent parameter

γ

into the wave equation in differential form. This drawback apparently limits the development of gradient-based inverse methods for spatially varying

γ

via the wave equation. In this paper, we use a weighting function method to derive the viscoacoustic wave equations for the power-law frequency-dependent

Q

, which explicitly involve the parameters

γ

and

Q

0

. A critical step in this method is to construct a dissipative model, for which the complex modulus is expressed as an

N

-order series in terms of the weighting function. Numerical examples are used to illustrate the accuracy of the dissipative model, the effect of

γ

on waveforms, and the application of the newly proposed wave equations in viscoacoustic wavefield modelling for the power-law frequency-dependent

Q

.
Handlebody decompositions of three-manifolds and polycontinuous patterns
Authors: Sakata N. , Mishina R. , Ogawa M. , Ishihara K. , Koda Y. , Ozawa M. , Shimokawa K.
Published: April 2022

We introduce the concept of a handlebody decomposition of a three-manifold, a generalization of a Heegaard splitting, or a trisection. We show that two handlebody decompositions of a closed orientable three-manifold are stably equivalent. As an application to materials science, we consider a mathematical model of polycontinuous patterns and discuss a topological study of microphase separation of a block copolymer melt.
Cross-ocean patterns and processes in fish biodiversity on coral reefs through the lens of eDNA metabarcoding
Authors: Mathon Laetitia , Marques Virginie , Mouillot David , Albouy Camille , Andrello Marco , Baletaud Florian , Borrero-Pérez Giomar H. , Dejean Tony , Edgar Graham J. , Grondin Jonathan , Guerin Pierre-Edouard , Hocdé Régis , Juhel Jean-Baptiste , Kadarusman  , Maire Eva , Mariani Gael , McLean Matthew , Polanco F. Andrea , Pouyaud Laurent , Stuart-Smith Rick D. , Sugeha Hagi Yulia , Valentini Alice , Vigliola Laurent , Vimono Indra B. , Pellissier Loïc , Manel Stéphanie
Published: April 2022

Increasing speed and magnitude of global change threaten the world's biodiversity and particularly coral reef fishes. A better understanding of large-scale patterns and processes on coral reefs is essential to prevent fish biodiversity decline but it requires new monitoring approaches. Here, we use environmental DNA metabarcoding to reconstruct well-known patterns of fish biodiversity on coral reefs and uncover hidden patterns on these highly diverse and threatened ecosystems. We analysed 226 environmental DNA (eDNA) seawater samples from 100 stations in five tropical regions (Caribbean, Central and Southwest Pacific, Coral Triangle and Western Indian Ocean) and compared those to 2047 underwater visual censuses from the Reef Life Survey in 1224 stations. Environmental DNA reveals a higher (16%) fish biodiversity, with 2650 taxa, and 25% more families than underwater visual surveys. By identifying more pelagic, reef-associated and crypto-benthic species, eDNA offers a fresh view on assembly rules across spatial scales. Nevertheless, the reef life survey identified more species than eDNA in 47 shared families, which can be due to incomplete sequence assignment, possibly combined with incomplete detection in the environment, for some species. Combining eDNA metabarcoding and extensive visual census offers novel insights on the spatial organization of the richest marine ecosystems.
Sinomicrobium weinanense sp. nov., a halophilic bacterium isolated from saline-alkali soil
Authors: Wu Pengyu , Ren Haoran , Zhu Qiuyan , Mei Yuxia , Liang Yunxiang , Chen Zhenmin
Published: April 2022

A Gram-stain-negative, facultative anaerobic, non-motile, rod-shaped strain was isolated from saline-alkali soil collected in PR China, and it was designated as strain FJxs
T
. Its optimal growth was observed at 37–40 °C in the presence of 0–3 % (w/v) NaCl (pH 7.0). The major fatty acids of strain FJxs
T
were iso-C15 : 0, iso-C17 : 0 3OH, summed feature 3, C16 : 0 and iso-C15 : 1 G. The predominant respiratory quinone was menaquinone 6. The DNA G+C content of the strain was 45.18 mol%. Whole genome and 16S rRNA gene sequence analyses indicated that strain FJxs
T
exhibited 94.78 % sequence identity (the maximum) with

Sinomicrobium soli

N-1-3-6T, 94.36 % with

Sinomicrobium pectinilyticum

5DNS001T, and 93.52 % with

Sinomicrobium oceani

SCSIO 03483T. Analyses of genotypic, phenotypic, phylogenetic and chemotaxonomic characteristics indicated that strain FJxs
T
represented a novel species of the genus

Sinomicrobium

. This novel species was named Sinomicrobium weinanense sp. nov. with its type strain as FJxs
T
(=CCTCC AB 2019251T=KCTC 72740T).
Hospital outbreak of carbapenem-resistant Enterobacterales associated with a bla
OXA-48 plasmid carried mostly by Escherichia coli ST399
Authors: Ledda Alice , Cummins Martina , Shaw Liam P. , Jauneikaite Elita , Cole Kevin , Lasalle Florent , Barry Deborah , Turton Jane , Rosmarin Caryn , Anaraki Sudy , Wareham David , Stoesser Nicole , Paul John , Manuel Rohini , Cherian Benny P. , Didelot Xavier
Published: April 2022

A hospital outbreak of carbapenem-resistant Enterobacterales was detected by routine surveillance. Whole genome sequencing and subsequent analysis revealed a conserved promiscuous bla
OXA-48 carrying plasmid as the defining factor within this outbreak. Four different species of Enterobacterales were involved in the outbreak.

Escherichia coli

ST399 accounted for 35 of all the 55 isolates. Comparative genomics analysis using publicly available

E. coli

ST399 genomes showed that the outbreak

E. coli

ST399 isolates formed a unique clade. We developed a mathematical model of pOXA-48-like plasmid transmission between host lineages and used it to estimate its conjugation rate, giving a lower bound of 0.23 conjugation events per lineage per year. Our analysis suggests that co-evolution between the pOXA-48-like plasmid and

E. coli

ST399 could have played a role in the outbreak. This is the first study to report carbapenem-resistant

E. coli

ST399 carrying blaOXA-48 as the main cause of a plasmid-borne outbreak within a hospital setting. Our findings suggest complementary roles for both plasmid conjugation and clonal expansion in the emergence of this outbreak.
Dairy streptococcal cell wall and exopolysaccharide genome diversity
Authors: Parlindungan Elvina , McDonnell Brian , Lugli Gabriele A. , Ventura Marco , van Sinderen Douwe , Mahony Jennifer
Published: April 2022

The large-scale and high-intensity application of

Streptococcus thermophilus

species in milk fermentation processes is associated with a persistent threat of (bacterio)phage infection. Phage infection of starter cultures may cause inconsistent, slow or even failed fermentations with consequent diminished product quality and/or output. The phage life cycle commences with the recognition of, and binding to, a specific host-encoded and surface-exposed receptor, which in the case of

S. thermophilus

can be the rhamnose-glucose polysaccharide (RGP; specified by the rgp gene cluster) or exopolysaccharide (EPS; specified by the eps gene cluster). The genomic diversity of 23

S

.

thermophilus

strains isolated from unpasteurized dairy products was evaluated, including a detailed analysis of the rgp and eps loci. In the present study, five novel eps genotypes were identified while variations of currently recognized rgp gene cluster types were also observed. Furthermore, the diversity of rgp genotypes amongst retrieved isolates positively correlated with phage diversity based on phageome analysis of eight representative dairy products. Our findings therefore substantially expand our knowledge on S. thermophilus’ strain and phage diversity in (artisanal) dairy products and highlight the merit of phageome analysis of artisanal and traditional fermented foods as a sensitive marker of dominant microbiota involved in the fermentation.