bluuebunny/crossref_metadata_2025 huggingface dataset:
The effectiveness of manual and exercise therapy on headache intensity and frequency among patients with cervicogenic headache: a systematic review and meta-analysis
Authors: Bini Pietro , Hohenschurz-Schmidt David , Masullo Vincenzo , Pitt Diana , Draper-Rodi Jerry
Published: November 2022

Background

Cervicogenic headache is a secondary headache, and manual therapy is one of the most common treatment choices for this and other types of headache. Nonetheless, recent guidelines on the management of cervicogenic headache underlined the lack of trials comparing manual and exercise therapy to sham or no-treatment controls. The main objective of this systematic review and meta-analysis was to assess the effectiveness of different forms of manual and exercise therapy in people living with cervicogenic headache, when compared to other treatments, sham, or no treatment controls.

Methods

Following the PRISMA guidelines, the literature search was conducted until January 2022 on MEDLINE, CENTRAL, DOAJ, and PEDro. Randomized controlled trials assessing the effects of manual or exercise therapy on patients with cervicogenic headache with headache intensity or frequency as primary outcome measures were included. Study selection, data extraction and Risk of Bias (RoB) assessment were done in duplicate. GRADE was used to assess the quality of the evidence.

Results

Twenty studies were included in the review, with a total of 1439 patients. Common interventions were spinal manipulation, trigger point therapy, spinal mobilization, scapulo-thoracic and cranio-cervical exercises. Meta-analysis was only possible for six manual therapy trials with sham comparators. Data pooling showed moderate-to-large effects in favour of manual therapy for headache frequency and intensity at short-term, small-to-moderate for disability at short-term, small-to-moderate for headache intensity and small for headache frequency at long-term. A sensitivity meta-analysis of low-RoB trials showed small effects in favor of manual therapy in reducing headache intensity, frequency and disability at short and long-term. Both trials included in the sensitivity meta-analysis studied spinal manipulation as the intervention of interest. GRADE assessment showed moderate quality of evidence.

Conclusion

The evidence suggests that manual and exercise therapy may reduce headache intensity, frequency and disability at short and long-term in people living with cervicogenic headache, but the overall RoB in most included trials was high. However, a sensitivity meta-analysis on low-RoB trials showed moderate-quality evidence supporting the use of spinal manipulation compared to sham interventions. More high-quality trials are necessary to make stronger recommendations, ideally based on methodological recommendations that enhance comparability between studies.

Trial registration The protocol for this meta-analysis was pre-registered on PROSPERO under the registration number CRD42021249277.
An efficient preparation and biocatalytic synthesis of novel C-glycosylflavonols kaempferol 8-C-glucoside and quercetin 8-C-glucoside through using resting cells and macroporous resins
Authors: Wu Yangbao , Wang Huan , Liu Yang , Zhao Linguo , Pei Jianjun
Published: November 2022

Background

C-glycosylated flavonoids are a main type of structural modification and can endow flavonoids with greater stability, bioactivity, and bioavailability. Although some C-glycosylated flavonoids have been biosynthesized in vivo or vitro, only a few C-glycosylflavonols have been prepared by these methods.

Results

In this study, several uridine 5’-diphosphate (UDP)-glucose biosynthesis pathways and Escherichia coli hosts were screened to reconstruct recombinant strains for producing the novel C-glycosylflavonols kaempferol 8-C-glucoside and quercetin 8-C-glucoside. To increase C-glycosylflavonol production, the timing of flavonol addition was adjusted, and glycerol was added to avoid degradation of C-glycosylflavonols. By using resting cell bioconversion, the highest kaempferol 8-C-glucoside and quercetin 8-C-glucoside production reached 16.6 g/L and 12.5 g/L, respectively. Then, ultrasound-assisted adsorption/desorption was used to prepare C-glycosylflavonols by using macroporous resins. Through screening macroporous resins and optimizing the adsorption/desorption conditions, the highest adsorption capacity and desorption capacity for kaempferol 8-C-glucoside on HPD100 reached 28.57 mg/g and 24.15 mg/g, respectively. Finally, kaempferol 8-C-glucoside (15.4 g) with a yield of 93% and quercetin 8-C-glucoside (11.3 g) with a yield of 91% were obtained from 1 L of fermentation broth.

Conclusions

Kaempferol 8-C-glucoside and quercetin 8-C-glucoside are novel C-glycosylflavonols, which have not been extracted from plants. This study provides an efficient method for the preparation and biocatalytic synthesis of kaempferol 8-C-glucoside and quercetin 8-C-glucoside by metabolic engineering of Escherichia coli.

Graphical Abstract
Rheumatoid arthritis sera antibodies to citrullinated collagen type II bind to joint cartilage
Authors: Li Qixing , Li Yanpeng , Liang Bibo , Xu Rui , Xu Bingze , Lönnblom Erik , Feng Hui , Bai Jing’an , Stawikowska Roma , Ge Changrong , Lu Aiping , Fields Gregg B. , Xiao Lianbo , Holmdahl Rikard
Published: November 2022

Objective

To investigate the occurrence and frequency of anti-citrullinated protein antibodies (ACPA) to cyclic citrullinated type II collagen (COL2) epitope with a capacity to bind joint cartilage.

Methods

Luminex immunoassay was used to analyze serum antibody reactivity to 10 COL2-citrullinated peptides (ACC10) and corresponding arginine peptide controls in rheumatoid arthritis (RA), osteoarthritis (OA), and healthy individuals’ cohorts. Top ten “promiscuous” sera (cross-reactive with all ACC10) and top ten “private” sera (restrictedly reactive with one ACC10 peptide) from RA and OA cohorts were selected. Enzyme-linked immunosorbent assay (ELISA) was used to detect response to native COL2. Sera were analyzed with naive and arthritic joints from DBA/1J mice by immunohistochemistry, using monoclonal ACPAs and COL2 reactive antibodies with human Fc as comparison. Staining specificity was confirmed with C1 (a major antibody epitope on COL2) mutated mice and competitive blocking with epitope-specific antibodies.

Results

All patient sera bound ACC10 compared with control peptides but very few (3/40) bound native triple-helical COL2. Most sera (27/40) specifically bound to arthritic cartilage, whereas only one private RA serum bound to healthy cartilage. Despite very low titers, private sera from both RA and OA showed an epitope-specific response, documented by lack of binding to cartilage from C1-mutated mice and blocking binding to wild-type cartilage with a competitive monoclonal antibody. As a comparison, monoclonal ACPAs visualized typical promiscuous, or private reactivity to joint cartilage and other tissues.

Conclusion

ACPA from RA and OA sera, reactive with citrullinated non-triple-helical COL2 peptides, can bind specifically to arthritic cartilage.
Unveiling sex-based differences in Parkinson's disease: a comprehensive meta-analysis of transcriptomic studies
Authors: López-Cerdán Adolfo , Andreu Zoraida , Hidalgo Marta R. , Grillo-Risco Rubén , Català-Senent José Francisco , Soler-Sáez Irene , Neva-Alejo Almudena , Gordillo Fernando , de la Iglesia-Vayá María , García-García Francisco
Published: November 2022

Background

In recent decades, increasing longevity (among other factors) has fostered a rise in Parkinson's disease incidence. Although not exhaustively studied in this devastating disease, the impact of sex represents a critical variable in Parkinson’s disease as epidemiological and clinical features differ between males and females.

Methods

To study sex bias in Parkinson’s disease, we conducted a systematic review to select sex-labeled transcriptomic data from three relevant brain tissues: the frontal cortex, the striatum, and the substantia nigra. We performed differential expression analysis on each study chosen. Then we summarized the individual differential expression results with three tissue-specific meta-analyses and a global all-tissues meta-analysis. Finally, results from the meta-analysis were functionally characterized using different functional profiling approaches.

Results

The tissue-specific meta-analyses linked Parkinson’s disease to the enhanced expression ofMED31in the female frontal cortex and the dysregulation of 237 genes in the substantia nigra. The global meta-analysis detected 15 genes with sex-differential patterns in Parkinson’s disease, which participate in mitochondrial function, oxidative stress, neuronal degeneration, and cell death. Furthermore, functional analyses identified pathways, protein–protein interaction networks, and transcription factors that differed by sex. While male patients exhibited changes in oxidative stress based on metal ions, inflammation, and angiogenesis, female patients exhibited dysfunctions in mitochondrial and lysosomal activity, antigen processing and presentation functions, and glutamic and purine metabolism. All results generated during this study are readily available by accessing an open web resource (http://bioinfo.cipf.es/metafun-pd/) for consultation and reuse in further studies.

Conclusions

Our in silico approach has highlighted sex-based differential mechanisms in typical Parkinson Disease hallmarks (inflammation, mitochondrial dysfunction, and oxidative stress). Additionally, we have identified specific genes and transcription factors for male and female Parkinson Disease patients that represent potential candidates as biomarkers to diagnosis.
Copper-coated hospital surfaces: reduction of total bacterial loads and resistant Acinetobacter spp.
Authors: Blehm Cláudia Justin , Monteiro Marina Silveira Gregis , Bessa Marjo Cadó , Leyser Mariana , Dias Amanda Simão , Sumienski Juliana , Gallo Stephanie Wagner , da Silva Anelise Baptista , Barros Andressa , Marco Roberta , Preve Camila Piuco , Ferreira Carlos Alexandre Sanchez , Ramos Fabiano , de Oliveira Sílvia Dias
Published: November 2022

Healthcare-associated infections (HAIs) represent a global challenge and an even more staggering concern when related to microorganisms capable of resisting and surviving for long periods in the environment, such as Acinetobacter spp. Strategies that allow a reduction of pathogens from hospital environments represent an additional barrier in infection control protocols, minimizing transmission to hospitalized patients. Considering the antimicrobial properties of copper, here, the bacterial load and the presence of Acinetobacter spp. were monitored on high handling surfaces covered by 99.9% copper films on intensive and non-intensive care unit bedrooms in a tertiary care hospital. Firstly, copper-coated films were able to inhibit the adhesion and biofilm formation of A. baumannii strains in in vitro assays. On the other hand, Acinetobacter spp. were isolated from both copper-coated and uncoated surfaces in the hospital, although the majority was detected on surfaces without copper. All carbapenem-resistant A. baumannii isolates identified harbored the blaoxa-23 gene, while the A. nosocomialis isolates were susceptible to most antimicrobials tested. All isolates were susceptible to polymyxin B. Regarding the total aerobic bacteria, surfaces with copper-coated films presented lower total loads than those detected for controls. Copper coating films may be a workable strategy to mitigate HAIs, given their potential in reducing bacterial loads in nosocomial environments, including threatening pathogens like A. baumannii.
Anomaly detection by using a combination of generative adversarial networks and convolutional autoencoders
Authors: Luo Xukang , Jiang Ying , Wang Enqiang , Men Xinlei
Published: November 2022

With the development of full digitalization, the amount of time series data generated by sensors is ever-increasing; thus, time series outlier detection has become crucial. Moreover, in practice, discovering and flagging anomalies is very time-consuming and expensive. To solve this problem, unsupervised anomaly detection methods have often been used in the past, in which the model is trained with normal data to learn its behavioral patterns. Generative adversarial networks (GANs) can simulate complex and high-dimensional distributions of data and can be used to learn the behavioral patterns of normal data for unsupervised anomaly detection. However, because of the problem of convergence, GANs are difficult to train. Thus, USADs (an unsupervised anomaly detection model) utilize an autoencoder (AE) to undertake the task of the generator and discriminator and enhance the stability during adversarial training by using the AE to alleviate the problem of non-convergence encountered in GANs. Therefore, in this study, we used the USAD’s generative adversarial training architecture combined with convolutional AEs to improve the model’s feature extraction capabilities. In addition, to reduce false-positive outcomes caused by the prominent sharp points in the reconstructed data, we used the exponential weighted moving average method to smooth the reconstruction error, thereby improving the anomaly detection accuracy of the model. Finally, we experimented with real-world time-series data (ECG and 2D gesture) and verified that our approach could improve accuracy. Compared to the best in the comparison method, our model improved by 0.028% in AUROC, 0.233% in AUPRC, and 0.187% in F1 on average.
Using a theoretical framework to inform implementation of the patient-centred medical home (PCMH) model in primary care: protocol for a mixed-methods systematic review
Authors: Mazevska Deniza , Pearse Jim , Tierney Stephanie
Published: November 2022

Background

The patient-centred medical home (PCMH) was conceived to address problems that primary care practices around the world are facing, particularly in managing the increasing numbers of patients with multiple chronic diseases. The problems include fragmentation, lack of access and poor coordination. The PCMH is a complex intervention combining high-quality primary care with evidence-based disease management. Becoming a PCMH takes time and resources, and there is a lack of empirically informed guidance for practices. Previous reviews of PCMH implementation have identified barriers and enablers but failed to analyse the complex relationships between factors involved in implementation. Using a theoretical framework can help with this, giving a better understanding of how and why interventions work or do not work. This review will aim to refine an existing theoretical framework for implementing organisational change — the Consolidated Framework for Implementation Research (CFIR) — to apply to the implementation of the PCMH in primary care.

Methods

We will use the ‘best-fit’ framework approach to synthesise evidence for implementing the PCMH in primary care. We will analyse evidence from empirical studies against CFIR constructs. Where studies have identified barriers and enablers to implementing the PCMH not represented in the CFIR constructs, we will use thematic analysis to develop additional constructs to refine the CFIR. Searches will be undertaken in MEDLINE (Ovid), Embase (Ovid), Web of Science Core Collection (including Science Citation Index and Social Science Citation Index) and CINAHL. Gaps arising from the database search will be addressed through snowballing, citation tracking and review of reference lists of systematic reviews of the PCMH. We will accept qualitative, quantitative and mixed methods primary research studies published in peer-reviewed publications. A stakeholder group will provide input to the review.

Discussion

The review will result in a refined theoretical framework that can be used by primary care practices to guide implementation of the PCMH. Narrative accompanying the refined framework will explain how the constructs (existing and added) work together to successfully implement the PCMH in primary care. The unpopulated CFIR constructs will be used to identify where further primary research may be needed.

Systematic review registration

PROSPERO CRD42021235960
Water, land, and air: how do residents of Brazilian remote rural territories travel to access health services?
Authors: Almeida Patty Fidelis de , Santos Adriano Maia dos , Silva Cabral Lucas Manoel da , Anjos Eduarda Ferreira dos , Fausto Márcia Cristina Rodrigues , Bousquat Aylene
Published: November 2022

Background

Ensuring adequate and safe means of travel is essential for maintaining and improving the health and well-being of residents of rural communities worldwide. This article maps costs, distances, travel times, and means of elective and urgent/emergency health transport in Brazilian remote rural municipalities.

Methods

Multiple case studies were conducted in 27 remote rural municipalities using a qualitative method. A total of 178 key informants (managers, doctors, and nurses) were interviewed. Secondary data from national information systems were analyzed for the socioeconomic characterization, to identify the costs, distances, and travel times. Through the thematic content analysis of the interviews, the means of transport, and strategies developed by managers, professionals and users for their provision were identified.

Results

The costs of traveling between remote rural municipalities and locations where most of specialized and hospital services are centered can compromise a significant part of the families’ income. The insufficiency, restriction of days, times, and routes of health transport affects the selection of beneficiaries based on socioeconomic criteria in places of high vulnerability and less investment in road infrastructure. In remote rural municipalities, travelling to seek health care involves inter-municipal and intra-municipal flows, as their territories have dispersed populations. Several means of transport were identified – air, river, and land – which are often used in a complementary way in the same route. Some patients travel for more than 1000 km, with travel times exceeding 20 h, especially in the Amazon region. While the demands for urgent and emergency transport are partially met by national public policy, the same is not true for the elective transport of patients. The impossibility of providing health transport under the exclusive responsibility of the municipalities is identified.

Conclusions

For the remote rural municipalities populations, the absence of national public policies for sufficient, continuous, and timely provision of transport for health services worsens the cycle of inequities and compromises the assumption of the universal right to health care.
Success rates of MRSA decolonization and factors associated with failure
Authors: Yiek Wing-Kee , Tromp Mirjam , Strik-Albers Riet , van Aerde Koen , van der Geest-Blankert Nannet , Wertheim Heiman F. L. , Meijer Corianne , Tostmann Alma , Bleeker-Rovers Chantal P.
Published: November 2022

Background

We evaluated the success rate of MRSA decolonization directly after treatment and after one year in patients who were treated at the outpatient MRSA clinic of a large university medical centre to identify potential contributing factors to treatment success and failure.

Methods

Data from November 1, 2013 to August 1, 2020 were used. Only patients who had undergone complete MRSA decolonization were included. Risk factors for MRSA treatment failure were identified using a multivariable logistic regression model.

Results

In total, 127 MRSA carriers were included: 7 had uncomplicated carriage, 91 had complicated carriage, and 29 patients had complicated carriage in combination with an infection. In complicated carriers and complicated carriers with an infection final treatment was successful in 75.0%. Risk factors for initial treatment failure included having one or more comorbidities and not testing the household members. Risk factors for final treatment failure were living in a refugee centre, being of younger age (0–17 years), and having one or more comorbidities.

Conclusions

The results of this study indicate that patients with a refugee status and children treated at the paediatric clinic have a higher risk of MRSA decolonisation treatment failure. For this reason, it might be useful to revise decolonization strategies for these subgroups and to refer these patients to specialized outpatient clinics in order to achieve higher treatment success rates.
Evaluation of interrelatedness of cities in the territorial space of Russia
Authors: Manaeva Inna , Rastvortseva Svetlana , Kanishcheva Aleksandra
Published: November 2022

The purpose of the article is to carry out the analysis of interrelatedness of cities in the territorial space of Russia. The evaluation method is based on the calculation of global and local Moran's indexes for determination of interrelatedness of the adjacent territories by the following parameters: "population size", "population density", "average monthly salary", "shipping volume per capita". Represented as the study object were cities of the Volga Federal District of Russia with a population size over 100 thousand people in 2017. As a result of the calculations performed the leading cities were determined for all researched parameters. The quantitative evaluations obtained by the authors can be used for investigation of the leading cities effects and determination of the region development strategies.
Preliminary validation of the pica, ARFID and rumination disorder interview ARFID questionnaire (PARDI-AR-Q)
Authors: Bryant-Waugh Rachel , Stern Casey M. , Dreier Melissa J. , Micali Nadia , Cooke Lucy J. , Kuhnle Megan C. , Burton Murray Helen , Wang Shirley B. , Breithaupt Lauren , Becker Kendra R. , Misra Madhusmita , Lawson Elizabeth A. , Eddy Kamryn T. , Thomas Jennifer J.
Published: November 2022

Background

The Pica, ARFID, and Rumination Disorder Interview (PARDI) is a structured interview that can be used to determine diagnosis, presenting characteristics, and severity across three disorders, including avoidant/restrictive food intake disorder (ARFID). The purpose of this study was to evaluate the psychometric properties of a questionnaire focused specifically on ARFID (PARDI-AR-Q), which has the potential to provide related information with less participant burden.

Methods

Adolescents and adults (n = 71, ages 14–40 years) with ARFID (n = 42) and healthy control participants (HC, n = 29) completed the PARDI-AR-Q and other measures. A subset of the ARFID group (n = 27) also completed the PARDI interview.

Results

An exploratory factor analysis of proposed subscale items identified three factors corresponding to the ARFID phenotypes of avoidance based on the sensory characteristics of food, lack of interest in eating or food, and concern about aversive consequences of eating. Further analyses supported the internal consistency and convergent validity of the PARDI-AR-Q subscales, and subscale ratings on the questionnaire showed large and significant correlations (all p-values < 0.001; r’s ranging from 0.48 to 0.77) with the corresponding subscales on the interview. The ARFID group scored significantly higher than HC on all subscales. Furthermore, 90% of the ARFID group scored positive on the PARDI-AR-Q diagnostic algorithm while 93% of the HC scored negative.

Conclusions

Though replication in larger and more diverse samples is needed, findings provide early support for the validity of the PARDI-AR-Q as a self-report measure for possible ARFID in clinical or research settings.
Home care nurses’ management of high-risk medications: a cross-sectional study
Authors: Dumitrescu Irina , Casteels Minne , De Vliegher Kristel , Mortelmans Laura , Dilles Tinne
Published: November 2022

Background

High-risk medications use at home entails an increased risk of significant harm to the patient. While interventions and strategies to improve medications care have been implemented in hospitals, it remains unclear how this type of medications care is provided in the home care setting. The objective was to describe home care nurses’ management of high-risk medications.

Methods

A cross-sectional, descriptive design was set up in home care nurses in Flanders, Belgium. Participants were recruited through convenience sampling and could be included in the study if they provided medications care and worked as a home care nurses. Participants completed an online structured questionnaire. Questions were asked about demographic information, work experience, nurses’ general attitude regarding high-risk medications, contact with high-risk medications and the assessment of risk and severity of harm, specific initiatives undertaken to improve high-risk medications care and the use of additional measures when dealing with high-risk medications. Descriptive statistics were used.

Results

A total of 2283 home care nurses participated in this study. In our study, 98% of the nurses reported dealing high-risk medications. Home care nurses dealt the most with anticoagulants (96%), insulin (94%) and hypnotics and sedatives (87%). Most nurses took additional measures with high-risk medications in less than 25% of the cases, with the individual double check being the most performed measure for all high-risk medications except lithium. Nurses employed by an organization received support mostly in the form of a procedure while self-employed nurses mostly look for support through external organizations and information sources.

Conclusions

The study shows several gaps regarding high-risk medications care, which can imply safety risks. Implementation and evaluation of more standardized high-risk medications care, developing and implementing procedures or guidelines and providing continuous training for home care nurses are advised.
Clinical performance of immediately placed and restored progressive-type implants in the esthetic zone: a prospective observational study
Authors: Trimpou G. , Schwarz F. , Begić A. , Hess P. , Lermen J. , Keim N. , Obreja K. , Parvini P.
Published: November 2022

Purpose

To assess implant success and survival of immediately placed and restored progressive-type implants in the esthetic zone.

Material and methods

A total of n = 21 patients (21 implants) had received an immediate placement of a tapered, two-part implant with a progressive thread design (PL) for a single tooth replacement in the anterior maxilla. An immediate ‘non full-functional loaded’ restoration was provided upon adequate primary stability on a final patient-specific abutment (one abutment-one time concept). The final restoration was provided at 12 weeks (baseline). Implant survival and success (e.g. bleeding on probing—BOP, probing pocket depth—PD, mucosal recession—MR, pink esthetic score—PES) as well as patient- reported outcomes (PROM`S) were recorded at 6 and 12 months.

Results

An adequate primary implant stability (i.e. insertion torque > 35 Ncm) was obtained at all but one sites. At 12 months, implant survival (n = 20 patients) amounted to 100%. Non-significant changes to baseline were noted for mean BOP (2.5 ± 28.2%), PD (− 0.26 ± 0.73 mm), and MR (0.0 ± 0.4 mm) values. PES values amounted to 12.9 ± 1.14 and 13.2 ± 0.84 at 6 and 12 months. Technical and mechanical complications were not observed. Patients expressed an overall high satisfaction.

Conclusions

The presented immediacy protocol was associated with high survival and success rates on the short-term.

Graphical Abstract
Intraoperative chlorhexidine-induced anaphylaxis suggesting an immunoglobulin-E-dependent mechanism indicated by basophil activation tests: two case reports
Authors: Orihara Masaki , Takazawa Tomonori , Horiuchi Tatsuo , Nagumo Kazuhiro , Maruyama Noboru , Tomioka Akihiro , Saito Shigeru
Published: November 2022

Background

Although chlorhexidine allergy has been shown to be mediated by immunoglobulin (Ig) E, few reports investigated the mechanism of chlorhexidine-induced anaphylaxis using basophil activation tests (BATs).

Case presentation

A 79-year-old man underwent cholecystectomy under general anesthesia. Anaphylaxis was diagnosed based on the clinical symptoms and high serum tryptase and histamine levels. Skin tests showed positive results only for chlorhexidine. Subsequently, BATs demonstrated that the causative agent was likely chlorhexidine. The inhibitory effect of wortmannin, an inhibitor of phosphoinositide 3-kinase, on basophil activation suggested an IgE-dependent mechanism underlying chlorhexidine-induced anaphylaxis.

An 89-year-old man underwent inguinal hernioplasty under general anesthesia. Anaphylaxis was diagnosed based on the clinical symptoms and high serum tryptase and histamine levels. Skin tests and BATs with wortmannin were performed, showing similar results to case 1.

Conclusions

BATs suggested an IgE-dependent mechanism for chlorhexidine-induced anaphylaxis and might be useful for investigating the mechanisms underlying drug-induced anaphylaxis.
Effect of cup, syringe, and finger feeding on time of oral feeding of preterm neonate’s: a randomized controlled clinical trial
Authors: Alinezhad Shebilouysofla Parinaz , Mostafa Gharebaghi Manizheh , Sattarzadeh Jahdi Niloufar , Abdoli Najmi Leila , Hakimi Sevil
Published: November 2022

Background

The oral nutrition is big challenge for preterm neonates. Since the best oral feeding method for preterm neonates is not yet known, the present study aimed to evaluate the effect of cup, syringe, and finger feeding methods on reaching the time of full oral feeding and weight gain among preterm neonates.

Method

This randomized clinical trial study was conducted on 99 preterm neonate’s, born at 30–34 weeks gestation, admitted to the neonatal intensive care unit (NICU) of Al-Zahra and Taleghani Therapeutic-Educational Centers in Tabriz, Iran. Subjects were assigned into finger feeding (n = 33), cup feeding (n = 33), and syringe feeding (n = 33) groups in the allocation ratio of 1:1:1 using block randomization with a block size 6 and 9. They were studied in terms of reaching the time of full oral feeding and weight gain. The data were analyzed using SPSS/version21 software, and ANOVA, chi-square, and ANCOVA tests.

Results

There was no significant difference in the mean score of reaching the time of full oral feeding among cup, finger, and syringe feeding groups (p = 0.652). The mean score of daily weight gain, oxygen saturation (SaO2), and heart rate after feeding was not significantly different among the three groups (p > 0.05). The effect of confounding variables, including birth weight and age, arterial oxygen saturation, and heart rate before feeding, was controlled.

Conclusion

Based on the results, one of the cup, finger, and syringe feeding methods can be applied in the NICU, considering the staff’s proficiency in feeding neonates.

Trial registration IRCT20150424021917N11.
Psychological burden in spinal muscular atrophy patients and their families: a systematic review
Authors: Sari Dian Marta , Wijaya Laurentia Cindy Gani , Sitorus Wintoro Duraman Roives , Dewi Mia Milanti
Published: November 2022

Background

Spinal muscular atrophy (SMA) is an autosomal-recessive disorder that manifests in paralysis and skeletal muscle weaknesses. This neuromuscular problem is caused by degeneration of the spinal cord anterior horn cells.

Main body of the abstract

SMA leads to a decreased motoric function that affects patients’ daily activity and eventually induces the psychological burden. Given the increasing psychological burden of the patients and their families, this review summarizes the studies assessing the psychological burden of SMA patients and their families. We aimed to highlight the leading causes of their psychological burden. We systematically searched literature from the period 2011 to 2020 in two electronic databases by using the keywords “Spinal Muscular Atrophy”, “Psychology”, “Caregivers”, and “Burden”, then filtered it with the eligibility criteria and screened the abstract of the studies. By searching, screening, and filtering the studies, we included seven studies in this review. This review showed an increasing psychological burden in SMA patients, moreover for the parents. The dependency mainly causes the psychological burden since they eagerly struggle to achieve an everyday life.

Conclusion

Health professionals’ understanding capability regarding the mental condition of patients and their families is a potential aspect that can create better care. This review is encouraging for researchers and clinicians to have an enormous understanding of SMA.
Subdural collection after transcortical approach for pediatric brain tumors; avoidance, consequence and solutions
Authors: Elhabashy Abdelrahman Magdy , Fayed Ahmed Abdelaziz , Khedr Wael M.
Published: November 2022

Introduction

Subdural collections, following brain surgeries in pediatrics, are common and unfortunately not always easily treated; especially in huge parenchymal tumors, intraventricular tumors and paraventricular tumors. Different approaches for prevention and treatment of theses subdural collections have been discussed by several studies, but till now no solid consensus has been reached. One of these approaches is to approximate incised cortical edges by suturing the pia, use of fibrin adhesive glue and subsequent Ringer inflation. The aim of our study is to avoid cortical mantle collapse and to prevent the development of progressive pressurizing subdural fluid collections.

Patients and methods

This study included 12 pediatric cases operated for large sized brain tumors between 2014 and 2019, in the department of Pediatric Neurosurgery at Alexandria University. All cases were operated via transcortical approach. Patients were followed prospectively for postoperative complications including postoperative subdural collections. In all patients, gel foam and fibrin glue on the cortical and ependymal edges, with suture approximation of the cortical edges and subsequent Ringer lactate inflation in the residual cavity were routinely done.

Results

With the consecutive follow-up images, six cases (50%) showed persistent subdural collection following tumor resection. Three cases had 5–6 mm asymptomatic subdural collection thickness that resolved within 3 to 6 months, and the rest three cases showed more than 7 mm thickness subdural collection. In these 3/12 (25%) cases patients had symptomatic and progressive increase in the subdural fluid collections. A subdural-peritoneal shunt was necessary only for 1 patient (8%). After finishing his adjuvant therapy, it was possible to remove the subdural-peritoneal shunt. While in the other 2 patients, the subdural collection was managed surgically with just a burr hole evacuation. The clinical manifestations resolved postoperatively but complete resolution of these 2 subdural collections occurred within 7 and 9 months.

Conclusion

The use of sutures and fibrin adhesive to seal surgical defects with inflation of the residual cavity with Ringer lactate solution might decrease the development of subdural fluid collections, through avoiding the cortical mantle collapse.
Clinical and molecular characterization of Xeroderma pigmentosum in Moroccan population: a case series of 40 patients
Authors: Abbassi Meriame , Sayel Hanane , Senhaji Nadia , Trhanint Said , Bay Bay Hanane , Bouguenouch Laila , Mernisi Fatima Zahra
Published: November 2022

Background

Xeroderma pigmentosum (XP) is a rare autosomal recessive skin disorder characterized by hyperpigmentation, premature skin aging, ocular and cutaneous photosensitivity with increased risk of skin tumors. XP is caused by mutations in DNA repair genes that protect cells from UV-induced DNA damage. The current study aims to investigate, on clinical and genetic basis, Moroccan XP patients. We explored by direct sequencing the involvement of the prevalent XPA and XPC genes mutations: nonsense mutation (c.682C>T, p.Arg228X) and a two-base-pair (2 bp) deletion (c.1643 1644delTG or p.Val548Ala fsX25), respectively, in 40 index cases from 37 unrelated families in Moroccan population.

Results

Early skin and ocular manifestations were detected with high rate of malignancy. Cutaneous lesions progressed to malignant skin tumor in 70% of cases. Ocular tumors were also observed in 11 patients including BCC in eight cases, SCC in three cases and melanoma in four cases. Among the 40 patients, there were 20 homozygous cases for the 2 bp deletion in the XPC gene and 9 homozygous cases carrying the nonsense XPA mutation.

Conclusion

These findings obtained in the present study revealed that the XPC gene mutation (c.1643 1644delTG, p.Val548AlafsX25) is the major cause of Xeroderma pigmentosum in our population. The c.682C>T (p.Arg228X) mutation is relatively associated with moderate phenotype in XP group A Moroccan families. This result will also contribute to improving the molecular diagnosis of XP disease and will have a significant impact on improving the care of Moroccan patients and their relatives.
Reporting unit context data to stakeholders in long-term care: a practical approach
Authors: Cranley Lisa A. , Lo T K T , Weeks Lori E. , Hoben Matthias , Ginsburg Liane R. , Doupe Malcolm , Anderson Ruth A. , Wagg Adrian , Boström Anne-Marie , Estabrooks Carole A. , Norton Peter G.
Published: November 2022

Background

The importance of reporting research evidence to stakeholders in ways that balance complexity and usability is well-documented. However, guidance for how to accomplish this is less clear. We describe a method of developing and visualising dimension-specific scores for organisational context (context rank method). We explore perspectives of leaders in long-term care nursing homes (NHs) on two methods for reporting organisational context data: context rank method and our traditionally presented binary method—more/less favourable context.

Methods

We used a multimethod design. First, we used survey data from 4065 healthcare aides on 290 care units from 91 NHs to calculate quartiles for each of the 10 Alberta Context Tool (ACT) dimension scores, aggregated at the care unit level based on the overall sample distribution of these scores. This ordinal variable was then summed across ACT scores. Context rank scores were assessed for associations with outcomes for NH staff and for quality of care (healthcare aides’ instrumental and conceptual research use, job satisfaction, rushed care, care left undone) using regression analyses. Second, we used a qualitative descriptive approach to elicit NH leaders’ perspectives on whether the methods were understandable, meaningful, relevant, and useful. With 16 leaders, we conducted focus groups between December 2017 and June 2018: one in Nova Scotia, one in Prince Edward Island, and one in Ontario, Canada. Data were analysed using content analysis.

Results

Composite scores generated using the context rank method had positive associations with healthcare aides’ instrumental research use (p < .0067) and conceptual research use and job satisfaction (p < .0001). Associations were negative between context rank summary scores and rushed care and care left undone (p < .0001). Overall, leaders indicated that data presented by both methods had value. They liked the binary method as a starting point but appreciated the greater level of detail in the context rank method.

Conclusions

We recommend careful selection of either the binary or context rank method based on purpose and audience. If a simple, high-level overview is the goal, the binary method has value. If improvement is the goal, the context rank method will give leaders more actionable details.
Machine learning for prediction of wind effects on behavior of a historic truss bridge
Authors: Wang Jun , Kim Yail J. , Kimes Lexi
Published: November 2022

This paper presents the behavior of a 102-year-old truss bridge under wind loading. To examine the wind-related responses of the historical bridge, state-of-the-art and traditional modeling methodologies are employed: a machine learning approach called random forest and three-dimensional finite element analysis. Upon training and validating these modeling methods using experimental data collected from the field, member-level forces and stresses are predicted in tandem with wind speeds inferred by Weibull distributions. The intensities of the in-situ wind are dominated by the location of sampling, and the degree of partial fixities at the supports of the truss system is found to be insignificant. Compared with quadrantal pressure distributions, uniform pressure distributions better represent the characteristics of wind-induced loadings. The magnitude of stress in the truss members is enveloped by the stress range in line with the occurrence probabilities of the characterized wind speed between 40% and 60%. The uneven wind distributions cause asymmetric displacements at the supports.
Effect of the COVID-19 Pandemic on Place of Death Among Medicaid and Commercially Insured Patients With Cancer in Washington State
Authors: Panattoni Laura E. , McDermott Cara L. , Li Li , Sun Qin , Fedorenko Catherine R. , Sanchez Hayley A. , Kreizenbeck Karma L. , Shankaran Veena , Ramsey Scott D.
Published: November 2022

PURPOSE

The COVID-19 pandemic–related disruptions in health care delivery might have affected end-of-life care in patients with cancer. We examined changes in place of death and hospice support for Medicaid and commercially insured patients during the pandemic.

PATIENTS AND METHODS

We linked Washington State cancer registry records with claims from Medicaid and two commercial insurers for patients with solid tumor age 18-64 years. The study included 322 Medicaid and 162 commercial patients who died between March 2017 and June 2019 (pre–COVID-19), along with 90 Medicaid and 47 commercial patients who died between March and June 2020 (COVID-19). Place of death was categorized as hospital, hospice (home or nonhospital facility), and home without hospice. Place of death was compared using adjusted multinomial logistic regressions stratified by payer and time period (pre–COVID-19 v COVID-19). The clinical and sociodemographic factors associated with dying at home without hospice were examined, and adjusted marginal effects (ME) are reported.

RESULTS

In the adjusted pre–COVID-19 analysis, Medicaid patients were more likely than commercially insured patients to die in hospital (48% v 36%; adjusted ME, 11%; P = .02). In the pre–COVID-19/COVID-19 analysis, Medicaid patients' place of death shifted from hospital (48% v 32%; ME, −16%; P < .01) to home without hospice (19.9% v 38.0%; ME, 16.5%; P < .01). However, there were no statistically significant changes pre–COVID-19/COVID-19 for commercial patients. As a result, during COVID-19, Medicaid patients were more likely than commercial patients to die at home without hospice (38% v 22%; ME, 16%; P = .04) as were male versus female patients (ME, 16%; P < .01).

CONCLUSION

The pandemic might have disproportionately worsened the end-of-life experience for Medicaid enrollees with cancer. Attention should be paid to societal and health system factors that decrease access to care for Medicaid patients.
Utility of Multimodality Approach Including Systemic FGF23 Venous Sampling in Localizing Phosphaturic Mesenchymal Tumors
Authors: Kato Hajime , Koga Minae , Kinoshita Yuka , Hidaka Naoko , Hoshino Yoshitomo , Takashi Yuichi , Arai Makoto , Kobayashi Hiroshi , Katsura Masaki , Nakamoto Yuji , Makise Naohiro , Ushiku Tetsuo , Hoshi Kazuto , Nangaku Masaomi , Makita Noriko , Fukumoto Seiji , Ito Nobuaki
Published: November 2022

Context

Tumor-induced osteomalacia (TIO) is one of the most common forms of acquired fibroblast growth factor 23 (FGF23)-related hypophosphatemia and is usually caused by phosphaturic mesenchymal tumors (PMTs). Although the complete resection of PMTs can cure TIO, preoperative localization of tumors by standard imaging modalities is often challenging. In addition to 18F-fluoro-2-deoxy-D-glucose positron emission tomography–computed tomography (FDG-PET) and 111In-pentetreotide scintigraphy (SRS), systemic FGF23 venous sampling (FGF23VS) has been used to help localize PMTs in specialized institutions.

Objective

This study aimed to evaluate the diagnostic performance of each imaging test and their combinations in localizing PMTs.

Methods

In an observational retrospective study of patients with adult-onset FGF23-related osteomalacia who underwent all 3 imaging studies (FDG-PET, SRS, and FGF23VS), the rate of successful preoperative localization of the tumors was evaluated only in the patients with pathological diagnoses of PMTs, considering the possibility that pathogenesis of patients without identified tumors might be due to other causes such as late-onset hereditary FGF23-related hypophosphatemia.

Results

A total of 30 Japanese patients with TIO (median age, 60 years [range, 28-87 years]; 10 women [33.3%]) were included in the study. The success rate of preoperative localization for each test and combinations of 2 or 3 tests among 18 patients with PMTs was as follows: 72% (FDG-PET), 72% (SRS), 94% (FGF23VS), 89% (FDG-PET, SRS), 100% (FDG-PET, FGF23VS), 94% (SRS, FGF23VS), and 100% (FDG-PET, SRS, and FGF23VS).

Conclusion

We observed the highest localization rate of PMTs in patients with identified PMTs with the combination of FDG-PET and FGF23VS.
Influence of different treatment methods of Left Colic Artery on postoperative rehabilitation of patients undergoing Laparoscopic Radical Resection of Rectal Cancer
Authors: Ding Chuang , Kong Lingyong , Zhang Ming , Chen Yan
Published: November 2022

Objective: To investigate the effect of different treatment methods of the left colic artery (LCA) on postoperative rehabilitation of patients undergoing laparoscopic radical resection of rectal cancer.

Methods: Retrospective analysis was performed on 70 patients undergoing laparoscopic radical resection of rectal cancer who were admitted to The Affiliated Suqian Hospital of Xuzhou Medical University from January, 2020 to December, 2022 were selected and divided into two groups according to different treatment methods of LCA. The preservation group (LCA group) (n=34 cases) and the non-preservation group (NLCA group) (n=36 cases). Both groups were treated with laparoscopic radical resection of rectal cancer. IMA was preserved in the LCA group, but not in the NLCA group. The efficacy indicators, surgical treatment and rehabilitation-related indicators, gastrointestinal hormone indicators (motilin (MTL), gastrin (GAS)), and postoperative complications risk were compared between the two groups before and after surgery.

Results: No statistically significant difference was observed between the two groups in terms of efficacy indicators (total number of lymph nodes dissected and number of lymph nodes at the root of the IMA), operation time, intraoperative blood loss, and postoperative drainage tube placement time (p>0.05). However, postoperative anal flatus and hospital stay in the LCA group were considerably shorter than those in the NLCA group (p<0.05). Postoperatively, the levels of MTL and GAS in the two groups were significantly decreased, and the LCA group decreased slightly compared with the NLCA group (p<0.05). Moreover, the incidence of complications in the LCA group (5.88%) was significantly lower than that in the NLCA group (27.78%) (p<0.05).

Conclusion: Preservation of LCA and no-preservation of LCA in laparoscopic radical resection of rectal cancer are comparable in terms of therapeutic effect, and the surgery with preservation of LCA is worthy of clinical promotion due to its various benefits such as less impact on gastrointestinal hormone indicators, lower risk of complications, and faster postoperative recovery.

doi: https://doi.org/10.12669/pjms.39.1.6366

How to cite this: Ding C, Kong L, Zhang M, Chen Y. Influence of different treatment methods of Left Colic Artery on postoperative rehabilitation of patients undergoing Laparoscopic Radical Resection of Rectal Cancer. Pak J Med Sci. 2023;39(1):---------.  doi: https://doi.org/10.12669/pjms.39.1.6366

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