bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of COVID‐19 restrictions on the delivery of occupational therapy: How technology use affected practice during COVID‐19 among occupational therapists in British Columbia
Authors: Fawkes Tanya , Yung Olivia , Miller William C. , Smith Emma , Matharu Parmeet , Yu Natalie
Published: August 2023

Introduction

COVID‐19 activity restrictions altered clinical practice around the world. Anecdotal evidence observed by the Canadian Association of Occupational Therapists – British Columbia (CAOT‐BC) suggested a rapid adjustment to virtual care technologies occurred among occupational therapists in the initial restrictions. The purpose of the study was to determine the scope of how COVID‐19 restrictions impacted the use of technology to provide client care in British Columbia. It will inform the future provision of occupational therapy in the developing technological landscape related to heath care provision.

Methods

This descriptive cross‐sectional survey was completed using Qualtrics, an online survey tool. Registered occupational therapists received the survey via email invitations. The data were analysed using descriptive statistics in IBM SPSS Software.

Results

Of 342 participants, 98.4% reported increased technology use to support practice with the advent of COVID‐19 restrictions. Those with some technology experience prior to COVID‐19 reported higher intent to continue using technology following COVID‐19 restrictions. Overall, occupational therapists were confident in their perceived abilities to use technology in their practice. Occupational therapist‐related, client‐related, and practice area considerations occurred with the rapid uptake of technology. Some components of practice were perceived to be improved and others impaired with the use of technology.

Conclusion

Occupational therapists substantially increased their use of technology to enable ongoing client care during the Covid‐19 restrictions. Implications for improvements and reduction of limitations in care delivery are substantial, given the intent to continue using technology going forward. These implications can be further explored to understand how the advances in occupational therapists' ability to use technology may impact rural or remote care, which practice areas may be most amenable technology use, and how policies and funding can facilitate effective and appropriate use of technology to support clinical care in public and private settings.
Implementing evidence‐based clinical and business data standards in Australian private practice clinics is feasible
Authors: Clark Peter W. , Williams Lauren T. , O'Shea Marie‐Claire , Ball Lauren
Published: August 2023

Aims

To assess the feasibility of implementing data standards in Australian primary care dietetics practices.

Methods

A mixed‐methods pragmatic study of dietitians working in primary care. Using a four‐point Likert scale, participants were surveyed on their baseline use of the 45 business and 33 clinical evidenced‐based data standards. The content validity index and kappa statistic for each standard were calculated with a kappa statistic of 0.60–0.74 considered ‘Good’ and > 0.74 ‘Excellent’. After 4 weeks of assessment, dietitians were surveyed on the feasibility of implementing each standard and standards in total. Qualitative feedback on enablers and barriers to implementing standards was gathered and triangulated with interviews with select participants.

Results

Forty‐five dietitians from every Australian state and territory completed both surveys (response rate: 100%). At baseline, 24% of business and 79% of clinical standards were rated ‘Good’ or ‘Excellent’ for current usage. The feasibility of implementing standards was rated ‘Good’ or ‘Excellent for 86% of the business and 97% of the clinical standards. Software, training and time limitations are enablers and barriers to implementing standards.

Conclusion

Embedding data standards within dietetics practices are feasible and have broad applicability for assessing outcomes of care.
Study Design for Restricted Mean Time Analysis of Recurrent Events and Death
Authors: Mao Lu
Published: August 2023

The restricted mean time in favor (RMT-IF) of treatment has just been added to the analytic toolbox for composite endpoints of recurrent events and death. To help practitioners design new trials based on this method, we develop tools to calculate the sample size and power. Specifically, we formulate the outcomes as a multistate Markov process with a sequence of transient states for recurrent events and an absorbing state for death. The transition intensities, in this case the instantaneous risks of another nonfatal event or death, are assumed to be time-homogeneous but nonetheless allowed to depend on the number of past events. Using the properties of Coxian distributions, we derive the RMT-IF effect size under the alternative hypothesis as a function of the treatment-to-control intensity ratios along with the baseline intensities, the latter of which can be easily estimated from historical data. We also reduce the variance of the nonparametric RMT-IF estimator to calculable terms under a standard set-up for censoring. Simulation studies show that the resulting formulas provide accurate approximation to the sample size and power in realistic settings. For illustration, a past cardiovascular trial with recurrent-hospitalization and mortality outcomes is analyzed to generate the parameters needed to design a future trial. The procedures are incorporated into the rmt package along with the original methodology on the Comprehensive R Archive Network (CRAN).
Impact of GVHD on lymphoma progression: Nationwide study from Japanese Society for Transplantation and Cellular Therapy
Authors: Watanabe Mizuki , Kanda Junya , Fukuda Takahiro , Uchida Naoyuki , Ikegame Kazuhiro , Kataoka Keisuke , Kobayashi Hikaru , Ara Takahide , Ishikawa Jun , Matsuoka Ken‐ichi , Sugio Yasuhiro , Nakazawa Hideyuki , Ikeda Takashi , Atsuta Yoshiko , Kondo Eisei , Suzuki Ritsuro ,   Japanese Society for Transplantation and Cellular Therapy, Adult Lymphoma Working Group
Published: August 2023

The graft‐versus‐lymphoma (GVL) effect and its association with acute and chronic GVHD (aGVHD, cGVHD) has not been comprehensively elucidated. We retrospectively analysed 2204 Japanese patients with non‐Hodgkin lymphomas (NHLs; indolent B‐NHLs, n = 689; aggressive B‐NHLs, n = 720; mature T/NK‐NHLs, n = 795) receiving a first allo‐HSCT in 2003–2017. Pre‐transplant lymphoma control showed complete response (CR) in 759 and non‐CR in 1445. We assessed the impact of aGVHD/cGVHD on lymphoma progression and other outcomes. Although aGVHD/cGVHD showed no statistical impact on lymphoma progression in the overall cohort, their impact was clear in certain groups: Grade I‐II aGVHD in CR patients (HR, 0.63; 95% CI, 0.43–0.91), especially in mature T/NK‐NHL (HR, 0.46; 95% CI, 0.26–0.83) and extensive cGVHD in patients with mature aggressive B‐NHLs (HR, 0.55; 95% CI, 0.31–0.97). In total, limited cGVHD was associated with superior survivals (progression‐free survival: HR, 0.71; 95% CI, 0.56–0.90), whereas severe GVHDs showed negative impacts on them. Our results support the presence of GVL effects differentially associated with GVHD in different lymphoma subtypes/controls. Meanwhile, it was also suggested that we should manage GVHDs within a limited activity, considering the negative impact of severe GVHDs. As pre‐transplant lymphoma control remains a strong factor influencing transplant outcomes, improving its management is an important issue to be addressed.
GingerenoneA overcomes dexamethasone resistance by activating apoptosis and inhibiting cell proliferation in pediatric T‐ALL cells
Authors: Katebi Melika , Rahgozar Soheila , Kazemi Farnoosh , Rahmani Saeideh , Najafi Dorcheh Somayeh
Published: August 2023

Plant‐based combination strategies have been widely considered in cancer therapy to attenuate chemotherapeutics side effects. The anti‐leukemic effect of the whole ginger extract was previously portrayed by our team, and the current study is centered around the cytotoxicity and mechanism of action of a phenolic subsidiary of ginger, GingerenoneA, on pediatric acute lymphoblastic leukemia. GingernoneA imposed, dose‐dependently, inhibitory effects on the viability of T and B leukemia cell lines confirmed by MTT assays. Resistance to Dexamethasone, a mostly used chemotherapeutic in acute lymphoblastic leukemia treatments, was overcome by GingernoneA. A synergistic effect of Dexamethasone and GingrenoneA on T leukemia cell lines and patient primary cells was confirmed. Annexin‐V/PI and acridine orange/ethidium bromide staining illustrated dose‐dependent apoptosis in CCRF‐CEM cells developed by GingerenoneA. The intrinsic and extrinsic apoptosis induction and antiproliferative attribution of GingerenoneA were validated by western blot and qPCR. Despite the supposed loss of function in CCRF‐CEM cells, TP53 showed increased expression levels and functional activity upon treatment with GingernoneA. Bioinformatic studies revealed the conceivable impact of GingerenoneA on the reactivity of mutant P53 through its binding to Cys124. Our findings may provide novel strategies for therapeutic intervention to ameliorate pALL outcomes.
Visual and cognitive processes contribute to age‐related improvements in visual selective attention
Authors: Lynn Andrew , Maule John , Amso Dima
Published: August 2023

Children (N = 103, 4–9 years, 59 females, 84% White, c. 2019) completed visual processing, visual feature integration (color, luminance, motion), and visual search tasks. Contrast sensitivity and feature search improved with age similarly for luminance and color‐defined targets. Incidental feature integration improved more with age for color‐motion than luminance‐motion. Individual differences in feature search ( = .11) and incidental feature integration ( = .06) mediated age‐related changes in conjunction visual search, an index of visual selective attention. These findings suggest that visual selective attention is best conceptualized as a series of developmental trajectories, within an individual, that vary by an object's defining features. These data have implications for design of educational and interventional strategies intended to maximize attention for learning and memory.
An exploration of the domain specificity of maternal sensitivity among a diverse sample in the infancy period: Unique paths to child outcomes
Authors: Taraban Lindsay , Shaw Daniel S. , Morris Pamela A. , Mendelsohn Alan L.
Published: August 2023

Maternal sensitivity during an observed mother–child clean‐up task at 18 months and maternal sensitivity during an observed mother–child free‐play task at 18 months were tested as independent predictors of child internalizing symptoms, externalizing symptoms, social competence, and language development at 24 months. Participants (n = 292 mothers) were recruited between 2015 and 2017, and were low‐income (mean annual income = $19,136) and racially and ethnically diverse (43.8% Black; 44.2% Latinx). Maternal sensitivity during clean‐up was a significant predictor of all social‐emotional outcomes, and a unique predictor of child internalizing symptoms. Maternal sensitivity during free‐play was a unique predictor of child language. Results suggest that context‐specific subtypes of maternal sensitivity may differentially relate to early child outcomes.
Use of tranexamic acid‐soaked NasoPore® in the emergency department, to reduce epistaxis admissions
Authors: Rosario Eleanor , Sharma Ekta , Patel Ankit , Guvensen Gabrielle , Ashroff Rizal , McClenaghan Fiona , Hariri Ahmad , Joseph Jonathan
Published: August 2023

Objectives

The aim of this study was to assess the efficacy of a new emergency department (ED) intervention for the management of non‐traumatic, anterior epistaxis in adult patients, aiming to reduce epistaxis admissions.

Design

A new epistaxis pathway was introduced for use by ED practitioners. This was disseminated in ED through an educational campaign by the ear, nose and throat team. A tranexamic acid (500 mg/5 mL)‐soaked NasoPore® packing step was introduced for epistaxis which did not terminate following 10 min of simple first aid. The pathway was utilised for adult patients presenting with non‐traumatic, anterior epistaxis. Pre‐ and post‐implementation periods were defined, and all adults attending ED with non‐traumatic, anterior epistaxis were included. Pre‐ and post‐implementation epistaxis treatment interventions, admission rates and re‐attendance rates were recorded by retrospective audit and compared.

Results

In the post‐implementation group, epistaxis admissions were 51.7% (p < .05) lower than in the pre‐implementation group, as a proportion of the total number attending ED with epistaxis during these periods.

Conclusions

The significant reduction in epistaxis admissions demonstrates that this ED intervention is beneficial for patient outcomes.
Cutaneous malakoplakia arising on the ankle of a patient with pyoderma gangrenosum
Authors: Whittington Carli P. , Saleh Jasmine S. , Schadler Eric , Bitar Carole , Wang Frank , Andea Aleodor A.
Published: August 2023

Malakoplakia is a rare chronic inflammatory condition that most commonly involves the urogenital tract. Cutaneous malakoplakia is extremely rare and many patients diagnosed with skin involvement are immunosuppressed. While the clinical presentation of cutaneous malakoplakia is variable, the histopathologic features are quite distinct and include sheets of closely packed dermal histiocytes with foamy‐appearing cytoplasm and Michaelis–Gutmann bodies that are positive with certain immunohistochemical stains. While the exact pathogenesis of malakoplakia is unknown, it has been associated with certain bacterial infections. Treatment generally involves a combination of surgery and antimicrobial agents and/or modulation of immunosuppressant therapy if appropriate. Herein, the authors report a unique case of cutaneous malakoplakia arising in a patient on chronic immunosuppressive therapy for the management of pyoderma gangrenosum.
Safety and effectiveness of dulaglutide in Chinese adults with type 2 diabetes mellitus in a real‐world setting: A prospective, observational post‐marketing study
Authors: Guo Lixin , Li Li , Yu Qiurong , Wang Na , Chen Jun , Xi Yue , Wang Huan , Wang Yihua , Xu Jiawei
Published: August 2023

Aim

To our knowledge, this is the first real‐world study to investigate the safety and effectiveness of a glucagon‐like peptide‐1 receptor agonist in Chinese patients with type 2 diabetes mellitus (T2DM).

Materials and Methods

This prospective, observational, post‐marketing study conducted at 46 hospitals in China included adults with T2DM prescribed dulaglutide in routine clinical practice. The primary endpoint was the incidence of treatment‐emergent adverse events (TEAEs) and serious AEs in patients who received ≥1 dose of dulaglutide, for up to 24 weeks. Exploratory endpoints included changes in patient‐reported glycated haemoglobin (HbA1c) and body weight. Post hoc analyses and multivariate regression were also performed.

Results

From 20 January 2020 to 24 November 2021, 3291 patients received dulaglutide and entered the safety analysis. TEAEs were reported in 1333 (40.5%) patients; the most commonly reported were nausea (n = 193, 5.9%), diarrhoea (n = 183, 5.6%) and decreased appetite (n = 179, 5.4%). serious AEs were reported in 160 (4.9%) patients. TEAEs led to treatment discontinuation in 212 (6.4%) patients. The mean absolute change in HbA1c from baseline to week 24 was −1.65% (p < .001). Greater reductions in HbA1c at week 24 were observed in patients with T2DM duration ≤5 years (p = .002), baseline HbA1c ≥8.5% (p < .001), and without atherosclerotic cardiovascular disease (p = .002). The mean absolute change in body weight from baseline at week 24 was −2.62 kg (p < .001).

Conclusion

Dulaglutide showed a safety profile consistent with previous reports and significantly reduced HbA1c in a real‐world setting. These findings support the clinical use of dulaglutide and inform the individualized treatment of patients with T2DM in China.
A retrospective comparative study of maxillofacial injury patterns caused by electric scooters and bicycles
Authors: Lee Seong Joon , Kim Ji Hun
Published: August 2023

Background/Aim

The emergence of shared stand‐up electric scooters has led to an increase in their usage and, subsequently, an increase in the incidence of maxillofacial trauma. This study aimed to investigate the trauma pattern associated with the use of stand‐up electric scooters compared with that related to the use of bicycles, which was a popular mode of personal mobility before the emergence of stand‐up electric scooters.

Materials and Methods

This study investigated the medical records of patients who visited Wonju Christian Hospital for maxillofacial trauma due to the use of stand‐up electric scooter and bicycles between November 1, 2017 and October 31, 2022. Maxillofacial trauma was analyzed based on medical records, including those in the evaluation results of teeth, maxillofacial bones, and soft tissues.

Results

Crown fractures and tooth avulsions were observed more frequently with the use of stand‐up electric scooters than with the use of bicycles. In contrast, crown‐root fractures, tooth subluxation, and extrusive luxation were more commonly observed in bicycle riders. Additionally, the proportion of root fractures was similar between the two groups. However, no vertical root fractures were observed in patients who rode bicycles. The maxillofacial bone fracture rates between the two groups were similar, although the fracture patterns were different.

Conclusion

The number of patients using stand‐up electric scooters is increasing, and they are likely to have a worse prognosis compared with those using existing personal mobility devices.
Eating disorders occur at high rates in adolescents with epilepsy and are associated with psychiatric comorbidities and suicidality
Authors: Tokatly Latzer Itay , Richmond Tracy K , Zhang Bo , Pearl Phillip L.
Published: August 2023

Objectives

To assess the occurrence rate, characteristics, and impact of eating disorders (EDs) in adolescents with epilepsy.

Methods

In this observational study, adolescents with epilepsy seen in a single center between 2013 and 2022 who had comorbid EDs were compared to two control groups of adolescents with only epilepsy and only EDs. Patients with intellectual disability or autism spectrum disorder were excluded. Data retrieved included demographic and anthropometric details and clinical variables relating to seizure types, EDs, and psychiatric disorders and behaviors.

Results

A total of 376 subjects were included in the study: 84 adolescents with both epilepsy and eating disorders, 135 with only epilepsy, and 157 with only EDs. The rate of EDs in adolescents with epilepsy was 7.0% (95% confidence interval [CI] 5.6%–8.5%) overall, 11.3% (95% CI 8.8%–14.3%) in females, and 3.1% (95% CI 1.9%–4.8%) in males. The median (interquartile range [IQR]) time difference between the onset of epilepsy to an ED was 1.6 (.5–3.6) years. Among adolescents with epilepsy, those with an ED were more likely to be female (p = .001) and have a lower body mass index z‐score (zBMI) percentile (p < .001). Epilepsy type, seizure frequency, or seizure duration were not specific for having or not having EDs. Among adolescents with EDs, those with epilepsy had a younger onset of their EDs (p < .001), included relatively more males (p = .007), and consisted of more cases of anorexia‐nervosa‐restrictive type (p < .001), and fewer cases of bulimia nervosa (p = .04) and binge eating disorder (p = .003). Adolescents with epilepsy and a comorbid ED were more likely to have psychiatric comorbidities such as depression, anxiety, and suicidality than adolescents with only epilepsy or EDs.

Significance

EDs should be suspected and screened for in intellectually intact female and male adolescents with epilepsy, irrespective of their epilepsy type. If disturbed eating behaviors or EDs are identified, further evaluation should be directed at detecting other psychopathologies, including suicidality.
Effects of individualised rehabilitation for horses with equine herpesvirus myeloencephalopathy
Authors: Ericson Cajsa , Lassa Emma , Olsen Emil
Published: August 2023

In 2019, a Swedish outbreak of equine herpes virus type 1 (EHV‐1) led to varying neurological symptoms also known as EHM (equine herpes myeloencephalopathy). Nineteen of the 39 exposed horses developed EHM. EHM outbreaks have become more common in recent decades and can result in large economic losses for the horse industry in addition to clear welfare implications. However, there is limited information about the estimated time to recovery from EHM and return to previous level of performance and there is limited published information regarding neurological rehabilitation in horses. Our objective was to describe and evaluate the potential benefit of implementing individual rehabilitation plans for horses recovering from EHM. Four horses with EHV‐1 and with clinical signs of neurological dysfunction were selected. All horses were initially hospitalised at an intensive care unit between 4 and 9 days and approximately 3 months after the outbreak they were considered sufficiently recovered to start a rehabilitation programme. The programs mainly focused on regaining proprioception, core stability and strength with consideration given to fatigue in the horse and risk to the handlers. A repeated neurological examination was performed six times over the first year and the rehabilitation programs were modified accordingly. The owners considered the horses ‘normal’, both mentally and physically, between 6 and 8 months after the outbreak. All horses were back to their previous level of performance after 8–11 months. A limitation of the study was a small study population with no control group. Our conclusions are that horses suffering from severe EHM may return to an acceptable athletic function given time and an individually adapted rehabilitation program. To potentially show that an individually adapted rehabilitation plan brings the horse back to acceptable function faster than nonspecific rehabilitation, a case‐control study would be required.
External validation of the Dat'AIDS score: A risk score for predicting 5‐year overall mortality in people living with HIV aged 60 years or older
Authors: Hentzien Maxime , Frossard Jaromil , Kouyos Roger , Prendki Virginie , Damas José , Hofmann Eveline , Braun Dominique , Schmid Patrick , Bernasconi Enos , Ragozzino Silvio , Efthimiou Orestis , Delpierre Cyrille , Allavena Clotilde , Bani‐Sadr Firouzé , Calmy Alexandra ,   the Swiss HIV Cohort Study
Published: August 2023

Objective

To perform an external validation of the Dat'AIDS score for predicting 5‐year overall mortality among people with HIV (PWH) aged 60 years or older.

Methods

This was a multi‐centre prospective cohort study at all sites participating in the Swiss HIV Cohort Study (SHCS). We calculated the Dat'AIDS score in PWH aged 60 years or older at their first visit between 1 January 2015 and 1 January 2020. People living with HIV‐2 and those whose Dat'AIDS score could not be calculated were excluded. Patients were followed until 1 January 2020. The primary endpoint was all‐cause mortality. Vital status was collected throughout the study period. We obtained population and score descriptive statistics and assessed the score's discrimination and calibration.

Results

We included 2205 participants (82% male) of median [interquartile range (IQR)] age 62.0 (60.3–67.0) years, mostly with viraemia <50 copies/mL (92.7%). Median follow‐up time was 15.9 years and median (IQR) CD4 cell count at enrolment was 586 (420–782) cells/μL. In all, 152 deaths were recorded during a total follow‐up period of 7147 patient‐years. The median (IQR) observed Dat'AIDS score was 3 (0–8). Discriminative capacities were good as the C‐statistic was 0.73 (95% CI: 0.69–0.77) and consistent across all subgroups. Comparison of observed and expected survival probabilities showed good calibration.

Conclusions

External validation of the Dat'AIDS score in patients aged 60 years or older showed that it could be a useful tool not only for research purposes, but also to identify older patients at a higher mortality risk and to tailor the most appropriate interventions.
Assessment of knowledge, attitude and practice for oxygen therapy among medical staff at the Colonial War Memorial Hospital in Fiji
Authors: Arasi Fa'amuamua , Bennett Elizabeth , Rokoduru Avelina , Kaspar Annette
Published: August 2023

Background

Oxygen therapy (OT) is a commonly prescribed essential medicine for people of all ages in the management of hypoxia. The adverse effects of inappropriate OT supplementation may be underestimated by health professionals and lead to poor health outcomes among hospitalised patients. Knowledge, attitude and practice (KAP) assessments of medical staff members to OT guidelines are essential to ensure optimal patient care.

Aims

To perform a KAP assessment of OT administration among doctors and nurses employed at the national hospital of Fiji in 2021.

Methods

Prospective cross‐sectional study design. KAP assessment was performed with an online questionnaire and clinical observation.

Results

The study population (N = 116) consisted of doctors (20.7%) and nurses (79.3%) representing the acute medical, burns, cardiac care, intensive care, surgical and postanaesthetic recovery units. Overall, the proportion of participants who obtained a good score (>70%) was 87% for knowledge, 87.93% for attitudes and 84% for practice. Best knowledge scores were obtained for general OT indications (71%) and scenarios where immediate oxygen application is required (70%). Lowest knowledge scores were for OT contraindications (14%) and oxygen saturation for acute myocardial infarction (32%), asthma (36%) and healthy newborns (43%). The most positive attitudes were in response to the statement that OT guidelines are essential (96%). A total of 78 (80.4%) patients were being cared for with good OT practice.

Conclusions

Good KAP scores were obtained for medical staff in Fiji regarding OT administration. Ongoing professional education activities should include updated training of OT contraindications and optimal oxygen saturation levels for special patient groups.
Investigation of human papilloma virus frequency in pregnant women
Authors: Topkara Serap , Sucu Sadun , Cakir Anil Turhan , Harma Muge , Harma Mehmet Ibrahim
Published: August 2023

Objective

The aim of this study was to determine the frequency of human papillomavirus (HPV), HPV types, and the association with age, pregnancy, and childbirth in pregnant women.

Method

Four hundred and forty‐eight pregnant women who visited our clinic were enrolled in the study. Polymerase chain reaction was used to determine HPV DNA and typing by cervical smear in the initial applications of patients with detailed history. Statistical Package for the Social Sciences (SPSS) 13.0 was used to analyze the data.

Results

HPV DNA was positive in 26 (5.8%) of 448 patients who participated in the study. High‐risk HPV types were detected in 77% of HPV‐positive cases and low‐risk HPV types in 23% of cases. Only one HPV type was detected in 13 patients (50%), while multiple HPV types were detected in 13 patients (50%) of the HPV‐positive cases. A significant negative association was found between gravidity and positivity of HPV DNA. HPV is more common in women with lower parity and gravidity.

Conclusion

Studies conducted in different populations in different regions of Turkey have shown that the incidence of HPV in women ranges from 2.2% to 26%. In our study, the incidence of HPV DNA in pregnant women was 5.8%. It was found that there was an inverse relationship between parity and HPV DNA positivity. The HPV DNA positivity decreased with the number of births.
Efficacy of cognitive behavioral therapy using self‐check sheet for patients with nocturia in real‐world clinical practice
Authors: Kyoda Yuki , Ichihara Koji , Muranaka Ippei , Sakai Yasuyuki , Nakamura Makoto , Shinkai Nobuo , Kozen Nodoka , Yorozuya Wakako , Morooka Daichi , Maruo Kazutaka , Tachikawa Kimihito , Shibamori Kosuke , Nofuji Seisuke , Fujino Keiko , Kato Shuichi , Yoshida Takashi , Shindo Tetsuya , Maehana Takeshi , Hashimoto Kohei , Kobayashi Ko , Tanaka Toshiaki , Masumori Naoya
Published: August 2023

Objectives

We previously demonstrated the efficacy of cognitive behavioral therapy (CBT) using a self‐check sheet for patients with nocturia in a randomized controlled study. Additionally, we investigated the efficacy of the intervention in real‐world clinical practice.

Methods

Two hundred forty‐three outpatients with complaint of nocturia who practiced CBT for 4 weeks using a self‐check sheet were included in this trial, which took place from April 2021 to March 2022 in 20 institutions.

Results

Of the 243 patients, 215 who achieved 50% or more of the behavioral therapy tasks were included in the analysis. Their mean age ± SD was 77.1 ± 7.7. A significant decrease was observed in nighttime frequency at 4 weeks after CBT using self‐check sheets (pre 3.3 and post 2.8, p < .001). Nighttime frequency was decreased one or more times and was defined as treatment success in 102 patients (47.4%). Pretreatment nighttime frequency in the treatment‐success group was significantly higher than that of the failure group (3.5 ± 1.0 vs. 3.2 ± 1.0, p = .013). In multivariate logistic regression analysis, predictive factors of treatment success were pretreatment nocturnal frequency of four or more (odds ratio [OR] 1.82, 95% confidence interval [CI] 1.01–3.30; p = .046) and the absence of diabetes mellitus (OR 3.08, 95% CI 1.34–7.06; p = .008).

Conclusions

CBT using a self‐check sheet requiring less time, less labor, less cost, and less medication is very beneficial for both patients and medical staff in real‐world clinical practice.
Uroflowmetry parameters in healthy children between 5 and 15 years old
Authors: Öztürk Yeşim Demirkıran , Elmas Ahmet Taner , Tabel Yılmaz
Published: August 2023

Objectives

Uroflowmetry (UFM) is the first‐line noninvasive screening test employed in the diagnosis of lower urinary tract dysfunction (LUTD). The purpose of this study was to determine normal UFM values in healthy Turkish children among our local population.

Methods

A total of 100 healthy girls and 62 healthy boys aged 5–15 years, who applied to İnönü University Turgut Özal Medical Center Pediatrics Polyclinic between February 2021 and January 2022, were included in the present study. The UFM parameters, including maximum flow rate (Qmax), average flow rate (Qavg), voided volume (VV), time to maximum flow, and voiding time, were measured using the Inoflow Smart System UFM Device and the resulting urine flow curve was recorded. The children were compared in terms of the UFM parameters based on their gender and age groups (5–10 years and 11–15 years).

Results

The mean Qmax value in healthy female children aged 5–15 years (21.8 ± 8.6 mL/s) was significantly higher than in male children (17.98 ± 6.1 mL/s) (p = .003). VV, Qmax, and Qavg values of the children in the 11–15 age group were significantly higher than those in the age group of 5–10 years (p > .05 for each). VV, Qmax, and Qavg values were directly proportional to age (p = .0001, for each).

Conclusions

We believe that this study adds to the limited knowledge base regarding normal flow patterns in healthy children.
Adenine phosphoribosyl transferase (APRT) deficiency and a novel sequence variant in APRT with phenotypic diversity and a literature review
Authors: Leow Esther Huimin , Chong Siew Le , Tan Ee Shien , Koh Ai Ling , Cham Breana Wen Min , Yap Celeste Jia Ying , Ng Yong Hong
Published: August 2023

Adenine phosphoribosyl transferase (APRT) deficiency is an autosomal recessive disorder and a rare cause of urolithiasis due to mutations in APRT (OMIM #102600). APRT deficiency results in increased urinary excretion of 2,8‐dihydroxyadenine (DHA) which can cause urolithiasis and kidney failure. However, with prompt diagnosis, patients with APRT deficiency can be treated with xanthine oxidoreductase inhibitors which decrease urinary DHA excretion and improve outcomes. We report a pair of siblings, an 11‐year‐old brother and his 14‐year‐old sister with compound heterozygous variants c.270del (p.Lys91Serfs*46) and c.484_486del (p.Leu162del) in APRT with variable clinical presentation of APRT deficiency. The brother presented at 17 months of age with urolithiasis and severe acute kidney injury. His elder sister remained well and asymptomatic with normal kidney function and did not develop renal calculi. Brownish disk or sphere‐like crystals with both concentric and radial markings were reported on urine microscopy in the sister on screening. The sister's diagnosis was confirmed with further laboratory evidence of absent red cell lysate APRT activity with corresponding elevated levels of urinary DHA. In conclusion, we identified a novel mutation in the APRT gene in a pair of siblings with greater phenotypic severity in the male.

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Clinical application of a lung sound analysis in infants with respiratory syncytial virus acute bronchiolitis
Authors: Ichinose Mami , Obara Takeru , Shibata Mayuko , Kagawa Takanori , Sakama Takashi , Takakura Hiromitsu , Hirai Kota , Furuya Hiroyuki , Kato Masahiko , Mochizuki Hiroyuki
Published: August 2023

Background

Objective investigation of the characteristics of acute bronchiolitis in infants is important for its diagnosis and treatment.

Methods

Lung sound data of 50 patients diagnosed with respiratory syncytial virus (RSV) acute bronchiolitis (m:f = 29:21, median of age 7 months), 20 patients with RSV acute respiratory tract infections without acute bronchiolitis (m:f = 10:10, 5 months) and 38 age‐matched control infants (m:f = 23:15, 8 months) were analyzed using a conventional method and compared. Furthermore, the relationships between lung sound parameters and clinical symptoms (clinical score, length of hospital stay and SpO2 level) in the bronchiolitis and the non‐bronchiolitis patients were examined.

Results

Results of lung sound analysis showed that the inspiratory sound power of patients with RSV respiratory tract infections was low and the expiratory sound power was high compared with those of the controls. When the patients with RSV respiratory tract infections were divided into the bronchiolitis and non‐bronchiolitis groups, the expiratory/inspiratory ratio of the bronchiolitis patients was greater than that of the non‐bronchiolitis patients. There was no difference in the clinical symptoms, clinical score and length of hospital stay between the bronchiolitis and non‐bronchiolitis patients, except for the SpO2 level on admission.

Conclusion

Lung sound analysis confirmed that patients with RSV acute bronchiolitis present with marked airway narrowing. Considering these results as a characteristic of acute bronchiolitis, it would be meaningful to reflect it in the improvement of diagnosis, treatment and subsequent management.
Effects of neuropeptide F2 on female reproduction in the cotton bollworm, Helicoverpa armigera (Lepidoptera: Noctuidae)
Authors: Habibi Fariba , Mikani Azam , Mehrabadi Mohammad , Fouda Maged Mohamed Ali
Published: August 2023

Recently, neuropeptide F2 (NPF2) has been demonstrated to increase food consumption and body weight in the cotton bollworm, Helicoverpa armigera. This study evaluated the effect of NPF2 on the adult female reproductive system of H. armigera. Daily NPF2 injections increased oocyte size, ecdysteroid titre in ovaries and haemolymph and the expression level of ecdysone receptor (EcR), ultraspiracle (USP) and vitellogenin (Vg) genes. However, NPF2 injection had no effect on the expression level of hormone receptor 3 (HR3). Fecundity and fertility were increased after the injection of NPF2. The knockdown of the NPF2 gene using RNA interference (RNAi) had opposite effects compared to NPF2 injection. Overall, these results revealed that NPF2 has a regulatory role in the female reproduction of the cotton bollworm.
Bone regeneration in implant dentistry: Which are the factors affecting the clinical outcome?
Authors: Donos Nikolaos , Akcali Aliye , Padhye Ninad , Sculean Anton , Calciolari Elena
Published: August 2023

The key factors that are needed for bone regeneration to take place include cells (osteoprogenitor and immune‐inflammatory cells), a scaffold (blood clot) that facilitates the deposition of the bone matrix, signaling molecules, blood supply, and mechanical stability. However, even when these principles are met, the overall amount of regenerated bone, its stability over time and the incidence of complications may significantly vary. This manuscript provides a critical review on the main local and systemic factors that may have an impact on bone regeneration, trying to focus, whenever possible, on bone regeneration simultaneous to implant placement to treat bone dehiscence/fenestration defects or for bone contouring. In the future, it is likely that bone tissue engineering will change our approach to bone regeneration in implant dentistry by replacing the current biomaterials with osteoinductive scaffolds combined with cells and mechanical/soluble factors and by employing immunomodulatory materials that can both modulate the immune response and control other bone regeneration processes such as osteogenesis, osteoclastogenesis, or inflammation. However, there are currently important knowledge gaps on the biology of osseous formation and on the factors that can influence it that require further investigation. It is recommended that future studies should combine traditional clinical and radiographic assessments with non‐invasive imaging and with patient‐reported outcome measures. We also envisage that the integration of multi‐omics approaches will help uncover the mechanisms responsible for the variability in regenerative outcomes observed in clinical practice.
Stability of steady‐state visual evoked potential contrast response functions
Authors: Ash Ryan T. , Nix Kerry C. , Norcia Anthony M.
Published: August 2023

Repetitive sensory stimulation has been shown to induce neuroplasticity in sensory cortical circuits, at least under certain conditions. We measured the plasticity‐inducing effect of repetitive contrast‐reversal‐sweep steady‐state visual‐evoked potential (ssVEP) stimuli, hoping to employ the ssVEP's high signal‐to‐noise electrophysiological readout in the study of human visual cortical neuroplasticity. Steady‐state VEP contrast‐sweep responses were measured daily for 4 days (four 20‐trial blocks per day, 20 participants). No significant neuroplastic changes in response amplitude were observed either across blocks or across days. Furthermore, response amplitudes were stable within‐participant, with measured across‐block and across‐day coefficients of variation (CV = SD/mean) of 15–20 ± 2% and 22–25 ± 2%, respectively. Steady‐state VEP response phase was also highly stable, suggesting that temporal processing delays in the visual system vary by at most 2–3 ms across blocks and days. While we fail to replicate visual stimulation‐dependent cortical plasticity, we show that contrast‐sweep steady‐state VEPs provide a stable human neurophysiological measure well suited for repeated‐measures longitudinal studies.
Abriendo brechas: la participación del campesinado en la política institucionalizada, estudios desde el suroccidente colombiano
Authors: Castaño Cristian
Published: August 2023

Este articulo indaga por las posibilidades tienen dos organizaciones campesinas del suroccidente colombiano, con antecedentes de interacción con actores armados, para acceder al poder político local mediante vías electorales. Para ello, se emplea el Process Tracing como método de trabajo, con el cual nos damos cuenta del mecanismo causal que nos permite explicar la interacción de diferentes factores que inciden en el fenómeno político a investigar. Como resultado, identificamos que la gobernanza rebelde se convierte en un factor que movilizan agencias en organizaciones y comunidades campesinas, lo que les brinda la oportunidad de insertarse en los escenarios institucionales a partir de las contiendas electorales. De esta forma, es posible comprender otras formas en que el campesinado puede llegar al poder político más allá de los clásicos análisis de las Ciencias Sociales sobre las revueltas y las rebeliones campesinas.
Relating clustered noise data to hospital patient satisfaction
Authors: Hummel Kenton , Ryherd Erica , Cheng Xiaoyue , Lowndes Bethany
Published: August 2023

Hospital noise can be problematic for both patients and staff and consistently is rated poorly on national patient satisfaction surveys. A surge of research in the last two decades highlights the challenges of healthcare acoustic environments. However, existing research commonly relies on conventional noise metrics such as equivalent sound pressure level, which may be insufficient to fully characterize the fluctuating and complex nature of the hospital acoustic environments experienced by occupants. In this study, unsupervised machine learning clustering techniques were used to extract patterns of activity in noise and the relationship to patient perception. Specifically, nine patient rooms in three adult inpatient hospital units were acoustically measured for 24 h and unsupervised machine learning clustering techniques were applied to provide a more detailed statistical analysis of the acoustic environment. Validation results of five different clustering models found two clusters, labeled active and non-active, using k-means. Additional insight from this analysis includes the ability to calculate how often a room is active or non-active during the measurement period. While conventional LAeq was not significantly related to patient perception, novel metrics calculated from clustered data were significant. Specifically, lower patient satisfaction was correlated with higher Active Sound Levels, higher Total Percent Active, and lower Percent Quiet at Night metrics. Overall, applying statistical clustering to the hospital acoustic environment offers new insights into how patterns of background noise over time are relevant to occupant perception.
Machine learning classification by fitting amplicon sequences to existing OTUs
Authors: Armour Courtney R. , Sovacool Kelly L. , Close William L. , Topçuoğlu Begüm D. , Wiens Jenna , Schloss Patrick D.
Published: August 2023

The ability to use 16S rRNA gene sequence data to train machine learning classification models offers the opportunity to diagnose patients based on the composition of their microbiome. In some applications, the taxonomic resolution that provides the best models may require the use of
de novo
operational taxonomic units (OTUs) whose composition changes when new data are added. We previously developed a new reference-based approach, OptiFit, that fits new sequence data to existing
de novo
OTUs without changing the composition of the original OTUs. While OptiFit produces OTUs that are as high quality as
de novo
OTUs, it is unclear whether this method for fitting new sequence data into existing OTUs will impact the performance of classification models relative to models trained and tested only using
de novo
OTUs. We used OptiFit to cluster sequences into existing OTUs and evaluated model performance in classifying a dataset containing samples from patients with and without colonic screen relevant neoplasia (SRN). We compared the performance of this model to standard methods including
de novo
and database-reference-based clustering. We found that using OptiFit performed as well or better in classifying SRNs. OptiFit can streamline the process of classifying new samples by avoiding the need to retrain models using reclustered sequences.

IMPORTANCE

There is great potential for using microbiome data to aid in diagnosis. A challenge with
de novo
operational taxonomic unit (OTU)-based classification models is that 16S rRNA gene sequences are often assigned to OTUs based on similarity to other sequences in the dataset. If data are generated from new patients, the old and new sequences must be reclustered to OTUs and the classification model retrained. Yet there is a desire to have a single, validated model that can be widely deployed. To overcome this obstacle, we applied the OptiFit clustering algorithm to fit new sequence data to existing OTUs allowing for reuse of the model. A random forest model implemented using OptiFit performed as well as the traditional reassign and retrain approach. This result shows that it is possible to train and apply machine learning models based on OTU relative abundance data that do not require retraining or the use of a reference database.
Long-term slope instability induced by the reactivation of mass transport complexes: An underestimated geohazard on the Norwegian continental margin
Authors: Jing Song , Alves Tiago M. , Omosanya Kamaldeen O. , Li Wei
Published: August 2023

Submarine landslides are significant geohazards, capable of displacing large volumes of sediment from continental margins to deposit mass transport complexes (MTCs) and generate offshore tsunamis. However, the reactivation of MTCs after their initial failure has long been overlooked. By analyzing high-quality three-dimensional seismic reflection data and seismic attribute maps, as well as comparing the geometry of different MTCs, we investigate the development of long-term slope instability and its hazardous consequences on the northwest flank of the Storegga Slide on the Norwegian margin. Our results demonstrate that the reactivation of MTCs can deform both their inner structure and overlying strata, promoting the formation of sinuous channels and local slope failures on the seafloor. These findings further reveal the MTCs that are underconsolidated or comprise slide blocks may remain unstable for a long time after their initial failure, particularly when affected by slope undercutting and a corresponding reduction in lateral support. This study shows that MTC-prone sequences are more likely to comprise regions of continental slopes with long-term instability and recurring marine geohazards.
Taxonomic revision of the sexually dimorphic flies of the Neotropical genus Euepalpus Townsend, 1908 (Diptera: Tachinidae), with notes on sexual patches in Tachinini
Authors: Gudin Filipe Macedo
Published: August 2023

Euepalpus Townsend, 1908 is a small Neotropical genus of bristle flies (Diptera: Tachinidae: Tachinini), which includes two valid species whose taxonomy is unclear, mainly because males and females are sexually dimorphic. Males exhibit a pair of sexual patches on the dorsal surface of abdominal tergite 5, an unusual feature in Tachinidae. Here, the genus is revised, including a key to species and detailed descriptions and illustrations of the type material and males and females of each species. The male and female terminalia of Euepalpus species are described for the first time. Finally, I discuss the occurrence and distribution of sexual patches in Tachinini.
Robo-Advice: Transforming Households into Rational Economic Agents
Authors: D'Acunto Francesco , Rossi Alberto G.
Published: August 2023

Robo-advice uses big and open data to provide consumers with fully informed and rational-expectation benchmarks in all realms of household finance, including consumption, saving, investment, and debt management choices. It also minimizes the monetary, cognitive, and psychological costs that households face in economic transactions. We review recent research on the features and effects of robo-advice on individual and aggregate economic outcomes through the lens of its differences from traditional human advice. We discuss the distributional implications of robo-advice, its potential role in increasing the effectiveness of economic policies, the role of providers’ incentives, and several questions that are still wide open for researchers in finance, economics, social psychology, and related fields.
Don’t forget the veggies! Identifying and addressing a lack of vegetable education in physiology
Authors: Moro Christian , Phelps Charlotte , McLean Michelle
Published: August 2023

Is nutritional literacy an important concept in physiology? This article identifies a paucity of content and addresses the need for vegetable intake education.