bluuebunny/crossref_metadata_2025 huggingface dataset:
Trends in healthcare utilization by patients with gout: A cross-sectional study using Health Insurance Review and Assessment Service data
Authors: Kang Do-Hyun , Lee Yoon Jae , Ha In-Hyuk , Song Ho Seub , Lee Ye-Seul
Published: February 2024

This study aimed to analyze the distribution of gout patients and the utilization of healthcare services in South Korea to provide valuable recommendations to clinicians and policymakers. A cross-sectional study was conducted. Claims data from the Health Insurance Review and Assessment Service spanning 2010 to 2019 were utilized, and a sample of 69,680 patients was included in the study. The incidence of gout was observed to be high in male patients over the age of 40, with most patients receiving outpatient care for gout management. Nonsteroidal anti-inflammatory drugs and urate-lowering agents were the most frequently prescribed medications, with prescriptions for colchicine and febuxostat increasing among urate-lowering agents. Musculoskeletal disorders were found to be the most common comorbidities among gout patients. Although the total costs of gout management increased, there was no significant increase in cost per patient. This study provides insights into the current state of healthcare utilization for gout patients in South Korea and trends in the disease burden and use of medications. The findings have crucial implications for clinicians and policymakers involved in decision-making regarding the management and treatment of gout.
Molecular characterization of allergic constitution based on network pharmacology and multi-omics analysis methods
Authors: Sun Pengcheng , Liu Xing , Wang Yi , Shen Rongmin , Chen Xuemei , Li Zhuqing , Cui Diankun , Wang Ji , Wang Qi
Published: February 2024

The objective of this study was to identify critical pathways associated with allergic constitution. Shared genes among allergic rhinitis (AR), asthma (AA), and atopic dermatitis (AD) were extracted from the GWAS catalog. RNA-seq data of AR, AA, and AD from gene expression omnibus (GEO) database were preprocessed and subjected to differential gene expression analysis. The differentially expressed genes (DEGs) were merged using the Robust Rank Aggregation (RRA) algorithm. Weighted gene co-expression network analysis (WGCNA) was performed to identify modules associated with allergies. Components of Guominkang (GMK) were obtained from 6 databases and activate components were identified by SwissADME website. Utilizing the SwissTarget Prediction, PharmMapper, SymMap, and HERB, the targets of GMK were predicted and subsequently validated using gene chip data from our team previous study. Differentially expressed proteins (DEPs) related to the allergic constitution were also extracted based on a previous study. Pathway enrichment analysis was performed using KOBAS-i on the GWAS, RRA, WGCNA modules, DEPs, and GMK targets. P values from multi-omics datasets were combined by meta-analysis, and Bonferroni correction was applied. The significant pathways were further validated using Gene Set Enrichment Analysis (GSEA) with intervention data of GMK. The GWAS results yielded 172 genes. Four datasets AR1, AA1, AD1, and AD2 were acquired from GSE75011, GSE125916, and GSE184237. The RRA algorithm identified 19 upregulated and 20 downregulated genes. WGCNA identified 5 significant modules, with the blue and turquoise modules displaying a moderate correlation with allergies. By performing network pharmacology analysis, we identified 127 active ingredients of GMK and predicted 618 targets. Validation using gene chip data confirmed 107 GMK targets. Single-omics pathway analysis was conducted using KOBAS-i, and 39 significant pathways were identified across multiple omics datasets. GSEA analysis using GMK intervention data identified 11 of 39 significant pathways as the final key pathways associated with the allergic constitution. Through multi-omics integrated pathway analysis, we identified 11 critical pathways of allergic constitution, including TH1 and TH2 cell differentiation, TLR cascade, and TH17 cell differentiation. Identifying these pathways suggests that the observed alterations at the pathway level may play significant roles in the molecular characteristics of the allergic constitution.
Ischemic stroke as an initial performance of polycythemia vera in young adults: A case report and literature review
Authors: Hui Shuo , Zhao Jingru , Huo Tiantian , Dong Lipeng , Xie Yanzhao , Wang Xinyao , Zhang Manli
Published: February 2024

Introduction:

As the second leading cause of death and disability worldwide, stroke is mainly caused by atherosclerosis and cardiac embolism, particularly in older individuals. Nevertheless, in young and otherwise healthy individuals, the causes of stroke can be more diverse and may include conditions such as patent foramen ovale, vasculitis, coagulopathies, genetic factors, or other undetermined causes. Although these other causes of stroke account for a relatively small proportion compared to ischemic stroke, they are becoming increasingly common in clinical practice and deserve attention. Here, we present a rare female patient with polycythemia vera (PV) who was admitted to the hospital as a stroke patient without any previous medical history.

Patient concerns:

A 40-year-old young woman felt sudden dizziness and slow response. After 4 days of being admitted, she developed blurry vision on the right.

Diagnoses:

Cranial magnetic resonance imaging revealed aberrant signals in the left temporal and parietal lobe, as well as multiple small focal signal abnormalities were observed in the left frontal lobe. Magnetic resonance angiography revealed partial stenosis of the left internal carotid artery. The patient’s blood routine examination revealed a significant elevation in complete blood counts, particularly the increase in red blood cells, as well as prolonged clotting time. An abdominal ultrasound and abdomen computed tomography showed splenomegaly. The outcome of the genetic testing was positive for the Janus kinase JAK2 exon V617F mutation (JAK2/V617F). The patient was diagnosed with PV-related stroke.

Interventions:

The patient was treated with phlebotomy, cytoreductive therapy, and low-dose aspirin antiplatelet therapy and was regularly followed up in hematology and neurology clinics after discharge.

Outcomes:

The patient’s red blood cell, leukocyte, and thrombocyte counts had fully normalized, with her hemoglobin level measuring at 146 g/L and hematocrit value at 43%. Furthermore, there had been a significant improvement in neurological symptoms.

Lessons:

PV, a rare hematological disorder, can present with ischemic stroke as the initial performance, and the diagnosis mainly relies on routine blood tests, bone marrow biopsies, and genetic test. Therefore, clinicians should pay attention to PV, a low-prevalence disease, when encountering stroke in youth.
Elucidation of the mechanism of Zhenbao pills for the treatment of spinal cord injury by network pharmacology and molecular docking: A review
Authors: Xu Mengru , Zhang Wenwen , Xu Sheng , Niu Xiaochen , Wang Li , Wang Xiaohui , Hao Haihu
Published: February 2024

To explore the mechanism of the Zhenbao pill (ZBP) in treating spinal cord injury (SCI). The TCMSP Database, HERB Database and literature search were used to screen the effective ingredients and targets of ZBP; SCI-related genes were searched in GeneCards, OMIM, PharmGkb, TTD and DrugBank databases; the potential targets of ZBP for treating SCI were predicted and Venn diagrams were drawn, and the “herb-ingredient-target” network was constructed by Cytoscape software. The PPI network was constructed by STRING software, and the core targets were screened by cytoNCA plug-in; GO enrichment and KEGG pathway analysis were performed on the predicted targets using the DAVID Platform, and visualized with the Microbiology Network Platform. The molecular docking between the key ingredients and the core target was carried out by AutoDockVina software. 391 active ingredients and 836 action targets were obtained from ZBP and there are 1557 SCI related genes in 5 disease databases. The top 5 active ingredients were Quercetin, Camptothecin, Kaempferol, Ethyl iso-allocholate, and Ethyl linoleate, and 5 core genes were SRC, CTNNB1, TP53, AKT1, and STAT3. GO enrichment analysis showed that the core targets were involved in 1206 biological processes, 120 cellular components and 160 molecular functions; KEGG enrichment analysis showed that the core targets involved 183 pathways, including PI3K-Akt signaling pathway and other signaling pathways. Molecular docking indicated that CTNNB1, SRC, TP53, AKT1 and STAT3 showed good binding ability with the active ingredients quercetin, kaempferol and ethyl isobutyric acid. ZBP improves SCI through multi-components, multi-targets and multi-pathways.
Status and trends of RGS16 based on data visualization analysis: A review
Authors: Wenbo Liu , Liangyu Xie , Zhiyong Lu , Gongchang Yu , Yuanzhen Chen , Bin Shi
Published: February 2024

G-protein signaling regulator 16 (RGS16) has been confirmed that RGS16 is associated with cancer, neurodegenerative diseases, and cardiovascular diseases. Moreover, many studies have shown that RGS16 can be used as a biomarker for cancer diagnosis and prognosis. We used CiteSpace and VOS viewer software to perform a bibliometric analysis of 290 publications in the core collection of Web of Science. All the articles come from 399 institutions, including 618 authors, 179 journals, 40 countries, 115 keywords, 1 language, two types of papers, and reviews. The United States has the largest number of publications. The Research Center of Allergy and Infectious Diseases (NIAID) publishes the most papers, Emory University is the most recent of all institutions with the most recent results in the RGS16 study. Cell biology is the most studied discipline, and the most studied topic is migration. Drury published RGS16-related articles with the most citations (n = 15), and Berman published articles with the most citations (n = 106). The biological applications of RGS16 are currently a hot area of RGS16 research, including inflammation, cancer, ulcerative colitis, metabolic acidosis, platelet activation, and thrombosis. The current scientometrics study provides an overview of RGS16 research from 1995 to 2022. This study provides an overview of current and potential future research hotspots in the field of RGS16 and can be used as a resource for interested researchers.
Preliminary investigation of a combined herbal extract of Aruncus dioicus, Cirsium nipponicum, and Ocimum basilicum for halitosis
Authors: Ha Na-Yeon , Jeong Haein , Son Juah , Cha Mi-Ran , Song Sukjin , Hwang Ji-Hyun , Kim Jinsung
Published: February 2024

Background:

Halitosis, the unpleasant odor in the oral cavity, has garnered increased attention and concern due to the growing significance of social interaction. SGE-107, a blend of 3 botanical drugs―Korean goat’s beard, Cirsium tanakae, and Basil―with caffeic acid as its indicator component. This study aims to investigate the efficacy of SGE-107 in treating halitosis in patients with mild gastrointestinal symptoms.

Methods:

We enrolled 25 participants with oral malodor and dyspeptic symptoms. We assessed the severity of halitosis using the visual analog scale. Throughout a 4-week period of administering SGE-107, we evaluated both objective and subjective parameters, including the halitosis-associated life-quality test, the Korean gastrointestinal symptom rating scale, levels of volatile sulfur compounds, salivary flow rate, oral moisture, tongue index, Winkel tongue coating index, and tongue temperature.

Results:

After the intervention period, both the visual analog scale (5.88 ± 1.03 vs 2.38 ± 0.93, P < .001) and the scores of the halitosis-associated life-quality test (31.21 ± 11.78 vs 13.83 ± 6.38, P < .001) showed significant reductions. The proportion of participants with abnormal levels of methyl mercaptan (a volatile sulfur compound) also significantly decreased (17, 70.8% vs 9, 37.5%, P = .039). Furthermore, there were significant improvements in reflux, constipation, diarrhea, and the total scores on the Korean gastrointestinal symptom rating scale. Throughout the study period, only 2 participants experienced mild adverse events.

Conclusion:

SGE-107 appears to be a safe and effective treatment for halitosis-associated with gastrointestinal symptoms; nevertheless, the limited sample size necessitates further large-scale randomized, controlled studies to confirm our findings.
Treatment outcomes and prognostic factors of patients with lymphoblastic lymphoma in East Asia
Authors: Kim Jinyong , Byun Ja Min , Hong Junshik , Koh Youngil , Shin Dong-Yeop , Kim Tae Min , Yoon Sung-Soo , Park Hyunkyung , Kim Inho
Published: February 2024

Lymphoblastic lymphoma (LBL) is a rare, aggressive non-Hodgkin lymphoma (NHL) that has no established therapeutic approaches. The aim of this study was to investigate optimal treatments and prognostic risk models for patients with LBL in East Asia. We retrospectively examined the clinical data and treatment courses of adult patients diagnosed as LBL by WHO 2017 classification system. Median overall survival (OS) of the 78 patients with LBL was 38.3 months. There was no significant difference in OS between the patients who were treated with acute lymphoblastic leukemia (ALL)-like protocols and with NHL-like protocols (72.4 months vs 37.5 months, respectively, P = .546). The patients treated with ALL-like protocols had significantly shorter progression-free survival (PFS) (median 11.7 months for ALL-like protocols vs 27.0 months for NHL-like protocols, P = .030). A multivariable analysis found that central nervous system (CNS) prophylaxis, relapse of CNS lesions, leukemic transformation, and response to initial treatment were risk factors for OS of patients with LBL. Hematopoietic stem cell transplantation had no survival benefit, compared with chemotherapy-only treatment. Less intensive chemotherapy may be more optimal for patients in East Asia. Prophylaxis and management of CNS lesions should be emphasized throughout the treatment of LBL.
Effects of hip abductor with external rotator strengthening versus proprioceptive training on pain and functions in patients with patellofemoral pain syndrome: A randomized controlled trial
Authors: Raju Aiswarya , Jayaraman Kavitha , Nuhmani Shibili , Sebastian Salbin , Khan Masood , Alghadir Ahmad H.
Published: February 2024

Background:

Strengthening the hip muscles, particularly the abductors and rotators, has been reported beneficial for treating Patellofemoral pain syndrome (PFPS). Proprioceptive training (PT) is also shown to improve musculoskeletal pain and function in PFPS. The most appropriate treatment from these 2 is unclear. This study aimed to compare the effects of hip abductors and external rotator strengthening exercises along with conventional physical therapy (CPT) vs the proprioceptive training of the knee along with CPT in patients with PFPS.

Methods:

Forty-five participants were divided into 3 groups, experimental group 1 (EG 1), experimental group 2 (EG 2), and control group (CG), with fifteen participants in each group. EG 1 received hip abductor and external rotator strengthening exercises in addition to CPT. EG 2 received proprioceptive training and CPT. CG received CPT alone. Intervention programs lasted for 4 weeks. The pain was measured by Kujala Anterior Knee Pain Scale (AKPS). The study was registered retrospectively in the protocol registration and results system (clinicaltrials.gov, ID: NCT05698797 on 26/01/2023).

Results:

AKPS scores significantly (P < .001) improved in all 3 groups. A significant (P < .05) difference was also observed between all 3 groups. The greatest improvement was observed in EG 1, followed by EG 2 and CG.

Conclusion:

The addition of hip abductor and external rotator strengthening exercises to a 4-week CPT program showed a more significant improvement in AKPS scores than the addition of proprioceptive training in patients with PFPS.
Considerations and anesthetic management of a patient with giant right atrial myxoma: A case report and literature review
Authors: Qu Yan , Li Lei , Deng Min , Song Duanyi , Gao Min , Su Guoning
Published: February 2024

Background:

Myxoma is a common type of primary cardiac tumor. However, there are few researches to illustrate challenge of safely inducing anesthesia in a patient with a giant right atrial myxoma at moderate altitude.

Patient concerns and diagnoses:

A 54-year-old female patient lived in a city with an average altitude of 1932 m with scheduled surgical treatment for giant right atrial myxoma, prompting discussions on appropriate anesthesia modalities given her prolonged residence at moderate altitude.

Methods and Results:

Considering the potential impact of moderate altitude on perioperative management, this study emphasizes the necessity of adequate volume preload therapy and the utility of transthoracic echocardiography or transesophageal echocardiography to prevent hemodynamic compromise. Furthermore, it highlights the unique consideration that, post-tumor removal, hypotension may not necessarily lead to decreased oxygen saturation in these patients.

Conclusion:

This case underscores the importance of avoiding hypotension, as pre-tumor resection blood pressure maintenance primarily determines blood oxygen concentration. Additionally, it sheds light on the intriguing observation that post-tumor removal hypotension may not result in decreased oxygen saturation. These findings have significant implications for the perioperative care of patients with giant right atrial myxoma at moderate altitudes.
Insight into deep learning for glioma IDH medical image analysis: A systematic review
Authors: Lv Qingqing , Liu Yihao , Sun Yingnan , Wu Minghua
Published: February 2024

Background:

Deep learning techniques explain the enormous potential of medical image analysis, particularly in digital pathology. Concurrently, molecular markers have gained increasing significance over the past decade in the context of glioma patients, providing novel insights into diagnosis and more personalized treatment options. Deep learning combined with imaging and molecular analysis enables more accurate prognostication of patients, more accurate treatment plan proposals, and accurate biomarker (IDH) prediction for gliomas. This systematic study examines the development of deep learning techniques for IDH prediction using histopathology images, spanning the period from 2019 to 2023.

Method:

The study adhered to the PRISMA reporting requirements, and databases including PubMed, Google Scholar, Google Search, and preprint repositories (such as arXiv) were systematically queried for pertinent literature spanning the period from 2019 to the 30th of 2023. Search phrases related to deep learning, digital pathology, glioma, and IDH were collaboratively utilized.

Results:

Fifteen papers meeting the inclusion criteria were included in the analysis. These criteria specifically encompassed studies utilizing deep learning for the analysis of hematoxylin and eosin images to determine the IDH status in patients with gliomas.

Conclusions:

When predicting the status of IDH, the classifier built on digital pathological images demonstrates exceptional performance. The study’s predictive effectiveness is enhanced with the utilization of the appropriate deep learning model. However, external verification is necessary to showcase their resilience and universality. Larger sample sizes and multicenter samples are necessary for more comprehensive research to evaluate performance and confirm clinical advantages.
LCN2 and ELANE overexpression induces sepsis
Authors: Wang Tao , Han Jian-Ge , Dong Wei , Yu Yong-Hao
Published: February 2024

Sepsis is a syndrome characterized by a systemic inflammatory response due to the invasion of pathogenic microorganisms. The relationship between Lipocalin-2 (LCN2), elastase, neutrophil expressed (ELANE) and sepsis remains unclear. The sepsis datasets GSE137340 and GSE154918 profiles were downloaded from gene expression omnibus generated from GPL10558. Batch normalization, differentially expressed Genes (DEGs) screening, weighted gene co-expression network analysis (WGCNA), functional enrichment analysis, Gene Set Enrichment Analysis (GSEA), immune infiltration analysis, construction and analysis of protein–protein interaction (PPI) networks, Comparative Toxicogenomics Database (CTD) analysis were performed. Gene expression heatmaps were generated. TargetScan was used to screen miRNAs of DEGs. 328 DEGs were identified. According to Gene Ontology (GO), in the Biological Process analysis, they were mainly enriched in immune response, apoptosis, inflammatory response, and immune response regulation signaling pathways. In cellular component analysis, they were mainly enriched in vesicles, cytoplasmic vesicles, and secretory granules. In Molecular Function analysis, they were mainly concentrated in hemoglobin binding, Toll-like receptor binding, immunoglobulin binding, and RAGE receptor binding. In Kyoto Encyclopedia of Genes and Genomes (KEGG), they were mainly enriched in NOD-like receptor signaling pathway, Toll-like receptor signaling pathway, TNF signaling pathway, P53 signaling pathway, and legionellosis. Seventeen modules were generated. The PPI network identified 4 core genes (MPO, ELANE, CTSG, LCN2). Gene expression heatmaps revealed that core genes (MPO, ELANE, CTSG, LCN2) were highly expressed in sepsis samples. CTD analysis found that MPO, ELANE, CTSG and LCN2 were associated with sepsis, peritonitis, meningitis, pneumonia, infection, and inflammation. LCN2 and ELANE are highly expressed in sepsis and may serve as molecular targets.
A randomized controlled trial: The efficacy and safety of Bushen Huoxue formula in the management of lower back pain from lumbar disc herniation
Authors: Yang Shengqi , Jia Yongwei , Zhang Jianpo , Zhai Weifeng , Xie Yue , Guo Ji
Published: February 2024

Background:

Lower back pain (LBP) arising from lumbar disc herniation (LDH) poses a challenging health issue, often necessitating therapeutic interventions. Bushen Huoxue formula (BSHXF) has proved as a potential treatment option with great clinical effect. However, comprehensive investigations into its efficacy and safety in conjunction with celecoxib for managing LBP from LDH are lacking. The objective of this article is to investigate the efficacy and safety of BSHXF in the management of patients with LBP from LDH.

Methods:

This single center, randomized clinical trial was conducted from March 2023 to September 2023 and all patients suffered from LBP of LDH. Participants were randomly assigned to the BSHXF group (celecoxib and BSHXF) or the control group (celecoxib and placebo). The patients received treatment for 2 weeks. Assessment was conducted before treatment, the last day of the treatment, 4 weeks and 8 weeks after the treatment. Oswestry Disability Index (ODI), Visual Analog Scale (VAS), Roland-Morris Disability Questionnaire (RMDQ), Timed up and go test (TUGT), trunk range of movement (Trunk ROM), Hospital Anxiety and Depression Scale (HADS) were used for the evaluation.

Results:

A total of 206 subjects completed treatment, among whom 104 participants were randomized to the BSHXF group and 102 participants were randomized to the control group. There were no significant differences between groups in terms of the observed indicators (P > .05). After treatment, patients in BSHXF group obtained significant lower scores at 2-week, 4-week, 8-week of VAS, ODI, RMDQ, TUGT, Trunk ROM and HADS than the baseline data (P < .05). The ODI score was significantly lower than the control group at 2-week, 4-week, 8-week (2w: 11.30 ± 5.80 vs 14.23 ± 6.33, P < .001; 4w: 10.95 ± 4.93 vs 13.54 ± 6.35, P < .001; 8w: 10.27 ± 5.25 vs 12.84 ± 6.57, P = .002). Similarly, the scores of VAS, RMDQ, TUGT, Trunk ROM scores of the BSHXF group markedly decreased at 2, 4, and 8-week when compared to their control group (P < .05). Furthermore, no significant difference showed up in the score of HADS between the between the BSHXF and the control group after treatment (P > .05).

Conclusion:

This randomized clinical trial found that BSXHF can help significantly improve the clinical outcomes of celecoxib including pain intensity reduction and lumbar function improvement in LBP patients.
Dynamic monitoring tools for patients admitted to the emergency department with circulatory failure: narrative review with panel-based recommendations
Authors: Douglas Ivor S. , Elwan Mohammed H. , Najarro Marta , Romagnoli Stefano
Published: February 2024

Intravenous fluid therapy is commonly administered in the emergency department (ED). Despite the deleterious potential of over- and under-resuscitation, professional society guidelines continue to recommend administering a fixed volume of fluid in initial resuscitation. Predicting whether a specific patient will respond to fluid therapy remains one of the most important, but challenging questions that ED clinicians face in clinical practice. Surrogate parameters (i.e. blood pressure and heart rate), are widely used in usual care to estimate changes in stroke volume (SV). Due to their inadequacy in estimating SV, noninvasive techniques (e.g. bioreactance, echocardiography, noninvasive finger cuff technology), have been proposed as a more accurate and readily deployable method for assessing flow and preload responsiveness. Dynamic monitoring systems based on cardiac preload challenge and assessment of SV, by using noninvasive and continuous methods, provide more accurate, feasible, efficient, and reasonably accurate strategy for prediction of fluid responsiveness than static measurements. In this article, we aimed to analyze the different methods currently available for dynamic monitoring of preload responsiveness.
Using case vignettes to study the presence of outcome, hindsight, and implicit bias in acute unplanned medical care: a cross-sectional study
Authors: Plaum Patricia , Visser Laura N. , de Groot Bas , Morsink Marlies E.B. , Duijst Wilma L.J.M. , Candel Bart G.J.
Published: February 2024

Background and importance

Various biases can impact decision-making and judgment of case quality in the Emergency Department (ED). Outcome and hindsight bias can lead to wrong retrospective judgment of care quality, and implicit bias can result in unjust treatment differences in the ED based on irrelevant patient characteristics.

Objectives

First, to evaluate the extent to which knowledge of an outcome influences physicians’ quality of care assessment. Secondly, to examine whether patients with functional disorders receive different treatment compared to patients with a somatic past medical history.

Design

A web-based cross-sectional study in which physicians received case vignettes with a case description and care provided. Physicians were informed about vignette outcomes in a randomized way (no, good, or bad outcome). Physicians rated quality of care for four case vignettes with different outcomes. Subsequently, they received two more case vignettes. Physicians were informed about the past medical history of the patient in a randomized way (somatic or functional). Physicians made treatment and diagnostic decisions for both cases.

Setting and participants

One hundred ninety-one Dutch emergency physicians (EPs) and general practitioners (GPs) participated.

Outcome measures and analysis

Quality of care was rated on a Likert scale (0–5) and dichotomized as adequate (yes/no). Physicians estimated the likelihood of patients experiencing a bad outcome for hindsight bias. For the second objective, physicians decided on prescribing analgesics and additional diagnostic tests.

Main results

Large differences existed in rated quality of care for three out of four vignettes based on different case outcomes. For example, physicians rated the quality of care as adequate in 44% (95% CI 33–57%) for an abdominal pain case with a bad outcome, compared to 88% (95% CI 78–94%) for a good outcome, and 84% (95% CI 73–91%) for no outcome (P < 0.01). The estimated likelihood of a bad outcome was higher if physicians received a vignette with a bad patient outcome. Fewer diagnostic tests were performed and fewer opioids were prescribed for patients with a functional disorder.

Conclusion

Outcome, hindsight, and implicit bias significantly influence decision-making and care quality assessment by Dutch EPs and GPs.
Risk factors and effect of dyspnea inappropriate treatment in adults’ emergency department: a retrospective cohort study
Authors: Balen Frederic , Lamy Sebastien , Froissart Léa , Mesnard Thomas , Sanchez Benjamin , Dubucs Xavier , Charpentier Sandrine
Published: February 2024

Dyspnea is a frequent symptom in adults’ emergency departments (EDs). Misdiagnosis at initial clinical examination is common, leading to early inappropriate treatment and increased in-hospital mortality. Risk factors of inappropriate treatment assessable at early examination remain undescribed herein. The objective of this study was to identify clinical risk factors of dyspnea and inappropriate treatment in patients admitted to ED. This is an observational retrospective cohort study. Patients over the age of 15 who were admitted to adult EDs of the University Hospital of Toulouse (France) with dyspnea were included from 1 July to 31 December 2019. The primary end-point was dyspnea and inappropriate treatment was initiated at ED. Inappropriate treatment was defined by looking at the final diagnosis of dyspnea at hospital discharge and early treatment provided. Afterward, this early treatment at ED was compared to the recommended treatment defined by the International Guidelines for Acute Heart Failure, bacterial pneumonia, chronic obstructive pulmonary disease, asthma or pulmonary embolism. A total of 2123 patients were analyzed. Of these, 809 (38%) had inappropriate treatment in ED. Independent risk factors of inappropriate treatment were: age over 75 years (OR, 1.46; 95% CI, 1.18–1.81), history of heart disease (OR, 1.32; 95% CI, 1.07–1.62) and lung disease (OR, 1.47; 95% CI, 1.21–1.78), SpO2 <90% (OR, 1.64; 95% CI, 1.37–2.02), bilateral rale (OR, 1.25; 95% CI, 1.01–1.66), focal cracklings (OR, 1.32; 95% CI, 1.05–1.66) and wheezing (OR, 1.62; 95% CI, 1.31–2.03). In multivariate analysis, under-treatment significantly increased in-hospital mortality (OR, 2.13; 95% CI, 1.29–3.52) compared to appropriate treatment. Over-treatment nonsignificantly increased in-hospital mortality (OR, 1.43; 95% CI, 0.99–2.06). Inappropriate treatment is frequent in patients admitted to ED for dyspnea. Patients older than 75 years, with comorbidities (heart or lung disease), hypoxemia (SpO2 <90%) or abnormal pulmonary auscultation (especially wheezing) are at risk of inappropriate treatment.
National Association of Clinical Nurse Specialists Affiliate Support for Professional Growth of Clinical Nurse Specialist Students
Authors: Pate Kimberly , Linder Julie Michelle
Published: February 2024

Purpose/Objectives

The purpose of this article was to describe how a National Association of Clinical Nurse Specialists affiliate partnered with a local university to engage clinical nurse specialist (CNS) students, enhance its mission and activities, and create succession planning opportunities, while providing mentorship and professional growth opportunities.

Description of the Project

Academic preparation of CNS students endeavors to instill professionalism. A 3-pronged partnership incorporating the inclusion of a student liaison on the board, presentation of student clinical work at the affiliate's annual conference, and development of a student scholarship was implemented.

Outcomes

Membership in professional nursing organizations for a CNS student provides exposure and access to professional development resources, socialization to the role, rewarding networking opportunities with peers and colleagues, and leadership development. Anecdotal feedback demonstrated a better understanding of the CNS role, increased confidence, and enhanced knowledge on topics such as legislative advocacy as well as experiences of sharing clinical challenges with CNS colleagues.

Conclusion

Partnership with the local university allowed the affiliate to maintain the influx of new CNSs, which sustains membership, nurtures the growth of new CNSs, and ensures the influx of new ideas. Furthermore, membership in professional nursing organizations is imperative to address the opportunities that exist in healthcare.
Lymphedema Surveillance and Prevention
Authors: Martone Patrick , Kline-Quiroz Cristina , Alpert Elisa , Lee Krystal , Marshall Genevieve
Published: February 2024

Lymphedema is a chronic condition, which can impact a person’s quality of life and function. Identifying lymphedema at an early stage is key to preventing a person from developing chronic lymphedema. Physiatry can play an important role in education, identification of risk factors, performing prospective lymphedema surveillance programs, and prevention/treatment of lymphedema. Incorporating lymphedema surveillance programs into routine cancer care provides physiatry with the opportunity to assess additional rehabilitation and functional needs of a cancer patient.
Fractured Knowledge
Authors: Engle Jessica , Marshall Genevieve , Lefkowitz Todd , Maltser Susan
Published: February 2024

Purpose

Traditional dogma suggests that individuals with cancer-related bone metastases should restrict their physical activity, potentially engaging cautiously in isometric exercises. However, occurrences of adverse skeletal events during supervised exercise in patients with known metastatic bone lesions are exceedingly rare, contrasting with the substantial risks of inactivity. Recent studies advocate for well-designed exercise regimens for individuals with bone metastases, highlighting the potential benefits of enhanced mental well-being, fatigue mitigation, enhanced physical function, and an overall improved quality of life. As cancer rehabilitation physicians, it falls within our scope of practice to diagnose, assess, and manage risk while emphasizing the role of exercise and rehabilitation therapies, accompanied by necessary precautions, for individuals with metastatic cancer. This review aims to explore the safety and feasibility of exercise interventions for individuals affected by metastatic bone disease.
Reliability, validity, and responsiveness of a smartphone-based manikin to support pain self-reporting
Authors: van der Veer Sabine N. , Ali S. Mustafa , Yu Ziqiao , McBeth John , Chiarotto Alessandro , James Ben , Dixon William G.
Published: February 2024

Introduction:

Many people worldwide suffer from chronic pain. Improving our knowledge on chronic pain prevalence and management requires methods to collect pain self-reports in large populations. Smartphone-based tools could aid data collection by allowing people to use their own device, but the measurement properties of such tools are largely unknown.

Objectives:

To assess the reliability, validity, and responsiveness of a smartphone-based manikin to support pain self-reporting.

Methods:

We recruited people with fibromyalgia, rheumatoid arthritis, and/or osteoarthritis and access to a smartphone and the internet. Data collection included the Global Pain Scale at baseline and follow-up, and 30 daily pain drawings completed on a 2-dimensional, gender-neutral manikin. After deriving participants' pain extent from their manikin drawings, we evaluated convergent and discriminative validity, test–retest reliability, and responsiveness and assessed findings against internationally agreed criteria for good measurement properties.

Results:

We recruited 131 people; 104 were included in the full sample, submitting 2185 unique pain drawings. Manikin-derived pain extent had excellent test–retest reliability (intraclass correlation coefficient, 0.94), moderate convergent validity (ρ, 0.46), and an ability to distinguish fibromyalgia and osteoarthritis from rheumatoid arthritis (F statistics, 30.41 and 14.36, respectively; P < 0.001). Responsiveness was poor (ρ, 0.2; P, 0.06) and did not meet the respective criterion for good measurement properties.

Conclusion:

Our findings suggest that smartphone-based manikins can be a reliable and valid method for pain self-reporting, but that further research is warranted to explore, enhance, and confirm the ability of such manikins to detect a change in pain over time.
Ambulatory Robotic Colectomy: Factors Affecting and Affected by Postoperative Opioid Use
Authors: Vu Michael M. , Franko Jace J. , Buzadzhi Anna , Prey Beau , Rusev Maksim , Lavery Marta , Rashidi Laila
Published: February 2024

Background:

The ongoing opioid crisis demands an investigation into the factors driving postoperative opioid use. Ambulatory robotic colectomies are an emerging concept in colorectal surgery, but concerns persist surrounding adequate pain control for these patients who are discharged very early. We sought to identify key factors affecting recovery room opioid use (ROU) and additional outpatient opioid prescriptions (AOP) after ambulatory robotic colectomies.

Methods:

This was a single-institution retrospective review of ambulatory robotic colon resections performed between 2019 and 2022. Patients were included if they discharged on the same day (SDD) or postoperative day 1 (POD1). Outcomes of interest included ROU [measured in parenteral morphine milligram equivalents (MMEs)], AOP (written between PODs 2 to 7), postoperative emergency department presentations, and readmissions.

Results:

Two hundred nineteen cases were examined, 48 of which underwent SDD. The mean ROU was 29.4 MME, and 8.7% of patients required AOP. Between SDD and POD1 patients, there were no differences in postoperative emergency department presentations, readmissions, recovery opioid use, or additional outpatient opioid scripts. Older age was associated with a lower ROU (−0.54 MME for each additional year). Older age, a higher body mass index, and right-sided colectomies were also more likely to use zero ROU. Readmissions were strongly associated with lower ROU. Among SDD patients, lower ROU was also associated with higher rates of AOP.

Conclusion:

Ambulatory robotic colectomies and SDD can be performed with low opioid use and readmission rates. Notably, we found an association between low ROU and more readmission, and, in some cases, higher AOP. This suggests that adequate pain control during the postoperative recovery phase is a crucial component of reducing these negative outcomes.
Pressure control of magnetic order and excitations in the pyrochlore antiferromagnet
MgCr2O4
Authors: Nassar L. S. , Lane H. , Haberl B. , Graves-Brook M. , Winn B. , Koohpayeh S. M. , Mourigal M.
Published: February 2024

MgCr2O4 is one of the best-known realizations of the pyrochlore-lattice Heisenberg antiferromagnet. The strong antiferromagnetic exchange interactions are perturbed by small further-neighbor exchanges such that this compound may in principle realize a spiral spin liquid (SSL) phase in the zero-temperature limit. However, a spin Jahn-Teller transition below TN≈13 K yields a complicated long-range magnetic order with multiple coexisting propagation vectors. We present neutron scattering and thermomagnetic measurements of MgCr2O4 samples under applied hydrostatic pressure up to P=1.7 GPa demonstrating the existence of multiple close-lying nearly degenerate magnetic ground states. We show that the application of hydrostatic pressure increases the ordering temperature by around 0.8 K per GPa and increases the bandwidth of the magnetic excitations by around 0.5 meV per GPa. We also evidence a strong tendency for the preferential occupation of a subset of magnetic domains under pressure. In particular, we show that the k=(0,0,1) magnetic phase, which is almost negligible at ambient pressure, dramatically increases in spectral weight under pressure. This modifies the spectrum of magnetic excitations, which we interpret unambiguously as spin waves from multiple magnetic domains. Moreover, we report that the application of pressure reveals a feature in the magnetic susceptibility above the magnetostructural transition. We interpret this as the onset of a short-range ordered phase associated with k=(0,0,1), previously not observed in magnetometry measurements.

Published by the American Physical Society
2024
Long-range
S
-wave
DD*
interaction in covariant chiral effective field theory
Authors: Zhai Qing-Yu , Liu Ming-Zhu , Lu Jun-Xu , Geng Li-Sheng
Published: February 2024

Motivated by the recent lattice QCD study of the DD* interaction at unphysical quark masses, we perform a theoretical study of the DD* interaction in covariant chiral effective field theory. In particular, we calculate the relevant leading-order two-pion exchange contributions. The results compare favorably with the lattice QCD results, supporting the conclusion that the intermediate-range DD* interaction is dominated by two-pion exchanges and the one-pion exchange contribution is absent. At a quantitative level, the covariant chiral perturbation theory results agree better with the lattice QCD results than their nonrelativistic counterparts, showing the relevance of relativistic corrections in the charm sector.

Published by the American Physical Society
2024
Sensor noise in
LISA

Pathfinder
: Laser frequency noise and its coupling to the optical test mass readout
Authors: Armano M. , Audley H. , Baird J. , Binetruy P. , Born M. , Bortoluzzi D. , Brandt N. , Castelli E. , Cavalleri A. , Cesarini A. , Cruise A. M. , Danzmann K. , de Deus Silva M. , Diepholz I. , Dixon G. , Dolesi R. , Ferraioli L. , Ferroni V. , Fitzsimons E. D. , Flatscher R. , Freschi M. , García A. , Gerndt R. , Gesa L. , Giardini D. , Gibert F. , Giusteri R. , Grimani C. , Grzymisch J. , Guzman F. , Harrison I. , Hartig M.-S. , Hechenblaikner G. , Heinzel G. , Hewitson M. , Hollington D. , Hoyland D. , Hueller M. , Inchauspé H. , Jennrich O. , Jetzer P. , Johann U. , Johlander B. , Karnesis N. , Kaune B. , Killow C. J. , Korsakova N. , Lobo J. A. , López-Zaragoza J. P. , Maarschalkerweerd R. , Mance D. , Martín V. , Martin-Polo L. , Martin-Porqueras F. , Martino J. , McNamara P. W. , Mendes J. , Mendes L. , Meshksar N. , Monsky A. , Nofrarias M. , Paczkowski S. , Perreur-Lloyd M. , Petiteau A. , Plagnol E. , Ramos-Castro J. , Reiche J. , Rivas F. , Robertson D. I. , Russano G. , Sanjuan J. , Slutsky J. , Sopuerta C. F. , Steier F. , Sumner T. , Texier D. , Thorpe J. I. , Vetrugno D. , Vitale S. , Wand V. , Wanner G. , Ward H. , Wass P. J. , Weber W. J. , Wissel L. , Wittchen A. , Zweifel P.
Published: February 2024

The (LPF) mission successfully demonstrated the feasibility of the technology needed for the future space borne gravitational wave observatory LISA. A key subsystem under study was the laser interferometer, which measured the changes in relative distance in between two test masses (TMs). It achieved a sensitivity of 32.0−1.7+2.4  fm/Hz, which was significantly better than the prelaunch tests. This improved performance allowed direct observation of the influence of laser frequency noise in the readout. The differences in optical path lengths between the measurement and reference beams in the individual interferometers of our setup determined the level of this undesired readout noise. Here, we discuss the dedicated experiments performed on LPF to measure these differences with high precision. We reached differences in path length difference between (368±5)  μm and (329.6±0.9)  μm which are significantly below the required level of 1 mm or 1000  μm. These results are an important contribution to our understanding of the overall sensor performance. Moreover, we observed varying levels of laser frequency noise over the course of the mission. We provide evidence that these do not originate from the laser frequency stabilization scheme which worked as expected. Therefore, this frequency stabilization would be applicable to other missions with similar laser frequency stability requirements.

Published by the American Physical Society
2024
Designing e-learning courses for classroom and distance learning in physics: The role of learning tasks
Authors: Laumann Daniel , Fischer Julian Alexander , Stürmer-Steinmann Tatjana K. , Welberg Julia , Weßnigk Susanne , Neumann Knut
Published: February 2024

Digital learning technologies have grown increasingly important in physics education, partly enforced through the COVID-19 pandemic. During the pandemic, digital technologies allowed for continued teaching and learning of students even when schools were closed. While research in psychology and educational technology has yielded many insights into the effectiveness of e-learning courses, fewer studies have examined the design of e-learning courses. Few studies have empirically investigated the design of learning tasks as a central element of e-learning courses. The present study analyzes how the design of tasks in e-learning courses, specifically with respect to their degree of openness as well as the relevance of their contexts, influences students’ behavioral engagement, learning outcomes, and situational interest. Due to the importance of e-learning courses during the COVID-19 pandemic, we also analyzed the extent to which specific learning settings (classroom learning, distance learning) influence the effects of e-learning course design on students’ behavioral engagement, learning outcomes, and situational interest. To investigate the research questions, we analyzed a total of N=1060 datasets for 12 different e-learning courses (3 to 5 lessons, middle school physics), of which n=557 were completed before and n=503 during the COVID-19 pandemic. The results suggest that e-learning courses with a high proportion of learning tasks that relate to meaningful real-world contexts appear to be more conducive to behavioral engagement, learning outcomes, and situational interest. Regarding the consideration of open-ended tasks, the results suggest that these appear to be more useful for classroom learning but should be used in a limited way when designing e-learning courses for distance education.

Published by the American Physical Society
2024
Multidimensional political polarization in online social networks
Authors: Peralta Antonio F. , Ramaciotti Pedro , Kertész János , Iñiguez Gerardo
Published: February 2024

Political polarization in online social platforms is a rapidly growing phenomenon worldwide. Despite their relevance to modern-day politics, the structure and dynamics of polarized states in digital spaces are still poorly understood. We analyze the community structure of a two-layer, interconnected network of French Twitter users, where one layer contains members of Parliament and the other one regular users. We obtain an optimal representation of the network in a four-dimensional political opinion space by combining network embedding methods and political survey data. We find structurally cohesive groups sharing common political attitudes and relate them to the political party landscape in France. The distribution of opinions of professional politicians is narrower than that of regular users, indicating the presence of more extreme attitudes in the general population. We find that politically extreme communities interact less with other groups as compared to more centrist groups. We apply an empirically tested social influence model to the two-layer network to pinpoint interaction mechanisms that can describe the political polarization seen in data, particularly for centrist groups. Our results shed light on the social behaviors that drive digital platforms towards polarization and uncover an informative multidimensional space to assess political attitudes online.

Published by the American Physical Society
2024