bluuebunny/crossref_metadata_2025 huggingface dataset:
International consensus recommendations on the management of people with haemophilia B
Authors: Hart Daniel P. , Matino Davide , Astermark Jan , Dolan Gerard , d’Oiron Roseline , Hermans Cédric , Jiménez-Yuste Victor , Linares Adriana , Matsushita Tadashi , McRae Simon , Ozelo Margareth C. , Platton Sean , Stafford Darrel , Sidonio Robert F. , Tiede Andreas
Published: April 2022

Haemophilia B is a rare X-linked genetic deficiency of coagulation factor IX (FIX) that, if untreated, can cause recurrent and disabling bleeding, potentially leading to severe arthropathy and/or life-threatening haemorrhage. Recent decades have brought significant improvements in haemophilia B management, including the advent of recombinant FIX and extended half-life FIX. This therapeutic landscape continues to evolve with several non-factor replacement therapies and gene therapies under investigation. Given the rarity of haemophilia B, the evidence base and clinical experience on which to establish clinical guidelines are relatively sparse and are further challenged by features that are distinct from haemophilia A, precluding extrapolation of existing haemophilia A guidelines. Due to the paucity of formal haemophilia B-specific clinical guidance, an international Author Group was convened to develop a clinical practice framework. The group comprised 15 haematology specialists from Europe, Australia, Japan, Latin America and North America, covering adult and paediatric haematology, laboratory medicine and biomedical science. A hybrid approach combining a systematic review of haemophilia B literature with discussion of clinical experience utilized a modified Delphi format to develop a comprehensive set of clinical recommendations. This approach resulted in 29 recommendations for the clinical management of haemophilia B across five topics, including product treatment choice, therapeutic agent laboratory monitoring, pharmacokinetics considerations, inhibitor management and preparing for gene therapy. It is anticipated that this clinical practice framework will complement existing guidelines in the management of people with haemophilia B in routine clinical practice and could be adapted and applied across different regions and countries.
An overview of treatment options for patients with relapsed/refractory multiple myeloma and renal impairment
Authors: Dimopoulos Meletios A. , Mikhael Joseph , Terpos Evangelos , Leleu Xavier , Moreau Philippe , Bladé Joan , Kim Jin Seok , Stockerl-Goldstein Keith , Richardson Paul G.
Published: April 2022

Renal impairment (RI) is a relatively common complication of multiple myeloma, which increases in frequency as disease becomes more advanced and recovery of renal function becomes less likely as patients progress through lines of therapy. Clinical trials in the relapsed/refractory multiple myeloma (RRMM) setting have not uniformly included patients with RI or robustly reported their outcomes. Here, we review existing data among patients with RI and RRMM across drug classes (including immunomodulatory agents, proteasome inhibitors, monoclonal antibodies, antibody-drug conjugates, chimeric antigen receptor T-cell therapies, and exportin-1 inhibitor) to provide an improved understanding of available treatment options for this important population. We highlight data from pivotal clinical trials, including data relating to renal response (as defined by the International Myeloma Working Group) and discuss real-world experiences in patients with RI, where applicable. Despite substantial advances in RRMM treatment, the presence of RI remains associated with reduced overall survival. Consistent inclusion of patients with RI, and uniform reporting of their outcomes, should be encouraged in future prospective trials of treatments for RRMM.
Supervisor Computer-Mediated Immediate Behaviors: Fostering Subordinate Communication
Authors: Kelly Stephanie , Dawkins Ayanna , Rocker Kenneth T. , Someshwar Shonai , Penny Travis
Published: April 2022

Through the guidance of construal level theory, this paper tested a model in which supervisor computer-mediated immediate behaviors indirectly increased subordinates’ relational maintenance communication at work and decreased their self-censoring behaviors in the presence of their supervisor. The influence of supervisor computer-mediated immediate behaviors was mediated through the affective construal variable of job satisfaction and the psychological construal variable of perceived immediacy. Results indicate that even in the virtual workplace, strategic use of supervisor communicative behaviors can promote healthy workplace communication practices for subordinates.
The Mental Health Impacts of COVID-19 on PK–12 Students: A Systematic Review of Emerging Literature
Authors: Naff David , Williams Shenita , Furman-Darby Jenna , Yeung Melissa
Published: April 2022

The mental health impact of the coronavirus disease 2019 (COVID-19) pandemic on PK–12 youth is likely an urgent and enduring concern, yet research on this topic is still emerging. To synthesize current knowledge, the researchers conducted a systematic review of empirical studies exploring the mental health impacts of COVID-19. Five themes emerged across 104 included studies: (a) the pandemic proved widely disruptive to PK–12 youth; (b) there was a clear connection between the mental health of caregivers (e.g., parents) and children; (c) the pandemic broadly increased levels of stress, anxiety, and depression in PK–12 youth; (d) students were particularly affected on the basis of age, gender, race/ethnicity, socioeconomic status, and previous mental health or disability diagnosis; and (e) youth demonstrated negative and positive coping strategies and even saw some positive mental health outcomes during the pandemic. Implications for research, practice, and policy are discussed.
Ultracompact Nanophotonics: Light Emission and Manipulation with Metasurfaces
Authors: Hong Yu-Heng , Hsu Wen-Cheng , Tsai Wei-Cheng , Huang Yao-Wei , Chen Shih-Chen , Kuo Hao-Chung
Published: April 2022

Internet of Things (IoT) technology is prosperous for the betterment of human well-being. With the expeditious needs of miniature functional devices and systems for adaptive optics and light manipulation at will, relevant sensing techniques are thus in the urgent stage of development. Extensive developments in ultrathin artificial structures, namely metasurfaces, are paving the way for the next-generation devices. A bunch of tunable and reconfigurable metasurfaces with diversified catalogs of mechanisms have been developed recently, enabling dynamic light modulation on demand. On the other hand, monolithic integration of metasurfaces and light-emitting sources form ultracompact meta-devices as well as exhibiting desired functionalities. Photon-matter interaction provides revolution in more compact meta-devices, manipulating light directly at the source. This study presents an outlook on this merging paradigm for ultracompact nanophotonics with metasurfaces, also known as metaphotonics. Recent advances in the field hold great promise for the novel photonic devices with light emission and manipulation in simplicity.
PyToxo: a Python tool for calculating penetrance tables of high-order epistasis models
Authors: González-Seoane Borja , Ponte-Fernández Christian , González-Domínguez Jorge , Martín María J.
Published: April 2022

Background

Epistasis is the interaction between different genes when expressing a certain phenotype. If epistasis involves more than two loci it is called high-order epistasis. High-order epistasis is an area under active research because it could be the cause of many complex traits. The most common way to specify an epistasis interaction is through a penetrance table.

Results

This paper presents PyToxo, a Python tool for generating penetrance tables from any-order epistasis models. Unlike other tools available in the bibliography, PyToxo is able to work with high-order models and realistic penetrance and heritability values, achieving high-precision results in a short time. In addition, PyToxo is distributed as open-source software and includes several interfaces to ease its use.

Conclusions

PyToxo provides the scientific community with a useful tool to evaluate algorithms and methods that can detect high-order epistasis to continue advancing in the discovery of the causes behind complex diseases.
Pentad: a tool for distance-dependent analysis of Hi-C interactions within and between chromatin compartments
Authors: Magnitov Mikhail D. , Garaev Azat K. , Tyakht Alexander V. , Ulianov Sergey V. , Razin Sergey V.
Published: April 2022

Background

Understanding the role of various factors in 3D genome organization is essential to determine their impact on shaping large-scale chromatin units such as euchromatin (A) and heterochromatin (B) compartments. At this level, chromatin compaction is extensively modulated when transcription and epigenetic profiles change upon cell differentiation and response to various external impacts. However, detailed analysis of chromatin contact patterns within and between compartments is complicated because of a lack of suitable computational methods.

Results

We developed a tool, Pentad, to perform calculation, visualisation and quantitative analysis of the average chromatin compartment from the Hi-C matrices in cis, trans, and specified genomic distances. As we demonstrated by applying Pentad to publicly available Hi-C datasets, it helps to reliably detect redistribution of contact frequency in the chromatin compartments and assess alterations in the compartment strength.

Conclusions

Pentad is a simple tool for the analysis of changes in chromatin compartmentalization in various biological conditions. Pentad is freely available at https://github.com/magnitov/pentad.
Elevated ASCL1 activity creates de novo regulatory elements associated with neuronal differentiation
Authors: Woods Laura M. , Ali Fahad R. , Gomez Roshna , Chernukhin Igor , Marcos Daniel , Parkinson Lydia M. , Tayoun Ahmad N. Abou , Carroll Jason S. , Philpott Anna
Published: April 2022

Background

The pro-neural transcription factor ASCL1 is a master regulator of neurogenesis and a key factor necessary for the reprogramming of permissive cell types to neurons. Endogenously, ASCL1 expression is often associated with neuroblast stem-ness. Moreover, ASCL1-mediated reprogramming of fibroblasts to differentiated neurons is commonly achieved using artificially high levels of ASCL1 protein, where ASCL1 acts as an “on-target” pioneer factor. However, the genome-wide effects of enhancing ASCL1 activity in a permissive neurogenic environment has not been thoroughly investigated. Here, we overexpressed ASCL1 in the neuronally-permissive context of neuroblastoma (NB) cells where modest endogenous ASCL1 supports the neuroblast programme.

Results

Increasing ASCL1 in neuroblastoma cells both enhances binding at existing ASCL1 sites and also leads to creation of numerous additional, lower affinity binding sites. These extensive genome-wide changes in ASCL1 binding result in significant reprogramming of the NB transcriptome, redirecting it from a proliferative neuroblastic state towards one favouring neuronal differentiation. Mechanistically, ASCL1-mediated cell cycle exit and differentiation can be increased further by preventing its multi-site phosphorylation, which is associated with additional changes in genome-wide binding and gene activation profiles.

Conclusions

Our findings show that enhancing ASCL1 activity in a neurogenic environment both increases binding at endogenous ASCL1 sites and also results in additional binding to new low affinity sites that favours neuronal differentiation over the proliferating neuroblast programme supported by the endogenous protein. These findings have important implications for controlling processes of neurogenesis in cancer and cellular reprogramming.
Influence of reduced N-fertilizer application on foliar chemicals and functional qualities of tea plants under Toxoptera aurantii infestation
Authors: Pokharel Sabin Saurav , Zhong Yanni , Changning Lv , Shen Fangyuan , Likun Li , Parajulee Megha N. , Fang Wanping , Chen Fajun
Published: April 2022

Background

The tea aphid,Toxoptera aurantii(Boyer de Fonscolombe) is a polyphagous pest predominant in tea orchards and has become the most pernicious pest deteriorating tea quality. Nitrogen (N) is essential to plant growth improvement, and it can significantly impact plant defensive ability against aphid infestation. This study was designed to quantify the influence of reduced N-fertilizer application on foliar chemicals and functional quality parameters of tea plants against the infestation ofT. aurantii. In this study, the tea seedlings (cv. Longjing43) were applied with normal level (NL) of N-fertilizer (240 kg N ha−1) along with reduced N-fertilizer levels (70%NL and 50%NL), and with and withoutT. aurantiiinfestation.

Results

The results showed that N-fertilizer application significantly affected plant biomass and photosynthetic indexes, foliar soluble nutrients and polyphenols, tea catechins, caffeine, essential amino acids, volatile organic compounds of tea seedlings, and the population dynamics ofT. aurantii. Compared with the normal N-fertilizer level, the reduced N-fertilizer application (70%NL and 50%NL) significantly decreased all the foliar functional quality components of tea seedlings without aphid infestation, while these components were increased in tea seedlings with aphid infestation. Moreover, the transcript expression levels of foliar functional genes (includingCsTCS, CsTs1,andCsGT1) were significantly higher in the NL, and significantly lower in the 50%NL for tea seedlings without aphid infestation, while the transcript expression levels were significantly higher in 50%NL in aphid inoculated tea seedlings.

Conclusion

The results demonstrated that the reduced N-fertilizer application could enhance foliar chemicals and functional quality parameters of tea plants especially withT. aurantiiinfestation, which can relieve soil nitrogen pressure and reduce pesticide use for control of tea aphid infestation in tea plantations.
Percutaneous dilatational tracheostomy with single use bronchoscopes versus reusable bronchoscopes – a prospective randomized trial (TraSUB)
Authors: Tariparast Pischtaz Adel , Brockmann Andrés , Hartwig Rainer , Kluge Stefan , Grensemann Jörn
Published: April 2022

Background

Apart from conventional reusable bronchoscopes, single-use bronchoscopes (SUB) were recently introduced. Data suggest that SUB might prevent from the risk of cross contamination (i.e. multiresistant pathogens, SARS CoV-2) and save costs. We aimed to investigate visualization, ventilation, handling characteristics, changes in patients’ gas exchange, and costs associated with both types of bronchoscopes during percutaneous dilatational tracheostomy (PDT).

Methods

In this prospective, randomized, noninferiority study, 46 patients undergoing PDT were randomized 1:1 to PDT with SUB (Ambu aScope) or reusable bronchoscopes (CONV, Olympus BF-P60). Visualization of tracheal structures rated on 4-point Likert scales was the primary end-point. Furthermore, quality of ventilation, device handling characteristics, changes in the patients’ gas exchange, pH values, and costs were assessed.

Results

Noninferiority for visualization (the primary endpoint) was demonstrated for the SUB group. Mean visualization scores (lower values better) were 4.1 (95% confidence intervals: 3.9;4.3) for SUB vs. 4.1 (4.0;4.2) for CONV. Noninferiority of ventilation (estimated by minute volume and SpO2) during the procedure could be shown as well. Mean score was 2.6 (2.0;3.1) for SUB vs. 2.4 (2.1;2.7) for CONV (lower values better). No significant differences regarding handling (SUB: 1.2 (1.0;1.4), CONV: 1.3 (1.1;1.6)), blood gas analyses and respiratory variables were found. Cost analysis in our institution revealed 93 € per conventional bronchoscopy versus 232.50 € with SUB, not considering an estimate for possible infection due to cross-contamination with the reusable device.

Conclusion

In our study, visualization and overall performance of the SUB during PDT were noninferior to reusable bronchoscopes. Therefore, PDT with SUB is feasible and should be considered if favored by individual institution’s cost analysis.

Trial registration.

ClinicalTrials.gov, NCT03952247. Submitted for registration on 28/04/2019 and first posted on 16/05/2019.
ABO and RhD blood group are not associated with mortality and morbidity in critically ill patients; a multicentre observational study of 29 512 patients
Authors: Kander Thomas , Bjurström Martin F. , Frigyesi Attila , Jöud Magnus , Nilsson Caroline U.
Published: April 2022

Background

The ABO and RhD blood group represent antigens on the surface of erythrocytes. The ABO blood group antigens are also present on multiple other cells. Interestingly, previous studies have demonstrated associations between the blood group and many types of disease. The present study aimed to identifying associations between the ABO blood group, the RhD blood group, and morbidity and mortality in a mixed cohort and in six pre-defined subgroups of critically ill patients.

Methods

Adult patients admitted to any of the five intensive care units (ICUs) in the Scania Region, Sweden, between February 2007 and April 2021 were eligible for inclusion. The outcomes were mortality analysed at 28– and 90–days as well as at the end of observation and morbidity measured using days alive and free of (DAF) invasive ventilation (DAF ventilation) and DAF circulatory support, including vasopressors or inotropes (DAF circulation), maximum Sequential Organ Failure Assessment score (SOFAmax) the first 28 days after admission and length of stay. All outcomes were analysed in separate multivariable regression models adjusted for age and sex. In addition, in a sensitivity analysis, five subgroups of patients with the main diagnoses sepsis, septic shock, acute respiratory distress syndrome, cardiac arrest and trauma were analysed using the same separate multivariable regression models.

Results

In total, 29,512 unique patients were included in the analyses. There were no significant differences for any of the outcomes between non-O blood groups and blood group O, or between RhD blood groups. In the sensitivity analysis of subgroups, there were no differences in mortality between non-O blood groups and blood group O or between the RhD blood groups. AB was the most common blood group in the COVID-19 cohort.

Conclusions

The ABO and RhD blood group do not influence mortality or morbidity in a general critically ill patient population.
Risk factors of the post-reperfusion syndrome during orthotopic liver transplantation: a clinical observational study
Authors: Sahmeddini Mohammad Ali , Tehran Samaneh Ghazanfar , Khosravi Mohammad Bagher , Eghbal Mohammad Hossein , Asmarian Naeimehossadat , Khalili Fatemeh , Vatankhah Pooya , Izadi Somayeh
Published: April 2022

Background

Post reperfusion syndrome (PRS) is a relatively common and life-threatening complication during orthotopic liver transplantation (OLT). It is associated with poor patient and transplanted liver outcomes.

Objective

This study aimed to compare the risk factors of PRS during OLT.

Design

Clinical-epidemiological observational retrospective study.

Setting

We gathered the records of patients who underwent OLT in 3 years, from May 22, 2016, to May 22, 2019, in Namazi and Bu-Ali Sina organ transplantation hospitals.

Patients

In this study, we assessed 1182 patients who underwent OLT. Patients were divided into two groups based on the presence or absence of PRS.

Main outcome measures

Diagnosing the predictors of PRS was the primary outcome of this study.

Results

Results showed that age > 60 years, Child-Pugh scores C, higher Model End Stage liver disease score, and preoperative sodium < 130 mmol/l (parameters of the liver recipient), increase in cold ischemic time (the donors’ parameters), and the classical technique (the surgical parameters) were the strong predictors of PRS.

Conclusions

The results indicated that underlying liver disease was not the predictor of PRS in the presence of other risk factors; therefore, clinicians have to consider these risk factors in patients undergoing OLT.
Anesthesiology trainees performing flexible scope intubation in spontaneously breathing patients in the left lateral position and the supine position: a prospective randomized trial
Authors: Charoenkoop Poonyanuch , Luetrakool Punchika , Puttapornpattana Tipanan , Sangdee Nakkanan
Published: April 2022

Background

Flexible scope intubation is an important airway management skill that requires hands-on training in a real airway. We compared flexible scope intubation by trainees between patients in the left lateral and supine positions.

Methods

Forty patients aged 20 to 80 years with American Society of Anesthesiologists physical status class I to III were scheduled for elective surgery under general endotracheal anesthesia in Ramathibodi Hospital from February 2020 to June 2020. Patients were randomly assigned to be intubated in one of two positions: supine (Group S) or left lateral (Group L). Trainees performed flexible scope intubation in sedated patients under the supervision of an attending anesthesiologist. Intubation success, time to successful intubation, number of attempts, airway adjustment maneuvers, and hemodynamic changes were compared between groups.

Results

Patient characteristics did not differ between groups except for Mallampati airway classification. The rate of successful intubation on the first attempt and intubation time did not significantly differ between groups. The proportion of patients who required a jaw thrust during intubation was significantly lower in Group L (10.5% vs. 85%; P < 0.01). Blood pressure and oxygen saturation declined in both groups after intubation. The relative risk of desaturation in patients in the left lateral position compared with the supine position was 0.44 (0.1649–1.1978).

Conclusion

The rate of successful flexible scope intubation on the first attempt and intubation time did not differ between the groups. The proportion of patients who required a jaw thrust maneuver was significantly lower in patients in the left lateral position.

Trial registration

https://www.thaiclinicaltrials.org/ (TCTR20200208001) on 08/02/2020.
Knowledge of diabetes among Gambian adults: evidence from a nation-wide survey
Authors: Nkoka Owen , Ntenda Peter A. M. , Phiri Yohane V. A. , Mabuza Gugulethu N. , Dlamini Sihle A.
Published: April 2022

Background

Diabetes is increasingly becoming a public health problem in developing countries like The Gambia. Prevention of diabetes and appropriate management of the disease largely depends on correct knowledge of the risk factors and signs and symptoms of the condition. However, studies that have assessed knowledge of diabetes at population level are limited. We examined the knowledge of diabetes risk factors, and signs and symptoms among Gambian adults.

Methods

The 2019–2020 Gambia demographic and health survey data was used to analyze 4, 436 men and 6, 186 women. Knowledge of diabetes was assessed two-fold: (1) diabetes risk factors and (2) diabetes signs and symptoms. Several sociodemographic factors were considered for analysis. A generalized estimating equation model was fitted to test the association between the selected sociodemographic factors and diabetes knowledge.

Results

Among the men, 7.6% and 3.1% had knowledge about diabetes risk factors, and signs and symptoms, respectively. Approximately 3.1% and 1.2% of the women included in the analysis had knowledge of diabetes risk factors, and signs and symptoms, respectively. Men who were aged ≥ 35 years were more likely to have knowledge regarding diabetes risk factors (adjusted odds ratio (AOR) = 1.90, 95% confidence interval (CI) = 1.12–3.22), and signs and symptoms (AOR = 2.59, 95% CI = 1.08–6.17). Having access to media was associated with increased odds of having knowledge regarding diabetes risk factors (AOR = 1.61, 95% CI = 1.09–2.37) and signs and symptoms (AOR = 2.04, 95% CI = 1.07–3.88) among men. Among other factors, educational level was positively associated with having diabetes knowledge among both men and women. Heterogeneities regarding diabetes knowledge were observed among different regions and areas of residence.

Conclusion

There is a need to improve awareness regarding diabetes in The Gambia as low knowledge has been observed. Programs aimed to improve diabetes knowledge should consider regional and area of residence variations in their designs. The use of mass media and strengthening the education sector in The Gambia may be of importance in raising diabetes knowledge among Gambian adults.
Impacts of eosinophil percentage on prognosis acute type A aortic dissection patients
Authors: Shao Yue , Ye Liu , Shi Hao-ming , Wang Xin-mei , Luo Jun , Liu Lu , Wu Qing-chen
Published: April 2022

Background

Eosinophils are pro-inflammatory cells involved in thrombosis and have been proposed as a prognosis marker in acute ischemic stroke and ST-elevation myocardial Infarction. Here, we sought to clarify the prognostic value of eosinophil percentage (EOS%) in patients with acute type A aortic dissection (AAAD).

Methods

We examined 183 consecutive AAAD patients. Based on the optimum cut-off value of EOS% determined by X-tile software, patients were classified into the low EOS% (EOS% ≤ 0.1) and high EOS% groups (EOS% > 0.1). We performed multivariate regression analysis and Kaplan–Meier (KM) survival curves to assess the association between EOS% and mortality. Eosinophil accumulation in aortic dissection intraluminal thrombus was confirmed using hematoxylin–eosin (H&E) staining. An external cohort from Medical Information Mart for Intensive Care IV was performed to validate the results.

Results

Relative to surviving patients, those who died during hospitalization had significantly lower EOS% (p = 0.001) but significantly higher WBC (p = 0.002) and neutrophil (p = 0.001) counts. Multivariate regression analysis identified EOS% as an independent predictor of in-hospital and 1-year mortality. KM curves revealed that 1-year cumulative mortality was significantly higher in the low EOS% group, although it was mainly attributed to the higher 30-day mortality. H&E staining revealed massive infiltration of eosinophils in all 20 thrombus specimens. The external validation confirmed that relative to survivors, patients with in-hospital mortality (p = 0.010) had significantly lower EOS%. Moreover, multivariate regression analyses identified that decreased EOS% was independently significantly associated with in-hospital mortality.

Conclusions

Low EOS% is significantly related to increased mortality rates in AAAD patients.
Age-friendly communities and well-being realization among older native and immigrant populations in the Netherlands: a theory-guided study protocol
Authors: Nieboer Anna P. , Cramm Jane M.
Published: April 2022

Background

With rapid population aging, policy makers and service providers are becoming increasingly aware of the importance of building and maintaining age-friendly communities. Clearly, “age-friendly” relates to the impact of context on people’s well-being. But how? What is an age-friendly community, and does that differ for native and immigrant older people? Up until now, how native and immigrant older people in the Netherlands perceive community age-friendliness, and whether and how age-friendly communities help them realize well-being, remains unknown which limits opportunities to develop appropriate interventions. This article presents a study protocol to identify, theoretically and empirically, how and under what conditions age-friendly communities help native and immigrant older people in the Netherlands realize well-being.

We present a theory-guided approach to elucidate differences in neighborhood age-friendliness and requirements for age-friendly community development between native Dutch and immigrant older people. Good interventions are built on good theory. The proposed research will add to theory building by systematically examining what older people get from their neighborhoods and the conditions that influence well-being realization, including the role of individual and neighborhood resources. We posit that physical and social well-being realization will be enhanced in age-friendly communities that support realization of multiple well-being needs and development of solidarity within and between groups in the neighborhood via cross-cutting sharing arrangements.

Methods

We present a mixed-methods design among native and immigrant older people (Turkish, Surinamese and Moroccan) consisting of: (i) Q-studies (combining in-depth interview-based and quantitative analyses); (ii) a pilot survey study; (iii) a main survey study in Rotterdam, the Hague, Utrecht, and Amsterdam; and (iv) focus groups.

Discussion

By exploring truly new ground in the field of age-friendly communities, the results of the proposed research will provide new empirical evidence, advance theory, and be helpful for the development of interventions aimed at improving age-friendliness and well-being for native and immigrant older populations, thereby contributing to resolving the societal challenges of caring for and supporting older people in the community.
Use, usability, and impact of a card-based conversation tool to support communication about end-of-life preferences in residential elder care – a qualitative study of staff experiences
Authors: Johansson Therese , Tishelman Carol , Eriksson Lars E. , Cohen Joachim , Goliath Ida
Published: April 2022

Background

Proactive conversations about individual preferences between residents, relatives, and staff can support person-centred, value-concordant end-of-life (EOL) care. Nevertheless, prevalence of such conversations is still low in residential care homes (RCHs), often relating to staff’s perceived lack of skills and confidence. Using tools may help staff to facilitate EOL conversations. While many EOL-specific tools are script-based and focus on identifying and documenting treatment priorities, the DöBra card tool is developed to stimulate reflection and conversation about EOL care values and preferences. In this study, we explore staff’s experiences of use, usability, and perceived impact of the DöBra cards in supporting discussion about EOL care in RCH settings.

Methods

This qualitative study was based on data from two participatory action research processes in which RCH staff tested and evaluated use of DöBra cards in EOL conversations. Data comprise 6 interviews and 8 group meetings with a total of 13 participants from 7 facilities. Qualitative content analysis was performed to identify key concepts in relation to use, usability, and impact of the DöBra cards in RCH practice.

Results

Based on participants’ experiences of using the DöBra cards as an EOL conversation tool in RCHs, we identified three main categories in relation to its usefulness. Outcomes of using the cards (1) included the outlining of content of conversations and supporting connection and development of rapport. Perceived impact (2) related to enabling openings for future communication and aligning care goals between stakeholders. Use and usability of the cards (3) were influenced by supporting and limiting factors on the personal and contextual level.

Conclusions

This study demonstrates how the DöBra cards was found to be useful by staff for facilitating conversations about EOL values, influencing both the content of discussion and interactions between those present. The tool encouraged reflection and interaction, which staff perceived as potentially helpful in building preparedness for future care-decision making. The combination of providing a shared framework and being adaptable in use appeared to be key features for the DöBra cards usability in the RCH setting.
Clinical value of serum cholinesterase levels in Nephrotic syndrome: an observational study
Authors: Goto Kimihiko , Kono Keiji , Fujii Hideki , Goto Shunsuke , Nishi Shinichi
Published: April 2022

Background

Nephrotic syndrome (NS) results in massive proteinuria and hypoalbuminemia, which are responsible for a compensatory increase in protein synthesis in the liver. Serum cholinesterase (ChE) also increases in NS. However, its clinical value is not fully elucidated.

Methods

In this study, 184 patients with NS who underwent kidney biopsy were included. The patients were divided into two groups according to serum ChE levels, as follows: hypercholinesterasemia (HC) and non-hypercholinesterasemia (NHC) groups. The clinical factors were compared between the two groups.

Results

The HC group had significantly more severe proteinuria and higher prevalence of high selective proteinuria than the NHC group. Furthermore, the prevalence of minimal change nephrotic syndrome (MCNS) was significantly higher in the HC group than that in the NHC group. Multivariate analysis revealed that the severity of proteinuria and MCNS were significantly associated with HC.

Conclusion

In this study, HC in NS was associated with the severity of proteinuria and MCNS, and could help clinicians predict the histological diagnosis of NS.
Neck-specific strengthening exercise compared with placebo sham ultrasound in patients with migraine: a randomized controlled trial
Authors: Benatto Mariana Tedeschi , Florencio Lidiane Lima , Bragatto Marcela Mendes , Dach Fabíola , Fernández-de-las-Peñas César , Bevilaqua-Grossi Débora
Published: April 2022

Background

Migraine patients have musculoskeletal disorders and pain in the cervical. And, despite the pathophysiology demonstrating the relationship between migraine and the cervical spine, the effectiveness of craniocervical exercises in these patients has not been verified. So, the aimed of this study was verify the effectiveness of craniocervical muscle-strengthening exercise (CMSE) in reducing the frequency and intensity of headache in migraine patients. 

Methods

A two-armed, parallel-group randomized controlled trial with a 3-month follow-up was performed. For eight weeks, the volunteers in the intervention group (n = 21) performed a protocol of CMSE, while those in the sham ultrasound group (n = 21) received the application of disconnected therapeutic ultrasound in the upper trapezius and guideline for home-stretching. The primary outcomes were the frequency and intensity of the headache. The secondary outcomes were questionnaires about migraine and neck disability, and satisfaction with the treatment, cervical range of motion, the pressure pain threshold, craniocervical flexion test (CCFT), cervical muscle strength and endurance test, and the cervical muscle activity during the physical tests.

Results

No differences were observed for the changes observed in primary outcomes after eight weeks and at the 3-months follow up (p > 0.05). For the secondary outcomes, craniocervical exercises improved the sensitivity of the frontal muscle (p = 0.040) and promoted a reduced amplitude of muscle activity of the anterior scalene and upper trapezius in the last stages of CCFT (p ≤ 0.010). There was also reduced muscle activity of the anterior scalene and splenius capitis in the endurance test (p ≤ 0.045), as evaluated by surface electromyography.

Conclusion

CMSE were insufficient in reducing the frequency and intensity of headache, improving the performance of the cervical muscles, or reducing migraine and neck pain-related disabilities. This was found despite a decreased electromyographic activity of the cervical muscles during the last stages of CCFT and increased median frequency during the endurance test.

Trial registration

Accession code RBR-8gfv5j, registered 28/11/2016 in the Registro Brasileiro de Ensaios Clínicos (ReBEC).
Enablers and barriers to introduction of obstetrics ultrasound service at primary care facilities in a resource-limited setting: a qualitative study in four regions of Ethiopia
Authors: Roro Meselech Assegid , Aredo Abebech Demissie , Kebede Tesfaye , Estifanos Abiy Seifu
Published: April 2022

Background

The World Health Organization (WHO) recommends a minimum of eight ANC contacts during pregnancy, of which having one ultrasound examination before 24 weeks of gestation is indicated. Ultrasound plays a significant role in the surveillance and management of high-risk pregnancies. However, the obstetric ultrasound coverage in resource limited settings remains low. Evidence examining the barriers and facilitators to obstetrics ultrasound use in a resource-limited setting like Ethiopia is lacking. This qualitative study explored the facilitators and barriers to introducing obstetric Vscan Access ultrasound in primary health care facilities in Ethiopia.

Methods

The study employed a qualitative descriptive exploratory study design using in-depth interviews (IDIs) and focus group discussions (FGDs). The study participant were mothers who have had recent birth, community members, maternal and newborn service providers, and their managers. We employed an inductive thematic analysis to analyze the data.

Result

We conducted a total of ten FGDs, three with community members and seven with maternal and newborn service providers, and 52 IDIs with the service providers and health facility managers. Two major themes, health system related and client-related factors, emerged from the analysis. The health system related enablers include increased knowledge and skill of the providers, improved mothers and providers’ motivation, increased service utilization, and improved quality of maternal and newborn care (MNC), and enhanced referral system. The health system related barriers include service interruption, staff shortage/workload, and the providers’ limited capacity. Under the main theme of client-related factors, barriers include perceived limited knowledge and skills of providers and the small size of the ultrasound machine while the facilitators include mothers’ needs and interest in ultrasound scan, availability of free of charge ultrasound service, and increased demand for ultrasound scan service.

Conclusion

Our data suggest that the health system provides an enabling context to introduce limited obstetric ultrasound service and routinely provide the service through mid-level maternal care providers at primary health care level in resource limited settings. Overcoming the health system and client related barriers will maximize and sustain the use of the technology.
The benefits and acceptability of virtual reality interventions for women with metastatic breast cancer in their homes; a pilot randomised trial
Authors: Reynolds Lisa M. , Cavadino Alana , Chin Stanley , Little Zoë , Akroyd Amelia , Tennant Geraldine , Dobson Rosie , Broom Reuben , Gautier Adèle
Published: April 2022

Background

Women with metastatic breast cancer (MBC) report debilitating physical and psychological symptoms, including fatigue, anxiety, and pain, that greatly impact their quality of life. Immersive virtual reality (VR) has been proposed as an adjunctive pain therapy for patients with cancer, and evidence suggests it may also decrease symptoms of anxiety and depression. The purpose of this pilot study was to assess whether VR should be pursued as a feasible and acceptable adjunctive therapy to alleviate physical and psychological symptoms in women with MBC.

Methods

We conducted a pilot study testing the acceptability and efficacy of VR interventions with MBC patients to improve quality of life and to produce enduring decreases in fatigue, pain, depression, anxiety, and stress. Participants completed two different week-long VR experiences, reporting the prevalence of symptoms immediately before and after each study week, and 48 h later. Linear mixed models including fixed effects (VR intervention, counterbalancing order, and study week) and random effects (participant) were used to assess the effect of immersive VR on all outcome measures.

Results

Thirty-eight women with MBC completed the VR interventions and were included in analyses. Significant improvements post-intervention and/or 48 h later were demonstrated for quality of life, fatigue, pain, depression, anxiety, and stress. Across the entire study period, these differences met the criteria of a clinically important difference for quality of life, fatigue, depression, and stress. Participants reported feelings of relaxation and enjoyment and were highly likely to use the interventions gain.

Conclusions

Our results demonstrate that VR experiences offer enduring benefits to the physical and psychological well-being of women with MBC. VR interventions are a feasible and acceptable intervention that can be conducted in a patient’s own home. Such interventions are worthy of future investigation as a novel approach to improving quality of life in a patient population that have often been overlooked.

Trial registration

Prospectively registered on 25th October 2019 with Australian New Zealand Clinical Trials Registry (ref: ACTRN12619001480178).
Application of One-Step Nucleic Acid Amplification (OSNA) in different cancer entities and usefulness in prostate cancer: a systematic review
Authors: Cuadras Mercè , Planas Jacques , Celma Ana , Regis Lucas , de Torres Inés M. , Semidey M. Eugenia , Trilla Enrique , Morote Juan
Published: April 2022

Background

Lymph node (LN) status is a key prognostic factor in the decision-making process of different cancer entities, including prostate cancer (PCa). Sectioning and haematoxylin and eosin (H&E) staining technique remain the gold standard for the evaluation of LN metastases despite some limitations, especially low sensitivity in detecting an accurate tumour burden within the LN, as well as a subjective and time-consuming result. One-step nucleic acid amplification (OSNA) quantifies mRNA copies of cytokeratin 19 (CK19) in a fast, objective, automated, and reproducible way, raising a general interest to explore its utility for lymphatic metastasis identification in different malignancies.

Methods

To present the latest evidence related to the detection of LN metastases in several tumours by using OSNA compared with the conventional H&E method, a systematic review of articles published since March 2021 was conducted using PubMed, Cochrane Library, and Web of Science databases. References from primary papers and review articles were checked to obtain further potential studies. Our procedure for evaluating records identified during the literature search followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria. With the aim to design and justify future clinical routine use of OSNA in PCa, novel PCa evidence has been included in this review for the first time.

Results

Twenty five studies were included. LN from six different groups of tumours: breast, gastrointestinal, gynecological, lung, head and neck and prostate cancers has been assessed. OSNA was compared with post-operative formalin-fixed paraffin-embedded tissue sections with H&E staining as the reference standard. Contingency tables were created, and concordance rate, sensitivity, specificity and predictive values were reported. Seventeen studies analysed the discordant cases using different techniques.

Conclusion

OSNA method has a high diagnostic accuracy for the detection of LN metastases in several CK19 expressing tumours. Available evidence might encourage future investigations about its usage in PCa patients to improve LN staging and prognosis.
Long-term survival among colorectal cancer patients in Finland, 1991–2015: a nationwide population-based registry study
Authors: Olenius Tobias , Koskenvuo Laura , Koskensalo Selja , Lepistö Anna , Böckelman Camilla
Published: April 2022

Background

Colorectal cancer (CRC) incidence in Finland has risen steadily. Given development in cancer treatments in recent decades, disease-specific data on the long-term prognosis of patients may be obsolete. Thus, this study aimed to report 5-year disease-specific survival (DSS) and relative survival based on tumour spread and site among CRC patients diagnosed between 1991 and 2015 in Finland.

Material and methods

We conducted a population-based registry study among 59 465 CRC patients identified from the Finnish Cancer Registry.

Results

The 5-year DSS for all CRC patients was 56.7% [95% confidence interval (CI) 56.3–57.1%] for 1991 through 2015. Tumour site-specific survival has improved for the period 2006–2015 versus 1991–2005 for right-sided colon cancer from 54.8% (95% CI 53.8–55.8%) to 59.9% (95% CI 58.7–61.1%), for left-sided colon cancer from 54.1% (95% CI 52.9–55.3%) to 61.0% (95% CI 59.8–62.2%) and for rectal cancer from 53.6% (95% CI 52.2–55.0%) to 62.3% (95% CI 61.3–63.3%). The 5-year relative survival for the period 2006 through 2015 was 93.6% for localised disease (stage I); 84.2% for locally advanced tumour invading adjacent structures (stage II); 68.2% for regional disease with regional lymph node metastases (stage III); and 14.0% for metastatic disease (stage IV).

Conclusions

This study confirms that survival for CRC has improved in recent decades in Finland, mirroring observations from other Western countries. However, the classification of tumour spread within the Finnish Cancer Registry differs slightly from the TNM classification, thereby limiting the generalisability of these results.
Influence of implantation of diffractive trifocal intraocular lenses on standard automated perimetry
Authors: Lee Jinhee , Mori Yosai , Minami Keiichiro , Miyata Kazunori
Published: April 2022

Background

This prospective comparative study aimed to investigate the influence of diffractive trifocal intraocular lenses (IOLs) implantation on standard automated perimetry.

Methods

Patients with no diseases affecting the visual field had undergone cataract surgery following the implantation of trifocal or monofocal IOLs from July 2019 to August 2020 were recruited. The normality of the anterior and posterior segments and absence of glaucomatous optic nerve cupping were confirmed preoperatively by slit-lamp examination. Standard automated perimetry was performed using Humphrey Visual Field 10–2 testing, 2–3 months after cataract surgery in only one eye per patient. The mean deviation (MD) and foveal sensitivity were compared between IOLs in eyes with acceptable reliability indices and best-corrected visual acuity of 20/25 or better.

Results

Among the 83 eyes of the 83 patients included, 39 and 29 eyes eligible for perimetry analysis had trifocal and monofocal IOLs, respectively. The mean MD and foveal sensitivity in eyes with trifocal IOLs were significantly lower than those in eyes with monofocal IOLs (P < 0.021), with mean differences of 0.77 and 1.01 dB, respectively.

Conclusion

The comparison in nonglaucomatous eyes demonstrated that the influence of trifocal IOLs on standard automated perimetry was greater than that of monofocal IOLs.