bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on Abuse in Home Care: A Scoping Review
Authors: Balkaran Kevin , Linton Janice , Doupe Malcolm , Roger Kerstin , Kelly Christine
Published: April 2023

Home care is the preferred care option for most people who need support; yet abuse exists in these settings toward both home care workers and clients. There are no existing reviews that assess the scope of current research on abuse in home care, and tangentially related reviews are dated. For these reasons, a scoping review is warranted to map the current state of research on abuse in home care and examine current interventions in this field. Databases selected for searching were Medline and EMBASE on OVID, Scopus, and the following databases in EBSCOhost: Academic Search Complete, AgeLine, and Cumulative Index to Nursing and Allied Health Literature. Records were included if: (a) they were written in English; (b) the participants were home care workers or clients age 18 years or older; (c) they were published in journals; (d) they undertook empirical research; and (e) they were published within the last 10-year period. Following Graham et al. (2006), the 52 included articles are categorized as either knowledge inquiry or as intervention studies. We find three themes among knowledge inquiry studies: (1) prevalence and types of abuse in home care, (2) abuse in the context of living with dementia, and (3) working conditions and abuse. Analysis from the intervention studies suggest that not all organizations have specific policies and practices to prevent abuse, and no existing interventions to protect the well-being of clients were identified. Findings from this review can inform up-to-date practice and policymaking to improve the health and well-being of home care clients and workers.
The Impact of Oversizing in Thoracic Endovascular Aortic Repair on Long-Term Outcomes in Uncomplicated Type B Aortic Dissection: A Single-Center Retrospective Study
Authors: Xiang Dongqiao , Chai Bin , Huang Jia , Liang Huimin , Liang Bin , Zhao Huangxuan , Zheng Chuansheng
Published: April 2023

Purpose:

The purpose of this study was to assess the impact of oversizing in thoracic endovascular aortic repair (TEVAR) on early and long-term survival and major adverse events in patients with uncomplicated type B aortic dissection (TBAD).

Methods:

Between January 2010 and December 2018, 226 patients who were diagnosed with uncomplicated TBAD and received TEVAR were analyzed retrospectively. The patients were divided into ≤5% oversizing (n=153) and >5% oversizing (n=73) groups. Primary end points were all-cause and aortic-related mortalities. Secondary end points were procedure-related complications, including retrograde type A aortic dissection (RTAD), endoleak, distal stent-induced new entry (SINE), and late reintervention. All-cause and aortic-related mortalities were assessed using the Kaplan-Meier survival method, while procedure-related complications were evaluated using a competing risk model with all-cause death as a competing risk.

Results:

Mean oversizing was 2.1%±1.5% in the ≤5% oversizing group and 9.6%±4.1% in the >5% oversizing group. Differences in the 30-day mortality and adverse events between the 2 groups were statistically insignificant. The freedom from all-cause mortality was comparable between the ≤5% oversizing group and the >5% oversizing group (≤5%: 93.3% at 5 years, >5%: 92.3% at 5 years, p=0.957). No significant difference was observed between both groups in the freedom from aortic-related mortality (≤5%: 95.0% at 5 years, >5%: 96.7% at 5 years, p=0.928). However, the competing risk analyses revealed that the cumulative incidence of RTAD was statistically significantly greater in the >5% oversizing group than in the ≤5% oversizing group (≤5%: 1(0.7%) at 5 years, >5%: 6(6.9%) at 5 years, p=0.007). All RTADs occurred within a year of TEVAR. The differences in the cumulative incidences of type I endoleak, distal SINE, and late reintervention were not significant between the 2 groups.

Conclusion:

The differences in the 5-year all-cause mortality and aortic-related mortality between patients with uncomplicated TBAD who received TEVAR with ≤5% oversizing and those who got TEVAR with >5% oversizing were insignificant. However, oversizing >5% was considerably associated with an increased risk of RTAD within a year of TEVAR, suggesting that oversizing ≤5% may be the appropriate size for TEVAR in patients with uncomplicated TBAD.

Clinical Impact

For patients with uncomplicated TBAD, choosing oversizing ≤5% in endovascular treatment is beneficial to reduce the risk of postoperative retrograde type A aortic dissection. This finding provides a basis for stent size selection in endovascular repair. In addition, one year after TEVAR is the main time period for postoperative retrograde type A aortic dissection, and attention should be paid to the management and follow-up of this period.
Long-term Evaluation of Proximal Aortic Neck Dilatation After Endovascular Abdominal Aortic Aneurysm Repair With a Variety of Contemporary Endografts
Authors: Chatzelas Dimitrios A. , Pitoulias Apostolos G. , Loutradis Charalampos N. , Zampaka Theodosia N. , Karkos Christos D. , Christopoulos Dimitrios C. , Pitoulias Georgios A.
Published: April 2023

Purpose:

To measure the long-term proximal aortic neck dilatation (AND) after elective endovascular aortic aneurysm repair (EVAR) with a variety of contemporary, third-generation, endograft devices.

Materials and Methods:

This is a noninterventional prospective cohort study of 157 patients that underwent standard EVAR with self-expanding abdominal endografts. Patients’ recruitment lasted from 2013 to 2017, and postoperative follow-up was up to 5 years. A computed tomography angiography (CTA) was performed at the first month and then at 1, 2, and 5 years. Proximal aortic neck’s (PAN) basic morphological characteristics (diameter, length, angulation) were measured based on the analysis of CTA in a standardized fashion. Neck-related adverse events, such as migration, endoleak or rupture, and reinterventions were recorded.

Results:

Significant straightening of the PAN was evident even in the first-month CTA with concurrent neck shortening that became significant at 5 years. Both the suprarenal aorta and the PAN significantly dilated overtime, with PAN dilating more progressively. Mean neck dilatation at the juxtarenal level was 0.8±0.4 mm at 1 year, 1.8±0.8 mm at 2 years, and 3.9±1.7 mm at 5 years, with a mean neck dilatation rate of 0.07 mm/month overall. The incidence of AND ≥2.5 mm was 37.2% at 2 years and 58.1% at 5 years after EVAR and was considered important (≥5 mm) in 11.5% of patients at 2 years and 30.6% of patients at 5 years. A multivariate analysis performed showed that the endograft oversizing, the preoperative neck diameter, and the preoperative abdominal aortic aneurysm sac diameter served as independent predictors of AND at 5 years. At the 5-year follow-up, 8 late type Ia endoleaks (6.5%) and 7 caudal migrations (5.6%) were identified, while no late ruptures were reported. In total, 11 late endovascular reinterventions (8.9%) were performed. Overall, proximal neck-related adverse outcomes (5/7 migrations and 5/8 endoleaks) and reinterventions (7/11) were significantly associated with the presence of important late AND.

Conclusion:

Proximal AND after EVAR is common. It can influence the long-term durability of proximal endograft fixation and is significantly associated with adverse outcomes, often leading to reinterventions. A systemic and extended surveillance protocol is needed for maintenance of good long-term results.

Clinical Impact

This is a thorough and systematic analysis of the long-term geometric remodeling of the proximal aortic neck after EVAR, that highlights the importance of a strict, and extended surveillance protocol for maintenance of good long-term results of EVAR.
The Construction and Validation of a new Predictive Model for Overall Survival of Clear Cell Renal Cell Carcinoma Patients with Bone Metastasis Based on Machine Learning Algorithm
Authors: Le Yijun , Xu Wen , Guo Wei
Published: April 2023

Background

This study aimed to develop and validate predictive models based on machine learning (ML) algorithms for patients with bone metastases (BM) from clear cell renal cell carcinoma (ccRCC) and to identify appropriate models for clinical decision-making.

Methods

In this retrospective study, we obtained information on ccRCC patients diagnosed with bone metastasis (ccRCC-BM), from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015 ( n = 1490), and collected clinicopathological information on ccRCC-BM patients at our hospital ( n = 42). We then applied four ML algorithms: extreme gradient boosting (XGB), logistic regression (LR), random forest (RF), and Naive Bayes model (NB), to develop models for predicting the overall survival (OS) of patients with bone metastasis from ccRCC. In the SEER dataset, 70% of the patients were randomly divided into training cohorts and the remaining 30% were used as validation cohorts. Data from our center were used as an external validation cohort. Finally, we evaluated the model performance using receiver operating characteristic curves (ROC), area under the ROC curve (AUC), accuracy, specificity, and F1-scores.

Results

The mean survival times of patients in the SEER and Chinese cohort were 21.8 months and 37.0 months, respectively. Age, marital status, grade, T stage, N stage, tumor size, brain metastasis, liver metastasis, lung metastasis, and surgery were included in the ML model. We observed that all four ML algorithms performed well in predicting the 1-year and 3-year OS of patients with ccRCC-BM.

Conclusion

ML is useful in predicting the survival of patients with ccRCC-BM, and ML models can play a positive role in clinical applications.
Enrichment of Circulating Tumor Cells of Lung Cancer and Correlation With Serum Leukomonocyte and Tumor Biomarkers: A Retrospective Study
Authors: Mei Zhou-Fang , Yan Jing , Qian Ling , He Yan-Chao , Feng Jing-Jing , Wang Jie , Jie Zhi-Jun , Zou Hua
Published: April 2023

Study design

Circulating tumor cells is important in the clinical diagnosis of cancer and there are a number of circulating tumor cell detection systems associated with different isolation strategies being validated. There is a novel platform, the CytoBot 2000, which utilizes a combination of physical and immunological technologies to isolate and capture circulating tumor cells.

Methods

In this retrospective study, 39 lung cancer patients and 11 normal healthy individuals were enrolled and performed circulating tumor cell tests and immunofluorescence staining with CytoBot 2000. The performance of this device was assessed by receiver operating characteristic curve. The clinical relevance of circulating tumor cells was assessed by Chi-square. The correlations between circulating tumor cell number and blood lymphocytes and tumor biomarkers were analyzed by Pearson correlation coefficient.

Results

The number of circulating tumor cell is significantly increased in lung cancer patients (3.74 > 0.45, P < .0001). The CytoBot 2000 presented a 100% (39/39) circulating tumor cell detection rate in lung cancer patients and 36% (4/11) in healthy individual blood samples, the sensitivity and specificity were 89.7% and 90.9%, respectively, and with the area under curve of 0.966. Further, there was a positive correlation between circulating tumor cell count and carcinoembryonic antigen 211 (R2 = 0.125, P = .027), but not blood lymphocytes ( P = .089).

Conclusions

This automatic platform showed excellent performance of circulating tumor cell detection by clinical sample. The tumor biomarkers increased with the number of circulating tumor cell in the lung cancer patients.
Advances in the Treatment of Rare Epidermal Growth Factor Receptor Mutations in Advanced Nonsmall-Cell Lung Cancer
Authors: Yu Limeng , Wang Ruilin , Zhao Yuhua , Wu Yingxi , Wang Lili , Chen Haiyang , He Zhen , Wang Qiming , Wu Yufeng
Published: April 2023

Epidermal growth factor receptor (EGFR) mutations are common driver genes in nonsmall-cell lung cancer and have different sensitivities to EGFR-tyrosine kinase inhibitors (EGFR-TKIs). EGFR is divided into classic mutations and rare mutations. Classic mutations are well known, but the understanding of rare mutations is not sufficient. In this article, we summarize the clinical research and treatment progress of rare mutations for different EGFR-TKIs and provide a basis for clinical treatment decisions.
Accumulated Dose Deviation of Rotational and Residual Setup Errors on Nasopharyngeal Carcinoma Using MIM Treated by Helical Tomotherapy
Authors: Yao Wenyan , Hu Jiang , Xu Peixun , He Mengxue , Fang Yongwen , Liu Mingzhi , Li Zongtai , He Huilang , Liu Hui , Sun Wenzhao , Xu Senkui
Published: April 2023

Background

To analyze the relationship between the rotational and residual setup errors and the dose deviation on nasopharyngeal carcinoma (NPC) treated by helical tomotherapy (HT).

Methods

From 25 July 2017 to 20 August 2019, 16 treated NPC patients were enrolled in the study. These patients were scanned with full target range megavoltage computed tomography (MVCT) every other day. Adaptive radiotherapy function application software MIM7.1.3 were used to accumulate the actual dose. The dose deviation with the initial plan dose of the patients’ target and organs at risk (OAR) were compared, and the correlation between the dose change and the setup errors (rotational setup errors and neck residual setup error) was analyzed.

Results

Translational setup errors increased farther away from the head. Statistically significant difference among 3 groups was achieved in the directions of left-right ( P < .001) and anteroposterior ( P < .001) by analysis of variance test. Compared with the initial plan dose, the actual accumulated dose of the target area decreased with the actual exposure dose of the OAR increased. However, most of the dosimetric parameters differed by less than 5%. No correlation was found between dose deviation values and the translational setup errors of target. However, sagittal rotational setup errors (pitch) had a positive relationship ( P < .05) with the avearge dose of PTVnd (L) ( r = 0.885), PTVnd(R) ( r = 0.547) PTV1( r = 0.633) and PTV2( r = 0.584). Transverse rotational setup errors (roll) had a positive relationship ( P < .05) with the avearge dose of PTVnd(R) ( r = 0.593), PTV1( r = 0.505) and PTV2( r = 0.662).

Conclusions

Dose deviation between the actual accumulated and initial plan is not negligible, but most indicators difference is less than 5%, NPC patients treated by HT with MVCT correction setup errors every other day did not need adaptive radiotherapy model unless got rapid tumor shrinkage or weight loss. Moreover, to minimize the dose deviation, more attention should be paid to the reduction of pitch, roll, and residual error of cervical vertebrae during body positioning.
Dose Delays, Dose Reductions, and Relative Total Dose Intensity in Patients With Advanced Cancer Who Exercised During Neoadjuvant Chemotherapy Treatment
Authors: Wonders Karen Y. , Schmitz Kathryn , Harness Jay
Published: April 2023

Background:

When it comes to chemotherapy, maintaining the dose and schedule of treatment are of vital importance, as clinical evidence suggests that dose intensity is associated with optimal treatment outcomes for various tumors. Yet, reduced dose intensity is a common method of mitigating the chemotherapy-induced side effects. Exercise has been shown to attenuate chemotherapy-related symptoms that frequently cluster together. Understanding this, we conducted a retrospective analysis in patients with advanced disease treated with adjuvant or neoadjuvant chemotherapy regimens and who completed exercise training during treatment.

Methods:

Data were collected retrospectively in a chart review of 184 patients, aged 18 years or older and treated for Stage IIIA-IV cancer. Data collection included baseline patient demographics and clinical characteristics, including age at diagnosis, cancer stage at initial diagnosis, chemotherapy regimen, and planned dose and schedule. Cancer types included brain (6.5%), breast (35.9%), colorectal (8.7%), non-Hodgkin’s lymphoma (7.6%), Hodgkin’s lymphoma (11.4%), non-small cell lung (16.8%), ovarian (10.9%), and pancreatic (2.2%). All patients completed at least 12 weeks of prescribed, individualized exercise. Each program included cardiovascular, resistance training, and flexibility components, under the supervision of a certified exercise oncology trainer once a week.

Results:

RDI was measured for each myelosuppressive agent in a regimen over the entire chemotherapy course and then averaged across the myelosuppressive agents in a regimen. An RDI of less than 85% was designated as the clinically meaningful threshold for reduction in RDI based on previously published studies.

Conclusions:

A considerable proportion of patients across regimens had dose delays (18.3%-74.3%) and dose reductions (18.1%-84.6%). Between 12% and 83.9% of patients missed at least 1 dose of a myelosuppressive agent that was part of their standard regimen. Overall, 50.8% of patients received less than 85% of the RDI. In short, patients with advanced cancer and an exercise adherence above 84.3% saw fewer chemotherapy dose delays and dose reductions. These delays and reductions occurred significantly less frequently compared to the published norms in the sedentary population ( P < .05).
Babao Dan Alleviates Cancer Cachexia in Mice Via Inhibiting IL-6/STAT3 Signaling Pathway
Authors: Qiu Zhengliang , Wo Da , Zhong Xiaomei , Chen Jinxiao , Ma En , He Jia , Peng Jun , Zhu Weidong , Ren Dan-ni
Published: April 2023

Background:

Cancer cachexia is a common but severe condition that causes muscle wasting, body weight loss, and progressive functional impairment, affecting over 50% of cancer patients. Currently, there are no effective treatments that can alleviate cachexia, and hence the discovery of new therapeutics that can effectively prevent or even reverse cancer cachexia is crucial. Babao Dan (BBD) is a Traditional Chinese Medicine (TCM) formula that has been used clinically in combating various cancers, however, its therapeutic potential in alleviating cancer cachexia remains unexplored. Our current study aims to determine the anti-cachectic effects of BBD treatment in alleviating cancer cachexia, as well as determining the underlying mechanisms involved.

Methods:

Mouse models of cancer cachexia were induced via implantation of CT26 colon adenocarcinoma cells, and the anti-cachectic effects and mechanisms of BBD were determined via examinations of body weight and muscle mass, as well as serum and muscle markers of cachexia and muscle atrophy.

Results:

CT26 tumor implantation reduced in the rapid occurrence of cancer cachexia characterized by marked reductions in body weight and muscle mass, functional decrease in muscle function and accelerated deaths. BBD administration not only demonstrated robust anti-cachectic ability via preventing decreases in body weight, muscle mass, and muscle atrophy, but also markedly prolonged survival. The effects of BBD in alleviating cancer cachexia and its associated adverse effects were due to its ability in preventing the activation of IL-6/STAT3 signaling post-CT26 tumor implantation.

Conclusion:

Our findings demonstrated the robust ability of BBD in preventing cancer cachexia and alleviating the main cachexia-induced symptoms as well as prolonging survival via inhibiting activation of IL-6/STAT3 signaling pathway. Therefore, our study demonstrating the strong anti-cachectic effects of BBD in mice may provide a theoretical basis for the use of BBD as a safe and effective drug in the treatment of cancer cachexia.
In Pursuit of the Most Cost-Effective Laparoscopic Appendicectomy: A Review of the Literature
Authors: Curwen Oliver , Gaber Mohannad , Gerogiannis Ioannis
Published: April 2023

Purpose

To review the literature and identify the most economical techniques for laparoscopic appendicectomy (LA) that do not compromise on patient care.

Methods

We performed a search of the Cochrane Library, PubMed, EMBASE and Google Scholar for papers published between January 2001 and January 2021. The outcomes of the included studies were then grouped by theme of cost analysis, with the main areas of focus being the use of disposable equipment, appendiceal stump closure, and retrieval of the appendix.

Results

After screening a total of 254 search results, 40 studies were included, representing 13 285 patient outcomes, having two main areas of focus: the use of reusable or disposable equipment and the different methods of appendiceal stump closure. Use of disposable instruments has been cost effective in LA in 2 studies. However, use of reusable trocars has reduced cost of procedure by €250 in another study. Appendiceal stump closure using ligature, endoloops or Endoclips had been cost-effective compared to Endostaplers in 25 studies. This can save up to €350. Endoscopic specimen bags are single use and represent further disposable equipment costs. The use of a sterile glove to replace this piece of kit can further provide cost benefit as shown in 2 studies.

Conclusion

Laparoscopic appendicectomy can be performed in a variety of ways with equivocal patient safety. We present the use of extracorporeal ligature of the appendiceal base, combined with the use of a surgical glove retrieval system as the most economic technique in laparoscopic appendicectomy.
Gaming for Ecological Activism: A Multidimensional Model for Networks Articulated Through Video Games
Authors: Amadori Gaia
Published: April 2023

In the past 2 decades, reflections on video games’ ideological and political aspects—and their overarching media ecosystems—have grown. Despite this, few contributions focus on environmental issues, mainly empirically-oriented studies or ecocritical contributions vis-à-vis shared models and systematizations. Starting from the “To The Last Tree Standing” campaign carried out in 2017 for Greenpeace Poland to stop the deforestation of the Białowieża forest, this research sets out to elaborate an analytical model to outline the constitutive dimensions to be taken into account in analyses of how video games and environmental activism can intersect in a specific intentional communicative instance. The results, which relied on semi-structured interviews with executives and designers ( n = 3) and inductive thematic analysis and sentiment analysis of the YouTube comments, delineate three initial categories ( controversy, campaign network, and game ecosystem). This evidence highlights new development trajectories for studying the intersection between the gaming world and ecological activism.
Improvements in Cardiometabolic Effects and Body Composition Outcomes Following an Online 8-Week Plant-Based Dietary and Lifestyle Worksite Intervention
Authors: Lopez Nanette V. , Seeton Valerie N. , Heath Ciara L. , Sutliffe Jay T.
Published: April 2023

Plant-based diets may positively impact body composition and cardiometabolic risk factors. An online 8-week plant-based dietary and lifestyle worksite intervention was implemented in spring 2021 among staff ( n = 52) at a public university in the southwestern United States. Participants attended weekly online small group counseling sessions and healthy living workshops with cooking classes. All measures and fasting blood draws were completed at baseline and 8-week post-intervention with changes analyzed using paired sample t-tests. Multiple linear regressions examined associations among knowledge gained and online attendance with outcomes. Results from paired sample t-tests indicated numerous statistically significant improvements from baseline to 8-week post-intervention: total cholesterol (mg/dL) (MBL = 193 ± 39, MPI = 176 ± 36), low-density lipoprotein cholesterol (LDL-C) (mg/dL) (MBL = 110 ± 33, MPI = 98 ± 30), body mass index (BMI) (kg/m2) (MBL = 26.3 ± 6.3, MPI = 25.9 ± 6.1), fat mass (lb) (MBL = 62.0 ± 29.4, MPI = 60.3 ± 28.4), fat-free mass (lb) (MBL = 104.1 ± 29.4, MPI = 102.4 ± 19.6), phase angle (MBL = 5.1 ± .6, MPI = 5.0 ± .6), and diet quality (MBL = 62.4 ± 12.5, MPI = 75.2 ± 10.3). High-density lipoprotein cholestero l(HDL-C) decreased significantly (MBL = 65 ± 18, MPI = 61 ± 18). Knowledge negatively predicted LDL-C (B = −.226, P = .048) and positively predicted diet quality (B = .155, P = .021). Attendance at group sessions positively predicted phase angle (B = .055, P = .038). Findings demonstrate how a plant-based lifestyle can improve cardiometabolic health by reducing risk factors for chronic disease and enhancing body composition. Clinicians can support patients by encouraging plant-based diets.
Perceptions of mindfulness practices as a support for individuals managing caregiving responsibilities and chronic disease: A qualitative study
Authors: West Nathan T. , Harmon Brook E. , Rawlett Kristen E , Short Sarah J. , Spanier Adam J. , Mathews Shifali , Kimble Katrina , McGehee Chad , Ratliff Macy L. , Puett Robin C.
Published: April 2023

Objectives

Explore the lived experience of individuals managing and/or caregiving for someone with a chronic disease and their perceptions of developing a mindfulness program for stress reduction.

Methods

Sixteen participants with chronic disease and/or caregivers participated. Participants completed eligibility screening, demographic questionnaires, and semi-structured interviews (30–60 min each) online or by phone. Interviews ( n = 16) were audio recorded, transcribed, and analyzed using thematic analysis and NVivo® 12. Survey data were analyzed using SPSS® 28.

Results

Four themes emerged: (a) Chronic disease management and stress—perspectives on life's stressors; (b) Stress reduction techniques/perceptions of mindfulness—knowledge and implementation of stress reduction practices and familiarity with mindfulness; (c) Mindfulness program acceptability, barriers, and facilitators—interest, barriers, and facilitators to attending; (d) Mindfulness program structure—logistics to increase access and appeal to diverse audiences.

Discussion

Mindfulness has the potential for addressing the complexities of stress associated with disease management. Targeting mindfulness programs for populations with chronic disease management and caregiving responsibilities should include: Consideration of group formats with participation limited to this population, structuring programs to overcome barriers (i.e., culturally appropriate location), and equipping members of the community being served as instructors to ensure culturally relevant instruction.
The interplay between bone and heart health as reflected in medication effects: A narrative review
Authors: Trost Susanne , Tesfaye Nolawit , Harindhanavudhi Tasma
Published: April 2023

There is mounting evidence of an association between osteoporosis and cardiovascular disease that extends beyond shared risk factors for these conditions. In turn, the medications used to treat each of these conditions can have effects that impact the other organ system: medications used in heart disease have the potential to affect bone health, while osteoporosis medications may modify cardiovascular health. While data in this subject area are limited by the paucity of large randomized controlled trials with bone mineral density or fracture risk as primary outcomes, this review explores the data available that can provide some insight into these reciprocal effects of medications on bone and heart health. Data on bone health effects of the loop and thiazide diuretics, beta blockers, calcium channel blockers, statins, warfarin, sodium-glucose cotransporter 2 inhibitors, metformin, and medications impacting the renin–angiotensin–aldosterone system are examined; the cardiovascular effects of osteoporosis therapies and vitamin D are also discussed. Importantly, while most data in this realm are inconclusive, recognizing the parallels between cardiovascular and bone disorders and how this is reflected in medication effects might prompt the clinician to consider the indirect impact of drug regimens when making therapeutic choices for patients with osteoporosis and heart disease.
“You can’t teach your students something that is divorced from reality”: Palestinian citizenship teachers making sense of the relevance of Islam for citizenship education in Israel
Authors: Muff Aline , Agbaria Ayman
Published: April 2023

Even though religion plays a central role in many people’s lives, it is often omitted from citizenship education in secularized societies. Educational scholars have increasingly demanded that teaching about religion should be included in citizenship curricula to foster effective participation for all citizens. However, this is an enormous challenge, especially in societies like Israel where religion is politicized as an aspect of violent conflict. Drawing on semi-structured interviews with Palestinian Muslim educators in Israel, we explored how citizenship teachers refer to Islam in their citizenship lessons. The teachers in our study drew on Islam as an important resource to either resist predominant conceptions of citizenship education in Israel or to make the subject more meaningful and relevant to their students. We argue that incorporating religious epistemologies alongside critical pedagogies in the citizenship curriculum is a necessary educational task in diverse and conflict-affected societies like Israel.
Lifting limitations following elbow arthroplasty: A survey of British Elbow and Shoulder Society members
Authors: Burden Eleanor G , Evans Jonathan P , Smith Christopher D
Published: April 2023

The primary aim of this survey was to capture current practice with regard to lifting limitations following elbow arthroplasty. An online survey was emailed to all members of the British Elbow and Shoulder Society. All consultant respondents who reported performing elbow arthroplasty were asked about their advice for post-operative lifting limitations. In total, 115 surveys were completed: 55 consultants reported performing linked total elbow arthroplasty, 18 reported performing unlinked total elbow arthroplasty and 44 reported performing distal humeral hemiarthroplasty. The majority of elbow consultants advise a lifelong lifting limitation following linked and unlinked total elbow arthroplasty (78% and 61% respectively). There was variation in the weight specified for lifelong lifting limitations, the median weight restriction in linked total elbow arthroplasty was 5 lb, and in unlinked total elbow arthroplasty was 10 lb (range 1−20 lb). In total, 13% of consultants performing linked total elbow arthroplasty and 33% of consultants performing unlinked total elbow arthroplasty do not advise any lifelong lifting limitations post-operatively. In a perceived attempt to prolong implant longevity, most surgeons recommend lifelong lifting limitations following total elbow arthroplasty. There is variation in the weight restriction advised by consultant elbow surgeons. Currently the optimal weight restriction to maximise implant longevity is not known and further work needs to be done to understand the true relationship between activity, loading and implant failure.
EF-24, a Curcumin Analogue, Could Inhibit HSP90 and Induce Apoptosis-Mediated by Autophagy/Inflammation/Oxidative Stress in Papillary Thyroid Cancer Cell Lines
Authors: Zhou Guangying , Zhang Yanting , Akbari Abolfazl , Wang Xin , Wei Jing
Published: April 2023

Objective

Papillary thyroid cancer (PTC) is one of the most common thyroid cancers and its prevalence has increased in recent years. Studies have shown that autophagy, angiogenesis, inflammation, oxidative damage, apoptosis, and some signaling pathways such as PI3K/AKT/mTOR play an important role in cancer progression. Moreover, most of their signaling molecules are the clients of heat shock protein 90 (HSP90), and its inhibition attenuates tumorigenesis. Diphenyl difluoroketone (EF-24), a curcumin analog, has antioxidative, anti-inflammatory, and anticancer properties and, unlike curcumin, has high efficacy, and may treat PTC. Therefore, the antioxidant, anti-inflammatory, angiogenic, apoptotic, and anticancer effects of EF-24 on PTC cell lines (BCPAP and TPC-1) were investigated in this study.

Methods

In this study, the effect of different concentrations of EF-24 and cisplatin on cell viability, apoptosis, inflammation, autophagy, oxidative status, and angiogenesis, along with HSP90 expression was evaluated in BCPAP and TPC-1 cell lines.

Results

The results showed that treatment with different EF-24 concentrations could significantly decrease cell viability by inducing apoptosis. EF-24 (40 µg/mL) also significantly downregulated HSP90 and the gene and protein involved in oxidative damage, angiogenesis, inflammation, and autophagy.

Conclusions

In conclusion, EF-24 could decrease cell viability by inducing apoptosis mediated by autophagy, oxidative stress, angiogenesis, inflammation, and the PI3K/AKT/mTOR pathway. It is possible that a decrease in HSP90 may mediate these effects. These results indicate that EF-24 is a viable option for the prevention and treatment of PTC.
Current State of Knowledge of Páramo Amphibians in Colombia: Spatio Temporal Trends and Information Gaps to Be Strengthened for Effective Conservation
Authors: Saboyá Acosta Liliana Patricia , Urbina-Cardona J. Nicolás
Published: April 2023

Background and Research Aims: Globally, Colombia is the country with the largest extent of Páramos (delimited in 36 complexes) and with the greatest number of amphibian species in this ecosystem. This work consolidated scientific literature on the amphibians of the Colombian Páramos to characterize temporal, taxonomic, thematic, and geographic patterns, which allow us to identify information gaps that must be fulfilled to achieve effective species conservation. Methods: We conducted a systematic literature survey with seven different search strategies and generated a database. We read each document's Abstract, Methods, Study Area, Results, and supplementary material, following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) protocol. Results: We found 405 documents published between 1863 and 2021. The composition and richness of 142 amphibian species (95 endemics to Colombia), presented significant differences in Páramo complexes and between sectors. Since 2000, the diversity of research topics has increased with a high proportion of studies on Natural History, Systematics and Taxonomy, and Conservation, distributed between 19 and 22 of the departments with Páramos in their jurisdiction. However, much of this knowledge concentrates in less than 20% of total species in just 6% of Páramos complexes. Conclusion: We found critical shortfalls in taxonomy, spatial information, and conservation actions on Páramos amphibians. We need to increase studies that include field data in more geographic areas and research topics, such as Population and Community ecology, Natural history (from a quantitative approach), Infectious disease, and Ecophysiology. Implications for Conservation: The scientific information gaps represent a challenge in generating effective strategies to conserve Páramo amphibians, considering the high degree of endemism and threats to these species. More than 80% of the Páramo amphibian species only have the information of their descriptions and little is known about their ecological requirements, population size, or data related to specific threats.
Epithelioid hemangioendothelioma of the distal lower extremity and the role of radiotherapy: A report of two cases
Authors: Go Robin , Lee Linus , Vijayakumar Gayathri , Tepper Sarah , Gitelis Steven , Blank Alan
Published: April 2023

We report two cases of epithelioid hemangioendothelioma (EHE) in the distal lower extremity. Our first patient had unicentric EHE of the left os calcis initially treated with an intralesional procedure; however, later developed two recurrences which were managed with radiation therapy. Our second patient had multicentric EHE of the distal tibia and fibula managed with primary radiation therapy. Although EHE is typically treated with wide resection or an intralesional procedure, we present two cases of EHE in the distal lower extremity to discuss the therapeutic role of radiation therapy in the management of distal EHE.
Researching Shame, Dissociation, and Their Relationship Using Latent Change Modeling
Authors: Kulla Patricia , Braun Tina , Reichenberger Tim , Kruse Joachim
Published: April 2023

Shame and dissociation play pivotal roles in the pathogenesis and treatment of (complex) post-traumatic stress disorder. However, the causal relationship between these two symptoms remains unclear. We tested the association between state shame and state dissociation in 249 participants (Mage = 27.55; SDage = 8.74; 60.24% female; 84.7% no mental illness). After completing questionnaires (trait shame and dissociation, trauma history), participants were randomly allocated to an imaginative shame or dissociation induction group, and changes in state shame and dissociation were measured. The data were analyzed using latent change score modeling. We found significant changes in both state shame and dissociation, with an isolated change of state shame in the shame induction group but changes in both shame and dissociation in the dissociation induction group. Thus, state shame and dissociation correlated only with the induction of dissociation. We found an effect of trait variables only on state dissociation and no effect of trauma history on state variables. The interaction between shame and dissociation remains complex and is only partially understood. Our study adds to research supporting the assumption that dissociation leads to shame. In addition, in experimental psychopathology approaches, imaginative procedures seem more suitable for studying shame than for studying dissociative symptoms.
Importance of preemptive analgesia and pain assessment as perceived by intensive care unit nurses
Authors: Abdalrahim Maysoon S , Hamdan Khaldoun M , Shaheen Abeer M
Published: April 2023

Background

The importance and efficacy of Preemptive analgesia in reducing pain for patients undergoing painful procedures still debatable and seldom investigated. The aim of this study was to describe intensive care nurses’ perception of the importance of pain assessment and Preemptive analgesia prior painful procedures in critical care settings in Jordan.

Method

A cross-sectional descriptive design was used. The sample consisted of 300 registered nurses recruited from 22 intensive care units in Jordan. The data was gathered using a self-administered questionnaire.

Results

The results showed that nurses considered pain assessment moderately and extremely important for surgical ( n = 263, 87.7%), burn ( n = 261, 87%), and trauma patients ( n = 256, 85.3%). The majority of nurses rated pain assessment as moderately to extremely important for invasive line placement 80.3%, wound care 78.3%, and drain removal 69%. Nurses assessed the need for Preemptive analgesia more frequently before wound care 70.7%, and before invasive line placement 69.7%. Nurses perceived pain assessment for Preemptive analgesia as less priority for unconscious patients.

Conclusion

Effective assessment and management of pain for critically ill patients is mandatory. Thus, it is important to improve nurses’ knowledge regarding the Preemptive analgesia and its effects in relieving post-procedural pain in critically ill patient. It is recommended to ensure proper clinical training on how to assess critically ill patients and auditing system.
Bilateral rectus femoris myocutaneous flaps to salvage exposed axillo-bifemoral graft of bilateral groins
Authors: Basnayake Oshan , Jayarajah Umesh , Dissanayake Dammika
Published: April 2023

Exposed prosthetic grafts are a challenge to vascular specialists. Groin dissections in vascular surgery can lead to local tissue breakdown, especially in patients who have multiple comorbidities and poor nutritional status. In this report, we describe a patient with exposed prosthetic bypass conduits in the groin region which was successfully covered with bilateral myocutaneous flaps. A 75-year-old Sri Lankan male with diabetes, hypertension and Parkinson’s disease presented with bilateral non-healing wound and rest pain for 3 months. Since his premorbid status precluded the aortic cross-clamping and aorto-bifemoral graft, a decision was made to perform a right axillo-bifemoral bypass using a prosthetic graft. Re-operation was required for graft thrombectomy on the same day of surgery. His post-operative period was complicated with lymph leak and surgical site infection of bilateral groin wounds which ultimately led to exposed prosthetic graft which was fortunately patent. After optimizing his nutritional status and comorbidities, he underwent bilateral rectus femoris myocutaneous flaps to cover the soft-tissue defect over the exposed prosthetic grafts. His initial post-operative period was unremarkable except for a small area of skin breakdown. Myocutaneous flaps are preferred as they are more resilient to breakdown compared to facio-cutaneous flaps, especially in a patient with compromised blood supply. The type of loco-regional flap should be carefully selected in an individualized manner depending on the regional vascularity. The rectus femoris flap is a suitable option in terms of ease of surgical technique and durability. Comorbidities and local factors should be optimized prior to definitive reconstruction to maximize the chances for optimal wound healing.
Coincidental or mimicking acute appendicitis secondary to MIS-C associated with SARS-CoV-2: A case report
Authors: Ramosaj-Morina Atifete , Keka-Sylaj Alije , Baloku Arbana , Gjaka Petrit , Podrimaj Arjeta
Published: April 2023

The predominant organic system involved in multisystem inflammatory syndrome in children associated with COVID-19 is the gastrointestinal system, which is observed in almost 90% of patients. Gastrointestinal symptoms can mimic acute appendicitis. There have been a few cases of misdiagnosed multisystem inflammatory syndrome in children associated with SARS-CoV-2 as appendicitis, and a few concomitant cases of a multisystem inflammatory syndrome associated with acute appendicitis during the COVID-19 pandemic. Here, we present the case of an 11-year-old girl who presented to our Intensive Care Unit with a 2-day history of fever, generalized abdominal pain, and vomiting. The clinical findings resulted in a clinical suspicion of acute appendicitis and subsequent surgery. While postoperatively, she became critically ill, and she was diagnosed with the multisystem inflammatory syndrome in children associated with COVID-19. When diagnosing children with acute appendicitis, healthcare professionals, especially pediatricians and surgeons, must pay attention to the multisystem inflammatory syndrome linked to the SARS-CoV-2 infection.
Effects of a zero-gravity treadmill on body composition and cardiorespiratory fitness after Achilles surgery in a Masters runner
Authors: Powell Adam W , Mays Wayne A , Hill Garick D
Published: April 2023

Zero-gravity treadmills allow alterations in training load. Data are lacking on the utilization of this strategy to allow injured Masters-level athletes to return to activity and regain their fitness. A 6-week training program was designed for a 39-year-old male runner recovering from Achilles surgery using a zero-gravity treadmill. Three training sessions per week were performed with gradually increasing loads. Cardiopulmonary exercise testing and bioelectrical impedance analysis were performed before and after program completion. Following the training program, the athlete was able to return to full weight-bearing running. On cardiopulmonary exercise testing, there were improvements in peak oxygen consumption (42.9 vs 47.3 mL/min/kg; 118.6% vs 130.5% of predicted). On bioelectrical impedance analysis, there were small improvements in total weight, skeletal muscle mass, and adiposity felt to be within the standard of error for bioelectrical impedance analysis. In conclusion, load-altering exercise may be helpful for the Masters-level athlete recovering from Achilles tendon surgery.
Older adults with complex care needs’ experiences within a hospital-to-home transition patient navigator program: A qualitative descriptive study
Authors: Kokorelias Kristina M , Singh Hardeep , Knoepfli Amanda , Das Gupta Tracey , Ziegler Naomi , Hitzig Sander L
Published: April 2023

Introduction

Older adults living with complex care needs are often hospitalized due to poor community support. Recommendations for improving patient and family experiences include having a patient navigator to support patients and caregivers in hospital and community settings. This study aimed to report on older adults’ and caregivers’ experiences of receiving services from a hospital-to-home patient navigation program.

Methods

A qualitative descriptive study was conducted. Telephone interviews were conducted with 14 older adults with complex care needs or their family caregivers in Toronto, Ontario from 2020 to 2021. Data were analyzed using inductive thematic analysis.

Results

Four themes were identified: (1) Initial Hesitancy; (2) Meeting Evolving Needs; (3) Unexpected Benefits of Patient Navigation; and (4) The Value of Patient Navigation in Sustaining Aging-in-Place. Participants viewed all their interactions with the navigator as positive, and perceived navigators improved their quality of care.

Discussion

These study findings suggest that patient navigators may be well-positioned to address gaps in services around psychosocial support and care coordination while also encouraging self-management in older adults with complex care needs.
Considerations for at-home upper-limb rehabilitation technology following stroke: Perspectives of stroke survivors and therapists
Authors: Forbrigger Shane , Liblong Madeleine , Davies TC , DePaul Vincent , Morin Evelyn , Hashtrudi-Zaad Keyvan
Published: April 2023

Introduction

This study investigated the needs of stroke survivors and therapists, and how they may contrast, for the design of robots for at-home post stroke rehabilitation therapy, in the Ontario, Canada, context.

Methods

Individual interviews were conducted with stroke survivors ( n = 10) and therapists ( n = 6). The transcripts were coded using thematic analysis inspired by the WHO International Classification of Functioning, Disability, and Health.

Results

Design recommendations, potential features, and barriers were identified from the interviews. Stroke survivors and therapists agreed on many of the needs for at-home robotic rehabilitation; however, stroke survivors had more insights into their home environment, barriers, and needs relating to technology, while therapists had more insights into therapy methodology and patient safety and interaction. Both groups felt a one-size-fits-all approach to rehabilitation robot design is inappropriate. Designs could address a broader range of impairments by incorporating household items and breaking activities down into their component motions. Designs should incorporate hand and wrist supports and activities. Designs should monitor trunk and shoulder motion and consider incorporating group activities.

Conclusion

While therapists can provide insight in the early stages of design of rehabilitation technology, stroke survivors’ perspectives are crucial to designing for the home environment.