bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanical Needling With Sterile Water Versus Lidocaine Injection for Lumbar Spinal Stenosis
Authors: Suputtitada Areerat , Chen Carl P. C. , Pongpirul Krit
Published: May 2022

Study Design: This was a retrospective observational study that assessed the clinical outcome of ageing patients who received ultrasound-guided (USG) mechanical needling with sterile water injection. In addition, the clinical outcome of age-and gender matched patients randomly selected from patients who received needling with sterile water was compared to the patients injected with lidocaine in a 1:1 ratio.

Objective: This present study aimed to explore the clinical effects of USG mechanical needling with sterile water injection for lumbar spinal stenosis (LSS).

Methods: The data was extracted from the medical records of ageing patients with LSS who received USG injection at the lumbosacral spine by the first author. Low back pain or axial pain, and leg pain or radicular pain were assessed by the visual analogue scale, and gait ability with walking distance were obtained at six different time points.

Results: A total of 4328 medical records were examined. Four thousand two hundred and twenty-eight ageing patients received mechanical needling with sterile water injection and found the efficacy lasted up to 6 months. One hundred patients were compared with 100 patients who received lidocaine injection. Those who received lidocaine had pain returned at 3 months and 6 months post-injection.

Conclusions: USG mechanical needling with sterile water injection could help relieve axial and radicular pain for at least 6 months. Removal of calcification and fibrosis as well as reduction of sensitization are all possible mechanisms.
Revising Reason: Creating an Emotionally Engaged Legal Academia
Authors: Mishra Pragya
Published: May 2022

In this article, my focus is to examine where, when, how, and why that most animating psychological concept—emotion—influences law and legal academia. In particular, this article will consider how law considers reason its supreme driving force, representing rationality and enlightenment and prizes the rigid, analytical, unemotional ability to ‘think like a lawyer’ whilst modern neuroscientific and philosophical findings no longer consider emotions as an antithesis of reason but rather deeply intertwined with cognition. Thus, briefly illustrating some of the inconsistencies, contradictions, and incoherence among legal education’s theories of emotion, as seen through law and emotions scholarship, this article argues that emotions can and should be the driver for a more holistic form of legal education, one in which emotions and well-being are integral within the curriculum itself, rather than occasional adjuncts.
Epidemiology of Sports-Related Traumatic Hip Dislocations Reported in United States Emergency Departments, 2010-2019
Authors: Moran Jay , Cheng Ryan , Schneble Christopher A. , Mathew Joshua I. , Kahan Joseph B. , Li Don , Gardner Elizabeth C.
Published: May 2022

Background:

Traumatic hip dislocations are rare injuries that most commonly occur in motor vehicle accidents. There is a paucity of literature that describes sports-related hip dislocations.

Purpose:

To estimate the incidence of sports-related hip dislocations and determine any sport- or sex-related epidemiological trends using the National Electronic Injury Surveillance System (NEISS) database.

Study Design:

Descriptive epidemiology study.

Methods:

Data regarding sports-related hip dislocations from 2010 to 2019 were retrieved from the NEISS, a database that catalogs injury information during emergency department visits from 100 hospitals across the United States to produce nationwide estimates of the injury burden. The estimated number of injuries was calculated using weights assigned by the NEISS database. The injuries were then stratified by sport and sex to determine any epidemiological patterns.

Results:

A total of 102 hip dislocation injuries were identified over the surveyed 10 years, indicating 2941 estimated injuries nationwide. Overall, 10 (9.8%) of 102 sports-related hip dislocations presented with concomitant acetabular fractures, representing an estimated 288 injuries nationally over 10 years. Male athletes sustained more sports-related hip dislocations than female athletes, with a relative incidence of 12.51 ( P < .001). Adolescents aged 15 to 19 years recorded the highest number of hip dislocations. There were 17 sports identified as having caused at least 1 hip dislocation over the 10-year period. More hip dislocation injuries were sustained from contact sports (91.2%) than noncontact sports (8.8%) ( P < .001). Football (estimated 164 injuries per year; 55.6%), snowboarding (28 per year; 9.5%), skiing (26 per year; 8.8%), and basketball (21 per year; 7.1%) had the highest rates of hip dislocation. Additionally, 43 (82.7%) football-related injuries were caused by tackling mechanisms, and 9 (17.3%) were caused by nontackling mechanisms ( P < .001).

Conclusion:

The incidence of traumatic sports-related hip dislocations was extremely low in the United States during the study period. Male adolescents, aged 15 to 19 years, sustained the greatest number of injuries during football. Significantly more hip dislocations occurred in contact sports, most commonly football, snowboarding, skiing, and basketball, compared with noncontact sports. As adolescent athletes may have limited treatment options if osteonecrosis occurs, these data serve to increase the clinical awareness of these injuries.
Anterior Cruciate Ligament Reconstruction in 107 Competitive Wrestlers: Outcomes, Reoperations, and Return to Play at 6-Year Follow-up
Authors: Marigi Erick M. , Song Bryant M. , Wasserburger Jory N. , Camp Christopher L. , Levy Bruce A. , Stuart Michael J. , Okoroha Kelechi R. , Krych Aaron J.
Published: May 2022

Background:

Wrestling is a physically demanding sport, with young athletes prone to anterior cruciate ligament (ACL) injuries. There is a paucity of data evaluating the results of ACL reconstruction (ACLR) in this cohort.

Purpose:

To assess return to sport (RTS), patient-reported outcomes, reoperation rates, and graft survival after ACLR in a large cohort of competitive wrestlers at midterm follow-up.

Study Design:

Case series; Level of evidence, 4.

Methods:

We identified all competitive wrestlers (club, high school, collegiate, or professional) with a history of an ACLR at a single institution between 2000 and 2019. Graft failure was defined as a retear (as determined via clinical or advanced imaging evaluation) and/or revision ACLR. All patients were contacted for determination of reinjury rates; current sport status; and pain visual analog scale, International Knee Documentation Committee, and Tegner activity scores.

Results:

Included were 107 knees in 103 wrestlers, with a median follow-up time of 5.9 years (interquartile range [IQR], 3.9-10.3 years). The median age was 17 years (IQR, 15-18 years), with 106 (99%) male patients, and the distribution of bone–patellar tendon–bone (BTB) and hamstring tendon (HT) autografts was 64 (60%) and 43 (40%), respectively. At final follow-up, 80% of athletes were able to RTP at a median of 280 days (IQR, 212-381 days). Graft failure occurred in 14 (13%) knees at a median time of 1.8 years (IQR, 0.7-5.3 years) after the index ACLR. BTB autograft demonstrated a lower failure rate compared with HT autograft (8% vs 21%; P = .044) and was associated with better survival compared with HT autograft up to 15 years after the index ACLR (90.4% vs 76.3%; P = .030). When compared by graft diameter, HT autografts of at least 7.5 mm were not associated with a lower graft failure than BTB constructs of all sizes ( P = .205).

Conclusion:

Return to competitive wrestling was observed in 80% of athletes after ACLR, with 14% of wrestlers experiencing graft failure. BTB autograft was associated with better survival than HT autograft.
Unveiling how Clinical Nursing Education can be Improved in Northern Ghana: The Perspectives of Key Informants
Authors: Nachinab Gilbert Ti-enkawol , Armstrong Susan Jennifer
Published: May 2022

Introduction

Clinical nursing education is an important component of the professional development of nursing students. Key informants such as nursing lecturers, nurse managers and clinical placement coordinators play an essential role in clinical education.

Purpose

The purpose of the study was to explore the perspectives of key informants on how the current state of clinical nursing education in Northern Ghana can be improved.

Methods

The study used an exploratory qualitative design. Sixteen participants were purposively selected and data were collected through face-to-face individual interviews. Data were analysed using framework analysis.

Findings

The study findings indicate that clinical nursing education can be improved by decreasing the overcrowding of students in the clinical setting, decreasing the theory-practice gap and providing relevant material resources in the clinical facilities. Also, nursing education institutions can improve clinical nursing education by equipping the skills laboratories, engaging an adequate number of lecturers, and carrying out clinical accompaniment.

Conclusion

There is a need to improve clinical education through collaboration between nursing education institutions and clinical facilities. Effective collaboration will ensure the planning of clinical placement to avoid overcrowding, provision of continuous professional development programmes for preceptors and improvement in clinical supervision. Also, the provision of material resources in skills laboratories and clinical facilities to enhance clinical teaching should be given priority.
Cultivating Successful Students in a Culturally Diverse Classroom
Authors: Schartz Tracey , Molina Ignacio , Molina Rob
Published: May 2022

In 2018, Gateway Community College reported that of its 5950 students who enrolled that year, 49% had classified themselves as minority. Roughly 28% of those students reported speaking a language other than English in the home setting. 1 Developing course material and assignments that assist all students in the first semesters of a healthcare program are difficult. Successfully accomplishing this task with students whose first language is not English adds to that level of difficulty. This study examined the global classroom achievements of first semester respiratory program students when additional vocabulary and purposeful terminology assignments are given, where the concentrated emphasis is on those students who speak English as a second language.
Prospective phase II study of sunitinib rechallenge in metastatic renal cell carcinoma: The “retry” study from the Italian Group of Onco-Nephrology (G.I.O.N.)
Authors: Porta Camillo , Ferrari Vittorio , Zucali Paolo A. , Fornarini Giuseppe , Bernardo Antonio , Falconeri Andrea , Santarossa Sandra , Tinelli Carmine , Rizzo Mimma , Pappagallo Giovanni , Bearz Alessandra
Published: May 2022

Background:

Sunitinib is still a recommended treatment option for metastatic renal cell carcinoma (RCC) patients; lack of cross-resistance to sequential antiangiogenic drugs has been postulated.

Objective:

The possibility of a successful rechallenge with sunitinib was tested in this prospective phase II trial.

Methods:

Main inclusion criteria were: histologically proven RCC with clear cell component, previous first-line sunitinib with a Disease Control Rate lasting ⩾10 months, and second-line everolimus. The primary end-point was 6-months progression-free survival (PFS). A Simon’s 2-stage design was used; after testing sunitinib on 12 patients, the trial would have been terminated if ⩽5 had a PFS <6 months. Otherwise, the trial would have proceeded enrolling a total of 38 patients. If the total number of patients free of progression at 6 months would have been ⩽18, sunitinib would have been rejected.

Results:

A total of 39 patients (30 males, 9 females) were enrolled. The study reached the second stage, and ultimately succeeded; indeed, 6-months PFS was 64.1%, median PFS being 14.9 months (95% confidence interval: 9.06–20.91). Treatment-related grade 3–4 adverse events observed in ⩾5% of the patients were: hand-foot skin reaction, fatigue, nausea, hypertriglyceridemia, hypophosphatemia, hypocalcemia, hyperglycemia, and neutropenia. One case each of myocardial infarction, atrial flutter, and spontaneous pneumothorax, were also reported.

Conclusions:

Despite an ineluctable time-lead-bias, median PFS on sunitinib rechallenge was high, clearly showing that many patients may become sensitive again to antiangiogenic treatment. In countries where treatment options are still limited, sunitinib rechallenge could represent an option. EudraCT number: 2012-000473-23.
Base borders: Militarisation and (post-)colonial bordering in Okinawa
Authors: Nishiyama Hidefumi
Published: May 2022

This article builds on the political geography of islands and emerging research on the relationship between island, border and sovereignty. Today, islands are recognised as crucial sites for the understanding of contemporary border controls. Military bases that were built during earlier colonial periods are increasingly used for transnational migrant detention practices. This article aims to offer another important insight to the politics of borders from an island perspective. Drawing from the case of Okinawa, the article shows how bases on islands themselves produce borders. Fences and lines that encircle the US bases on Okinawa Island cannot be reduced to conventional military off-limits boundaries. They are particular kinds of borders, which I would call ‘base borders’, that continue to divide the island into military and public spaces and demarcate two seemingly territorially bound sovereignties. Base borders are, however, more than the manifestation of extraterritoriality. While they regulate the mobility of local residents, base borders enable military servicemembers to enjoy extraterritorial rights, including the right to avoid being held responsible for a crime they committed outside the bases. In addition to this uneven mobility control, base borders have a function to control local resistance movements through the criminalisation of the base border crossing by protesters and the authorisation of the use of force by security guards. This article closely investigates how base borders function and are used in reality, and in doing so, it uncovers multiple ways in which base borders reproduce colonial relations between the US military (in coordination with Japan) and Okinawa.
The protective role of internal/external factors on Covid-19 related stressors among resource parents
Authors: Zak Sarah , Gallitto Elena , Romano Elisa
Published: May 2022

Background: The Covid-19 pandemic has had detrimental effects on almost everyone worldwide, but one particularly vulnerable group are resource parents (foster and kinship) and the young people in out-of-home care. Resource parents have experienced the same increases in pandemic-related stressors as other parents but have the added challenge of caring for a young person involved with child welfare. There are, however, various possible protective factors that have been found to positively influence families during times of stress. Methods: We examined how internal (family functioning/resilience and emotion regulation) and external (parent/child welfare worker relationship and social supports) resource parent protective factors are related to the degree of perceived stressors experienced due to the pandemic. A sample of 47 resource parents from the province of Ontario (Canada) caring for a young person between 4 and 17 years old completed an online questionnaire. Results: Multiple regression analyses showed that a higher quality relationship between resource parents and child welfare workers was associated with lower perceived pandemic-related stressors. Higher parent emotion regulation was also found to be associated with a significant decrease in resource parents’ perceived stressors. Conclusion: Overall, resource parents experienced an increase in pandemic-related stressors. However, both internal and external protective factors could be associated with a decrease in experienced stressors. Impact: This study used a strengths-based approach and showed the importance of a positive resource parent and child welfare worker relationship as well as effective parental emotion regulation strategies during times of stress.
Development of NGA-Sub ground-motion prediction equation of 5%-damped pseudo-spectral acceleration based on database of subduction earthquakes in Japan
Authors: Si Hongjun , Midorikawa Saburoh , Kishida Tadahiro
Published: May 2022

We developed an empirical ground-motion model for subduction earthquakes in Japan. The model is based on the extensive, comprehensive subduction database for Japan by the Pacific Earthquake Engineering Research Center. The model predicts the RotD50 horizontal components of peak ground acceleration, peak ground velocity, and 5%-damped elastic pseudo-spectral acceleration ordinates in the selected periods ranging from 0.01 to 10 s. The model includes predictor variables considering tectonic setting (i.e. interplate and intraplate), the hypocentral depths, magnitude scaling, distance attenuation, shallow soil, and the basin responses. The magnitude scaling of interplate earthquakes is well constrained in Japan for different periods because the database includes the well-recorded large-magnitude events (i.e. the 2003 Tokachi-Oki and 2011 Tohoku earthquakes). The developed ground-motion prediction equation covers the subduction earthquakes that occurred in Japan for moment magnitudes ranging from 5.5 to 9.1 with closest distances to the fault of less than 300 km.
Clinical application of oscillometry in respiratory diseases: an impulse oscillometry registry
Authors: Liang Xiaolin , Zheng Jinping , Gao Yi , Zhang Zhe , Han Wen , Du Jing , Lu Yong , Chen Li , Wang Tao , Liu Jinming , Huang Gang , Zhao Bingrong , Zhao Guihua , Zhang Xuhua , Peng Yi , Chen Xin , Zhou Ning
Published: May 2022

Background

Respiratory oscillometry is a promising complement to the traditional pulmonary function tests for its simplicity. The usefulness of oscillometry in adult clinical practice has not been clarified. This study aimed to analyse the characteristics and diagnostic performance of oscillometry in respiratory diseases, and explore the cut-offs of oscillometric parameters for severity grading.

Methods

In this multicentre registry of impulse oscillometry (IOS), IOS and spirometric data of healthy individuals and patients with respiratory diseases were collected and analysed. Linear mixed model analysis was performed to explore the effects of disease and forced expiratory volume in 1 s (FEV1) on oscillometric parameters.

Results

The study included 567 healthy subjects, 781 asthmatic patients, 688 patients with chronic obstructive pulmonary disease (COPD), 109 patients with bronchiectasis, 40 patients with upper airway obstruction (UAO) and 274 patients with interstitial lung disease (ILD) in the analysis. Compared at the same FEV1level, asthma, COPD, bronchiectasis, UAO and ILD displayed different oscillometric characteristics. The z-score of resistance at 5 Hz (R5) was the best variable to identify respiratory diseases with a sensitivity of 62.4–66.7% and a specificity of 81.5–90.3%. With reference to the severity grading cut-offs of FEV1,R5z-scores of 2.5 and 4 were defined as the cut-off values of moderately and severely increasedR5.

Conclusion

Respiratory oscillometry is more appropriate to be a tool of evaluating, rather than of diagnosing, respiratory diseases. A severity grading system of oscillometric parameters was developed to help the interpretation of oscillometry in clinical practice.
A deep learning approach for orphan gene identification in moso bamboo (Phyllostachys edulis) based on the CNN + Transformer model
Authors: Zhang Xiaodan , Xuan Jinxiang , Yao Chensong , Gao Qijuan , Wang Lianglong , Jin Xiu , Li Shaowen
Published: May 2022

Background

Orphan gene play an important role in the environmental stresses of many species and their identification is a critical step to understand biological functions. Moso bamboo has high ecological, economic and cultural value. Studies have shown that the growth of moso bamboo is influenced by various stresses. Several traditional methods are time-consuming and inefficient. Hence, the development of efficient and high-accuracy computational methods for predicting orphan genes is of great significance.

Results

In this paper, we propose a novel deep learning model (CNN + Transformer) for identifying orphan genes in moso bamboo. It uses a convolutional neural network in combination with a transformer neural network to capture k-mer amino acids and features between k-mer amino acids in protein sequences. The experimental results show that the average balance accuracy value of CNN + Transformer on moso bamboo dataset can reach 0.875, and the average Matthews Correlation Coefficient (MCC) value can reach 0.471. For the same testing set, the Balance Accuracy (BA), Geometric Mean (GM), Bookmaker Informedness (BM), and MCC values of the recurrent neural network, long short-term memory, gated recurrent unit, and transformer models are all lower than those of CNN + Transformer, which indicated that the model has the extensive ability for OG identification in moso bamboo.

Conclusions

CNN + Transformer model is feasible and obtains the credible predictive results. It may also provide valuable references for other related research. As our knowledge, this is the first model to adopt the deep learning techniques for identifying orphan genes in plants.
scSemiAE: a deep model with semi-supervised learning for single-cell transcriptomics
Authors: Dong Jiayi , Zhang Yin , Wang Fei
Published: May 2022

Background

With the development of modern sequencing technology, hundreds of thousands of single-cell RNA-sequencing (scRNA-seq) profiles allow to explore the heterogeneity in the cell level, but it faces the challenges of high dimensions and high sparsity. Dimensionality reduction is essential for downstream analysis, such as clustering to identify cell subpopulations. Usually, dimensionality reduction follows unsupervised approach.

Results

In this paper, we introduce a semi-supervised dimensionality reduction method named scSemiAE, which is based on an autoencoder model. It transfers the information contained in available datasets with cell subpopulation labels to guide the search of better low-dimensional representations, which can ease further analysis.

Conclusions

Experiments on five public datasets show that, scSemiAE outperforms both unsupervised and semi-supervised baselines whether the transferred information embodied in the number of labeled cells and labeled cell subpopulations is much or less.
Revealing potential functions of hypothetical proteins induced by genistein in the symbiosis island of Bradyrhizobium japonicum commercial strain SEMIA 5079 (= CPAC 15)
Authors: Ferreira Everton Geraldo Capote , Gomes Douglas Fabiano , Delai Caroline Vanzzo , Barreiros Marco Antônio Bacellar , Grange Luciana , Rodrigues Elisete Pains , Henning Liliane Marcia Mertz , Barcellos Fernando Gomes , Hungria Mariangela
Published: May 2022

Background

Bradyrhizobium japonicum strain SEMIA 5079 (= CPAC 15) is a nitrogen-fixing symbiont of soybean broadly used in commercial inoculants in Brazil. Its genome has about 50% of hypothetical (HP) protein-coding genes, many in the symbiosis island, raising questions about their putative role on the biological nitrogen fixation (BNF) process. This study aimed to infer functional roles to 15 HP genes localized in the symbiosis island of SEMIA 5079, and to analyze their expression in the presence of a nod-gene inducer.

Results

A workflow of bioinformatics tools/databases was established and allowed the functional annotation of the HP genes. Most were enzymes, including transferases in the biosynthetic pathways of cobalamin, amino acids and secondary metabolites that may help in saprophytic ability and stress tolerance, and hydrolases, that may be important for competitiveness, plant infection, and stress tolerance. Putative roles for other enzymes and transporters identified are discussed. Some HP proteins were specific to the genus Bradyrhizobium, others to specific host legumes, and the analysis of orthologues helped to predict roles in BNF.

Conclusions

All 15 HP genes were induced by genistein and high induction was confirmed in five of them, suggesting major roles in the BNF process.
Detection of Haemophilus influenzae by loop-mediated isothermal amplification coupled with nanoparticle-based lateral flow biosensor assay
Authors: Cao Qilong , Liang Shaoshuai , Lin Feng , Cao Jun , Wang Lin , Li Hui , Liu Mengyang , Wang Yajuan , Zhao Lijun , Cao Xiaolong , Guo Yan
Published: May 2022

Background

Haemophilus influenzaewas the most aggressive pathogen and formed a major cause of bacterial meningitis and pneumonia in young children and infants, which need medical emergency requiring immediate diagnosis and treatment. However, From isolation to identification ofH. influenzae, the traditional diagnose strategy was time-consuming and expensive. Therefore, the establishment of a convenient, highly sensitive, and stable detection system is urgent and critical.

Results

In this study, we used a combined method to detectH. influenzae. Six specific primers were designed on the basis of outer membrane proteinP6gene sequence ofH. influenzae. The reaction condition such as the optimum temperature was 65℃, and the optimum reaction time was 30 min, respectively. Through the loop-mediated isothermal amplification (LAMP) in combination with nanoparticle-based lateral flow biosensor (LFB), the sensitivity of LAMP-LFB showed 100 fg was the lowest genomic DNA templates concentration in the pure cultures. Meanwhile, the specificity ofH. influenzae-LAMP-LFB assay showed the exclusive positive results, which were detected inH. influenzaetemplates. In 55 clinical sputum samples, 22 samples were positive with LAMP-LFB method, which was in accordance with the traditional culture and Polymerase Chain Reaction (PCR) method. The accuracy in diagnosingH. influenzaewith LAMP-LFB could reach 100%, compared to culture and PCR method, indicating the LAMP-LFB had more advantages in target pathogen detection.

Conclusions

Taken together, LAMP-LFB could be used as an effective diagnostic approach forH.influenzaein the conditions of basic and clinical labs, which would allow clinicians to make better informed decisions regarding patient treatment without delay.
Experience of relatives in the first three months after a non-COVID-19 Intensive Care Unit discharge: a qualitative study
Authors: Danielis Matteo , Terzoni Stefano , Buttolo Tamara , Costantini Chiara , Piani Tommaso , Zanardo Davide , Palese Alvisa , Destrebecq Anne Lucia Leona
Published: May 2022

Background

The novel coronavirus brought Intensive Care Units (ICUs) back to their past when they were closed to family members. The difficulties of family caregivers encountered after the ICU discharge might have been increased during the coronavirus disease 2019 (COVID-19) pandemic. However, no traces of their experience have been documented to date. The objective of this study is to explore the everyday life experience of relatives in the first three months after a non-COVID-19 ICU discharge.

Methods

A descriptive qualitative study was conducted in 2020–2021. Two Italian general non-COVID-19 ICUs were approached. Follow-up telephone interviews were conducted three months after the ICU discharge. The study has been conducted according to the COnsolidated criteria for REporting Qualitative research principles.

Results

A total of 14 family members were interviewed. Participants were mostly females (n = 11; 78.6%), with an average age of 53.9 years. After three months of care of their beloved at home, relatives’ experience is summarised in three themes: “Being shaken following the ICU discharge”, as experiencing negative and positive feelings; “Returning to our life that is no longer the same”, as realising that nothing can be as before; and “Feeling powerless due to the COVID-19 pandemic”, given the missed care from community services and the restrictions imposed.

Conclusions

Relatives seem to have experienced a bilateral restriction of opportunities – at the hospital without any engagement in care activities and their limited possibility to visit the ICU, and at home in terms of formal and informal care.
A motivational interview program for cardiac rehabilitation after acute myocardial infarction: study protocol of a randomized controlled trial in primary healthcare
Authors: Rodríguez-Romero Rocío , Falces Carles , Kostov Belchin , García-Planas Noemí , Blat-Guimerà Esther , Alvira-Balada María C. , López-Poyato Mireia , Benito-Serrano María L. , Vidiella-Piñol Ingrid , Zamora-Sánchez Juan J. , Benet Marta , Garnacho-Castaño Manuel V. , Santos-Ruiz Susana , Santesmases-Masana Rosalia , Roura-Rovira Silvia , Benavent-Areu Jaume , Sisó-Almirall Antoni , González-de Paz Luis
Published: May 2022

Background

Cardiac rehabilitation after acute myocardial infarction permits recovery of the heart function and enables secondary prevention programs in which changes in lifestyle habits are crucial. Cardiac rehabilitation often takes place in hospitals without coordination with primary healthcare and is not focused on individual patient preferences and goals, which is the core of the motivational interview. The objective of this study was to evaluate the efficacy of a cardiac rehabilitation program with a motivational interview in patients discharged from hospital after acute myocardial infarction.

Methods/design

A randomized, non-pharmacological clinical trial in six primary healthcare centers in Barcelona (Spain) will assess whether a tailored cardiac rehabilitation program consisting of four motivational interviews and visits with family physicians, primary healthcare nurses and a cardiologist, coordinated with the reference hospital, results in better cardiac rehabilitation than standard care. A minimum sample of 284 participants requiring cardiac rehabilitation after acute myocardial infarction will be randomized to a cardiac rehabilitation group with a motivational interview program or to standard primary healthcare. The main outcome will be physical function measured by the six-minute walk test, and the secondary outcome will be the effectiveness of secondary prevention: a composite outcome comprising control of blood pressure, cholesterol, diabetes mellitus, smoking and body weight. Results will be evaluated at 1,3 and 6 months.

Discussion

This is the first clinical trial to study the impact of a new primary healthcare cardiac rehabilitation program with motivational interviews for patients discharged from hospital after myocardial infarction. Changes in lifestyles and habits after myocardial infarction are a core element of secondary prevention and require patient-centered care strategies such as motivational interviews. Therefore, this study could clarify the impact of this approach on health indicators, such as functional capacity.

Trial registration

ClinicalTriasl.govNCT05285969registered on March 18, 2022.
Diagnostic and therapeutic challenges of treating opportunistic fungal cellulitis: a case series
Authors: Paul Jed , Czech Mary M. , Balijepally Ramya , Brown Janice Wes
Published: May 2022

Background

Cellulitis is an infection most commonly caused by bacteria and successfully treated with antibiotics. However, certain patient populations, especially the immunocompromised, are at risk for fungal cellulitis, which can be misidentified as bacterial cellulitis and contribute to significant morbidity and mortality.

Case presentations

We describe three cases of opportunistic fungal cellulitis in immunosuppressed patients that were initially mistaken for bacterial infections refractory to antibiotic therapy. However, atypical features of cellulitis ultimately prompted further diagnostics to identify fungal cellulitis and allow initiation of appropriate antifungals. We discuss: (1) a 52-year-old male immunosuppressed hematopoietic cell transplant recipient with Fusarium solani cellulitis on his right lower extremity that was treated with amphotericin B and voriconazole with full resolution of the cellulitis; (2) a 70-year-old male lung transplant recipient with Fusarium solani cellulitis on his left lower extremity that ultimately progressed despite antifungals; and (3) a 68-year-old male with a history of kidney transplantation with suspected Purpureocillium lilacinum cellulitis on his left lower extremity ultimately treated with posaconazole with resolution of the skin lesions.

Conclusions

Fusarium solani and Purpureocillium lilacinum are important pathogens causing opportunistic fungal cellulitis. These cases remind providers to be vigilant for fungal cellulitis when skin and soft tissue infection does not adequately respond to antibiotics and atypical features of cellulitis are present.
What web-based information is available for people with Parkinson’s disease interested in aquatic physiotherapy? A social listening study
Authors: Terrens Aan Fleur , Soh Sze-Ee , Morgan Prue
Published: May 2022

Background

Aquatic physiotherapy is becoming a more frequently utilised treatment for people with Parkinson’s Disease (PD). Consumers are increasingly accessing information regarding health choices online, and it is not known what type or quality of information regarding aquatic physiotherapy is available.

Methods

Web-based platforms (Facebook™, Twitter™, YouTube™, Instagram™, blogs and the web) were searched using the Awario© social listening software. Webpages had to be in English, mention PD, aquatic physiotherapy and its effects. Quality of webpages was assessed using a modified DISCERN tool and content analysis summarised reported effects.

Results

Awario© identified 2992 entries, with 133 assessed using the modified DISCERN tool. A small number (n = 31, 24%) described the effects of aquatic physiotherapy for people with PD. Quality of webpages was low, with many lacking information regarding clear sources of information, contraindications to aquatic physiotherapy and descriptions of the therapeutic environment. Content analysis showed several themes; general physical, PD-specific and psychosocial effects. More than a third of webpages indicated that aquatic physiotherapy would improve strength, balance, pain and aid relaxation. A large number (n = 96, 72%) described at least one hydrodynamic or hydrostatic property of water, most commonly buoyancy (n-83, 62%).

Conclusions

Overall quality of information was poor, and it is recommended that webpages list all potential contraindications to aquatic physiotherapy and direct consumers to discuss potential participation with their healthcare professionals. Webpages also should include information regarding the therapeutic environment, disclose sources of information and focus on enablers to exercise to improve engagement of people with PD in aquatic physiotherapy.
Reflecting on the utility of standardized uptake values on 18F-FDG PET in nasopharyngeal carcinoma
Authors: Qiu Xiufang , Wu Haixia , Xu Ting , Xie Shihan , You Ziqing , Hu Yixin , Zheng Yinghong , Liang Zewei , Huang Chaoxiong , Yi Li , Li Li , Liu Jing , Fei Zhaodong , Chen Chuanben
Published: May 2022

Background

To rethink the clinical significance of standardized uptake values (SUVs) of nasopharyngeal carcinoma (NPC) on 18F-fluorodeoxyglucose (18F-FDG) positron-emission tomography (PET).

Methods

We retrospectively reviewed 369 NPC patients who underwent pretreatment 18F-FDG PET. The predictive value of the SUVmax of the primary tumor (SUVmax-t) and regional lymph nodes (SUVmax-n) was evaluated using probability density functions. Receiver operating characteristic curves were used to determine optimal cutoffs for the SUVmax-n/SUVmax-t ratio (NTR). Kaplan–Meier and Cox regression analyses were used to assess survival.

Results

The optimal SUVmax-t and SUVmax-n cutoffs were 7.5 and 6.9, respectively. High SUVmax-t and SUVmax-n were related to local and regional recurrence, respectively. Patients with low SUVmax had better 3-year overall survival (OS). To avoid cross-sensitization of cutoff points, we stratified patients with high SUVmax into the low and high NTR groups. The 3-year distant metastasis-free survival (DMFS; 92.3 vs. 80.6%, P = 0.009), progression-free survival (PFS; 84.0 vs. 67.7%, P = 0.011), and OS (95.9 vs. 89.2%, P = 0.002) significantly differed between the high vs. low NTR groups for patients with high SUVmax. Multivariable analysis showed that NTR was an independent prognostic factor for DMFS (hazard ratio [HR]: 2.037, 95% CI: 1.039–3.992, P = 0.038), PFS (HR: 1.636, 95% CI: 1.021–2.621, P = 0.041), and OS (HR: 2.543, 95% CI: 1.214–5.325, P = 0.013).

Conclusion

High SUVmax was associated with NPC recurrence. NTR is a potential prognosticator for DMFS, suggesting that heterogeneity in the pretreatment 18F-FDG uptake between the primary tumor and lymph nodes is associated with high invasion and metastatic potential.
Interventional closure of a bronchopleural fistula in a 2 year old child with detachable coils
Authors: Baden Winfried , Hofbeck Michael , Warmann Steven W. , Schaefer Juergen F. , Sieverding Ludger
Published: May 2022

Background

Bronchopleural fistula (BPF) is a severe complication following pneumonia or pulmonary surgery, resulting in persistent air leakage (PAL) and pneumothorax. Surgical options include resection, coverage of the fistula by video-assisted thoracoscopic surgery (VATS), or pleurodesis. Interventional bronchoscopy is preferred in complex cases and involves the use of sclerosants, sealants and occlusive valve devices.

Case presentation

A 2.5-year-old girl was admitted to our hospital with persistent fever, cough and dyspnoea. Clinical and radiological examination revealed right-sided pneumonia and pleural effusion. The child was started on antibiotics, and the effusion was drained by pleural drainage. Following removal of the chest tube, the child developed tension pneumothorax. Despite insertion of a new drain, the air leak persisted. Thoracoscopic debridement with placement of another new drain was performed after 4 weeks, without abolishment of the air leak. Bronchoscopy with bronchography revealed a BPF in right lung segment 3 (right upper-lobe anterior bronchus). We opted for an interventional approach that was performed under general anaesthesia during repeat bronchoscopy. Following bronchographic visualisation of the fistula, a 2.7 French microcatheter was placed in right lung segment 3 (upper lobe), allowing occlusion of the fistula by successive implantation of 4 detachable high-density packing volume coils, which were placed into the fistula. Subsequent bronchography revealed no evidence of residual leakage, and the chest tube was removed 2 days later. The chest X-ray findings normalized, and follow-up over 4 years was uneventful.

Conclusions

Bronchoscopic superselective occlusion of BPF using detachable high-density packing large-volume coils was a successful minimally invasive therapeutic intervention performed with minimal trauma in this child and has not been reported thus far. In our small patient, the short interventional time, localized intervention and minimal damage in the lung seemed superior to the corresponding outcomes of surgical lobectomy or pleurodesis in a young growing lung, enabling normal development of the surrounding tissue. Follow-up over 4 years did not show any side effects and was uneventful, with normal lung-function test results to date.
Impact of early term and late preterm birth on infants’ neurodevelopment: evidence from a cohort study in Wuhan, China
Authors: Chen Zhong , Xiong Chao , Liu Hua , Duan Junyu , Kang Chun , Yao Cong , Chen Kai , Chen Yawen , Liu Yan , Liu Mingzhu , Zhou Aifen
Published: May 2022

Background

The incidences of early term and late preterm birth have increased worldwide during recent years. However, there is a lack of prospective study about the influence of early term and late preterm birth on infants’ neurodevelopment, especially at the early stage. Therefore, we conducted this cohort study to investigate the impact of early term and late preterm birth on infants’ neurodevelopment within 6 months.

Methods

This cohort study was conducted in Wuhan, China, between October 2012 and September 2013. A total of 4243 singleton infants born within 34-41 weeks of gestation at Wuhan Children’s Hospital were included. The Gesell Developmental Scale (GDS) was utilized to evaluate the neurodevelopment of infants.

Results

Among the 4243 included participants, 155 (3.65%) were late preterm infants, 1288 (30.36%) were early term infants, and 2800 (65.99%) were full term infants. After adjusted for potential confounders, significant negative relationship was shown between late preterm birth and development quotient (DQ) in all domains of neurodevelopment: gross motor (β = − 17.42, 95% CI: − 21.15 to − 13.69), fine motor (β = − 23.61, 95% CI: − 28.52 to − 18.69), adaptability (β = − 10.10, 95% CI: − 13.82 to − 6.38), language (β = − 6.28, 95% CI: − 9.82 to − 2.74) and social behavior (β = − 5.99, 95% CI: − 9.59 to − 2.39). There was a significant negative trend for early term birth in DQ of fine motor (β = − 2.01, 95% CI: − 3.93 to − 0.09). Late preterm infants had a significantly elevated risk of neurodevelopmental delay in domains of gross motor (adjusted OR = 3.82, 95% CI: 2.67 to 5.46), fine motor (adjusted OR = 3.51, 95% CI: 2.47 to 5.01), and adaptability (adjusted OR = 1.60, 95% CI: 1.12 to 2.29), whereas early term birth was significantly associated with neurodevelopmental delay of fine motor (adjusted OR = 1.22, 95% CI: 1.05 to 1.42).

Conclusions

This study suggested that late preterm birth mainly elevated the risk of neurodevelopmental delay of gross motor, fine motor, and adaptability, whereas early term birth was associated with the developmental delay of fine motor within 6 months. Further research is needed to determine the effectiveness and necessity of the interventions at the early stage for early term and late preterm infants who had suspected neurodevelopmental delay.
Diverging levels of COVID-19 governmental response satisfaction across middle eastern Arab countries: a multinational study
Authors: Itani Rania , Karout Samar , Khojah Hani M. J. , Rabah Makram , Kassab Mohamad B. , Welty Francine K. , AlBaghdadi Mazen , Khraishah Haitham , El-Dahiyat Faris , Alzayani Salman , Khader Yousef S. , Alyahya Mohammad S. , Alsane Danah , Abu-Farha Rana , Mukattash Tareq L. , Soukarieh Tarek , Awad Mohamad Fawzi , Awad Reem , Wehbi Abir , Abbas Fatima , El Mais Hadi , El Mais Huda , Karout Lina
Published: May 2022

Background

Public acceptance of governmental measures are key to controlling the spread of infectious diseases. The COVID-19 pandemic has placed a significant burden on healthcare systems for high-income countries as well as low- and middle-income countries (LMICs). The ability of LMICs to respond to the challenge of the COVID-19 pandemic has been limited and may have affected the impact of governmental strategies to control the spread of COVID-19. This study aimed to evaluate and compare public opinion on the governmental COVID-19 response of high and LMICs in the Middle East and benchmark it to international countries.

Methods

An online, self-administered questionnaire was distributed among different Middle Eastern Arab countries. Participants’ demographics and level of satisfaction with governmental responses to COVID-19 were analyzed and reported. Scores were benchmarked against 19 international values.

Results

A total of 7395 responses were included. Bahrain scored highest for satisfaction with the governmental response with 38.29 ± 2.93 on a scale of 40, followed by the Kingdom of Saudi Arabia (37.13 ± 3.27), United Arab Emirates (36.56 ± 3.44), Kuwait (35.74 ± 4.85), Jordan (23.08 ± 6.41), and Lebanon (15.39 ± 5.28). Participants’ country of residence was a significant predictor of the satisfaction score (P < 0.001), and participants who suffered income reduction due to the pandemic, had a history of SARS-CoV-2 infection, and held higher educational degrees had significantly lower satisfaction scores (P < 0.001). When benchmarked with other international publics, countries from the Gulf Cooperation Council had the highest satisfaction level, Jordan had an average score, and Lebanon had one of the lowest satisfaction scores.

Conclusion

The political crisis in Lebanon merged with the existing corruption were associated with the lowest public satisfaction score whereas the economical instability of Jordan placed the country just before the lowest position. On the other hand, the solid economy plus good planning and public trust in the government placed the other countries of the Gulf Cooperation Council on top of the scale. Further investigation is necessary to find out how the governments of other low-income countries may have handled the situation wisely and gained the trust of their publics. This may help convey a clearer picture to Arab governments that have suffered during the pandemic.
Meditative practices, stress and sleep among students studying complementary and integrative health: a cross-sectional analysis
Authors: Sadowski Adam , Wexler Ryan S. , Hanes Douglas , Buttolph Lita , Torrens Tediana , Moehle Jillian , Sarrar Hadil , Harnett Joanna , Zava David T. , Bradley Ryan
Published: May 2022

Background

The International Cohort on Lifestyle Determinants of Health (INCLD Health) is an ongoing, prospective cohort study assessing the health behaviours and lifestyles of higher education students, including their use of specialty diets and complementary and integrative health (CIH) practices. Purpose: This cross-sectional analysis of the INCLD Health cohort aims to (1) evaluate the associations between perceived stress, sleep disturbance, and meditative practices with diurnal salivary free cortisol and (2) evaluate the associations of meditative practices as well as mind-body practices with perceived stress and sleep disturbance.

Methods

Serial multivariable linear regression models, adjusting for sociodemographic and lifestyle behaviours, were used to assess associations of (1) perceived stress, sleep disturbance, and meditative practices with salivary cortisol, and (2) meditative practices as well as mind-body practices with perceived stress and sleep disturbance. Meditative and mind-body practices were evaluated using a stress-management and self-care survey; perceived stress and sleep disturbance were evaluated using the 10-item Perceived Stress Scale (PSS), and the patient reported outcome measures information system-29 (PROMIS-29) sleep sub-score respectively. Salivary cortisol was collected at 4 time points over a 24-hour period and area under the curve (AUC) calculations conducted.

Results

82.5% (n = 80) of participants utilized at least monthly meditative practices. Greater disturbed sleep, but not perceived-stress, meditative, nor mind-body practices was independently associated with increased AUC cortisol (b = 0.02, 95% CI: 0.002–0.05, p = 0.03) after adjusting for age, sex, race, ethnicity, and BMI. Neither meditative nor mind-body practices were associated with perceived stress or disturbed sleep.

Conclusions

Among INCLD Health participants, greater sleep disturbance, but not perceived stress or meditative practices were associated with daytime cortisol.