bluuebunny/crossref_metadata_2025 huggingface dataset:
Neoaortoiliac system and cryopreserved human allograft for the treatment of aortic graft infections
Authors: Omran Safwan , Gröger Steffen , Bruder Leon , Bürger Matthias , Kapahnke Sebastian , Haidar Haidar , Konietschke Frank , Greiner Andreas
Published: May 2022

Objective

To report and compare neoaortoiliac system reconstruction and cryopreserved human allograft in treating aortic graft infections.

Methods

We retrospectively analysed the data of the patients treated for aorto graft infections between January 2015 and May 2021 in our hospital. The clinical data, diagnostic procedures, and surgical options were evaluated. The primary endpoint of this study was the 30-day and 1-year mortality; secondary endpoints were major postoperative complications.

Results

We retrospectively reviewed a series of 31 consecutive patients (28 males; median age 72 years, range, 50–87 years) with aortic graft infection treated with NAIS (n = 20, 65%) or cryopreserved allograft (n = 11, 36%). The clinical presentation included fever attacks in 18 (58%) patients, abdominal pain in 15 (48%) patients, haemodynamic instability in 6 (19%) patients, and haematemesis in 2 (7%) patients. The median operative time of the NAIS was longer than CHA without a statistically significant difference (458 min vs. 359 min, p = .505). The postoperative morbidity for all patients was 81%, with no significant difference between NAIS and CHA groups (85% vs. 73%, p = .638). There was no limb thrombosis of the new reconstructions. Limb loss occurred in 4 (13%) patients, including 2 (10%) NAIS patients and 2 (18%) CHA patients. One NAIS patient developed complications in the form of a distal (femoral) disruption of the vein 15 days after surgery. There were no significant differences between NAIS and CHA groups in ICU stay (12 vs 8 days, .984) but in hospitalization (22 vs 33, p = .033). The most common bacteria isolated were staphylococci strains in 15 (48%). In 13 (36%) patients, candida was positive. The in-hospital 30-day and 1-year mortality for all patients was 16% (5/31) and 29% (9/31), with no significant differences between NAIS and CHA at 30 days (25% vs. 0, p = .133) or 1 year (35% vs. 18%, .429). Five NAIS patients died during the hospital stay; three of them had end-of-life decisions. After a median follow-up of 16 months (1–66 months), 12 (39%) patients died, including 9 patients with NAIS and 3 with CHA reconstructions. The causes of death included overwhelming sepsis in 5 (42%) patients, graft disruption in one (8%) NAIS patient, non–small cell lung cancer in one (8%) patient, COVID-19 in one (8%) patient and unknown causes (8%) in one.

Conclusions

Non-staged neoaortoiliac system reconstruction and cryopreserved human allografts show comparable short- and midterm results for treating aortic graft infections. However, both procedures remain challenging with high morbidity and mortality rates.
Clostridium butyricum powders combined with zinc gluconate on inflammatory factors and intestinal microecology in children with infectious diarrhea
Authors: Xu Xiaonan , Zhang Ni , Li Binde , Huang Li
Published: May 2022

Objective: To investigate the clinical value of Clostridium butyricum powders combined with zinc gluconate in the treatment of infectious diarrhea in children, clinical data of 86 children with infectious diarrhea were retrospectively analyzed. Methods: Both groups received routine treatments to reduce symptoms, among which the control group ( n = 40) was given Clostridium butyricum powders, and the experiment group ( n = 46) was given Clostridium butyricum powders and zinc gluconate. Patients in both groups were treated for 5 days. The clinical efficacy, recovery time, safety, serum levels of inflammatory markers (interleukin-6, interleukin-17, C-reactive protein), indicators of the intestinal mucosal function (diamine oxidase, D-lactate) and indicators to intestinal microecology (bifidobacteria, lactobacillus) before and after treatment were compared between the two groups. Results: The clinical efficacy in the experiment group (95.65%) was higher than that in the control group (77.50%, p < 0.05). The time of recovery from symptoms including diarrhea, abdominal pain and vomiting, and to normal body temperature in the experiment group were shorter than those in the control group (all p < .001). After treatment, the serum IL-6, IL-17, CRP levels and DAO, D-lactate levels in both groups were lower than those before treatment, and were lower in the experiment group than in the control group (all p < .001). After treatment, the intestinal bifidobacteria and lactobacillus levels in both groups were higher than those before treatment, and were higher in the experiment group than in the control group (all p < .01). There was no significant difference in the incidence of adverse reactions between the experiment group (8.70%) and the control group (2.50%). Conclusion: In this open-label study, Clostridium butyricum powders combined with zinc gluconate are significantly effective in treating children with infectious diarrhea, which is conducive to relieving early symptoms, downregulating serum inflammatory factor levels, improving intestinal mucosal function, regulating intestinal microecology, and ensuring the safety of patients.
The impact of smoking status on anticipated stigma and experience of care among smokers and ex-smokers with chronic illness in general practice
Authors: Madawala Sanduni , Enticott Joanne , Sturgiss Elizabeth , Selamoglu Melis , Barton Chris
Published: May 2022

Objectives

To compare self-reported levels of ‘anticipated’ stigma and experience of care in general practice between current and ex-smokers living with COPD, other chronic illnesses, or those with no chronic conditions.

Methods

Participants completed an online survey, advertised through social media, about their experience of care from general practitioners (GPs) in the past 12 months. Respondents self-reported doctor-diagnosed chronic illnesses. Experience of care and anticipated stigma was assessed using validated questions. Multi-nominal regressions were used to determine independent effect of smoking status on anticipated stigma and other indicators of patient experience in primary care.

Results

Patients with COPD (n = 161) reported significantly higher anticipated stigma scores compared to those with other chronic conditions (n = 225) and this was strongly related to delayed or avoidance in seeking help from a GP when needed. This relationship remained irrespective of current smoking status. There was no difference between groups for relational components of experience of care.

Discussion

Primary care patients living with COPD reported worse experience of care across several domains and were more likely to anticipate experiencing stigma in the GP setting irrespective of their current smoking status compared to those with other chronic illnesses or no chronic illnesses.
Didactic device for teaching the importance of the time-dependent model for heat transfer calculations in constructive systems of buildings
Authors: Ramírez-Zúñiga Guillermo , Barrios Guillermo , Huelsz Lesbros Guadalupe , Sattele Vanessa
Published: May 2022

There is a worldwide effort aimed at reducing energy consumption in buildings. Part of this effort includes bioclimatic design in the curricula for architects and engineers. The selection of constructive systems for the building envelope according to the climate is of significant importance for bioclimatic design. This has to be done by calculating the heat transfer through the constructive system using the time-dependent model. However, because the time-dependent model is easier to use it is also more commonly employed. To contribute to the teaching of the importance of using the time-dependent model, a didactic device and a practice were proposed. This paper presents the physical problem and the heat transfer models; the didactic device’s design process, its components and operating method; as well as the methodology for the practice. The didactic device and practice were created by the interaction of experts and students who gave their opinions and suggestions during different workshops.
Remote cognitive training for children with congenital brain malformation or genetic syndrome: a scoping review
Authors: Corti Claudia , Oldrati Viola , Storm Fabio , Bardoni Alessandra , Strazzer Sandra , Romaniello Romina
Published: May 2022

Increased attention is arising on the delivery of remote cognitive interventions, which allow performing exercises in everyday settings, favouring rehabilitation continuity. The present study offers an overview of remote cognitive training programs for children with congenital brain malformation or genetic syndrome affecting the central nervous system, included in papers published in the time period 2011-2021. A total of 13 records was found and discussed including efficacy studies, feasibility studies and study protocols. Many studies have focused on a specific diagnosis, such as cerebral palsy, Down Syndrome, Fragile X Syndrome, while no or little evidence has been gathered on more rare diseases or brain malformations. Interventions were found to generate benefits on some cognitive functions, but problems with adherence were highlighted, especially due to excessive cognitive load from the training or clinical comorbidities. Conclusions remain tentative due to heterogeneity in training, study and patients characteristics, and methodological limitations of studies.
“Nobody talks about it”: Preconception health and care among women in the rural, Midwestern United States
Authors: Clark Akia D , Mager Natalie A DiPietro
Published: May 2022

Introduction:

Good preconception and interconception health are fundamental to optimizing women’s health and reducing risk factors for adverse maternal–infant outcomes. Although rural women in the United States tend to experience health disparities, no published qualitative studies have focused on their preconception/interconception health. The purpose of this study was to determine what rural, Midwestern women perceive to be their most pressing health needs and effective ways to provide outreach and education regarding preconception/interconception health and care.

Methods:

Non-pregnant, reproductive-age women in Hardin County, Ohio, regardless of parity, were recruited through convenience sampling. Semi-structured interviews with four domains (beliefs and behaviors; perceived needs; knowledge and information sources; barriers to care) were conducted in May–June 2021 until saturation was reached. Qualitative methods were used to analyze data and determine themes. Binomial tests were used to compare selected demographic characteristics of participants to the county’s reproductive-age residential female population.

Results:

Nineteen women aged 20–44 years were individually interviewed. Comparing race/ethnicity, education, and insurance status, participants appeared to be representative of the county population. Four themes were identified: (1) needs regarding healthcare and other resources; (2) lack of preconception/interconception care and perceived unimportance due to intergenerational knowledge transfer and paucity of healthcare providers; (3) difference in understanding of the term “women’s health” and low health literacy; and (4) suggested interventions including education and outreach.

Conclusion:

Interviews with rural Midwestern women revealed needs regarding preconception/interconception health and care and potential ways to raise awareness. These findings can inform strategies to improve rural women’s health and birth outcomes.
Testing links between pain-related biases in visual attention and recognition memory: An eye-tracking study based on an impending pain paradigm
Authors: Zuo Xibo , Ling Ying , Jackson Todd
Published: May 2022

Although separate lines of research have evaluated pain-related biases in attention or memory, laboratory studies examining links between attention and memory for pain-related information have received little consideration. In this eye-tracking experiment, we assessed relations between pain-related attention biases (ABs) and recognition memory biases (MBs) among 122 pain-free adults randomly assigned to impending pain ( n = 59) versus impending touch ( n = 63) conditions, wherein offsets of trials that included pain images were followed by subsequent possibly painful and non-painful somatosensory stimulation, respectively. Gaze biases of participants were assessed during presentations of pain-neutral (P-N) and happy-neutral (H-N) face image pairs within these conditions. Subsequently, condition differences in recognition accuracy for previously viewed versus novel pained and happy face images were examined. Overall gaze durations were significantly longer for pain (vs. neutral) faces that signalled impending pain than impending non-painful touch, particularly among the less resilient in the former condition. Impending pain cohorts also exhibited comparatively better recognition accuracy for both pained and happy face images. Finally, longer gaze durations on pain faces that signalled potential pain, but not potential touch, were related to more accurate recognition of previously viewed pain faces. In sum, pain cues that signal potential personal discomfort maintain visual attention more fully and are subsequently recognised more accuracy than are pain cues that signal non-painful touch stimulation.
Synthesis of quinazolinone derivatives containing an acyl hydrazone skeleton as potent anti-urease agents enzyme kinetic studies and anti-oxidant properties
Authors: Baltaş Nimet
Published: May 2022

This paper covers the synthesis, in vitro urease inhibition, enzyme kinetic parameters, and anti-oxidant studies of a novel series of quinazolinone derivatives containing an acyl hydrazone skeleton. Compounds 3a, 3b, 5a, and 5b, having IC50 values ranging from 1.86 ± 0.07 to 6.38 ± 0.11 µg mL−1, show greater inhibitory activity than the standard inhibitor, thiourea. Among the products, (2-[2-(3-methoxybenzyl)-4-oxoquinazolin-3(4 H)-yl]acetohydrazide) proves to be the most potent, exhibiting enzyme inhibition activity with an IC50 value of 1.86 ± 0.07 µg mL−1. Kinetic studies involving the Lineweaver–Burk plots reveal that the inhibition mechanism of the most active compounds (3a, 3b, 5a, and 5b) on urease activity are found to be in competitive mode. Also, the anti-oxidant activity and radical-scavenging properties of the synthesized compounds are evaluated using cupric reducing anti-oxidant activity, ferric reducing anti-oxidant capacity, 2,2′-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid), and 2,2-diphenyl-1-picrylhydrazyl assays. Compounds 3a, b and 5a, b have good anti-oxidant properties and radical-scavenging activity at various final concentrations.
Accident causation models: A comparison of SCM and 24Model
Authors: Chen Ping , Fu Gui , Wang Yi , Meng Han , Lv Mingkai
Published: May 2022

The Swiss Cheese Model (SCM) and 24Model have proved over the years to be lasting influences for many researchers and practitioners in various safety areas. However, as one practical tool for accident analysis, a gap still exists for whether these two models are consistent in current studies. A theoretical comparison of these two models to reveal constructive foundation, related concepts, correspondence to each level of cause-effect and characteristics of sub modules were presented. The basic structure of the two modular models is consistent and each sub module can match. The foundation of the two models is different, reflecting the differences between Eastern and Western cultures. 24Model overcomes the fuzziness of SCM model classification and divides organizational factors into two stages: safety management system and safety culture and refines the meaning of accident and hazard. Hazard identification based on SCM is presented at the design and commissioning of the system, while the identification of 24Model following PDCA cycle, which is an continuous improvement throughout the entire life cycle of the system. In conclusion, 24Model is a deepening and development of SCM, and explicit taxonomy for individual and organization is proposed by integrating factors on SCM. The comparisons will build a bridge of communication and exchange between East and West accident causation theories and will lead to more knowledge of the causes to the accident, placing focus on need for improved organizational behaviors, more efficient safety management systems and safety culture in companies.
Moral work in victim–offender meetings
Authors: Birkbeck Christopher , Smith Greg
Published: May 2022

Although many studies of restorative justice touch on its moral dimensions, they provide a rather fragmentary view of the moral work that takes place in meetings between victims and offenders. We treat moral work as a discursive phenomenon that emerges through the evaluative rendering of character and behaviour in extended sequences of talk. Using transcripts from four victim–offender meetings, we explore how participants work within the structural constraints of the script to develop or resist particular moral conceptions of the incident, themselves and each other. We identify the significant role of the facilitator in the construction of narratives and reflections by the offender and victim, and find that ambivalence, selective attention and persuasion all appear to be necessary for achieving the moral work implied by the script.
Port-site hernias in patients undergoing laparoscopic and/or robotic surgery: Can they be prevented?
Authors: Richards Yvonne
Published: May 2022

As laparoscopic surgery advances into robotic surgery, there still remains the occurrence of port-site hernias. This can have severe consequences for the patient, including needing further surgery such as bowel resection. This has an impact on both patient and the National Health Service as the stay in hospital is prolonged, increasing the demand on staff and creating more expense to the National Health Service. This literature review explores the prevalence of port-site hernias and discovers the recommendations in preventive measures. Findings include the benefit of using non-bladed trocars and further studies need to be conducted into the association between smaller or larger ports and port-site hernias.
‘Fiction keeps memory about the war alive’: Mnemonic migration and literary representations of the war in Bosnia
Authors: Ortner Jessica , Sindbæk Andersen Tea , Wierød Borčak Fedja
Published: May 2022

This article investigates how literary works of fiction depicting wartime memories from Bosnia were received by groups of lay readers in Copenhagen, Manchester and Berlin. We introduce the concept of mnemonic migration to include both the narrative strategies employed by migrant authors in order to represent such memories in new mnemonic contexts, and the reception of this type of literature in different social and cultural settings. By investigating readers’ reactions to literature by migrants who write about topics related to own or fictional experiences in wartime Bosnia, we explore literature as a medium that makes memories travel and has the potential to create prosthetic memories. Studying what happens in the encounter between the texts and recipients within the following three national communities of remembrance – Denmark, Germany and England – we ask if the texts are capable of representing Bosnian wartime memories in an emotionally appealing manner that urges the reader to incorporate them into their own stock of memories. Based on focus group interviews in the three cities, we argue that the agency of literature in transmitting memories into new frameworks is limited but definitely present. We found that the literary style of memory mediations was an important factor and many readers preferred texts with more clarity and factuality. Nevertheless, in spite of the frustration experienced by a significant group, most readers felt emotionally engaged by at least parts of the texts. We observed that there were considerable differences in how readers in the three social settings related to the events. However, in all three countries, differences between generational groups most obviously affected the readings. Often, the books made readers aware of the limited role of the Bosnian War in their respective public frameworks of memory and created a wish for a more thorough commemoration of that event.
A more perfect union? The place of Black lives in presidential plantation sites
Authors: Hanna Stephen P , Alderman Derek H , Potter Amy , Carter Perry L , Bright Candace Forbes
Published: May 2022

While Mount Vernon, Monticello, Montpelier, and Highland work to recover the lives of people enslaved by Washington, Jefferson, Madison, and Monroe, their institutional missions emphasize the importance of these four men within American history. The resulting impediments to honoring Black lives within these spaces can be best understood using the analytical framework of reputational politics and by recognizing the roles visitors have in reproducing the reputations of the presidents and the women and men they enslaved. We base our examination of visitors’ participation in these reputational politics on a systematic documentation of tours and exhibits combined with surveys of visitors. Our results suggest that there are significant differences among the four sites in how visitors balance the reputations of enslaved communities with those of the Founding Fathers. On the whole, the emphasis on the presidents’ important positions within American social memory continues to inhibit efforts to honor Black lives at presidential plantation museums.
Management of conflict injuries to the upper limb. Part 1: assessment and early surgical care
Authors: Brown Kate V. , Roberts Darren C. , Wordsworth Matthew , Duraku Liron S. , Jose Rajive M. , Power Dominic M. , Stapley Sarah A.
Published: May 2022

Upper limb injuries are common in conflict zones. The functions of the upper limb are impossible to replicate with prosthetic replacement and wherever possible attempts should be made to preserve the limb with further secondary reconstruction aimed at restoration of function. Casualty assessment, haemorrhage control and resuscitation are simultaneously undertaken at the receiving medical facility. Primary surgical management involves decontamination and debridement, skeletal stabilization, restoration of vascularity, compartment fasciotomy where indicated and wound temporization with dressings. Operative findings and interventions should be documented and if evacuation of the casualty is possible, copies should be provided in the medical records to facilitate communication in the chain of care. Secondary procedures are required for further assessment and debridement prior to planning reconstruction and definitive fracture stabilization, nerve repair, wound cover or closure.
An analytical framework to understand individual running-related injury risk response patterns to footwear
Authors: Mai Patrick , Robertz Leon , Robbin Johanna , Thelen Matthias , Kurz Markus , Trudeau Matthieu B. , Weir Gillian , Hamill Joseph , Willwacher Steffen
Published: May 2022

Running footwear is continuously being modified and improved; however, running-related overuse injury rates remain high. Nevertheless, novel manufacturing processes enable the production of individualized running shoes that can fit the individual needs of runners, with the potential to reduce injury risk. For this reason, it is essential to investigate functional groups of runners, a collective of runners who respond similarly to a footwear intervention. Therefore, the objective of this study was to develop a framework to identify functional groups based on their individual footwear response regarding injury-specific running-related risk factors for Achilles tendinopathy, Tibial stress fractures, Medial tibial stress syndrome, and Patellofemoral pain syndrome. In this work, we quantified the footwear response patterns of 73 female and male participants when running in three different footwear conditions using unsupervised learning ( k-means clustering). For each functional group, we identified the footwear conditions minimizing the injury-specific risk factors. We described differences in the functional groups regarding their running style, anthropometric, footwear perception, and demographics. The results implied that most functional groups showed a tendency for a single footwear condition to reduce most biomechanical risk factors for a specific overuse injury. Functional groups often differed in their hip and pelvis kinematics as well as their subjective rating of the footwear conditions. The footwear intervention only partially affected biomechanical risk factors attributed to more proximal joints. Due to its adaptive nature, the framework could be applied to other footwear interventions or performance-related biomechanical variables.
Post-stroke management
Authors: Kurup Meenakshi , Thomas Revin
Published: May 2022

Stroke incidence increases with age and becomes a significant public health burden. Depending on the area of the brain affected by a stroke, a wide range of symptoms may develop including weakness, deficits in language skills, cognition, sensation and vision. Symptoms can have a significant and immediate impact on a patient’s ability to conduct personal and extended activities of daily living. The recovery process can be affected later by an inability to drive, difficulties returning to work and impaired societal participation. Hidden stroke symptoms, such as low mood and fatigue, may not be apparent to healthcare professionals, but have a detrimental impact on a patient’s recovery and overall quality of life. This article offers an overview of stroke rehabilitation, secondary prevention of stroke, specialist investigations, complications from stroke and rehabilitation in the community.
Propensity score matching analysis for adverse events of EUS-guided biliary drainage in advanced elderly patients (PEACE study)
Authors: Ogura Takeshi , Ishiwatari Hirotoshi , Fujimori Nao , Iwasaki Eisuke , Ishikawa Kazuma , Satoh Tatsunori , Kaneko Junichi , Sato Junya , Oono Takamasa , Matsumoto Kazuhide , Fukuhara Seiichiro , Kayashima Atsuto , Hakoda Akitoshi , Higuchi Kazuhide
Published: May 2022

Background:

Several studies have suggested that elderly patients, as well as younger patients, can be safely treated using endoscopic retrograde cholangiopancreatography (ERCP). However, endoscopic ultrasound-guided biliary drainage (EUS-BD) has not been clinically evaluated for very elderly patients. The present multicenter, retrospective study aimed to determine the safety of EUS-BD for advanced elderly patients.

Method:

Patients who underwent EUS-BD during this period were retrospectively enrolled, and they were divided into two groups based on age: group A (age  < 75 years) and group B (age ⩾ 75). In this study, capnographic monitoring was used only for elderly patients (age ⩾ 75 years).

Results:

A total of 271 patients who underwent EUS-BD were enrolled in this study (group A = 177, group B = 94). The types of adverse events that were associated with EUS-BD was observed in 38 patients, and they did not differ significantly between two groups ( p = 0.855). This result was confirmed after propensity score matching ( p = 0.510). Adverse events were associated with sedation after propensity score matching; hypoxemia ( p = 0.012) and severe hypoxemia ( p = 0.003) were significantly higher in group A compared with group B. According to logistic regression analysis, monitoring (non-capnography) was also only risk factor (odds ratio: 0.317, 95% confidence interval: 0.143–0.705; p = 0.005) for sedation-related adverse events.

Conclusion:

In conclusion, EUS-BD could be safety performed in advanced elderly patients, the same as in younger patients. Also, capnographic monitoring might be helpful in case of sedation by a gastroenterologist in a non-intubated patient. Further prospective, randomized studies are needed to confirm these conclusions.
Apoyo social y obesidad: el papel de los síntomas depresivos y la alimentación emocional en un modelo estratificado por sexo
Authors: Salinas-Rehbein Belén , Schleef Jorge , Neira-Vallejos Sebastián , Ortiz Manuel S.
Published: May 2022

Introducción:

la obesidad es un problema de salud pública a nivel mundial, cuya prevalencia ha aumentado sostenidamente en Latinoamerica. En Chile, el 75% de la población tiene sobrepeso u obesidad, siendo esta última más prevalente en mujeres (38%) que en hombres (30%). Si bien la percepción de apoyo social ha sido identificada como un factor protector para el desarrollo de la obesidad, el papel de la sintomatología depresiva y la alimentación emocional como mecanismos mediadores ha sido menos estudiado.

Objetivo:

determinar si el vínculo entre la percepción de apoyo social y el perímetro de cintura está mediado por la sintomatología depresiva y la alimentación emocional en una muestra de adultos chilenos estratificada por sexo.

Métodos:

trescientos veinticinco ( n = 325) adultos chilenos de una región del sur de Chile fueron seleccionados mediante un muestreo no probabilístico intencional (55% mujeres, Medad mujeres = 57.21, Medad hombres = 58.34). Se midió el perímetro de cintura como indicador de obesidad y se utilizaron instrumentos de autorreporte para evaluar variables psicológicas, conductuales y sociodemográficas.

Resultados:

la alimentación emocional medió totalmente el vínculo entre sintomatología depresiva y perímetro de cintura tanto en hombres (β = 0.089, p = 0.042), como en mujeres (β = 0.086, p = 0.013). La percepción de apoyo social se vinculó indirecta y negativamente con el perímetro de cintura a través de una secuencia de mediación que incluyó sintomatología depresiva y alimentación emocional solo en mujeres (β = −0.043, p = 0.015).

Conclusiones:

la alimentación emocional es una variable a través de la cual la sintomatología depresiva se vincula con obesidad tanto en hombres como mujeres. Los hallazgos avalan el papel protector de la percepción de apoyo social en obesidad en mujeres, lo que puede orientar el desarrollo de estrategias para disminuir las altas tasas de obesidad en población chilena adulta.
Perceptions of practising physiotherapists in Saudi Arabia about their role in the health promotion of patients with musculoskeletal conditions: a qualitative study
Authors: Alodaibi Faris A. , Alotaibi Mazyad A. , Almohiza Mohammad. A. , Alhowimel Ahmed. S.
Published: May 2022

Objective:

This study aimed to explore physiotherapists’ perceptions in Saudi Arabia about their understanding and role in health promotion through lifestyle behaviours and risk factors assessment and management of patients with musculoskeletal pain and disabilities.

Study design:

Qualitative study.

Method:

One-to-one interviews with 12 physiotherapists (six females; mean age 34.5 ± 8) within a constructivist framework. Interviews were recorded, transcribed verbatim, and analysed using a thematic analysis approach.

Result:

Three themes were identified: (1) the physiotherapists’ awareness and knowledge of health promotion; (2) current practice of physiotherapists to implementing health promotion practice; and (3) the physiotherapists’ perceived barriers to implementing health promotion practice. Participants generally perceived health promotion to be within their scope of practice. However, their understanding and approaches to deliver this practice were varied and non-standardised. Some barriers to routine engagement in health promotion were identified, including time constraints, the beliefs of healthcare practitioners, and limited education and training.

Conclusion:

This study highlighted that physiotherapists acknowledged the role of health promotion in their practice. However, there were different explanations of the concept and it was informally practised.
Outcomes after salvage reverse shoulder arthroplasty for failed primary fixation or hemiarthroplasty for proximal humerus fractures: A systematic review
Authors: Levy Hannah A , Szeto Stanley , O Starks Alexandria , Davis Daniel E
Published: May 2022

Background

Salvage reverse shoulder arthroplasty (RSA) for failed proximal humerus fractures (PHFs) fixation and hemiarthroplasty (HA) may maximize outcomes in the absence of tuberosity healing or a chronically torn rotator cuff. The purpose of this systematic review was to examine the improvement in clinical outcomes for patients after revision RSA was performed for failed PHFs fixation or HA.

Methods

An electronic database search of SCOPUS, PubMed, Embase, MEDLINE, SPORTDiscus, CINAHL, and ClinicalTrials.gov was performed. A meta-analysis was carried out to determine weighted mean outcome differences between two primary intervention cohorts (failed fixation: open reduction and internal fixation, intramedullary nail, or K-wire vs. failed HA).

Results

Fifteen studies were included (primary fixation: 208 patients; HA: 162 patients). Patients improved meaningfully in all clinical outcomes after revision surgery (constant: 18.5–48.3; abduction: 44–95; forward flexion: 47–107; external rotation: 5–10), with a 16.2% complication and 9.4% revision rate. The failed fixation group performed significantly better than the failed HA group in postoperative constant (fixation: 53.3 vs. HA: 45.1, p = 0.016) and shoulder abduction (fixation: 102 vs. HA: 87, p = 0.026).

Conclusions

RSA is a successful revision intervention for primary PHF operative failures with the greatest benefit for failures of primary fixation versus HA.
First Outpatient Clinical Trial of a Full Closed-Loop Artificial Pancreas System in South America
Authors: Garelli Fabricio , Fushimi Emilia , Rosales Nicolás , Arambarri Delfina , Mendoza Leandro , Serafini María Cecilia , Moscoso-Vásquez Marcela , Stasi Marianela , Duette Patricia , García-Arabehety Julia , Giunta Javier Nicolás , De Battista Hernán , Sánchez-Peña Ricardo , Grosembacher Luis
Published: May 2022

Background:

The first two studies of an artificial pancreas (AP) system carried out in Latin America took place in 2016 (phase 1) and 2017 (phase 2). They evaluated a hybrid algorithm from the University of Virginia (UVA) and the automatic regulation of glucose (ARG) algorithm in an inpatient setting using an AP platform developed by the UVA. The ARG algorithm does not require carbohydrate (CHO) counting and does not deliver meal priming insulin boluses. Here, the first outpatient trial of the ARG algorithm using an own AP platform and doubling the duration of previous phases is presented.

Method:

Phase 3 involved the evaluation of the ARG algorithm in five adult participants (n = 5) during 72 hours of closed-loop (CL) and 72 hours of open-loop (OL) control in an outpatient setting. This trial was performed with an own AP and remote monitoring platform developed from open-source resources, called InsuMate. The meals tested ranged its CHO content from 38 to 120 g and included challenging meals like pasta. Also, the participants performed mild exercise (3-5 km walks) daily. The clinical trial is registered in ClinicalTrials.gov with identifier: NCT04793165.

Results:

The ARG algorithm showed an improvement in the time in hyperglycemia (52.2% [16.3%] OL vs 48.0% [15.4%] CL), time in range (46.9% [15.6%] OL vs 50.9% [14.4%] CL), and mean glucose (188.9 [25.5] mg/dl OL vs 186.2 [24.7] mg/dl CL) compared with the OL therapy. No severe hyperglycemia or hypoglycemia episodes occurred during the trial. The InsuMate platform achieved an average of more than 95% of the time in CL.

Conclusion:

The results obtained demonstrated the feasibility of outpatient full CL regulation of glucose levels involving the ARG algorithm and the InsuMate platform.
No Laughing Matter: Armin Laschet and the Photographic Exposé
Authors: Olesen Thomas
Published: May 2022

On July 17, 2021, the CDU's chancellor candidate Armin Laschet was photographed laughing during a speech by the German Federal President in the flood-stricken city of Erftstadt. The photographic images caused an uproar and contributed to the CDU's defeat in the September 23 election. The paper analyzes why these images resonated with such damaging effects. Theoretically, it sets the analysis on the background of the moralization and personalization of politics and argues that photography, with its ability to capture behavior at a distance, plays a prominent role in these processes. While this condition explains why an image of a laughing politician can generate such indignation in the first place, the paper discusses how this effect was amplified in the case of Laschet by a range of contextual features: (a) the timing of the images in the middle of an election period where politicians come under intense scrutiny; (b) their appearance in a crisis situation (the German flooding disaster) where politicians are surrounded by other role expectations than in routine periods; (3) Laschet's new, insecure position as leader of the CDU; (d) his history of scandals and poor political judgment; and (e) the frivolous and boisterous manner of his laughter. At a general theoretical level, the paper's insights caution us to avoid prima facie conclusions about the autonomous power of photographs. Instead, they encourage analytical sensitivity to the importance of timing and context as explanatory elements in our understanding of photographic exposés.
“Pivoting Between the Past/Present and Towards the Future/perfect of Autoethnography”
Authors: Alexander Bryant K.
Published: May 2022

Following the guide of the Autoethnography Special Interest Group preconference at the 2021 International Congress of Qualitative Inquiry (ICQI), this short think piece was placed on the closing panel. The charge was to “speculate on autoethnographic futures.” This contribution uses the notion of national and international pivoting due to the Covid pandemic in practical everyday engagements to theorize on the notion of “the new normal,” not only reduced to conditions of pandemic but political and civic unrest linked with a range of identities to push commitments to social justice. The piece engages a provocation of autoethnographic futurity that is not just about standing in the present reflecting on the past, but a call for civic action for future (queer) worldmaking.
Elbow Ulnar Collateral Ligament Injuries in Overhead Athletes: An Infographic Summary
Authors: Zaremski Jason L.
Published: May 2022

Ulnar collateral ligament (UCL) injuries of the elbow are common in throwing athletes. Given that the UCL’s primary function is to provide valgus stability during the deceleration phase of throwing, injury to the UCL will render throwing difficult to nearly impossible.15 Injuries will occur more so in the sports of baseball, softball, and javlineers participating in track and field.5,10,14 Data has indicated that valgus torque reaches 64 N-m and proximal forces as high as 1000 N to prevent elbow distraction. Further, angular velocity across elbow may reach 1900-2480 degrees/second.6,8 Imaging modalities that have the greatest accuracy for diagnosis include magnetic resonance imaging (MRI), MRI-arthrogram, and stress ultrasonography.2,3,11,12 Treatment of UCL injury depends on multiple factors. These include if the injury is a partial tear or complete tear and the location (distal versus proximal) of the partial tear.7 Further, complete tears, as well as partial distal tears, are more likely to undergo surgical intervention.1,13 Treatment decision-making is primarily dependent on following factors: location, severity, if the patient is a throwing athlete, and if the patient is in his or her last year of his/her throwing career due to the length of the rehabilitation process if surgery is pursued.15 Return-to-play success rates when treated conservatively vary from anywhere from 42% to 100%. Conservative treatment includes rest, rehabilitation, platelet-rich plasma injections, and a throwing program.4 Surgical treatment has evolved significantly with various reconstructive techniques and (when indicated) surgical repair with internal bracing. Return-to-play rates are high, ranging from 80% to 95% with low complication rates, but rehabilitation for reconstruction can range from 12-18 months or longer. Therefore, patients must be made aware of the commitment to the rehabilitation process if electing to undergo surgical reconstruction.9
Spontaneous base of penile abscess successfully treated by transperineal incision and drainage: A case report
Authors: Lee Lian Thai , Hon Shu Ann , Chuah Jun Sen , Tee Yu Jin , Mohd Ibrahim Syed Omar
Published: May 2022

Base of penile abscesses are uncommon genitourinary tract infection. We present a case of a 31 years old man with poorly controlled diabetes mellitus, whom presented with scrotal pain and scrotal swelling for 1 week duration. Physical examination revealed a bulging mass at the base of penis. A high index of suspicion is needed to look for possible causes such as extension of abscess from perineum or anorectal, sexually transmitted disease, tuberculosis, history of penile instrumentation or injection and trauma. A large abscess at the base of penis was diagnosed by magnetic resonance imaging. He was successfully treated with transperineal incision and drainage, systemic antibiotic therapy, wound care and strict diabetic control. To the best of our knowledge, this is the first report of isolated base of penile abscess. The description of case, comprising the clinical presentation and management, is discussed in detailed with emphasis on the treatment approach.
Exploring the weight bias of professionals working in the field of obesity with a mobile IAT: a pilot study
Authors: Jungnickel Tobias , von Jan Ute , Engeli Stefan , Albrecht Urs-Vito
Published: May 2022

Background:

Obesity is common in many industrialized nations and often accompanied by related health issues. Furthermore, individuals living with overweight or obesity are often confronted with stigmatization in their daily lives. These problems may be aggravated if the objectivity of health care professionals is compromised due to (unconscious) prejudices. If pharmaceutical companies, regulatory agencies, and health insurers are also susceptible to these biases, decisions related to the development, approval, and reimbursement of obesity-related therapies may be negatively impacted.

Materials and Methods:

The ‘Implicit Association Test’ (IAT) is a psychometric test allowing to measure these attitudes and could therefore assist to reveal unconscious preferences. A self-developed mobile version, in the form of a ResearchKit-based IAT app was employed in the presented study. The objective was to determine (potential) weight bias and its characteristics for professionals attending a national obesity-related conference in Germany (G1), compared to a control group (without stated interest in the topic, G2) – both using the mobile app – and a historical control (G3) based on data provided by Project Implicit acquired by a web app.

Results:

Explicit evaluations of G1 were neutral at a higher percentage compared with G2 and G3, while implicit preference toward lean individuals did not differ significantly between G2 and G3, and G1.

Conclusion:

The greater discrepancy between the (more neutral) explicit attitude and the unconscious preference pointing in the anti-obesity direction could indicate an underestimated bias for the professional participants in G1. Implicit preference is often ingrained from childhood on, and difficult to overcome. Thus, even for professionals, it may unconsciously influence decisions made in the care they provide. Professionals in any given health care sector directed at obesity care should thus be made aware of this inconsistency to enable them to consciously counteract this potential effect.
Leveraging digital technologies for information technology-enabled healthcare transformation at SingHealth
Authors: Perdana Arif , Mokhtar Intan Azura
Published: May 2022

Singapore Health Services, or SingHealth in short, is Singapore’s largest public health organisation. SingHealth was established in the year 2000 with ‘the aim to deliver consistently high-quality care that is appropriate and accessible to patients’. Since its inception, SingHealth has introduced numerous digital innovations to strengthen its business model and healthcare delivery. These include investments in mobile applications such as HealthBuddy and MyCare, which are widely used by patients in Singapore to manage their medical appointments, order their medication and monitor their health, which can all be done remotely. With the Covid-19 pandemic, SingHealth introduced Swabot which helped carry out automated nasal swabs at Covid-19 testing sites; Doctor Covid, which is a chatbot hosted on Telegram, an online messaging application that helps to improve care for Covid-19 patients in community care settings; and an AI-based tool called the Community-Acquired Pneumonia and Covid-19 AI Predictive Engine, which can determine the severity of pneumonia in Covid-19 patients based on chest x-ray images. SingHealth’s investments in information systems and technologies have enabled SingHealth to improve its operations, provide better healthcare delivery to patients, better manage doctors’ and nurses’ workload, and address the various challenges posed by the Covid-19 pandemic. This case examines how digital technologies revolutionised SingHealth’s workflows and processes, resulting in better quality healthcare for patients, and will be helpful for healthcare organisations looking to leverage on technology and health informatics for optimum healthcare delivery.
The core minimum dataset for measuring pain outcomes in pain services across Scotland. Developing and testing a brief multi-dimensional questionnaire
Authors: Laskawska Magdalena S , Hébert Harry L , Richardson Cara , Berlouis Katherine , Cameron Paul , Colvin Lesley A , Smith Blair H
Published: May 2022

Background:

There is currently no agreed minimum dataset to inform specialist chronic pain service provision. We aimed to develop a Core Minimum Dataset (CMD) for pain services in Scotland and perform preliminary analysis to evaluate its psychometric properties in adults with chronic pain.

Methods:

The questionnaire was developed following a review of existing relevant data collection instruments and national consultation. The CMD questionnaire was completed alongside a routine pre-clinic questionnaire by patients attending two pain services over 3 months. Concurrent validity was tested by comparing scores between the CMD and pre-existing questionnaires. Reliability was assessed by test-retest and discriminative validity via receiver operating characteristic (ROC) curves.

Results:

The final CMD questionnaire consisted of five questions on four domains: pain severity (Chronic Pain Grade [CPG] Q1); pain interference (CPG Q5); emotional impact (Patient Health Questionnaire-2 [PHQ-2], two questions); and quality of life (Short Form Health Survey-36 [SF-36] Q1). 530 patients completed the questionnaire. Strong correlation was found with the Hospital Anxiety and Depression Scale (rs= 0.753, p < 0.001). Moderate correlations were found with the Brief Pain Inventory for pain interference (rs= 0.585, p < 0.001) and pain severity (rs= 0.644, p < 0.001). Moderate to good reliability was demonstrated (Intra-class Correlation Coefficient = 0.572–0.845). All items indicated good discrimination for relevant health states.

Conclusions:

The findings represent initial steps towards developing an accurate questionnaire that is feasible for assessing chronic pain in adults attending specialist pain clinics and measuring service improvements in Scotland. Further validation testing, in clinical settings, is now required.