bluuebunny/crossref_metadata_2025 huggingface dataset:
What influences the decision to undergo rotator cuff repair surgery: A survey of clinician's perspectives
Authors: Pitt Lisa , Mazuquin Bruno , Littlewood Chris
Published: October 2024

Background

Many factors may influence a patient's decision to undergo rotator cuff repair surgery. The aim of this survey was to understand from a clinician's perspective how different factors influence the likelihood of a patient undergoing a repair.

Methods

An online survey presenting a range of clinical scenarios was distributed through professional networks to understand how each patient related factor influenced the likelihood of a patient undergoing a rotator cuff repair.

Results

One hundred three clinicians completed the survey. Clinicians indicated that patients were more likely to undergo a repair if they were younger, had a traumatic or larger tear, high pain levels (64.1%), high functional demands (93.2%), and arm weakness (86.4%). Surgery was less likely in older patients who had degenerative or smaller tears, diabetics (62.1%), smokers (78.9%) and those with high body mass index (57.3%). 74.8% of clinicians indicated a repair was more likely if the patient expected that surgery was required to improve symptoms.

Discussion

From a clinician's perspective, the decision to undergo surgery is complex, it is influenced by onset, age, tear size and other health related factors. Patient expectations of treatment also appear to influence the decision, and this is an area that needs further exploration.
Comparative safety of novel targeted therapies in relapsed/refractory chronic lymphocytic leukemia: a network meta-analysis
Authors: Monica Magdalena , Reczek Monika , Kawalec Paweł
Published: October 2024

Background:

The emergence of new antileukemic drugs, including Bruton tyrosine kinase inhibitors (BTKis), phosphoinositide 3-kinase inhibitors (PI3Kis), and B-cell lymphoma 2 antagonists (BCL-2a), has significantly improved the outcomes for patients with relapsed/refractory chronic lymphocytic leukemia (CLL). Despite advances in treatment efficacy, the comprehensive safety profile of these novel agents versus traditional chemotherapy and immunotherapy has not been adequately explored, and there have been few direct comparisons.

Objectives:

This study aimed to compare the safety profiles of novel therapeutic agents, chemotherapy, and immunotherapy in patients with relapsed/refractory CLL using a Bayesian network meta-analysis (NMA).

Methods:

A systematic literature review was conducted to identify randomized clinical trials on relapsed/refractory CLL. The search encompassed major medical databases (MEDLINE, Embase, and CENTRAL) and gray literature, with the aim to integrate the findings into a Bayesian NMA framework for safety outcome assessment.

Design:

Systematic literature review with Bayesian NMA.

Results:

The systematic search identified 14 randomized trials that formed networks for the comparison of safety outcomes. No differences were shown between therapies in terms of overall adverse events (AEs). However, bendamustine + rituximab had a more favorable safety profile for grade ⩾3 AEs when compared with ibrutinib (risk ratio 0.62 (95% credible interval 0.40–0.86)), acalabrutinib (0.69 (0.45–0.94)), zanubrutinib (0.64 (0.42–0.91)), and venetoclax + rituximab (0.87 (0.79–0.96)). The frequency of grade ⩾3 AEs, serious AEs, and treatment discontinuations and deaths due to AEs was comparable between acalabrutinib, zanubrutinib, and venetoclax + rituximab. There were no significant differences in the safety profiles regarding hematological events, events affecting the quality of life, and infections for most comparisons of venetoclax + rituximab with BTKis. Among BTKi-specific events, zanubrutinib was associated with a higher risk of hypertension (2.96 (1.74–5.16)) and bleeding (1.38 (1.06–1.81)) than acalabrutinib. No differences in the risk of atrial fibrillation were found between acalabrutinib and zanubrutinib (1.56 (0.74–3.34)).

Conclusion:

Our findings showed that venetoclax + rituximab, acalabrutinib, and zanubrutinib have acceptable safety profiles, which indicates that they may be the preferred therapeutic options in the setting of relapsed/refractory CLL.

Trial registration:

PROSPERO CRD42022304330.
A scoping review to map public-facing websites for non-traumatic wrist disorders with quality evaluation
Authors: Mitchell Thomas , Bircumshaw Michael , Cryan Clare , Kotwica Dawid , Hamilton Nick , Dean Ben , McLean Sionnadh
Published: October 2024

Introduction

Public-facing resources for non-traumatic wrist disorders (NTWD) exist, but care recipients and healthcare professionals alike are uncertain where to access the most useful resources and have raised concerns over the quality of information provided. Previous studies involving stakeholders highlight a need for quality evaluation of these resources. The aim of this study was to identify website resources accessible to UK-based online health seekers and explore their content through quality assessment.

Methods

A scoping review of public-facing websites was conducted in accordance with Joanna Briggs Institute guidelines and PRISMA-ScR checklist. An a-priori search strategy was performed of publicly accessible websites using lay terms were entered into a simple Google search. The DISCERN tool was used to appraise the quality of health information with additional data charted to pre-determined criteria.

Results

The 82 websites meeting inclusion criteria scored an average of 2/5 DISCERN. Nine funding categories existed with private service websites were the most common. 18 different diagnoses were found with twenty different management interventions were recommended.

Conclusion

Considerable variation was found in the quality of websites providing information which people with NTWD are likely to access. Quality and trustworthiness of website information on NTWD are not the preserve of any sector or organisation and we identified potential for improvements across the board.
Insights from communities’ awareness and participation in greening semi-arid lands for effective environmental conservation
Authors: Gayo Leopody , Mmbaga Naza , Ngongolo Kelvin
Published: October 2024

Background and Research Aims

Tree planting holds significant potential for environmental protection in the era of climate change and variability. It is particularly crucial in semi-arid areas where tree density is extremely low, necessitating the engagement of local communities. However, information about local people's awareness and their willingness to participate in greening practices is rarely considered. We assessed the levels of community awareness, the extent of participation, and the factors influencing their willingness to green the Dodoma semi-arid area between 2018 and 2022.

Methods

We collected data from 145 respondents using a household questionnaire survey, focus group discussions, and in-depth interviews. Quantitative data were analyzed using SPSS version 26, while template analysis was applied to the qualitative data.

Results

We found the overwhelming majority of respondents (n= 136) are aware of the importance of tree planting, and 89.7% of respondents participated in greening practices. Income level, education level, environmental awareness, perceived benefits of tree planting, and social influence were significant predictors of communities' willingness to plant trees.

Conclusion

Despite the greater awareness and active participation of tree planting found among local actors in the study area, efforts must be directed towards suitable selection of adaptive, affordable and improved tree species for sustainable and feasible socio-ecological benefits of afforestation in semi-arid areas.

Implications for conservation

The study underscores the potential of community awareness and participation in tree planting for environmental conservation and the sustainable supply of forest products, which are vital for local livelihood development. We advocate for the consideration of socioeconomic and ecological factors when engaging local actors in greening urban semi-arid lands through technical and financial empowerment.
Estimating Repetitions in Reserve During the Bench Press Exercise: Should We Consider Sex and the Exercise Equipment?
Authors: Ruiz-Alias Santiago A. , Baena-Raya Andrés , Hernández-Martínez Alba , Díez-Fernández David M. , Rodríguez-Pérez Manuel A. , Pérez-Castilla Alejandro
Published: October 2024

Background:

Estimating repetitions in reserve (RIR) has been established as a valid and practical method for monitoring set configuration concerning proximity to failure in resistance training. However, factors such as sex and exercise equipment could interfere with the estimation process. Therefore, this study aimed to determine the influence of sex (female vs male) and exercise equipment (free-weight vs Smith machine) on the RIR estimation at different relative loads during the bench press exercise.

Hypothesis:

Men would be more accurate than women in the RIR estimation, and participants would better perceive their actual effort at the Smith machine compared with the free-weight bench press exercise.

Study Design:

Repeated measures design.

Level of Evidence:

Level 3.

Methods:

In a counterbalanced order, recreationally trained participants (12 female, 14 male) performed 2 identical sessions with the free-weight bench press exercise in 1 week and 2 identical sessions with the Smith machine bench press exercise in another week (first session for familiarization and second session for validity analysis). In each session, participants performed single sets of repetitions to failure against 3 relative loads (65%, 75%, and 85% of the 1-repetition maximum [1RM]).

Results:

Results revealed a significant interaction between RIR and sex at 65% 1RM ( P < 0.01; women: -1.2 [-1.7 to -0.6] repetitions; men: -0.1 [-0.6 to 0.3] repetitions), and between RIR and exercise equipment at 65% 1RM ( P < 0.01; free-weight: -1.1 [-1.5 to -0.6] repetitions; Smith machine: -0.2 [-0.6 to 0.2] repetitions), but not at 75% and 85% 1RM.

Conclusions:

RIR estimation is a valid method for monitoring set configuration. However, this method tends to underestimate RIR at 65%1RM with female athletes and in the free-weight exercise for both sexes.

Clinical Relevance:

Strength and conditioning coaches should help their athletes understand effort awareness in the aforementioned context.
Burnout and associated factors among nurses in psychiatric and general tertiary hospitals in Botswana: A cross-sectional study
Authors: Molebatsi Keneilwe , Musindo Otsetswe , Bojosi Kagiso , Wambua Nduku , Olashore Anthony A
Published: October 2024

Introduction:

Research has consistently documented that nurses are at a higher risk for developing burnout syndrome due to the nature of their jobs. The high prevalence of burnout among nursing staff negatively affects healthcare delivery. Nurses experiencing burnout cannot provide quality care or actively participate in health promotion, and those experiencing emotional exhaustion are unlikely to be able to tend to the emotional needs of patients.

Objective:

The study aimed to determine the prevalence and factors associated with burnout syndrome among nursing staff in Botswana referral general and psychiatric hospitals.

Methods:

A cross-sectional survey was conducted among 249 nursing staff working in a referral psychiatric and general hospital. The job satisfaction survey, Maslach burnout inventory, and the OCEAN-20 were used to assess job satisfaction, burnout occurrence, and personality traits, respectively. A researcher-designed sociodemographic questionnaire was used to capture demographic data. Variables identified to be associated with burnout on bivariate analyses were entered into a regression analysis to determine to what extent these factors predicted burnout.

Results:

The prevalence of emotional exhaustion, depersonalization, and reduced personal accomplishment was 65.7%, 56.9%, and 54%, respectively. Being in a general hospital, neuroticism, poor operating condition, and poor communication predicted emotional exhaustion, R2 = 28%, F (9, 229) = 9.937, p < 0.001. Depersonalization was predicted by neuroticism and poor operating conditions, R2 = 17%, F (9, 229) = 4.709, p < 0.001. Reduced personal achievement was significantly predicted by the number of people in the household, time at the current hospital, agreeableness, and nature of work, R2 = 21%, F (7, 203) = 7.875, p < 0.001.

Conclusions:

Our findings highlight the need for interventions to be developed to address burnout among nursing staff to optimize healthcare delivery.
Systematic review of the orally administered microbiome therapeutic, fecal microbiota spores, live-brpk, to prevent recurrence of Clostridioides difficile infection in adults
Authors: LaPlante Kerry , Stevens Robert , Gonzales-Luna Anne J
Published: October 2024

Background:

Clostridioides difficile infection (CDI) has been linked to over 200,000 cases of illness in hospitalized patients and over 20,000 deaths annually. Up to 25% of patients with an initial CDI episode will experience recurrent CDI (rCDI), which most commonly occurs in the first 8 weeks following antibiotic therapy. In patients with first or multiple rCDI, infection, the microbiome is similarly disrupted, which highlights the challenges of using antibiotics alone while underscoring the need for microbiome restoration regardless of the number of recurrences. In this systematic review, we describe the role of the gastrointestinal microbiome in CDI, and systematically review fecal microbiota spores, live-brpk (VOWST™; VOS for Vowst Oral Spores) for prevention of recurrence in rCDI.

Methods:

The PubMed database was searched using “recurrent Clostridioides difficile infection” AND (SER-109 OR VOS) and limited to clinical trials. The search yielded 7 results: 3 articles describing 3 clinical trials (two Phase 3 trials (ECOSPOR III and ECOSPOR IV) and one Phase 2 trial (ECOSPOR)), 1 describing follow-up of ECOSPOR III, 1 describing a post hoc analysis of comorbidities in ECOSPOR III, and 2 describing health-related quality of life in ECOSPOR III.

Results:

Compared with placebo, VOS following standard-of-care antibiotics for CDI significantly reduced risk of recurrence at 8 weeks (relative risk, 0.32 (95% CI: 0.18–0.58); p < 0.001; number needed to treat: 4) with a tolerable safety profile; rCDI rates remained low through 24 weeks. The disrupted microbiome, secondary to/exacerbated by antibiotic treatment, was rapidly (i.e., Week 1) restored with VOS. Compared with placebo, VOS demonstrated greater improvements in health-related quality of life.

Conclusions:

Clinical care of patients with rCDI now includes Food and Drug Administration-approved therapeutics to address microbiome restoration. Clinical trial evidence supports use of VOS following antibiotics and importance of microbiome restoration in rCDI.
Challenges in diagnosing spongiotic dermatitis: A complex case report
Authors: Lewis Joshua , Desta Bethel D , Ibidapo-Obe Oyetokunbo , Nicanord Ernst J
Published: October 2024

This case study presents a challenging case of spongiotic dermatitis manifesting in the vaginal region. Spongiotic dermatitis, characterized by fluid buildup causing skin swelling, poses diagnostic difficulties due to its resemblance to other skin conditions. A 64-year-old female initially misdiagnosed with various genital infections underwent multiple treatments without relief. With Sexually Transmitted Diseases (STD) tests being negative, a biopsy later revealed spongiotic dermatitis. Histological examination confirmed characteristic features of spongiotic dermatitis, guiding definitive diagnosis. Following confirmation of spongiotic dermatitis through biopsy, the patient received appropriate treatment, leading to the resolution of symptoms. This case underscores the importance of biopsy in diagnosing spongiotic dermatitis amidst variable clinical presentations, highlighting the need for further research to understand spongiotic dermatitis prognosis and clinical manifestations.
Case report of a delayed diagnosis of radiation induced ulcer in a patient following angioplasty
Authors: Harvey Gabrielle , Waddell Andréanne , Despatis Marc-Antoine
Published: October 2024

Diagnosis of fluoroscopy-induced radiodermatitis remains challenging for dermatologists. We present a case report where a patient had predictable risks of developing chronic radiodermatitis, yet the diagnostic was delayed for over a year and a half. In the current absence of appropriate follow-ups in some institutions, dermatologists should keep high suspicion for chronic fluoroscopy-induced radiodermatitis when encountering lesions characteristic of radiation dermatitis without a history of radiotherapy, prompting the necessity to inquire about antecedents of fluoroscopy-guided interventions.
Development of a digital multidomain lifestyle intervention for mild cognitive impairment: A pilot study on the feasibility and efficacy of cognitive training
Authors: Han Hyun Jung , Ko Myung Jin , Park Ahyoung , Cheun Jaemin , Nam Yeonjoo , Kim Tae Hui
Published: October 2024

Background

The heterogeneous etiology of mild cognitive impairment (MCI) presents significant challenges in monitoring its progression and impeding its advancement toward dementia. Digital multidomain lifestyle interventions have shown promise as potential solutions for their ability to treat MCI.

Objective

This study is the first phase in a series of evaluations aimed at assessing various components of Silvia-Rx, which was originally designed as a digital multidomain lifestyle intervention. Specifically, this study focused on a 60-session core cognitive training program to evaluate its feasibility and efficacy in addressing cognitive decline in individuals with MCI.

Methods

Individuals aged 60 to 80 years diagnosed with MCI were enrolled to participate in a 60-session tablet-based cognitive regimen of Silvia-Rx. Feasibility was assessed through adherence and retention rates, while the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-cog) scale was utilized to measure cognitive function as the primary indicator of efficacy.

Results

The mean age of the participants was 71.11 years, and 13 (68.42%) were women. Only one withdrawal occurred, resulting in a 95% retention rate (19 participants) post-intervention. The completion rate was excellent at 100%, indicating that the 60-session core cognitive program in Silvia-Rx was well tolerated by older participants with MCI. Regarding efficacy, there was a statistically significant improvement in cognitive function among MCI participants after the intervention, as evidenced by changes in total ADAS-cog scores.

Conclusions

Results demonstrated excellent adherence throughout the program and significant cognitive improvements after the intervention. This pilot study indicates that Silvia-Rx's digital cognitive program is feasible for people diagnosed with MCI, suggests potential for improving cognitive function, though further research with large sample size is needed to confirm these results.
The effectiveness of digital health interventions for the maintenance of physical activity following cardiac rehabilitation: A systematic review and meta-analysis
Authors: Luijk Alexander , Mortensen Sofie Rath , Hamborg Trine Grønbek , Zangger Graziella , Ahler Jonas Risum , Christensen Jan , Skou Søren T , Tang Lars Hermann
Published: October 2024

Objective

To summarise the effectiveness of digital health maintenance interventions for subjectively and objectively measured physical activity level (PA) and physical function, fitness and health-related quality of life (HRQoL) after completion of phase II cardiac rehabilitation (CR).

Methods

We conducted a search for studies in MEDLINE, Embase, CENTRAL, and CINAHL (inception to May 2024). Independent reviewers selected and included randomised controlled trials (RCTs) using digital health interventions to maintain PA in patients with cardiovascular disease after phase II CR. Independent reviewers conducted data extraction, assessed the risk of bias using the Cochrane Risk of Bias 2 tool and rated the certainty of evidence using Grading of Recommendations Assessment, Development and Evaluation – registered at PROSPERO: CRD42023396629.

Results

From 17,455 hits, 20 RCTs with 1801 participants were included. Risk of bias for most studies reporting on PA outcomes was rated as ‘some concerns’. Comparing digital health intervention with minimal intervention/usual care showed no effect of objective PA (standardised mean difference (SMD) 0.85, 95% CI: −0.07 to 1.77) and a small effect of subjective PA (SMD 0.37, 95% CI: 0.05 to 0.69) at the end of intervention both graded as very low certainty of evidence. We found very low certainty of evidence for moderate effects on physical function (SMD 0.63, 95% CI: 0.03 to 1.24), and low certainty of evidence for no effect on physical fitness (SMD 0.19, 95% CI: 0.05 to 0.34) and HRQoL (SMD 0.13, 95% CI: −0.02 to 0.28), I2= 0.00%) at the end of intervention.

Conclusion

Digital health interventions showed a small effect on subjectively measured PA, and no effect on objective PA, physical fitness and HRQoL, but may increase physical function after CR completion. Yet, the certainty of evidence is low and higher quality studies with longer follow-up duration are needed to guide this area further.
The Career Development and Social Determinants Framework: An Integrative Approach
Authors: Brookover Dana L.
Published: October 2024

This conceptual article introduces an innovative career development framework that integrates a focus on the social determinants of health within career development and postsecondary readiness counseling. This article provides an overview of career development and postsecondary readiness in schools, reviews the existing literature base on social determinants of health and school counseling, introduces the Career Development and Social Determinants Framework (CDSD-F), and lists implications for school counselors and counselor educators.
Within the Ecology of communication: Identifying Crucial Elements that Drive Use Intentions on Knowledge-sharing Platforms
Authors: Zhang Yihe , Jahng Surnggahb
Published: October 2024

This research delves into the factors influencing use intentions on knowledge-sharing platforms, leveraging the theory of ecology of communication. The study constructs a model of use intentions, encompassing content, technical, and social aspects. Data from 511 users was gathered via questionnaires and analyzed using structural equation modeling and Bootstrap. Results indicate that perceived enjoyment and community influence bolster use intentions and brand trust, while platform design impacts brand trust. Cultural identity enhances use intentions, but perceived knowledge value and platform design showed no significant influence on use intentions or brand trust. These findings provide insights into user behavior on knowledge-sharing platforms and have implications for platform design and user experience.
The injectable hydrogel loading cannabidiol to regulate macrophage polarization in vitro for the treatment of chronic enteritis
Authors: Wang Ye , Ji Xingming , Wang Xinyi , Sun Mengyu , Li Cheng , Wu Dongmei
Published: October 2024

Objective:

Chronic bowel disease has the characteristics of high recurrence rate, prolonged and non-healing, and the incidence has increased year by year in recent years. Cannabidiol (CBD) has significant anti-inflammatory and antioxidant activities, but it is limited by its characteristics of fat solubility and low bioavailability. This study aims to treat chronic inflammatory bowel disease by preparing a CBD-loaded hydrogel system (GelMA + CBD) that can deliver CBD in situ and improve its bioavailability through slow release.

Method:

The study designed and constructed GelMA + CBD, and its surface morphology was observed by scanning electron microscopy, and its pore size, swelling rate and release rate were evaluated to evaluate its bioactivity and biosafety. The expression of various inflammatory factors was detected by ELISA, and the expression of protein and reactive oxygen species were observed by laser confocal microscopy to evaluate their anti-inflammatory and antioxidant properties.

Results:

Our study found that GelMA + CBD with biosafety, could make CBD be slowly released, and effectively inhibit the M1-type polarization of macrophages in vitro, and promote the M2-type polarization. In addition, GelMA + CBD can also reduce the expression of pro-inflammatory factors (such as iNOS) in macrophages, and increase the expression of anti-inflammatory factors (such as Arg-1), clear intracellular reactive oxygen species (ROS), and relieve oxidative stress.

Conclusion:

The vitro experiments have confirmed that the CBD-loaded hydrogel system has good biosafety, and can alleviate inflammation by regulating the polarization direction of macrophages, and then inhibiting the secretion of pro-inflammatory factors, laying a strong foundation for the treatment of chronic enteritis.
Residual Performance and Biomechanical Asymmetries During Jumping Tasks in Female Athletes at 9 Months After Anterior Cruciate Ligament Reconstruction
Authors: Warnecke Berit Flora , Richter Chris , King Enda , Paternoster Florian Kurt
Published: October 2024

Background:

Biomechanics and anterior cruciate ligament injury mechanisms differ in males and females. There is a need for more data on between-limb biomechanical differences after anterior cruciate ligament reconstruction (ACLR) in females.

Purpose:

To explore biomechanical asymmetries throughout the kinetic chain during the single-legged (SL) and double-legged (DL) countermovement jump (CMJ) and drop jump (DJ) in female athletes after ACLR.

Study Design:

Descriptive laboratory study.

Methods:

Kinematic and kinetic between-limb differences were analyzed during the SL and DL CMJ and DJ in 67 female athletes 9 months after ACLR. Biomechanical and performance asymmetries between limbs during the jumps and isokinetic strength testing were analyzed with statistical parametric mapping. The entire stance phase was used for the paired t tests of the biomechanical variables, with Cohen d effect sizes of significant portions of the stance phase (reported as % of stance) calculated in a point-by-point manner.

Results:

Decreased vertical ground-reaction force, internal knee abduction moment, knee internal rotation angle, hip external rotation angle, internal ankle eversion, and external rotation moments were seen in the ACLR limb during all 4 vertical jump tests. The greatest number and highest value of differences were found during the DLDJ, with asymmetries having medium to large effect sizes. They tended to appear more frequently in the concentric phase (50% to 100% of stance) during the SLCMJ and DLCMJ and in the eccentric (0% to 49% of stance) and concentric (50% to 100% of stance) phase during the SLDJ and DLDJ. For the SLCMJ, SLDJ, and quadriceps strength, performance asymmetries of >15% were detected but not for change of direction.

Conclusion:

The findings suggest that return-to-play testing in female athletes should examine the entire stance phase and include assessments of kinetic and kinematic variables throughout the kinetic chain. Greater deficits were highlighted in the DJ than in the CMJ, and greater performance asymmetries were evident in the SL tasks, with greater kinetic and kinematic and compensatory strategies evident in the DL tests.

Clinical Relevance:

Biomechanical analysis focusing on contralateral compensation strategies and sex-specific interventions are necessary before return to play.
Effect of Quadriceps Tendon Autograft Preparation and Fixation on Graft Laxity During Suspensory Anterior Cruciate Ligament Reconstruction: A Biomechanical Analysis
Authors: Bedi Asheesh , Smith Benjamin L. , Mitchell Justin J. , Frank Rachel M. , Hauck Oliver L. , Wijdicks Coen A.
Published: October 2024

Background:

Favorable collagen fibril density and thickness combined with advances in graft preparation and fixation have significantly increased interest in the quadriceps tendon (QT) autograft for anterior cruciate ligament (ACL) reconstruction. While various suspensory techniques have been described, the biomechanical profile of these constructs is largely undefined.

Purpose:

To compare the biomechanics of suspensory techniques for soft tissue QT autograft fixation in an in vitro model of ACL reconstruction.

Study Design:

Controlled laboratory study.

Methods:

Full-thickness QT grafts were harvested using a 9-mm graft blade. Adjustable-loop devices (ALDs) were secured to the graft (n = 6 per group) with a combination implant containing the ALD and suture tape-reinforced whipstitching (tape-reinforced [TR] group), tethered superficially to the graft with a whipstitch (onlay [OL] group), luggage-tagged through and around the graft (luggage tag [LT] group), or staggered behind superficial suturing (staggered [SG] group). Grafts were tested on an electromechanical testing machine following a validated in vitro reconstruction model of intraoperative workflow and postoperative ACL kinematics, cyclic loading, and load to failure.

Results:

The TR group had significantly less postcyclic tension loss (mean, 24%) compared with the OL (56%; P = .002), LT (69%; P < .001), and SG (90%; P < .001) constructs. Cyclic elongation was below the 3.0-mm threshold defined as clinical failure for TR (1.6 mm), but not for OL (3.3 mm), LT (7.9 mm), and SG (11.3 mm). All constructs were within native ACL stiffness limits (220 ± 72 N/mm) without significant differences. Ultimate loads significantly exceeded a normal ACL loading limit of 454 N for TR (739 N; P = .023), OL (547 N; P = .020), and LT (769 N; P = .001), but not for SG (346 N; P = .236).

Conclusion:

The TR ALD construct demonstrated the most favorable time-zero biomechanical properties of modern soft tissue QT suspensory constructs, with 32% less tension loss and 52% less cyclic elongation versus the closest construct. Failure loading of all constructs was acceptable with respect to the native ACL except for the SG group, which had suboptimal ultimate load.

Clinical Relevance:

TR ALD implants may protect soft tissue QT autografts before graft-bone healing in ACL reconstruction by minimizing time-zero laxity and fixation failure.
Effects of the PRECEDE-PROCEDE Model on Self-Care Ability and Quality of Life Among Primipara During Puerperium
Authors: Lei Xueli , Zhou Yanhui
Published: October 2024

Background

Many parturients have poor self-care ability, strong dependence on others, and lack mother-infant related nursing skills and health care knowledge. Due to their lack of pregnancy experience, many primiparas lack the relevant skills and knowledge, which can affect maternal and infant health and maternal quality of life.

Purpose

The study aimed to investigate the effects of the PRECEDE-PROCEDE model on self-care ability and quality of life among primipara during puerperium.

Methods

This quasi-clinical study selected eligible primaparas from those who gave birth at a Grade A hospital in Hengyang, China between April and July 2019. Eighty puerperium primiparas were divided into a control group receiving standard care and an intervention group following the PRECEDE-PROCEDE model. Comparison of self-care ability and quality of life scores was conducted between the two groups pre-intervention, at 3 weeks, and at 6 weeks postpartum. Statistical analysis using SPSS 18.0 included mean and standard deviation for measurement data, and frequency and constituent ratio for counting data. Tests such as t-test, Chi-squared test, rank-sum test, and repeated measure analysis of variance were applied.

Findings

The control group's self-care ability scores were (150.8 ± 9.9), (150.9 ± 9.3), and (152.0 ± 10.2) before intervention, at 3 weeks postpartum, and at 6 weeks postpartum, respectively. For the intervention group, the corresponding scores were (151.1 ± 15.1), (157.8 ± 8.5), and (162.4 ± 7.2). Quality of life scores for the control group were (54.7 ± 8.6), (54.8 ± 7.7), and (55.1 ± 7.7) before intervention, at 3 weeks postpartum, and at 6 weeks postpartum, respectively. At the same time points, while the intervention group saw increases from (55.6 ± 7.6) to (59.2 ± 5.9) and (61.0 ± 5.3). There were statistically significant differences in the time effect and inter-group effect of the total score of self-care ability during puerperium, total score of quality of life, and the score of each dimension between the two groups ( P < 0.05), and we also found an interaction effect between grouping and time factors ( P < 0.05). After intervention, the incidence of common puerperium health problems except neonatal constipation and diarrhea in the intervention group was lower than that in the control group ( P < 0.05).

Conclusion

PRECEDE-PROCEDE model may improve self-care ability, reduce the occurrence of common health problems, and improve the quality of life of primiparas during puerperium.
Care-leaver activism and criminogenic welfare: An Australian case study
Authors: Wilson Jacqueline Z , Musgrove Nell , McGinniss David
Published: October 2024

This article discusses the failings of out-of-home care (OOHC) in Australia, focussing on 20th century OOHC systems’ construction of non-offending minors as “problems” while exposing them to high-risk environments defined here as “crime scenes”. Governments are deemed culpable for the inherent criminality of the system and its institutions. Juxtaposed to this is the development of care-leaver activist groups since the 1990s, and their fight to make governments and institutions accountable and to advocate in legal and bureaucratic forums for care-leavers and those currently in care. The discussion benefits from the insights of the article's lead author, herself a former state ward and a long-time care-leaver activist. The article identifies obstacles militating against activist successes, including institutional resistance and the historical reluctance of academics, especially criminologists, to engage with the problem.
Outsourcing, Augmenting, or Complicating: The Dynamics of AI in Fact-Checking Practices in the Nordics
Authors: Dierickx Laurence , Sirén-Heikel Stefanie , Lindén Carl-Gustav
Published: October 2024

The practice of fact-checking involves using technological tools to monitor online disinformation, gather information, and verify content. How do fact-checkers in the Nordic region engage with these technologies, especially artificial intelligence (AI) and generative AI (GAI) systems? Using the theory of affordances as an analytical framework for understanding the factors that influence technology adoption, this exploratory study draws on insights from interviews with 17 professionals from four Nordic fact-checking organizations. Results show that while AI technologies offer valuable functionalities, fact-checkers remain critical and cautious, particularly toward AI, due to concerns about accuracy and reliability. Despite acknowledging the potential of AI to augment human expertise and streamline specific tasks, these concerns limit its wider use. Nordic fact-checkers show openness to integrating advanced AI technology but emphasize the need for a collaborative approach that combines the strengths of both humans and AI. As a result, AI and GAI-based solutions are framed as “enablers” rather than comprehensive or end-to-end solutions, recognizing their limitations in replacing or augmenting complex human cognitive skills.
DISTORTION OF POLY(ETHYLENE TEREPHTHALATE) FILMS INDUCED BY A HIGH TEMPERATURE LAMINATION PROCESS
Authors: Santelices P. , Baker A. , Stacer R.
Published: October 2024

An experimental effort was conducted to determine the influence of processing on the distortion of poly(ethylene terephthalate), (PET), sheets during high temperature lamination. The evaluated sheets were coated and biaxially oriented semicrystalline PET of 0.18 mm thickness. Intrinsic parameters of the laminator were quantified and controlled including pressure, rate and temperature. Viscoelastic reponse was measured by forced dynamic tensile oscillation and constant stress test. Master curves of these data were prepared and used to predict the properties of the PET sheets during lamination. The results are discussed in terms of the characterized molecular structure of the PET.
Clinical improvements after endoscopic lung volume reduction with valves in patients with advanced emphysema and a 6-min walk test ≤140 m at baseline
Authors: Saccomanno Jacopo , Kilic Lara , Sgarbossa Thomas , Neumann Konrad , Stanzel Franz , Holland Angelique , Grah Christian , Gesierich Wolfgang , Krist Joanna , Ficker Joachim H. , Eggeling Stephan , Andreas Stefan , Schmidt Bernd , Eisenmann Stephan , Schwick Björn , Franke Karl-Josef , Fertl Andreas , Witzenrath Martin , Hübner Ralf-Harto
Published: October 2024

Background

Data regarding the effectiveness and safety of endoscopic lung volume reduction with valves (ELVR) in emphysema patients with a very low 6-min walk test (6MWT) are limited. Patients with severe emphysema and very low exercise capacity, as indicated by a 6MWT ≤140 m, are often excluded from clinical studies on ELVR, assuming limited therapeutic benefits and increased complication risk.

Study designs and methods

This study utilised data from the Lungenemphysemregister e.V., a large German national multi-centre prospective open-label clinical trial, and aimed to assess the outcomes of ELVR in patients with a baseline 6MWT ≤140 m and dyspnoea primarily attributed to hyperinflation.

Results

54 patients with a baseline 6MWT ≤140 m and 365 patients with a baseline 6MWT between 140 and 450 m were included in the study. Baseline characteristics were representative for patients with advanced lung emphysema. Patients with a 6MWT ≤140 m at baseline had a lower forced expiratory volume in 1 s and diffusing capacity of the lung for carbon monoxide and higher symptom burden. In the 3-month follow-up, patients of both groups showed statistically significant improvements in lung function parameters, exercise capacity and quality of life parameters compared to baseline. Patients with a 6MWT ≤140 m at baseline showed significantly more 6MWT improvement compared to patients with baseline 6MWT between 140 and 450 m. Moreover, complication rates were similar in both groups.

Interpretation

In summary, the data indicate that ELVR may be an effective and safe treatment for emphysema patients with a very low 6MWT of ≤140 m if very limited exercise capacity is predominately caused by lung emphysema. Therefore future studies should include emphysema patients with a very low 6MWT.
Laryngeal mask airway or high-flow nasal cannulaversusnasal cannula for advanced bronchoscopy: a randomised controlled trial
Authors: Pikman Gavriely Regina , Freund Ophir , Tiran Boaz , Perluk Tal Moshe , Kleinhendler Eyal , Matot Idit , Bar-Shai Amir , Gershman Evgeni
Published: October 2024

Background

Advanced bronchoscopic procedures have become a widely prevalent evaluation and treatment modality. These procedures require appropriate sedation and respiratory support. This study directly compares three respiratory support methods during advanced bronchoscopy.

Methods

This three-arm, prospective, block randomised trial included 60 consenting adult patients that were referred for advanced bronchoscopy involving endobronchial ultrasound (EBUS) with transbronchial needle aspiration and met inclusion/exclusion criteria. Patients were randomised to undergo bronchoscopy through a laryngeal mask airway (LMA) or with a high-flow nasal cannula (HFNC) or low-flow nasal cannula (NC), with bronchoscopy performed through a bite block. Demographic, procedural and clinical parameters were compared between the three groups, including complications, oxygenation, ventilation and need for intervention.

Results

Analysis according to intention to treat was made for the 20 patients in each arm. There were no significant differences in demographic parameters, pre-morbidities and procedure type and duration between groups. Hypoxia was significantly more common in the NC group (90%) compared with the LMA (45%) and HFNC (26%) groups (p<0.01). The need for interventions and their number were also lower in the LMA (40%) and HFNC (52.6%) groups compared with the NC group (90%, p<0.01). A multivariate analysis confirmed both HFNC and LMA as independent predictors of a lower rate of recurrent desaturation events and fewer complications in general compared with NC.

Conclusion

In this prospective randomised trial, we demonstrated the advantages of using LMA or HFNC over NC during advanced bronchoscopy with EBUS.
Estimation of tuberculosis mortality burden in spain: a review of the major data sources
Authors: Redin Miriam Roncal , Barroso Diana Gómez , Herrera Laura , Gómez-Castellá Javier , Herrador Zaida ,   Spanish Working Group on Tuberculosis
Published: October 2024

Introduction

In Spain, notifications of cases of tuberculosis (TB) are registered through the National Epidemiological Surveillance Network (RENAVE). The Minimum Basic Data Set (CMBD) provides information on hospital discharge and the Statistics National Institute (INE) draws on medical death certificates. This study aimed to describe TB mortality in Spain and to compare estimates across data sources, as well as with EU/EEA countries.

Material and Methods

A retrospective study of TB data between 2008 −2021 was performed. Mortality rates (MR) were calculated for the three databases as well as fatality rates (CFR) for TB location and HIV status using RENAVE data. Time trends were calculated and the average MR and annual average percentage change for Spain were compared with EU/EEA countries.

Results

Between 2008 and 2021, 4127 TB deaths were reported to RENAVE, 3877 to INE and 4775 to CMBD. The MR was 0.62 per 100,000 inhabitants for RENAVE, 0.59 for INE and 0.72 for CMBD. A statistically significant downward annual trend was observed. Highest MR across all databases were found in men and in those over 80 years old. CFR was higher for meningeal TB and for HIV patients with a risk ratio of 2.02 (95%CI: 1.82-2.2; p<0.05).

Conclusion

Although the TB MR in Spain has followed a downward annual trend, it is necessary to continue improving prevention, diagnosis and treatment. This will require comprehensive measurement, better knowledge and better use of all information to complement surveillance systems.
Heart rate recovery after the 6-min walk test in people with bronchiectasis
Authors: Sáez-Pérez Juan Antonio , Arbillaga-Etxarri Ane , Alcaraz-Serrano Victoria , Gimeno-Santos Elena , Torres Antoni , Herrero-Cortina Beatriz
Published: October 2024

Background

The cardiac autonomic response to exercise and during recovery has been poorly explored in bronchiectasis.

Methods

A longitudinal study was conducted in adults with bronchiectasis. Sociodemograhic and clinical data were collected at baseline and after 12 months of follow-up. The heart rate recovery after the first (HRR1) and second minute (HRR2) of recovery in the six-minute walk test (6MWT) was estimated in both assessments. Adjusted regression models were used to identify predictors of a delayed HRR1(HRR1≤ 14).

Results

104 participants with a mean (sd) age of 64 (13) years and mostly woman (67%) were included. A delayed HRR1after the baseline 6MWT was identified in 36% of participants. These participants presented a higher proportion of males, increased body mass index, higher disease severity, more likely to required hospitalisation, more impact on quality of life, lower exercise capacity, lower HR at the end of the 6MWT and lower HRR2. Disease severity (ß, 95%CI) (moderate and severeversusmild, −0.47 (−0.94 to −0.01)) and distance walked (0.34 (0.11 to 0.56)) were the independent variables associated with HRR1. Of the 45 participants who completed the entire follow-up period, 24% exhibited delayed HRR1. The presence of at least two exacerbations during the follow-up period (OR, 95%CI) (16.89 (1.44 to 197.48)) was the only predictor of a delayed HRR1in the assessment completed at the end of the study.

Conclusion

HRR1is related to disease severity and mainly affected by having severe exacerbations in people with bronchiectasis.
Proteome signature for differential diagnosis of patients with bilateral lung infiltrates
Authors: Oh Yumi , Kim Kyunggon , Kim Ho Jeong , Hong Sang-Bum , Lim Chae-Man , Koh Younsuck , Ahn Hee-Sung , Huh Jin Won
Published: October 2024

Background

The differential diagnosis of bilateral lung infiltrates and prognosis prediction can be challenging for clinicians in the intensive care unit (ICU). We analysed the proteome from bronchoalveolar lavage fluid (BALF) and determined its usefulness for evaluating the infectious causes and mortality associated with bilateral lung infiltrates.

Methods

In the ICU cohort, 136 patients with bilateral infiltrate on chest radiographs were selected, and bronchoscopy with bronchoalveolar lavage (BAL) was performed. Proteomic profiling of the exosomes in the BALF (n=20) was conducted to identify candidate protein biomarkers potentially associated with infection or mortality. The BAL samples (n=116) were used to measure the candidate biomarker levels.

Results

The candidate biomarkers, CD20, CLIC4, SCFD1 and TAP1, were selected for the differential diagnosis of infection or mortality. The levels of CD20 were significantly elevated in patients with non-infectious causes, compared with those with infectious causes (248.6±154.5versus177.6±150.9 ng·mL−1, p=0.014). The levels of CLIC4, SCFD1 and TAP1 did not differ between the two groups. As per the receiver operating characteristic analysis, CD20 was a significant predictor of non-infectious causes (area under curve 0.668; 95% confidence interval 0.567–0.769; p=0.002; cut-off value 167.6 ng·mL−1; sensitivity 74.1%; specificity 63.2%). There were no significant differences in the concentrations of the biomarkers between survivors and non-survivors.

Conclusions

Our results suggest that CD20 levels in BALF might be a useful biomarker for differentiating non-infectious and infectious diseases in patients with bilateral lung infiltrates.
Effects of acetazolamide on exercise performance in patients with COPD going to high altitude: randomised controlled trial
Authors: Kind Roman F. , Furian Michael , Buergin Aline , Scheiwiller Philipp M. , Mayer Laura , Schneider Simon R. , Lichtblau Mona , Muralt Lara , Mademilov Maamed , Sooronbaev Talant M. , Ulrich Silvia , Bloch Konrad E.
Published: October 2024

Background

In patients with COPD, preventive treatment with acetazolamide reduces adverse health effects during altitude travel. We investigated whether preventive acetazolamide treatment modifies exercise performance in COPD patients going to high altitude.

Methods

In this randomised, double-blind trial, lowlanders with COPD, forced expiratory volume in 1 s (FEV1) 40–80% predicted, were assigned to acetazolamide (375 mg per 24 h) or placebo treatment starting 24 h before ascent and while staying at 3100 m. Patients performed progressive cycling exercise to exhaustion at 760 m, before taking the study drug, and within 4 h after arrival at 3100 m. The primary outcome was the maximal power output (Wmax).

Results

103 patients (32 women), mean±sdage 57.2±8.1 years, FEV166±11% predicted, were included in per-protocol analyses. In 53 patients receiving acetazolamide, Wmaxand oxygen uptake (V′O2max) at 760 m and 3100 m were 105±27 and 91±25 W, and 18.0±4.8 and 15.5±3.7 mL·min−1·kg−1(p<0.001, both changes). Corresponding WmaxandV′O2maxin 50 patients receiving placebo were 107±34 and 97±28 W, and 18.9±6.0 and 17.2±5.0 mL·min−1·kg−1(p<0.001, both changes). Between-group differences (95% CI) in altitude-induced Wmaxchanges were −3.0 W (−8.7 to +2.7, p=0.305) and inV′O2maxchanges were −0.8 mL·min−1·kg−1(−2.1 to +0.5, p=0.213). Acetazolamide mitigated the altitude-induced reduction ofPaO2by 0.7 kPa (0.1 to 1.3, p=0.016). At 3100 m, maximal work rate with respiratory exchange ratio ≤1 was greater with acetazolamide than with placebo by 10.1 W (4.0 to 16.2, p=0.022).

Conclusions

In lowlanders with COPD, preventive treatment with acetazolamide did not modify the altitude-induced reduction in maximal work rate. However, acetazolamide enhanced arterial oxygenation and submaximal, moderate-intensity work capacity compared with placebo.