bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel troubleshooting technique for below-the-knee artery occlusions with proximal cap ambiguity: Transpedal Retrograde Wire Just Marker Technique
Authors: Buturak Ali , Tatli Ersan , Erkin Alper
Published: April 2024

Background

Chronic total occlusions with ambiguous proximal caps pose a challenging problem in below-the-knee artery endovascular interventions.

Case Report

We defined a new technique for antegrade puncture and penetration of an ambiguous proximal cap in a 52-year old male patient with a non-healing wound on his right forefoot. Anterior tibial artery (ATA) was determined as the target vessel; however, its origin and course could not be determined. A retrograde guidewire (Asahi Gladius 0.018 inch, Asahi Intecc) was advanced into the distal ATA via transpedal loop following pedal loop angioplasty. This guidewire was advanced through and parked to the tibioperoneal trunk with a small distal loop at the tip. While the looped wire was held in its position as a marker for ATA ostium, a second guidewire (Asahi Gladius 0.018 inch, Asahi Intecc) with the guidance of 4F vertebral catheter (Vert Catheter, Merit Medical) successfully penetrated the ambiguous cap and subsequent target vessel revascularization was achieved with 2.5/150 mm peripheral balloon angioplasty catheter (Minerva SC 0.018 inch, BrosMed Medical).

Conclusion

Transpedal Retrograde Wire Just Marker Technique is a novel and practical technique which can be used in chronic total occlusions of below-the-knee arteries with ambiguous proximal caps.
Strategies to guide the successful implementation of deprescribing in community practice: Lessons learned from the front line
Authors: Turner Justin P. , Newport Kelda , McEvoy Aisling M. , Smith Tara , Tannenbaum Cara , Kelly Deborah V.
Published: April 2024

Background:

Sustainable implementation of new professional services into clinical practice can be difficult. In 2019, a population-wide initiative called SaferMedsNL was implemented across the province of Newfoundland and Labrador (NL), to promote appropriate medication use. Two evidence-based interventions were adapted to the context of NL to promote deprescribing of proton pump inhibitors and sedatives. The objective of this study was to identify and prioritize which actions supported the implementation of deprescribing in community practice for pharmacists, physicians and nurse practitioners across the province.

Methods:

Community pharmacists, physicians and nurse practitioners were invited to participate in virtual focus groups. Nominal Group Technique was used to elicit responses to the question: “What actions support the implementation of deprescribing into the daily workflow of your practice?” Participants prioritized actions within each group while thematic analysis permitted comparison across groups.

Results:

Five focus groups were held in fall 2020 involving pharmacists ( n = 11), physicians ( n = 7) and nurse practitioners ( n = 4). Participants worked in rural ( n = 10) and urban ( n = 12) settings. The different groups agreed on what the top 5 actions were, with the top 5 receiving 68% of the scores: (1) providing patient education, (2) allocating time and resources, (3) building interprofessional collaboration and communication, (4) fostering patient relationships and (5) aligning with public awareness strategies.

Conclusion:

Pharmacists, physicians and nurse practitioners identified similar actions that supported implementing evidence-based deprescribing into routine clinical practice. Sharing these strategies may help others embed deprescribing into daily practice and assist the uptake of medication appropriateness initiatives by front-line providers. Can Pharm J (Ott) 2024;157:xx-xx.
Comparative sonographic assessment of renal volume and arterial Doppler velocimetric indices among women with pregnancy-induced hypertension and normotensive controls in Northern Nigeria
Authors: Isiaka Olanrewaju Akintunde Taiwo , Suwaid Muhammad Abba , Adamu Mansur Yahuza , Musa Aliyu , Nafiah Abolanle Taiwo , Ismail Anas
Published: April 2024

Introduction:

Pregnancy-induced hypertension is a global public health problem, worsening maternal morbidity and mortality. Renal complications have additional devastating consequences on maternal morbidity. Renal Doppler ultrasound is a valuable tool in the management of pregnancy-induced hypertension. It helps in the assessment of renal hemodynamics with the potential to monitor renal function and predict complications. We aimed to determine the relationship between the renal volume and arterial Doppler velocimetric indices in pregnancy-induced hypertension and matched normotensive controls.

Methods:

Following the documentation of demographic and basic obstetric characteristics of 150 women with pregnancy-induced hypertension and an equal number of their matched controls, a 3.5-MHz convex transducer was used to measure the maternal renal volumes and renal arterial Doppler velocimetric indices (peak systolic velocity, end diastolic velocity, resistive index, pulsatility index, and systolic–diastolic radio). Student’s t-test and linear regression were used to determine the differences and relationships between the quantitative variables among women with pregnancy-induced hypertension and their controls. The association chi-square test was used to determine the association between the qualitative and categorical variables. A p-value of less than 0.05 was considered significant.

Results:

The mean renal volume of pregnancy-induced hypertension patients is higher bilaterally when compared to normotensive women. The mean peak systolic velocity and resistive index in pregnancy-induced hypertension patients were significantly higher compared to normotensives (59.13 ± 13.5 vs 54.19 ± 9.8 cm/s; p < 0.001) and (0.74 ± 0.2 vs 0.68 ± 0.3).

Conclusion:

The maternal renal volume and peak systolic velocity of the renal arteries are significantly higher in women with pregnancy-induced hypertension compared to normotensives.
Fits and funny turns in adults
Authors: Siddiqui Dr Zubair Ahmed , Ali Dr Abdishakur Mohamed
Published: April 2024

Blackouts and syncope, often colloquially termed ‘fits and funny turns’, are common presentations in the adult population, with studies showing that up to 50% of the UK population may experience a blackout in their lifetime. This presentation encompasses a wide range of potential causes, which creates a diagnostic challenge for the clinician. An incorrect diagnosis can have a significant impact on the patient by delaying treatment, increasing the risk to their health and in some cases may even affect a person’s employment. As such, a deep understanding of the assessment, causes, and management is vital for any GP. This article delves into the intricacies of these episodes, shedding light on their causes, presentation, and implications for patient care.
The diagnosis of adrenal insufficiency and its implications in primary care
Authors: Fleming Dr Daniel
Published: April 2024

Adrenal insufficiency can be clinically challenging to diagnose, due to relatively low incidence rates in the European population. It is a condition requiring active consideration to achieve diagnosis. The main pathologies discussed here are primary adrenal insufficiency (PAI) and tertiary adrenal insufficiency. PAI is also commonly termed Addison’s disease. Secondary adrenal insufficiency is not considered in detail in this article. The article will address the underlying pathophysiology, presentation and investigation of adrenal insufficiency. It will also consider iatrogenic adrenal insufficiency and management of adrenal insufficiency in the primary care setting.
Faltering growth
Authors: Harris Dr Bradley
Published: April 2024

The monitoring of growth is perhaps the longest-standing health surveillance practice in paediatrics, with routine assessments of height and weight occurring throughout childhood. Faltering from these predicted centiles will often result in a review in primary care accompanied by heightened parental anxiety. Although a drop in growth velocity may well be normal for an individual, it may also be the first warning sign of underlying pathology. The challenge for clinicians is to differentiate what is normal from faltering growth that occurs as the culmination of underlying medical, environmental, or psychosocial factors. This article gives an overview of growth and its assessment, alongside current UK criteria for faltering growth and an approach for its management in primary care.
Treatment algorithms of relapsing multiple sclerosis: an exploration based on the available disease-modifying therapies in China
Authors: Guo Jun , Wu Jiayong , Wang Lihua , Liu Hongbo , Wu Xiaomu , Yang Huan , Li Wenyu , Wang Honghao , Bu Bitao , Yang Chunsheng , Zhou Hongyu , Guo Shougang , Zhao Yinan , Wang Zhanhang , Li Chunyang , Tian De-Cai , Chen Sheng , Xue Huiru , Zhang Yanlin , Xu Yongfeng , Liang Hui , Wu Zhe , Zhang Yu , Dong Qiang , Wang Jiawei , Quan Chao
Published: April 2024

Multiple sclerosis (MS) was defined as a rare disease in China due to its low prevalence. For a long time, interferon β was the only approved disease-modifying therapy (DMT). Since the first oral DMT was approved in 2018, DMT approval accelerated, and seven DMTs were approved within 5 years. With an increasing number of DMTs being prescribed in clinical practice, it is necessary to discuss the standardized MS treatment algorithms depending on the disease activity and DMT availability. In this review paper, more than 20 Chinese experts in MS have reviewed the therapeutic progress of MS in China and worldwide and discussed algorithms for treating relapsing MS (RMS) based on the available DMTs in China, providing insights for establishing the standardized RMS treatment algorithms in this country.
Real-world evidence and patient preference for subcutaneous versus intravenous natalizumab in the treatment of relapsing-remitting multiple sclerosis – initial results from the observational SISTER study
Authors: Gold Ralf , Schmidt Stephan , Deisenhammer Florian , Motte Jeremias , Richter Nils , Taipale Kirsi , Salmen Hans Christian , Bohland Christian , Schirduan Ksenija
Published: April 2024

Background:

The consideration of patient preference for a certain drug route of administration (RoA) plays an important role in promoting patient adherence in chronic diseases. Natalizumab is an established treatment for relapsing-remitting multiple sclerosis (RRMS) and can be administered as intravenous (IV) infusion or subcutaneous (SC) injection developed to enable a shorter and easier administration versus IV RoA.

Study objectives:

Primary objective is to compare patients’ preference for RoA and satisfaction with SC versus IV natalizumab at baseline and subsequent visits up to 12 months. Secondary objectives include drug utilization, clinical outcomes, safety, and treatment satisfaction in a usual care setting.

Design and methods:

SISTER (Subcutaneous: Non-Interventional Study for Tysabri Patient Preference – Experience from Real World) is an ongoing, prospective, observational study where natalizumab is utilized according to local label. RRMS patients are included in three natalizumab cohorts: Patients switching from current IV to SC administration (switcher) and patients newly starting natalizumab on either SC or IV route (starter SC/IV). This interim analysis includes 262 patients (184 switchers, 39 SC starters, and 39 IV starters), median observation period was 9 months.

Results:

80.8% IV starters and 93.9% SC starters reported at baseline that they prefer the assigned RoA. Although initial satisfaction with chosen RoA was maintained over time from baseline through Month 12 in all three cohorts, the wish for change of the current RoA after 6 and 12 months was more frequently expressed among IV starters than in either SC cohort. Consistently, six patients (23.1%) starting with IV changed their RoA from IV to SC route. Mean global treatment satisfaction according to TSQM-II score at baseline remained high in the switcher group and increased through Month 12 in both IV and SC starter cohorts.

Conclusion:

Based on current data, there is a trend toward patients’ preference for the natalizumab SC route over the IV route, which provides valuable insights into patients’ preference for natalizumab RoA in routine care and complements available data from clinical studies with real-world data on SC natalizumab.

Trial registration:

This observational (non-interventional) study was registered in the local German PEI register for non-interventional studies (NIS-No. 611) and in the international CTgov register (NCT05304520).
Hypoglycemia and Hyperglycemia According to Type of Diabetes: Observations During Fully Closed-Loop Insulin Delivery in Adults With Type 1 and Type 2 Diabetes
Authors: Kadiyala Nithya , Wilinska Malgorzata E. , Daly Aideen B. , Nwokolo Munachiso , Lakshman Rama , Hartnell Sara , Ware Julia , Allen Janet M. , Cezar Alina , Evans Mark L. , Hovorka Roman , Boughton Charlotte K.
Published: April 2024

Background:

CamAPS HX fully closed-loop (FCL) system, with no user input required at mealtimes, has been shown to be safe and effective in adults with type 1 and type 2 diabetes. We assessed whether time spent in hypoglycemia and hyperglycemia during FCL insulin delivery in adults varied by type of diabetes over the 24-hour period.

Methods:

We retrospectively analyzed eight weeks of data from 52 participants (adults with type 1 diabetes and adults with insulin-treated type 2 diabetes) recruited to two single-center randomized controlled studies using FCL insulin delivery during unrestricted-living conditions. Key outcomes were time spent in hypoglycemia <70 mg/dL and marked hyperglycemia >300 mg/dL by type of diabetes.

Results:

The median percentage of time spent in hypoglycemia <70 mg/dL over the 24-hour period was lower for those with type 2 diabetes than for those with type 1 diabetes (median [interquartile range (IQR)] 0.43% [0.20-0.77] vs 0.86%, [0.54-1.46]; mean difference 0.46 percentage points [95% CI 0.23-0.70]; P < .001). Median percentage time in marked hyperglycemia >300 mg/dL was lower for those with type 2 diabetes than for those with type 1 diabetes (median [IQR] 1.8% [0.6-3.5] vs 9.3% [6.9-11.8]; mean difference 7.8 percentage points [95% CI 5.5-10.0]; P < .001).

Conclusions:

Using the FCL system, hypoglycemia and marked hyperglycemia exposure were lower in type 2 diabetes than in type 1 diabetes.
Hybrid Closed Loop in Adults With Type 1 Diabetes and Severely Impaired Hypoglycemia Awareness
Authors: Lee Melissa H. , Gooley Judith , Obeyesekere Varuni , Lu Jean , Paldus Barbora , Hendrieckx Christel , MacIsaac Richard J. , McAuley Sybil A. , Speight Jane , Vogrin Sara , Jenkins Alicia J. , Holmes-Walker D. Jane , O’Neal David N. , Ward Glenn M.
Published: April 2024

Background:

Benefits of hybrid closed-loop (HCL) systems in a high-risk group with type 1 diabetes and impaired awareness of hypoglycemia (IAH) have not been well-explored.

Methods:

Adults with Edmonton HYPO scores ≥1047 were randomized to 26-weeks HCL (MiniMed™ 670G) vs standard therapy (multiple daily injections or insulin pump) without continuous glucose monitoring (CGM) (control). Primary outcome was percentage CGM time-in-range (TIR; 70-180 mg/dL) at 23 to 26 weeks post-randomization. Major secondary endpoints included magnitude of change in counter-regulatory hormones and autonomic symptom responses to hypoglycemia at 26-weeks post-randomization. A post hoc analysis evaluated glycemia risk index (GRI) comparing HCL with control groups at 26 weeks post-randomization.

Results:

Nine participants (median [interquartile range (IQR)] age 51 [41, 59] years; 44% male; enrolment HYPO score 1183 [1058, 1308]; Clarke score 6 [6, 6]; n = 5 [HCL]; n = 4 [control]) completed the study. Time-in-range was higher using HCL vs control (70% [68, 74%] vs 48% [44, 50%], P = .014). Time <70 mg/dL did not differ (HCL 3.8% [2.7, 3.9] vs control 6.5% [4.3, 8.6], P = .14) although hypoglycemia episode duration was shorter (30 vs 50 minutes, P < .001) with HCL. Glycemia risk index was lower with HCL vs control (38.1 [30.0, 39.2] vs 70.8 [58.5, 72.4], P = .014). Following 6 months of HCL use, greater dopamine (24.0 [12.3, 27.6] vs −18.5 [−36.5, −4.8], P = .014), and growth hormone (6.3 [4.6, 16.8] vs 0.5 [−0.8, 3.0], P = .050) responses to hypoglycemia were observed.

Conclusions:

Six months of HCL use in high-risk adults with severe IAH increased glucose TIR and improved GRI without increased hypoglycemia, and partially restored counter-regulatory responses.

Clinical trial registration:

ACTRN12617000520336
Biofilm Disruption and Virulence Attenuation Effects of Essential Oil From Endemic Algerian Cistus munbyi (Cistaceae) Against Clinical Strains of Pseudomonas aeruginosa
Authors: Benaissa Asma , Khadir Abdelmounaim , Tamfu Alfred Ngenge , Kucukaydin Selcuk , Latti Nawel , Benbelaïd Fethi , Boudiba Sameh , Eroglu Busra , Bendahou Mourad , Ceylan Ozgur
Published: April 2024

Background: Pseudomonas aeruginosa is an opportunistic, resistant and highly pathogenic bacteria, responsible for severe nosocomial infections in humans. There is need to search new antimicrobials to target P. aeruginosa strains. Cistus munbyi is used in traditional medicine to manage infections. Objectives: This work aims to investigate the antimicrobial, antibiofilm and other antivirulence effects of essential oil from C. munbyi against P. aeruginosa. Materials and methods: Essential oil (EO) was prepared by hydro-distillation from C. munbyi, characterized by GC–MS and evaluated for its antimicrobial, antibiofilm and anti-virulence effects against clinical isolates of P. aeruginosa. Results: 100% of compounds were identified with Terpinen-4-ol (33.20%), Sabinene (13.20%), α-Thujene (11.30%), and p-Cymene (9.94%) being the major constituents. The EO had good antimicrobial activity determined by diameters of inhibition zones and broth dilution. At minimal inhibitory concentration (MIC), the EO eliminated more that 70% of young biofilms in 19 strains out of 24 tested strains while at 2MIC, only one strain had biofilm inhibition below 70%. The EO eliminated more than 50% of mature biofilms in 13 strains out of 24 tested. Biofilm disruption was concentration-dependent at sub-MIC and indicated good potential of C. munbyi EO as P. aeruginosa antibiofilm agent. Scanning electron microscopy (SEM) images revealed that untreated colonies had a well-developed biofilm while there was significant reduction of biofilms with distorted architecture and cell shrinkage upon treatment with EO. The C. munbyi EO at MIC and sub-MIC was able to reduce quorum-sensing (QS) virulence factors such as pyocyanin production, exopolysaccharides matrix and elastase secretion. Significant QS revealed by reduction of violacein in C. violaceum (CV12472 and CV026) was observed. Conclusion: The overall results show good anti-pseudomonal effects of C. munbyi EO which makes it a potential agent to reduce the spread of infections and resistance to antibiotics from P. aeruginosa strains.
Phytochemical Composition and Cytotoxic Activity of Senecio asirensis Hexane Fraction Using In Vitro and In Silico Approaches
Authors: Al kamaly Omkulthom , Imtara Hamada , Alanazi Ashwag S. , Noman Omar
Published: April 2024

Objective

Senecio asirensis, an endemic species of Saudi Arabia, has been traditionally used to treat various ailments. The present study aimed to investigate the phytochemical composition, antimicrobial activity, and cytotoxic potential of Senecio asirensis fractions, and to identify the main compounds in the extract that are the most active.

Methods

The antimicrobial activity was evaluated using disc diffusion assay. Moreover, the cytotoxic activity evaluated using the MTT assay in various cancer cell lines (MCF-7, HepG2, and A549) and validated by molecular docking for the major compound of the most active fraction. Finally, gas chromatography and a mass spectrometer (GC-MS) analysis was carried out to identify the chemical compounds in hexane extract of Senecio asirensis.

Results

The hexane fraction exhibited significant antimicrobial activity against Gram-positive bacteria ( S. aureus) and yeast organisms ( C. albicans and C. tropicalis), while chloroform and butanol fractions showed no activity against the tested microbial strains. Moreover, in the cytotoxic activity assay, notably, the hexane fraction showed a significantly higher cytotoxic effect on MCF-7. The GC-MS analysis of the hexane fraction revealed the presence of 26 phytoconstituents, with nonacosane being the most abundant compound. Therefore, the molecular docking was employed to validate the cytotoxic activity for the major compound of the most active fraction (nonacosane) against human DNA topoisomerase IIa.

Conclusion

These findings provide a scientific basis for the traditional use of S. asirensis in medicine and suggest that its bioactive compounds have potential therapeutic applications in anticancer treatments. Further research is needed to isolate and characterize other active compounds and to explore potential synergistic effects among them.
Novel Insights Into the Intratendinous Pressure Behavior of the Achilles Tendon in Athletes
Authors: Pringels Lauren , Van Acker Gilles , Wezenbeek Evi , Burssens Arne , Vanden Bossche Luc
Published: April 2024

Background:

In contrast to other musculoskeletal tissues, the normal pressure behavior of the Achilles tendon is poorly understood. This study aimed to explore the normal intratendinous and perfusion pressures of the Achilles tendon at rest and during exercise, and investigate potential correlations with tendon load and morphology.

Hypothesis:

Intratendinous and perfusion pressures of the Achilles tendon exhibit similarities to other musculoskeletal tissues and depend on tendon load and morphology.

Study Design:

Observational study.

Level of Evidence:

Level 3.

Methods:

A total of 22 recreational athletes were enrolled. Demographics, activity level, and blood pressures were recorded. Achilles tendon thickness and echogenicity were assessed 25 mm proximal to the posterosuperior calcaneal border. In this region, intratendinous and perfusion pressures of the Achilles tendon were measured at rest and during isometric plantarflexion up to 50 N, using the microcapillary infusion technique. Linear mixed models were used to investigate the effects of plantarflexion force, tendon thickness, and echogenicity on intratendinous and perfusion pressures.

Results:

At rest, intratendinous and perfusion pressures of the Achilles tendon were 43.8 ± 15.2 and 48.7 ± 18.4 mmHg, respectively. Intratendinous pressure increased linearly with plantarflexion force, reaching 101.3 ± 25.5 mmHg at 50 N (P < 0.01). Perfusion pressure showed an inverse relationship, dropping below 0 mmHg at 50 N (P < 0.01). Neither intratendinous nor perfusion pressures of the Achilles tendon correlated with tendon thickness or echogenicity.

Conclusion:

The normal intratendinous resting pressure of the Achilles tendon is higher than other musculoskeletal tissues, making it more susceptible to ischemia. During exercise, intratendinous pressure increases significantly to a level that lowers perfusion pressure, thereby compromising blood supply at already low plantarflexion forces.

Clinical Relevance:

Given the potential role of ischemia in Achilles tendinopathy, our findings caution against intratendinous injections, as they may exacerbate high intratendinous resting pressure, and against prolonged postexercise tendon stretching, as the associated rise in intratendinous pressure may impair the required hyperemic response.
Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) Scores > 55 at 6 Months Postoperative Predict Ability to Achieve Patient Acceptable Symptomatic State at Minimum 1 Year Postoperative Following Autologous Chondrocyte Implantation for Grade IV Chondral Defects About the Patellofemoral Joint
Authors: Retzky Julia S. , Fletcher Connor , Rizy Morgan , Burge Alissa , Strickland Sabrina M.
Published: April 2024

Purpose

The primary aim is to evaluate the relationship between MOCART scores and patient satisfaction, as evaluated by achievement of (1) the Patient Acceptable Symptomatic State (PASS) and (2) the minimal clinically important difference (MCID) for Knee Injury and Osteoarthritis Score Quality of Life (KOOS QoL), for patients undergoing autologous chondrocyte implantation (ACI) for focal Grade IV patellofemoral chondral defects. The secondary aim is to determine the threshold MOCART score which predicts the ability to meet the PASS and the MCID for KOOS QoL.

Methods

Patients undergoing ACI for grade IV patellofemoral chondral defects by a single surgeon from 2017 to 2020 were identified by search of the EMR. To determine PASS status, patients were asked, “Do you consider your current level of symptoms to be acceptable?” KOOS QoL scores were also collected. Patients with 6-month postoperative knee MRI, PASS scores, and minimum 2-year follow-up data were included. Paired t tests and Wilcoxon Rank-Sum tests were used to evaluate the relationship between MOCART scores and (1) PASS achievement and (2) achievement of the MCID for KOOS QoL (12.8).

Results

Thirty-four patients were included, with a median age of 35.1 years [IQR: 24.6, 37.1], and BMI of 24.0 kg/m2 [IQR: 21.5, 28.1]. The median time to postoperative MRI was 6.7 months [IQR: 5.8, 7.9], and average follow-up time was 3.7 ± 1.2 years. Twenty-five patients (74%) achieved PASS, and 18 patients (out of 27 who had postop KOOS QoL Scores, 67%) achieved the MCID for KOOS QoL. Patients who achieved PASS had higher average MOCART scores (61.8 ± 16.0) than those who did not achieve PASS (45.0 ± 12.8, p=0.011), whereas patients who achieved the MCID for KOOS QoL did not have higher MOCART scores than those who did not achieve the MCID (61.9 ± 18.3 versus 53.3 ± 17.1, P = 0.25). There was no relationship between age, sex, lesion size, and lesion location and ability to achieve PASS or MCID for KOOS QoL (p>0.05). A threshold MOCART value of 55 was associated with the highest AUC on ROC analysis for likelihood of achieving PASS (0.778) and MCID for KOOS QoL (0.667).

Conclusion

Higher MOCART scores are associated with an increased likelihood of achieving PASS following patellofemoral ACI. Moreover, MOCART scores > 55 predict the ability to achieve PASS and the MCID for KOOS QoL following patellofemoral ACI.

Level of Evidence:

IV
Woven endo bridge device for recurrent intracranial aneurysms: A systematic review and meta-analysis
Authors: Habibi Mohammad Amin , Rashidi Farhang , Fallahi Mohammad Sadegh , Arshadi Mohammad Reza , Mehrtabar Saba , Ahmadi Mohammad Reza , Shafizadeh Milad , Majidi Shahram
Published: April 2024

Background

Recurrent intracranial aneurysms present a significant clinical challenge, demanding innovative and effective treatment approaches. The Woven EndoBridge (WEB) device has emerged as a promising endovascular solution for managing these intricate cases. This study aims to assess the safety and efficacy of the WEB device in treating recurrent intracranial aneurysms.

Methods

We conducted a comprehensive search across multiple databases, including PubMed, Scopus, Embase, and Web of Science, from inception to June 5, 2023. Eligible studies focused on evaluating WEB device performance and included a minimum of five patients with recurrent intracranial aneurysms. The complete and adequate occlusion rates, neck remnant rates, and periprocedural complication rates were pooled using SATA V.17.

Results

Our analysis included five studies collectively enrolling 73 participants. Participant ages ranged from 52.9 to 65 years, with 64.4% being female. Aneurysms were wide-necked and predominantly located in the middle cerebral artery, basilar artery, and anterior cerebral artery. Previous treatments encompassed coiling, clipping, and the use of WEB devices. Our study found an overall adequate occlusion rate of 0.80 (95% CI 0.71–0.89), a complete occlusion rate of 0.39 (95% CI 0.28–0.50), and a neck remnant rate of 0.38 (95% CI 0.27–0.48). Periprocedural complications were reported at a rate of 0%, although heterogeneity was observed in this data. Notably, evidence of publication bias was identified in the reporting of periprocedural complication rates.

Conclusion

Our findings suggest that the WEB device is associated with favorable outcomes for treating recurrent wide-neck intracranial aneurysms.
Radiology-pathology correlation: Giant tumefactive perivascular spaces
Authors: Benson John C , Trejo-Lopez Jorge A , Cormier Jason L , Parney Ian F , Mark Ian T , Madhavan Ajay A , Kotsenas Amy L , Rydberg Charlotte H , Luetmer Patrick H , Eckel Laurence J , Johnson Derek R
Published: April 2024

Dilated perivascular spaces (PVSs) are common and easily recognized on imaging. However, rarer giant tumefactive PVSs (GTPVSs) can have unusual multilocular cystic configurations, and are often confused for other pathologic entities, including neoplasms, cystic infarctions, and neuroepithelial cysts. Because GTPVSs are scarcely encountered and even more infrequently operated upon, many radiologists are unaware of the imaging and pathologic features of these lesions. Here, a case of a resected GTPVS is presented, highlighting both its radiologic and histologic characteristics, and discussing how such lesions can be differentiated from their closest mimickers on imaging.
Appearance of intracranial cottonoids on intraoperative magnetic resonance imaging
Authors: Terrani Kristina F , Madura Casey , Rogers Samuel , Avellino Anthony M
Published: April 2024

To our knowledge, this is a unique report of intraoperative magnetic resonance imaging (iMRI) of an intracranial cottonoid. The current literature describes images of cottonoids as a post-operative finding in the setting of an unintentionally retained foreign body; however, the iMRI images we present are important as the use of iMRI in the resection of complex tumors and epilepsy foci increases. This series of images was obtained during a craniotomy for tumor resection of a patient with dysembryoplastic neuroepithelial tumor. To determine both the degree of tumor resection and the amount of residual tumor, cottonoids were left in our patient’s resection cavity and underwent iMRI. The ability to distinguish cottonoids in these images is important for intraoperative localization of resection margins and to prevent the retention of cottonoids.
Safety Listening in Organizations: An Integrated Conceptual Review
Authors: Pandolfo Alyssa M. , Reader Tom W. , Gillespie Alex
Published: April 2024

Failures of listening to individuals raising concerns are often implicated in safety incidents. To better understand this and theorize the communicative processes by which safety voice averts harm, we undertook a conceptual review of “safety listening” in organizations: responses to any voice that calls for action to prevent harm. Synthesizing research from disparate fields, we found 36 terms/definitions describing safety listening which typically framed it in terms of listeners’ motivations. These motivational accounts, we propose, are a by-product of the self-report methods used to study listening (e.g., surveys, interviews), which focus on listening perceptions rather than actual responses following speaking-up. In contrast, we define safety listening as a behavioral response to safety voice in organizational contexts to prevent harms. Influenced by cognitive, interactional, and environmental factors, safety listening may prevent incidents through enabling cooperative sensemaking processes for building shared awareness and understanding of risks and hazards.
Essential factors influencing registered nurses to stay in their position at a university hospital medical department: A rapid qualitative research study
Authors: Berthelsen Connie , Kjærgaard Kristine Mildahl , Hansen Carrinna Aviaja
Published: April 2024

Retention of nurses in medical departments is complicated due to the high and stressful workload. The aim of this study was therefore to describe registered nurses’ perceptions of essential factors influencing their desire to stay in their position in a university hospital medical department. A rapid qualitative research methodology was followed. Data collection, consisting of qualitative interviews with 22 registered nurses during December 2022 and January 2023, and analysis, was guided by the Rigorous and Accelerated Data Reduction (RADaR) technique. The COREQ guidelines were used for reporting this study. The findings showed how the registered nurses collectively expressed collegial unity, flexible working hours, opportunities for development and training, the patient category and the managers’ importance as the five essential factors important for them to stay in their position. The study recommends that future research on retention has a point of departure in the local context and culture of the hospital wards.
Twitch spouse: Livestreaming and the legacy of spousal labour in the video game industry
Authors: Tran Christine H
Published: April 2024

Precarious careers in the games industry have long relied on the unpaid and largely feminized support of spouses and family members. This paper addresses the role of spouses and other domestic cohabitants in the production of live game broadcasts on Twitch, Amazon’s world-leading platform in live video entertainment. I introduce the heuristic of the ‘Twitch Spouse’ to underscore the crucial role that domestic partners have played as invisible workers in the wider games industry, whose precarious conditions have been extended by the rise of at-home livestreaming. Drawing from ‘playful’ interviews and ethnographic observation with 12 Twitch creators located across the United States and Canada, I delineate three themes by which the partners of Twitch streamers vitally contribute to livestreaming: collaborative space production, the management of intimacy, and timekeeping. Herein, I show how a theorization of the ‘Twitch Spouse’ will build future pathways for recognizing the intertwined struggles of domestic and digital work within the precarious horizons of the game industry. This paper argues that Twitch streamers’ conceptualizations of intimate partners’ supportive labour reinforce domesticity and visibility as co-extended forces in the evolving relevance of digital labour to contemporary capitalism.
Climate Change Education as an Adaptative Strategy for Dairy Farmers: A Sociocultural Perspective
Authors: Ramos de Robles Silvia Lizette , Barbosa Carmona Xochitl , Gallard Martínez Alejandro José , Gran Castro Juan Alberto
Published: April 2024

Purpose

This study aims to develop a transdisciplinary informal curriculum for climate change education (CCE) to increase the adaptive capacity of the small-farm milk-producing sector in Encarnación de Díaz, Jalisco, México.

Design/Approach/Methods

A sustainable rural livelihood framework assessing six types of capital (animal, financial, human, natural, physical, and sociocultural) in a sequential exploratory method design was used to determine the adaptive capacity of 61 milk producers to climate change. Several interrelated aspects of capital are associated with milk producers’ vulnerability to climate change.

Findings

Dairy farmers’ knowledge is based on traditional, historical, and cultural ways of interacting with their environment. Respecting this knowledge allowed us to use their experiential knowledge to co-jointly develop a CCE model to decrease the vulnerability of each of the six identified types of capital, with financial, human, and sociocultural capital being the most vulnerable.

Originality/Value

Using local knowledge to cultivate adaptive actions for climate change and reducing the vulnerability of affected communities is essential when developing an informal CCE curriculum.
Centering Agency: Examining the Relationship Between Acts of Resistance, Anxiety, and Depression Among Undocumented College Students
Authors: Morales Hernandez Martha , Flores Morales Josefina , Enriquez Laura E.
Published: April 2024

Research has established that legal vulnerability has detrimental consequences for the mental health of undocumented individuals. The purpose of our study is to consider how practicing agency is associated with mental health in the face of such structural marginalization. To meet this goal, we conceptualize actions taken to resist structural inequality as acts of resistance to center immigrants’ agency in navigating and contesting their marginalization. Drawing on survey data with California undocumented college students, we examine to what extent engaging in three acts of resistance is associated with depression and anxiety symptomatology. We find that students with higher rates of political engagement and critical consciousness raising report higher depression and anxiety symptomatology. Findings suggest that structural approaches to studying mental health must also consider immigrants’ agency and efforts to navigate, respond to, and challenge their marginalization.
Negotiating Between Individualism and Techno-Nationalism: An Empirical Analysis of Chinese Maker Ideology and Practices
Authors: Fu Pengfei
Published: April 2024

Over the past decade, the maker movement has gained prominence in China, garnering attention from policymakers, scholars, and practitioners. Although several studies have explored the movement’s macro-level impacts on the country’s economy and society, an adequate understanding of the individual makers’ lived experiences, practices, and ideologies remains elusive. This paper addresses this gap by examining how individual makers negotiate and respond to the global maker movement’s individualistic values and China’s state-led techno-nationalism. Framed by concepts of “critical making” and “maker ideology,” the study draws on qualitative data obtained from individual makers to offer insights into the evolving maker culture in China. Our findings suggest that Chinese makers have moved away from the Westernized critical-making paradigm and embraced a more techno-nationalistic orientation. By contributing to a nuanced understanding of the non-uniform and diverse development of the global maker movement in non-Western contexts, this paper sheds new light on the maker movement’s ongoing transformation in China.
Understanding Migrant School-Aged Children’s Education in Public Schools Thailand: Teachers’ Perspectives and Classroom Narratives
Authors: Peungcharoenkun Tipaya , Waluyo Budi
Published: April 2024

Despite Thailand’s popularity as a destination for migrant laborers from neighboring Southeast Asian countries, little research has been conducted on the education of migrant school-aged children in Thailand’s public schools. However, knowledge in this area is important for improving Thailand’s education policy and curriculum for migrant children and addressing issues related to Thailand’s migrant education. As a response, framed by a phenomenological approach, this study conducted classroom teaching observations and interviews with Thai public-school teachers in the provinces, which are well-known for their large migrant populations. Presented in classroom narratives and teachers’ perspectives individually, the findings revealed teachers’ intentional misperceptions of ethnicity, pedagogical strategies to integrate migrant children into classrooms with Thai students, barriers that teachers must overcome to aid the educational advancement of migrant children, and non-governmental organizations’ support for teacher training (NGOs). Since Thailand has implemented a policy allowing migrant and stateless children to freely enroll in public schools, this study calls for the implementation of non-discriminatory, integrative efforts at the school level, beginning with the provision of training for teachers on multilingual education and ending with the enhancement of school participation in the integration of migrant children into the educational environment.
How Idiographic Methodologies Can Move the Clinical-Science Field Forward to Integrate Personalized Treatment Into Everyday Clinical Care and Improve Treatment Outcomes
Authors: Levinson Cheri A. , Christian Caroline , Becker Carolyn B.
Published: April 2024

The research–practice gap refers to the fact that most evidence-based treatments created by researchers are not used in routine clinical care, which affects real-world treatment outcomes negatively. One key reason that evidence-based care is not used more frequently is its nonpersonalized format. For example, most evidence-based treatments are based on averages and are limited in addressing comorbidity, heterogeneity, and the needs of clients with minoritized identities. These limitations reduce therapist uptake of evidence-based treatment at large. As a result, most patients seeking treatment in community settings do not receive evidence-based care, which could more quickly and effectively reduce mental-health suffering. Furthermore, even clinicians who want to engage in evidence-based practice must still rely on their clinical judgment in decision-making when treatments fail to address client-specific needs. This reliance on decision-making can influence outcomes negatively. We propose that idiographic (i.e., one-person; N = 1) methodologies (data analysis of one person’s data) combined with digital mental-health technology could help reduce the research–practice gap and improve treatment outcomes. In this article, we outline the many issues contributing to these problems and how idiographic methods of personalization can address these issues. We provide an overview of idiographic methodologies and examples of how to use these methods to personalize existing evidence-based treatments with patients. Finally, we conclude with recommendations for future research and movement within the field that is needed to propel this type of personalization into routine clinical care to reduce the research–practice gap and improve treatment outcomes broadly.
Modern Internet Search Analytics: Is There a Difference in What Patients are Searching Regarding the Operative and Nonoperative Management of Scoliosis?
Authors: Mastrokostas Paul G. , Mastrokostas Leonidas E. , Emara Ahmed K. , Wellington Ian J. , Ginalis Elizabeth , Houten John K. , Khalsa Amrit S. , Saleh Ahmed , Razi Afshin E. , Ng Mitchell K.
Published: April 2024

Study Design

Observational Study.

Objectives

This study aimed to investigate the most searched types of questions and online resources implicated in the operative and nonoperative management of scoliosis.

Methods

Six terms related to operative and nonoperative scoliosis treatment were searched on Google’s People Also Ask section on October 12, 2023. The Rothwell classification was used to sort questions into fact, policy, or value categories, and associated websites were classified by type. Fischer’s exact tests compared question type and websites encountered between operative and nonoperative questions. Statistical significance was set at the .05 level.

Results

The most common questions concerning operative and nonoperative management were fact (53.4%) and value (35.5%) questions, respectively. The most common subcategory pertaining to operative and nonoperative questions were specific activities/restrictions (21.7%) and evaluation of treatment (33.3%), respectively. Questions on indications/management (13.2% vs 31.2%, P < .001) and evaluation of treatment (10.1% vs 33.3%, P < .001) were associated with nonoperative scoliosis management. Medical practice websites were the most common website to which questions concerning operative (31.9%) and nonoperative (51.4%) management were directed to. Operative questions were more likely to be directed to academic websites (21.7% vs 10.0%, P = .037) and less likely to be directed to medical practice websites (31.9% vs 51.4%, P = .007) than nonoperative questions.

Conclusions

During scoliosis consultations, spine surgeons should emphasize the postoperative recovery process and efficacy of conservative treatment modalities for the operative and nonoperative management of scoliosis, respectively. Future research should assess the impact of website encounters on patients’ decision-making.
Improving Adherence to the Target Window for Cabotegravir + Rilpivirine Long-Acting Injections Through the CHORUS™ App and Web Portal: A Cluster Randomized Trial
Authors: Wohlfeiler Michael B. , Brunet Laurence , Cochran Quateka , Fusco Jennifer S. , Hsu Ricky K. , Fusco Gregory P.
Published: April 2024

Background

We evaluated the impact of the CHORUS™ app on adherence to the cabotegravir and rilpivirine long-acting injectable (CAB + RPV LAI) monthly injections schedule.

Methods

Healthcare centers (HCCs) were randomized to access CHORUS™ CAB + RPV LAI features (intervention) or not (control) from 01OCT2021-31JAN2022. Target window adherence (maintenance injections ≤7 days before/after target day) was assessed with multivariate logistic regression (generalized estimating equations).

Results

CAB + RPV LAI was administered to 188 and 79 individuals at intervention and control HCCs, respectively. Intervention was not associated with improved target window adherence (adjusted odds ratio: 0.61 [95% CI: 0.30-1.25]). However, app use was associated with increased odds of adherence compared to no app use among all intervention HCCs (2.98 [1.26-7.06]) and at smaller HCCs (3.58 [1.31-9.80]).

Conclusions

While access to CHORUS™ CAB + RPV LAI features did not improve target window adherence, app use did, especially at smaller HCCs which may not have established LAI management procedures.

Trial registration

https://clinicaltrials.gov/show/NCT04863261.
Remixing Preferences for Western Instrumental Classical Music of Bilateral Cochlear Implant Users
Authors: Althoff Jonas , Gajecki Tom , Nogueira Waldo
Published: April 2024

For people with profound hearing loss, a cochlear implant (CI) is able to provide access to sounds that support speech perception. With current technology, most CI users obtain very good speech understanding in quiet listening environments. However, many CI users still struggle when listening to music. Efforts have been made to preprocess music for CI users and improve their music enjoyment. This work investigates potential modifications of instrumental music to make it more accessible for CI users. For this purpose, we used two datasets with varying complexity and containing individual tracks of instrumental music. The first dataset contained trios and it was newly created and synthesized for this study. The second dataset contained orchestral music with a large number of instruments. Bilateral CI users and normal hearing listeners were asked to remix the multitracks grouped into melody, bass, accompaniment, and percussion. Remixes could be performed in the amplitude, spatial, and spectral domains. Results showed that CI users preferred tracks being panned toward the right side, especially the percussion component. When CI users were grouped into frequent or occasional music listeners, significant differences in remixing preferences in all domains were observed.