bluuebunny/crossref_metadata_2025 huggingface dataset:
The association between conditioned pain modulation and psychological factors in people with chronic spinal pain: A systematic review
Authors: Mansfield Michael , Roviello Gianluca , Thacker Mick , Willett Matthew , Bannister Kirsty , Smith Toby
Published: January 2024

Chronic spinal pain has negative effects on physical and mental well-being. Psychological factors can influence pain tolerance. However, whether these factors influence descending modulatory control mechanisms measured by conditioned pain modulation (CPM) in people with chronic spinal pain is unclear. This systematic review investigated the association between CPM response and psychological factors in people with chronic spinal pain. Published and unpublished literature databases were searched from inception to 23rd October 2023 included MEDLINE, EMBASE, CINAHL, and PubMed. Studies assessing the association between CPM response and psychological factors in people with chronic spinal pain were eligible. Data were pooled through meta-analysis. Methodological quality was assessed using the AXIS tool and the certainty of evidence measured through GRADE. From 2172 records, seven studies ( n = 598) were eligible. Quality of included studies was moderate. There was very low certainty of evidence that depression ( r = 0.01 [95% CI −0.10 to 0.12], I2 = 0%), and anxiety ( r = −0.20 [95% CI −0.56 to 0.16], I2 = 84%), fear avoidance ( r = −0.10 [95% CI −0.30 to 0.10], I2 = 70%) had no statistical associations with CPM responder status. Higher pain catastrophising was associated with CPM non-responder status (r = −0.19; 95% CI: −0.37 to −0.02; n = 545; I2: 76%) based on a very low certainty of evidence measured by GRADE. There is currently limited available evidence demonstrating an association between CPM response and psychological factors for people with chronic pain. Managing an individual’s chronic pain symptoms irrespective of comorbid psychological distress, should continue until evidence offer insights that more targeted interventions are needed.
Review of Muslim Patient Needs and Its Implications on Healthcare Delivery
Authors: Zagloul Maie , Mohammed Buruj , Abufares Nawara , Sandozi Afsar , Farhan Sarah , Anwer Saba , Tumusiime Shakirah , Bojang Matida
Published: January 2024

Background:

In the rapidly changing environment of healthcare, striving toward health equity and providing patient-centered care is imperative to the patient’s experience. To achieve these goals, a comprehensive understanding of the diverse patient populations seeking these services, their needs, and the multitude of religious, cultural, and structural elements that impact their well-being is required. Muslim patients represent a considerable demographic, both in number and complexity of religious and cultural beliefs and practices. This scoping review examines the intersection of religion and cultural values with healthcare delivery in the context of the Muslim patient experience.

Objectives:

The objective of this review is to identify key concepts and challenges that impact the Muslim patient experience.

Search Methods:

The research databases Cochrane Library, OVID Medline, and PubMED were used to conduct a comprehensive systemic review of original, empirical peer-reviewed publications with the following search terms: “Muslim healthcare,” “Muslim patient,” and “Muslim experience.”

Selection Criteria:

Inclusion and exclusion criteria were used to narrow down articles to those that addressed Muslim patient needs and their healthcare experience.

Results:

A total of 21 articles met the criteria of this scoping review. Five central topics were identified during thematic analysis: Ramadan and Fasting, Barriers in the Patient-Physician Relationship, Trauma and Perceived Discrimination, Mental Health Awareness and Stigma, and Awareness of Advanced Care Planning.

Conclusion:

This scoping review demonstrates that in order to provide patient-centered care addressing the unique needs of Muslim patients, religious and cultural values need to be explored under the frameworks of cultural humility and structural competency.
The Role of Gender in Evaluating Athletes’ Endorsements of Corporate Social Advocacy Initiatives
Authors: Brown Kenon A. , Jackson Joshua R. , Quick Mackenzie , Harrison Vernon Ray
Published: January 2024

When considering that athletes are becoming more vocal about their beliefs related to social justice initiatives, the role of an athlete’s gender could have an impact on how sports fans view that athlete. When deciding to support or oppose a corporate social advocacy initiative, it can be argued that an individual’s perception of an athlete’s or team’s stance towards social justice can be influenced by elements of one’s social identity. Therefore, the current study expands on this idea by exploring how gender affects the perception of the credibility of an athlete as an endorser of CSA initiatives, considering both the gender of the participant and the gender of the athlete. Using both NBA and WNBA athletes, this experiment manipulates a league CSA initiative and players’ endorsements of the initiative to determine if (a) the participant’s reported gender and (b) the athlete’s gender will impact the perception of the athlete’s credibility. Results provided evidence that gender plays a significant role in that evaluation, such that the NBA player was perceived as more credible regardless of respondent gender, and while female respondents recorded no difference, male participants perceived the NBA player as more credible than his WNBA counterpart.
Characterizing Gabapentinoid Use Among Patients With Isolated Low Back Pain
Authors: Maloy Gwyneth C. , Halperin Scott J. , Ratnasamy Philip P. , Grauer Jonathan N.
Published: January 2024

Study Design

Retrospective cohort study.

Objectives

Gabapentinoids have been increasingly studied as a non-narcotic option for neuropathic and postoperative pain. However, there is evidence suggesting that off-label use of these medications for the treatment of isolated LBP is not effective. The purpose of the current study was to evaluate prescription patterns for gabapentinoids among patients with isolated low back pain.

Methods

Adult patients with LBP were abstracted from the 2019 M91Ortho PearlDiver dataset using International Classification of Diseases (ICD-10) code M54.5. Patients were excluded if they had a diagnosis of neurologic symptoms, history of spinal surgery, spinal fracture, or conditions for which gabapentinoids are FDA approved. Gabapentinoid and narcotic prescriptions within one year of LBP diagnosis were identified. Patient characteristics and prescriber specialty were extracted from the dataset and predictors of gabapentinoid prescriptions were determined using univariate and multivariate analyses.

Results

Among the 1,158,875 isolated LBP patients, gabapentinoids were prescribed for 11%, narcotics for 8%, and both for 3%. The most common prescriber specialties included: primary care physicians (45%), nurse practitioners (15%), and pain management physicians (5%). Independent predictors of gabapentinoid prescriptions included: female sex, region of the country, and insurance type ( P-values <.001).

Conclusions

Of nearly 1.2 million patients with isolated LBP, 14.2% were prescribed gabapentinoids within one year of their LBP diagnosis. Patient characteristics predictive of receiving gabapentinoids were predominantly non-clinical factors.
Perioperative vaginal misoprostol versus intraoperative pericervical hemostatic tourniquet outcome during abdominal myomectomy: A systematic review and meta-analysis
Authors: Adrianto Nicholas , Mangkuliguna Ghea , Sibarani Candra Novi Ricardo
Published: January 2024

Background:

Abdominal myomectomy is a commonly performed surgical procedure for removing fibroids. Various techniques and interventions have been explored to minimize blood loss during abdominal myomectomy. This study aims to assess and compare the efficacy of perioperative vaginal misoprostol and intraoperative pericervical hemostatic tourniquet in minimizing blood loss during abdominal myomectomy.

Method:

Eligible studies were identified using several databases. Analysis was conducted using RevMan version 5.3. This systematic review and meta-analysis were registered in PROSPERO on June 20, 2023, with registration number CRD42023434191. We included three studies with 88 participants.

Results:

Of the 73 records identified initially, 3 met the inclusion criteria—sample sizes of the included studies involving 88 participants. There was a significant mean difference in intraoperative blood loss ( p = 0.022 (95% CI, 0.0706–0.901) and operative time ( p = 0.015, 95% CI, 0.116–1.066) between groups. There was no significant mean difference in postoperative hematocrit ( p = 0.053 (95% CI, −0.734 to 0.00411)) and intraoperative blood transfusion (OR = 1.60 (95% CI, 0.587–4.405), p = 0.355)) between group.

Conclusion:

Our studies indicate that using tourniquets lowered intraoperative bleeding and shortened operating time among the participants. Intraoperative vaginal misoprostol has no significant advantage over the tourniquet group in either intraoperative blood transfusion needs or postoperative hematocrit.
Comparison of Clinical Outcomes Between Modern Augmented ACL Repair and Autograft ACL Reconstruction: A Systematic Review and Meta-analysis of Studies With Minimum 2-Year Follow-up
Authors: Ren Yunong , Wang Jia , Ji Junjie , Zhang Chao , Meng Qingyang
Published: January 2024

Background:

Anterior cruciate ligament (ACL) reconstruction has been the gold standard for primary ACL rupture since the 1990s. In the past decade, ACL repair has received renewed attention and increased research.

Purpose:

To compare the clinical outcomes of modern augmented ACL repair versus autograft reconstruction for ACL ruptures.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

A search of the PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Library databases was conducted for prospective or retrospective comparative studies published between January 1, 2010, and January 3, 2023, with a minimum 2-year follow-up. Two independent reviewers performed data extraction and methodological quality assessment. Sensitivity analysis was performed to maintain the stability of results.

Results:

Nine studies were included (minimum follow-up period, 24-60 months). The total sample size was 833 patients (augmented repair group: 358 patients; autograft ACL reconstruction group: 475 patients). There were 4 randomized controlled trials (level 1), 1 prospective comparative study (level 2), 2 retrospective comparative studies (level 3), and 2 case-control studies (level 3). The augmented ACL repair group attained significantly higher Lysholm score (weighted mean difference [WMD] = 1.57; 95% confidence interval [CI], 0.14-3.01; P = .03) and hamstring strength (WMD = 36.69; 95% CI, 29.07-44.31; P < .01) but had higher rates of hardware removal (odds ratio [OR] = 6.30; 95% CI, 2.44-16.23; P = .0001), reoperation (OR = 1.87; 95% CI, 1.33-2.62; P = .0003), and failure (OR = 1.58; 95% CI, 1.03-2.43; P = .0003) compared with the autograft ACL reconstruction group. No significant differences were observed between the repair and reconstruction groups regarding postoperative International Knee Documentation Committee scores, Tegner scores, knee laxity, satisfaction, ACL revisions, complications, and reoperation rather than revision.

Conclusion:

Augmented ACL repair was associated with higher rates of reoperation, hardware removal, and failure compared with autograft ACL reconstruction in studies with minimum 2-year follow-up data. However, augmented ACL repair had higher Lysholm scores and hamstring strength versus autograft ACL reconstruction.
Effect of Bone Marrow Stimulation on Arthroscopic Rotator Cuff Repair: A Systematic Review and Meta-analysis
Authors: Shin Kyun-Ho , Kim Jin-Uk , Jang Il-Tae , Han Seung-Beom
Published: January 2024

Background:

Arthroscopic rotator cuff repair (RCR) is a common orthopaedic procedure, but it has a high rate of retears that can negatively affect the functional outcomes. Bone marrow stimulation (BMS) has been suggested as an additional treatment to improve the outcomes of RCR.

Purpose:

To compare the effectiveness of the BMS procedure during RCR with conventional RCR.

Study Design:

Systematic review; Level of evidence, 2.

Methods:

A systematic literature search was conducted in MEDLINE/PubMed, Embase, Cochrane Library, and Scopus, on March 1, 2023, for studies comparing postoperative retear rates and functional outcomes between patients who underwent primary arthroscopic RCR with and without the BMS procedure. Only level 1 and 2 randomized controlled trials with a minimum 12-month follow-up were included. The primary outcomes were retear rates and functional outcomes as measured by the Constant; American Shoulder and Elbow Surgeons (ASES); and University of California, Los Angeles (UCLA) scores and by postoperative range of motion. Subgroup analyses were performed based on repair technique (single-row repair vs double-row or suture-bridge repair). The standardized mean difference (SMD) and odds ratio (OR) were utilized to synthesize continuous and dichotomous outcomes, respectively. Homogeneity was evaluated using the chi-square test and I2 statistic.

Results:

The literature search yielded 661 articles, of which 6 studies (522 patients; 261 with BMS, 261 without BMS) met the eligibility criteria. The combined analysis showed no significant decrease in retear rates with the utilization of the BMS procedure during RCR (OR, 0.60; 95% CI, 0.35 to 1.03; P = .07; I2 = 24%). There was no significant intergroup difference in functional outcomes (Constant score: SMD, 0.13; 95% CI, –0.04 to 0.31; P = .13; I2 = 0%; ASES score: SMD, 0.04; 95% CI, –0.20 to 0.28; P = .73; I2 = 0%; UCLA score: SMD, –0.13; 95% CI, –0.50 to 0.23; P = .47; I2 = 0%). Subgroup analyses revealed no significant differences in postoperative retear risk or total Constant score according to the repair technique.

Conclusion:

Based on the available evidence, this systematic review did not find a significant benefit of the BMS procedure at the footprint during arthroscopic RCR compared with conventional RCR in terms of retear rates and functional outcomes at short-term follow-up.
Young Infants Clinical Signs Study 8-sign Algorithm for Identification of Sick Infants Adapted for Routine Home Visits: A Systematic Review and Critical Appraisal of its Measurement Properties
Authors: Fung Alastair , Farmer Julie , Borkhoff Cornelia M.
Published: January 2024

Objective. The 8-sign algorithm adapted from the Young Infants Clinical Signs Study (YICSS) is widely used to identify sick infants during home visits (YICSS-home algorithm). We aimed to critically appraise the development and evidence of measurement properties, including sensibility, reliability, and validity, of the YICSS-home algorithm. Methods. Relevant studies were identified through a systematic literature search. Results. The YICSS-home algorithm has good sensibility. The algorithm demonstrated at least moderate inter-rater reliability and sensitivity ranging from 69% to 80%. However, the algorithm was developed among sick infants brought for care to a health facility and not initially developed for use by community health workers (CHWs) during home visits. Some important risk factors were omitted at item generation. Inter-CHW reliability and construct validity have not been estimated. Conclusion. Future research should build on the strengths of the YICSS-home algorithm and address its limitations to develop a new algorithm with improved predictive accuracy.
Black Disadvantage or Advantage? Misalignment between State and Popular Understandings of Blackness in Mexico
Authors: Sue Christina A. , Riosmena Fernando , Telles Edward
Published: January 2024

Growing numbers of countries are including ethnoracial questions on their national censuses, spawning new scholarship on the politics of state classification and ethnoracial stratification. However, these literatures have generally not focused on how alignment or misalignment between state and popular conceptualizations of ethnoracial categories affects official measurements, including population size and ethnoracial inequality. The authors leverage a quasi-natural experiment on state-popular alignment in Mexico by drawing on three recent government surveys, which, for the first time in the nation’s history, sought to measure black identification yet defined blackness in divergent ways. The authors find that questions that define blackness in cultural terms (which misalign with popular conceptions of blackness) produce substantially smaller population estimates and considerably less black disadvantage than a noncultural (racial origins) question. This article bridges the literatures on the politics of ethnoracial classification and stratification and produces new empirical and theoretical insights into the study of ethnoracial measurement and inequality.
De facto standstill: Ruination and deterioration in the Abkhazian borderlands
Authors: Venhovens Mikel J.H.
Published: January 2024

This article explores the ruination of homes and infrastructure in the Gal(i) district of the contemporary de-facto state of Abkhazia. After the 1992–1993 conflict, over 200,000 ethnic Georgians were forcefully displaced, making the roughly 40,000 ethnic Georgians who stayed behind as an unwanted minority. Like the demographics, the landscape changed significantly. The homes became ruins, and the infrastructure fell apart. Since the recognition of Abkhazia by the Russian Federation in 2008, there has been significant rebuilding in Abkhazia, but the Gal(i) district has often been left out of this process. This article argues, that within the context of the concept of de facto-ness, the process of ruination in the Gal(i) district is a material demonstration of the post-conflict Abkhazian social hierarchy and a result of the political reality, and not simply decay over time. It argues that the material environment in the Gal(i) district is a tangible spectacle of the uncertainty that comes with being a post-conflict de facto state, and furthermore illustrates the socio-political situation of the Gal(i) population within the de facto Republic of Abkhazia.
Comparison of efficacy between levonorgestrel intrauterine system and dienogest in adenomyosis: a randomized clinical trial
Authors: Choudhury Satish , Jena Saubhagya Kumar , Mitra Subarna , Padhy Biswa Mohan , Mohakud Sudipta
Published: January 2024

Background:

Medical management of adenomyosis is an emerging perspective in modern gynecology. Though levonorgestrel intrauterine system (LNG-IUS) and dienogest (DNG) effectively relieve symptoms in adenomyosis, neither has been approved for the same indication. Our study aims to compare the efficacy and safety of these progestins in treating adenomyosis.

Objective:

To study the efficacy and safety of LNG-IUS versus DNG in patients with symptomatic adenomyosis.

Design:

Open-labeled, parallel, single-centered, randomized clinical trial.

Methods:

Patients with adenomyosis-associated pain with or without abnormal uterine bleeding were randomly allocated to either LNG-IUS group or DNG group. The primary outcome was a reduction in painful symptoms after 12 weeks of treatment measured by visual analog scale (VAS) score. Changes in menstrual blood loss (MBL), improvement in quality of life (QoL), and adverse drug reactions were also analyzed.

Results:

The VAS score significantly decreased from baseline in both groups. The baseline and post-treatment VAS scores in the LNG-IUS group were 6.41 ± 1.07 and 3.41 ± 1.04 ( p = <0.001) and in the DNG group, were 6.41 ± 0.95 and 3.12 ± 1.40 ( p = <0.001), respectively. A significantly greater proportion of patients in the LNG-IUS group experienced lighter MBL as compared to the DNG group [27/30 (90%) in the LNG-IUS group versus 17/22 (77.2%) in the DNG group ( p = 0.006)]. Both the groups had improvement in QOL scores calculated by the World Heath Organisation QOL scale (WHOQOL BREF) questionnaire; however, it was more pronounced in the DNG group [(28.76 ± 30.47 in the LNG-IUS group versus 48.26 ± 44.91 in the DNG group ( p = 0.04)]. Both the agents were safe as there were no reported major adverse drug reactions.

Conclusion:

DNG can be an effective and safe alternative to LNG-IUS for the medical management of adenomyosis.

Trial registration:

The trial was prospectively registered at the clinical trial registry – India (CTRI) vide CTRI number CTRI/2020/05/025186.
Is Botox or Dermabond Superior in the Appearance of the Lip Scar After Primary Cleft Lip Repair and Revision? A Systematic Review and Meta-Analysis
Authors: Martinez Paul F. , Webster Theresa K. , Imahiyerobo Thomas A.
Published: January 2024

Background:

Cleft lip scar formation is an inevitable consequence of cleft lip repair (CLR) and is exacerbated by the dynamic movement of the middle face. Various methods to correct or prevent these deformities have been described including silicone sheeting, surgical revisions, laser therapy, and more recently, Botulinum toxin-A (Botox) and Dermabond. This study aims to analyze and compare the impact of Botox versus Dermabond on scar appearance after CLR.

Methods:

Following PRISMA guidelines, a systematic review was performed on Medline, Embase, Cochrane, and CINAHL using the following keywords: “Dermabond,” “botulinum toxin,” and “cleft lip.” Outcomes of interest were the rates of scar hypertrophy, scar width, Vancouver scar scale (VSS), visual analog scale (VAS), Hollander wound evaluation scale (HWES), and complications.

Results:

Nine studies were included of which 4 articles analyzed Botox and 5 analyzed Dermabond. Forest plots for scar width at the first and second time point supported the use of Botox to achieve a smaller scar width with P < .0001 (95% CI: −1.09 [−1.56 to −0.63] and 95% CI: −0.94 [−1.37 to −0.50], respectively). A significant increase in VAS was observed with Botox (95% CI: 1.66 [1.27-2.05], P value < .0001) and VSS was insignificant. Of the articles that analyzed Dermabond, scar appearance was comparable to the traditional suture closure group. There were no feeding complications for either intervention. Pooled forest plots for VAS comparing Botox and Dermabond supported the use of Botox with improved VAS (95% CI: 1.66 [1.27-2.05], P < .0001) compared to Dermabond (95% CI: 0.07 [ −0.48 to 0.61], P = .80).

Conclusions:

The current literature supports the use of Botox for scar improvement following CLR or revision. However, there is limited data to support Dermabond’s utility in improving scars in CLR, which highlights the need for further studies.
The Anatomy and Physiology of the Glymphatic System and Its Role in Craniectomies and Syndrome of the Trephined
Authors: Talbot-Stetsko Haley K. , Holste Katherine G. , Dietze-Fiedler Megan , Hespe Geoffrey E. , Vercler Christian J. , Muraszko Karin M.
Published: January 2024

Background:

The glymphatic system, a relatively recently discovered system for transport of cerebrospinal fluid (CSF) and waste products in the central nervous system, has been implicated in several neurologic disorders. Altered CSF dynamics are seen after decompressive craniectomy, suggesting this procedure may impact glymphatic function. We aimed to systematically review the current literature to understand the effect of the glymphatic system on patients with decompressive craniectomies and Syndrome of the Trephined (SoT).

Methods:

PubMed and Embase were searched for preclinical and clinical studies investigating the glymphatic system and craniectomy, cranioplasty, or SoT in years 2012 to 2023.

Results:

Sixty-three studies were identified for review. Intracranial oscillations, cerebral perfusion, and arterial pulsations have been identified as major drivers of glymphatic influx. Each of these processes are diminished following craniectomy, suggesting craniectomy may impair glymphatic function. Reductions in brain pulsatility and alterations in glymphatic drainage after craniectomy were accompanied by impaired functional outcomes, as seen in SoT. Radiologically, CSF flow alterations are seen after craniectomies, which improve with cranioplasty.

Conclusions:

Glymphatic system dysfunction after craniectomy and in SoT may be a potential therapeutic target for patients with iatrogenically altered cranial vault anatomy.
Virus-reactive T cells expanded in aplastic anemia eliminate hematopoietic progenitor cells by molecular mimicry
Authors: Ben Hamza Amin , Welters Carlotta , Stadler Serena , Brüggemann Monika , Dietze Kerstin , Brauns Olaf , Brümmendorf Tim H. , Winkler Thomas , Bullinger Lars , Blankenstein Thomas , Rosenberger Leonie , Leisegang Matthias , Kammertöns Thomas , Herr Wolfgang , Moosmann Andreas , Strobel Julian , Hackstein Holger , Dornmair Klaus , Beier Fabian , Hansmann Leo
Published: January 2024

Acquired aplastic anemia is a bone marrow failure syndrome characterized by hypocellular bone marrow and peripheral blood pancytopenia. Frequent clinical responses to calcineurin inhibition and antithymocyte globulin strongly suggest critical roles for hematopoietic stem/progenitor cell–reactive T-cell clones in disease pathophysiology; however, their exact contribution and antigen specificities remain unclear. We determined differentiation states and targets of dominant T-cell clones along with their potential to eliminate hematopoietic progenitor cells in the bone marrow of 15 patients with acquired aplastic anemia. Single-cell sequencing and immunophenotyping revealed oligoclonal expansion and effector differentiation of CD8+ T-cell compartments. We reexpressed 28 dominant T-cell receptors (TCRs) of 9 patients in reporter cell lines to determine reactivity with (1) in vitro–expanded CD34+ bone marrow, (2) CD34− bone marrow, or (3) peptide pools covering immunodominant epitopes of highly prevalent viruses. Besides 5 cytomegalovirus-reactive TCRs, we identified 3 TCRs that recognized antigen presented on hematopoietic progenitor cells. T cells transduced with these TCRs eliminated hematopoietic progenitor cells of the respective patients in vitro. One progenitor cell–reactive TCR (11A5) also recognized an epitope of the Epstein-Barr virus–derived latent membrane protein 1 (LMP1) presented on HLA-A∗02:01. We identified 2 LMP1-related mimotopes within the human proteome as activating targets of TCR 11A5, providing proof of concept that molecular mimicry of viral and self-epitopes can drive T cell–mediated elimination of hematopoietic progenitor cells in aplastic anemia.
Positive airway pressure telehealth models and long-term therapy termination: a healthcare database analysis
Authors: Woehrle Holger , Schoebel Christoph , Ficker Joachim H. , Graml Andrea , Schnepf Jürgen , Fietze Ingo , Young Peter , Arzt Michael
Published: January 2024

Background

Telemonitoring-guided interventions can improve short-term positive airway pressure (PAP) therapy adherence, but long-term effects are unknown. This study investigated long-term PAP therapy termination in patients with sleep apnoea managed with standard care, telemonitoring-guided proactive care or telemonitoring-guided proactive care + patient engagement tool.

Methods

German healthcare provider data were analysed retrospectively. Individuals aged 18–100 years who started PAP from 2014 to 2019 and had device type/interface data were included. Time-to-termination periods were analysed using Kaplan–Meier plots and Cox proportional hazards regression, adjusted for age, sex, insurance type, and device and mask type.

Results

The per-protocol population (valid telemonitoring data) included 104 612 individuals (71% male; 95% aged >40 years). Mean follow-up was 3.3±2.0 years. The overall therapy termination rate was significantly lower in the telemonitoring-guided proactive care groupversusstandard care (20%versus27%; p<0.001), and even lower in the telemonitoring-guided care + patient engagement tool group (11%; p<0.001versusother treatment groups). Adjusted risk of therapy termination was lowerversusstandard care (hazard ratio 0.76, 95% confidence interval 0.74–0.78; and 0.41 (0.38–0.44) for telemonitoring-guided proactive care alone + patient engagement). Age <50 or >59 years and use of a nasal pillows or full-face mask were significant predictors of therapy termination; male sex, use of telemonitoring-guided proactive care (± patient engagement) and private insurance were significantly associated with lower therapy termination rates.

Conclusions

Use of telemonitoring-guided proactive care and a patient engagement tool was associated with lower rates of PAP therapy termination.
Clinical, tomographic and functional comparison of sporadic and tuberous sclerosis complex-associated forms of lymphangioleiomyomatosis: a retrospective cohort study
Authors: Oliveira Martina Rodrigues , Wanderley Mark , Freitas Carolina Salim Gonçalves , Kairalla Ronaldo Adib , Chate Rodrigo Caruso , Amaral Alexandre Franco , Arimura Fabio Eiji , Samorano Luciana Paula , Watanabe Elieser Hitoshi , Carvalho Carlos Roberto Ribeiro , Baldi Bruno Guedes
Published: January 2024

Background

Lymphangioleiomyomatosis (LAM) is a rare disease that can occur sporadically (S-LAM) or associated with the tuberous sclerosis complex (TSC-LAM). The natural history of LAM is not completely understood, including whether there is a difference between the clinical courses of the two forms. This study aimed to compare the clinical, functional and tomographic features between S-LAM and TSC-LAM, and evaluate the annual rates of change in lung function.

Methods

This retrospective cohort study included patients with LAM followed up between 1994 and 2019. Clinical, functional and imaging variables were evaluated, and the lung cysts were automatically quantified. Quality of life and predictors of lung function impairment were accessed, and the annual rate of lung function decline was compared between S-LAM and TSC-LAM.

Results

Of the 107 patients included, 77 had S-LAM and 30 had TSC-LAM. Although patients with TSC-LAM had a higher prevalence of renal angiomyolipomas and neurological and dermatological manifestations, pulmonary function tests were similar. Patients with S-LAM had a greater rate of forced expiratory volume in 1 s decline and a higher extent of cysts. Pneumothorax, desaturation in the 6-minute walking test and a higher extent of lung cysts were predictors of functional impairment. A greater impact on vitality and emotional health was observed in the TSC-LAM.

Conclusion

Greater functional decline and a higher cystic extension were found in patients with S-LAM. Our study provides a broad clinical, functional and tomographic characterisation of patients with LAM, adding valuable information to the existing evidence to better understand the two forms of the disease.
Bandwidth tunability of graphene absorption enhancement by hybridization of delocalized surface plasmon polaritons and localized magnetic plasmons
Authors: Wu Yifan , Nie Qingmiao , Tang Chaojun , Yan Bo , Liu Fanxin , Zhu Mingwei
Published: January 2024

The bandwidth-tunable absorption enhancement of monolayer graphene is theoretically studied in the near-infrared wavelengths. The monolayer graphene is placed on the silver substrate surface with a periodic array of one-dimensional slits. Two absorption peaks are found to result from the hybridization of delocalized surface plasmon polaritons and localized magnetic plasmons. The positions of absorption peaks are accurately predicted by a coupling model of double oscillators. The full width at half maximum of absorption peaks is largely tuned from about 1–200 nm by changing the array period of slits. The effect of the slit size on absorption peaks is also investigated in detail. Our work is promising in applications for photoelectric devices.
Live longer, work longer? An investigation of the health capacity to work at older ages in Denmark using combined register and survey data
Authors: Aaskoven Maiken Skovrider , Lauridsen Jørgen T. , Kjær Trine
Published: January 2024

Publicly funded pension systems are facing the challenge of remaining financially sustainable without lowering pensions. Raising the statutory retirement age gradually in line with the increase in life expectancy has been a key measure to solve the problem. The implicit assumption is that the additional years of life are lived in good health, or as a minimum that health status is compatible with work. However, some individuals may not have the ability to work. Furthermore, a uniform retirement age ignores the different exposures to morbidity and mortality risks across social groups. Consequently, it is important to examine whether the health of older individuals will allow them to continue working and whether there is significant heterogeneity in the ability to work. Combining the Survey of Health, Ageing and Retirement in Europe (SHARE) with data from the Danish registers enables us to create a composite health index that includes an extensive range of health indicators. Utilising the health capacity to work approach, we estimate the health capacity to work among Danes aged 55 and above. We divide health capacity into physical and mental health. We investigate heterogeneity in health capacity across educational and occupational attainment. Substantial additional work capacity is found for older Danes. Depending on the type of health index applied, the health capacrk varies. There is evidence of a socio-economic gradient in work capacity. Results thereby show that policies that intend to utilise the additional work capacity should consider heterogeneity in health.

Highlights

We provide new evidence of the health capacity work in Denmark.

The combination of survey and register data allow for comprehensive health indices.

There is substantial additional health capacity to work.

There is variation across health indices.

There is variation across educational and occupational attainment.
Acute care pathway assessed through performance indicators during the COVID-19 pandemic in OECD countries (2020–2021): a scoping review
Authors: V. Carvalho Ana Sofia , Broekema Bente , Brito Fernandes Óscar , Klazinga Niek , Kringos Dionne
Published: January 2024

Background

The COVID-19 pandemic severely impacted care for non-COVID patients. Performance indicators to monitor acute care, timely reported and internationally accepted, lacked during the pandemic in OECD countries. This study aims to summarize the performance indicators available in the literature to monitor changes in the quality of acute care in OECD countries during the first year and a half of the pandemic (2020-July 2021) and to assess their trends.

Methods

Scoping review. Search in Embase and MEDLINE (07-07-2022). Acute care performance indicators and indicators related to acute general surgery were collected and collated following a care pathway approach. Indicators assessing identical clinical measures were grouped under a common indicator title. The trends from each group of indicators were collated (increase/decrease/stable).

Results

A total of 152 studies were included. 2354 indicators regarding general acute care and 301 indicators related to acute general surgery were included. Indicators focusing on pre-hospital services reported a decreasing trend in the volume of patients: from 225 indicators, 110 (49%) reported a decrease. An increasing trend in pre-hospital treatment times was reported by most of the indicators (n = 41;70%) and a decreasing trend in survival rates of out-of-hospital cardiac arrest (n = 61;75%). Concerning care provided in the emergency department, most of the indicators (n = 752;71%) showed a decreasing trend in admissions across all levels of urgency. Concerning the mortality rate after admission, most of the indicators (n = 23;53%) reported an increasing trend. The subset of indicators assessing acute general surgery showed a decreasing trend in the volume of patients (n = 50;49%), stability in clinical severity at admission (n = 36;53%), and in the volume of surgeries (n = 14;47%). Most of the indicators (n = 28;65%) reported no change in treatment approach and stable mortality rate (n = 11,69%).

Conclusion

This review signals relevant disruptions across the acute care pathway. A subset of general surgery performance indicators showed stability in most of the phases of the care pathway. These results highlight the relevance of assessing this care pathway more regularly and systematically across different clinical entities to monitor disruptions and to improve the resilience of emergency services during a crisis.
A time series driven model for early sepsis prediction based on transformer module
Authors: Tang Yan , Zhang Yu , Li Jiaxi
Published: January 2024

Sepsis remains a critical concern in intensive care units due to its high mortality rate. Early identification and intervention are paramount to improving patient outcomes. In this study, we have proposed predictive models for early sepsis prediction based on time-series data, utilizing both CNN-Transformer and LSTM-Transformer architectures. By collecting time-series data from patients at 4, 8, and 12 h prior to sepsis diagnosis and subjecting it to various network models for analysis and comparison. In contrast to traditional recurrent neural networks, our model exhibited a substantial improvement of approximately 20%. On average, our model demonstrated an accuracy of 0.964 (± 0.018), a precision of 0.956 (± 0.012), a recall of 0.967 (± 0.012), and an F1 score of 0.959 (± 0.014). Furthermore, by adjusting the time window, it was observed that the Transformer-based model demonstrated exceptional predictive capabilities, particularly within the earlier time window (i.e., 12 h before onset), thus holding significant promise for early clinical diagnosis and intervention. Besides, we employed the SHAP algorithm to visualize the weight distribution of different features, enhancing the interpretability of our model and facilitating early clinical diagnosis and intervention.
Feasibility of a reconfigured domestic violence and abuse training and support intervention responding to affected women, men, children and young people through primary care
Authors: Szilassy Eszter , Coope Caroline , Emsley Elizabeth , Williamson Emma , Barbosa Estela Capelas , Johnson Medina , Dowrick Anna , Feder Gene
Published: January 2024

Background

Identification in UK general practice of women affected by domestic violence and abuse (DVA) is increasing, but men and children/young people (CYP) are rarely identified and referred for specialist support. To address this gap, we collaborated with IRISi (UK social enterprise) to strengthen elements of the IRIS + intervention which included the identification of men, direct engagement with CYP, and improved guidance on responding to information received from other agencies. IRIS + was an adaptation of the national IRIS (Identification and Referral to Improve Safety) model focused on the needs of women victim-survivors of DVA. Without diminishing the responses to women, IRIS + also responded to the needs of men experiencing or perpetrating DVA, and CYP living with DVA and/or experiencing it in their own relationships. Our study tested the feasibility of the adapted IRIS + intervention in England and Wales between 2019–21.

Methods

We used mixed method analysis to triangulate data from various sources (pre/post intervention questionnaires with primary care clinicians; data extracted from medical records and DVA agencies; semi-structured interviews with clinicians, service providers and referred adults and children) to assess the feasibility and acceptability of the IRIS + intervention.

Results

The rate of referral for women doubled (21.6/year/practice) from the rate (9.29/year/practice) in the original IRIS trial. The intervention also enabled identification and direct referral of CYP (15% of total referrals) and men (mostly survivors, 10% of total referrals). Despite an increase in self-reported clinician preparedness to respond to all patient groups, the intervention generated a low number of men perpetrator referrals (2% of all referrals). GPs were the principal patient referrers. Over two-thirds of referred women and CYP and almost half of all referred men were directly supported by the service. Many CYP also received IRIS + support indirectly, via the referred parents. Men and CYP supported by IRIS + reported improved physical and mental health, wellbeing, and confidence.

Conclusions

Although the study showed acceptability and feasibility, there remains uncertainty about the effectiveness, cost-effectiveness, and scalability of IRIS + . Building on the success of this feasibility study, the next step should be trialling the effectiveness of IRIS + implementation to inform service implementation decisions.
Review: application of the Safety Attitudes Questionnaire (SAQ) in primary care - a systematic synthesis on validity, descriptive and comparative results, and variance across organisational units
Authors: Olesen Anne Estrup , Juhl Marie Haase , Deilkås Ellen Tveter , Kristensen Solvejg
Published: January 2024

Patient safety research has focused mostly on the hospital and acute care setting whereas assessments of patient safety climate in primary health care settings are warranted. Valid questionnaires as e.g., the Safety Attitudes Questionnaire (SAQ) may capture staff perceptions of patient safety climate but until now, an overview of the use of SAQ in primary care has not been systematically presented. Thus, the aim of this systematic review is to present an overview of SAQ used in primary care.

Methods The electronic databases: PubMed, Embase, Cinahl, PsycInfo and Web of Science were used to find studies that used any version of SAQ in primary care. Studies were excluded if only abstract or poster was available, as the information in abstract and posters was deemed insufficient. Commentaries and nonempirical studies (e.g., study protocols) were excluded. Only English manuscripts were included.

Results A total of 43 studies were included and 40 of them fell into four categories: 1) validation analysis, 2) descriptive analysis, 3) variance assessment and 4) intervention evaluation and were included in further analyses. Some studies fell into more than one of the four categories. Seventeen studies aimed to validate different versions of SAQ in a variety of settings and providers. Twenty-five studies from fourteen different countries reported descriptive findings of different versions of SAQ in a variety of settings. Most studies were conducted in primary health care centres, out-of-hours clinics, nursing homes and general practice focusing on greatly varying populations. One study was conducted in home care. Three studies investigated variance of SAQ scores. Only five studies used SAQ to assess the effects of interventions/events. These studies evaluated the effect of electronic medical record implementation, a comprehensive Unit-based Safety Program or COVID-19.

Conclusion The synthesis demonstrated that SAQ is valid for use in primary care, but it is important to adapt and validate the questionnaire to the specific setting and participants under investigation. Moreover, differences in SAQ factor scores were related to a variety of descriptive factors, that should be considered in future studies More studies, especially variance and intervention studies, are warranted in primary care.

Trial registration This systematic review was not registered in any register.
Associations between UGT1A1, SLCO1B1, SLCO1B3, BLVRA and HMOX1 polymorphisms and susceptibility to neonatal severe hyperbilirubinemia in Chinese Han population
Authors: Fan Juan , He Hua-Yun , Li Huan-Huan , Wu Pi-Liu , Tang Lei , Deng Bo-Yin , Dong Wen-Hui , Wang Jian-Hui
Published: January 2024

Background

Severe neonatal hyperbilirubinemia could lead to kernicterus and neonatal death. This study aimed to analyze the association between single nucleotide polymorphisms in genes involved in bilirubin metabolism and the incidence of severe hyperbilirubinemia.

Methods

A total of 144 neonates with severe hyperbilirubinemia and 50 neonates without or mild hyperbilirubinemia were enrolled in 3 institutions between 2019 and 2020. Twelve polymorphisms of 5 genes (UGT1A1, SLCO1B1, SLCO1B3, BLVRA, and HMOX1) were analyzed by PCR amplification of genomic DNA. Genotyping was performed using an improved multiplex ligation detection reaction technique based on ligase detection reaction.

Results

The frequencies of the A allele in UGT1A1-rs4148323 and the C allele in SLCO1B3-rs2417940 in the severe hyperbilirubinemia group (30.2% and 90.6%, respectively) were significantly higher than those in the controls (30.2% vs.13.0%, 90.6% vs. 78.0%, respectively, both p < 0.05). Haplotype analysis showed the ACG haplotype of UGT1A1 were associated with an increased hyperbilirubinemia risk (OR 3.122, p = 0.001), whereas the GCG haplotype was related to a reduced risk (OR 0.523, p = 0.018).

Conclusion

The frequencies of the A allele in rs4148323 and the C allele in rs2417940 are highly associated with the incidence of severe hyperbilirubinemia in Chinese Han neonates.

Trial registration

Trial registration number:ChiCTR1800020424; Date of registration:2018-12-29.
Psilocybin-assisted therapy for severe alcohol use disorder: protocol for a double-blind, randomized, placebo-controlled, 7-month parallel-group phase II superiority trial
Authors: Vanderijst Laetitia , Hever Felix , Buot Anne , Dauré Charles , Benoit Janaïna , Hanak Catherine , Veeser Johannes , Morgiève Margot , Campanella Salvatore , Kornreich Charles , Mallet Luc , Leys Christophe , Noël Xavier
Published: January 2024

Background

A significant number of individuals with alcohol use disorder remain unresponsive to currently available treatments, which calls for the development of new alternatives. In parallel, psilocybin-assisted therapy for alcohol use disorder has recently yielded promising preliminary results. Building on extant findings, the proposed study is set to evaluate the feasibility and preliminary clinical efficacy of psilocybin-assisted therapy when incorporated as an auxiliary intervention during inpatient rehabilitation for severe alcohol use disorder. Moreover, it intends to pinpoint the modifications in the two core neurocognitive systems underscored by dual-process models of addiction.

Methods

In this double-blind, randomized, placebo-controlled, 7-month parallel-group phase II superiority trial, 62 participants aged 21–64 years will be enrolled to undergo psilocybin-assisted therapy as part of a 4-week inpatient rehabilitation for severe alcohol use disorder. The experimental group will receive a high dose of psilocybin (30 mg), whereas the control group will receive an active placebo dose of psilocybin (5 mg), both within the context of a brief standardized psychotherapeutic intervention drawing from key elements of acceptance and commitment therapy. The primary clinical outcome is the between-group difference regarding the change in percentage of heavy drinking days from baseline to four weeks posthospital discharge, while safety and feasibility metrics will also be reported as primary outcomes. Key secondary assessments include between-group differences in terms of changes in (1) drinking behavior parameters up to six months posthospital discharge, (2) symptoms of depression, anxiety, trauma, and global functioning, (3) neuroplasticity and key neurocognitive mechanisms associated with addiction, and (4) psychological processes and alcohol-related parameters.

Discussion

The discussion outlines issues that might arise from our design.

Trial registration

EudraCT 2022-002369-14 and NCT06160232.