bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute Care Physical Therapy and Sickle Cell Disease
Authors: Reader Ben , Tysowsky Melana , Collins Andrew B. , Power-Hays Alexandra
Published: September 2022

Background and Purpose:

Vaso-occlusive crises (VOC) are the most common cause for hospitalization in children and adolescents with sickle cell disease (SCD) in the United States. Physical therapy interventions provide nonpharmacological pain management and help hospitalized patients maintain mobility and function, but little is known about their application to the unique pathophysiology of those with SCD. The purpose of this review is to summarize evidence relevant to the physical therapy management of children and adolescents hospitalized with VOC.

Methods:

A literature search of PubMed, Cochrane, CINAHL, and EMBASE databases was performed using key words relevant to physical therapy interventions for children and adolescents with SCD and acute pain.

Results:

Sixteen articles were included in this review. Interventions identified included heat, mobilization, transcutaneous electrical nerve stimulation, massage, yoga, mindfulness, breathing exercises, virtual reality, incentive spirometry, and patient/family education.

Conclusions:

Physical therapists may be able to aid in the acute pain management of patients with SCD. Current literature relies on small observational studies making generalization difficult. Future studies are critical to improve evidence-based physical therapy practice in this population.
Nano–Calcium Carbonate Affect the Respiratory and Function Through Inducing Oxidative Stress
Authors: Lyu Yi , Zhang Qian , Liu Yan , Zhang Wen-Ping , Tian Feng-Jie , Zhang Hui-Fang , Hu Bo-Hua , Feng Juan , Qian Yi , Jiang Yong , Zhang Pan-Hong , Ma Ning , Tang Shi-Chuan , Zheng Jin-Ping , Qiu Yu-Lan
Published: September 2022

Objective

The aim of the study is to investigate whether nano–calcium carbonate (nano-CaCO3) occupational exposure could induce adverse health effects in workers.

Methods

A cross-sectional study was conducted in a nano-CaCO3manufacturing plant in China. Then, we have studied the dynamic distribution of nano-CaCO3in nude mice and examined the oxidative damage biomarkers of subchronic administrated nano-CaCO3on Sprague-Dawley rats.

Results

The forced vital capacity (%) and the ratio of FEV1 to FVC is the rate of one second of workers were significantly decreased than unexposed individuals. Dynamic imaging in mice of fluorescence labeled nano-CaCO3showed relatively high uptake and slow washout in lung. Similar to population data, the decline in serum glutathione level and elevation in serum MDA were observed in nano-CaCO3–infected Sprague-Dawley rats.

Conclusions

We found that nano-CaCO3exposure may result in the poor pulmonary function in workers and lead to the changes of oxidative stress indexes.
Attenuated Cardiovascular Reactivity to Acute Psychological Stress Predicts Future Fatigue Symptoms in Truck Drivers
Authors: Guest Amber J. , Clemes Stacy A. , King James A. , Chen Yu-Ling , Ruettger Katharina , Sayyah Mohsen , Sherry Aron , Varela-Mato Veronica , Paine Nicola J.
Published: September 2022

Objectives

This study aimed to investigate the impact of a 6-month health intervention on truck drivers' cardiovascular reactivity to stress and whether cardiovascular reactivity was predictive of depression, anxiety, or fatigue symptoms at 6-month follow-up.

Methods

Two hundred thirty-eight truck drivers completed a 6-month cluster randomized controlled trial to increase physical activity and completed a stress protocol (Stroop and mirror-tracing tasks) with measurements of heart rate, systolic blood pressure, and diastolic blood pressure taken, alongside fatigue, anxiety, and depressive symptoms assessment. Measures were taken at 0 and 6 months.

Results

Analyses showed a negative relationship between 0-month diastolic blood pressure reactivity and 6-month persistent fatigue. Trends toward negative relationships between systolic blood pressure reactivity and future anxiety and fatigue symptoms at 6 months were evident.

Conclusions

Our findings may have serious implications, as fatigue can be a major cause of road traffic collisions in truck drivers.
Rapid-cycle deliberate practice telehealth as an integrative learning strategy in nurse practitioner education
Authors: Sheikh Kathleen R.
Published: September 2022

Telehealth is a way for clinicians to deliver care and for patients to access care via the internet. This method of health care delivery has become an expectation of nurse practitioner practice. Rapid-cycle deliberate practice (RCDP) is a technique grounded in cognitive load theory used to teach a sequence of predetermined skills to learners through purposeful skill augmentation and strategic repetition. Throughout the process, students receive feedback based on well-defined objectives. Material is processed from working memory into long-term memory in small portions with the intent to prevent working memory overload. Advanced practice physical assessment in-person simulation laboratory sessions were framed and focused using the RCDP model. In-person sessions were followed by telehealth simulations for the skill area. Both the in-person laboratory and online telehealth visits followed a similar framework: isolate the skill, baseline knowledge, measurable objectives, practice expectations, and evaluation. Leveled telehealth competencies and domain descriptors were used as a guide for the telehealth sessions. Using the RCDP model to facilitate student translation of physical assessment skills from an in-person venue to the telehealth care environment yielded encouraging potential to isolate and evaluate specific skills, address measurable objectives, and identify behaviors that encompass multiple competencies, developmental milestones, and levels of proficiency. The RCDP telehealth simulations showed promise in the education of nurse practitioner students to accomplish key telehealth health assessment behaviors and progression toward readiness for practice.
Cochlear Implantation After Intralabyrinthine Schwannoma Microsurgical Resection
Authors: Goates Andrew J. , Nassiri Ashley M. , Van Gompel Jamie J. , Carlson Matthew L.
Published: September 2022

Cochlear implantation after microsurgical resection of intralabyrinthine schwannomas has shown promising results in a limited number of small studies with safe and favorable outcomes. Cochlear implantation is a mainstream treatment for advanced bilateral sensorineural hearing loss and, more recently, has been applied to patients with single-sided deafness.

The case presented is a 66-year-old gentleman with a history of progressive right-sided sensorineural hearing loss and bothersome tinnitus with a right intralabyrinthine schwannoma involving the semicircular canals, vestibule, and basal turn of the cochlea. The authors describe concomitant cochlear implantation after microsurgical resection of an intralabyrinthine schwannoma. Intralabyrinthine schwannomas represent an uncommon subtype of benign tumors arising from the terminal branches of the vestibulocochlear nerve. Symptoms often include sensorineural hearing loss, dizziness, and tinnitus, and in this location, symptoms often arise at a small tumor size. In this featured case, we present a patient who underwent gross total tumor resection and cochlear implantation for hearing rehabilitation and treatment of tinnitus. Six months after surgery, the patient achieved good device performance, scoring 46% on consonant–nucleus–consonant word testing and 66% on AzBio sentence testing, and subjective improvement in his tinnitus.
Tissue factor-dependent coagulation activation in intracranial neoplasms: a comparative study
Authors: Bierwagen Maciej , Wierciński Marcin , Góralczyk Krzysztof , Góralczyk Barbara , Janczarek Andrzej , Kulwas Arleta , Rość Danuta , Ruszkowska-Ciastek Barbara
Published: September 2022

The aim of the study was to investigate the concentration and activity of tissue factor (TF) and Tissue factor pathway inhibitor (TFPI) as well as the concentration of thrombin–antithrombin (TAT) complexes in patients with primary and metastatic intracranial neoplasms. The study included 69 patients with an average age of 62 years. Twenty-one patients were diagnosed with gliomas, 18 meningioma stage II (M) patients, and 30 metastatic brain tumour cases (Meta). The control group consisted of 30 individuals with a mean age of 57 years. In the plasma of all the participants and in tumour tissue-derived homogenate, the concentrations and activities of TF, TFPI, the concentration of TAT complexes and the concentration of total protein were measured. The results were converted per 1 mg of protein. The concentration of TF was over 80 times higher in the tumour tissue-derived homogenate in respect to patients’ plasma levels. Plasma TF activity in intracranial cancer patients was almost six times higher compared with noncancer counterparts, while in the tumour tissue-derived homogenate it was more than 14 times higher than in the intracranial cancer patients’ plasma, whereas the concentration of TFPI in the tumour tissue-derived homogenate was significantly lower than in the patients’ plasma. However, a significantly higher TFPI activity in the tumour tissue derived than in the patients’ plasma was reported. The high concentration and activity of TF, along with the coexisting low concentration and activity of TFPI in the plasma of intracranial tumour patients, is associated with a higher prothrombotic risk in these patients.
Prenatal diagnosis for hemophilia A (intron 22 inversion) reveals a rare association with Klinefelter syndrome with diagnostic difficulties in molecular interpretation
Authors: Sharma Ritika , Jamwal Manu , Senee Harikishan , Kaur Jasbir , Kumar Narender , Arora Aashima , Gainder Shalini , Ahluwalia Jasmina , Das Reena
Published: September 2022

Hemophilia A is an X-linked recessive disorder caused by genetic abnormalities in the F8. Klinefelter syndrome is sex chromosome aneuploidy caused by nondisjunction during meiosis in the germ cells or mitotic cell divisions in the early embryonic cells. We here report an intriguing case of a prenatal diagnosis where a rare association of hemophilia A and Klinefelter syndrome was found in a fetus. This case highlights the diagnostic difficulty where the inverse-PCR for intron 22 inversion defect leading to hemophilia A did not amplify. Indirect molecular testing was done using multiallelic extragenic variable number tandem repeat (VNTR) DXS52 (St14) and polymorphic markers. The interpretation was further complicated by the presence of Klinefelter syndrome. This case highlights the challenges faced when such rare combinations are found during prenatal diagnosis.
Patients with severe coronavirus disease 2019 have high frequency of factor 5 Leiden and prothrombin gene mutations
Authors: Avcı Burcu Altındağ , Doğan Mustafa , Batar Bahadır , Yıldırım İlker , Serdal Elif , Gezer Sümbül , Onar Çağatay L. , Akpınar Seval , Turgut Burhan
Published: September 2022

We investigated the frequency of factor 5 Leiden (FVL) and prothrombin gene (PTG) mutations in patients with severe coronavirus disease 2019 (COVID-19). Our primary aim is to reveal whether these mutations are associated with severity of disease and mortality. A total of 249 patients were included in this cross-sectional study. Severe COVID-19 cases (with oxygen saturation of less than 90 mmHg and who received ventilation support invasively or noninvasively) were included. FVL and PTG mutations were identified by real time- PCR technique. Frequency of mutations for FVL was 11.7%, whereas for PTG was 3.5%. The frequency of FVL and PTG's mutations in our patient group was found to be significantly higher than the normal population (P < 0.0001, 0.004, respectively). There was no difference in the frequency of mutations of FVL and PTG between the patients ventilated – invasively and noninvasively. There was also no difference in D-dimer, ferritin, fibrinogen, ex status, and entubational status between the groups of FVL and PTG mutated and wild-type. To the best of our knowledge, it is the first time that we have examined the frequencies of FVL and PGM's mutations in severe COVID-19 disease on such a large scale. The frequencies of both mutations in severe COVID-19 patients were higher than in the healthy population. We believe that studies prospectively designed, including asymptomatic and mild COVID-19 patients, will provide more comprehensive information on the subject.
The correlation between neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with nonalcoholic fatty liver disease: a cross-sectional study
Authors: Zhou Yuge , Tian Ning , Li Peiling , He Yanting , Tong Lijun , Xie Weining
Published: September 2022

Objective

The aim of this study is to investigate the correlation between neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with nonalcoholic fatty liver disease (NAFLD).

Methods

All subjects underwent medical check-ups, which included the measurement of basic clinical, biochemical tests and imaging tests. Univariate and multivariate logistic regression models and piece-wise linear regression were used to assess the relationship between NLR and PLR with NAFLD.

Results

All participants were divided into two groups: the Non-NAFLD group and the NAFLD group. Univariate analysis model indicated PLR was negatively correlated with NAFLD (P < 0.001) and NLR was not significantly associated with NAFLD (P > 0.05). Multiple logistic regression showed that no correlation between NLR and PLR with NAFLD after adjusting all covariates (P > 0.05). Interestingly, a nonlinear association was detected between NLR and PLR with NAFLD by piece-wise linear regression adjusting for all confounding factors. The inflection points of NLR and PLR were 1.23 and 42.29, respectively. On the left side of the inflection point (NLR < 1.23), a positive correlation was detected between NLR and NAFLD (β = 2.35, 95% CI: 1.20~4.61, P = 0.013). And PLR was found to be negatively associated with NAFLD on the right side of the inflection point (β = 0.99, 95% CI: 0.98~0.99, P < 0.001).

Conclusion

This study demonstrated that the relationship between NLR and PLR with NAFLD was nonlinear after adjusting for potential confounding factors. The result suggested that PLR ≥ 42.29 might be a protective factor of NAFLD, while NLR < 1.23 might be a risk factor of NAFLD.
Screening for colorectal cancer: awareness and adherence among Italian women
Authors: Pelullo Concetta Paola , Torsiello Livio , Della Polla Giorgia , Di Giuseppe Gabriella , Pavia Maria
Published: September 2022

Objective

To evaluate women’s awareness about and attendance to colorectal cancer (CRC) screening programs in an area of Southern Italy, and to investigate related potential determinants.

Methods

The survey was conducted among women through a self-administered questionnaire.

Results

Overall, only 20.3% of respondents knew the three cancer screening tests offered to women and this knowledge, at the multivariate logistic regression analysis, resulted to be significantly higher in women who knew the two most common cancers in females, in those who were graduated, had a personal or family history of cancer, and had been informed about cancer prevention by physicians. Only 29.2% of women had ever undergone FOBT, 25% for screening purposes and, of these, 76.4% in the previous 2 years. Among those who had never undergone FOBT, 28.9% reported they had not been invited to attend, 34.5% that the test had not been prescribed by anyone, and 19.1% had no time to undergo. The results of the multivariate logistic regression model revealed that significant determinants of having undergone FOBT for screening purposes were having undergone mammography, having at least one chronic disease, not reporting alcohol consumption and having been informed about cancer screening by physicians.

Conclusion

Our findings have revealed a concerning low awareness about and adherence to CRC screening in women and have highlighted the fundamental role of healthcare workers and of enabling factors in the decision process. Interventions should be directed to increasing awareness, and to promote cancer prevention screening pathways more centered on women’s health needs and convenience.
Continuous clinical remission with biologics in ulcerative colitis: the ‘AURORA’ comparison study
Authors: Cassinotti Andrea , Mezzina Nicolò , De Silvestri Annalisa , Di Paolo Dhanai , Lenti Marco Vincenzo , Bezzio Cristina , Stradella Davide , Mauri Martina , Zadro Valentina , Ricci Chiara , Casini Valentina , Radice Elisa , Massari Alessandro , Maconi Giovanni , Saibeni Simone , Caprioli Flavio , Tari Roberto , Fichera Maria , Cortelezzi Claudio Camillo , Parravicini Marco , Tinelli Carmine , Testoni Pier Alberto , Pace Fabio , Segato Sergio , Invernizzi Pietro , Occhipinti Pietro , Manes Gianpiero , Di Sabatino Antonio , Pastorelli Luca , Vecchi Maurizio , Ardizzone Sandro
Published: September 2022

Objectives

Comparative trials among biological drugs for the treatment of ulcerative colitis (UC) provided conflicting results. After patent expire of infliximab originator, adalimumab, infliximab biosimilar, golimumab and vedolizumab have been approved in Italy.

We compared the efficacy of these four biologics in UC according to the concept of continuous clinical remission (CCR).

Methods

In a retrospective, multicentre study, all UC patients treated with adalimumab, infliximab biosimilar, golimumab or vedolizumab between 2014 and 2019 were included. All drugs were compared to each other according to the 1-year CCR rate, defined as Mayo partial score ≤2, with bleeding subscore = 0, without any relapse or optimization with dose escalation, topical treatments or steroid use after first clinical remission.

Results

Four-hundred sixteen patients (adalimumab = 90, infliximab biosimilar = 105, golimumab = 79, vedolizumab = 142) were included. CCR was achieved in similar percentages among the groups (33%, 37%, 28%, 37%, respectively). All drugs were equivalent in biologic-naive patients, while vedolizumab was better than a second anti-TNFα in prior anti-TNFα agent failures. No differences were found according to type of adverse events or severe adverse events.

Conclusions

Based on a strict definition of clinical remission, all biologics appear equally effective at 1 year. Changing to vedolizumab is more effective than switching to another anti-TNFα in TNFα failures.
Real-world evidence of quality of life improvement in patients with distal ulcerative colitis treated by mesalazine: the Quartz study
Authors: Paupard Thierry , Gonzalez Florent , Caron Bénédicte , Siproudhis Laurent , Peyrin-Biroulet Laurent
Published: September 2022

Background

Distal ulcerative colitis (UC) is responsible for distressing symptoms and reduces quality of life (QoL). Oral and topical formulations of 5-amino-salicylic acid are the first line therapy for mild to moderate distal UC.

Objective

Our aim was to evaluate the impact of mesalazine treatment for mild to moderate ulcerative proctitis and proctosigmoiditis on patient QoL.

Methods

Ninety-three patients with mild to moderate ulcerative proctitis and proctosigmoiditis, initiating a treatment with Pentasa, were prospectively included. The primary endpoint was the change from baseline to W8 in patient health-related QoL (HRQoL) as measured by the Short Inflammatory Bowel Disease Questionnaire (SIBDQ) total score.

Results

More than 80% of patients were prescribed with a rectal formulation, either alone (47.9%) or with an oral formulation (35.1%), and 17.0% of patients were prescribed oral formulation alone. Mean SIBDQ score was improved at W8 in patients affected with mild and moderate disease (P < 0.001 versus baseline in both groups, as well as in patients who achieved clinical remission (P < 0.001). Patients who achieved clinical remission at W8 reached a mean change of +6.7 (±7.1), whereas those who did not achieve clinical remission had a mean change of +1.1 (±8.9). Seventy-five per cent of patients had an improvement of their disability index at W8. Fecal incontinence was also improved at W8.

Conclusion

HRQoL measuring with the SIBDQ is proportionally related to disease activity in patients with distal UC treated with mesalazine.
Risk prediction model for early postoperative death in patients with hepatocellular carcinoma: a retrospective study based on random forest algorithm and logistic regression
Authors: Gao Yang , Wu Fu-gui , Guo Wen-bo , Zheng Hao , Zhang Lu , Chen Xiu-li , Li Man
Published: September 2022

Background

At present, little is known about the risk factors of early postoperative death in patients with hepatocellular carcinoma (HCC).

Methods

We collected the data of patients who were diagnosed with primary liver cancer between 2010 and 2015 in the Surveillance, Epidemiology, and End Results database and further allocated them to the training set and validation set. Univariate and multivariate logistic regression analysis was used to determine the independent influencing factors of early postoperative death of HCC patients. Random forest and Least absolute shrinkage and selection operator regression analysis were used to screen out vital variables for the construction of the nomogram. It was evaluated by receiver operating characteristic curve, calibration curve and decision curve analysis.

Results

A total of 4154 patients were selected in this process, including 2647 patients with postoperative early death (outcome1) and 1507 patients with liver cancer-specific postoperative early death (outcome2). Surgery method, age category, marital status and tumor grade were the risk factors for early postoperative death. As for the liver cancer-specific early postoperative death, AJCC, surgery method, chemotherapy and tumor grade were independent prognostic factors. Early death and liver cancer-specific early death nomograms have an area under curves of 0.643 and 0.679 in the training set, respectively, and 0.617 and 0.688 in the validation set. The calibration curve and decision curve analysis shows that the nomograms have good performance.

Conclusion

This model provides an intuitive and practical tool for future studies based on large-scale cohorts by exploring the risk factors of early death in patients with HCCs undergoing surgery.
Prognostic value and morphological findings of overexpression of glypican-3 in hepatocellular carcinoma
Authors: Karaoğullarindan Ümit , Gümürdülü Yüksel , Üsküdar Oguz , Odabaş Emre , Güler Hasan Selim , Tozluklu Nur , Bağir Emine , Kuran Sedef
Published: September 2022

Objectives

Hepatocellular carcinoma (HCC) is the seventh most common cancer all worldwide and is second in cancer-related deaths. In HCC, whose prognosis is still not good despite current treatments, there is a need for prognostic markers as well as early diagnosis. Glypican (GPC)-3 has been proposed as a potential serologic and histochemical marker specific to HCC. This study aimed to determine the relationship between GPC3 overexpression and HCC prognosis and clinicomorphologic features.

Materials and methods

In total 152 patients who were diagnosed as a result of hepatectomy, lobectomy or liver transplantation were enrolled. The patients were divided into two groups, GPC3-positive (overexpression) (>10%) and GPC3-negative (<10%). The demographic data of the patients, tumor characteristics and survival times were recorded.

Results

Survival was significantly lower in the GPC3+ group. In the multivariate analysis, hepatitis C, AFP, tumor number, tumor focality, portal vein tumor thrombosis and GLP3 positivity were found to be independent risk factors for survival.

Conclusion

Our study shows that GPC3 overexpression is a poor prognostic factor in HCC. GPC3 positivity were found to be an independent risk factor for survival.
“Long-term follow-up and prognosis of celiac hepatitis”
Authors: Garrido Isabel , Liberal Rodrigo , Peixoto Armando , Macedo Guilherme
Published: September 2022

Introduction

Celiac disease has been associated with abnormal liver function tests at diagnosis that usually resolve with a gluten-free diet (GFD). The aim of this study was to assess the evolution of liver involvement and possible long-term complications in patients on a GFD.

Methods

Retrospective and single-center study, which included all individuals with Celiac disease followed in specialized consultation in a tertiary referral hospital.

Results

A total of 162 patients were included, most of them female (77.8%) with a median age of 24 years (IQR, 7–39). Seventy-four (45.7%) patients had abnormal liver function tests at diagnosis. These individuals had higher anti-tissue transglutaminase IgA (tTG-IgA) antibody titers (126 vs. 29 IU/L; P = 0.003). There were no significant differences in the Marsh classification (P = 0.599). During follow-up, most celiac hepatitis patients had normalization of liver function tests and tTG-IgA antibodies. At the last follow-up, all the patients had fibrosis-4 index <2.4 and an aspartate aminotransferase-to-platelet ratio index score <0.6. Vibration-controlled transient elastography showed values <6.4 kPa in all cases. On the other hand, it was found that 42.9% of the individuals had a controlled attenuation parameter >206.5 db/m.

Conclusions

In our cohort, liver function tests normalized in the vast majority of celiac hepatitis patients on a GFD, with no progression to chronic liver disease. It should be noted the high number of individuals who present hepatic steatosis during follow-up, which may be related to a diet that tends to be hyperlipidemic and hypercaloric.
Simulated daily readout for maintaining nuclear medicine education in residency training amidst declining case volume: evidence from the COVID-19 pandemic
Authors: Jaroonvanichkul Vorapol , Leksuwankun Surachai , Vachatimanont Sira
Published: September 2022

Background

Simulated daily readout (SDR) is a teaching initiative in radiology and nuclear medicine developed to simulate a resident’s experience during periods of case volume reduction. SDR was employed by many training centers during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to evaluate the perception of radiology residents on the effectiveness of SDR.

Method

The SDR was conducted in the nuclear medicine rotations from 2019 to 2020 during the shutdown of the radionuclide imaging facilities using a combination of strategies including case selection, assignment, reporting and feedback. A brief 8-item questionnaire with Likert scale values was completed by radiology residents who participated in the SDR-based nuclear medicine rotations.

Results

Thirty-five of 54 residents returned the questionnaire. The majority of residents affirmed the negative impact of the reduction in case volume on their training experiences and perceived that SDR could alleviate the effects. The SDR strategies perceived as more effective were targeted case selection, in-advanced assignment, verbal interpretation and reporting, and verbal feedback.

Conclusion

The radiology residents perceived the SDR as an effective tool to preserve their training experiences. The SDR has the potential to be a useful initiative when teaching centers face the threat of declining case volume.
Gastrointestinal symptoms in COVID-19: the long and the short of it
Authors: Freedberg Daniel E. , Chang Lin
Published: September 2022

Purpose of review

A large and growing number of patients have persistent gastrointestinal symptoms that they attribute to COVID-19. SARS-CoV-2, the virus that causes COVID-19, replicates within the gut and acute COVID-19 is associated with alteration of the gut microbiome. This article reviews recent observational data related to gastrointestinal symptoms in ‘long COVID’ and discusses pathophysiologic mechanisms that might explain persistent post-COVID gastrointestinal symptoms.

Recent findings

Gastrointestinal symptoms are present in half of the patients with acute COVID-19, persist 6 months after COVID-19 in 10–25% of patients, and are rated as the most bothersome symptom in 11% of all patients. These symptoms include heartburn, constipation, diarrhoea and abdominal pain and decline in prevalence with the passage of time. Long COVID gastrointestinal symptoms are associated with mental health symptoms (anxiety and depression) that predate COVID-19 and also with mental health symptoms that are concurrent, after recovery from COVID-19. The cause of long COVID gastrointestinal symptoms is unknown and hypotheses include the SARS-CoV-2 virus itself, which infects the gastrointestinal tract; COVID-19, which can be accompanied by gut microbiome changes, a profound systemic inflammatory response and critical illness; and/or effects of pandemic stress on gastrointestinal function and symptom perception, which may be unrelated to either SARS-CoV-2 or to COVID-19.

New, persistent gastrointestinal symptoms are commonly reported after recovery from COVID-19. The pathophysiology of these symptoms is unknown but likely to be multifactorial.
Management of upper gastrointestinal symptoms in patients with autoimmune gastritis
Authors: Cifuentes Juan D. Gomez , Sparkman Jordan , Graham David Y.
Published: September 2022

Purpose of review

Autoimmune gastritis is characterized by atrophy of acid secreting parietal cells resulting in achlorhydria. Upper gastrointestinal symptoms are common in autoimmune gastritis and frequently result in prescriptions for acid suppressant medications despite the inability of the stomach to secrete acid. Evidence-based recommendations for management of gastrointestinal symptoms in autoimmune gastritis are lacking.

Recent findings

The most common symptoms in patients with autoimmune gastritis are dyspepsia, heartburn, and regurgitation. Gastroesophageal reflux should be confirmed by pH-impedance testing and is typically weakly acid or alkaline. Therapy for reflux focuses on mechanical prevention of reflux (i.e., elevation of the head of the bed and alginates) or when severe, antireflux surgery. The etiology of dyspepsia in autoimmune gastritis is unclear and largely unstudied. In the first half of the 20th century, oral administration of acid to “aid digestion” was widely used with reported success. However, randomized, placebo-controlled trials are lacking. Here, we provide suggestions for attempting gastric acidification therapy.

Upper GI symptoms are common in autoimmune gastritis. Their pathogenesis and therapy remain incompletely understood. Acid suppressant medications are useless and should be discontinued. A trial of acid replacement therapy is recommended especially in the form of placebo-controlled trials.
Paediatric mandibular distraction: optimizing outcomes
Authors: Discolo Christopher
Published: September 2022

Purpose of review

The purpose of this review is to summarize current evidence surrounding the use of mandibular distraction osteogenesis in children and to highlight recent advances in our knowledge of this subject.

Recent findings

Distraction osteogenesis of the mandible has gained in popularity since its initial description about 30 years ago. Its efficacy and safety have been well described. More recently, proper patient selection, technique modifications and long-term outcomes have been the subject of much discussion around this revolutionary technique.

Distraction osteogenesis of the mandible is a powerful tool for surgeons. Technological advances and high-quality research have allowed for optimization of this technique within the field of craniomaxillofacial surgery.
Ambulatory Care Nurse-Sensitive Indicators
Authors: Siaki Leilani A. , Patrician Patricia A. , Loan Lori A. , Matlock Ann Marie , Start Rachel E. , Gardner Cubby L. , McCarthy Mary S.
Published: September 2022

Background/Purpose:

Meeting recommendations that nurses should partner in leading health care change is hampered by the lack of ambulatory care nurse-sensitive indicators (ACNSIs). This scoping review was conducted to identify evidence regarding ACNSI identification, development, implementation, and benchmarking.

Methods:

Following the PRISMA-ScR reporting guide, we performed PubMed/MEDLINE, CINAHL, and Cochrane Library searches for the period January 2006 to March 2021.

Results:

Twelve of the 1984 articles from 6 countries met inclusion criteria. All focused on identifying, developing/pilot testing indicators, and included structure, process, and outcome indicators. Seven articles were level II and all were at least grade B quality. Leverage points involved leadership support, automated data extraction infrastructure, and validating links between nurses' roles/actions and patient outcomes.

Conclusions:

While high-quality work is ongoing to identify clinically meaningful and feasible ACNSIs, knowledge in this field remains underdeveloped. Prioritizing this work is imperative to address gaps and facilitate national strategic health care goals.
Neonatal Nurses' Perceptions and Needs of End-of-Life Care Practice
Authors: Shattnawi Khulood Kayed , Younis Bayan Jehad , Omran Suha Mohammad
Published: September 2022

End-of-life (EOL) care for newborns is challenging and requires well-prepared nurses to provide the best care for the dying baby and to prepare and support parents during such a difficult experience. This study aimed to explore Jordanian neonatal intensive care unit nurses' perceptions and needs regarding the provision of EOL care. This study used an exploratory descriptive qualitative approach and was conducted among a sample of 12 Jordanian neonatal intensive care unit nurses. Semistructured interviews were conducted to allow the nurses to describe their personal experiences and express their needs related to the provision of EOL care. Two main themes and 6 subthemes emerged from the analysis process. Main themes were (1) the challenges related to the provision of EOL care, and (2) nurses' needs: what matters most. The findings of this study shed light on neonatal care unit nurses' experiences and needs related to the provision of EOL care. The results of this study may be used to develop EOL care guidelines, programs, and protocols to be applied in intensive care units.
Differences in Guilt, Shame, Self-Anger, and Suicide Cognitions Based on Recent Suicide Ideation and Lifetime Suicide Attempt History
Authors: Szeto Edwin H. , Ammendola Ennio , Starkey Austin , Hay Jarrod , McClung James G. , Bryan Craig J.
Published: September 2022

Suicide risk factors such as hopelessness and psychiatric disorders can predict suicide ideation (SI) but cannot distinguish between those with SI and those who attempt suicide (SA). The fluid vulnerability theory of suicide posits that a person's activation of the suicidal mode is predicated on one's predisposition, triggers, and baseline/acute risks. This study compared guilt, shame, self-anger, and suicidal beliefs based on recent SI and lifetime SA. In a total of 2222 primary care patients in this cross-sectional, observational study reported no recent SI or lifetime SA (SI−SA−), 161 reported recent SI only (SI−SA+), 145 reported lifetime SA only (SI+SA−), and 56 reported both recent SI and lifetime SA (SI+SA+). Kruskal-Wallis test showed that the four risk factors were the highest for SI+SA+, followed by SI+SA−, then SI−SA+, and lastly SI−SA−. The study shows that risk factors may be worse in those with recent SI than those with SA history.
Magnet® Empirical Outcomes
Authors: Petto Pamela N. , Tosh Staci L. , Wentzel Karen R.
Published: September 2022

Healthcare organizations are challenged to demonstrate sustainability of quality outcomes within an ever-changing healthcare environment. The Magnet® model and empirical outcomes component provides a framework for demonstrating improvements in quality outcomes and is a foundation for creating professional nursing care environments to support sustainability. Within this high-performing professional nursing care environment, nursing leaders are able to engage in key strategies to enhance sustainability of quality outcomes once achieved.
Meaningful Recognition
Authors: Zimmermann Deborah
Published: September 2022

Meaningful recognition is powerful and tied to purpose. As nurses, we are motivated by our ability to contribute and make a difference in our patients' lives. As leaders, we can buffer the negative effects of burnout, foster a positive work environment, and cultivate a culture of gratitude and trust by creating and sustaining a culture of recognition.
The Effect of Career Plateauing as a Mediating Factor on Nurses' Job Satisfaction and Promotability
Authors: Farghaly Abdelaliem Sally Mohammed , Ibrahim El-Sayed Ahmed Abdelwahab
Published: September 2022

AIM

The aim of this study was to investigate the effect of career plateau as a mediating factor on nurses' job satisfaction and promotability.

BACKGROUND

A nurse's career, as well as other professionals, may arrive at a point where further hierarchical development is limited. Nurses may remain longer than expected in the same position within an organization and may be plateaued, resulting in career dissatisfaction, job dissatisfaction, and turnover.

METHODS

This is a descriptive correlational study. Two hundred twenty-one nurses were recruited from 1 university hospital in Egypt. Respondents completed the self-administered, printed questionnaires. Measures included career plateau, job satisfaction, and promotability questionnaires. Findings were investigated via descriptive and inferential statistics as well as structured equation modeling to examine the mediating effect of career plateauing on job satisfaction and promotability.

RESULTS

The mean scores of job satisfaction, career plateauing, and promotability were 3.09 ± 0.71, 3.75 ± 0.43, and 3.70 ± 0.53, respectively. Data revealed that nurses' career plateauing accounted for 34% and 18% of the variance of their job satisfaction and promotability, respectively.

CONCLUSION

Career plateauing is a significant determinant of nurses' job satisfaction and promotability.
Dental Age Assessment of United States Black and White Children
Authors: Collier Shanetha L. , Lewis James M. , Kasper Kathleen A. , Marks Murray K. , Heidel R. Eric
Published: September 2022

Medicolegal authorities use forensic dental age assessment of children to establish a biologic profile to assist in human identification, answer questions related to immigration, and answer questions used to substantiate eligibility for social benefits. The goal of this study was to assess the performance reliability of the child dental age assessment data previously published for White and Black children in the United States. A total of 432 dental panoramic radiographs were obtained from 3 geographic locations in the United States: Memphis, Tennessee, Knoxville, Tennessee, and Saint Louis, Missouri. Radiographs were staged, and the estimated age was calculated using the previously published data. Multiple age assessments were conducted to determine the effect of excluding certain teeth on estimated age. The results indicated estimated ages using the previously published reference data set were accurate and concordant with known chronologic age across the ancestral, sex, and geographic categories. The results also indicated that the known chronologic age fell within one standard deviation of the estimated age more than the statistical expectation for most categories. Excluding canines provided the most accurate estimation of known chronologic age.
A Novel Approach for Fluoroscopic Guided Intra-Articular Hip Injections: Technique Description and Case Series
Authors: Santana De Los Santos Javier Antonio , Cross Aaron , Castaneda Pablo , Sherman Andrew L.
Published: September 2022

Fluoroscopic guided intra-articular hip injections generally utilize a standard anterior-posterior (AP) view. However, this approach can expose patients to inadvertent femoral nerve or vessel infiltration due to the proximity of the neurovascular bundle to the joint space. This case-series study describes a novel technique using fluoroscopic ipsilateral oblique angulation and caudal tilt of the image intensifier. With this view, the clinician can advance the needle in a lateral to medial trajectory to obtain intra-articular access and minimize the risk of complications. This method was performed in five patients with refractory chronic hip osteoarthritis, which resulted in notable pain improvements and no reported adverse events. The suggested technique could provide a safer alternative to the AP imaging technique for intra-articular hip injections by avoiding the femoral neurovascular bundle, limiting needle repositioning, and offering a satisfactory post-procedural analgesic effect.
Bmp5 Mutation Alters mRNA Expression During External Ear Development
Authors: Liu Wei , Lin Lin , Sun Yiwei , Jin Shengyang , Yang Qinghua , Jiang Haiyue
Published: September 2022

To understand changes in gene regulation and mRNA expression in external ear development, we used a bone morphogenetic protein 5 (BMP5) short-ear mouse model. External ear tissues at E15.5 and E17.5 were collected, and mRNA expression profiles were analyzed. Upregulated and downregulated mRNA expression was identified using find_circ and CIRI2 software. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed using the differentially expressed mRNAs. Alterations in related signal pathways were identified from the upregulated and downregulated mRNA transcripts. The results showed a correlation between the mRNA expression during external ear development in BMP5 short-ear mice, including key regulatory mRNA changes after point mutations of the Bmp5 gene. This study provides evidence for the mechanism underlying mRNA regulation during external ear development. Changes in mRNA expression profiles also provide clues for future studies regarding the regulatory mechanisms underlying external ear development.
FLUOROFENIDONE ATTENUATES PULMONARY INFLAMMATION AND FIBROSIS BY INHIBITING THE IL-11/MEK/ERK SIGNALING PATHWAY
Authors: Song Cheng , Liu Xiaofan , Tan Weijun , Guo Xiaoqun , Mao Yahui , Zhou Qi , Geng Shuang , Hu Yi
Published: September 2022

Idiopathic pulmonary fibrosis is defined as a specific form of chronic, progressive fibrosing interstitial pneumonia of unknown cause. Interleukin (IL)-11 plays an important role in the pathogenesis of idiopathic pulmonary fibrosis. In this study, we explore whether a potential antifibrotic agent fluorofenidone (FD) exerts its anti-inflammatory and antifibrotic effects through suppressing activation of the IL-11/MEK/ERK signaling pathway in vivo and in vitro. Male C57BL/6 J mice were intratracheally injected with bleomycin or saline. Fluorofenidone was administered throughout the course of the experiment. Lung tissue sections were stained with hemotoxylin and eosin, and Masson trichrome. Cytokines were measured using the enzyme-linked immunosorbent assay. The α-smooth muscle actin (α-SMA), fibronectin, and collagen I were measured using immunohistochemistry, and the phosphorylated extracellular signal–regulated kinase, phosphorylated mitogen-activated protein kinase, IL-11RA, and gp130 were measured using Western blot. The RAW264.7 cells and the normal human lung fibroblasts were treated with IL-11 and/or FD, IL-11RA–siRNA, or MEK inhibitor. The expressions of phosphorylated extracellular signal–regulated kinase, phosphorylated mitogen-activated protein kinase, IL-11RA, gp130, α-SMA, fibronectin, and collagen I were measured using Western blot and/or real-time polymerase chain reaction, and the cytokines were measured using enzyme-linked immunosorbent assay. Results showed that FD markedly reduced the expressions of IL-8, IL-18, IL-11, monocyte chemotactic protein-1, α-SMA, fibronectin, and collagen I in mice lung tissues. In addition, FD attenuated IL-11–induced expressions of α-SMA, fibronectin, and collagen I and inhibited IL-11RA, gp130, and phosphorylation of the ERK and MEK protein expression, as well as reduced the expressions of IL-8, IL-18, and monocyte chemotactic protein-1 in vitro. This study demonstrated that FD attenuated bleomycin-induced pulmonary inflammation and fibrosis in mice by inhibiting the IL-11/MEK/ERK signaling pathway.
Comparison of Various Predictive Energy Equations for Female University Students With Measured Basal Metabolic Rate
Authors: Meseri Reci , Küçükerdönmez Özge , Akder Rana Nagihan
Published: September 2022

The aim of this study was to compare basal metabolic rate (BMR) calculated with various equations and BMR measured using an indirect calorimeter. The study was carried out on second-year university female students (n = 48) with a body mass index of less than 30. Indirect calorimetry with a ventilated hood was accepted as the gold standard and 11 predictive equations were used. Among the equations, Mifflin-St Jeor had the highest correlation (r = 0.435), but Bernstein (66.7%) and Owen (56.3%) were the most accurate equations. According to Bland-Altman analysis, the lowest bias and the highest explanation were obtained with the Bernstein and Owen equations. More comprehensive studies are needed in different groups to develop new equations with higher accuracy.
The Benefit of Supplemental Vitamin E to Reduce Radiation-Induced Oral Side Effects in Head and Neck Cancer
Authors: Lutes Christine , Samavat Hamed , Parker Anna , Zelig Rena
Published: September 2022

Antioxidant use during oncology treatment is controversial. Inconsistent research indicates that antioxidant supplementation can be both beneficial and harmful. The purpose of this review is to evaluate the recently published literature to determine whether oral supplementation with the antioxidant vitamin E is beneficial for reducing common side effects of radiation therapy in adults diagnosed with head and neck cancer. Three studies demonstrated supplementation can be effective in reducing side effects without compromising locoregional control, disease-free survival, or overall survival. Larger studies are needed to determine the optimal dose and duration of supplementation and the effectiveness of vitamin E as monotherapy.
Impact of Prebiotics, Probiotics, and Synbiotics on Stool Output, Mortality, and Recovery in the Critically Ill
Authors: Chin Haley J. , Yu Zhiping
Published: September 2022

This study reviewed the research published between 2010 and 2020 on application and usage of prebiotics, probiotics, and synbiotics on stool output, mortality, and recovery in critically ill patients. A total of 15 articles were retrieved and 11 were identified for review. Among studies addressing stool output, 4 of 7 reported improved outcomes. No statistically significant effect of the intervention was seen in 5 studies addressing mortality. Concerning elements of recovery, positive evidence was seen in the areas of return to gut function, time on mechanical ventilation, time to ventilator weaning, and length of stay in intensive care unit and/or hospital.