bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Anterolateral Ligament Reconstruction or Lateral Extra-articular Tenodesis for Revision Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Comparative Clinical Studies
Authors: Boksh Khalis , Sheikh Nomaan , Chong Han Hong , Ghosh Arijit , Aujla Randeep
Published: March 2023

Background:

After its success in restoring rotational stability and reducing failure rates in primary anterior cruciate ligament reconstruction (ACLR), lateral extra-articular tenodesis (LET) or anterolateral ligament reconstruction (ALLR) has been endorsed for use in revision ACLR surgery, where failure rates are historically higher.

Purpose:

To perform a systematic review and meta-analysis on whether the addition of a LET or ALLR results in superior clinical outcomes and stability compared with isolated revision ACLR (iACLR).

Study Design:

Meta-analysis; Level of evidence, 4.

Methods:

The Cochrane Controlled Register of Trials, PubMed, Medline, and Embase were used to perform a systematic review and meta-analysis of comparative studies using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria with the following search terms: (“extra-articular” OR “tenodesis” OR “anterolateral ligament” OR “iliotibial”) AND (“anterior cruciate ligament”) AND (“revision” OR “re-operation”). Data pertaining to all patient-reported outcome measures (PROMs), rotational stability, and postoperative complications were extracted from each study.

Results:

After abstract and full-text screening, 10 clinical comparative studies were included. There were 793 patients, of whom 390 had an iACLR while 403 had an ACLR augmented with a LET or an ALLR (augmented ACLR [aACLR]). The mean time for assessment of PROMs was 35 months. The aACLR group had superior International Knee Documentation Committee (IKDC) scores (standardized mean difference [SMD], 0.27; 95% CI, 0.01 to 0.54; P = .04), rotational stability (odds ratio [OR], 2.77; 95% CI, 1.91 to 4.01; P < .00001), and lower side-to-side difference (OR, −0.53; 95% CI, −0.81 to −0.24; P = .0003) than those without the augmentation. Furthermore, they were less likely to fail (OR, 0.44; 95% CI, 0.24 to 0.80; P = .007). Subgroup analysis in the higher-grade laxity cohort (grade ≥2) revealed an even greater IKDC score (SMD, 0.51; 95% CI, 0.16 to 0.86; P = .005) and an improved Lysholm score (SMD, 0.45; 95% CI, 0.24 to 0.67; P < .0001) in the aACLR group.

Conclusion:

Revision aACLR with a LET or an ALLR can improve subjective IKDC scores, restore rotational stability, and reduce failure rates compared with iACLR. Although controversy remains on the necessity of augmenting all revision ACLRs, the present meta-analysis advocates adding a lateral procedure, particularly in those with a higher-grade pivot shift.
Toxicity of organophosphorus flame retardants
Authors: Howell Bob A
Published: March 2023

As the development and use of organophosphorus flame retardants have become more prevalent, concerns about potential toxicity are being raised. To date, most studies on potential toxicity have focused on simple phosphate esters and often include both alkyl and aryl esters or, in some cases, even halogenated phosphate esters (which should more properly be included among organohalogen flame retardants). The inclusion of several kinds of esters into a single study leads to muddled conclusions. Each class of phosphate esters should be subjected to toxicity assessment separately. Furthermore, the potential toxicity of the more effective (lower level of oxygenation at phosphorus: phosphonates, phosphinates, phosphine oxides) organophosphorus flame retardants has been little explored. The few results available suggest that these compounds exhibit no or minimal toxicity (lower than that of phosphates?). This represents an area that should be the focus of careful detailed studies to establish any potential toxicity.
Phenobarbital as Anticonvulsant Prophylaxis in Patients With Traumatic Brain Injury at Risk for Alcohol Withdrawal Syndrome
Authors: McGinnis Cory B. , Wang Fajun , Chiappelli Abby L. , Okonkwo David O. , Darby Joseph M.
Published: March 2023

Background: Anticonvulsant prophylaxis (ACP) for early post-traumatic seizures (PTS) is recommended in patients with traumatic brain injury (TBI). Phenobarbital (PB) may be used to prevent alcohol withdrawal syndrome (AWS) in at-risk patients. The dual-purpose use of PB in the TBI population would allow for consolidation of pharmacotherapy. Objective: The primary objective of this study was to determine the frequency of early PTS in TBI patients at risk of AWS treated with PB as ACP. Secondary objectives included determining rates of over sedation and endotracheal intubation. Methods: Patients received an intravenous (IV) loading dose of PB at 15-20 mg/kg followed by 1 mg/kg every 12 hours for 7 days with a goal level of 15-20 mcg/mL. Medication data, seizure frequency, and episodes of over sedation and endotracheal intubation were collected. Results: Eighty patients were treated with PB over a 1-year period. Thirty-nine patients were analyzed. Median loading dose was 19.9 (Interquartile Range 19.1-20.0) mg/kg with a median post load level of 21.7 mcg/mL (IQR 18.3-25.8) mcg/mL. One patient (2.6%) had electrographic evidence for early PTS. PB was discontinued in 4 (10.3%) patients out of concern for over sedation. One patient required endotracheal intubation after rapid PB loading. Conclusion: The frequency of early PTS was low when PB was used as primary ACP in patients with TBI at risk for AWS. Over sedation is a potential adverse effect that should be considered in the choice of ACP. No conclusions can be drawn as to the effectiveness of PB in preventing AWS.
Impact of financial development, trade flows, and institution on environmental sustainability in emerging markets
Authors: Bekun Festus Victor , Gyamfi Bright Akwasi , Köksal Cihat , Taha Amjad
Published: March 2023

The present study is motivated by the need to decouple economic growth from environmental degradation given the new wave of chase for higher economic growth trajectories comes with its environmental cost implications, especially among developing blocs like the Emerging 7 (E7) countries. There is a consistent trade-off between economic growth versus environmental quality. Government apparatus are perpetually on the chase for low-carbon emission policies via the pursuit for green economy. To this end, this present study extends the conventional environmental Kuznets curve (EKC) argument by incorporating the role of institution in emerging industrialized economies (E7) and using second-generation panel analysis methods like mean group (MG), augmented mean group (AMG), common correlated effects mean group (CCEMG), and the Dumitrescu and Hurlin causality test for more robust estimates and inferences. To this end, we explore the long-run and causality relationship between economic growth, quadratic form of economic growth, institutional quality, trade flow, investment in energy sector, and financial development in an EKC environment. Empirical analysis established a long-run equilibrium relationship among the outlined variables over the study period. The long-run regression shows the presence of EKC in the E7. Thus, suggesting the preference for GDP growth over environmental quality at the earlier stage of growth curve. Interestingly, investment in energy, trade flow dynamics across the blocs, and financial development dampens the detrimental effect of environmental pollution as we observed negative relationship with the ecological footprint. On the contrary, quality of institution is weak as institutional quality increase (worsen) the quality of environment in the E7 economies. From a policy perspective, this current study proposed the need for more stringent environmental treaties and regulations and promotion of green economy without compromising economic growth. In the conclusion part of the study, more details and specifics about the policy blueprint are presented.
Does menopause elevate the risk for developing depression and anxiety? Results from a systematic review
Authors: Alblooshi Salama , Taylor Mark , Gill Neeraj
Published: March 2023

Objective

To determine whether menopause elevates the risk for developing diagnostic depression and anxiety. Menopause-associated vasomotor symptoms such as insomnia and hot flushes are well recognized, but no systematic review of the psychological consequences of menopause has been undertaken. Menopause can be a time of social change for women, confounding any correlation.

Methods

Using PRISMA methodology, we conducted a systematic review of all published (in English) original data examining a relationship between menopause and depression and anxiety. We ranked the quality of all included studies using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria.

Results

Twenty-two selected studies were summarized and compared, being eight cross-sectional surveys; one retrospective cohort, and 13 prospective cohort studies. Depression and anxiety are common during menopause and the post-menopause, with vasomotor symptoms and a prior history of major depression elevating risk of menopausal associated depression. Psychosocial factors also may increase risk of depression during menopause.

Conclusions

Menopause increases vulnerability to depression and anxiety, perhaps via estrogen fluctuations affecting serotonin and GABA. Underlying neuroticism and contemporaneous adverse life events are also risk factors for menopausal decompensation with depression.
Evaluation of a Postpartum Hemorrhage Escape Room: A Multisite Study
Authors: Holland Tamara , Kuhnly Joan Esper , McKelvey Michele , Prast Jean , Walter Laurie
Published: March 2023

Background

The purpose of this study was to evaluate a teaching strategy that engaged baccalaureate maternity nursing students at two universities in a postpartum hemorrhage escape room. The study examined students’ attainment of knowledge, as well as teamwork, collaboration, communication, and safety.

Method

A mixed method study was conducted with 85 junior-level and senior-level maternity students at two universities in the Northeastern region of the United States. Participants completed a survey and attended one of 20 focus groups after completion of a healthcare simulation escape room on postpartum hemorrhage.

Results

Participants (95.2%) reported that the escape room helped with knowledge and skill acquisition. All of the participants reported that it was an effective team building strategy and 97.6% said it fostered communication, learning, and the ability to provide safe patient care. Participants unanimously reported that the escape room was enjoyable, an effective strategy for team building, and they would recommend it to others. Qualitative findings showed six major themes: It was Fun!, No I in Team, Escaping to Learn: Building Knowledge and Confidence, Pressure Cooker, Big Picture, and Lessons Learned.

Conclusion

Healthcare simulation escape rooms are an effective teaching strategy and can be used by nursing faculty to foster knowledge, teamwork, collaboration, communication and safety. Participant feedback showed high satisfaction and they felt the escape room provided a valuable learning experience.
PROMIS Scores for Plantar Fasciitis Before and After Gastrocnemius Recession
Authors: Sanchez Thomas , Sankey Turner , Schick Sam , Arthur Rodney , Young Matt , Underwood Meghan , Harrelson Whitt , Shah Ashish
Published: March 2023

Background:

There has been an established relationship between increased loading on the Achilles tendon and tension on the plantar fascia. This supports the idea that either tight gastrocnemius and soleus muscles or contractures of the Achilles tendon are risk factors for plantar fasciitis. Gastrocnemius recession has gained popularity as a viable surgical intervention for cases of chronic plantar fasciitis due to isolated gastrocnemius contracture. To our knowledge, this is the first study to investigate Patient-Reported Outcome Measurement Information Systems (PROMIS) scores in patients with plantar fasciitis before and after gastrocnemius recession.

Methods:

The Electronic Medical Record was queried for medical record numbers associated with Current Procedural Terminology code 27687 (gastrocnemius recession). Our study included all patients with a preoperative diagnosis of chronic plantar fasciitis with treatment via isolated gastrocnemius recession with 1-year minimum follow-up. Forty-one patients were included in our study. Patient variables were collected via chart review. Preoperative and postoperative PROMIS scores were collected in the clinic.

Results:

We followed up 41 patients with a median age of 48 years (interquartile range [IQR] 38-55) and median body mass index of 29.02 (IQR 29.02-38.74) for 1 year post surgery. Preoperative and postoperative PROMIS scores improved for physical function from 39.3 to 44.5 ( P = .0005) and for pain interference from 62.8 to 56.5 ( P = .0001). PROMIS depression scores were not significantly different ( P = .6727). Visual analog scale (VAS) scores significantly decreased from 7.05 to 1.71 ( P < .0001).

Conclusion:

In this case series, we found the gastrocnemius recession to be an effective option for patients with refractory pain in plantar fasciitis. Our PROMIS and VAS data confirm this procedure’s utility and highlight its ability to significantly decrease pain and improve physical function in patients with chronic plantar fasciitis, although final median scores did not reach normative standards for the population, suggesting some residual pain and/or dysfunction was, on average, present. Based on the results of this study, the authors conclude that gastrocnemius recession is a reasonable treatment option for chronic plantar fasciitis patients who fail nonoperative management.

Level of Evidence:

Level III, retrospective cohort study.
More than just the regional promotion in Japan: The case of Chita Musume
Authors: Abe Yasuhito
Published: March 2023

This article investigates a Japanese transmedia regional promotion project known as Chita Musume Jikkō Iinkai (or the Executive Committee of Daughters of Chita); it critically discusses how the elusive concept of moe was deployed to facilitate and promote regional tourism. Drawing on the male gaze as a theoretical framework, this study uses Rose's discourse analysis I to investigate a wide variety of texts and documents related to the project. In doing so, it demonstrates that this regional promotion practice does not merely contribute to reinforcing its audience as heteronormative masculine subjects, but also redesigns its region as a gazed-upon dating spot.
Connection Brokers: How educators work within and between social networks to cultivate community digital resilience to support children with disabilities using the Internet
Authors: Hammond Simon P , D’Arcy Jeanette , Polizzi Gianfranco
Published: March 2023

For children with disabilities, being online can have great benefits, and being part of a well-connected community pays dividends. Research has focused on the development of digital resilience at an individual level, but the ways in which surrounding networks of community support impact this is underexplored. Drawing on digital resilience as a socio-ecological concept and undertaking a thematic analysis of semi-structured interviews with educators, this article addresses this gap by exploring how educators work within and between community networks to support children with disabilities online. Findings suggest that educators are key connection brokers who activate and provide access to a variety of assets and manage pools of resources to build digital resilience at a community level as well as for the individual. We note, however, that addressing structural holes to allow information to flow beyond the community level is challenging and requires continued investment to cultivate greater capacity.
To infinity and beyond: A teaching case on Rocket Lab and the emergence of New Zealand's space ecosystem
Authors: Borroz Nicholas , Korber Stefan
Published: March 2023

This teaching case focuses on the relationship between entrepreneurs, their ventures and the broader context—the innovation and entrepreneurship ecosystem (I&EE)—in which entrepreneurial activity occurs. Building on secondary data and informal conversations with industry experts, the case recounts the story of Rocket Lab, an aerospace manufacturer and launch service provider founded in 2006 in New Zealand. The case elaborates on how unique contextual conditions in combination with the founder's vision and skills enabled Rocket Lab to become a dominant force in the space sector, even though the firm was founded in a country with virtually no history in spacefaring and highlights that Rocket Lab's emergence constituted the foundation of a burgeoning space industry in New Zealand. In doing so, the case sensitises students to the importance of self-reinforcing and mutually interdependent relationships in well-functioning I&EEs and the role policymakers play in this context. At the same time, it allows a critical discussion of I&EEs, particularly if they are dominated by a small number of anchor firms.
Embryonic intersectionality: W.E.B. Du Bois and the inauguration of intersectional sociology
Authors: Rabaka Reiland
Published: March 2023

As a brief exercise in the critical sociology of sociology, this article demonstrates W.E.B. Du Bois’s undeniable contributions to the history, discourse, and development of American sociology in particular, and the wider world of sociology in general. This dialectical approach to Du Bois’s sociological discourse will enable objective interpreters of his work to see that when compared and contrasted with the monumental work of Karl Marx, Max Weber and Emile Durkheim, what was and what remains really and truly distinctive about Du Bois’s sociology is precisely his unpretentious preoccupation with uniquely and unequivocally American social, political, and cultural issues, such as, for example: race and anti-Black racism in the context of slavery, lynching, Black Codes, Jim Crow laws, segregation, and other forms of racial oppression in the United States; racial capitalism and the racial colonization of social classes in the United States; and the racial colonization of gender and sexuality in the United States.
Becoming Southern: 10 Autoethnographic Polaroids
Authors: Kavoori Anandam
Published: March 2023

I call it “the great emptying.” This business of making and re-making of the self. The immigrant self, that is:

  I hold a bucket in my hand

   Piled high with memories

    Of Delhi, India,

    I begin Swirling,

   Swinging it over head

Holding in a deep-deep breath,

Throwing it out, away, as far as I can

    Back to where it belongs

     The past

I call it The Great Filling. This business of making and re-making of the self. The immigrant self, that is:

I hold a bucket in my hand

  Filling it with memories,

   Of Athens and Sapelo

    I begin swirling,

  Swinging it over my head

Holding in a deep deep breath

  Pouring it all over me

   Over My Place

   My Deep South
Feasibility of Microwave Scissors-Based Off-Clamp Laparoscopic Partial Nephrectomy in a Porcine Model
Authors: Nguyen Ha Ngoc , Yamada Atsushi , Naka Shigeyuki , Mukaisho Ken-Ichi , Tani Tohru
Published: March 2023

Objectives

To assess the feasibility of off-clamp laparoscopic partial nephrectomy using microwave scissors.

Methods

We performed transperitoneal laparoscopic partial nephrectomy, without hilar clamping or renorrhaphy, using only microwave scissors for renal resection in a porcine model. For each kidney, 2 types of procedures were performed: a middle pole resection excising an area of 2-cm diameter and approximately 1-cm depth and a lower pole resection at the level of the lower polar line. The renal calyces exposed during renal resection were sealed and transected using microwave scissors. After 3 days of follow-up, the pigs were reoperated to inspect for postoperative complications. Euthanasia was performed to collect the remaining kidneys for histopathological examination.

Results

Ten procedures were successfully performed, without hilar clamping or suturing of the renal calyces and parenchyma, in 5 kidneys from 3 pigs. The median resecting time, blood loss, and lateral thermal injury were 23.2 min, 47.1 mL, and 6.8 mm in the middle pole resection, and were 15.1 min, 26.5 mL, and 6.9 mm in the lower pole resection, respectively. No complications were noted during reoperation, such as postoperative hemorrhage and major urine leakage. Extravasation occurred in 2 middle pole resections and 3 lower pole resections during retrograde pyelogram. Hematoxylin and eosin staining revealed thermal injury characterized by tissue microwave fixation in the near zone and acute coagulative necrosis in the intermediate zone.

Conclusions

Microwave scissors-based off-clamp laparoscopic partial nephrectomy is feasible in pigs and can be used for clinical applications.
Post-traumatic Stress Disorder as an Independent Risk Factor for Increased Opioid Use Following Carpal Tunnel Surgery
Authors: Hudock Nicholas L. , Kshir Sean A. , Taylor Kenneth F.
Published: March 2023

Background:

Carpal tunnel release (CTR) is one of the most common hand surgeries. Studies have highlighted a mental-physical connection to hand pathologies and psychological connections to postoperative pain burden. Post-traumatic stress disorder (PTSD) has been identified as a medical-psychological comorbidity like other mental health disorders such as generalized anxiety disorder (GAD). There remains a gap in the literature regarding PTSD as a comorbidity for hand surgeries, where there is this mental-physical connection. We hypothesize PTSD will be associated with increased risk of postoperative pain, evidenced by greater prevalence of opioid usage.

Methods:

The authors performed a retrospective analysis using the TriNetX Research Database. Patients who underwent elective CTR were identified within the database. Two groups were created and compared against individual controls: the first was identified based on the diagnosis of PTSD, and the second was identified based on the diagnosis of GAD. Cohorts were matched and opioid usage was compared postoperatively.

Results:

Patients with PTSD who underwent CTR were found to be at significantly increased risk of postoperative opioid use ( P = .033) and more likely to present to the emergency department (ED) ( P = .001). Patients with GAD were found to be significantly less likely to require postoperative opioids ( P = .040).

Conclusions:

We found patients with PTSD to be at increased risk of opioid use and more likely to present to ED following CTR. Patients with GAD were found to be at decreased risk of opioid use after CTR. Owing to the independent significant risks not found in GAD, further research of postoperative pain in patients with PTSD is needed.
Proximal right subclavian artery aneurysms: A case report and review of the literature
Authors: Cui Hong-jie , Wu Ying-feng
Published: March 2023

Background

Subclavian aneurysms are rare in clinic; right subclavian artery aneurysms (SAAs) are more common than left SAAs in clinical practice. Although the causes and methods of treating subclavian aneurysms have been studied, it is still unknown how they form naturally.

Objective

While describing the uncommon subclavian aneurysm, examine the pertinent literature to discuss its etiology and treatment outcomes, and offer some recommendations for this patient’s treatment plan.

Methods

In this case report, we describe a man patient who had a right subclavian proximal aneurysm that was discovered by accident. No clear clinical symptoms or signs were present in the patient. Upon admittance, an examination revealed an aneurysm in the vertebral artery but no peripheral embolization or compression symptoms. The patient refused operation, so we opted for follow-up instead.

Result

The patient took an ultrasound examination at our first follow-up appointment 3 months after discharge, and the results showed no thrombosis or appreciable aneurysm enlargement. Follow-up appointments for 6 months and a year have begun.

Conclusion

Follow-up is a good method to monitor the course of subclavian aneurysms without a clear indication for surgery when there is a clear operation mode and risk.
Retrospective cohort study to devise a treatment decision score predicting adverse 24-month radiological activity in early multiple sclerosis
Authors: Hapfelmeier Alexander , On Begum Irmak , Mühlau Mark , Kirschke Jan S. , Berthele Achim , Gasperi Christiane , Mansmann Ulrich , Wuschek Alexander , Bussas Matthias , Boeker Martin , Bayas Antonios , Senel Makbule , Havla Joachim , Kowarik Markus C. , Kuhn Klaus , Gatz Ingrid , Spengler Helmut , Wiestler Benedikt , Grundl Lioba , Sepp Dominik , Hemmer Bernhard
Published: March 2023

Background:

Multiple sclerosis (MS) is a chronic neuroinflammatory disease affecting about 2.8 million people worldwide. Disease course after the most common diagnoses of relapsing-remitting multiple sclerosis (RRMS) and clinically isolated syndrome (CIS) is highly variable and cannot be reliably predicted. This impairs early personalized treatment decisions.

Objectives:

The main objective of this study was to algorithmically support clinical decision-making regarding the options of early platform medication or no immediate treatment of patients with early RRMS and CIS.

Design:

Retrospective monocentric cohort study within the Data Integration for Future Medicine (DIFUTURE) Consortium.

Methods:

Multiple data sources of routine clinical, imaging and laboratory data derived from a large and deeply characterized cohort of patients with MS were integrated to conduct a retrospective study to create and internally validate a treatment decision score [Multiple Sclerosis Treatment Decision Score (MS-TDS)] through model-based random forests (RFs). The MS-TDS predicts the probability of no new or enlarging lesions in cerebral magnetic resonance images (cMRIs) between 6 and 24 months after the first cMRI.

Results:

Data from 65 predictors collected for 475 patients between 2008 and 2017 were included. No medication and platform medication were administered to 277 (58.3%) and 198 (41.7%) patients. The MS-TDS predicted individual outcomes with a cross-validated area under the receiver operating characteristics curve (AUROC) of 0.624. The respective RF prediction model provides patient-specific MS-TDS and probabilities of treatment success. The latter may increase by 5–20% for half of the patients if the treatment considered superior by the MS-TDS is used.

Conclusion:

Routine clinical data from multiple sources can be successfully integrated to build prediction models to support treatment decision-making. In this study, the resulting MS-TDS estimates individualized treatment success probabilities that can identify patients who benefit from early platform medication. External validation of the MS-TDS is required, and a prospective study is currently being conducted. In addition, the clinical relevance of the MS-TDS needs to be established.
Chemical Constituents From the Marine Microalgae Thraustochytrium pachydermum
Authors: Thuy Nguyen Thi Thu , Minh Hien Hoang Thi , Ha Nguyen Cam , Thom Le Thi , Hong Dang Diem , Thinh Nguyen Van , Dan Nguyen Trong , Hoi Nguyen Dang , Loan Vu Thi , Quang Hoang Duc , Hang Dan Thi Thuy , Kiem Phan Van , Dat Nguyen Tien , Nhiem Nguyen Xuan
Published: March 2023

Objectives

Isolation, structure determination, and antimicrobial activities evaluation of compounds from the methanol extract of the marine microalga Thraustochytrium pachydermum TSL10.

Methods

Using chromatographic methods to isolate compounds from the methanol extract of the T pachydermum. The chemical structures were elucidated by analyses of HR-ESI-MS and NMR spectral data. The antimicrobial activities of compounds were evaluated using the dilution turbidimetric broth method as the standard protocol published by the Clinical and Laboratory Standard Institute.

Results

One new sterol, (24 R)-ergosta-7,22-diene-3 β,5 α,9 α-triol (1), and 16 known compounds, ergosta-7,22-diene-3 β,5 α-diol (2), cerevisterol (3), (22 E,24 S)-5 α,6 α-epoxy-ergosta-8(9),22-diene-3 β,7 α-diol (4), ergosterol (5), 5 α,8 α-epidioxyergosta-6,22-diene-3 β-ol (6), linoleic acid (7), 4-((9 Z,12 Z)-octadeca-9,12-dienoyloxy)butanoic acid (8), 1-linoleoyl-sn-glycero-3-phosphocholine (9), cibotiglycerol (10), gingerglycolipid B (11), oleic acid (12), 4-((9Z)-octadec-9-enoyloxy)butanoic acid (13), (2 S)-1- O-(9 Z)-octadec-9-enoyl)-3- O-(6-sulfo-D-quinovopyranosyl)glycerol (14), 6′- O-linoleylsucrose (15), gingerglycolipid C (16), and ( S)-3-stearoyl- sn-glycerol (17) were identified from the marine microalga Thraustochytrium pachydermum TSL10. Sterols 1–6 were found to exhibit significant antimicrobial activities on Gram-( + ) bacteria ( Enterococcus faecalis ATCC29212 , Staphylococcus aureus ATCC25923, and Bacillus cereus ATCC14579) and the yeast ( Candida albicans ATCC10231) with MIC values ranging from 32 to 256 µg/mL.

Conclusions

The results suggested sterols 1–6 could be potential antimicrobial agents against Gram-( + ) bacteria.
Determination of 4 Nucleosides via One Reference Compound in Chinese Cordyceps by HPLC-UV at Equal Absorption Wavelength
Authors: Li Wenjia , Lei Qinggui , Li Wenqing , Tan Guoying , Liu Xingzhong , Qian Zhengming
Published: March 2023

A high-performance liquid chromatography (HPLC) method for the determination of 4 nucleosides by one reference compound in Chinese cordyceps was developed. The sample of Chinese cordyceps was prepared by ultrasonic extraction with a 0.5% phosphoric acid aqueous solution. The separation of the sample was performed on a CORTECS T3 column (100 mm × 4.6 mm, 2.7 μm) by gradient elution with acetonitrile and water at a flow rate of 1.0 mL/min. The wavelengths were set as 258 nm (0-5 min), 252 nm (5-9.1 min), 258 nm (9.1-10.5 min), 249 nm (10.5-20 min) at which 4 nucleosides exhibited identical ultraviolet absorption. The accuracy, precision, reproducibility, and stability tests of the HPLC method were carried out, and the results indicated that the established HPLC method was suitable for the quantitative analysis of 4 nucleosides in Chinese cordyceps. This approach was compared to the traditional external standard method with 4 nucleoside reference compounds and the relative standard errors of the content determination results by the 2 methods were less than 3.5%. The HPLC method developed for quantitative measurement of 4 nucleosides in Chinese cordyceps is simple, lower cost, and time-saving, which provides a methodology alternative for quality control of Chinese cordyceps.
The process of Transformative Learning in Dialog Café with Health Professionals and Citizens/Patients
Authors: Son Daisuke , Ishikawa Hirono , Yonekura Yuki , Nakayama Kazuhiro
Published: March 2023

Introduction:

Dialogue Café, which is an inclusive process that provides a platform for the exchange of ideas or perspectives on certain issues, is a suitable approach to facilitating mutual understanding between health professionals and citizens/patients. However, little is known about the effects of the Dialogue Café on participants in the context of health communication. Previous studies suggest that transformative learning occurs after dialogue.

Objectives:

This study aimed to clarify the process of the transformative learning process among participants of the Dialog Café and to evaluate whether their transformative learning would lead to an understanding of others’ perspectives.

Methods:

We conducted a psychometric analysis of a web-based questionnaire consisting of 72 items for participants of Dialog Café held from 2011 to 2013 in Tokyo and studied the relationships between various concepts using structural equation modeling (SEM). To evaluate the validity and reliability of concept measurement, we conducted an exploratory factor analysis and a confirmatory factor analysis.

Results:

The questionnaire response rate was 39.5% (141/357), of which 80 (56.7%) respondents were health professionals and 61 (43.3%) respondents were citizens/patients. The SEM analysis revealed that transformative learning occurred in both groups. The process of transformative learning consisted of 2 types; one process leading directly to “perspective transformation” and the other leading to “perspective transformation” via “critical self-reflection” and “disorienting dilemmas.” “Perspective transformation” was related to “understanding others” in both groups. Among health professionals, “perspective transformation” was related to “transformation of awareness toward patients/users.”

Conclusion:

Dialog Café can facilitate the process of transformative learning among participants, and transformative learning may lead to mutual understanding between health professionals and citizens/patients.
End-of-Life Care for Transgender Older Adults
Authors: Catlett Lauren , Acquaviva Kimberly D. , Campbell Lisa , Ducar Dallas , Page Enoch H. , Patton Jude , Campbell Cathy
Published: March 2023

As the number of transgender older adults increases, the need for respectful and inclusive end-of-life (EOL) care for this population is becoming more apparent. Aging transgender adults often face discrimination, inadequate access to care, and poor quality of care. In response, we organized a think tank that invited participation from 19 transgender older adults, scholars in EOL care, and palliative care providers in the United States to generate recommendations for EOL care for transgender older adults. Subsequently, we conducted a qualitative descriptive exploration of the written record of think tank discussions for the purpose of identifying key EOL care considerations for transgender older adults. We identified four themes that highlight the importance of understanding the experiences of transgender older adults for the advancement of future research, policy, and education initiatives aiming to ensure inclusive and equitable provision of EOL care by nurses and other clinicians for this population.
Lost in translation? A qualitative study of representations and management of chronic depression in general practice
Authors: Linder Audrey , Widmer Daniel , Fitoussi Claire , Gagnebin Lucile , de Roten Yves , Despland Jean-Nicolas , Ambresin Gilles
Published: March 2023

Background

GPs are on the front line for the identification and management of chronic depression but not much is known of their representations and management of chronic depression.

Objectives

To analyze GPs’ representations of chronic depression and to explore how they manage it.

Methods

Three focus groups were conducted with 22 French-speaking general practitioners in Switzerland. The focus groups were transcribed and coded with MaxQDA. A detailed content analysis was carried out and the results were synthesized into a conceptual map.

Results

GPs form representations of chronic depression at the intersection of expert and lay knowledge. When talking about patients suffering from chronic depression, GPs mention middle-aged women with complex psychosocial situations and somatic complaints. GPs’ management of chronic depression relies on the relationship with their patients, but also on taking care of them as a whole: psyche, body and social context. GPs often feel helpless and lonely when confronted with a patient with chronic depression. They insist on the importance of collaboration and supervision. As regards chronic depression management, GPs remain alone with patients suffering from complex biopsychosocial situations. In other situations, GPs seek the help of a psychiatrist, sometimes quickly, sometimes after a long approach. In each situation, GPs have to develop skills for translating patients’ complaints.

Conclusion

GPs endorse a role of interpreter, making the physical presentation of their patient complaints move towards a psychological appreciation. Our results call for a renewed interest in GPs’ role as interpreters and the means to achieve it.
How do respondents of primary care surveys compare to typical users of primary care? A comparison of two surveys
Authors: Cronin Shawna , Li Allanah , Bai Yu Qing , Ammi Mehdi , Hogg William , Wong Sabrina T. , Wodchis Walter P.
Published: March 2023

Background

Primary care surveys are a key source of evaluative data; understanding how survey respondents compare to the intended population is important to understand results in context. The objective of this study was to examine the physician and patient representativeness of two primary care surveys (TRANSFORMATION and QUALICOPC) that each used different sampling and recruitment techniques.

Methods

We linked the physician and patient participants of the two surveys to health administrative databases. Patients were compared to other patients visiting the practice on the same day and other randomly selected dates using sociodemographic data, chronic disease diagnosis, and health system utilization. Physicians were compared to other physicians in the same practice, and other physicians in the intended geographic area using sociodemographic and practice characteristics.

Results

Physician respondents of the TRANSFORMATION survey included more males compared to their practice groups, but not to other physicians in the area. TRANSFORMATION physicians cared for a larger roster of patients than other physicians in the area. Patient respondents of the QUALICOPC survey did not have meaningful differences from other patients who visit the practice. Patient respondents of the TRANSFORMATION survey resided in more rural areas, had less chronic disease, and had lower use of health services than other patients visiting the practice.

Conclusion

Differences in survey recruitment methods at the physician and patient level may help to explain some of the differences in representativeness. When conducting primary care surveys, investigators should consider diverse methods of ensuring representativeness to limit the potential for nonresponse bias.
Protocol for the SEHNeCa randomised clinical trial assesing Supervised Exercise for Head and Neck Cancer patients
Authors: Rodriguez-Arietaleanizbeaskoa M. , Mojas Ereño E , Arietaleanizbeaskoa MS , Grandes G. , Rodríguez Sánchez A , Urquijo V. , Hernando Alday I , Dublang M. , Angulo-Garay G. , Cacicedo J. ,   on behalf of the SEHNeCa group, Rodriguez-Arietaleanizbeaskoa Mario , Mojas Ereño Egoitz , Arietaleanizbeaskoa Maria S. , Grandes Gonzalo , Garcia-Alvarez Arturo , Coca Aitor , Mendizabal Nere , Hoyo Olga del , García-Escobedo Javier , Rodríguez Sánchez Ángel , Flores Barrenechea Lucía , Sánchez Rebeca , Urquijo Virginia , Barbier Herrero Luis , Díaz-Basterra Goiztidi , Gómez-Suarez Javier , Calles Romero Laura A , Iglesias-Hernandez Natalia C. , Hernando Alday Iñigo , Dublang Maddalen , Ramirez-Garcia Lina M. , Angulo-Garay Garazi , Dominguez-Martinez Silvia , Gil-Rey Erreka , Martinez-Aguirre Aitor , Gutierrez-Santamaria Borja , Cacicedo Jon
Published: March 2023

Objectives

To evaluate the effectiveness of an innovative supervised exercise programme to mitigate the loss of lean body mass, functional capacity and quality of life in people with head and neck cancer, as well as to identify the optimal moment to apply it, before or after radiotherapy treatment, compared with the prescription of a physical activity plan carried out autonomously.

Methods

Patients with squamous cell carcinoma of the head and neck (n = 144), treated with radiotherapy, will be randomly assigned to one of 3 comparison groups: pre-radiotherapy supervised exercise, post-radiotherapy supervised exercise and autonomous exercise, stratifying by human papillomavirus infection and previous surgery.

The exercise programme will be carried out in 36 sessions over 12 weeks, combining moderate and high intensity strength and aerobic exercises. The main outcome variable is the change in lean body mass at 6 months measured by bioimpedance, while secondary variables are functional capacity, symptoms, quality of life and adverse effects. Longitudinal generalised mixed models will be used for the analyses of the repeated measurements at 3, 6, and 12 months after baseline.

Conclusions

The pilot study supports the feasibility and safety of the project. However, as the programme progressed, attendance at the sessions decreased. Strategies will be necessary for increasing attendance, as well as involving the patient in their recovery and other incentives. Follow-up after treatment to assess acute/late toxicity will enable us to know the response to both the exercise programme and its adherence.

Trial registration

NCT04658706 Date and version identifier: March 1, 2023. Version 1.1
A novel pupilloplasty in crescent-shaped suturing pattern for coloboma and traumatic iris defects
Authors: Yao Xiaoming , Kang Qian , Qi Wei , Liu Yuan , Zhou Xiaoping , Wang Mingwu , Yang Yukun , Zhu Fengjiao , Cao Wenchao
Published: March 2023

Objective

Purpose

To observe the safety and effect of the C-pupilloplasty for the treatment of iris coloboma and traumatic iris defects.

Methods

A total of 21 cases (21 eyes) with iris coloboma or traumatic iris defects who underwent C-pupilloplasty (a single-pass three-throw technique) from Feb. 2016 to Mar. 2020 were analyzed retrospectively. Uncorrected visual acuity, refraction, corneal topographic keratometry and endothelial cell density were examined.

Results

All the patients were successfully treated, and a central and round pupil was restored. The mean follow-up duration was 8.76 ± 3.58 months (ranging from 2 to 14 months). All patients had round or round-like pupils with a diameter less than or equal to 3 mm after the C-pupilloplasty. Very slightly endothelial loss, negligible symptoms such as glare, distortion, dizziness and photophobia were observed.

Conclusion

We introduced a new technique of pupilloplasty (C-pupilloplasty) which could be a more straight forward and more effective treatment for iris coloboma and traumatic iris defect.
The experience of caregivers providing therapeutic patient education for people living with bipolar disorder: a qualitative study
Authors: Chirio-Espitalier Marion , Harscoët Yves-Antoine , Duval Mélanie , Jupille Julien , Moret Leïla , Grall-Bronnec Marie
Published: March 2023

Background

Therapeutic patient education (TPE) programs are psycho-educational treatments suggested for all chronic diseases. For several years, these programs have been developing for people living with bipolar disorder. However, to date, only few qualitative studies have explored the experience of caregivers. We wanted to explore the experience of caregivers working in psychiatry as facilitators of a therapeutic education program for people living with bipolar disorder.

Method

A single-center qualitative study was carried out. We conducted an inductive exploration, examining the content of the discourse produced in a focus group of eight caregivers in therapeutic education. The corpus was transcribed manually and a thematic analysis was conducted by two authors in a blinded fashion before combining.

Results

Four dimensions and twenty themes were identified: i) facilitators' pleasant experiences of the TPE sessions with a secure climate and a sense of belonging to a group, ii) being a TPE facilitator with a new horizontal and collaborative posture valuing the experiential knowledge, iii) the role of the TPE sessions with knowledge provision, empowerment and destigmatization, and iv) perceived changes in patients with an appeasement, the awareness of a shared experience, openness to others, a phenomenon of identification to peers and a new commitment.

Conclusions and implications for practice

The observations noted overlap with the elements of the personal recovery well known CHIME framework (Connectedness, Hope, positive Identity, Meaning in life and Empowerment). Therapeutic education is a developing form of psychosocial rehabilitation care: through the mobilization of a new attitude of caring, the facilitation of TPE programs could be a lever for changing the posture of caregivers in favor of supporting the personal recovery of people with bipolar disorder. These results would need to be confirmed by further studies.
Risk factors for perioperative hidden blood loss after one-segment posterior circumferential decompression surgery on thoracic ossification of the posterior longitudinal ligament: a finding of the double-layer sign on CT
Authors: Liang Huiqiang , Zhao Xuan , Wang Linfeng , Li Jia , Shen Yong
Published: March 2023

Background

Hidden blood loss (HBL) is of increasing interest to spine surgeons. This retrospective study aimed to evaluate perioperative HBL and its risk factors in patients undergoing one-segment posterior circumferential decompression surgery on thoracic ossification of the posterior longitudinal ligament (T-OPLL).

Method

We retrospectively studied 112 patients diagnosed with T-OPLL following posterior circumferential decompression surgery from August 2015 to June 2020. Patient demographics, blood loss-related parameters, surgery-related data and imaging parameters were extracted. Postoperative complications were also recorded. Pearson or Spearman correlation analysis was used to investigate the correlation between patient demographics and HBL. Multivariate linear regression analysis was performed to determine the independent risk factors associated with HBL.

Results

Forty-five men and 67 women were involved in this research, with an average age of 56.4 ± 10.2 years. The mean HBL was 459.6 ± 275.4 ml, accounting for 56.5% of the total blood loss. Multiple linear regression analysis showed that double-layer sign (P = 0.000), ossification occupancy ratio (OOR) > 60% (P = 0.030), age (P = 0.010), hematocrit (Hct) loss (P = 0.034), and postoperative Hct (P = 0.016) were independent risk factors for HBL. However, OPLL morphology (P = 0.319), operation time (P = 0.587), hemoglobin (Hb) loss (P = 0.644), and postoperative Hb (P = 0.952) were not significantly different from HBL.

Conclusion

A high proportion of HBL was found after posterior circumferential decompression surgery on T-OPLL during the perioperative period, which should not be overlooked. Double-layer sign, OOR > 60%, age, Hct loss and postoperative Hct are independent risk factors for HBL.