bluuebunny/crossref_metadata_2025 huggingface dataset:
The Occurrence Parallelism of the 1st and 2nd Ray in Mid Foot Fracture Dislocations. A Review of 234 Cases
Authors: Mason Lyndon W. , Tanaka Hiro , Mangwani Jitendra , Airey Grace L. , Chapman James , Kyaw Htin , Boksh Khalis , Elbannan Mamdouh M.
Published: November 2022

Category:

Trauma

Introduction/Purpose:

The parallel nature of the 1st and 2nd metatarsal has been reported in Lisfranc type injuries to the midfoot, reportedly the result of the lateral and dorsal subluxation of the 2nd metatarsal base. In this study, our aim was to explore the prevalence of parallelism in midfoot injuries and the associated features.

Methods:

Setting: Multicentre observational study Methods: Data was retrospectively collected from three centres on surgically treated midfoot fracture dislocations between 2011 and 2021. Radiographs were analysed using departmental PACS. Parallelism was defined as a 1/2 intermetatarsal angle of less than 6. All statistics was performed using SPSS 26.

Results:

A total of 234 cases were included in the study. All 234 had undergone non-weightbearing (NWB) radiographs, with 80 patients who had also undergone (WB) weightbearing radiographs. The prevalence of parallelism was 21.3% (17/80) in the WB radiographs and 20.1% (47/234) in the NWB radiographs. The average IMA in the non-parallel group was 9.45 (95% CI 9.12,9.77) and 4.18 (95% CI 3.78, 4.57) in the parallel group. Concomitant lateral column injury was the only factor with a significant association with parallelism (p=.015). Other factors such as bone or ligamentous injury (p=.657), medial column injury (p=.085) and central column injury (p=.323) did not have a significant association.

Conclusion:

Parallelism in midfoot fracture dislocations occurs in approximately 20% of cases. If present, a high index of suspicion to the presence of a lateral column injury should be maintained due to its significant association.
Peritalar Configuration Following Fusion in Varus Ankle Osteoarthritis: A 3D Weight Bearing CT Analysis
Authors: Mitsui Hiroyuki , Mehdi Nazim , Bernasconi Alessio , Fernando Céline , Karube Tomoko , Niki Hisateru , Lintz Francois
Published: November 2022

Category:

Ankle Arthritis; Ankle

Introduction/Purpose:

In varus-type osteoarthritis of the ankle (VAOA), it is known that the subtalar joint compensates in valgus/eversion for the malalignment of the tibiotalar joint. However, previous studies were mainly based on X-ray measurements and did not take into account peri-talar changes that extend to the subtalar and Chopart joints. Furthermore, the effect on peritalar compensation when tibio-talar arthrodesis is performed is still unclear. Distance Mapping (DM) is a technology that can produce a 3D point-to-point distance map of joint interactions from cone beam weight bearing CT (WBCT) images. The purpose of this study was to quantify the peri-talar changes that occur when the tibiotalar joint is fused. We hypothesized that talar varus would improve and that the Chopart/Subtalar joint complex would present compensatory varus/inversion.

Methods:

The subjects were 14 patients (15 feet) who underwent arthrodesis for VAOA at our institution. The average postoperative follow-up period was 6.6 months. Foot alignment (Foot Ankle Offset (FAO)) was measured from WBCT datasets pre and postoperatively. The pre to post op shift vectors of the weighted distance maps center points were measured for the tibiotalar, subtalar, calcaneocuboid and talonavicular joints. Statistical analysis was performed by paired T-test, and the significance level set at p<0.05.

Results:

FAO improved significantly from preoperative -12.9 +-7.4 % to postoperative -6.4 +-3.9 %. The DM vectors were 4.9 +-2.8 mm (lateral direction) for the tibiotalar joint, 0.86 +-0.93 mm (posterior) for the subtalar joint and 4.9 +-2.6 mm (plantar- medial) for the talonavicular joint.

Conclusion:

The main finding in this study was that foot alignment was improved following tibiotalar arthrodesis with peritalar compensation, more so in the talonavicular than in the subtalar joint and not in the calcaneocuboid joint. The limitations of this study include the small number of cases and the short postoperative follow-up. Our results suggest that the flexibility of the talonavicular joint may be necessary when arthrodesis is performed on VAOA to contribute to the alignment correction. If it is not the case, TAR could be considered an alternative.
Incidence and Functional Impact of Floating Toe after Distal Metatarsal Minimal Invasive Osteotomy Compared to Open Modified Weil Osteotomy
Authors: Mocoçain Mac-iver Pablo E. , Valderrama Carlos , Radkievich Ruben D. , Elgueta Stephane , Salinas David A. , Díaz Andres Keller , Zanolli de Solminihac Diego H.
Published: November 2022

Category:

Lesser Toes; Hindfoot

Introduction/Purpose:

Distal metatarsal osteotomies for metatarsalgia are one of the most frequent procedures in foot and ankle surgery, however, sometimes their results are not so favorable, with sequelae such as floating toe or loss of toe grip. The open modified Weil osteotomy (OWO) is considered the first alternative in metatarsalgia cases for many surgeons, nevertheless, in recent years, minimally invasive surgery (MIS) has become an attractive alternative for the management of this pathology. To date, there is scarce literature that compares clinical and functional results between both techniques. The objective of this study is to compare the clinical and functional outcomes between OWO and minimally invasive distal metatarsal osteotomy (DMMO), with and without lesser toe procedures.

Methods:

We performed a retrospective review of 77 patients who underwent OWO or DMMO, with at least 12 month follow up. We excluded patients with incomplete data, previous forefoot surgery, and patients with neuromuscular or rheumatological diseases. Our main outcome was to evaluate the presence of floating toe. Our secondary outcomes were to evaluate toe grip strength (paper pullout test), functional scores (LEFS and AOFAS) and satisfaction. All patients were clinically evaluated by one foot and ankle surgeon who did not participate in any of the surgical procedures. Statistical analysis was performed using Student's t-test, Fisher's test, and Chi-square.

Results:

77 patients (188 rays) were included. 120 rays received OWO, and 68 rays DMMO. 95% women, with a mean age of 57 years. The mean follow-up was 39.4 months. The floating toe incidence was 56.7% in the OWO group (67.3% when a DuVries procedure was added), which was significantly higher (p=0.001) than the 25% in the DMMO group (37.9% when P1 MIS osteotomy was added). When comparing lesser toe grip strength between both groups, the DMMO patients had significantly greater grip strength (p=001) Significant differences were obtained between both groups when comparing satisfaction (p=0.04), LEFS (p=0.001), and AOFAS scores (p=0.001), being better in the DMMO group.

Conclusion:

In our series, the DMMO procedure had significantly lower incidence of floating toe, greater toe grip strength, better functional outcomes and superior satisfaction scores than the OWO. When a bone procedure in the lesser toe is added (MIS osteotomy or DuVries) the floating toe incidence is increased, but not with statistical significance.
The multimodal meaning-making potential of self-representation and self-expression in digital storytelling
Authors: Towndrow Phillip A
Published: November 2022

This auto-ethonographic essay offers an analysis of my work as an education researcher and digital storyteller. Using research data and drawing on Mikhail Bakhtin’s literary theory relating to addressivity and answerability, I describe and attempt to justify the proposition that sense-making in and of the world through viewing and representing is an educative dialogic process. This statement stands in vivid contradistinction to a view of the world that is typically objective and impersonal. In closing, I discuss an important implication of my reflections for multimodal research.
Design research and the study of the possible
Authors: Crilly Nathan
Published: November 2022

Design research has much to contribute to and much to gain from the emerging field of possibility studies. In this short essay, I discuss these opportunities with respect to four topics: (1) processes of mediation and representation, (2) systems perspectives on creative work, (3) methodological options for investigation, and (4) educational challenges that should be addressed. Considering design research’s contributions to each of these topics raises interesting questions that possibility studies might address as it develops. Conversely, possibility studies is already raising issues that design research should also attend to.
Psychological history and predicting the future
Authors: Seligman Martin
Published: November 2022

The central hypothesis of new work on Agency is that when people believe they can achieve their goals, progress occurs. When they do not have this mindset, stagnation occurs. This seems to be true for the Greco-Roman Epoch, Ancient China, Biblical time, and Europe from 400 CE to 1800. New quantitative methods for measuring progress and for measuring the frequency of agentic words allow for rigorous collaboration between psychologists and historians. These same methods may contribute to predicting the future.
Another future
Authors: Pickering Andrew
Published: November 2022

This essay discusses the macrodynamics of cultural change. Drawing on the history of science, I offer an analysis of revolutionary transformation in terms of the waxing and waning of traditions of practice, in which marginal traditions become mainstream and vice versa. I apply this model to the Anthropocene, identifying dualist traditions of mastery and domination as currently mainstream and nondualist traditions of acting-with, exemplified by indigenous approaches to the environment and by cybernetics, as marginal. My concern is with the growth and unification of the latter as a path to another future, and I point to the need for the establishment of symbiotic relations between them, which has yet to come to pass.
The role of gene–ambient air pollution interactions in paediatric asthma
Authors: Kelchtermans Jelte , Hakonarson Hakon
Published: November 2022

Globally, asthma prevention and treatment remain a challenge. Ambient air pollution (AAP) is an environmental risk factor of special interest in asthma research. AAP is poorly defined and has been subdivided either by the origin of the air pollution or by the specific bioactive compounds. The link between AAP exposure and asthma exacerbations is well established and has been extensively reviewed. In this narrative review, we discuss the specific genetic variants that have been associated with increased AAP sensitivity and impact in paediatric asthma. We highlight the relative importance of variants associated with genes with a role in oxidant defences and the nuclear factor-κB pathway supporting a potential central role for these pathways in AAP sensitivity.
Burden of respiratory syncytial virus infection in older and high-risk adults: a systematic review and meta-analysis of the evidence from developed countries
Authors: Nguyen-Van-Tam Jonathan S. , O'Leary Maureen , Martin Emily T. , Heijnen Esther , Callendret Benoit , Fleischhackl Roman , Comeaux Christy , Tran Thao Mai Phuong , Weber Karin
Published: November 2022

Background

Respiratory syncytial virus (RSV) significantly impacts the health of older and high-risk adults (those with comorbidities). We aimed to synthesise the evidence on RSV disease burden and RSV-related healthcare utilisation in both populations.

Methods

We searched Embase and MEDLINE for papers published between 2000 and 2019 reporting the burden and clinical presentation of symptomatic RSV infection and the associated healthcare utilisation in developed countries in adults aged ≥60 years or at high risk. We calculated pooled estimates using random-effects inverse variance-weighted meta-analysis.

Results

103 out of 3429 articles met the inclusion criteria. Among older adults, RSV caused 4.66% (95% CI 3.34–6.48%) of symptomatic respiratory infections in annual studies and 7.80% (95% CI 5.77–10.45%) in seasonal studies; RSV-related case fatality proportion (CFP) was 8.18% (95% CI 5.54–11.94%). Among high-risk adults, RSV caused 7.03% (95% CI 5.18–9.48%) of symptomatic respiratory infections in annual studies, and 7.69% (95% CI 6.23–9.46%) in seasonal studies; CFP was 9.88% (95% CI 6.66–14.43%). Data paucity impaired the calculation of estimates on population incidence, clinical presentation, severe outcomes and healthcare-related utilisation.

Conclusions

Older and high-risk adults frequently experience symptomatic RSV infection, with appreciable mortality; however, detailed data are lacking. Increased surveillance and research are needed to quantify population-based disease burden and facilitate RSV treatments and vaccine development.
Evaluation of word embedding models to extract and predict surgical data in breast cancer
Authors: Sgroi Giuseppe , Russo Giulia , Maglia Anna , Catanuto Giuseppe , Barry Peter , Karakatsanis Andreas , Rocco Nicola ,   ETHOS Working Group, Pappalardo Francesco
Published: November 2022

Background

Decisions in healthcare usually rely on the goodness and completeness of data that could be coupled with heuristics to improve the decision process itself. However, this is often an incomplete process. Structured interviews denominated Delphi surveys investigate experts' opinions and solve by consensus complex matters like those underlying surgical decision-making. Natural Language Processing (NLP) is a field of study that combines computer science, artificial intelligence, and linguistics. NLP can then be used as a valuable help in building a correct context in surgical data, contributing to the amelioration of surgical decision-making.

Results

We applied NLP coupled with machine learning approaches to predict the context (words) owning high accuracy from the words nearest to Delphi surveys, used as input.

Conclusions

The proposed methodology has increased the usefulness of Delphi surveys favoring the extraction of keywords that can represent a specific clinical context. It permits the characterization of the clinical context suggesting words for the evaluation process of the data.
A longitudinal study of humoral immune responses induced by a 3-dose inactivated COVID-19 vaccine in an observational, prospective cohort
Authors: Tao Yue , Ma Mengyin , Hu Fenghua , Li Ming , Geng Yu , Wan Yawen , Mao Minxin , Chen Lin , Shen Ya , Zhu Liguo , Shen Han , Chen Yuxin
Published: November 2022

Background

To determine the dynamic SARS-CoV-2 specific antibody levels induced by 3 doses of an inactivated COVID-19 vaccine, CoronaVac. An observational, prospective cohort study was performed with 93 healthy healthcare workers from a tertiary hospital in Nanjing, China. Serum SARS-CoV-2 specific IgM, IgG, and neutralizing antibodies (NAb) were measured at different time points among participants who received 3 doses of inactivated COVID-19 vaccine.

Results

91.3% (85/93) and 100% (72/72) participants showed positive both for SARS-CoV-2 specific IgG and NAb after 2-dose CoronaVac and after 3-dose CoronaVac, respectively. Anti-SARS-CoV-2 IgG responses reached 91.21 (55.66–152.06) AU/mL, and surrogate NAb was 47.60 (25.96–100.81) IU/mL on day 14 after the second dose. Anti-SARS-CoV-2 IgG responses reached 218.29 (167.53–292.16) AU/mL and surrogate NAb was 445.54 (171.54–810.90) IU/mL on day 14 after the third dose. Additionally, SARS-CoV-2 specific surrogate neutralizing antibody titers were highly correlated with serum neutralization activities against Ancestral, Omicron, and Delta strains. Moreover, significantly higher SARS-CoV-2 IgG responses, but not NAb responses, were found in individuals with breakthrough infection when compared to that of 3-dose CoronaVac recipients.

Conclusions

CoronaVac elicited robust SARS-CoV-2 specific humoral responses. Surrogate NAb assay might substitute for pseudovirus neutralization assay. Monitoring SARS-CoV-2 antibody responses induced by vaccination would provide important guidance for the optimization of COVID-19 vaccines.
The application of magnetic anchoring traction device in assisting donor liver bench surgery in classic orthotopic liver transplantation
Authors: Song Jiashu , Wang Yue , Cai Xianming , Shi Jianhua , Hu Liangshuo , Chang Pengkang , Zhang Wei , Tang Bo , Lv Yi , Zhang Xiaogang
Published: November 2022

Objective

To explore the clinical application of a newly developed magnetic anchoring traction (MAT) system in the liver bench trimming and transplantation surgery.

Background

The conventionally limited space, vision, and exposure have always been a challenge for the quality of surgery in the liver bench trimming due to the fact that the exposure depends largely on the experience of surgeon. To deal with this problem, a MAT system is developed as an alternative support to enhance exposure. The preliminarily experiments on animals verified its feasibility and reliability in the practical use, and its clinical application and effects were examined in the present research.

Methods

A total of 20 DCD (donation of cardiac death) donor livers were collected and divided evenly between the magnetic anchor traction (MAT) assisted group (n = 10) and the manual assisted group (n = 10). The results and quality assessment from experts about the liver bench surgery performed by two groups were examined and compared.

Results

The MAT system can be employed effectively to compete and replace the manual assistance to achieve a better exposure in the liver bench trimming. No statistical difference was found regarding the baseline data between the MAT and the manual groups. In the inferior vena cava and hepatic artery trimming, the MAT group outperformed the manual group remarkably in many aspects. The surgery time for liver bench shortened considerably after a quick grasp of MAT skills by surgeons.

Conclusion

The MAT system provides a more stable, reliable and qualified local exposure in the liver bench surgery, and can preferably be employed to replace the manual assistance in the procedures of liver transplantation.
Comparison of efficiency and safety between dual-clip and rubber band-assisted ESD and conventional ESD for colonic lateral spreading tumors (LSTs) with different levels of technical difficulty: a retrospective case–control study
Authors: Ma Xingbin , Ma Huaiyuan , Gao Tao , Cao Jingrun , Liu Chengxia , Niu Qiong
Published: November 2022

Background

Dual-clip and rubber band-assisted endoscopic submucosal dissection (DCRB-ESD) is a useful technique in the management of lateral spreading tumors (LSTs) of the colon and is suggested by researchers compared with conventional ESD (C-ESD). The aim of this retrospective study is to further analyze the efficiency and safety of DCRB-ESD in a setting with varying technical difficulties.

Methods

Patients who underwent endoscopic treatment (DCRB-ESD or C-ESD) due to LSTs between Jan 1st, 2019 and Jan 1st, 2022, were retrospectively collected. Patients were classified into the following two groups: the DCRB-ESD group (n = 46) and the C-ESD group (n = 81). Baselines were compared and propensity score matching (PSM) was employed to manage the heterogeneity. The technical difficulty and outcomes of the two groups were evaluated based on a semiquantitative model (CS-CRESD) previously described.

Results

The baseline characteristics of the two groups were balanced except sex and LST classification before PSM and were corrected after PSM. The median ESD operation time of DCRB-ESD was shorter than that of C-ESD (32 vs 41 and 30 vs 44 before and after PSM respectively, P < 0.05). The operation durations of cases with different CS-CRESD scores were different (P < 0.05). In the subgroup with a score of 0, DCRB-ESD showed no advantage than C-ESD in terms of operation duration before and after PSM. In subgroups with a score of 1–3, DCRB-ESD was faster than C-ESD. In subgroups with a score of 4–5, the between-group operation duration was not significantly different due to the limited number of cases, although the median time of DCRB-ESD was shorter. The R0 resection rates, curative resection, complications, and additional surgery in both groups were not significantly different. No adverse events, such as a clip falling off or rubber band rupturing occurred during this study.

Conclusion

DCRB-ESD was an efficient and safe procedure in the management of colonic LSTs. With DCRB-ESD, the operation duration of difficult cases can be shortened without sacrificing complication risk. However, not all cases would benefit from DCRB-ESD. For easy cases (CS-CRESD score = 0), DCRB-ESD may not be prior to C-ESD by experienced endoscopists. A pre-ESD technical difficulty evaluation was recommended to decide whether to perform DCRB-ESD or not.
Walking a mile in Grandma’s shoes - medical students’ evaluation of a very simple online aging game to enhance their understanding of older patients
Authors: Geier Anne-Kathrin , Lippmann Stefan , Rau Antje , Schrimpf Anne , Bleckwenn Markus , Deutsch Tobias
Published: November 2022

Background

Aging simulation games are established educational interventions to make older patients’ perspectives noticeable, raise awareness about their needs, and positively influence attitudes toward older adults. Due to the COVID-19 pandemic restrictions imposed on education, we replaced a classroom-based aging simulation course with a simple online equivalent. This consisted of short introductory screencasts, four downloadable Portable Document Format (PDF) files containing issue-specific audio and video links, quizzes, case studies, and prompts for reflection. We explored how well our self-directed simple online simulation succeeded in providing students with relevant insights and experiences, raising awareness about age-related difficulties, and enhancing understanding of older patients.

Methods

In this cross-sectional study, an anonymous post hoc online survey was conducted among 277 5th-year medical students eligible for the course at the Leipzig University in May 2020. The questionnaire addressed overall course evaluations, assessments of the individual PDF components (working enjoyment, personal insights, professional learning gain, enhanced understanding, increased interest in working with older patients), and students’ main insights from the course (free text). Descriptive statistical and qualitative content analyses were performed.

Results

The response rate was 92.4% (n = 256, mean age 25.7 ± 3.4 years, 59.8% women). Nearly all respondents reported that the course was well structured, easily understandable, and that processing was intuitive. The majority (82.8%) perceived the course as practice-oriented, 88.3% enjoyed processing, 60.3% reported having gained new professional knowledge, and 75.4% had new personal insights. While only 14.8% agreed that the online course could generally replace the real-world simulation, 71.1% stated that it enabled them to change their perspective and 91.7% reported enhanced understanding of older patients. PDF components containing audio and video links directly imitating conditions (visual or hearing impairment) were rated highest. Qualitative data revealed manifold insights on the part of the students, most frequently referring to aspects of professional doctor-patient interaction, knowledge about conditions and diseases, role reversal, and enhanced empathy.

Conclusion

Simple online aging simulations may be suitable to provide students with relevant insights and enhance their understanding of older patients. Such simulations could be alternatively implemented in health professionals’ education where resources are limited.
The relationship between physical activity trajectories and frailty: a 20-year prospective cohort among community-dwelling older people
Authors: Lin Yen-Kuang , Chen Chen-Yueh , Cheung Denise Shuk Ting , Montayre Jed , Lee Chen-Yin , Ho Mu-Hsing
Published: November 2022

Background

Studies on examining the relationship between physical activity patterns and frailty are lacking. This study examined physical activity patterns in older people and investigated the relationship between physical activity and frailty as well as identifying the predictors of frailty.

Methods

We used a nationally representative longitudinal database, the Taiwan Longitudinal Study of Aging (TLSA) database, and data for a 20-year period were extracted and analyzed. A total of 5131 participants aged ≥ 60 years in 1996 were included in the current analysis. Information regarding demographic characteristics, frailty, physical activity, comorbidities, oral health, and depressive symptoms was extracted from the TLSA database. Physical activity patterns were examined using group-based trajectory modeling from 1996 to 2015. Potential predictors were examined by performing multivariate logistic regression.

Results

Four trajectories of the physical activity pattern were found: consistently physically inactive (33.7%), consistently physically active (21.5%), incline (21.6%), and decline (23.2%). Throughout the period, the trajectories of the four groups significantly differed from each other at year 2015, with the incline and decline groups exhibiting the lowest and highest frailty scores, respectively (p < 0.001). Older age, male, poor oral health, diabetes, chronic kidney disease, and depressive symptoms were identified as risk factors for frailty.

Conclusion

Physical activity reduces the risk of chronic conditions, which contributes to healthy longevity. This study can guide the development of future research and interventions to manage frailty in older people, particularly in considering previous physical activity trajectories within the life course.
CELPI: trial protocol for a randomised controlled trial of a Carer End of Life Planning Intervention in people dying with dementia
Authors: Arendts G , Chenoweth L , Hayes BJ , Campbell E , Agar M , Etherton-Beer C , Spilsbury K , Howard K , Braitberg G , Cubitt M , Sheehan C , Magann L , Sudharshan T , Schnitker LM , Pearce J , Gilmore I , Cerra N , duPreez J , Jaworski R , Soh S-C , Celenza A
Published: November 2022

Background

Dementia is a leading cause of death in developed nations. Despite an often distressing and symptom laden end of life, there are systematic barriers to accessing palliative care in older people dying of dementia. Evidence exists that 70% of people living with severe dementia attend an emergency department (ED) in their last year of life. The aim of this trial is to test whether a Carer End of Life Planning Intervention (CELPI), co-designed by consumers, clinicians and content specialists, improves access to end of life care for older people with severe dementia, using an ED visit as a catalyst for recognising unmet needs and specialist palliative care referral where indicated.

Methods

A randomised controlled trial (RCT) enrolling at six EDs across three states in Australia will be conducted, enrolling four hundred and forty dyads comprising a person with severe dementia aged ≥ 65 years, and their primary carer.

Participants will be randomly allocated to CELPI or the control group. CELPI incorporates a structured carer needs assessment and referral to specialist palliative care services where indicated by patient symptom burden and needs assessment. The primary outcome measure is death of the person with dementia in the carer-nominated preferred location. Secondary outcomes include carer reported quality of life of the person dying of dementia, hospital bed day occupancy in the last 12 months of life, and carer stress. An economic evaluation from the perspective of a health funder will be conducted.

Discussion

CELPI seeks to support carers and provide optimal end of life care for the person dying of dementia. This trial will provide high level evidence as to the clinical and cost effectiveness of this intervention.

Trial registration

ACTRN12622000611729 registered 22/04/2022.
The association between social activity and physical frailty among community-dwelling older adults in Japan
Authors: Katayama Osamu , Lee Sangyoon , Bae Seongryu , Makino Keitaro , Chiba Ippei , Harada Kenji , Shinkai Yohei , Shimada Hiroyuki
Published: November 2022

Background

Physical frailty is associated with social activity. However, the relationship between physical frailty and levels of engagement with other people during social activities remains unclear. Thus, we aimed to clarify the relationship between physical frailty and social activity using a taxonomy of activity levels among community-dwelling older adults in Japan.

Methods

This cross-sectional observational study analyzed data from 12,788 older adults (7001 women, mean age: 73.8 years, standard deviation = 5.9; range: 60–96 years) from the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes. Physical frailty was assessed using the following components: slow walking speed, muscle weakness, exhaustion, low activity, and weight loss. We asked participants about seven social activities that included social participation and engagement and examined their relationship to physical frailty.

Results

Physical frailty was independently associated with all social activities. Exercise circle activity, which includes a level of social participation, was strongly associated with physical pre-frailty and physical frailty. Results of sub-analyses indicated that the level of social engagement was independently associated with physical frailty in the older group (over 75 years) but not in the younger group (60–74 years).

Conclusions

Our results indicate that the strength of the association between social activity and physical frailty differs by the level of social participation. Given the increasingly high prevalence of physical frailty in Japan and its strong association with numerous adverse health outcomes, the relationship between physical frailty and levels of social participation may assist in developing measures to prevent the incidence and progression of physical frailty.
Ways that nursing home nursing staff build resilience: a phenomenographic approach
Authors: Chang Sung Ok , Kim Eun Young
Published: November 2022

Background

Resilience has been studied as an effective concept in nursing that acts as a protective factor which aids in overcoming difficult situations and related mental problems. With the recent increase in demand for nursing homes, nursing home nursing staff are facing a variety of stresses and psychological burdens. Improving resilience has been suggested as one way to deal with the difficulties, such as stress, exhaustion, and burnout, that nursing home nursing staff are experiencing. In order to provide successful education aimed at improving such resilience, it is very important to understand how to perceive experience from the learner’s point of view.

Aim

The study’s aim is to identify the ways that nursing home nursing staff build resilience.

Method

This study used phenomenography, a methodology for exploring the relationship between subject and phenomenon. From January 15, 2022 to February 20, 2022, data collection was undertaken at three nursing homes located in the Republic of Korea. The data was collected through semi-structured interviews with 20 nursing staff members in NHs and a data analysis that strictly followed the 7-step analysis process of phenomenography.

Results

Eight categories were derived. The eight categories were then divided into two groups of four representing perception and strategy. Perception included four categories: ‘grasping the situation’, ‘thinking about one’s responsibility for the resident and personal values’, ‘considering one’s strength’ and ‘thinking of an improved self’. Strategy included four categories: ‘evaluation of oneself and one’s environment’, ‘taking care of oneself’, ‘finding concrete ways to manage the problem’ and ‘self-development for growth’. Perception had three levels of awareness, valuing and assuring, while strategy had three levels of identifying, introspecting and concretizing.

Conclusion

This study provides insight into how individual nursing staff build resilience, a complex and subjective concept. It provides a foundation for future resilience education of nursing home nursing staff and suggests future educational intervention development directions.
A study protocol for improving the delivery of acute kidney replacement therapy (KRT) to critically ill patients in Alberta – DIALYZING WISELY
Authors: Opgenorth Dawn , Bagshaw Sean M. , Lau Vincent , Graham Michelle M. , Fraser Nancy , Klarenbach Scott , Morrin Louise , Norris Colleen , Pannu Neesh , Sinnadurai Selvi , Valaire Shelley , Wang Xiaoming , Rewa Oleksa G.
Published: November 2022

Background

Acute kidney replacement therapy (KRT) is delivered to acutely ill patients to support organ function and life in the Intensive Care Unit (ICU). Implementing standardized acute KRT pathways can ensure its safe and effective management. At present, there is no standardized approach to the management of acute KRT in Alberta ICUs.

Methods

Dialyzing Wisely is a registry embedded, stepped-wedge, interrupted time-series evaluation of the implementation of a standardized, stakeholder-informed, and evidence-based acute KRT pathway into Alberta ICUs. The acute KRT pathway will consist of two distinct phases. First, we will implement routine monitoring of evidence-informed key performance indicators (KPIs) of acute KRT. Second, we will provide prescriber and program reports for acute KRT initiation patterns. After the implementation of both phases of the pathway, we will evaluate acute KRT performance quarterly and implement a customized suite of interventions aimed at improving performance. We will compare this with baseline and evaluate iterative post implementation effects of the care pathway.

Discussion

Dialyzing Wisely will implement, monitor, and report a suite of KPIs of acute KRT, coupled with a care pathway that will transform the quality of acute KRT across ICUs in Alberta. This program will provide a framework for scaling evidence-informed approaches to monitoring and management of acute KRT in other jurisdictions. We anticipate improvements in acute KRT performance, decreased healthcare system costs and improved patient quality of life by decreasing patient dependence on maintenance dialysis.

Trial registration

Clinicaltrials.gov, NCT05186636. Registered 11, January, 2022.
Clinical manifestations and pathological correlation of immunoglobulin A nephropathy in children
Authors: Sausukpaiboon Karnchanit , Panombualert Sunee , Wisanuyotin Suwannee , Puapairoj Anucha , Suparattanagool Piyanan , Techasatian Leelawadee , Tantawarak Nattakarn
Published: November 2022

Background

IgA nephropathy in children has various clinical manifestations. Kidney biopsy is a gold standard for diagnosis by using Oxford classification 2016 with few studies about the correlation between clinical and pathology manifestations. This study aims to find these correlations at the time of diagnosis and during short-term follow-up.

Method

In this retrospective cohort study, 47 pediatric patients who underwent renal biopsy from 2010 to 2021 in Thailand, were included. Oxford classification 2016 has been used to score patients’ pathology. Univariate and multivariate associations have been used for correlation between clinical and pathologic parameters.

Results

The most common clinical manifestations were microscopic hematuria and proteinuria. There were 68% of children with mesangial hypercellularity (M1), 42% with segmental glomerulosclerosis (S1), 25% with moderate to severe crescent (C1/C2), 23% with endocapillary hypercellularity (E1), and 14% with moderate to a severe tubular atrophy/interstitial fibrosis (T1/T2). Microscopic hematuria was strongly associated with mesangial hypercellularity (M1) OR 7.14 (95%CI 1.83 – 27.88, p-value 0.005) and hypertension was strongly associated with segmental glomerulosclerosis (S1) adjusted OR 7.87 (95%CI 1.65 – 37.59, p-value 0.01). Intensive treatment was used more in the patients with tubular atrophy/interstitial fibrosis lesion on renal biopsy than other lesions from MEST-C scores OR 4.98 (95%CI 1.17–21.24, p-value 0.03). Furthermore, pulse methylprednisolone and cyclophosphamide were used in patients with crescentic lesions significantly than other lesions with OR 15.5 (95%CI 3.16- 75.93, p-value 0.001) and OR 5.75 (95%CI 1.31–25.29, p-value 0.021), respectively.

Conclusion

Tubular atrophy/interstitial fibrosis and crescent lesions were correlated to intensive treatment in short-term outcomes.
Epidemiologic patterns of biliary tract cancer in the United States: 2001–2015
Authors: Koshiol Jill , Yu Binbing , Kabadi Shaum M. , Baria Katherine , Shroff Rachna T.
Published: November 2022

Background

Biliary tract cancer (BTC) includes intrahepatic cholangiocarcinoma (ICC), extrahepatic cholangiocarcinoma, gallbladder cancer, and ampulla of Vater cancer (AVC). Although BTC is rare in the US, incidence is increasing and elevated in certain populations. This study examined BTC epidemiology in the US by age, sex, race/ethnicity, geographic region, and anatomic site.

Methods

BTC incidence, prevalence, mortality, and survival from 2001 to 2015 were evaluated using the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program and the Centers for Disease Control and Prevention’s National Program of Cancer Registries databases. Incidence and mortality rates were calculated and reported as age-standardized rates. Data were assessed by age, anatomic sites, geographic region, and race/ethnicity, and a joinpoint regression model was used to predict trends for age-adjusted BTC incidence and mortality rates.

Results

BTC incidence increased during the study period (annual percent change = 1.76, 95% confidence interval [1.59–1.92]), with the highest increase in ICC (6.65 [6.11–7.19]). Incidence of unspecified BTC initially increased but has recently begun to drop. Hispanic, Asian/Pacific Islander, Black, or American Indian/Alaska Native race/ethnicity was associated with higher BTC mortality rates than White race/ethnicity. Patients with ICC had the highest mortality rate (age-standardized rate = 1.87/100,000 person-years [1.85–1.88]). Five-year survival was 15.2% for all BTC, ranging from 8.5% (ICC) to 34.5% (AVC), and patients with distant disease at diagnosis had lower survival (3%) compared with those with regional (19.1%) or locally advanced disease (31.5%).

Conclusions

BTC incidence increased, survival was low across all subtypes, and mortality was greatest in patients with ICC. This underscores the serious, increasing unmet need among patients with BTC. Treatment options are limited, although clinical studies investigating immunotherapy, targeted therapies, and alternative chemotherapy combinations are ongoing. Epidemiological insights may improve patient care and inform the integration of novel therapies for BTC.
Re-vitrectomy for recurrent retinal detachment in post-vitrectomy eyes of rhegmatogenous retinal detachment
Authors: Bai Jun-Xing , Zheng Wei-Yu , Zhu Xiao-Qing , Peng Xiao-Yan
Published: November 2022

Background

Recurrent retinal detachment (Re-RD) usually affects the prognosis of surgery for rhegmatogenous retinal detachment (RRD). Previous clinical studies of Re-RD were not specific. This study aimed to analyze the clinical characteristics of Re-RD in post-vitrectomy eyes with RRD and surgical outcomes after revitrectomy without combining it with retinectomy or scleral buckling.

Methods

This is a retrospective case series analyzed the ocular characteristics of 20 recurrent and contralateral eyes, evaluated the significance of the associations between variables before reoperation and the final best-corrected visual acuity (BCVA), and calculated the outcome of revitrectomy.

Results

Patients with phakic eyes, those undergoing only one surgery, and those with more than one break had better final BCVA. The final BCVA was negatively correlated with the axial length and positively correlated with the preoperative BCVA. Among the 12 eyes with no break detected before surgery, 11 (92%) were found to have a small crevice-like break beside the pigment scar of a large number of original laser spots. The single-operation complete retinal reattachment rate was 75%, the complete retinal reattachment rate was 80%, and the final incomplete retinal reattachment rate was 90%. The BCVA improved from 1.2 ± 0.6LogMAR (0.06 ± 0.25) before surgery to 0.8 ± 0.7LogMAR (0.15 ± 0.2) at the last follow-up. The BCVA of 16 patients with complete retinal reattachment improved from 1.0 ± 0.5LogMAR (0.1 ± 0.3) to 0.6 ± 0.4LogMAR (0.25 ± 0.4). In the contralateral eyes, 15% already had vision-damaging disease, and the incidence of eyesight-threating lesions was 5.9% during follow-up.

Conclusions

Revitrectomy without retinectomy or scleral buckling can effectively treat Re-RD in post-vitrectomy eyes. In Re-RD patients with no definite retinal break detected preoperatively, the retinal hole usually shows small crevice-like changes alongside a large number of original laser pigment scars.
Prevalence and factors associated with post traumatic stress disorder among field police patrol officers serving in Kampala Metropolitan region
Authors: Isabirye Rogers Agenda , Namuli Justine Diana , Kinyanda Eugene
Published: November 2022

Background

Occupation groups like police officers and fire fighters are exposed to a number of traumatic events which put them at a risk of developing post-traumatic stress disorder (PTSD). Previous studies have found the prevalence of PTSD in police officers to vary between 7 and 19%. However, most of these studies have been undertaken in western setting with little research having been undertaken in sub-Saharan Africa including Uganda.

Objective

To determine the prevalence and factors associated with post-traumatic stress disorder among field police patrol officers serving in Kampala Metropolitan Police (KMP) North Region.

Methods

This was a cross sectional study that was conducted on 392 field police patrol officers serving in KMP North Region. Diagnosis of PTSD was undertaken using the Clinician Administered PTSD Scale for DSM-5. In order to assess for psychiatric comorbidities, the study used the Mini International Neuropsychiatric Interview (M.I.N.I.)

Results

In this study, the prevalence of PTSD was 7.4%. An additional 62.5% had sub-threshold PTSD, which was defined as, the presence of at least one PTSD symptom but not meeting full criteria for PTSD diagnosis. The factors found to be significantly associated with PTSD were all related to the presence of psychiatric comorbidities, namely the presence of: a current major depressive episode (aOR = 4.7; 95% CI: 1.5- 14.8; p = .009); an alcohol use disorder (aOR = 5.1; 95% CI: 2.0–13.0; p = .001); and presence of dissociation symptoms (aOR = 6.7; 95% CI: 2.0–22.2; p = .002).

Conclusion

PTSD is one of the common psychiatric disorders experienced by serving police officers in Uganda. The tendency of PTSD in this group to co-occur with other psychiatric disorders means that any treatment program to address it should be part of a comprehensive multi-disorder mental health treatment programme in the police office.
ChildTalks+: a study protocol of a pre-post controlled, paired design study on the use of preventive intervention for children of parents with a mental illness with focus on eating disorders
Authors: Farářová Adéla , Papežová Hana , Gricová Jana , Štěpánková Tereza , Čapek Václav , Reedtz Charlotte , Lauritzen Camilla , van Doesum Karin
Published: November 2022

Background

Children of parents with a mental illness are at high risk of developing a mental disorder as a result of transgenerational transmission. Without effective intervention, they could form the next generation of psychiatric patients. ChildTalks+ is a preventive intervention involving four structured psychoeducational sessions designed for parents affected by a mental disorder and their children. Its aim is to reduce the risk of mental disorders in children of parents with mental illness. This study draws on our clinical practice and involves a group of patients with eating disorders. The aim of the project, which will run in the Czech Republic, is to evaluate the effectiveness of ChildTalks+ methodology.

Methods

ChildTalks+ therapists (professionals from health, social, and educational facilities) will recruit 66 families where a parent is treated for a mental disorder and the family includes children aged 6–18. Paired allocation into an intervention group (N = 33) and a control group (N = 33) will be based on the number of risk factors identified in the family. Both groups will complete questionnaires at the baseline, post-test, and follow-up assessments after six and 12 months. The intervention group will receive the ChildTalks+ intervention within 2 months of the baseline assessment; the control group after the last assessment. Questionnaires will be completed by parents and children aged 12+ and, in two cases, 15+ years. Quantitative data will be supplemented with qualitative data from ChildTalks+ therapists working with patients with eating disorders.

Discussion

The ChildTalks+ intervention is expected to strengthen parenting competencies and family protective factors, improve family communication, increase awareness of parental mental health issues, and improve the wellbeing of children of parents with mental illness with long-term sustainable outcomes. The study should contribute to the evidence base for the ChildTalks+ program and help identify key themes in the implementation of similar preventive interventions.

Trial registration

ClinicalTrials.gov Identifier: NCT05554458. Registered 26 September 2022. Retrospectively registered.