bluuebunny/crossref_metadata_2025 huggingface dataset:
Motivation–opportunity–ability–behaviour of community members and program implementers towards mass drug administration for lymphatic filariasis elimination in India: a systematic review and implementation priority
Authors: Sinha Abhinav , Mohapatra Sumegha , Sahoo Krushna Chandra , Mohanty Shubhashisha , Sahoo Banamber , Pati Sanghamitra , Sahoo Prakash Kumar
Published: March 2024

Lymphatic filariasis (LF) is a significant public health issue in India. Despite 10–15 rounds of mass drug administration (MDA) in India, the global LF elimination target of 2030 appears challenging. To strengthen the program, community and provider perspectives on ways to bridge a gap in MDA are needed. Through the motivation–opportunity–ability–behaviour (MOAB) lens, we systematically reviewed the facilitators and barriers encountered in LF elimination in India. We followed Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. We searched PubMed, Embase, ProQuest and Google Scholar databases to explore factors related to MDA program implementation in India through 30 June 2021. We analysed the data using a thematic framework. We identified 576 studies; of these, 20 studies were included. This review revealed that the public health system for distributing MDA drugs in India created a better enabling environment, including zero out-of-pocket expenditure, door-step distribution of medicines and ample capacity-building training and follow-up. However, community members were unaware of the rationale for drug consumption, leading to a gap in drug distribution and consumption. Motivation is required among community members, which suggests capacity-building training for service providers to counsel the community.
VIPERA: Viral Intra-Patient Evolution Reporting and Analysis
Authors: Álvarez-Herrera Miguel , Sevilla Jordi , Ruiz-Rodriguez Paula , Vergara Andrea , Vila Jordi , Cano-Jiménez Pablo , González-Candelas Fernando , Comas Iñaki , Coscollá Mireia
Published: March 2024

Viral mutations within patients nurture the adaptive potential of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during chronic infections, which are a potential source of variants of concern. However, there is no integrated framework for the evolutionary analysis of intra-patient SARS-CoV-2 serial samples. Herein, we describe Viral Intra-Patient Evolution Reporting and Analysis (VIPERA), a new software that integrates the evaluation of the intra-patient ancestry of SARS-CoV-2 sequences with the analysis of evolutionary trajectories of serial sequences from the same viral infection. We have validated it using positive and negative control datasets and have successfully applied it to a new case, which revealed population dynamics and evidence of adaptive evolution. VIPERA is available under a free software license at https://github.com/PathoGenOmics-Lab/VIPERA.
Arceuthobium Species (Viscaceae) Parasitizing an Angiosperm: The Unique Case of A. azoricum in the Azores Islands
Authors: Elias Rui Bento , Moura Mónica , Roxo Guilherme , Borges Silva Lurdes , Pavão Diogo Cláudio , Resendes Roberto , Pereira Fernando , Nickrent Daniel
Published: March 2024

Arceuthobium azoricum Wiens & Hawksw. is a rare Azorean endemic epiphytic hemiparasite (mistletoe), which typically parasitizes branches of the gymnosperm Juniperus brevifolia (Hochst. ex Seub.) Antoine (Cupressaceae), which is also an Azorean endemic. Here, we describe a population of A. azoricum, on Pico Island, parasitizing Erica azorica Hochst. ex Seub. (Ericaceae), which is also an Azorean endemic. Our molecular analysis (using nuclear ribosomal internal transcribed spacer) showed no differences between individuals parasitizing Erica and Juniperus species. Moreover, a preliminary analysis showed no differences in morphological characteristics between accessions sampled from different hosts. Given that this is the first bona fide record of Arceuthobium sp. parasitizing an angiosperm, this population represents a unique host-shifting event, and its conservation is important because it may allow new insights into host recognition mechanisms in mistletoes. Immediate attention should be given to characterizing this Pico Island population using appropriate molecular methods and additional morphological analyses.
Inter- and Intra-Specific Variations in Phenotypic Traits of Pectobacterium Strains Isolated from Diverse Eudicots and Monocots in Taiwan
Authors: Tang Wen-Chien , Wang Liang-Hsuan , Chan Jiun-Jie , Goh Reun-Ping , Wu Yea-Fang , Chu Chia-Ching
Published: March 2024

Pectobacterium spp. are phytopathogenic bacteria whose phylogeny has been continuously revised throughout the years. Previous studies on Pectobacterium’s phenotypic diversity often analyzed strains obtained from specific crops or adopted outdated Pectobacterium classification systems. Therefore, a current perspective on trait variations in Pectobacterium species or strains infecting more diverse plant species is limited. This study conducted phylogenetic and phenotypic analyses on strains isolated from eight eudicot and four monocot families in Taiwan. Phylogenetic analysis on 78 strains identified six recognized species, namely, P. brasiliense, P. aroidearum, P. actinidiae, P. colocasium, P. carotovorum, and P. versatile. Among these, the first two were the most predominant species. Patterns suggesting varying host preferences among bacterial species were detected; most P. aroidearum strains were isolated from monocots, whereas P. brasiliense and P. actinidiae tended to exhibit preferences for eudicots. Physiological tests and Biolog analyses conducted on representative strains of each species revealed great within-species phenotypic variations. Despite these strain-level variations, a combination of indole production and phosphatase activity tests was capable of distinguishing all representative strains of P. brasiliense from those of other identified species. Inoculation assays on potato, bok choy, calla lily, and onion showed inter- and intra-specific heterogeneities in the tested strains’ maceration potentials. Virulence patterns across Pectobacterium species and strains differed depending on the inoculated host. Altogether, the findings from this work expand the understanding of Pectobacterium’s phenotypic diversity and provide implications for pathogen identification and management.
Risk Factors and Frequency of Foot Ulceration in Patients Receiving Chronic Hemodialysis Treatment
Authors: Özdemir Vacide Aşik , Nural Nesrin
Published: March 2024

OBJECTIVE

To determine the prevalence and risk factors of foot ulceration in patients receiving hemodialysis treatment.

METHODS

A total of 180 patients who received hemodialysis treatment in two state hospitals and a private health center between April 2017 and September 2017 were included in the study. The researchers collected data using a patient information form and by conducting physical evaluation of the lower extremities. They used the diabetic foot risk assessment algorithm to classify risk according to the data obtained.

RESULTS

Of the patients receiving hemodialysis treatment, 6.7% had foot ulceration, 19.4% had a history of foot ulceration, and 8.3% had a history of hospitalization associated with ulceration in a lower extremity. Infected foot ulceration was the most common (6.1%) cause of hospitalizations. In the group with current or past foot ulceration, diabetic nephropathy was the most common etiologic factor of end-stage kidney disease (48.6%); there was a significant between-group difference in diabetic nephropathy (P < .05). Etiologic factors had a significant effect on foot ulcerations: As determined by univariate logistic regression, diabetes (odds ratio [OR], 2.727; P < .05), presence of neuropathy (OR, 4.208; P < .05), low-density lipoprotein cholesterol (OR, 1.013; P < .05), and serum albumin (OR, 0.302; P < .036) all had a statistically significant effect on the presence of foot ulcerations.

CONCLUSIONS

Patients receiving hemodialysis treatment are at high risk for foot ulceration. Therefore, patient awareness strategies should be expanded to include individuals with end-stage renal disease regardless of diabetes status. Clinical and dialysis nurses should educate these patients about foot ulcerations and foot health to prevent ulcer development.
Exploring the Experiences of Patients with Autoimmune Skin Diseases During the COVID-19 Pandemic
Authors: Dehghan Nayeri Nahid , Fooladzadeh Dehghan Mohsen
Published: March 2024

OBJECTIVE

To explore the experiences of patients with an autoimmune disease during the COVID-19 pandemic.

METHODS

A total of 12 patients with autoimmune skin disease who were hospitalized in dermatology wards between 2021 and 2022 participated in this qualitative study. The researchers conducted in-depth, semi-structured interviews, which they analyzed using conventional content analysis.

RESULTS

Data analysis revealed three main themes: changes in mental/psychological status, social impacts and financial problems, and physical consequences. These patients reported changes in mental/psychological status as their most important experiences.

CONCLUSIONS

During a pandemic, it is important to manage the therapeutic course of patients who are at risk of infection, especially patients with autoimmune skin diseases, via appropriate planning.
Healthcare Utilization Among Adults With Vestibular Vertigo in the United States
Authors: Matthews Jacob C. , Agrawal Yuri , Qian Z. Jason , Wei Eric X.
Published: March 2024

Objectives:

Vestibular vertigo has been shown to have a high lifetime prevalence. Previous studies have described the increased morbidities associated with vestibular vertigo.

Design:

In this cross-sectional study of the 2016 National Health Interview Study, we sought to explore whether individuals with vestibular vertigo were more likely to utilize healthcare resources compared with those without vestibular vertigo. We characterized utilization of specific healthcare resources including general doctors, specialist doctors, emergency departments, mental health professionals, and others among individuals with vestibular vertigo to better understand how individuals with vertigo interact with the US healthcare system.

Results:

In multivariable analyses, participants with vestibular vertigo had an increased number of nights in the hospital in the last 12 months (mean difference = 0.67 days, 95% confidence interval [CI] = 0.37 to 0.97), increased odds of receiving healthcare 10 or more times in the last 12 months (odds ratio = 2.22, 95% CI = 1.99 to 2.48) and increased number of visits to a healthcare professional in the last 2 weeks (mean difference = 0.17 visits, 95% CI = 0.14 to 0.21). In addition, participants with vestibular vertigo had increased odds of visiting both general doctors, specialist doctors, and other healthcare professionals.

Conclusions:

These findings characterize how individuals with vestibular vertigo utilize and interact with healthcare resources compared with those without vestibular vertigo.
Does Scheduled Low-Dose Short-Term NSAID (Ketorolac) Modulate Cytokine Levels Following Orthopaedic Polytrauma? A Secondary Analysis of a Randomized Clinical Trial
Authors: Foster Jeffrey A. , Hawk Gregory S. , Landy David C. , Griffin Jarod T. , Bernard Andrew C. , Oyler Douglas R. , Southall Wyatt G.S. , Muhammad Maaz , Sierra-Arce Carlos R. , Mounce Samuel D. , Borgida Jacob S. , Xiang Lusha , Aneja Arun
Published: March 2024

OBJECTIVES:

To determine whether scheduled low-dose, short-term ketorolac modulates cytokine concentrations in orthopaedic polytrauma patients.

METHODS:

Design:

Secondary analysis of a double-blinded, randomized controlled trial.

Setting:

Single Level I trauma center from August 2018 to October 2022.

Patient Selection Criteria:

Orthopaedic polytrauma patients between 18-75 years with a New Injury Severity Score greater than 9 were enrolled. Participants were randomized to receive 15 mg of intravenous (IV) ketorolac every 6 hours for up to 5 inpatient days or 2 mL of IV saline similarly.

Outcome Measures and Comparisons:

Daily concentrations of prostaglandin E2 (PGE2), interleukin (IL)-1a, IL-1b, IL-6, and IL-10. Clinical outcomes included hospital and intensive care unit (ICU) length of stay (LOS), pulmonary complications, and acute kidney injury (AKI).

RESULTS:

Seventy orthopaedic polytrauma patients were enrolled, with 35 participants randomized to the ketorolac group and 35 to the placebo group. The overall IL-10 trend over time was significantly different in the ketorolac group (p = 0.043). IL-6 was 65.8% higher at enrollment compared to Day 3 (p < 0.001) when aggregated over both groups. There was no significant treatment effect for PGE2, IL-1a, or IL-1b (p > 0.05). There were no significant differences in clinical outcomes between groups (p > 0.05).

CONCLUSIONS:

Scheduled low-dose, short-term, IV ketorolac was associated with significantly different mean trends in IL-10 concentration in orthopaedic polytrauma patients with no significant differences in PGE2, IL-1a, IL-1b, or IL-6 levels between groups. The treatment did not have an impact on clinical outcomes of hospital or ICU LOS, pulmonary complications, or AKI.

LEVEL OF EVIDENCE:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Distal Femoral Stress Fractures Has High Operation Rates in Adolescent and Young Adult Athletes
Authors: DeFoor Mikalyn T. , Mullin Edmund P. , Cuenca Rachel A. , Pierrie Sarah N.
Published: March 2024

Background:

Although stress fractures of the distal femur are rare, symptoms can overlap with other peri-articular knee pathology, delaying diagnosis. Untreated stress fractures have the potential to progress into completed fractures with a higher likelihood for requiring surgery and longer recovery times in otherwise healthy adolescents and young adults. This case series represents the largest cohort of adolescent athletes with distal femoral stress fractures who presented with activity-related knee pain.

Methods:

Patients treated nonoperatively and operatively for metaphyseal distal femur stress fractures at a tertiary referral center over a four-year period were retrospectively identified from the medical record.

Results:

Eight patients (mean age 16.8 y; range 14 to 22 y; 87.5% male; mean body mass index [BMI] 20.9) with a total of 10 distal femur stress fractures were identified. All patients were involved in competitive sports or military training. There was an average of 3.8 encounters with a medical provider between presentation with activity-related knee pain and diagnosis with distal femur stress fracture. All except 1 patient (87.5%) were initially incorrectly diagnosed with another type of peri-articular knee pathology. Six stress fractures (60%) were treated conservatively with protected weight bearing, activity modification, and gradual return to activity. Four completed stress fractures (40%) required operative fixation—3 healed uneventfully, while 1 had an asymptomatic delayed union. Vitamin D insufficiency (<30 ng/mL) was identified in 7 of 8 patients (87.5%) and 3 patients (37.5%) had an underweight BMI (<18.5). The mean clinical follow-up was 13.1 weeks (range, 2.8 to 32.0 wk).

Conclusions:

High clinical suspicion for distal femoral stress fractures is needed to avoid misdiagnosis or delayed diagnosis in young, active individuals with activity-related knee pain refractory to conservative management. In this patient population, activity-related knee pain recalcitrant to activity modification, rest, and physical therapy warrants further workup with magnetic resonance imaging and orthopaedic evaluation. Though rare, misdiagnosis can result in catastrophic fractures with prolonged rehabilitation needs. An open line of communication and streamlined access for referral between primary care providers and orthopaedic surgeons is critical in preventing misdiagnosis and delayed treatment. Furthermore, the treatment of concomitant metabolic disorders and nutritional deficiency should not be neglected when treating distal femoral stress fractures.

Level of Evidence:

Level—IV (case series).
How Accurate Are Anatomical Surface Topography Parameters in Indicating the Presence of a Scoliosis?
Authors: Gardner Adrian , Berryman Fiona , Pynsent Paul
Published: March 2024

Study Design.

Retrospective analysis of a longitudinal cohort.

Objective.

To identify the presence of scoliosis from surface data.

Summary of Background Data.

Identifying AIS can be difficult. Screening is not universal for reasons including high false positive and negative rates. These difficulties can lead to some adolescents missing out on bracing.

Methods.

Logistic regression analysis of ISIS2 surface topography images only was performed. The x,y positions of the shoulders (Sh), axillae (Ax), waist (waist) and the x,y,z positions of the most prominent points over the posterior torso (scap) were used for the thoracic, thoracolumbar/lumbar and whole spine. The models were used to identify the presence of a 20-degree or larger scoliosis. Differences in the position of the landmarks were analyzed comparing left and right, with the suffix “Ht” representing a difference in the y coordinate, ”Off” the x coordinate, and “Depth,” the z coordinate. Model accuracy was assessed as both percentages and ROC curves with the coefficients as odds ratios.

Results.

There were 1283 images (1015 females and 268 males) all with a diagnosis of AIS. The models identified scoliosis in the thoracic spine with an 83% accuracy (AUC 0.91), thoracolumbar/lumbar spine with 74% accuracy (AUC 0.76), and whole spine with 80% accuracy (AUC 0.88). Significant parameters were AxDiffHt, AxDiffOff, WaistDiffHt, ScapDiffOff, and ScapDiffHt for the thoracic curves, AxDiffHt, AxDiffOff, WaistDiffHt for the thoracolumbar/lumbar curves, and AxDiffHt, AxDiffOff, WaistDiffHt and ScapDiffHt for the whole spine.

Conclusions.

The use of fixed anatomical points around the torso, analyzed using logistic regression, has a high accuracy for identifying curves in the thoracic, thoracolumbar/lumbar, and whole spines. While coming from surface topography images, the results raise the future use of digital photography as a tool for the identification of small scoliosis without using other imaging techniques.
Mesh Strip Repair for Midline Ventral Hernias: A Case Series
Authors: Sarac Benjamin A. , Hackenberger Paige , Janis Jeffrey E.
Published: March 2024

Background:

Polypropylene mesh strip repair is a novel method of hernia closure. Currently, there is limited representation in the literature regarding both the reproducibility of this method and its outcomes. The present study sought to analyze a second institution’s experience with fascial closure using the mesh strip technique with long-term follow-up.

Methods:

A retrospective review of all patients undergoing abdominal wall reconstruction by the senior author was performed. Patients undergoing midline ventral hernia repair with mesh strip only fascial closure and greater than 1 year follow-up were including for analysis. Demographic data; operative details; and outcomes, specifically presence and timing of hernia recurrence, were recorded.

Results:

Eighteen patients met inclusion criteria. Average follow-up was 860 ± 307 days. Nine patients (50%) had recurrence of their hernia after repair. Average time to recurrence was 602 ± 406 days, with the earliest recurrence occurring at 126 days postoperatively. Seven patients (39%) underwent concurrent anterior component separation (four unilateral, three bilateral), of which there were three recurrences, all occurring in patients with bilateral anterior component separation.

Conclusions:

The mesh strip repair is a novel technique that shows uncertain reproducibility of outcomes, specifically with concurrent component separation techniques. With the recent Food and Drug Administration approval of a mesh suture, further multi-institutional analysis will allow for better characterization of the outcomes and indications for this technique.
New Graduate Nurses' Experiences by Generation in South Korea: A Qualitative Meta-Synthesis
Authors: CHUNG Heejin , PARK Mihyun
Published: March 2024

Background

As the nursing organization environment evolves into one in which several generations work together, there are concerns about generational differences leading to conflicts.

Purpose

A synthesis of qualitative studies was used to gain insight into the experiences and perceptions of new nurses working in South Korean hospitals and identify generational differences between nurses of Generations X and Y.

Methods

Eight databases were searched systematically for qualitative studies published up to June 2020. The Critical Appraisal Skills Programme Checklist for Qualitative Research was used to evaluate the quality of the retrieved studies, and the data were synthesized thematically using the Thomas and Harden method.

Results

Of the 2,482 studies retrieved, 19 were included in this meta-synthesis. The experience of new nurses were presented in the three analytical themes of work experience, interpersonal relationships, and adaptation, from which eight descriptive themes were derived: (a) dissatisfied with own work performance, (b) negative feedback on work outcomes, (c) irregular daily life, (d) colleagues who help adapt to work life or make work life harder, (e) feelings of sympathy toward peers, (f) disrespectful patients or caregivers, (g) effective reactions, and (h) ineffective reactions. Although the new nurses from Generations X and Y reported similar experiences during their first year of nursing, differences were found in their values and tendencies regarding work and interpersonal relationships. Compared with new Generation X nurses, new Generation Y nurses placed more value on the meaning of individual work contributions, intimacy with colleagues, and appropriate feedback.

Conclusions/Implications for Practice

The findings of this study support nursing administrators implementing strategies that both acknowledge and reduce the impact of generational category on nursing teams. Furthermore, emphasizing communication and acknowledging ongoing change as generations progress may strengthen bonds that lead nurses to value each other and their work.
Persistent Fatigue in Patients With Hepatocellular Carcinoma Receiving Radiotherapy
Authors: CHEN Chiao-Yi , HUANG Bing-Shen , HONG Ji-Hong , CHANG Joseph Tung-Chieh , CHEN Min-Chi , TANG Woung-Ru , SHUN Shiow-Ching , CHEN Mei-Ling
Published: March 2024

Background

Radiation therapy has attracted much attention in the treatment of patients with hepatocellular carcinoma (HCC). However, the association between radiotherapy-related fatigue and HCC has been examined in only a few studies.

Purpose

This study was designed to explore the change over time in fatigue in patients with HCC treated with radiotherapy and related factors.

Methods

One hundred patients were enrolled in this prospective longitudinal study using convenience sampling at a medical center in northern Taiwan. The Functional Assessment of Chronic Illness Therapy-Fatigue scale, the Brief Pain Inventory-Short Form, and the psychological subscale of Memorial Symptom Assessment Scale-Short Form were used to assess the symptoms at five time points: before radiotherapy (T0), during treatment (T1), and at 1 month (T2), 3 months (T3), and 6 months (T4) after radiotherapy. The generalized estimating equations method was used to determine the changes in fatigue and the influencing factors.

Results

Fatigue levels at T1, T2, T3, and T4 were significantly higher than that at T0. Higher fatigue was significantly associated with lower income and poorer functional status. Having worse pain levels and psychological symptoms were both associated with higher fatigue.

Conclusions/Implications for Practice

The results indicate fatigue does not recover to the baseline (pretherapy) level by 6 months after radiotherapy. Thus, fatigue in patients with HCC receiving radiotherapy should be regularly and effectively assessed, and patients experiencing pain and psychological symptoms should be given greater attention from clinicians.
Perspectives of Chinese New Nurses Regarding Successful Transition: A Qualitative Study
Authors: MA Weiguang , XU Yutong , LIU Yuanfei , LIANG Tao , MA Fang
Published: March 2024

Background

Transition issues have been discussed for many decades, yet little is known about successful transition expectations in the context of Chinese culture.

Purpose

This article was designed to describe the expectations of newly graduated nurses in China regarding successful transition.

Methods

A qualitative, descriptive study design was employed, and a purposive sampling method was used to recruit interviewees. All of the one-to-one conversations were held in a quiet room to ensure privacy. All of the interviews were transcribed and then analyzed using thematic analysis.

Results

Nineteen new nurses were recruited from seven tertiary hospitals and participated in the in-depth interview process. Transition success, that is, “professional metamorphosis,” was revealed through the four themes of “being competent in nursing work,” “establishing a professional identity,” “establishing comfortable interpersonal relationships,” and “achieving balance between work and life.”

Conclusions/Implications for Practice

Chinese new nurses expect their successful transition to achieve a professional metamorphosis in many aspects. A successful transition is not only a journey of professionalization but also a process of socialization. New nurses expect to achieve both maturity in their work and wisdom in life. The results of this study provide a greater understanding of transition issues in the context of Chinese culture. Thus, support and strategies cannot be limited to interventions designed to improve working competence but should be individualized to help new nurses achieve a smooth transition.
Examining the Early Academic Performance of Doctor of Physical Therapy Students After Holistic Review: A Retrospective Cohort Study
Authors: Eikenberry Megan
Published: March 2024

Introduction.

A diverse health care workforce can help to address systemic health disparities. Holistic review and use of an expanded definition of underrepresented minority (URM) that includes factors beyond race and ethnicity are suggested methods to promote diversity in the physical therapist (PT) workforce and ultimately address societal health disparities.

Review of Literature.

Evidence suggests that holistic review can promote PT student diversity; however, limited evidence exists that describes the academic outcomes of holistic review that consider social determinants of learning (SDOL) factors in the review process. The purpose of this study was to examine the early academic outcomes of students after a holistic review and to examine relationships between SDOL factors and academic performance.

Subjects.

A convenience sample of 160 students admitted to a doctor of physical therapy (DPT) program from June 2020 to June 2022 was used.

Methods.

A secondary analysis of students' self-reported responses from their admissions application was used to categorize response data into SDOL groups. An independent-sample t-test was used to test group differences in academic performance, and regression modeling was used to test relationships between SDOL factors and academic performance.

Results.

The mean 6-month DPT program grade point average (GPA) of the sample was 3.32 ± .43. Nonstatistically significant differences appeared in early DPT GPA between URM and non-URM student groups. However, after controlling for undergraduate GPA, a history of educational disadvantage was the only SDOL factor that contributed to early DPT GPA variance (2.6%), P < .05.

Discussion and Conclusion.

The similar academic performance of URM and non-URM students provides support for using an expanded URM definition in holistic review. Most of the educationally disadvantaged group were first-generation college students, which was associated with lower early GPA. These results provide emerging evidence that first-generation students in DPT programs may benefit from additional academic support.
Abdominal normothermic regional perfusion in the United States: current state and future directions
Authors: Wall Anji , Gupta Amar , Testa Giuliano
Published: March 2024

Purpose of review

Normothermic regional perfusion (NRP) is a novel procurement technique for donation after circulatory death (DCD) in the United States. It was pioneered by cardiothoracic surgery programs and is now being applied to abdominal-only organ donors by abdominal transplant programs.

Recent findings

Liver and kidney transplantation from thoracoabdominal NRP (TA-NRP) donors in the United States was found to have lower rates of delayed kidney graft function and similar graft and patient survival versus recipients of cardiac super rapid recovery (SRR) DCD donors. The excellent outcomes with NRP have prompted the expansion of NRP technology to abdominal transplant programs.

Excellent early outcomes with liver and kidney transplantation have prompted the growth of NC-NRP procurement for abdominal-only DCD donors across the US, and now requires standardization of technical and nontechnical aspects of this procedure.
Evaluation of the relationship between restless legs syndrome, mental status, and sleep disorders among Moroccan women during their third trimester of pregnancy
Authors: Guerroumi Maroua , Aquil Amina , El Kherchi Ouassil , Ait Bouighoulidne Salma , Belhaj Haddou Meryam , Elgot Abdeljalil
Published: March 2024

Background:

Restless legs syndrome (RLS) is a motor disorder encountered during pregnancy and leads to psychological and sleep impairments. The latter seems to be non-restorative and its occurrence alters the quality of life of pregnant women. The objective of this study was to evaluate the prevalence of RLS and its relationship with both anxio-depressive symptoms and sleep disorders among a population of Moroccan pregnant women during their third trimester of pregnancy.

Methods:

A cross-sectional study was conducted in a population of pregnant women in their third trimester (n=178) admitted to two health facilities in the city of Marrakech: Youssef Ibn Tachafine and Oasis. The face-to-face questionnaire was used to collect data including demographic and clinical characteristics, the four diagnostic criteria of RLS, the Pittsburgh Sleep Quality Index (PSQI), and the Hospital Anxiety and Depression Scale (HADS). Patients were divided into two groups RLS+ (women with RLS) and RLS− (women without RLS).

Results:

The prevalence of RLS was 59.5%; this syndrome was more common in the ninth month (74.15%) compared with the seventh and eighth months. Sleep impairment, including sleep efficiency, was significantly higher in RLS+ than RLS− (P-value 0.05). Anxiety but not depression is significantly increased in RLS+ compared to RLS− (48.11% versus 38.8%, P = 0.000). There were no significant differences between RLS+ and RLS− in terms of socio-demographic and other clinical characteristics.

Conclusion:

RLS is encountered during the prenatal period, with a higher prevalence in the last trimester. During this stage of pregnancy, women suffering from RLS were vulnerable to anxiety and sleep disorders. Prevention and early diagnosis of RLS could be a proactive healthcare management leading to better health outcomes and better conditions of pregnancy, which precedes childbirth.
Understanding Risk Factors for Complaints Against Pharmacists: A Content Analysis
Authors: Wang Yufeng , Ram Sanyogita (Sanya) , Scahill Shane
Published: March 2024

Objectives

Pharmacists constitute a crucial component of the healthcare system, significantly influencing the provision of medication services and ensuring patient safety. This study aims to understand the characteristics and risk factors for complaints against pharmacists through Health and Disability Commissioner (HDC) published decisions.

Methods

This study adopts a retrospective, qualitative approach. An inductive content analysis technique was used to analyze 37 complaints against pharmacists published decisions from the New Zealand Health and Disability Commissioner website to investigate a range of underlying risk factors contributing to the occurrence of complaints against pharmacists.

Results

A set of 20 categories of risk factors emerged through the content analysis and were subsequently grouped into five overarching themes: pharmacist individual factors, organizational factors, system factors, medication-specific factors, and external environmental factors.

Conclusions

The findings of this study provide valuable insights that expand the understanding of risk management in pharmacist practice, serving as a valuable resource for regulatory bodies, policymakers, educators, and practitioners. It is recommended not only to focus solely on individual pharmacists but also to consider integrating their environment and individual behaviors to proactively address situations prone to errors and subsequent complaints.
Communication of Incidental Imaging Findings on Inpatient Discharge Summaries After Implementation of Electronic Health Record Notification System
Authors: Mattay Govind , Mallikarjun Kushanth , Grow Paula , Mintz Aaron , Ciesielski Thomas , Dao Anthony , Mattay Shivani , Cislo Geoffrey , Mattay Raghav , Narra Vamsi , Bierhals Andrew
Published: March 2024

Objectives

Inadequate follow-up of incidental imaging findings (IIFs) can result in poor patient outcomes, patient dissatisfaction, and provider malpractice. At our institution, radiologists flag IIFs during report dictation to trigger electronic health record (EHR) notifications to providers and patients. Nurse coordinators directly contact patients or their primary care physicians (PCPs) regarding IIFs if follow-up is not completed within the recommended time frame. Despite these interventions, many patients and their PCPs remain unaware of IIFs. In an effort to improve awareness of IIFs, we aim to investigate communication of IIFs on inpatient discharge summaries after implementation of our EHR notification system.

Methods

Inpatient records with IIFs from 2018 to 2021 were retrospectively reviewed to determine type of IIFs, follow-up recommendations, and mention of IIFs on discharge summaries. Nurse coordinators spoke to patients and providers to determine their awareness of IIFs.

Results

Incidental imaging findings were reported in 51% of discharge summaries (711/1383). When nurse coordinators called patients and PCPs regarding IIFs at the time follow-up was due, the patients and PCPs were aware of 79% of IIFs (1096/1383).

Conclusions

With implementation of EHR notifications to providers regarding IIFs, IIFs were included in 51% of discharge summaries. Lack of inclusion of IIFs on discharge summaries could be related to transitions of care within hospitalization, provider alert fatigue, and many diagnostic testing results to distill. These findings demonstrate the need to improve communication of IIFs, possibly via automating mention of IIFs on discharge summaries, and the need for care coordinators to follow up on IIFs.
Enhancing Patient Safety in Prehospital Environment: Analyzing Patient Perspectives on Non-Transport Decisions With Natural Language Processing and Machine Learning
Authors: Farhat Hassan , Alinier Guillaume , Tluli Reem , Chakif Montaha , Rekik Fatma Babay EP , Alcantara Ma Cleo , Gangaram Padarath , El Aifa Kawther , Makhlouf Ahmed , Howland Ian , Khenissi Mohamed Chaker , Chauhan Sailesh , Abid Cyrine , Castle Nicholas , Al Shaikh Loua , Khadhraoui Moncef , Gargouri Imed , Laughton James
Published: March 2024

Objective

This research explored the experiences and perspectives of patients declining hospital transportation after receiving prehospital emergency care using advanced computational techniques.

Method

Between 15th June and 1st August 2023, 210 patients in Qatar, treated by Hamad Medical Corporation Ambulance Service (HMCAS) but refusing transportation to hospital, were interviewed. Key outcome variables stratified by demographics included “reasons for refusing transport,” “satisfaction with HMCAS service,” and “postrefusal actions.” Responses underwent sentiment analysis and topic modeling using latent Dirichlet allocation. Machine learning models, such as Naïve Bayes, K-nearest neighboring, random forest, and support vector machine, were used to predict patients’ subsequent actions.

Results

Participants had an average age of 38.61 ± 19.91 years. The chief complaints were primarily chest and abdominal pains (18.49%; n = 39). Sentiment Analysis revealed a generally favorable perception of HMCAS-provided service. Latent Dirichlet allocation identified two main topics pertaining to refusal reasons and service satisfaction. Naïve Bayes and support vector machine algorithms were most effective in predicting postrefusal actions with an accuracy rate of 81.58%.

Conclusions

This study highlighted the utility of Natural Language Processing and ML in enhancing our understanding of patient behaviors and sentiments in prehospital settings. These advanced computational methodologies allowed for a nuanced exploration of patient demographics and sentiments, providing insights for Quality Improvement initiatives. The study also advocates for continuously integrating automated feedback mechanisms to improve patient-centered care in the prehospital context. Continuous integration of automated feedback systems is recommended to improve prehospital patient-centered care.
Using Mobile and Remote Simulation as a Research Methodology for Health Care Delivery Research
Authors: Yeh Vicky J.-H. , Tekin Aysun , Green Ellen , Reifsnider Elizabeth , Lewis Alicia , Carver Morgan , Dong Yue
Published: March 2024

Summary Statement

Mobile and remote simulation can be used as a research methodology to collect data in simulated environments to answer research questions pertaining to health care delivery. This research methodology can exponentially increase the reachable target study participants and provide generalizable conclusions. Using a large-scale national study in the United States as an exemplar, this article outlines the technology and equipment required to conduct mobile and remote simulations for research purposes. The cost associated with using mobile and remote simulations as well as the advantages and challenges of using this research methodology are also discussed.
Kenneth Dawson Bagshawe. 17 August 1925—27 December 2022
Authors: Begent Richard , Seckl Michael
Published: March 2024

Kenneth Bagshawe was a physician, a scientist and an architect of modern oncology. He was first to show that combination chemotherapy can cure a non-haematological cancer, choriocarcinoma. He demonstrated how a tumour marker in blood and urine can give a quantitative representation of the total amount of tumour, providing a monitor of response to treatment or relapse and an indicator of prognosis. He enhanced understanding and treatment of gestational trophoblastic diseases (GTD), a group of which choriocarcinoma is the most lethal member. The most common form of GTD is hydatidiform mole and he developed a national system for management, resulting in a cure rate of virtually 100%. For choriocarcinoma, the figure is today approaching 98%. His system is used in many countries, and over several decades has contributed to the cure and preservation of fertility in hundreds of thousands of women who previously had little or no hope. He used the same principles to treat testicular and ovarian germ cell tumours, again achieving high levels of cure in patients whose disease had spread and would previously have been fatal. He innovated throughout his career, seeking improved tumour specificity in diagnosis and treatment of GTD and inventing antibody-directed enzyme prodrug therapy for more common cancers. He founded the first department of oncology in the UK and devoted much time to developing the speciality, directing research funding organizations and supporting the development of the speciality worldwide. He was a dedicated, original and hugely productive pioneer of oncology.
Melting of wall-mounted ice in shear flow
Authors: Jolley Ellen M. , Dang Thuy Duong , Smith Frank T.
Published: March 2024

The melting of wall-mounted ice deep inside a water layer flow is investigated, the ice being initially in the form of a slender hump or step-up and the oncoming water upstream near the wall being warmer than the ice. The wall is at the same temperature as the oncoming water except beneath the ice where the wall temperature is the same as that of the ice. The unsteady interaction of the flow, heat transfer and phase change is studied analytically and computationally for a basic pure-ice model in two spatial dimensions at high flow rates. In-flow predictions of ice-shape evolution are presented along with the complete melting times and the vanishing points where melting is completed on the solid surface. This is for a range of initial conditions and background heat transfers. The unsteady movement of the contact points at the edges of the ice formation is determined explicitly for the cases of humps and steps, together with the ultimate behaviours of both the ice humps and the ice steps. Effects of reducing the sub-ice wall temperature and accretion leading to flow separation are also discussed.
Artificial water fluoridation for dental health improvement: a review and meta-analysis of the evidence and implications of a possible association between water fluoride and IQ
Authors: Braithwaite Vickie S. , Valentine Ruth A. , Wareham Nicholas J.
Published: March 2024

Background

Globally, dental caries affects 60-90% of schoolchildren. Although artificial water fluoridation improves dental health and reduces dental health inequalities, there is concern that excessive fluoride exposure may lower cognition.

We systematically reviewed and meta-analysed the association between water fluoride and intelligence quotient (IQ).

Methods

A literature search of Medline and Web of Science and random-effects meta-analysis comparing mean IQ of children living in low/normal or higher water fluoride areas was investigated. Followed by exploration of possible dose effects among sub-groups, living in moderate (<1.5 ppm) high (1.5-3.0 ppm) or extremely high (>3ppm) water fluoride areas.

Results

Twenty-three observational studies (n=9539 children) were included. Overall, the higher water fluoride group had a lower mean IQ compared with the low water fluoride group (standardised mean difference (95% confidence interval): -0.43 (-0.63 to -0.24) p<0.0001, I2=94.2% p<0.0001). Sub-group analysis showed no association between water fluoride and mean IQ in studies of moderate fluoride concentrations (moderate: 0.04 (-0.08 to 0.15) p=0.53, I2=0.0% p=0.68). Mean IQ was lower in the higher water fluoride groups (high: - 0.52 (-0.92 to -0.12) p=0.01, I2=96.2% p<0.00001, extremely high: -0.60 (-0.87 to -0.33), p<0.0001, I2=84.6% p<0.0001).

Conclusions

At moderate levels (<1.5 ppm) there was no statistical or clinically meaningful association between water fluoride and IQ. This suggests that populations living in these areas could benefit from artificial water fluoridation without experiencing neurotoxicity. An association between lower mean IQ and high water fluoride observed suggests a need to prioritise removal of excess fluoride from drinking water in these regions.

Key Message (3-5 bullet points in complete sentence)

At low concentrations of water fluoride (<1.5 ppm) there was no detectable association between water fluoride and intelligence quotient (IQ);

At high levels of water fluoride concentrations (>1.5 ppm) there was an inverse association between increasing fluoride concentration and decreasing mean IQ;

In countries in which fluoridation of water is considered but kept within safe concentrations, the available evidence suggests that fluoridation has demonstrable benefits on public dental health without any clinically significant effect on IQ.

In countries with excessive groundwater fluoride concentrations there is an imperative to promote water de-fluoridation schemes to protect the public from skeletal and dental fluorosis and from possible neurotoxicity.
H2inhalation therapy in patients with moderate Covid 19 (H2COVID): a prospective ascending-dose phase 1 clinical trial
Authors: Salomez-Ihl Cordélia , Giai Joris , Barbado Maud , Paris Adeline , Touati Saber , Alcaraz Jean- Pierre , Tanguy Stéphane , Leroy Corentin , Lehmann Audrey , Degano Bruno , Gavard Marylaure , Bedouch Pierrick , Pavese Patricia , Moreau-Gaudry Alexandre , Roustit Mathieu , Boucher François , Cinquin Philippe , Brion Jean-Paul
Published: March 2024

Introduction

The Covid-19 pandemic, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has triggered a serious global health crisis, resulting in millions of reported deaths since its initial identification in China in November 2019. The global disparities in immunization access emphasize the urgent need for ongoing research into therapeutic interventions. This study focuses on the potential use of molecular dihydrogen (H2) inhalation as an adjunctive treatment for Covid-19. H2 therapy shows promise in inhibiting intracellular signaling pathways associated with inflammation, particularly when administered early in conjunction with nasal oxygen therapy.

Methods

This Phase I study, characterized by an open-label, prospective, monocentric, and single ascending dose design, seeks to assess the safety and tolerability of the procedure in individuals with confirmed SARS-CoV-2 infection. Employing a 3+3 design, the study includes three exposure durations (target durations): 1 day (D1), 3 days (D2), and 6 days (D3).

Results

We concluded that the Maximum Tolerated Duration is at least three days. Every patient showed clinical improvement and excellent tolerance to H2 therapy.

Discussion/conclusion

To the best of our knowledge, this phase 1 clinical trial is the first to establish the safety of inhaling a mixture of H2 (3.6%) and N2 (96.4%) in hospitalized Covid-19 patients. The original device and method employed ensure the absence of explosion risk. The encouraging outcomes observed in the 12 patients included in the study justify further exploration through larger, controlled clinical trials.

Question

What is the Maximum Tolerated Duration of inhalation for a gaseous mixture including 3.6% of molecular dihydrogen in moderate COVID-19 patients?

Findings

The Maximum Tolerated Duration is at least three days. All patients showed clinical improvement and excellent tolerance to H2 therapy. To the best of our knowledge, this phase 1 clinical trial is the first to establish the safety of inhaling a mixture of H2 (3.6%) and N2 (96.4%) in hospitalized Covid-19 patients.

Meaning

A gaseous mixture including 3.6% H2, considered in the literature to have promising anti-inflammatory potential, and presenting no risk of explosion, can be used in patients with moderate COVID 19 for at least three days.