bluuebunny/crossref_metadata_2025 huggingface dataset:
The first successful treatment and genetic sequencing of primary hepatic adenosarcoma with sarcomatous overgrowth: a case report
Authors: Hu Hanjie , Song Qianqian , Zhao Hong , Zheng Bo , Lu Haizhen
Published: April 2022

Adenosarcoma is a rare type of tumor with a mixture of epithelial and stromal components and often occurs in the female reproductive system. Primary hepatic adenosarcoma (PHAS) is extremely rare, with only two cases reported so far. Both patients had poor outcomes. Here, we report the case of a 36-year-old man with pain under the xiphoid process who was diagnosed with a bile duct tumor. He was treated with adjuvant radiotherapy when surgery was performed on him. Pathologically, the tumor contained benign epithelial tissue, and the submucosa of the bile duct in the liver showed infiltrating growth of spindle cell components. The cells were dense, mildly heterotypic, and occasionally mitotic, and the patient was diagnosed with PHAS. Whole-exome sequencing results showed that a total of 12 mutations were shared by the two tissues. The patient received adjuvant radiotherapy and he was tumor-free until 31 months postoperatively. This case will provide some references of the disease to other researchers.
Pain sensitivities predict prophylactic treatment outcomes of flunarizine in chronic migraine patients: A prospective study
Authors: Pan Li-Ling Hope , Wang Yen-Feng , Ling Yu-Hsiang , Lai Kuan-Lin , Chen Shih-Pin , Chen Wei-Ta , Treede Rolf-Detlef , Wang Shuu-Jiun
Published: April 2022

Background

We aimed to assess the differences in quantitative sensory testing between chronic migraine and healthy controls and to explore the association between pain sensitivities and outcomes in chronic migraine following preventive treatment.

Methods

In this prospective open-label study, preventive-naïve chronic migraine and healthy controls were recruited, and cold, heat, mechanical punctate, and pressure pain thresholds over the dermatomes of first branch of trigeminal nerve and first thoracic nerve were measured by quantitative sensory testing at baseline. Chronic migraines were treated with flunarizine and treatment response was defined as ≥50% reduction in the number of monthly headache days over the 12-week treatment period.

Results

Eighty-four chronic migraines and fifty age-and-sex-matched healthy controls were included in the analysis. The chronic migraine had higher cold pain thresholds over the dermatomes of the first branch of trigeminal nerve and the first thoracic nerve ( p < 0.001 and < 0.001), lower pressure pain thresholds over the dermatomes of the first thoracic nerve ( p = 0.003), heat pain thresholds over the dermatomes of the first branch of the trigeminal nerve and the first thoracic nerve ( p < 0.001 and p = 0.015) than healthy controls. After treatment, 24/84 chronic migraine had treatment response. The responders with relatively normal pain sensitivity had higher heat pain thresholds over the dermatome of the first branch of the trigeminal nerve ( p = 0.002), mechanical punctate pain thresholds over the dermatomes of the first branch of the trigeminal nerve ( p = 0.023), and pressure pain thresholds over the dermatomes of the first branch of the trigeminal nerve ( p = 0.026) than the hypersensitive non-responders. Decision tree analysis showed that patients with mechanical punctate pain threshold over the dermatomes of the first branch of the trigeminal nerve > 158 g ( p = 0.020) or heat pain threshold over the dermatome of the first branch of the trigeminal nerve > 44.9°C ( p = 0.002) were more likely to be responders.

Conclusions

Chronic migraine were generally more sensitive compared to healthy controls. Preventive treatment with flunarizine should be recommended particularly for chronic migraine who have relatively normal sensitivity to mechanical punctate or heat pain. Trial registration: This study was registered on ClinicalTrials.gov (Identifier: NCT02747940).
Differentiating Reading Profiles of Children With Specific Comprehension Deficits From Skilled Readers: A Systematic Review
Authors: Guo Daibao , Feng Luxi , Hodges Tracey S.
Published: April 2022

The primary goal of the present systematic review was to examine the criteria and measures used for assessing students with specific comprehension deficit (SCD) who have adequate decoding skills but still perform poorly on reading comprehension assessments. From a systematic review of 32 studies, we found four predominant selection approaches for classifying students with SCD and a wide range of measurements of reading skills used to distinguish students with SCD from skilled readers. In addition, to develop a reading profile for students with SCD, we performed a meta-analysis to quantify the characteristics of SCD by comparing their reading skills to those of skilled readers. Results revealed that students with SCD demonstrated deficits in oral language (i.e., vocabulary and listening comprehension) and reading comprehension, despite adequate decoding and fluency skills. Their reading comprehension deficits (Hedges’s g = −3.28) were also more severe than their oral language deficits (Hedges’s g = −0.95). We provide recommendations and implications for future researchers and classroom teachers.
Single-Case Experimental Design for Evaluating Basic Reading Interventions for Students With Learning Disabilities: An Illustrative Case
Authors: Berkeley Sheri , Hock Michael , Washburn Jocelyn
Published: April 2022

Many students with learning disabilities (LD) do not master basic reading skills, which affects later reading fluency and reading comprehension development. Single-case experimental design (SCED) research yields unique opportunities to better understand which aspects of a basic reading intervention are effective with a particular student, including the individual’s rate of growth, stability, or maintenance of acquired skills, and whether or not modifications need to be made to the intervention under study. In this article, we use a case study illustration to highlight unique considerations for using SCED research to investigate basic reading interventions for students with LD. Finally, we provide a discussion of future directions and a potential shift in SCED methodology that is responsive to the comprehensive and multiple skill nature of reading instruction.
Suboptimal Dosing of Benzodiazepines and Levetiracetam in a Cohort of Status Epilepticus Patients and Outcomes Associated with Inadequate Dosing
Authors: Braun Kristina R. M. , Pham L. Lisa , Wall Geoffrey C. , Welty Timothy E.
Published: April 2022

Background: Status epilepticus (SE) is a neurologic emergency that can result in serious morbidity and mortality. Recent studies have suggested underdosing of both benzodiazepines (BZDs) and antiseizure medications (ASM) which may result in poorer outcomes. Objectives: This study aims to determine the dose of BZDs and levetiracetam given in our emergency department for episodes of SE and determine the outcomes associated with this dosing. Methods: We conducted a retrospective cohort study of all adult patients with SE admitted to our hospital from 2017 to 2020. We collected demographic data, type of SE, dose of BZD and levetiracetam, and outcomes which included mortality and a calculated Glasgow outcome scale (GOS). We compared outcomes of patients with SE who received adequate dosing (according to practice guidelines) to those who did not. Results: 111 adult patients were included of whom 91% were seen initially in our emergency department. 75% had convulsive SE on presentation. Approximately 55% and 68% of patients did not receive an appropriate dose of BZD or levetiracetam, respectively. Inadequate dosing of BZD was associated with worse clinical outcomes based on GOS (43.6% favorable outcome vs 62.5% with adequate dosing P = .046 (95% CI, 1.01–4.60)) and inadequate dosing of both drugs was also associated with a worse GOS outcome (HR, 2.91 (95% CI, 1.05–9.67, P = .02). No difference was found in length of stay or mortality alone. Conclusion: Our study found inadequate dosing of drugs to treat SE in adults was common in our institution and was associated with worse outcomes.
Functional outcome of infected endoprosthesis: A 20-year retrospective analysis
Authors: Ajit Singh Vivek , Balakrishnan Sashi Darshan , Dhanoa Amreeta , Santharalinggam Rupini Devi , Yasin Nor Faissal
Published: April 2022

Purpose

Bone tumours are increasingly treated with limb-salvage surgeries. However, implant infection is a devastating complication, greatly affecting the functional outcome. Yet, data on functional outcome post-implant infection are scarce. This study aims to determine the functional outcome and implant survival of these patients.

Methods

Patients' data on endoprosthetic replacement surgeries at our institution (January 1996–December 2016) was retrospectively reviewed. Information was available for 161 patients and was analysed using SPSS and SMART Partial Least Squares. Functional outcome was determined using the Musculoskeletal Tumor Society (MSTS) and Toronto Extremity Salvage Score (TESS) scoring system.

Results

Both mean rank MSTS (33.14 vs 87.02) and TESS (48.17 vs 85.13) scores were significantly lower in the infected group. These differences remained statistically significant after excluding amputation and rotationplasty cases within the infected group. Even after the resolution of infection, both MSTS and TESS remained significantly higher in the non-infected group. However, analysis of the infected group showed no significant differences in functional outcome between persistent and resolved infections (implant in-situ). Age significantly impacted the functional outcome for both the non-infected and infected groups, while local recurrence and metastasis significantly impacted the non-infected cases. Local tumour recurrence was lower in infected endoprosthetic patients (8.3% vs 10.5%). 56% of infected implants were removed; the majority were treated with two-stage revision surgery.

Conclusion

Endoprosthesis infection worsens the overall functional outcome. Additional factors affecting functional outcome were age, presence of local recurrence and metastatic disease. Local tumour recurrence was lower amongst infected endoprosthesis cases, and >50% of infected implants were removed.
Investigation on the etiology of patients undergoing non-traumatic total hip arthroplasty in China
Authors: Ma Yunqing , Zhi Xin , Zhang Hong
Published: April 2022

Background

China has neither a nationwide joint replacement registry similar to Sweden and New Zealand nor a universal healthcare (medical insurance) registry similar to Hong Kong and Singapore to check. The purpose was to initially understand the distribution characteristics of gender, age and etiology of patients undergoing total hip replacement for non-traumatic reasons nationwide.

Methods

The clinical data of patients who underwent initial artificial total hip replacement due to non-traumatic reasons in joint surgery of 13 large general first-class hospitals at Grade 3 in northern, western, eastern, southern, and southwestern China were collected. After the classification of patients by gender, the etiological characteristics and age distribution of male and female patients were compared, as well as male to female ratio and disease composition ratio of patients of different ages, distribution of causes in different regions, composition ratio, and age distribution characteristics of patients of different ethnic groups.

Results

In this study, the data of a total of 7663 patients in joint surgery of 13 general first-class hospitals at Grade 3 from 2015 to 2017 were collected, and 7622 patients were finally included in the study after excluding missing age, gender and some foreign patients. The main causes of diagnosis in male patients were AVN, DDH, and OA, and top 3 causes in female patients were DDH, AVN, and OA.

Conclusions

This study initially understand the distribution characteristics of gender, age and etiology of patients undergoing total hip replacement for non-traumatic reasons nationwide, and further guide the clinical diagnosis, early prevention and treatment of the disease and provide data.
Comorbidity of Lifetime History of Abuse and Trauma With Opioid Use Disorder: Implications for Nursing Assessment and Care
Authors: Driscoll Powers Linda , Cook Paul F. , Weber Mary , Techau Aimee , Sorrell Tanya
Published: April 2022

BACKGROUND:

Opioid use disorder (OUD) is a public health crisis and is challenging to treat. Previous research has shown correlations between OUD, abuse/trauma, and chronic pain.

AIMS:

The purpose of this study was to investigate history of lifetime sexual, physical, and/or emotional abuse among participants in a medication-assisted treatment (MAT) program for OUD, and to investigate associations between abuse history and chronic pain.

METHODS:

This is a secondary analysis of intake data from a 2-year, nonexperimental cohort treatment program of patients with OUD in rural Colorado. De-identified data were provided by 476 adult MAT patients using the Adult Addiction Severity Index (ASI-6). The ASI-6 includes three yes/no questions about history of abuse (emotional, physical, and sexual), with separate scoring for “past 30 days” and “lifetime” abuse.

RESULTS:

Lifetime history among MAT program for OUD patients was 23% for sexual abuse, 43% for physical abuse, and 58% for emotional abuse. History of physical abuse was significantly associated with having a chronic pain diagnosis, χ2 = 4.49, p = .03, and also with higher reported pain levels, t(460) = 2.71, p = .007.

CONCLUSION:

Lifetime history of physical abuse was associated with OUD and chronic pain, yet standard pain assessments do not assess these factors. In health care settings, the implementation of standardized trauma-informed screening tools, prompt recognition of abuse/trauma history, and adjunct psychological interventions may reduce stigma, reduce opioid use escalation, and help patients overcome OUD.
Equity in the Perceived Quality of Care Received by Malaria Patients Under National Health Insurance Scheme in Ghana
Authors: Amporfu Eugenia , Apanya Selom , Amoako Prince
Published: April 2022

The Ghana National Health Insurance Scheme (NHIS) seeks to provide access to quality healthcare to its members regardless of the health facility in which they receive care. However, it is unclear if all members of the Scheme receive quality care. The objective of the study is to examine the equity of perceived healthcare quality received by NHIS members depending on the type of facility in which care was provided. The study purposively sampled 2000 NHIS members who sought malaria treatment in the study areas. Only patients who had visited the health facilities at least twice not more than 12 months, before the data collection, were sampled. The SERVQUAL model was used to examine perceived quality of healthcare services in 5 quality dimensions: Reliability, Assurance, Tangibility, Empathy, and Responsiveness. These quality dimensions were compared in health facilities according to ownership (public, private, and faith-based facilities), capacity (hospital vs health centers), and finally location (urban vs rural health facilities). Instrumental variable estimation method was used to analyze data to address health facility selection bias problem. The results showed that faith-based health facilities scored the highest in all 5 perceived quality dimensions followed by public and private. Hospitals had higher score in perceived quality than health centers just as urban facilities scored higher in quality than rural facilities. These results represent high inequality in the perceived quality of care received by NHIS members.
‘Our old pastor thinks the mobile phone is a source of evil.’ Capturing contested and conflicting insights on digital wellbeing and digital detoxing in an age of rapid mobile connectivity
Authors: Mutsvairo Bruce , Ragnedda Massimo , Mabvundwi Kames
Published: April 2022

While Africa has largely been considered a digitally-disconnected country, recent studies have shown that connectivity figures are on a rise. In this paper, we theorize digital wellbeing in a context characterized by a fast-growing number of mobile data users despite a historically low Internet penetration. It is focused on an ongoing ethnographic research on mobile users and digital inequalities in Africa, zooming in on results from an explorative study featuring 10 in-depth interviews with young adult heavy users (more than 4–5 hours a day) and seeking to understand strategies they use in attaining digital wellbeing. The findings show how the sampled young adults (18–30 years old) struggle with the daily realities of digital participation including addiction and generational conflict in technology use. Results also reveal ways through which electronic connectivity is perceived both be a tool of freedom as well as a subtle form of potential digital enslavering.
Synchronization behaviors of a vibrating mechanical system with adjustable frequencies and motion trajectories
Authors: Zhang Xueliang , Zhang Wei , Chen Weihao , Hu Wenchao , Zhang Xu , Wen Bang-Chun
Published: April 2022

In present work, the double and triple-frequency synchronization behaviors of a vibrating mechanical system with two different driving frequencies, driven by three reversed rotating exciters, are investigated by theory, numeric, and experiment. Based on Lagrange’s equations, the dynamic model corresponding to vibrating machine is proposed and motion differential equations are constructed. The Bogoliubov standard formal equations for three exciters are established, by introducing the asymptotic method, in which the synchronization problem is converted into that of the existence and stability of zero-valued solution of the average differential equations. The synchronization criterion of satisfying the synchronous operation is deduced. According to the Routh–Hurwitz criterion, the stability criterion of the synchronous states is achieved analytically. Based on the obtained theory results, the stability characteristics of the system, are numerically discussed in detail, including the stability ability coefficients and stable phase differences. Finally, simulations and experiments under the condition of two different driving frequencies, are performed to further examine the validity of the theoretical and numerical qualitative results. The present work can provide a theoretical reference for designing some new types of the vibrating machines with adjustable frequencies and motion trajectories.
Algorithms, contexts, governance: An introduction to the special issue
Authors: Gritsenko Daria , Markham Annette , Pötzsch Holger , Wijermars Mariëlle
Published: April 2022

This introduction to the special issue on algorithmic governance in context offers an outline of the field and summarizes each contribution to the issue.
What to Blend? Exploring the Relationship Between Student Engagement and Academic Achievement via a Blended Learning Approach
Authors: Argyriou Paraskevi , Benamar Kenza , Nikolajeva Milena
Published: April 2022

The present study investigated whether student engagement with different online blended learning activities predicts academic performance as measured via a multiple-choice online exam for an undergraduate cognitive psychology course. Higher completion rates of weekly online quizzes predicted final exam performance. Findings are discussed in relation to using online learning resources to enhance student engagement and performance and learning analytics to identify students in need of further support. Since findings only revealed one significant predictor, more research is required to identify additional factors influencing academic achievement in an online blended learning approach.
Vocabulary Assessment Techniques: Perspectives of School-Based Speech-Language Pathologists
Authors: Steele Sara C. , Gibbons L. Grace
Published: April 2022

This study documented the standardized tests and informal assessment techniques that school-based speech-language pathologists (SLPs) reported as most helpful for identifying vocabulary deficits and for monitoring progress. Speech-language pathologists ( N = 142) working in U.S. public school settings completed an online survey that included multiple-choice, multiple-answer, and open-ended formats. Percentages and frequency counts were reported. For identifying vocabulary deficits, SLPs favored omnibus language tests over vocabulary-specific tests. The most frequently selected informal assessments for identifying vocabulary deficits were language samples and curricular-based measures. For monitoring progress, respondents favored creating their own tasks and using curricular-based measures. Minor differences were noted in the responses of elementary and middle-high school SLPs. Results were compared with evidence-based principles for vocabulary assessment.
A single centre retrospective analysis of short- and medium-term outcomes using the Woven EndoBridge (WEB) device and identification of the device-to-aneurysm volume ratio as a potential predictor of aneurysm occlusion status
Authors: Kewlani Bharti , Ryan David John , Henry Jack , Wyse Gerald , Fanning Noel
Published: April 2022

Background

The Woven EndoBridge (WEB) is a potential treatment option in patients with wide-necked bifurcation aneurysms (WNBAs). We analysed our WEB device outcomes (occlusion rates and complications) and studied factors that may predict aneurysm occlusion status at short- and medium-term follow-up.

Methods

74 patients with ruptured and unruptured aneurysms underwent treatment with the WEB device over a 5-year period. Simple hypothesis tests assessed differences between treated ruptured and unruptured aneurysms. Univariable binary logistic regression was used to assess the effect of age, gender, and aneurysm location on the likelihood of adequate occlusion at six months. Aneurysm dimentions including device-to-aneurysm volume (DAV) ratios were compared between adequately and inadequately occluded aneurysms.

Results

The mean age at the time of the procedure was 58.2 years (SD 12.2; range 34–88) and the male to female ratio was 1:2.7. Middle cerebral artery (MCA) was the most commonly treated aneurysm. There was no significant difference in occlusion rates between ruptured and unruptured aneurysms. The six- and 18-month angiographic follow-up data was available for 61 and 32 patients respectively with adequate occlusion rates of 78.7% (48/61) and 78.1% (25/32). Procedure-related complications occurred in 6 patients (8.1%). Baseline DAV ratio was found to be significantly higher in aneurysms that were adequately occluded at both short- ( p-value 0.015) and medium-term ( p-value 0.047) follow-up.

Conclusions

WEB devices are a safe and effective endovascular treatment option for WNBAs. WEB device selection incorporating the peri-procedural DAV ratio may help improve the accuracy of device sizing thereby improving the successful occlusion rate.
Developing Grounded Theory Systematic Approach for Public Policy Researches
Authors: Aslipour Hosein , Zargar Mohamad Reza
Published: April 2022

This paper seeks to facilitate the use of grounded theory (GT) methodology by novice researchers and PhD students of public policy discipline. The GT is widely used in social sciences research. This methodology has different variations, while Strauss and Corbin’s systematic approach is more pragmatic than others due to the introduction of a staged process known as axial coding. Regarding the fact that applying this method is largely dependent on the context of the research area, the main question is, what would be the elements of a systematic approach specifically customized for the public policy research domain? This paper is an analytical review of the research literature in 3 areas: variants of grounded theory approaches, soft systems models in social science, and public policy subsystem elements. This research suggests the use of 6 categories of context and discourse, content and ideas, participants, structure, policy process, and outputs and effects as a substitute for the three categories of Strauss and Corbin’s axial coding paradigm of GT.
Preliminary study of astragaloside IV on oxaliplatin-induced peripheral neurotoxicity in rats
Authors: Yi Lanjuan , Li Shan , Hou Aihua , Dai Lingling
Published: April 2022

Objective: As an effective component of Astragalus membranaceus, astragaloside IV (AS-IV) has a history of thousands of years in China. Many evidences have indicated that AS-IV has a potential neuroprotective effect. In this study, we aimed to preliminarily study the effects of AS-IV on oxaliplatin-induced peripheral neurotoxicity (OIPN) in rats.

Methods: Intraperitoneal injection of oxaliplatin for 4 weeks (4 mg/kg, twice a week) was used to establish peripheral neurotoxicity in rats. 40 Sprague Dawley rats were randomly divided into five groups, eight rats in each group, including control group, model group, and three AS-IV treated groups. Different doses of AS-IV (5 mg/kg, 10 mg/kg, and 20 mg/kg, daily) were orally administrated to OIPN rats once a day for 4 weeks at beginning of oxaliplatin administration. Behaviors and histologic evaluation of sciatic nerve and dorsal root ganglia (DRG) were performed to assess the changes of peripheral neurotoxicity through mechanical allodynia and cold allodynia, immunofluorescence, H&E staining, myelin staining, and Nissl staining.

Results: AS-IV treatments were able to significantly reduce oxaliplatin induced mechanical and cold allodynia. Moreover, AS-IV administration could increase the levels of NGF, but decrease the levels of TNF-α and IL-6 in oxaliplatin induced rats. AS-IV suppressed the activation of Iba-1 in anterior horn of spinal cord of OIPN rats. The myelin sheath degenerations in the sciatic nerve of OIPN rats were repaired after AS-IV administration. Through observation of sciatic nerves and DRG, AS-IV treatments improved the oxaliplatin induced pathologic injuries in a dose-dependent.

Conclusion: AS-IV administration was able to attenuate the oxaliplatin-induced peripheral neurotoxicity in rats.
Good news is good news for new economic powers
Authors: Zhang Jianhong , Zhou Chaohong , Ebbers Haico
Published: April 2022

Although negativity bias is well-documented in media and communication studies, negative news may not always be more influential than positive news. This study adds to the literature by looking at how the positive-negative asymmetry varies with the characteristics of the objects. It examines the media effect on the public perception of three large emerging countries (China, India and South Africa) and their firms. The results indicate that both negative news and positive news influenced respondents’ evaluation of country image and firm attractiveness; the negativity bias was associated with political country image, and the positivity bias was associated with eco-technological country image, affective country image and firm attractiveness; the effect size of media salience on affective country image was higher than on eco-technological and political country image. Comparing the three countries, the study also found that national economic and political development level and international relations were relevant to understanding media salience and public perception of foreign countries.
Comparison of 3D constructive interference in steady state (CISS) and T2 sampling perfection with application optimized contrasts using different flip angle evolution MR imaging of the intracranial trigeminal nerve and central skull base neuroforamina
Authors: Kinger Nikhar P , Chien Ling-Chen , Sharma Puneet S , Gravolet Ryan B , Aiken Ashley H , Baugnon Kristen L , Wu Xin
Published: April 2022

Background and Purpose:

Due to surgical advancements, the accurate detection of perineural disease spread has become increasingly important in the management and prognostication of head and neck cancers, though MR evaluation has thus far been limited by technical and logistic challenges. The purpose of this study was to specifically evaluate the relative capability of 3D CISS and 3D T2-SPACE imaging to delineate the proximal intracranial divisions of the normal trigeminal nerve, an area important in determining the resectability of intracranial perineural disease.

Materials and methods

A single center HIPAA-compliant, IRB approved retrospective review of 40 patients with clinical temporal bone/internal auditory canal MR imaging was conducted. 20 patients with 3D CISS images and 20 patients with 3D T2-SPACE images met inclusion criteria. Two radiologists scored the sequences on a 3-point scale based on ability to visualize anatomic structures surrounding the trigeminal nerve in Meckel’s cave, intracranial trigeminal divisions, skull base neuroforamina, and proximal extracranial mandibular division.

Results

The following anatomic locations scored significantly better in the T2-SPACE sequence compared to the CISS sequence for both raters: intracranial V3 ( p < .05), foramen ovale ( p < .05), and extracranial V3 ( p < .01). The average scores for the anterior Meckel’s cave and foramen rotundum were higher for the T2-SPACE sequence, although not significantly. Percent interobserver agreement ranged from 50 to 90% and 65–100% for the different anatomic locations on the CISS and T2-SPACE sequences, respectively.

Conclusion

3D T2-SPACE was found to be superior to 3D CISS in the evaluation of the distal intracranial and extracranial portions of the normal trigeminal nerve.
Digital tools to support the maintenance of physical activity in people with long-term conditions: A scoping review
Authors: Clarkson Paul , Stephenson Aoife , Grimmett Chloe , Cook Katherine , Clark Carol , Muckelt Paul E , O’Gorman Philip , Saynor Zoe , Adams Jo , Stokes Maria , McDonough Suzanne
Published: April 2022

Objective

This scoping review aimed to bring together and identify digital tools that support people with one or more long-term conditions to maintain physical activity and describe their components and theoretical underpinnings.

Methods

Searches were conducted in Cumulative Index to Nursing and Allied Health Literature, Medline, EMBASE, IEEE Xplore, PsycINFO, Scopus, Google Scholar and clinical trial databases, for studies published between 2009 and 2019, across a range of long-term conditions. Screening and data extraction was undertaken by two independent reviewers and the Preferred Reporting Items for Scoping Reviews guidelines informed the review's conduct and reporting.

Results

A total of 38 results were identified from 34 studies, with the majority randomised controlled trials or protocols, with cardiovascular disease, type 2 diabetes mellitus and obesity the most common long-term conditions. Comorbidities were reported in >50% of studies but did not clearly inform intervention development. Most digital tools were web-browser-based ± wearables/trackers, telerehabilitation tools or gaming devices/components. Mobile device applications and combination short message service/activity trackers/wearables were also identified. Most interventions were supported by a facilitator, often for goal setting/feedback and/or monitoring. Physical activity maintenance outcomes were mostly reported at 9 months or 3 months post-intervention, while theoretical underpinnings were commonly social cognitive theory, the transtheoretical model and the theory of planned behaviour.

Conclusions

This review mapped the literature on a wide range of digital tools and long-term conditions. It identified the increasing use of digital tools, in combination with human support, to help people with long-term conditions, to maintain physical activity, commonly for under a year post-intervention. Clear gaps were the lack of digital tools for multimorbid long-term conditions, longer-term follow-ups, understanding participant's experiences and informs future questions around effectiveness.
A bibliometric analysis on global eHealth
Authors: Tian Hua , Chen Jie
Published: April 2022

Background

The current coronavirus disease 2019 pandemic highlights the potential of eHealth. Drawing the knowledge map of eHealth research through data mining and visual analysis technology was helpful to systematically present the research status and future trends of global academic circles.

Methods

Based on the web of Science Core Collection (SCIE/SSCI) database, using bibliometric theory and visual analysis technology, this work analyzed the global eHealth research publications from 2000 to 2021, and introduced the interdisciplinary characteristics, hot topics and future trends in this field.

Results

A total of 10188 authors, 891 journals, 3586 institutions, 98 countries using 12 languages had conducted eHealth research in the world. The United States, the Netherlands, Australia and the United Kingdom were the main forces and international cooperation. However, the international co-operation between Eastern and Western countries was still relatively few. The frontier of global eHealth research mainly focused on #0eHealth innovation, #1physical activity, #2generalised anxiety disorder, #3lightweight authentication protocol, #4 eHealth information, #5technology readiness, #6 ehealth literacy scale, #7family carer, #8citance analysis, #9 guiding patient. Clusters #3 lightweight authentication protocol and #9 guiding patient were the latest clusters, indicating the research trend and direction of eHealth in the future.

Conclusions

Cooperation network framework at the regional, national and global levels and the cooperation of multidisciplinary teams with complementary backgrounds and expertise were needed to realize the in-depth popularization and application of eHealth knowledge. Interdisciplinary international cooperation should be the trend of eHealth research in the future.
Patients with treated autoimmune hepatitis and persistent suppression of plasmacytoid dendritic cells: A different point of view
Authors: dos Santos Irene P , de Assunção Mayra T , Mauch Renan M , Sandy Natascha Silva , Nolasco da Silva Marcos Tadeu , Bellomo-Brandão Maria Angela , Riccetto Adriana Gut Lopes
Published: April 2022

Objectives: Plasmacytoid dendritic cells (pDCs) have been shown to have a role in autoimmune diseases, but their role in Autoimmune Hepatitis (AIH) is not completely clear. In the present study, we assessed the frequency of pDCs in peripheral blood of AIH patients under long-term standard immunosuppressive therapy. Methods: This cross-sectional analysis enrolled 27 AIH patients and 27 healthy controls. We analyzed and compared their proportion of pDCs, CD4+, CD8+, γδ T cells, CD25+ regulatory T (Treg) cells, FoxP3+, Foxp3+CD39+ Treg cells, total B (CD19+) cells, and plasma cells (CD38+) in peripheral blood using flow cytometry immunophenotyping. Results: AIH patients had a lower percentage of pDCs (median frequencies of 0.2% vs. 0.4%; p = .002) and higher expression of CD8 T cells (32.5% vs 28.6%; p = 0.008) in peripheral blood, when compared to healthy controls. We did not find statistically significant differences between the groups regarding the other cell subtypes.Conclusion: Our data suggest a persistent suppression of pDCs in AIH patients, along with increased CD8 T cell activity, years after AIH diagnosis and despite of good clinical response to treatment, thus pointing to a role of pDCs in the AIH pathogenesis.
Use of prophylactic antibiotics on surgical site infections in arthroplasty patients (Scoping Review)
Authors: Almuhtarihan Irsan Fahmi , S Suharjono  , Airlangga Primadenny Ariesa , Padolo Elfri
Published: April 2022

Background

Increased demand for arthroplasty also increases the number of complications of arthroplasty, especially surgical site infection (SSI). One of the effective strategies in preventing surgical site infection is the use of appropriate prophylactic antibiotics.

Objective

To identify and analyse information from clinical studies regarding factors affecting the effectiveness of prophylactic antibiotics in arthroplasty patients.

Methods

A scoping review was conducted through the PubMed, Scopus, and Google Scholar databases within a publication range from January 2004 to August 2020. Study data are extracted and analysed by a minimum of two reviewers.

Results

The search results found 2.419 articles, with 39 articles were included for further analysis. Cefazolin monotherapy was the most frequently studied antibiotic (15 articles) followed by vancomycin monotherapy (8 articles). Most widely used antibiotics in arthroplasty were cefazolin mono-therapy (997.599 procedures with SSI incidence range: 0,20–16,05%) followed by vancomycin mono-therapy (125.170 procedures with SSI incidence range: 0.27–3,88%) The correct antibiotic dose has a lower percentage of the SSI than the wrong antibiotic dose. Meanwhile, administration of antibiotics within single dose or <24 h had a lower SSI percentage than administration of antibiotics >24 h. Administration antibiotics before incision also have a lower SSI percentage than after incision. There were no studies that discussed re-dosing of antibiotics in this scoping review.

Conclusions

There is still a need for further research related to the duration and specific timing of first dose of prophylactic antibiotics, especially regarding single dose or multiple dose antibiotics to obtain maximum effectiveness of antibiotic prophylaxis
Impacts of the COVID-19 Pandemic on the Healthcare Provision and Lived Experiences of Patients with Hydrocephalus
Authors: Pricop Diana F. , Subotic Arsenije , Anghelescu Beatrice A.M. , Eagles Matthew , Hamilton Mark , Roach Pamela
Published: April 2022

The emergence of COVID-19 (SARS-CoV-2) led to distancing measures which acutely affected healthcare infrastructure, leading to limited in-person clinical visits and an increased number of virtual appointments. This study aimed to examine the effects this had on adults with hydrocephalus by describing the lived experiences of a cohort of patients at an outpatient hydrocephalus clinic. Between early May and early July of 2020, remote structured interviews were conducted with participants. Interviews were in-depth and open-ended, allowing participants to reflect and expand on the effects of the social distancing mandate on their well-being and quality of care. Three themes emerged: (1) impacts of changes in treatment provision, (2) impacts of changes in mitigating activities, and (3) impacts of changes on personal well-being. The comprehensive understanding of lived experiences may inform the future provision of healthcare services and social policy. Improved approaches to remote care telemedicine have the potential to facilitate high-quality care.
Integrating the Choosing Wisely 5 Questions into Family Meetings in the Intensive Care Unit: A Randomized Controlled Trial Investigating the Effect on Family Perceived Involvement in Decision-Making
Authors: Drury Ashleigh , Muscat Danielle M , Wibrow Bradley , Jacques Angela , Anstey Matthew
Published: April 2022

Family members often act as surrogate decision makers for patients in the intensive care unit (ICU). The use of printed prompts may assist with families feeling empowered to fulfill this role. Prospective, randomized controlled trial in 3 ICUs in Western Australia. In the intervention arm, families received the Choosing Wisely 5 questions as printed prompts prior to a family meeting, and the control arm did not receive prompts. The primary outcome was family perceived involvement in decision-making. Outcomes were measured using a survey. Sixty families participated in the study. The majority of families (87.1% control, 79.3% intervention; P = .334) reported feeling “very included” in decision-making. There was no difference in secondary outcomes, including minimal uptake of the questions by the intervention arm. This has been the first randomized trial evaluating the use of a decision-making tool for families in the ICU. Despite ceiling effects in outcome measures, these results suggest room for future study of the Choosing Wisely 5 questions in the ICU.
Dental Caries Postradiotherapy in Head and Neck Cancer
Authors: Brennan M.T. , Treister N.S. , Sollecito T.P. , Schmidt B.L. , Patton L.L. , Lin A. , Elting L.S. , Helgeson E.S. , Lalla R.V.
Published: April 2022

Background:

Treatment for head and neck cancer (HNC) such as radiotherapy (RT) can lead to numerous acute and chronic head and neck sequelae, including dental caries. The goal of the present study was to measure 2-y changes in dental caries after radiotherapy in patients with HNC and test risk factors for caries increment.

Methods:

Cancer and dental disease characteristics, demographics, and oral health practices were documented before and 6, 12, 18, and 24 mo after the start of RT for 572 adult patients with HNC. Patients were eligible if they were age 18 y or older, diagnosed with HNC, and planned to receive RT for treatment of HNC. Caries prevalence was measured as decayed, missing, and filled surfaces (DMFS). The association between change in DMFS and risk factors was evaluated using linear mixed models.

Results:

On average, DMFS increased from baseline to each follow-up visit: 6 mo, +1.11; 12 mo, +2.47; 18 mo, +3.43; and 24 mo, +4.29 (P < 0.0001). The increase in DMFS during follow-up was significantly smaller for the following patient characteristics: compliant with daily fluoride use (P = 0.0004) and daily oral hygiene (brushing twice daily and flossing daily; P = 0.015), dental insurance (P = 0.004), and greater than high school education (P = 0.001). DMFS change was not significantly associated with average or maximum RT dose to the parotids (P > 0.6) or salivary flow (P > 0.1). In the subset of patients who had salivary hypofunction at baseline (n = 164), lower salivary flow at follow-up visits was associated with increased DMFS.

Conclusion:

Increased caries is a complication soon after RT in HNC. Fluoride, oral hygiene, dental insurance, and education level had the strongest association with caries increment after radiotherapy to the head and neck region. Thus, intensive oral hygiene measures, including fluoride and greater accessibility of dental care, may contribute to reducing the caries burden after RT in HNC.

Knowledge Transfer Statement:

The results of this study can be used by clinicians when deciding how to minimize oral complications related to cancer therapy for patients with head and neck cancer. Identification of modifiable factors (e.g., oral hygiene and prescription fluoride compliance) associated with increased caries risk can minimize radiation caries burden.
Cerebral Venous Sinus Thrombosis (CVST) as a Complication of SARS-COV2 Infection
Authors: Pujari Shripad S. , Ojha Pawan K. , Kulkarni Rahul V. , Kharat Sumit , Gupta Dulari , Lalla Rakesh , Panchal Keyur , Walzade Priyanka S. , Palasdeokar Nilesh , Nadgir Dattatraya , Nirhale Satish , Dhonde Pramod , Ichaporia Nasli , Jagtap Sujit A. , Dravid Ameet , Purandare Bharat , Jog Sameer , Khan Zafer , Meshram Chandrashekhar
Published: April 2022

Background and Purpose:

Severe acute respiratory syndrome coronavirus 2 (SARS-COV2) infection induces a prothrombotic state frequently associated with arterial ischemic strokes. Cerebral venous sinus thrombosis (CVST) is also reported with corona virus disease-19 (COVID-19) but a large cohort study is lacking. Our aim was to study the characteristics, treatment response, and outcomes of CVST occurring in association with COVID-19 (COVID-CVST) and the causal relationship with COVID-19.

Methods:

Data of 34 patients admitted in COVID facility and suffering from CVST and SARS-COV2 infection was studied with respect to their clinic-radiological and lab features, predisposing factors, treatment, and outcome.

Observations and Results:

15 patients with CVST were detected positive for COVID but remained asymptomatic for the same. 14 patients had CVST along with symptoms of COVID, whereas 5 had CVST after recovery from COVID, at an average of 18 days after COVID-19. 4 patients were on aspirin as prophylaxis against thrombo-embolic events. The number of males exceeded females (22:12), conventional risk factors were seen in only 8 patients (postpartum state-3, alcohol abuse-2 and anemia-3), whereas the majority (26/34) showed none of them. The mean serum homocysteine level was normal and antiphospholipid antibody was tested normal in the assessed subjects. D-dimer and C reactive protein were elevated in all. 4 symptomatic patients who suffered from severe pneumonia died because of systemic complications.

Conclusion:

COVID-19 predisposes to CVST and the outcome is related to the severity of COVID pneumonia. CVST related to COVID occurs during or after a few weeks of COVID pneumonia and can also be seen in asymptomatic SARS-COV2 infection. COVID-19 can occur independently or in association with traditional thrombotic risk factors which increase the risk and severity of CVST in COVID. If recognized early, CVST associated with COVID can usually be treated effectively to achieve a very good outcome.
Hepatoid Adenocarcinoma of the Lung: A Rare Form of Lung Cancer
Authors: Laraqui Houssein Yasmine , Derqaoui Sabrine , Khouloud Raissouni , Jahid Ahmed , Zouaidia Fouad , Bernoussi Zakiya , Znati Kaoutar
Published: April 2022

Hepatoid adenocarcinoma is a rare type of extrahepatic adenocarcinoma with glandular and hepatocyte differenciation. The tumor can occur in many organs, generally in the stomach, the location of the lung being extremely rare. Despite poor prognosis and few effective treatment options, a timely and accurate histopathological diagnosis is key to optimal clinical management for long-term survival. Given the few reports published to characterized hepatoid adenocarcinoma, the emergence of any new case will contribute to improve understanding of the disease. Very few reports have been published to characterize hepatoid adenocarcinoma cytologically or even histologically. The aim of this work is to focus on the anatomoclinical characteristics of this rare entity. We present a retrospective study of 2 cases of pulmonary hepatoid adenocarcinoma confirmed by histological and immunohistochemical study.
Long-term follow-up of liver-directed, adeno-associated vector-mediated gene therapy in the canine model of hemophilia A
Authors: Batty P. , Mo A. M. , Hurlbut D. , Ishida J. , Yates B. , Brown C. , Harpell L. , Hough C. , Pender A. , Rimmer E. K. , Sardo Infirri S. , Winterborn A. , Fong S. , Lillicrap D.
Published: April 2022

Questions remain concerning the long-term efficacy, safety, and site(s) of transgene expression following adeno-associated vector (AAV) therapy. We report a long-term follow-up of 8 (male = 4, hemizygous, and female = 4, homozygous) dogs with severe hemophilia A treated with a single portal vein infusion of a B-domain–deleted (BDD)-canine FVIII (cFVIII) AAV vector (median dose = 1.25 × 1013 vg/kg, AAV2 = 4, AAV6 = 3, and AAV8 = 1). After a median follow-up of 10.8 years (8.2-12.0 years), persistent FVIII:C (median one-stage = 12.7%, chromogenic = 7.2%) was seen in all responding dogs (n = 6), with improvement in annualized bleed rates (pre = 3.9 vs post = 0.3 event per year; P = .003). Anti-AAV capsid neutralizing antibodies (nAbs) toward the dosed capsid were detected throughout the study, with limited cross-reactivity to other capsids. nAb titers for all capsid serotypes declined with time, although they remained at levels precluding redosing with the same capsid. AAV-BDD-cFVIII DNA was detected in the liver of all dogs (median = 0.15 vg per diploid genome), with lower levels in the spleen in 4 dogs (median = 0.005 vg per diploid genome). Consistent with the liver-specific promoter, BDD-cFVIII mRNA was only detected in the liver. Postmortem examination demonstrated no evidence of chronic liver disease or liver malignancy. Persistent FVIII expression and an improved bleeding phenotype was seen for more than a decade after vector delivery. This is the longest follow-up reported in a preclinical model supporting long-term efficacy and safety of AAV-mediated gene therapy.