bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of microfibre parameters on the tensile properties of fabric-reinforced cementitious mortar
Authors: Dang Cong-Thuat , Pham My , Dinh N.H.
Published: January 2024

In recent years, Fabric-Reinforced Cementitious Mortar (FRCM) has gained widespread application for strengthening reinforced concrete and masonry structures. This research investigated the influence of microfibre parameters on the tensile characteristics of FRCM, focusing on the fibre type, length, and volume fraction. Three distinct types of microfibres were scrutinized: amorphous metallic (AM) fibres, polyvinyl alcohol (PVA) fibres, and nylon fibres. FRCM coupons were designed and fabricated based on the AC434 standard. A tensile experimental program, following RILEM TC232-TDT, revealed the pronounced advantage of employing AM fibres in the pre-cracking stage by significantly improving the crack stress up to 226% and pre-cracking stiffness of FRCM. Conversely, synthetic fibres such as nylon and PVA were beneficial in the post-cracking stage by enhancing cracked stiffness, peak stress, and tensile toughness. Additionally, it was found that using fibres with shorter lengths improved the tensile behavior of FRCM composites in the post-cracking stage due to better random distribution in the cement-based matrix. Finally, an artificial neural network (ANN) model was proposed to predict the tensile parameters of the FRCM composites incorporating microfibres.
Criteria and Indicators for Centers of Clinical Excellence in Stroke Recovery and Rehabilitation: A Global Consensus Facilitated by ISRRA
Authors: Stockley Rachel C. , Walker Marion F. , Alt Murphy Margit , Azah Abd Aziz Noor , Amooba Philemon , Churliov Leonid , Farrin Amanda , Fini Natalie A. , Ghaziani Emma , Godecke Erin , Gutierrez-Panchana Tania , Jia Jie , Kandasamy Thoshenthri , Lindsay Patrice , Solomon John , Thijs Vincent , Tindall Tierney , Tippett Donna C. , Watkins Caroline , Lynch Elizabeth
Published: January 2024

Background

The aim of the International Stroke Recovery and Rehabilitation Alliance is to create a world where worldwide collaboration brings major breakthroughs for the millions of people living with stroke. A key pillar of this work is to define globally relevant criteria for centers that aspire to deliver excellent clinical rehabilitation and generate exceptional outcomes for patients.

Objectives

This paper presents consensus work conducted with an international group of expert stroke recovery and rehabilitation researchers, clinicians, and people living with stroke to identify and define criteria and measurable indicators for Centers of Clinical Excellence (CoCE) in stroke recovery and rehabilitation. These were intentionally developed to be ambitious and internationally relevant, regardless of a country’s development or income status, to drive global improvement in stroke services.

Methods

Criteria and specific measurable indicators for CoCE were collaboratively developed by an international panel of stroke recovery and rehabilitation experts from 10 countries and consumer groups from 5 countries.

Results

The criteria and associated indicators, ranked in order of importance, focused upon (i) optimal outcome, (ii) research culture, (iii) working collaboratively with people living with stroke, (iv) knowledge exchange, (v) leadership, (vi) education, and (vii) advocacy. Work is currently underway to user-test the criteria and indicators in 14 rehabilitation centers in 10 different countries.

Conclusions

We anticipate that use of the criteria and indicators could support individual organizations to further develop their services and, more widely, provide a mechanism by which clinical excellence can be articulated and shared to generate global improvements in stroke care.
The incidence, trends, and costs of treatment of femoral shaft fractures among Finnish children aged 2–12 years between 1998 and 2016
Authors: Laitakari Elina , Koukkula Topias , Huttunen Tuomas T , Mattila Ville M , Salonen Anne
Published: January 2024

Purpose:

The purpose of this study was to determine the incidence and trends of both hip spica casting and elastic stable intramedullary nailing in children aged 2–12 years who sustained femoral diaphyseal fracture between 1998 and 2016 in Finland. We also evaluated the actual hospital costs of both treatment methods as well as calculating the length of hospital stay.

Methods:

This study included all 2- to 12-year-old children with femoral diaphyseal fracture who were treated in Finland between 1998 and 2016. Data were collected from the National Hospital Discharge Register of Finland. Children were classified by age into five groups. The annual incidences per 100,000 persons were calculated using annual mid-year population census data obtained from Statistics Finland. Data on the annual actual daily hospital costs were collected from the Finnish Institute for Health and Welfare.

Results:

In total, 1064 patients aged 2–12 years who had sustained femoral diaphyseal fracture were treated with elastic stable intramedullary nailing or hip spica casting between 1998 and 2016. In children aged 4–5 years, the incidence of elastic stable intramedullary nailing increased during the study period from 5.4 per 100,000 persons in 1998 to 8.1 per 100,000 persons in 2016.

Conclusions:

The length of hospitalization in patients treated with elastic stable intramedullary nailing was shorter and, therefore, the total costs of hospital treatment were lower than in those children treated with hip spica cast.

Level of evidence:

level III.
Perception of In-Person Prerounding Amongst Neurology Residents Across Two Academic Centers
Authors: Chen Amalie , Prasad Sashank , Bowley Michael , Krupat Edward , Galetta Kristin
Published: January 2024

Background and Purpose

In-person prerounding has long been a routine practice for residents in the field of neurology. However, with the emergence of the COVID-19 pandemic, many institutions, including our two academic neurology centers, have shifted to computer rounding. This study aims to assess the effects of computer rounding alone compared to a combination of computer rounding and in-person prerounding from the perspective of neurology residents.

Methods

A mixed-methods approach was employed, including a survey administered to 79 neurology residents and a qualitative thematic analysis of their responses.

Results

The quantitative analysis revealed that residents who engaged in inperson prerounding spent significantly more time on prerounding and computer rounding compared to those who did not. The majority of residents reported a neutral effect of in-person prerounding on their relationship with patients and bedside time, but a significant impact on personal lives and other tasks. Qualitative analysis identified four key themes: accessibility to team members, learning opportunities gained and lost, inefficiency, and sleep disturbance.

Conclusions

Overall, residents perceived in-person prerounding as inefficient and causing sleep disruption for both patients and themselves. While some residents valued the face-to-face interaction and improved accessibility, others felt that computer rounding allowed for thorough review of patient data, improving preparedness and efficiency. The potential elimination of in-person prerounding from residents' routines may enhance their overall wellbeing. Further research is needed to assess the advantages and drawbacks of removing this classic approach to caring for patients from the perspective of residents, attendings and patients.
Social Change in the Turbulent Times of the COVID-19 Pandemic: Impacts of Work-Related Demands on Work-to-Family Conflict, Mastery, and Psychological Distress
Authors: Montazer Shirin , Pineault Laura , Brumley Krista M. , Maguire Katheryn , Baltes Boris
Published: January 2024

This study examines whether (and why) the accumulation of perceived work-related demands associated with social change in the context of the COVID-19 pandemic relates to psychological distress among a sample of employed adults in dual-earning relationships living in the United States. Using data from a cross-sectional online survey ( N = 418) administered during the early months of the pandemic, multivariate results indicate a positive association between demands of social change and distress, net of other factors. This association is due to an increase in work-to-family conflict and a decrease in mastery, and it does not vary by the gender or parental status of the respondent. According to the findings, part of the COVID-19 pandemic’s negative impact on the distress of the employed occurred through its translation into more negative proximal opportunity structures in the context of work, where it confronted individuals with different demands, comprising new uncertainties and new expectations.
State Perceived Stress Is Concurrently, but Not Prospectively, Associated With State Impulsivity in Youths
Authors: Seldin Katherine , Upton Natalie F. , Feil Madison C. , Smith Michele R. , Bryson Morgan A. , Lengua Liliana J. , King Kevin M.
Published: January 2024

Stress is considered a transdiagnostic mechanism underlying psychopathology. Research has suggested that when people experience more stress, they also act more impulsively. Most prior work has focused on between-persons associations or tested broad conceptualizations of impulsivity. We tested associations of momentary reports of perceived stress and appraisal of coping difficulty with three dimensions of impulsivity (urgency, planning, and persistence). High school and college students ( N = 146) self-reported momentary perceived stress, coping appraisals, affect, urgency, planning, and persistence three times per day for 10 days. Higher perceived stress was concurrently associated with higher urgency and lower persistence, even after controlling for negative affect. Higher coping appraisals were concurrently associated with higher planning and persistence. No prospective effects were observed. Perceived stress may relate to a time-limited decreased ability to regulate responses to negative affect and persist, whereas coping appraisals may be associated with changes in multiple types of self-regulation.
Predictive Factors for Converting Endoscopic to Open Carpal Tunnel Release
Authors: Coady-Fariborzian Loretta , Anstead Christy
Published: January 2024

Introduction: Both open and endoscopic methods of carpal tunnel release are accepted treatments for carpal tunnel syndrome. The objective was to determine the endoscopic to open conversion rate of all carpal tunnel surgeries. We evaluated potential predictive factors for an increased rate of conversion. Methods: The IRB/IRBnet approved (#20210613/1639264) a retrospective chart review of all attempted endoscopic carpal tunnel surgeries performed from July 1, 2012 through June 30, 2021. Charts were reviewed for procedure, age, sex, body mass index (BMI), electromyograph (EMG) reading, wrist arthritis on x-ray, preoperative steroid injections, trainee as surgeon, diabetes, hand dominance, and operated side. Conversion rate was noted. A chi-square test using a P-value of <0.05 was used to determine the statistical significance of the patients’ age, sex, BMI, EMG severity, the presence of wrist arthritis, preoperative steroid injections, resident as surgeon, diabetic status, and operated hand dominance as predictive factors for conversion. Results: The plastic surgery service attempted 1053 endoscopic carpal tunnel releases using the Chow dual port technique over a 9-year period. Forty-five cases converted to an open release. Median age ( P = 0.54), sex ( P = 0.43), median BMI ( P = 0.76), EMG severity ( P = 0.20), wrist arthritis ( P = 1.0), preoperative steroid injections ( P = 0.65), resident surgeon ( P = 0.53), diabetes ( P = 0.50), and operated hand dominance ( P = 0.36) were not statistically significant predictive risk factors. Nineteen of 45 converted cases had a future successful contralateral endoscopic release. Conclusion: Our study found a 4.27% endoscopic to open conversion rate. No identifiable risk factors could predict conversion. Prior conversion does not determine a future contralateral conversion.
Making plans findable, accessible, interoperable, and reusable with data infrastructure: A search engine for constructing, analyzing, and visualizing planning documents
Authors: Poirier Lindsay , Antonio Dexter , Dettmann Makenna , Eng Tiffany , Ganata Jennifer , Ghosh Sujoy , Lopez Mirthala , Karma Ranesh , Natekal Asiya , Brinkley Catherine
Published: January 2024

Local land-use plans help guide future development, but it is often difficult to compare content across jurisdictions, making regional coordination and plan evaluation challenging. This research reviews federal, state, and local data infrastructure guidance for land-use plans and compares such guidance to compliance with a California use-case. Findings indicate a number of obstacles to fostering data sharing and comparative analysis of plans: there is currently no central repository of land-use plans; plans are not uniform in format and are often out of date; many plans are not machine-readable thereby inhibiting text extraction, and planning language varies so greatly that there are numerous synonyms for terms of interest. Nonetheless, we demonstrate that the creation of digital platforms for archiving and searching across plans is currently feasible and enables large-scale quantitative analysis. Based on currently available metadata in existing land-use plans, we designed and piloted a structured database to enable users to search for terms and phrases across over 500 land-use plans. To center issues of social equity, the open access platform was developed in collaboration with state agencies and community organizations focused on environmental justice. Based on the pilot, we conclude with a framework for both developing plan data infrastructure given current constraints in standardized plan metadata and availability as well as guidance for plan formatting using FAIR standards (Findable, Accessible, Interoperable, and Reusable).
Computed Tomography Scans and Fixation Rates for Trimalleolar Ankle Fractures Over 10 Years at a Level 1 Trauma Center
Authors: Kocan Joseph , Joseph Elias , Mercado Paul , Haider Mohammad N. , Pavlesen Sonja , Rohrbacher Bernard
Published: January 2024

Background:

The posterior malleolus component of the trimalleolar ankle fracture has posed a controversial topic for diagnostic imaging and surgical management. Preoperative computed tomography (CT) scans are used to better appreciate fracture morphology and may affect management techniques. No prior study has investigated the trend in preoperative CT scan use and the rates of posterior and syndesmotic fixation for trimalleolar injuries.

Methods:

This retrospective cohort study evaluated the use of preoperative CT scans and the rates of posterior and syndesmotic fixation for trimalleolar ankle fractures over a 10-year period at an adult level 1 trauma center. Patients surgically managed for ankle fractures with OTA/AO classifications of 44B3, 44C3.3, 44C1.3, 44C2.3, and 44A3 were identified and included using Current Procedural Terminology codes and a prospectively collected fracture registry. Demographic information, comorbidities, fixation methods, and use of preoperative CT scan were recorded. Comparative analyses were performed to assess for yearly differences in demographic characteristics along with changes in trends of preoperative CT scans and posterior and syndesmotic fixation.

Results:

A total of 1191 patients were included in the analyses. OTA/AO 44B3.2 fractures were the most common injuries (yearly range of 59.4%-80.1%). The rate of posterior fixation did not significantly increase during the study interval (1.4% growth per year [95% CI −0.27, 3.07]). However, the rate of preoperative CT scan use significantly increased by 2.76% (95% CI 1.99, 3.52) per year and the rate of syndesmotic fixation increased by 2.58% (95% CI 1.17, 3.99) per year. Fixation methods for both the syndesmosis and posterior malleolus changed during the study timeline.

Conclusion:

Despite a relatively stable rate of posterior fixation, the frequency of preoperative CT scans and use of syndesmotic fixation increased significantly over a 10-year study period.

Level of Evidence:

Level IV, descriptive pilot study.
Cystic Hygroma in an Adult Male: A Rare Case Report
Authors: Gorai Arpan , Taneja Punya , Mishra Madan , Singh Gaurav , Das Manthan Kumar
Published: January 2024

“Cystic hygroma” is defined as a fluid-filled sac, resulting from a blockage in the lymphatic system. This large, deep, diffuse swelling commonly occurs in the neck as a result of the congenital malformation of lymphatic system having an equal distribution between males and females. It results as a failure of development of the communications between lymphatics which is mostly found in the posterior triangle of neck. Its recurrence rate may be up to 10%–15%. Different treatment modalities for treating cystic hygroma are surgical excision, sclerotherapy, laser and radiofrequency. Here we report a rare case of cystic hygroma present in a 20-year-old male on left side of his neck treated by total surgical excision of the lesion. The patient is on regular follow up for 12 months and he has been asymptomatic till now.
An Unusual Case of Isolated Right Ventricular Thrombus and Bilateral Extensive Pulmonary Thromboembolism in an Adult with Nephrotic Syndrome Occurring Five Years after the Diagnosis: A Case Report
Authors: Sudhakar Balijepalli Gopala K.
Published: January 2024

It is an established fact that nephrotic syndrome is associated with a heightened risk of thromboembolic complications including deep vein thrombosis (DVT), renal vein thrombosis (RVT) and pulmonary thromboembolism (PTE). Intra-cardiac thrombi are not uncommon but predominantly involve left atrium (LA), right atrium (RA) and left ventricle (LV). However, Isolated right ventricular (RV) thrombus in an adult with nephrotic syndrome was very rarely reported. Common causes of intra-cardiac thrombi include LV dysfunction, atrial fibrillation (AF), mitral stenosis (MS), nephrotic syndrome, cardiac prosthetic valves, indwelling central venous catheters, pacing leads, anti-phospholipid antibody syndrome, hyperhomocysteinemia, infection with COVID-19 virus, Behcet’s disease and congenital thrombophilia. Above conditions can cause intra-arterial, intravenous, as well as, intra-cardiac thrombi. Patients with nephrotic syndrome especially due to membranous glomerulonephritis can develop a hypercoagulable state in greater than 25% of adult patients. The risk of thrombosis was noted to be highest in the first three to six months after diagnosis. The exact incidence and prevalence of venous thromboembolism (VTE) are unknown in nephrotic syndrome. We are reporting a rare case of isolated RV thrombus presenting as acute PTE five years after initial diagnosis of nephrotic syndrome due to membranous glomerulonephritis which responded to thrombolytic therapy. There were only three case reports of isolated RV thrombus in an adult with nephrotic syndrome published so far.
Unraveling cervical cancer screening dilemmas: histopathological insights from VIA and LEEP at bugando medical centre, Mwanza
Authors: Kaizilege Godfrey K. , Ndaboine Edgar , Chuma Clotilda , Mujuni Fridolin , Kiritta Richard , Matovelo Dismas , Ottoman Oscar , Elias Edrick , Masalu Nestory , Kidenya Benson R. , Mazigo Humphrey D.
Published: January 2024

Background

The single-visit strategy, also known as the “screen-and-treat” approach, is widely used to screen for cervical cancer in low- and middle-income countries. The screen-and-treat approach leads to unnecessary or inadequate treatment. Thus, a study was conducted to determine the histopathological patterns of aceto-white lesions on visual inspection with acetic acid (VIA) in patients who underwent a Loop Electrosurgical Excision Procedure (LEEP) at Bugando Medical Centre between January 2016 and December 2020.

Method

A 5-year retrospective cross-sectional case record review was conducted on 329 women who had LEEP at Bugando Medical Centre following a positive VIA cervical screening test. A standard data abstraction form was used to collect patient information. Missing client information records and LEEP without histopathological results were exclusion criteria. For statistical analysis, STATA version 15 was used; in descriptive statistics, frequency, mean, and standard deviation were used. The Chi2 and Fisher’s exact tests were used to investigate the relationship between patient characteristics and histopathological patterns, and a P-value of 0.05 was considered statistically significant in multinomial models.

Results

This study looked at 329 patients who had LEEP following a VIA positive but were not eligible for cryotherapy. Our study participants had a mean age of 40 ± 8.2 SD. There were 203 (61.7%) patients with benign lesions, including 4 with schistosomiasis and 2 with cervical tuberculosis. The precancerous lesions were discovered in 100 cases (30.4%), and 26 (7.9%) already had invasive cervical cancer. Out of 100 patients with precancerous lesions, 58 (17.6%) and 42 (12.8%) have high- and low-grade squamous intraepithelial (HSIL and LSIL) lesions, respectively. The presence of a precancerous lesion was found to be associated with age 31–40 years (P-value 0.042) and HIV positivity (P-value 0.004).

Conclusion

Most patients in this study had benign cervical lesions, which do not require LEEP treatment. Nonetheless, a considerable percentage of invasive cervical malignancies and rare benign diseases such as schistosomiasis and cervical tuberculosis were identified. A screen-and-treat approach within well-equipped tertiary hospitals like Bugando Medical Centre should explore alternative options instead of relying solely on straight LEEP.
Advanced-stage presentation of cancer at the time of diagnosis and its associated factors among adult cancer patients at Northwest Amhara comprehensive specialized hospitals, Northwest Ethiopia 2022
Authors: Wassie Likinaw Abebaw , Mekonnen Chilot Kassa , Tiruneh Yenework Mulu , melkam Mamaru , Belachew Eyayaw Ashete , Zegeye Alebachew Ferede
Published: January 2024

Introduction

Screening of cancer is the maximum effort and critical element for providing health related care in order to decrease cancer related dealt because of the disease burden is in its advanced stages. Unfortunately, advanced-stage presentation and late diagnosis of cancers endure a problem in low-income countries including Ethiopia. However, there is scarcity of published articles about the problem in Ethiopia.

Objective

This study aimed to assess the prevalence of advanced-stage -stage presentation of cancer at the time of diagnosis and associated factors among adult cancer patients at Northwest Amhara comprehensive Specialized Hospitals, oncology treatment units, Northwest Ethiopia, 2022.

Methods

An institution based cross-sectional study was conducted in Northwest Amhara public referral hospitals on 422 study participants. A systematic random sampling technique was performed. The data were collected through face to face interview and document review via structured, pretested questionnaires. Epi. Data version 4.6 and Stata version 14.0 software’s were used for data entry and analysis respectively. Logistic regression were carried out to recognize factors associated with advanced-stage -stage presentation of cancer at the time of diagnosis. Adjusted odds ratio with a 95% confidence interval were used to measure the strength of association. Variables having p-value less than 0.2 in bivariable analysis were entered in to multivariable analysis; variables with a p-value < 0.05 were declared significantly associated with advanced-stage -stage presentation of cancer at the time of diagnosis.

Results

The overall prevalence of advanced-stage presentation of cancer at the time of diagnosis was found to be 67.57%. Age ≥ 60 years old patients (AOR = 6.10, 95%: (1.16–32.1)), patients had have a feeling of burden (AOR = 1.82, 95%, CI: (1.04–3.20)), and cancer patients with comorbidity illness (AOR = 2.40, 95%, CI: (1.40–4.12)) were significantly associated with advanced-stage presentation of cancer at the time of diagnosis.

Conclusion

The prevalence of advanced-stage presentation of cancer at the time of diagnosis was found to be high. Its better, health care providers in oncology treatment facilities need to give special attention to older patients, having feeling of burden and cancer patient with comorbidity to reduce the risk of developing late stage presentation of cancer.
A study of Samoan, Tongan, Cook Island Māori, and Niuean infant care practices in the Growing Up in New Zealand study
Authors: Langridge Fiona C. , Paynter Janine , Ghebreab Luam , Heather Maryann , Matenga-Ikihele Amio , Percival Teuila , Nosa Vili
Published: January 2024

Background

Despite a low rate of infant mortality, Aotearoa New Zealand has a high rate of Sudden Unexpected Death in Infants (SUDI), with disproportionate impact for Pacific infants. This study explored the infant care practices, factors and relationships associated with increased risk of SUDI amongst Tongan, Samoan, Cook Islands Māori, and Niuean mothers in New Zealand, to inform evidence-based interventions for reducing the incidence of SUDI for Pacific families and their children.

Methods

Analysis comprised of data collected in 2009–2010 from 1089 Samoan, Tongan, Cook Islands Māori and Niuean mothers enrolled in the Growing Up in New Zealand longitudinal cohort study. The sleeping environment (bed-sharing and sleep position) of the infants was assessed at 6 weeks. Multivariable logistic regression analysis were conducted, controlling for sociodemographic factors to explore the association between selected maternal and pregnancy support and environment factors and the sleeping environment for infants.

Results

Mothers who converse in languages other than English at home, and mothers who consulted alternative practitioners were less likely to follow guidelines for infant sleeping position. Similarly language, smoking, alcohol, household dwelling, crowding and access to a family doctor or GP were associated with mothers following guidelines for bed-sharing.

Conclusion

The impact of SUDI on Pacific infants may be lessened or prevented if communication about risk factors is more inclusive of diverse ethnic, cultural worldviews, and languages. Societal structural issues such as access to affordable housing is also important. This research suggests a need for more targeted or tailored interventions which promote safe sleeping and reduce rates of SUDI in a culturally respectful and meaningful way for Pasifika communities in Aotearoa, New Zealand.
Characteristics of lumbar spondylolysis: L5 versus non-L5
Authors: Gamada Hisanori , Tatsumura Masaki , Okuwaki Shun , Asai Reo , Funayama Toru , Yamazaki Masashi
Published: January 2024

Background

Fifth lumbar vertebra (L5) spondylolysis has a lower bone union rate than non-L5 spondylolysis, but the reason for this is unknown. This study aimed to evaluate the differences in patient and lesion characteristics between L5 and non-L5 spondylolysis.

Methods

A total of 410 patients with lumbar spondylolysis aged 18 years or younger who were treated conservatively were enrolled. Patients and lesions were divided into L5 and non-L5 (L2–L4) spondylolysis. Factors, including sex, age, presence of spina bifida occulta, stage of the main side lesion, whether the lesion was unilateral or bilateral, presence and stage of the contralateral side lesion and treatment duration, were evaluated at the first visit and compared between the two groups.

Results

A total of 250 patients with 349 lesions were included. The bone union rate of L5 lesions was lower than that of non-L5 lesions (75% vs. 86%, p = 0.015). Patients with L5 spondylolysis were more likely to be male (86% vs. 66%) and younger (14.0 vs. 14.6 years) than patients with non-L5 spondylolysis. Lesions of L5 spondylolysis were more likely to be in a progressive stage (28% vs. 15%), less likely to be in a pre-lysis stage (28% vs. 43%) and more likely to be in a contralateral terminal stage (14% vs. 5.3%, p = 0.013) compared with lesions of non-L5 spondylolysis.

Conclusions

L5 spondylolysis was characterised by a lower bone union rate, more males, younger age, more progressive stage and more contralateral pseudarthrosis than non-L5 spondylolysis.
Developing an initial set of quality indicators for chiropractic care: a scoping review
Authors: Vining Robert , Smith Jennifer , Anderson Brian , Almquist Zachary , Wong Danveshka
Published: January 2024

Background

Quality indicators are standardized, evidence-based measures of health care quality. Currently, there is no basic set of quality indicators for chiropractic care published in peer-reviewed literature. The goal of this research is to develop a preliminary set of quality indicators, measurable with administrative data.

Methods

We conducted a scoping review searching PubMed/MEDLINE, CINAHL, and Index to Chiropractic Literature databases. Eligible articles were published after 2011, in English, developing/reporting best practices and clinical guidelines specifically developed for, or directly applicable to, chiropractic care. Eligible non-peer-reviewed sources such as quality measures published by the Centers for Medicare and Medicaid Services and the Royal College of Chiropractors quality standards were also included. Following a stepwise eligibility determination process, data abstraction identified specific statements from included sources that can conceivably be measured with administrative data. Once identified, statements were transformed into potential indicators by: 1) Generating a brief title and description; 2) Documenting a source; 3) Developing a metric; and 4) Assigning a Donabedian category (structure, process, outcome). Draft indicators then traversed a 5-step assessment: 1) Describes a narrowly defined structure, process, or outcome; 2) Quantitative data can conceivably be available; 3) Performance is achievable; 4) Metric is relevant; 5) Data are obtainable within reasonable time limits. Indicators meeting all criteria were included in the final set.

Results

Literature searching revealed 2562 articles. After removing duplicates and conducting eligibility determination, 18 remained. Most were clinical guidelines (n = 10) and best practice recommendations (n = 6), with 1 consensus and 1 clinical standards development study. Data abstraction and transformation produced 204 draft quality indicators. Of those, 57 did not meet 1 or more assessment criteria. After removing duplicates, 70 distinct indicators remained. Most indicators matched the Donabedian category of process (n = 35), with 31 structure and 4 outcome indicators. No sources were identified to support indicator development from patient perspectives.

Conclusions

This article proposes a preliminary set of 70 quality indicators for chiropractic care, theoretically measurable with administrative data and largely obtained from electronic health records. Future research should assess feasibility, achieve stakeholder consensus, develop additional indicators including those considering patient perspectives, and study relationships with clinical outcomes.

Trial registration

Open Science Framework, https://osf.io/t7kgm
Airway disease decreases the therapeutic potential of epithelial stem cells
Authors: Zhang Lisa , Kelly Natalie , Shontz Kimberly M , Hill Cynthia L. , Stack Jacob T. , Calyeca Jazmin , Matrka Laura , Miller Audrey , Reynolds Susan D , Chiang Tendy
Published: January 2024

Backgorund

Tissue-engineered tracheal grafts (TETG) can be recellularized by the host or pre-seeded with host-derived cells. However, the impact of airway disease on the recellularization process is unknown.

Methods

In this study, we determined if airway disease alters the regenerative potential of the human tracheobronchial epithelium (hTBE) obtained by brushing the tracheal mucosa during clinically-indicated bronchoscopy from 48 pediatric and six adult patients.

Results

Our findings revealed that basal cell recovery and frequency did not vary by age or region. At passage 1, all samples produced enough cells to cellularize a 3.5 by 0.5 cm2 graft scaffold at low cell density (~ 7000 cells/cm2), and 43.75% could cellularize a scaffold at high cell density (~ 100,000 cells/cm2). At passage 2, all samples produced the number of cells required for both recellularization models. Further evaluation revealed that six pediatric samples (11%) and three (50%) adult samples contained basal cells with a squamous basal phenotype. These cells did not form a polarized epithelium or produce differentiated secretory or ciliated cells. In the pediatric population, the squamous basal cell phenotype was associated with degree of prematurity (< 28 weeks, 64% vs. 13%, p = 0.02), significant pulmonary history (83% vs. 34%, p = 0.02), specifically with bronchopulmonary dysplasia (67% vs. 19%, p = 0.01), and patients who underwent previous tracheostomy (67% vs. 23%, p = 0.03).

Conclusions

In summary, screening high-risk pediatric or adult population based on clinical risk factors and laboratory findings could define appropriate candidates for airway reconstruction with tracheal scaffolds.

Level of evidence. Level III Cohort study.

Graphical Abstract
Oxidative stress in acute pulmonary embolism: emerging roles and therapeutic implications
Authors: Yang Jingchao , Xu Jinzhu , Xu Shuanglan , Fan Zeqin , Zhu Chenshao , Wan Jianyuan , Yang Jiao , Xing Xiqian
Published: January 2024

Oxidative stress is an imbalance between the body’s reactive oxygen species and antioxidant defense mechanisms. Oxidative stress is involved in the development of several cardiovascular diseases, such as pulmonary hypertension, atherosclerosis, and diabetes mellitus. A growing number of studies have suggested the potential role of oxidative stress in the pathogenesis of pulmonary embolism. Biomarkers of oxidative stress in pulmonary embolism have also been explored, such as matrix metalloproteinases, asymmetric dimethylarginine, and neutrophil/lymphocyte ratio. Here, we comprehensively summarize some oxidative stress mechanisms and biomarkers in the development of acute pulmonary embolism and summarize related treatments based on antioxidant stress to explore effective treatment strategies for acute pulmonary embolism.
Exosomes in skin photoaging: biological functions and therapeutic opportunity
Authors: Hajialiasgary Najafabadi Amirhossein , Soheilifar Mohammad Hasan , Masoudi-Khoram Nastaran
Published: January 2024

Exosomes are tiny extracellular vesicles secreted by most cell types, which are filled with proteins, lipids, and nucleic acids (non-coding RNAs, mRNA, DNA), can be released by donor cells to subsequently modulate the function of recipient cells. Skin photoaging is the premature aging of the skin structures over time due to repeated exposure to ultraviolet (UV) which is evidenced by dyspigmentation, telangiectasias, roughness, rhytides, elastosis, and precancerous changes. Exosomes are associated with aging-related processes including, oxidative stress, inflammation, and senescence. Anti-aging features of exosomes have been implicated in various in vitro and pre-clinical studies. Stem cell-derived exosomes can restore skin physiological function and regenerate or rejuvenate damaged skin tissue through various mechanisms such as decreased expression of matrix metalloproteinase (MMP), increased collagen and elastin production, and modulation of intracellular signaling pathways as well as, intercellular communication. All these evidences are promising for the therapeutic potential of exosomes in skin photoaging. This review aims to investigate the molecular mechanisms and the effects of exosomes in photoaging.
Recent advances in various adeno-associated viruses (AAVs) as gene therapy agents in hepatocellular carcinoma
Authors: Hadi Meead , Qutaiba B. Allela Omer , Jabari Mansoureh , Jasoor Asna Mahyazadeh , Naderloo Omid , Yasamineh Saman , Gholizadeh Omid , Kalantari Leila
Published: January 2024

Primary liver cancer, which is scientifically referred to as hepatocellular carcinoma (HCC), is a significant concern in the field of global health. It has been demonstrated that conventional chemotherapy, chemo-hormonal therapy, and conformal radiotherapy are ineffective against HCC. New therapeutic approaches are thus urgently required. Identifying single or multiple mutations in genes associated with invasion, metastasis, apoptosis, and growth regulation has resulted in a more comprehensive comprehension of the molecular genetic underpinnings of malignant transformation, tumor advancement, and host interaction. This enhanced comprehension has notably propelled the development of novel therapeutic agents. Therefore, gene therapy (GT) holds great promise for addressing the urgent need for innovative treatments in HCC. However, the complexity of HCC demands precise and effective therapeutic approaches. The adeno-associated virus (AAV) distinctive life cycle and ability to persistently infect dividing and nondividing cells have rendered it an alluring vector. Another appealing characteristic of the wild-type virus is its evident absence of pathogenicity. As a result, AAV, a vector that lacks an envelope and can be modified to transport DNA to specific cells, has garnered considerable interest in the scientific community, particularly in experimental therapeutic strategies that are still in the clinical stage. AAV vectors emerge as promising tools for HCC therapy due to their non-immunogenic nature, efficient cell entry, and prolonged gene expression. While AAV-mediated GT demonstrates promise across diverse diseases, the current absence of ongoing clinical trials targeting HCC underscores untapped potential in this context. Furthermore, gene transfer through hepatic AAV vectors is frequently facilitated by GT research, which has been propelled by several congenital anomalies affecting the liver. Notwithstanding the enthusiasm associated with this notion, recent discoveries that expose the integration of the AAV vector genome at double-strand breaks give rise to apprehensions regarding their enduring safety and effectiveness. This review explores the potential of AAV vectors as versatile tools for targeted GT in HCC. In summation, we encapsulate the multifaceted exploration of AAV vectors in HCC GT, underlining their transformative potential within the landscape of oncology and human health.
Response to PD-1 inhibitor in SMARCB1‑deficient undifferentiated rectal carcinoma with low TMB, proficient MMR and BRAF V600E mutation: a case report and literature review
Authors: Shen Wenjuan , Pan Yi , Zou Shuangmei
Published: January 2024

Background

Despite major advancements, effective treatment for patients with SMARCB1-deficient cancers has remained elusive. Here, we report the first case of a SMARCB1-deficient undifferentiated carcinoma in the rectum expressing high PD-L1 and responding to a PD-1 inhibitor, as well as with low tumor mutation burden (TMB), proficient mismatch repair (MMR) and BRAF V600E mutation.

Case presentation

A 35-year-old man visited our hospital complaining of increased defecation frequency, bloody stools and weight loss of 3 kg for one month. Colonoscopy revealed an ulcerated and irregular mass approximately 8–12 cm from the anus. Surgical resection was performed. Histopathological findings revealed that the tumor cells had poor connectivity with each other; each cell had eosinophilic cytoplasm and a polymorphic nucleus. Brisk mitotic activity and necrosis were frequently observed in the tumor cells. Immunohistochemical examination showed that the tumor cells were negative for SMARCB1. The tumor proportion score (TPS) of PD-L1 (22C3) expression was 95%, and the combined positive score (CPS) was 100; the tumor was mismatch repair (MMR) proficient. Next-generation sequencing showed a low tumor mutation burden (TMB), as well as the BRAF V600E mutation. The final diagnosis was SMARCB1-deficient undifferentiated carcinoma. Chemotherapy was useless in this case. His tumor recurred during chemotherapy, and he then received targeted therapy with tirelizumab, an inhibitor of PD-1. At present, his general condition is good. A recent computed tomography (CT) scan showed that the tumor had disappeared, indicating that the immunotherapy was effective. Astonishingly, his most recent follow-up was in August, and his condition continued to improve with the tumor has disappeared.

Conclusion

SMARCB1‑deficient undifferentiated carcinoma in the rectum is extremely rare, and it has aggressive histological malignancy and poor progression. The observed response to PD-1 inhibitors suggests a role for prospective use of SMARCB1 alterations as a predictive marker for immune checkpoint blockade.
Combined effects of targeted blood pressure, oxygenation, and duration of device-based fever prevention after out-of-hospital cardiac arrest on 1-year survival: post hoc analysis of a randomized controlled trial
Authors: Meyer Martin A. S. , Hassager Christian , Mølstrøm Simon , Borregaard Britt , Grand Johannes , Nyholm Benjamin , Obling Laust E. R. , Beske Rasmus P. , Meyer Anna Sina P. , Bekker‑Jensen Ditte , Winther-Jensen Matilde , Jørgensen Vibeke L. , Schmidt Henrik , Møller Jacob E. , Kjaergaard Jesper
Published: January 2024

Background

The “Blood Pressure and Oxygenation Targets in Post Resuscitation Care” (BOX) trial investigated whether a low versus high blood pressure target, a restrictive versus liberal oxygenation target, and a shorter versus longer duration of device-based fever prevention in comatose patients could improve outcomes. No differences in rates of discharge from hospital with severe disability or 90-day mortality were found. However, long-term effects and potential interaction of the interventions are unknown. Accordingly, the objective of this study is to investigate both individual and combined effects of the interventions on 1-year mortality rates.

Methods

The BOX trial was a randomized controlled two-center trial that assigned comatose resuscitated out-of-hospital cardiac arrest patients to the following three interventions at admission: A blood pressure target of either 63 mmHg or 77 mmHg; An arterial oxygenation target of 9–10 kPa or 13–14 kPa; Device-based fever prevention administered as an initial 24 h at 36 °C and then either 12 or 48 h at 37 °C; totaling 36 or 72 h of temperature control. Randomization occurred in parallel and simultaneously to all interventions. Patients were followed for the occurrence of death from all causes for 1 year. Analyzes were performed by Cox proportional models, and assessment of interactions was performed with the interventions stated as an interaction term.

Results

Analysis for all three interventions included 789 patients. For the intervention of low compared to high blood pressure targets, 1-year mortality rates were 35% (138 of 396) and 36% (143 of 393), respectively, hazard ratio (HR) 0.92 (0.73–1.16) p = 0.47. For the restrictive compared to liberal oxygenation targets, 1-year mortality rates were 34% (135 of 394) and 37% (146 of 395), respectively, HR 0.92 (0.73–1.16) p = 0.46. For device-based fever prevention for a total of 36 compared to 72 h, 1-year mortality rates were 35% (139 of 393) and 36% (142 of 396), respectively, HR 0.98 (0.78–1.24) p = 0.89. There was no sign of interaction between the interventions, and accordingly, no combination of randomizations indicated differentiated treatment effects.

Conclusions

There was no difference in 1-year mortality rates for a low compared to high blood pressure target, a liberal compared to restrictive oxygenation target, or a longer compared to shorter duration of device-based fever prevention after cardiac arrest. No combination of the interventions affected these findings.

Trial registration ClinicalTrials.gov NCT03141099, Registered 30 April 2017.
Evaluation of the psychometric properties of the family adaptability and cohesion scale (FACES III) through item response theory models in students from Chile and Colombia
Authors: Vilca Lindsey W. , Díaz-Narváez Víctor , Hidalgo Wilson Pastén , Niekerk Bakit Nicolás Van , Reyes Paula Moreno , Herazo-Beltrán Yaneth , Gauna-Quiñonez Aura , Reyes-Reyes Alejandro , Palacio Luz Marina Alonso , Mendoza Marco Cervantes
Published: January 2024

Background

A psychometric study of the Family Adaptability and Cohesion Scale (FACES III) has been conducted in Spanish-speaking countries from the perspective of the classical test theory. However, this approach has limitations that affect the psychometric understanding of this scale.

Objective

Accordingly, this study used the item response theory to investigate the psychometric performance of the items. Furthermore, it evaluated the differential performance of the items for Colombia and Chile.

Method

For this purpose, 518 health science students from both countries participated. Confirmatory Factor Analysis was used.

Results

The study results revealed that the cohesion and adaptability items presented adequate discrimination and difficulty indices. In addition, items 5, 8, 13, 17, and 19 of cohesion indicated differential functioning between students from both countries, with Chilean students exhibiting a greater discriminatory power. Further, the Colombian group exhibited a greater discriminatory power for item 18 of adaptability.

Conclusions

The study concluded that the items of FACES III indicated adequate psychometric performance in terms of their discriminative capacity and difficulty in Chile and Colombia.
Building telework capability in the new business era for SMEs, using spherical fuzzy AHP methodology for prioritizing the actions
Authors: Yorulmaz Halil , Eti Serkan
Published: January 2024

Working types are one of the main issues affected by the turbulences in today’s business life and should be handled carefully. Telework is developing in the shadow of information and communication technologies and has become a necessary capability for companies to adapt to today’s business conditions. This study determined the importance of the factors in the telework structure with the analytic hierarchy process method. This multi-criteria decision-making method uses fuzzy numbers, which is rare in the telework literature. The results of this study in the context of SMEs show that the factors related to the work attributes significantly impact the telework capability structure. Adoption of telework by senior management as a business strategy is the factor with the highest impact, with some factors related to the culture being other factors with high impact. The fact that technological infrastructure factors did not show the expected effect was a surprising result.