bluuebunny/crossref_metadata_2025 huggingface dataset:
Proximal row carpectomy or scaphoid excision and four-corner arthrodesis for treatment of scapholunate advanced collapse arthritis
Authors: Lin James S. , Moran Steven L.
Published: August 2024

Degenerative wrist conditions, such as scapholunate advanced collapse and scaphoid nonunion advanced collapse, often require salvage procedures to reduce pain and improve function. For early stages of disease, both proximal row carpectomy and scaphoid excision four-corner arthrodesis are viable motion-preserving options. There remains controversy on which technique is superior. Selection is a nuanced decision that requires consideration of patient characteristics and stage of disease. The traditional notion that proximal row carpectomy should be reserved for older individuals with low demands has been challenged; long-term studies in younger populations demonstrate similar patient-reported outcomes, pain relief and survivorship without conversion to total wrist arthrodesis between proximal row carpectomy and four-corner arthrodesis. The existing evidence suggests proximal row carpectomy has advantages of greater range of motion, fewer complications and lower costs. Advancements such as arthroscopic techniques for both procedures show potential, although mastery involves a steep learning curve.
Extensor tendons: can we design a simpler classification zone system?
Authors: Tang Jin Bo , Lalonde Donald
Published: August 2024

We summarize the attention that has been drawn to and the thought process about the complexity of current classification zones of extensor tendons. A possible new, simpler classification was proposed by the lead author and discussed with the co-author. A simplified classification is presented with rationale, mainly based on the simplified treatment strategies used by the authors. We also discuss the possible drawbacks and call for investigations on this topic to make the current treatment strategies less complex. An updated system should be based on improved understandings of clinical treatment, including an increasing trend of using conservative treatment for closed injuries and strong surgical repair methods for open injuries of extensor tendons.
Survival Analysis and Prognostic Factors After Endonasal Resection of Advanced Olfactory Neuroblastomas: A Single Institution Experience
Authors: Song Xiaole , Yang Jingyi , Yuan Cuncun , Gu Dantong , Wang Li , Zhang Qianqian , Zhou Chengle , Wang Huan , Hu Li , Zhang Chen , Liu Quan , Wang Dehui , Sun Xicai , Yu Hongmeng
Published: August 2024

Objectives

To explore the prognostic factors in patients with advanced olfactory neuroblastoma (ONB) underwent endoscopic surgery.

Materials and Methods

Retrospective medical records were reviewed of patients with pathologically proven ONB who underwent endoscopic surgical resection. Clinicopathological characteristics including patient demographics, treatment, complications, follow-up, and outcomes were analyzed. Kaplan–Meier overall survival (OS) and disease-free survival (DFS) curves were plotted. Univariate and multivariate Cox regression models were used to determine prognostic factors.

Results

Eighty-five patients with Kadish stage C ONB were examined. According to the various staging systems used, most patients harbored modified Kadish stage C (78.8%). Twenty-six patients (30.6%) underwent bony skull base resection, 11 (12.9%) underwent dura resection, and 24 (28.2%) underwent additional intracranial resection that included the olfactory bulb and duct. Median follow-up was 39 months. Five-year OS and DFS rates were 83.7% and 74.9%, respectively. Five-year OS was 100% in patients treated with bony skull base resection and 77.5% in those who were not ( P = .052). Dura resection did not improve OS. Multivariate Cox regression analysis identified perioperative complications ( P = .009), gross total resection ( P = .004), orbital invasion ( P = .014), postoperative radiotherapy ( P = .030), and bony skull base resection ( P = .019) as independent prognostic predictors.

Conclusion

For patients with advanced ONB, endoscopic surgery in conjunction with radiotherapy and chemotherapy is effective and safe. Dura resection should be performed with caution in selected patients to balance survival and complications. Postoperative radiotherapy is important to improve OS and DFS.
Preseason and In-Season High-Speed Running Demands of 2 Professional Australian Rules Football Teams
Authors: Freeman Brock W. , Talpey Scott W. , James Lachlan P. , Rayner Russell J. , Young Warren B.
Published: August 2024

Background:

Australian Rules Football athletes complete long preseasons, yet injuries occur frequently at early stages of the competitive season. Little is known about the high-speed running (HSR) prescription during a preseason or whether players are adequately prepared for competition. This study described absolute and relative preseason and in-season HSR demands of 2 professional Australian football teams.

Hypothesis:

HSR and sprinting volumes are significantly lower in elite Australian Rules football athletes during in-season compared with preseason.

Study Design:

Cohort study.

Level of Evidence:

Level 3.

Methods:

During the 2019 season, HSR volume was collected for 2 professional Australian football teams (n = 55). Individual maximum speeds (Vmax) were captured to calculate relative running speed thresholds, as reported in 5% increments from 70%Vmax to 100%Vmax.

Results:

Weekly volume of running above 70%Vmax ( P = 0.01; r = 0.56) and 80%Vmax ( P = 0.01; r = 0.58) was significantly greater in the preseason than the in-season. The weekly volume completed above 90%Vmax was not significantly greater in the preseason than the in-season ( P = 0.10; r = 0.22). Individual variation in the distance completed at specific percentages of Vmax expressed as a coefficient of variation was reported as 51% at 71% to 80%Vmax, 39% at 81% to 90%Vmax, and 41% at 91% to 100%Vmax.

Conclusion:

The volume of HSR completed by athletes is far greater in the initial 4 weeks of the preseason than in any other point in preseason or competitive phases. At the individual level, there is substantial variation in the distance covered. This supports the concept of a heavily individualized approach to high-speed prescription and monitoring.

Clinical Relevance:

Practitioners should carefully consider individual variation regarding sprinting volume during both preseason and in-season when prescribing and monitoring training to improve on-field performance and reduce the risk of injury.
Feasibility of Percutaneous Gastrostomy Tube Placement Using Only Local Anesthetic in Patients With Neuromuscular Dysfunction
Authors: Shanmugasundaram Srinidhi , Mikhail Nardine , Jazmati Tarek , Kumar Abhishek , Shukla Pratik A.
Published: August 2024

Background

Patients with neuromuscular disorders often require gastrostomy tube placement for feeding but routinely have contraindication to sedation due to poor airway control with intubation avoided at the risk of ventilator dependence.

Purpose

To assess the feasibility of percutaneous gastrostomy tube (G-tube) placement using only local anesthesia in patients with neuromuscular dysfunction.

Research Design

A retrospective chart review was performed from 2013 to 2019 for all patients who underwent percutaneous G-tube placement under local anesthesia only.

Study Sample

12 patients (6 females, 6 males; mean age = 52.3 ± 21.8) with neuromuscular disorders underwent G-tube placement with only local anesthesia.

Data Collection

Data collected included demographic data, medical history (source of neuromuscular dysfunction), procedural information, and complications.

Results

Technical success was achieved in 100% of patients with no major complications.

Conclusion

Placement of a percutaneous gastrostomy tube using only local anesthesia is safe and feasible in patients who have a contraindication to sedation due to poor airway control and for whom intubation is avoided due to risk of ventilator dependence.
Young females affected with hydatidosis, case report
Authors: Endara Santiago A , Davalos Gerardo A , Serpa Frans I , Cueva Marta L , Narvaez C Sebastian , Delgado Cesar M , Redroban Ligia M , Brito M Maribel , Caceres Pablo M
Published: August 2024

Hydatidosis is a zoonosis, caused by a cestode ( Echinococcus). Management will depend on the organs affected by the infection and the response to medical treatment. Therapy may be clinical in early stages, but in case of poor response to drug therapy, surgery is the preferred choice. We present two cases in young females, the first case is with Hydatid cysts in both lungs and liver, she received initial medical treatment with lack of response, and surgery was indicated to resect the pulmonary and hepatic lesions. The second case is of a female with Hydatid cysts in the right lung. She was misdiagnosed at the beginning thinking of pneumonia and pulmonary abscess but after further investigation, hydatid cysts were the diagnosis, due to symptoms consistent with thoracic pain and persistent cough and the size of the cyst, surgery was indicated.
To biopsy or not to biopsy adrenal mass: is that the question?
Authors: Purenne Edouard , Cornu Erika , Mezzarobba Vincent , Juttet Pauline , Cimarelli Sébastien , Watkin Emmanuel , Paepegaey Anne-Cécile
Published: August 2024

The European Society of Endocrinology recommends surgical approach for suspicious adrenal mass with a limited role for adrenal biopsy. We report here a case of a patient with a 70 mm adrenal mass in whom adrenal biopsy avoided unnecessary adrenalectomy. An 80-year-old man was explored for a 67 × 41 mm suspect left adrenal tumor. Hormonal explorations were normal. 18F-FDG-PET/CT showed an increase in uptake of the adrenal mass (SUVmax: 44.6). As the diagnostic was uncertain, biopsy was performed. Pathology found T lymphocytic inflammatory infiltrate with CD4 phenotype without malignancy criteria. Simple close monitoring was decided in multidisciplinary meeting and with the patient’s consent. At 1 and 3 months, CT and 18F-FDG-PET/CT showed a significant decrease in size and uptake of adrenal mass (40 × 20 mm and 19 × 10 mm and SUVmax 5.9 and 0.0). This report shows the interest of adrenal biopsy for well-selected cases to avoid unnecessary adrenal surgery.
Durability of Aortic Homografts in Pulmonary Atresia and Major Aortopulmonary Collateral Arteries
Authors: Ragheb Daniel K. , Martin Elisabeth , Zhang Yulin , Jaggi Ayush , Asija Ritu , Peng Lynn F. , Ma Michael , Hanley Frank L. , McElhinney Doff B.
Published: August 2024

Objectives: It is well-known that right ventricle-to-pulmonary artery homograft conduit durability is worse for smaller conduits and smaller/younger patients. However, there is limited literature on age and conduit-size specific outcomes, or on the role of conduit oversizing. Methods: Patients diagnosed with tetralogy of Fallot and major aortopulmonary collateral arteries undergoing right ventricular outflow tract (RVOT) reconstruction with a valved aortic homograft conduit from November 2001 through March 2023, at our institution were included. Conduits were grouped and evaluated by diameter, diameter Z-score, and patient age at implant. The primary time-related outcome was freedom from RVOT reintervention. Factors associated with freedom from time-related outcomes were assessed with univariable Cox regression analysis. Results: A total of 863 RVOT conduits were implanted in 722 patients. On multivariable analysis, younger age, male sex, Alagille syndrome, smaller diameter of the conduit, and smaller Z-score were associated with shorter freedom from reintervention. Among patients with smaller diameter conduits, larger Z-scores were associated with longer freedom from conduit reintervention ( P < .001). Transcatheter interventions were commonly used to extend conduit lifespan across ages and conduit sizes. Conclusions: Larger conduit diameter, older age, and higher conduit Z-score were associated with longer freedom from reintervention in patients undergoing RVOT reconstruction in this cohort. Oversizing of conduits, even beyond a Z-score of 4, is generally appropriate.
The Influence of Intuitive-Analytical Cognitive Styles on Entrepreneurial Decision-Making Logic: Moderated by Environmental Uncertainty
Authors: Wei Yalong , Long Dan , Fu Lihua
Published: August 2024

By neglecting endogenous factors, existing studies that usually focus on examining the effect of exogenous characteristics on entrepreneurial decision-making logic has drawn conflicting conclusions. This paper explores the influences of cognitive styles on entrepreneurial decision-making logic, as well as the moderating role of environmental uncertainty. Using a multiregional sample of 336 Chinese entrepreneurs, the study obtained results by conducting multiple linear regression. Entrepreneurs with an intuitive cognitive style tend to apply causal logic, while those with an analytical cognitive style are inclined to adopt effectual logic. Environmental uncertainty moderates the effect of cognitive styles on some dimensions of entrepreneurial decision-making logic. In an uncertain environment, entrepreneurs with an intuitive cognitive style reduce the use of the logics of affordable loss and leveraging contingencies, while entrepreneurs with an analytical cognitive style reduce the use of the expected return logic. This paper clarifies the relationship between intuitive and analytical cognitive styles, which are always considered to be antithetical. This implies that they always coexist, instead of competing with each other in entrepreneurial decision-making. This finding verifies that entrepreneurial decision-making logic is the result of interactions between cognition and the environment, inspiring scholars to explore it from the combination of multiple elements.
Mental Health Needs and Help-Seeking Behaviors Among First-Year University Students Amidst COVID-19: A Mixed Methods Inquiry
Authors: McCormick Katie A. , Manohar Ishaan , Merola Laura E. , Cohen Deborah A.
Published: August 2024

Emerging research suggests an uptick in mental health challenges during the COVID-19 pandemic among university students. Using a sequential explanatory mixed methods design, this study examined first-year university students’ mental health and help-seeking behaviors during the COVID-19 pandemic. Findings reveal approximately one third of students had mental health needs, but few sought out mental health services. Participants described a range of barriers across external, interpersonal, and intrapersonal domains that influenced whether or not they sought out mental health services. Findings indicate the need for structural changes among universities that increase access to services and facilitate narrative change about mental health help-seeking.
Redefining the Future of Work: A Mediation Model Enabling Workplace Transformation for Medium-Sized IT Product Companies of South India
Authors: Kalahasthi Prasannakumar , Usha N
Published: August 2024

Organizations face myriad challenges in implementing a hybrid workplace as a future work policy in the post-pandemic period. Employers should identify the influencing factors and mitigation plans for successfully implementing a hybrid workplace. This study aims to investigate a mediation model of a hybrid workplace for medium-sized IT product companies. This research considers moonlighting, work engagement and work–life balance as parallel mediation constructs and employee satisfaction as serial mediation construct to understand the impact on employee performance with independent constructs as hybrid workplace and work ethics. A questionnaire-based survey was conducted through expert opinion, and the mediation constructs were analysed using bootstrapping technique. One of the key findings is that work engagement, work–life balance and employee satisfaction have significant positive impact on employee performance in hybrid workplace. Moonlighting has a significant negative impact on employee performance at a hybrid workplace. The proposed mediation model postulates and evinces that a hybrid workplace has to be implemented to enhance the work–life balance, employee satisfaction and employee performance. The identified constructs have contributed to social exchange theory using organizational citizenship behaviour and psychological employment contract as the pertinent theories of this study with future recommendations. The proposed hybrid workplace model would assist Human resources in redefining the future work policy for an exquisite work environment.
Hantavirus Cardiopulmonary syndrome: Another Reason to Avoid Mice
Authors: Kennedy Mark , Mctabi Omar , Rickman Christopher
Published: August 2024

Hantavirus cardiopulmonary syndrome is a severe illness transmitted by rodent excretions. We describe a case of a 24-year-old man who presented to the emergency department with cough, shortness of breath, chills, myalgias, nausea, and diarrhea. Physical examination and laboratory analysis revealed signs of respiratory distress and thrombocytopenia. The trajectory of his illness led to acute respiratory distress syndrome (ARDS) and hemodynamic instability. Serum testing was positive for hantavirus IgM and IgG antibodies. The patient was managed with supportive care and improved. This case highlights the importance of considering hantavirus when managing patients who develop thrombocytopenia, ARDS, and hemodynamic instability in the appropriate clinical setting.
Foster Care in India from 2010 to 2024—Policy and Humanity Lens
Authors: Forber-Pratt Ian
Published: August 2024

The feature article explores the journey of foster care in India from 2010 to 2024 as an analysis and commentary on the substantive changes between the foster care 2016 model guidelines and the newly released foster care 2024 guidelines.

The article highlights the historical context of foster care in India, acknowledging the efforts of pioneers over the past decades. It discusses the challenges of scaling up foster care nationwide, emphasising the need for proper support systems and cultural sensitivity.

Reflecting on the journey since 2016, the article acknowledges the slow progress and instances of corruption in foster care implementation. It underscores the importance of trained oversight and social work expertise in ensuring the well-being of children in foster care.

Looking ahead to 2024, with the release of new foster care guidelines, the article suggests a shift towards a child-centred approach and emphasises the need for robust monitoring and evaluation mechanisms.

In summary, the article advocates for a comprehensive approach to foster care implementation in India, encompassing cultural sensitivity, capacity building, community engagement, legal framework alignment, child-centred practices and effective monitoring and evaluation.
Global Health Competency of Nursing Personnel: A Cross-Sectional Study
Authors: Kang Jiwon , Song Jeongeun , Noh Wonjung
Published: August 2024

Introduction

As global health issues become more important, nursing education is undergoing change to reflect the changing global health environment and new knowledge. Nurses are required to be able to understand and interact with patients of diverse cultural backgrounds and characteristics and have relevant global health competencies.

Objectives

The aims of this study were to determine the GHC status of nurses and to analyze the association between GHC and nurse characteristics.

Methods

This study was a cross-sectional descriptive survey using a convenience sampling method. Data were collected from 473 nurses to collect information about participants’ GHC and general characteristics, including gender, age, nursing experience (years), experience of caring for foreign patients, English communication skills, learning experience in global health, and global preparedness. Multiple regression analysis was used to determine the relationship between GHC and nurse characteristics.

Results

The mean GHC score of nurses was 2.21 out of 4. “Nursing practice in globalization” was the most important global health competency, while “resource management in globalization” was the one that was most necessary. In addition, “Resource management in globalization” was the highest priority for global health competency. Global preparedness ( β = .25, p < .001) and the perceived necessity of GHC in nursing practice ( β = .28, p < .001) were statistically significant factors influencing the global health competency of nurses.

Conclusion

Based on the relationship identified between GHC and the characteristics of nurses, it is essential to develop an education program for enhancing global preparedness and perception of the necessity of GHC.
Outcomes of Rhegmatogenous Retinal Detachment Repair in Pseudophakic Eyes With Multifocal vs Monofocal Intraocular Lenses
Authors: Shahlaee Abtin , Israilevich Rachel N. , Mahmoudzadeh Raziyeh , Salabati Mirataollah , Wakabayashi Taku , Yonekawa Yoshihiro , Klufas Michael A.
Published: August 2024

Purpose: To compare the anatomic and visual acuity (VA) outcomes of rhegmatogenous retinal detachment (RRD) repair in eyes with a multifocal intraocular lens (IOLs) and eyes with monofocal IOLs. Methods: This retrospective matched-cohort study comprised pseudophakic eyes that had pars plana vitrectomy (PPV) or PPV with scleral buckling for RRD. Eyes with multifocal IOLs (multifocal group) were matched with eyes with monofocal IOLs (control group) in a 1:2 ratio for age, sex, primary surgeon, timing of surgery from presentation, type of surgery, and macular status. Results: The multifocal group included 67 eyes and the control group, 134 eyes. The mean (±SD) follow-up was 785 ± 595 days and 746 ± 566 days, respectively ( P = .57). Overall, the single-surgery anatomic success rate was 76.1% in the multifocal group and 86.6% in the control group ( P = .06); 75.0% and 85.9%, respectively, for PPV ( P = .06); and 100% for PPV with scleral buckling in both groups ( P = 1.00). The mean final logMAR VA was 0.26 ± 0.34 (20/36 Snellen) in the multifocal group and 0.27 ± 0.36 (20/37 Snellen) in the control group ( P = .60). Conclusions: In pseudophakic eyes with an RRD, there was a trend toward better single-surgery anatomic success in eyes with a monofocal IOL than in eyes with a multifocal IOL treated with PPV, with similar anatomic outcomes for PPV with scleral buckling. Visual outcomes were similar between the groups and significantly improved compared with baseline.
Validation of the follicular and ovarian thresholds by an 18-MHz ultrasound imaging in polycystic ovary syndrome: a pilot cutoff for North African patients
Authors: Ach Taieb , Guesmi Ayoub , Kalboussi Maha , Ben Abdessalem Fatma , Mraihi Emna , El Mhabrech Houda
Published: August 2024

Background:

Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrinopathies among young women. Ultrasound evidence of polycystic ovaries is one of its crucial diagnostic criteria.

Objectives:

Our main objective is to study the contribution of ultrasound data in diagnosing PCOS. In addition, we aim to establish a new cutoff point for the use of ultrasound and to determine its sensitivity as well as its specificity.

Design:

It was a prospective study, including all patients presenting with clinical hyperandrogenism.

Methods:

The ultrasound examination of these patients was performed using a novel ultrasound machine (18 MHz) compared to an older ultrasound machine (2 Hz–8 MHz). Inclusion criteria encompassed adult female patients over 18 years presenting symptoms suggestive of PCOS, particularly hyperandrogenism and oligo-anovulation, meeting Rotterdam’s diagnostic criteria. Prior to inclusion, assessments were conducted to eliminate other potential causes explaining hyperandrogenism or menstrual disorders in both groups.

Results:

We examined 92 patients diagnosed with PCOS. Menstrual disorders were the main symptoms, with amenorrhea being more frequent in the PCOS group (G1) (48.9% vs the control group (G2): 11.1%). The follicle number was significantly lower in the control group, as assessed by both ultrasound machines ( p < 10−3). The accuracy of the new ultrasound device was evaluated compared to the old one using the receiver operating characteristic (ROC) curve, revealing a cutoff of 18 follicles (sensitivity of 68.1%, specificity of 100%) and an area under the curve of 0.955. We found a significant difference between the median values of the number of follicles (NF) by both ultrasound machines (18 vs 12). It was positively correlated with an index of r = 0.916. For the volume, it was distinctively higher in G1 ( p < 10−3). ROC curve analysis revealed an ovarian volume cutoff of 9.25 ml with a sensitivity of 48.9% and a specificity of 100%. Both ultrasound machines were positively correlated with an index of r = 0.979 ( p < 10−3).

Conclusion:

In conclusion, we were able to establish significant correlations between the new and the old ultrasound devices for both the NF and ovarian volume. Our study is distinctive as it represents the first on the African continent to re-evaluate the ultrasound criterion for PCOS.
Visibility Isn’t Enough: Supply Chains Also Need Vigilance
Authors: Phadnis Shardul S. , Schoemaker Paul J.H.
Published: August 2024

Were you ill-prepared for COVID-19’s organizational upheavals and supply chain disruptions? Shardul Phadnis and Paul Schoemaker introduce supply chain vigilance, a system which brings a wide-angle view and disciplined scrutiny to scanning and managing the supply chain’s broader ecosystem.
Why Working Backwards Works Better
Authors: Day George S.
Published: August 2024

“Working backwards” is a signature method that Amazon uses to assess its innovation initiatives. The system works because the company has the essential ingredients: leadership commitment, investment in finding opportunities, empathy at all levels, and collective curiosity. George Day explains how all firms can use working backwards to assess, challenge, and rethink how they innovate.
How to Manage Technical Debt and Shadow IT to Synchronize Digital Strategy
Authors: Mithas Sunil , Kohli Rajiv
Published: August 2024

The digital transformation of many firms is impeded by misalignment between their IT and business strategies, evidenced by technical debt and shadow IT. Sunil Mithas and Rajiv Kohli explain how companies can overcome these hurdles by investing wisely in information technology.
Getting More from Crowdsourcing: Solving Wicked Business and Societal Problems
Authors: Majchrzak Ann , Malhotra Arvind
Published: August 2024

Ann Majchrzak and Arvind Malhotra outline a collective production process that unmindcuffs crowds to solve wicked societal and business problems.
AI in Personalized Product Recommendations
Authors: Hosanagar Kartik , Lee Dokyun
Published: August 2024

Consumers today are presented with a vast wealth of product offerings in digital marketplaces and storefronts. It is essential that managers consider how to ensure that shoppers find their company’s products. Kartik Hosanagar and Dokyun Lee explain the power of recommender systems, fueled by AI, to do just that.
AI + Human Is the Essential Formula for Customer Engagement
Authors: Dube Chetan
Published: August 2024

As AI systems for customer engagement become ever more prevalent, it is vital that business leaders understand how to design and use them. Chetan Dube explains why the AI + human formula is essential to high-quality, long-term customer engagement.
Resurrecting Jimi Hendrix: The Power of AI to Expand Consumer Engagement Through Musical Fan Cultures
Authors: Schulman Alan , Schulman Stacey Lynn
Published: August 2024

Alan Schulman and Stacey Lynn Schulman describe how generative AI can make classic, iconic musical styles feel new again, helping people to engage with artists who are gone, but not forgotten. This technology could fuel consumer engagement with brands that invest in musical cultures and branding.
Singapore’s Hospital to Home Program: Raising Patient Engagement Through AI
Authors: Abisheganaden John , Lee Kheng Hock , Low Lian Leng , Shum Eugene , Goh Han Leong , Lee Ang Christine Gia , An Ta Andy Wee , Miller Steven M.
Published: August 2024

Because of their complex care needs, many elderly patients are discharged from hospitals only to be readmitted for multiple stays within the following twelve months. John Abisheganaden and his fellow authors describe Singapore’s Hospital to Home program, a community care initiative fueled by artificial intelligence.
“They Did Not Understand”: Exploring Adult Survivors of Childhood Cancer's Memories of Their Experiences With Peers
Authors: Hinton Tori , Burns-Nader Sherwood
Published: August 2024

Background: Peer relationships are impacted by the diagnosis of childhood cancer. Children with cancer can feel isolation, such as bullying and lack of engagement, from their peers. As the rates of survival increase, one way to further learn about the experiences of childhood cancer is to reflect on the memories of adult survivors. This study examines adult survivors of childhood cancer's memories of their experiences with peers during their cancer. Method: Twenty-seven adult survivors (15 male, 12 female) of childhood cancer were recruited from Amazon Mechanical Turk, a crowdsourcing marketplace for survey distribution, and surveyed about their experiences with peers during childhood cancer. Using inductive thematic analysis, open-ended survey questions were analyzed. Results: Five main themes emerged, including age, perceptions of cancer, acts of kindness, peer responses, and limited peer engagement. Participants’ memories included peers’ lack of understanding about their diagnosis, prognosis, and treatment, positive and negative responses to their cancer diagnosis, acts of services and gifts from peers, and feelings of isolation during the cancer experience. Discussion: In the current study, adult survivors of childhood cancer had specific memories about how cancer impacted peer relationships. Such findings contribute to the evidence that children with cancer could benefit from psychosocial interventions, including education to peers about the diagnosis and the impact of diagnosis on peer relationships, peer engagement activities, and peer support groups.
Floor-hugging Intervention: A Perspective on Floor Exposure and After-Fall Contingency Intervention
Authors: Ghai Shashank , Ghai Ishan
Published: August 2024

The fear of falling is a pressing public health issue, yet current interventions often fall short in addressing it effectively. As a result, there is a need for innovative interventions that go beyond symptom relief to address the underlying causes. From this standpoint, we propose that limited exposure to floors and a lack of post-fall contingencies may contribute to the uncertainty that amplifies the fear of falling, particularly in fall prone populations. We explore the theoretical underpinnings of this hypothesis and propose a framework based on the Uncertainty and Anticipation model to elucidate potential connections. Building upon this, we introduce the Floor-hugging intervention—a two-part strategy designed to confront these challenges. Firstly, we propose gradual exposure to different floor scenarios through guided imagery to diminish fear by familiarizing individuals with such situations. Secondly, we advocate for the adoption of evidence-based ways to get up from the floor for developing after fall contingencies. We delve into the theoretical framework supporting our approach and its potential to reduce the fear of falling while improving physical, social, and psychological well-being. Additionally, we outline prospective outcome measures to comprehensively assess the impact of the intervention across biopsychosocial domains. This perspective aims to stimulate discussion on the potential role of floor exposure and post-fall strategies in reducing the fear of falling, while also advocating for innovative interventions to empower and protect fall-prone populations.
Experiences of friendships among autistic children in UK schools: A qualitative meta-synthesis
Authors: Fox Laura , Williams Rosina , Asbury Kathryn
Published: August 2024

Friendships can be difficult for autistic children; therefore, understanding their experiences is necessary to support successful and meaningful friendship development. This systematic review aims to synthesise qualitative findings on how autistic children experience friendships. Searches identified six studies exploring the friendship experiences of autistic children in UK primary school settings and their results were synthesised using thematic synthesis. Findings highlight the common and unique experiences of friendship among autistic children. Autistic children reported having a desire for friendships, with many particularly valuing shared interests and companionship, and it was evident that autistic children can and do make and maintain successful friendships. Autistic children across all settings spoke of what they believed friendship to be, and their understanding of friendship differed from that of key adults, highlighting the importance of including autistic children themselves in the design and implementation of social support interventions. Autistic children in special schools appeared to face fewer challenges than peers in mainstream education. We also noted a clear want for more training and education on neurodiversity to increase understanding of the needs and wants of autistic children across all school settings.
Out-of-pocket healthcare expenditure in emerging economies: Evidence from panel data analysis
Authors: Kaladharan Sanju , Manayath Dhanya
Published: August 2024

Background:

Achieving universal health coverage is one of the prominent targets of the United Nations’ sustainable development goals. Reducing out-of-pocket expenditure (OOPE) is essential because high OOPE can deter the use of healthcare services, which can lead to poor health outcomes and medical impoverishment.

Objectives:

The study sought to determine the effects of various factors such as Domestic General Government Health Expenditure, Gross Domestic Product, Government schemes and compulsory contributory healthcare financing schemes, and Voluntary health insurance schemes on OOPE per Capita in emerging economies.

Design:

Econometric methods using panel data

Data Sources and Methods:

The study analyzed the publicly available panel data from the World Health Organization using fixed, random, and dynamic models.

Results:

Domestic General Government Health Expenditure and Gross Domestic Product are associated with an increase in OOPE. Government schemes, compulsory contributory healthcare financing schemes, and voluntary health insurance programs are linked to a reduction in OOPE.

Conclusion:

In conclusion, this study, conducted through econometric methods on panel data, sheds light on the critical importance of reducing OOPE to achieve universal health coverage, aligning with the United Nations’ sustainable development goals. Countries shall implement a holistic approach focusing on preventive healthcare and health promotion, providing comprehensive health insurance, strengthening public health systems, and regulating medicine prices.
Identifying disease-modifying potential in myelofibrosis clinical trials
Authors: Ross David M. , Lane Steven W. , Harrison Claire N.
Published: August 2024

The ultimate goal of bringing most new drugs to the clinic in hematologic malignancy is to improve overall survival. However, the use of surrogate end points for overall survival is increasingly considered standard practice, because a well validated surrogate end point can accelerate the outcome assessment and facilitate better clinical trial design. Established examples include monitoring minimal residual disease in chronic myeloid leukemia and acute leukemia, and metabolic response assessment in lymphoma. However, what happens when a clinical trial end point that is not a good surrogate for disease-modifying potential becomes ingrained as an expected outcome, and new agents are expected or required to meet this end point to demonstrate “efficacy”? Janus kinase (JAK) inhibitors for myelofibrosis (MF) have a specific impact on reducing symptom burden and splenomegaly but limited impact on the natural history of the disease. Since the introduction of ruxolitinib more than a decade ago there has been modest incremental success in clinical trials for MF but no major leap forward to alter the natural history of the disease. We argue that the clinical development of novel agents for MF will be accelerated by moving away from using end points that are specifically tailored to measure the beneficial effects of JAK inhibitors. We propose that specific measures of relevant disease burden, such as reduction in mutation burden as determined by molecular end points, should replace established end points. Careful reanalysis of existing data and trials in progress is needed to identify the most useful surrogate end points for future MF trials and better serve patient interest.
Decreasing chronic graft-versus-host disease rates in all populations
Authors: Carpenter Paul A. , Gooley Ted A. , Boiko Julie , Lee Catherine J. , Burroughs Lauri M. , Mehta Rohtesh , Salit Rachel B. , Bhatt Neel S. , Krakow Elizabeth , Dahlberg Ann E. , Yeh Albert C. , Summers Corinne N. , Ueda Oshima Masumi , Petersdorf Effie W. , Vo Phuong , Connelly-Smith Laura , Lee Stephanie J.
Published: August 2024

Since 2005, there has been a steady decline in chronic graft-versus-host disease (cGVHD) at the Fred Hutchinson Cancer Center. To better understand this phenomenon, we studied the risk of cGVHD requiring systemic immunosuppression (cGVHD-IS) as a function of hematopoietic cell transplantation (HCT) date in 3066 survivors from 2005 through 2019. Cox regression models were fit to assess associations of HCT date (as a continuous linear variable) with cause-specific hazards of cGVHD using unadjusted and adjusted models. Median follow-up for study subjects was 7.0 years (range, 1.0-17.2). Two-year probabilities of cGVHD-IS declined among all survivors from 45% to 52% (2005-2007) to ∼40% (2008-2012) and then further to ∼26% by 2017. A decline was also observed when the analysis was restricted to 502 pediatric survivors, with cGVHD-IS probabilities <10% since 2013. Among 305 adult and pediatric survivors who underwent transplantation for nonmalignant diseases, cGVHD rates showed greater fluctuation but remained <20% after 2016. Each 5-year increase in HCT date was associated with a 27% decrease in the cause-specific hazard of cGVHD (unadjusted hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.68-0.78; P < .0001); the HR was 0.81 (95% CI, 0.75-0.87; P < .0001) even after adjusting for various factors (age, donor/stem-cell source, race, sex, conditioning intensity, GVHD prophylaxis, among others) that could lead to cGVHD reduction. The decline in cGVHD was not fully explained by demographic shifts and greater use of HCT approaches that are generally associated with lower cGVHD rates. This observation underscores that single-cohort cGVHD prevention studies should use contemporaneous and not historical controls for comparison.
Health-related quality of life with gilteritinib vs placebo posttransplant for FLT3-ITD
+ acute myeloid leukemia
Authors: Hamilton Betty K. , Pandya Bhavik J. , Ivanescu Cristina , Elsouda Dina , Hamadani Mehdi , Chen Yi-Bin , Levis Mark J. , Ueda Oshima Masumi , Litzow Mark R. , Soiffer Robert J. , Ustun Celalettin , Perl Alexander E. , Singh Anurag K. , Geller Nancy , Hasabou Nahla , Rosales Matt , Cella David , Corredoira Laura , Pestana Carolina , Horowitz Mary M. , Logan Brent
Published: August 2024

The Blood and Marrow Transplant (BMT) Clinical Trials Network conducted a phase 3 randomized trial comparing gilteritinib with placebo after allogeneic hematopoietic cell transplantation (HCT) for FLT3-ITD+ acute myeloid leukemia (AML). The primary analysis demonstrated no statistically significant difference in relapse-free survival (RFS); however, patients with FLT3-ITD measurable residual disease (MRD) peri-HCT had significantly longer RFS with gilteritinib. This analysis investigates the effect of post-HCT gilteritinib vs placebo on health-related quality of life (HRQOL). HRQOL was measured with Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT), FACT-Leukemia (FACT-Leu), and EuroQOL-5 Dimensions (EQ-5D-5L) at post-HCT randomization; day 29; months 3, 6, 12, 18, 24; and/or end of therapy. HRQOL and clinically meaningful differences were summarized using descriptive statistics and compared using mixed model repeated measures to evaluate longitudinal change from baseline and stratified Cox model to evaluate time to improvement. HRQOL completion rate was acceptable (>70%) across all time points and measures. There were no differences in HRQOL scores at any time point between cohorts. Clinically meaningful and time to improvement in HRQOL were similar in both arms. Despite higher treatment-emergent adverse effects with gilteritinib, response to the question of being “bothered by side effects of treatment” did not differ between groups. Subgroup analysis of MRD-positive and negative patients demonstrated no differences in HRQOL between arms. For patients with FLT3-ITD+ AML undergoing HCT, gilteritinib maintenance was not associated with any difference in HRQOL or patient-reported impact of side effects. This trial was registered at www.ClinicalTrials.gov as #NCT02997202.
Pharmacological and pre-clinical safety profile of rSIV.F/HN, a hybrid lentiviral vector for cystic fibrosis gene therapy
Authors: Moiseenko Alena , Sinadinos Anthony , Sergijenko Ana , Pineault Kyriel , Saleh Aarash , Nekola Konradin , Strang Nathalie , Eleftheraki Anastasia , Boyd A. Christopher , Davies Jane C. , Gill Deborah R. , Hyde Stephen C. , McLachlan Gerry , Rath Tim , Rothe Michael , Schambach Axel , Hobbie Silke , Schuler Michael , Maier Udo , Thomas Matthew J. , Mennerich Detlev , Schmidt Manfred , Griesenbach Uta , Alton Eric W.F.W. , Kreuz Sebastian
Published: August 2024

Rationale and objective

Cystic fibrosis (CF) is caused by mutations in the CF transmembrane conductance regulator (CFTR) gene. CFTR modulators offer significant improvements, but ∼10% of patients remain nonresponsive or are intolerant. This study provides an analysis of rSIV.F/HN, a lentiviral vector optimised for lung delivery, including CFTR protein expression, functional correction of CFTR defects and genomic integration site analysis in preparation for a first-in-human clinical trial.

Methods

Air–liquid interface cultures of primary human bronchial epithelial cells (HBECs) from CF patients (F508del/F508del), as well as a CFTR-deficient immortalised human lung epithelial cell line mimicking class I (CFTR-null) homozygous mutations, were used to assess transduction efficiency. Quantification methods included a novel proximity ligation assay for CFTR protein expression. For assessment of CFTR channel activity, Ussing chamber studies were conducted. The safety profile was assessed using integration site analysis andin vitroinsertional mutagenesis studies.

Results

rSIV.F/HN expressed CFTR and restored CFTR-mediated chloride currents to physiological levels in primary F508del/F508del HBECs as well as in a class I cells. In contrast, the latter could not be achieved by small-molecule CFTR modulators, underscoring the potential of gene therapy for this mutation class. Combination of rSIV.F/HN-CFTR with the potentiator ivacaftor showed a greater than additive effect. The genomic integration pattern showed no site predominance (frequency of occurrence ≤10%), and a low risk of insertional mutagenesis was observed in anin vitroimmortalisation assay.

Conclusions

The results underscore rSIV.F/HN as a promising gene therapy vector for CF, providing a mutation-agnostic treatment option.
High-frequency percussive ventilation in acute respiratory failure
Authors: Bruni Andrea , Neri Giuseppe , Cammarota Gianmaria , Bosco Vincenzo , Biamonte Eugenio , Troisi Letizia , Boscolo Annalisa , Navalesi Paolo , Longhini Federico , Garofalo Eugenio
Published: August 2024

Introduction

High-frequency percussive ventilation (HFPV) is a ventilation mode characterised by high-frequency breaths. This study investigated the impact of HFPV on gas exchange and clinical outcomes in acute respiratory failure (ARF) patients during spontaneous breathing, noninvasive ventilation (NIV) and invasive mechanical ventilation (iMV).

Methods

This systematic review included randomised and nonrandomised studies up to August 2023. Inclusion criteria focused on adult ARF patients, HFPV application, comparisons with other ventilation modes, and outcomes related to oxygenation and clinical parameters. A pooled data analysis was performed comparing HFPV with iMV concerning gas exchange, pulmonary infection and mortality.

Results

Of the 51 identified records, 29 met the inclusion criteria. HFPV was safely and effectively applied to ARF patients during spontaneous breathing or NIV, improving oxygenation. For patients who underwent iMV, HFPV significantly enhanced oxygenation and the arterial partial pressure of carbon dioxide, reduced pulmonary infection occurrence and improved survival. Barotrauma rates were not elevated with HFPV, and haemodynamic stability remained unaffected. HFPV was also utilised in patients undergoing extracorporeal membrane oxygenation, resulting in improved lung recruitment and oxygenation.

Conclusion

HFPV had favourable effects on physiological and certain clinical outcomes in ARF patients. However, the overall evidence quality remains weak, necessitating large-scale randomised controlled trials for definitive conclusions.
DElaying disease Progression In COPD with early escalation to Triple therapy – A Modelling Study (DEPICT-2)
Authors: Singh Dave , Litewka Diego Fabian , Soriano Joan B , Rendon Adrian , Fernandes Frederico Leon Arrabal , Páramo-Arroyo Rafael , Trinidad Tim , Günen Hakan , Acharya Sudeep , Aggarwal Bhumika , Levy Gur , Compton Chris , El Hasnaoui Abdelkader , Daley-Yates Peter
Published: August 2024

Introduction

In patients with chronic obstructive pulmonary disease (COPD), dual bronchodilator (long-acting muscarinic antagonist (LAMA)/long-acting beta2-agonist (LABA)) and triple therapy (inhaled corticosteroid (ICS)/LAMA/LABA) reduce risk of exacerbations and lung function decline in short-mid-term, but their long-term impact is unknown. This modelling study explores long-term impact of these therapies on lung function decline, quality of life (QoL) and all-cause mortality.

Methods

This modelling approach used a longitudinal non-parametric superposition model using published data regarding exacerbations, QoL (assessed by St. George's Respiratory Questionnaire (SGRQ)), and mortality. The model simulated disease progression from 40 to 75 years of age and assessed the impact of initiating dual bronchodilator at age 45 years (“LAMA/LABA only” group) and escalation to triple therapy at age 50 years (“Escalation to triple” group) on forced expiratory volume in 1 s (FEV1) decline, QoL, and mortality.

Results

Model simulation predicted that by 75 years of age: “LAMA/LABA only” preserves 159.1 mL of FEV1versusno treatment, “Escalation to triple” preserves an additional 376.5 mL and 217.3 mL of FEV1versusno pharmacotherapy and “LAMA/LABA only”, respectively. In “LAMA/LABA only”, SGRQ score reduces (−3.2)versusno treatment, which further reduces to −7.5 therapy in “Escalation to triple”. In “LAMA/LABA only”, mortality reduces by 5.4% by 75 yearsversusno treatment, while the “Escalation to triple” shows further decrease in mortality by 12.0%.

Conclusion

Early pharmacotherapy initiation and escalation from dual bronchodilator to triple therapy could slow disease progression by preserving lung function and improving QoL and survival in patients with COPD.