bluuebunny/crossref_metadata_2025 huggingface dataset:
The properties of RR Lyrae variable stars in the Local Group dwarf galaxy LGS-3
Authors: Sarajedini Ata
Published: January 2024

We present a sample of 56 RR Lyrae variable stars (48 ab-type and 8 c-type) measured from a set of F475W (≈B filter) and F814W (≈I filter) archival images taken with the Hubble Space Telescope/Advanced Camera for Surveys of one field in the Local Group dwarf galaxy LGS-3 (also known as the Pisces Dwarf or Pisces I). The ab-type variables exhibit a mean period of =0.623 ± 0.007 d. Applying a relationship between [Fe/H] and period, we calculate a mean metallicity of 〈[Fe/H]〉 = −1.81 ± 0.04 on the Zinn & West scale. Finally, we conclude that the mean metal abundance of the RR Lyraes in LGS-3 is consistent with that of the LGS-3 field stellar population at an age of >10 Gyr.
Ages and metallicities of globular clusters in M81 using GTC/OSIRIS spectra
Authors: Lomelí-Núñez Luis , Mayya Y D , Rodríguez-Merino L H , Ovando P A , Alzate Jairo A , Rosa-González D , Cuevas-Otahola B , Bruzual Gustavo , Cortesi Arianna , Gómez-González V M A , Escudero Carlos G
Published: January 2024

We here present the results of an analysis of the optical spectroscopy of 42 globular cluster (GC) candidates in the nearby spiral galaxy M81 (3.61 Mpc). The spectra were obtained using the long-slit and multi-object spectroscopic modes of the OSIRIS instrument at the 10.4-m Gran Telescopio Canarias at a spectral resolution of ∼1000. We used the classical H β versus [MgFe]′ index diagram to separate genuine old GCs from clusters younger than 3 Gyr. Of the 30 spectra with continuum signal-to-noise ratio >10, we confirm 17 objects to be classical GCs (age >10 Gyr, −1.4 < [Fe/H] < −0.4), with the remaining 13 being intermediate-age clusters (1–7.5 Gyr). We combined age and metallicity data of other nearby spiral galaxies (≲18 Mpc) obtained using similar methodology like the one we have used here to understand the origin of GCs in spiral galaxies in the cosmological context. We find that the metal-poor ([Fe/H] < −1) GCs continued to form up to 6 Gyr after the first GCs were formed, with all younger systems (age <8 Gyr) being metal rich.
Understanding the relative importance of magnetic field, gravity, and turbulence in star formation at the hub of the giant molecular cloud G148.24+00.41
Authors: Rawat Vineet , Samal M R , Eswaraiah Chakali , Wang Jia-Wei , Elia Davide , Panigrahy Sandhyarani , Zavagno A , Yadav R K , Walker D L , Jose J , Ojha D K , Zhang C P , Dutta S
Published: January 2024

The relative importance of magnetic fields, turbulence, and gravity in the early phases of star formation is still not well understood. We report the first high-resolution dust polarization observations at 850 $\mu$m around the most massive clump, located at the hub of the Giant Molecular Cloud G148.24+00.41, using SCUBA-2/POL-2 at the James Clerk Maxwell Telescope. We find that the degree of polarization decreases steadily towards the denser portion of the cloud. Comparing the intensity gradients and local gravity with the magnetic field orientations, we find that local gravity plays a dominant role in driving the gas collapse as the magnetic field orientations and gravity vectors seem to point towards the dense clumps. We also find evidence of U-shaped magnetic field morphology towards a small-scale elongated structure associated with the central clump, hinting at converging accretion flows towards the clump. Our observation has resolved the massive clump into multiple substructures. We study the magnetic field properties of two regions, central clump (CC) and northeastern elongated structure (NES). Using the modified Davis–Chandrasekhar–Fermi method, we determine that the magnetic field strengths of CC and NES are ∼24.0 ± 6.0 $\mu$G and 20.0 ± 5.0 $\mu$G, respectively. The mass-to-flux ratios are found to be magnetically transcritical/supercritical, while the Alfv$\acute{\text{e}}$n Mach number indicates a trans-Alfv$\acute{\text{e}}$nic state in both regions. These results, along with Virial analysis, suggest that at the hub of G148.24+00.41, gravitational energy has an edge over magnetic and kinetic energies.
Dharma Protectors, Violence, and Warfare
Authors: Bailey Cameron
Published: January 2024

The protector cults of Buddhism in their narrative, ritual, and iconographic elements are characterized largely, if not entirely, by sublimated violence. From their mythic origins to their (usually) fearsome appearance in art and literature, to the way they are liturgically utilized and invoked in ritual practice, these Buddhist deities are most well-known for their violent and warlike nature. In the traditional emic understanding of Dharma protectors, especially in the context of Indo-Tibetan tantric Buddhism, they function essentially as spiritual warriors, a parallel demonic sangha, who are called on to combat enemies in both the outer and inner worlds, capable of subduing evil forces on both the psychological and physical battlefields. As the psychology of Buddhism grew more sophisticated within the framework of tantric hermeneutics and ritual over the course of the first millennium in India, and further developed in Tibet beginning in the seventh and eighth centuries, soteriological focus shifted from the mere avoidance and suppression of negative emotions to a concerted effort to control their energy and turn them on themselves. Within the tantric or esoteric Buddhism that flourished most successfully in Tibet and Japan, the wrathful and sexualized worldly deities of local pantheons that were originally seen as embodiments of spiritual obscurations were powerfully reframed in terms of enlightened transformation. Tantric control of wrathful energy and dangerous spiritual and magical power paralleled and combined with the Mahāyāna doctrinal acceptance of compassionate violence, where violence became interpreted as not only permissible, but an essential way of stopping evil actions and eliminating evil beings when no other option was tenable. In tantric hermeneutics, “killing” became euphemistically known as “liberation,” and is traditionally understood as a virtue as long it is based in genuine compassion. Dharma protectors are one important subset of these krodha-vighnāntaka (“wrathful destroyers of obstacles”) particularly prevalent in Tantric Buddhism and are almost inevitably steeped in violence, at least on the virtual level of narrative and ritual. This includes both the violence that is often said to have been done against them, necessarily to tame them, and the violence they then carry out on other demons and human enemies of Buddhism once their fearsome nature has been harnessed and redirected. The following scholarly sources discuss the various facets of protector deity beliefs and cults and their wrathful and violent aspects.
Gender, Indigenous and Ethnic Political Representation in Oceania
Authors: Hayward Janine , Timperley Claire
Published: January 2024

This entry draws attention to literature on political representation in Oceania, understood primarily to mean elected representation in the formal institutions of government. Literature across the region has been dominated by analysis of women in politics, but there is assessment of Indigenous and ethnic representation in some countries. While the focus is on formal representation, this article includes literature on representation beyond elected roles, guided by scholarship that emphasizes the importance of politics beyond parliament, especially for women. Literature on Indigenous representation also includes theoretical research that considers the relationship between Indigenous sovereignty and formal representation. Oceania is a region of tremendous diversity in relation to history, language, culture, and political systems. In social science literature the region is often divided into three subregions—Melanesia, Polynesia, and Micronesia—each with some distinct characteristics. Given the diversity of the region, and related scholarship, there are many ways to configure this literature. This entry follows the contours of the scholarship, which clusters around Australia, New Zealand, and the Pacific Island states and territories. To guide readers new to the field, Australia and New Zealand are separated out, reflecting the scholarly attention these countries have received, as well as their similar histories as colonial settler societies. Each section highlights scholarship specific to the two countries, but there is also substantial overlap in the literature drawing connections between these two cases and with other Westminster democracies. The article concludes with some of this comparative literature, especially where it highlights important findings for each country, but there are many excellent studies that are not listed here. To introduce readers to scholarship in Oceania beyond Australia and New Zealand, this topic is approached thematically, highlighting the relatively extensive literature that analyzes the low numbers of women represented in formal politics across the region, the obstacles to women’s representation, and the impacts of electoral systems on women. Scholars also offer recommendations to address this deficit, and provide a fuller picture of the contributions women choose to make beyond parliament in the public sector, local government, and community politics. The literature also gives a voice to women who defy the odds and get elected. Political science scholarship is highlighted in these sections, but attention is also drawn to a number of important reports written for the UN and aid organizations (some authored by political scientists) that have had a major impact on the research in the region. Three countries—Papua New Guinea, Fiji, and Solomon Islands—have received higher levels of scholarly attention, which is reflected in the final three sections that focus on each in turn, providing a sample of the representation literature over time in each country.
Political Clientelism in Democracies
Authors: Borges Martins da Silva Mariana
Published: January 2024

Clientelism has been a central theoretical framework within political behavior and political economy used by political scientists to understand the behavior of low-income individuals in the developing world. Although the topic has been present in the social sciences for decades, political science has witnessed a sharp rise in studies of the topic since the 2000s, mostly, but not all, using surveys and, more recently, experiments to study the phenomena. There is considerable debate in the literature about what clientelism is or what can or cannot be considered clientelism. This article covers all studies that name the practice they study as clientelism, which ranges from studies that understand it as a cultural, political practice to those that conceptualize it as a mode of exchange or a tie between voters and politicians. The article only covers studies that use clientelism to analyze political behavior in democracies. Another set of studies not covered here is dedicated to uncovering how authoritarian leaders may also use clientelism as a tool of political mobilization. The article is divided among the major research topics in the field, covering issues that include conceptual discussions, the mechanism underlying clientelism, and the methodological discussion about measuring an informal practice.
Use of a Home-Based, Commercial Exercise Platform to Remotely Monitor Aerobic Exercise Adherence and Intensity in People With Parkinson Disease
Authors: Rosenfeldt Anson B , Lopez-Lennon Cielita , Suttman Erin , Jansen A Elizabeth , Owen Kelsey , Dibble Leland E , Alberts Jay L
Published: January 2024

Objective

Physical therapists are well-positioned to prescribe exercise outside of a clinical setting to promote positive health behaviors in people with Parkinson disease (PD). Traditionally, a barrier to precise exercise prescription has been reliance on participant self-reported exercise adherence and intensity. Home-based, commercially available exercise platforms offer an opportunity to remotely monitor exercise behavior and facilitate adherence based on objective performance metrics. The primary aim of this project was to characterize the feasibility and processes of remote aerobic exercise data monitoring from a home-based, commercially available platform in individuals participating in the 12-month Cyclical Lower Extremity Exercise for PD II (CYCLE-II) randomized clinical trial. Secondary aims focused on using exercise behavior to classify the cohort into exercise archetypes and describing a shared decision-making process to facilitate exercise adherence.

Methods

Data from each exercise session were extracted, visualized, and filtered to ensure ride integrity. Weekly exercise frequency was used to determine exercise archetypes: Adherent (2–4 exercise sessions per week), Over-adherent (>4 exercise sessions per week), and Under-adherent (<2 exercise sessions per week).

Results

A total of 123 people with PD completed 22,000+ exercise sessions. Analysis of exercise frequency indicated that 79% of participants were adherent; 8% were over-adherent; and 13% were under-adherent. Three case reports illustrate how shared decision-making with the use of exercise performance data points guided exercise prescription.

Conclusions

The number of exercise sessions and completeness of the data indicate that people with PD were able to utilize a commercial, home-based exercise platform to successfully engage in long-term aerobic exercise. Physical therapists can use objective data as a part of a shared decision-making process to facilitate exercise adherence.

Impact

Commercially available exercise platforms offer a unique approach for physical therapists to monitor exercise behavior outside of a clinical setting. The methods used in this project can serve as a roadmap to utilizing data from consumer-based platforms.
Placenta-Derived Decidua Stromal Cells: A New Frontier in the Therapy of Acute Graft-Versus-Host Disease
Authors: Ringdén Olle , Sadeghi Behnam
Published: January 2024

Acute graft-versus-host disease (GVHD) is a frequent and potentially life-threatening complication following allogeneic hematopoietic cell transplantation (HCT). Mesenchymal stromal cells (MSCs), rare precursors found in all body tissues, possess immunosuppressive properties and can inhibit alloreactivity both in vitro and in vivo. Two decades ago, we introduced bone marrow-derived (BM) MSCs as a novel therapy for acute GVHD. While some patients responded to BM-MSCs, the response was not universal. Commercially available BM-MSCs are now used for acute GVHD treatment in Canada, Japan, and New Zealand. The fetus is protected from the mother’s immune system by the placenta, and our research found that placenta-derived decidua stromal cells (DSCs) offer a stronger immunosuppressive effect than other sources of stromal cells. Safety studies in rabbits, rats, mice, and humans have shown negligible or no side effects from BM-MSCs or DSCs. In a phase I/II trial for severe acute GVHD, we treated 21 patients (median age, 49 years; range 1.6-72 years) with severe biopsy-proven gastrointestinal acute GVHD. The median cell dose of DSCs was 1.2 × 106 (range 0.9-2.9) cells/kg body weight, with a median of 2 (range 1-6) infusions given 1 week apart. The cell viability of DSCs was 93% (range, 69%-100%), and the median cell passage number was 4 (range, 2-4). All patients responded, with a complete response of acute GVHD in 11 patients and partial response in 10 and 1-year survival of 81%. Randomized trials are needed to prove the superiority of DSCs compared to ruxolitinib and/or other novel immunosuppressive therapies.
Auditory, Visual, and Cognitive Abilities in Normal-Hearing Adults, Hearing Aid Users, and Cochlear Implant Users
Authors: Ceuleers Dorien , Keppler Hannah , Degeest Sofie , Baudonck Nele , Swinnen Freya , Kestens Katrien , Dhooge Ingeborg
Published: January 2024

Objectives:

Speech understanding is considered a bimodal and bidirectional process, whereby visual information (i.e., speechreading) and also cognitive functions (i.e., top-down processes) are involved. Therefore, the purpose of the present study is twofold: (1) to investigate the auditory (A), visual (V), and cognitive (C) abilities in normal-hearing individuals, hearing aid (HA) users, and cochlear implant (CI) users, and (2) to determine an auditory, visual, cognitive (AVC)-profile providing a comprehensive overview of a person’s speech processing abilities, containing a broader variety of factors involved in speech understanding.

Design:

Three matched groups of subjects participated in this study: (1) 31 normal-hearing adults (mean age = 58.76), (2) 31 adults with moderate to severe hearing loss using HAs (mean age = 59.31), (3) 31 adults with a severe to profound hearing loss using a CI (mean age = 58.86). The audiological assessments consisted of pure-tone audiometry, speech audiometry in quiet and in noise. For evaluation of the (audio-) visual speech processing abilities, the Test for (Audio) Visual Speech perception was used. The cognitive test battery consisted of the letter-number sequencing task, the letter detection test, and an auditory Stroop test, measuring working memory and processing speed, selective attention, and cognitive flexibility and inhibition, respectively. Differences between the three groups were examined using a one-way analysis of variance or Kruskal–Wallis test, depending on the normality of the variables. Furthermore, a principal component analysis was conducted to determine the AVC-profile.

Results:

Normal-hearing individuals scored better for both auditory, and cognitive abilities compared to HA users and CI users, listening in a best aided condition. No significant differences were found for speech understanding in a visual condition, despite a larger audiovisual gain for the HA users and CI users. Furthermore, an AVC-profile was composed based on the different auditory, visual, and cognitive assessments. On the basis of that profile, it is possible to determine one comprehensive score for auditory, visual, and cognitive functioning. In the future, these scores could be used in auditory rehabilitation to determine specific strengths and weaknesses per individual patient for the different abilities related to the process of speech understanding in daily life.

Conclusions:

It is suggested to evaluate individuals with hearing loss from a broader perspective, considering more than only the typical auditory abilities. Also, cognitive and visual abilities are important to take into account to have a more complete overview of the speech understanding abilities in daily life.
Research Trends and Highlights Toward Virtual Reality in Patients With Cancer
Authors: Sezgin Merve Gozde , Bektas Hicran
Published: January 2024

This retrospective bibliometric analysis was conducted to explore research trends and identify studies in fields of nursing, virtual reality, and cancer. Data were obtained from the Web of Science database using an advanced search strategy. The study data were analyzed using the R Studio software and visualized using VOSviewer. A total of 594 studies were retrieved and analyzed from January 1995 to December 2021. It was determined that 59.4% of the studies were research articles and that these studies had been conducted by 2771 authors. The reviewed studies were produced by researchers from 25 countries and were published in 29 different journals. Of these, 169 were conducted by researchers in the United States. “Virtual reality” and “nursing” were found to be prominent topics. Studies on virtual reality in patients with cancer in the field of nursing have increased over the past 8 years. Researchers have actively conducted studies in this field. Prominent studies have covered various patients with cancer in all age groups and palliative care processes. It was seen that the majority of the studies were randomized controlled trials, reviews, and systematic reviews. In addition, studies have used virtual reality as a distraction method in the management of symptoms in patients with breast, lung, and pediatric cancers undergoing chemotherapy treatment. This study provides a detailed and up-to-date analysis of the findings obtained from the Web of Science database by emphasizing bibliometric models of virtual reality technologies in nursing patients with cancer. We believe that the current data on the use of virtual reality applications in patients with cancer will guide the clinical practice and scientific studies of healthcare professionals.
Tildrakizumab for moderate-to-severe plaque psoriasis in Chinese patients: A 12-week randomized placebo-controlled phase III trial with long-term extension
Authors: Yu Chen , Geng Songmei , Yang Bin , Deng Yunhua , Li Fuqiu , Kang Xiaojing , Bi Mingye , Zhang Furen , Zhao Yi , Pan Weili , Tian Zhongwei , Xu Jinhua , Zhang Zhenghua , Yu Nan , Duan Xinsuo , Guo Shuping , Sun Qing , Li Weiquan , Tao Juan , Liu Zhijun , Yin Yuanyuan , Wang Gang
Published: January 2024

Background:

There is a need for effective and safe therapies for psoriasis that provide sustained benefits. The aim of this study was to assess the efficacy and safety of tildrakizumab, an anti-interleukin-23p19 monoclonal antibody, for treating moderate-to-severe plaque psoriasis in Chinese patients.

Methods:

In this multi-center, double-blind, phase III trial, patients with moderate-to-severe plaque psoriasis were enrolled and randomly assigned (1:1) to receive subcutaneous tildrakizumab 100 mg or placebo at weeks 0 and 4. Patients initially assigned to placebo were switched to receive tildrakizumab at weeks 12, 16, and every 12 weeks thereafter. Patients in the tildrakizumab group continued with tildrakizumab at week 16, and every 12 weeks until week 52. The primary endpoint was the Psoriasis Area and Severity Index (PASI 75) response rate at week 12.

Results:

At week 12, tildrakizumab demonstrated significantly higher PASI 75 response rates (66.4% [73/110]vs.12.7% [14/110]; difference, 51.4% [95% confidence interval (CI), 40.72, 62.13];P<0.001) and Physician's Global Assessment (60.9% [67/110]vs.10.0% [11/110]; difference, 49.1% [95% CI, 38.64, 59.62];P<0.001) compared to placebo. PASI 75 response continued to improve over time in both tildrakizumab and placebo-switching to tildrakizumab groups, reaching maximal efficacy after 28 weeks (86.8% [92/106]vs. 82.4% [89/108]) and maintained up to 52 weeks (91.3% [95/104]vs. 87.4% [90/103]). Most treatment-emergent adverse events were mild and not related to tildrakizumab.

Conclusion:

Tildrakizumab demonstrated durable efficacy through week 52 and was well tolerated in Chinese patients with moderate-to-severe plaque psoriasis.

Trial registration:

ClinicalTrials.gov, NCT05108766.
Microbiome and Abdominopelvic Radiotherapy Related Chronic Enteritis: A Microbiome-based Mechanistic Role of Probiotics and Antibiotics
Authors: Giridhar Prashanth , Pradhan Satyajit , Dokania Shubham , Venkatesulu Bhanuprasad , Sarode Rahul , Welsh James S.
Published: January 2024

Chronic diarrhea and abdominal pain after radiotherapy continue to be a problem in cancer survivors. Gut microbiomes are essential for preventing intestinal inflammation, maintaining intestinal integrity, maintaining enterohepatic circulation, regulating bile acid metabolism, and absorption of nutrients, including fat-soluble vitamins. Gut microbiome dysbiosis is expected to cause inflammation, bile acid malabsorption, malnutrition, and associated symptoms. Postradiotherapy, Firmicutes and Bacteroidetes phylum are significantly decreased while Fusobacteria and other unclassified bacteria are increased. Available evidence suggests harmful bacteria Veillonella, Erysipelotrichaceae, and Ruminococcus are sensitive to Metronidazole or Ciprofloxacin. Beneficial bacteria lactobacillus and Bifidobacterium are relatively resistant to metronidazole. We hypothesize and provide an evidence-based review that short-course targeted antibiotics followed by specific probiotics may lead to alleviation of radiation enteritis.
Sensitivity and specificity of SS-OCT for detecting macular pathologies vs SD-OCT
Authors: Yeu Elizabeth , Berdahl John P. , Gupta Preeya K. , Patterson Michael
Published: January 2024

Purpose:

To evaluate the sensitivity and specificity of swept-source optical coherence tomography (SS-OCT) biometer compared with the gold standard spectral-domain optical coherence tomography (SD-OCT) for detecting macular pathology in patients with cataract.

Setting:

Eye Centers of Tennessee, Crossville, TN.

Design:

Prospective, cross-sectional, observational, examiner-masked.

Methods:

The study included 132 participants aged 50 years and older, who underwent precataract surgery work-up. All participants underwent fixation check retinal scans using SS-OCT biometer (IOLMaster 700) as well as full macular scans using Cirrus SD-OCT. 3 independent masked examiners evaluated the scans if they were normal or had a suspected pathology. Different measures of diagnostic accuracy were calculated for 3 examiners.

Results:

True positive rate (sensitivity) ranged from 71.1% (32/45) to 79.2% (42/53), and false negative rate was between 20.8% (11/53) and 28.9% (13/45) for the 3 examiners. True negative rate (specificity) ranged from 86.8% (59/68) to 94.1% (64/68), and false positive rate was between 5.9 (4/68) and 13.2% (9/68). The fitted receiver operating characteristic area ranged from 0.83 to 0.95.

Conclusions:

Using retinal SS-OCT biometer scans as a replacement of the dedicated macular SD-OCT for screening or diagnosing macular health would not be appropriate because of its low sensitivity. SS-OCT biometer may potentially fail to identify approximately one-fourth of patients who actually have the disease. Therefore, the final decision on macular health should be based on the gold standard SD-OCT scans. When full macular SD-OCT scans are not accessible, the limited retinal scan information from SS-OCT biometer may still provide useful insights into the macular health.
An Analysis of Pain and Quality of Life in Patients Undergoing Targeted Muscle Reinnervation After Upper-Limb Amputations
Authors: Zargaran David , Zargaran Alexander , Nagra Rav , Akella Medha , Kokkinos Costas , Ajam Yazan , Woollard Alexander , Kang Norbert
Published: January 2024

Introduction

Targeted muscle reinnervation (TMR) surgery is now increasingly performed when individuals with amputation develop problems with chronic, nerve-related limb pain. This study evaluates the effectiveness of TMR for individuals with upper-limb amputations in terms of quality-adjusted life years (QALYs) and subjective neuroma pain (NP) and phantom limb pain (PLP).

Methods

A retrospective single-center study assessed patient-reported outcome measures in postoperative TMR patients. Digital records were analyzed, and telephone interviews were conducted for all patients over an 8-year period.

Results

Significant reductions were observed in NP (−3.9, P < 0.01) and PLP (−4.9, P < 0.01), as well as an improvement in VAS scores (pre-TMR mean = 60.7, post-TMR mean = 76.3, P < 0.01) and pain scores (pre-TMR mean = 3.6, post-TMR mean = 2.5, P < 0.01) on the Euroqol EQ5D-5L scale.

Conclusions

We observed significant improvements in NP and PLP after TMR surgery, as well as improved pain scores on the EuroQol EQ5D-5L scale. This suggests that TMR may represent a reasonable management option for patients with nerve-related pain after an upper-limb amputation. More work needs to be done in the form of randomized controlled studies and economic analyses to quantify benefit and scalability.

Clinical Relevance

This article adds to the body of evidence in support of the potential important role of TMR in the management of chronic pain after upper-limb amputations.
Alcohol Misuse Screening Performance Improvement Initiative
Authors: Hightower Todd , Stucke Sheri , Specht Katherine , Bertolani Jennifer , Malone Cheryl , Dhanyamraju Krishna , Rivera Nancy , Rodriguez Rodrigo
Published: January 2024

Background:

A trauma registry review of our trauma center's alcohol misuse screening compliance noted inconsistent screening and data collection methods, putting our American College of Surgeons trauma center reverification at risk for a deficiency.

Objective:

The objective of this study was to evaluate an alcohol misuse screening improvement initiative on screening compliance in trauma patients.

Methods:

This before and after analysis of a quality improvement initiative to improve alcohol misuse screening was conducted from 2019 to 2021 at a Southwestern U.S. Level II trauma center on admitted trauma patients aged 13 years and older. The multicomponent initiative included a change in the screening instrument and timing of application, implementing electronic medical record documentation screens, and educating staff. The primary outcome measure was screening adherence.

Results:

A total of n = 4,734 patients were included in the study period. Alcohol misuse screening improved from 2.9% to 87.4% and remained sustained for over a year after the initiative's implementation.

Conclusion:

The performance improvement initiative improved the alcohol misuse screening process, resulting in consistent screenings exceeding the American College of Surgeons standards of 80% for verified trauma centers.
The application of dual-heart nursing mode in patients with coronary heart disease and angina pectoris and its impact on anxiety, depression, and quality of life
Authors: Li Lu , Tan Piaopiao , Li Gaoya , Yang Shengxiang , Guo Meng , Zhang Cangyun
Published: January 2024

To diagnose and treat patients with coronary heart disease and angina pectoris with dual heart care mode and analyze the treatment effect. Three hundred cases meeting the inclusion criteria were equally divided into 3 groups, each containing 50 male and female cases. The patients in experimental group 1 took the dual heart nursing method proposed by the subject; experimental group 2 received betastatins; control group received conventional treatment. After 12 weeks of treatment, Hamilton depression scale scored the 3 groups, and their anxiety and depression scores, clinical manifestations, symptom scores and self-acceptance were analyzed. The chi square value of these data was compared withP, and judge whether they meet the needs and differences of statistical data. Then compare their scores before and after treatment to identify the treatment status. The anxiety and depression scores of experimental group 1 were the lowest among the 3 groups, with the values of 59.62 ± 7.925 and 58.64 ± 6.416; The total patients who responded effectively to treatment in experimental group 1 accounted for 83%, and the patients who responded effectively to treatment rate was the highest in the 3 groups; The effect of decreasing the score of complications in experimental group 1 was also the most obvious, from 9.07 ± 4.28 to 3.14 ± 2.07, which was the best in the 3 groups; the self-evaluation of patients in experimental group 1 was the highest among the 3 groups, 89.72 ± 4.28. The proposed dual heart care and treatment method can effectively treat coronary heart disease and angina pectoris, and can effectively improve the clinical performance and self-acceptance of patients. It can effectively restore the anxiety and depression of patients after treatment, and then improve patients’ life quality, which has the value of popularization and use.
Effects of virtual reality-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: A meta-analysis
Authors: Chai Xiuqin , Wu Lingyun , He Zhihong
Published: January 2024

Background:

Virtual reality (VR)-based pulmonary rehabilitation has been used in the management of chronic obstructive pulmonary disease (COPD). The efficacy of VR-based pulmonary rehabilitation for improving lung function in patients with COPD is controversial. Therefore, the aim of this meta-analysis was to evaluate the efficacy of VR combined with pulmonary rehabilitation for lung function in patients with COPD.

Methods:

This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search was performed in the Cochrane Library, EMBASE, Web of Science, PubMed, and China National Knowledge Infrastructure databases from inception to February 1, 2023. All included studies were randomized controlled trials that assessed VR combined with pulmonary rehabilitation for COPD patients. The effect size was calculated with standardized mean difference (SMD) and its 95% confidence interval (CI). The Cochrane Collaboration tool was used to assess the risk of bias. Publication bias was assessed by Egger test.

Results:

A total of 11 studies met the inclusion criteria and were included in this study. The combined effect size showed that VR combined with pulmonary rehabilitation was more effective than pulmonary rehabilitation alone at improving forced expiratory volume in 1 second% (SMD: 0.51; 95% CI 0.19,0.82;P = .002), forced expiratory volume in 1 second/forced vital capacity (SMD: 0.71; 95% CI 0.49,0.93;P < .001), dyspnea (SMD: −0.44; 95% CI −0.66, −0.22;P < .001), and 6-minute walking test (SMD: 059; 95% CI 0.39, 0.79;P < .001). In addition, the VR combined with pulmonary rehabilitation improved depression (SMD: −0.34; 95% CI −0.05, −0.03;P = .033) and anxiety mood (SMD: −0.57; 95% CI −1.11, −0.04;P = .036) compared with the pulmonary rehabilitation group.

Conclusion:

This meta-analysis indicated that VR regimens could be used to enhance the therapeutic effect of pulmonary rehabilitation in patients with COPD. However, as a rapidly evolving field, more well-designed randomized controlled trials are needed to determine the impact of VR-based pulmonary rehabilitation on COPD patients.
Chronic kidney disease associated cardiomyopathy: recent advances and future perspectives
Authors: Dobre Mirela A. , Ahlawat Shruti , Schelling Jeffrey R.
Published: January 2024

Purpose of review

Cardiomyopathy in chronic kidney disease (CKD) is a complex condition with multiple triggers and poor prognosis. This review provides an overview of recent advances in CKD-associated cardiomyopathy, with a focus on pathophysiology, newly discovered biomarkers and potential therapeutic targets.

Recent findings

CKD is associated with a specific pattern of myocardial hypertrophy and fibrosis, resulting in diastolic and systolic dysfunction, and often triggered by nonatherosclerotic processes. Novel biomarkers, including amino-terminal type III procollagen peptide (PIIINP), carboxy-terminal type I procollagen peptide (PICP), FGF23, marinobufagenin, and several miRNAs, show promise for early detection and risk stratification. Treatment options for CKD-associated cardiomyopathy are limited. Sodium glucose cotransporter-2 inhibitors have been shown to reduce left ventricle hypertrophy and improve ejection fraction in individuals with diabetes and mild CKD, and are currently under investigation for more advanced stages of CKD. In hemodialysis patients calcimimetic etelcalcetide resulted in a significant reduction in left ventricular mass.

CKD-associated cardiomyopathy is a common and severe complication in CKD. The identification of novel biomarkers may lead to future therapeutic targets. Randomized clinical trials in individuals with more advanced CKD would be well posed to expand treatment options for this debilitating condition.
Formal Ethics Consultation in Extracorporeal Membrane Oxygenation Patients: A Single-Center Retrospective Cohort of a Quaternary Pediatric Hospital*
Authors: Siegel Bryan , Taylor Lisa S. , Alizadeh Faraz , Barreto Jessica A. , Daniel Dennis , Alexander Peta M.A. , Lipsitz Stuart , Moynihan Katie
Published: January 2024

OBJECTIVE:

To examine characteristics associated with formal ethics consultation (EC) referral in pediatric extracorporeal membrane oxygenation (ECMO) cases, and document ethical issues presented.

DESIGN:

Retrospective cohort study using mixed methods.

SETTING:

Single-center quaternary pediatric hospital.

PATIENTS:

Patients supported on ECMO (January 2012 to December 2021).

INTERVENTIONS:

We compared clinical variables among ECMO patients according to the presence of EC. We defined optimal cutoffs for EC based on run duration, ICU length of stay (LOS), and sum of procedures or complications. To identify independent explanatory variables for EC, we used a forward stepwise selection multivariable logistic regression model. EC records were thematically characterized into ethical issues.

MEASUREMENTS AND MAIN RESULTS:

Of 601 ECMO patients and 225 patients with EC in 10 years, 27 ECMO patients received EC (4.5% of ECMO patients, 12% of all ECs). On univariate analysis, use of EC vs. not was associated with multiple ECMO runs, more complications/procedures, longer ICU LOS and ECMO duration, cardiac admissions, decannulation outcome, and higher mortality. Cutoffs for EC were ICU LOS >52 days, run duration >160 hours, and >6 complications/procedures. Independent associations with EC included these three cutoffs and older age. The model showed good discrimination (area under the curve 0.88 [0.83, 0.93]) and fit. The most common primary ethical issues were related to end-of-life, ECMO discontinuation, and treatment decision-making. Moral distress was cited in 22 of 27 cases (82%).

CONCLUSION:

EC was used in 4.5% of our pediatric ECMO cases, with most ethical issues related to end-of-life care or ECMO discontinuation. Older age, longer ICU LOS, prolonged runs, and multiple procedures/complications were associated with greater odds for EC requests. These data highlight our single-center experience of ECMO-associated ethical dilemmas. Historical referral patterns may guide a supported decision-making framework. Future work will need to include quality improvement projects for timely EC, with evaluation of impacts on relevant endpoints.
The Severity of Depressive Symptoms as an Independent Predictor of Sustained Virological Response During Treatment of Hepatitis C With Pegylated Interferon-α2a and Oral Ribavirin
Authors: Pawłowski Tomasz , Radkowski Marek , Perlejewski Karol , Laskus Tomasz , Małyszczak Krzysztof
Published: January 2024

Background

Sustained virological response (SVR) is the best indicator of successful therapy for hepatitis C virus (HCV) infection. Patients with chronic HCV infection treated with pegylated interferon-α and ribavirin (PEG-IFN-α/RBV) can achieve SVR 56% of the time.

Objectives

This study aimed to evaluate baseline predictors of SVR in patients treated with PEG-IFN-α/RBV for HCV chronic infection.

Methods

A total of 101 patients receiving PEG-IFN-α/RBV for chronic HCV infection participated in the prospective cohort study. Symptoms of depression were assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS) before the treatment. The multivariate regression analysis was applied to determine predictors of SVR.

Results

Of a total of 101 patients included, 99 patients reached the primary end point—24 weeks after completing treatment. After the initial analysis of probable predictive variables, the logistic analysis included age, sex, HCV genetic type, and MADRS score. The HCV genotype (odds ratio = 0.22 [confidence interval = 0.073–0.68, p = .008) and MADRS score (OR = 0.88 [confidence interval = 0.80–0.98), p = .013]) predicted an SVR outcome.

Conclusions

The severity of depressive symptoms before treatment and HCV genotype are independent predictors of SVR.
Preexisting Psychiatric Conditions as Risk Factors for Diagnosed Long COVID-19 Syndrome Within Aggregated Electronic Health Record Data
Authors: Bobak Lukas , Dorney Ian , Kovacevich Alexsandra , Barnett Brian , Kaelber David C.
Published: January 2024

Objective

This study aimed to investigate the frequency of long COVID diagnosis among patients infected with severe acute respiratory syndrome coronavirus 2 with preexisting psychiatric conditions versus those without preexisting psychiatric conditions.

Methods

The TriNetX Analytics platform, an aggregated electronic health record research network containing the deidentified electronic health record data of more than 90 million patients, was queried for patients who were diagnosed with COVID-19 infection based on International Classifications of Disease, Tenth Revision codes. Patients were stratified based on their preexisting psychiatric conditions, and new diagnoses of long COVID were recorded and reported as the primary outcome.

Results

Among 1,180,948 patients previously diagnosed with COVID-19, 17,990 patients (1.52%) were diagnosed with long COVID based on the newly implemented International Classifications of Disease, Tenth Revision code “U09: post–COVID-19 condition.” After propensity score matching, patients with any preexisting psychiatric diagnosis had a 1.52 (95% confidence interval [CI] = 1.47–1.58) times greater prevalence of diagnosed long COVID within 180 days of infection than patients without preexisting psychiatric diagnoses. Patients with diagnosed anxiety disorders (relative risk [RR] = 1.64; 95% CI = 1.57–1.71), mood disorders (RR = 1.65; 95% CI = 1.57–1.72), bipolar disorder (RR = 1.37; 95% CI = 1.21–1.54), major depressive disorder (RR = 1.69; 95% CI = 1.56–1.83), psychotic disorders (RR = 1.23; 95% CI = 1.06–1.44), and substance use disorders (RR = 1.28; 95% CI = 1.22–1.36) had higher risks for long COVID diagnoses when compared with patients without preexisting psychiatric illness at the time of diagnosis.

Conclusions

Multiple preexisting psychiatric diagnoses are associated with an increased risk of being diagnosed with long COVID after COVID-19 infection.
Optimism and Sleep in Aging Women: Bidirectional Relationships
Authors: Monroe Addison D. , Judge Stephanie T. , Bass Chelsea L. , Crofford Leslie J. , Segerstrom Suzanne C.
Published: January 2024

Objective

Sleep quality and duration are important for biological restoration and promotion of psychological well-being. Optimism may facilitate or result from sufficient sleep, but questions remain as to directionality. The present study tested how optimism is associated with levels of and variability in sleep quantity and quality in a longitudinal burst design.

Methods

Midlife and older women (N = 199) reported their sleep quantity and quality in online diaries for a 7-day period, every 3 months for 2 years. Optimism was measured at baseline and end-of-study. Multilevel models tested the effects of optimism on sleep. Linear regression models tested the effect of sleep on optimism.

Results

Baseline optimism was associated with higher sleep quality (γ = 2.13 [1.16 to 3.11], p < .0001) and lower intraindividual variability (IIV; night-to-night and wave-to-wave) in sleep quantity (night-to-night: γ = −0.07 [−0.13 to −0.005], p = .03; wave-to-wave: b = −0.07 [−0.12 to −0.02], p = .003). In turn, higher average sleep quality (but not quantity) was associated with higher optimism at end-of-study (b = 0.02 [0.007 to 0.03], p = .002). Variability in sleep was unrelated to optimism.

Conclusions

Optimism may play an important role in maintaining sleep quality and consistency in sleep quantity, perhaps by buffering stress. Similarly, sleep quality may play an important role in maintaining optimism. The cycle whereby optimism and sleep enhance one another could improve physical health and psychological well-being among aging adults.
Role of Shear Wave Elastography of Placenta in Prediction of Preeclampsia in High-Risk Pregnancy
Authors: Singh Tulika , Roy Choudhury Shayeri , Singh Mandeep , Singla Veenu , Jain Vanita
Published: January 2024

The aim of our study was to compare the placental elasticity values between normal pregnancies and preeclamptic pregnancies and evaluate the utility of shear-wave elastography of the placenta as a predictor for preeclampsia in high-risk pregnancy. A prospective study was performed with 90 singleton high-risk pregnancies having any of the 7 risk factors for developing preeclampsia (primigravida, history of preeclampsia, family history of preeclampsia, history of pregestational diabetes, chronic hypertension, advanced maternal age [≥40 years], and body mass index ≥26 kg/m2) were enrolled in the study. Shear-wave elastography was performed in all patients at 20 to 24 weeks' gestation and at 34 to 36 weeks' gestation, at 2 sites: center and edge of the placenta. The patients were divided into 2 groups: normal pregnancies (group A) or developed preeclampsia (group B). Women with posterior placentation, obstetric disorders other than preeclampsia, or multiple gestation were excluded from the study. Group comparisons were done using the χ
2 test or Fisher exact test. Shear-wave elasticity values at 20 to 24 weeks' gestation for group B at the center of the placenta (21.73 vs 9.72 kPa) and at the edge of the placenta (21.6 kPa vs 10.15 kPa) were significantly higher than those for group A (P < 0.05). Similar results were seen at 34 to 36 weeks' gestation. With a cutoff of 13.1 kPa, we attained sensitivity of 95.2%, specificity of 92.8% and diagnostic accuracy of 93.3% for predicting development of preeclampsia. Patients with preeclampsia have a significantly higher stiffness of the placenta. Shear-wave elastography is useful to evaluate placental function. Elastography can be used as a supplementary tool for prediction of preeclampsia.
Post-operative pain management by nurses in an intensive care unit: a best practice implementation project
Authors: Moraes Érica Brandão de , Antunes Juliane de Macedo , Ferrari Maria Fernanda Muniz , Fontes Bárbara Ventura , Pereira Renata Castro da Silva , Ogawa Luciana , Daher Donizete Vago
Published: January 2024

Introduction:

Post-operative pain is the most prevalent type of acute pain. Nurses are the health care professionals who most frequently assess pain, as well as evaluating the patient's response to pain management treatment and monitoring for the occurrence of adverse events. Thus, to improve outcomes and quality of care, the interventions used by nurses should be based on best practices.

Objectives:

The aim of this project was to implement best practices in post-operative pain management in an intensive care unit.

Methods:

This evidence implementation project was conducted in a hospital for the surgical treatment of orthopedic diseases and trauma. The project followed the JBI Evidence Implementation Framework. The project used JBI PACES software as well as JBI's Getting Research into Practice (GRiP) audit and feedback tools to develop eight audit criteria for the baseline and follow-up audits.

Results:

The baseline audit showed that Criteria 3 and 6 had low compliance, with few patients having documented plans and goals, and receiving multimodal analgesia in the ICU, respectively. Criteria 7 and 8, which assessed the use of opioids and follow-up by a pain specialist, revealed compliance of 60% and 50%, respectively. Criterion 3 improved from 0% to 20%. Criteria 6, 7, and 8 also improved, rising to 30%, 22.8%, and 50%, respectively.

Conclusion:

The project improved compliance with best practices in post-operative pain management. Further studies are needed to ensure the project's long-term sustainability.