bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Routine Nurse Caregiving on the Stress Responses and Behavior State in Preterm Infants
Authors: Cistone Nicole , Pickler Rita H. , Fortney Christine A. , Nist Marliese D.
Published: July 2024

Background:

Although routine nurse caregiving is vital for the overall health of preterm infants, variations in approaches may exert distinct effects on preterm infants’ stress responses and behavior state.

Purpose:

The purpose of this systematic review was to examine routine nurse caregiving in the neonatal intensive care unit and its effect on stress responses and behavior state in preterm infants.

Data Sources:

A systematic search was conducted using PubMed, Embase, and CINAHL for studies published between 2013 and 2023.

Study Selection:

Included studies enrolled preterm infants born <37 weeks gestational age and investigated nurse caregiving practices and effects on stress responses and/or behavior state.

Data Extraction:

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, data about study design, methods, findings, and limitations were extracted and summarized. Included studies were evaluated for bias using the National Health, Lung, and Blood Institute quality assessment tools.

Results:

All 13 studies included in the review received a fair quality rating. Nurse caregiving activities, including suctioning, diaper changes, bathing, and weighing, were associated with increases in heart and respiratory rates, blood pressure, energy expenditure, and motor responses, lower oxygen saturations, and fewer sleep states.

Implications for Practice and Research:

Adapting nurse caregiving frequency and duration, aligning caregiving with infant state, and integrating developmental care strategies may reduce infant stress responses and support behavioral rest. Further research is needed to understand how caregiving activities affect stress responses and behavior state in preterm infants, aiding in identifying modifiable caregiving stressors to promote optimal development.
Time to Positive Blood Cultures Among Critically Ill Children Admitted to the PICU
Authors: Yasechko Stephanie M. , Hillyer Margot M. , Smith Alison G. C. , Rodenbough Anna L. , Fernandez Alfred J. , Gonzalez Mark D. , Jaggi Preeti
Published: July 2024

OBJECTIVES:

Our study aimed to assess the time to positivity (TTP) of clinically significant blood cultures in critically ill children admitted to the PICU.

DESIGN:

Retrospective review of positive blood cultures in patients admitted or transferred to the PICU.

SETTING:

Large tertiary-care medical center with over 90 PICU beds.

PATIENTS:

Patients 0–20 years old with bacteremia admitted or transferred to the PICU.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

The primary endpoint was the TTP, defined as time from blood culture draw to initial Gram stain result. Secondary endpoints included percentage of cultures reported by elapsed time, as well as the impact of pathogen and host immune status on TTP. Host immune status was classified as previously healthy, standard risk, or immunocompromised. Linear regression for TTP was performed to account for age, blood volume, and Gram stain. Among 164 episodes of clinically significant bacteremia, the median TTP was 13.3 hours (interquartile range, 10.7–16.8 hr). Enterobacterales, Staphylococcus aureus, Streptococcus agalactiae, and Streptococcus pneumoniae were most commonly identified. By 12, 24, 36, and 48 hours, 37%, 89%, 95%, and 97% of positive cultures had resulted positive, respectively. Median TTP stratified by host immune status was 13.2 hours for previously healthy patients, 14.0 hours for those considered standard risk, and 10.6 hours for immunocompromised patients (p = 0.001). Median TTP was found to be independent of blood volume. No difference was seen in TTP for Gram-negative vs. Gram-positive organisms (12.2 vs. 13.9 hr; p = 0.2).

CONCLUSIONS:

Among critically ill children, 95% of clinically significant blood cultures had an initial positive result within 36 hours, regardless of host immune status. Need for antimicrobial therapy should be frequently reassessed and implementation of a shorter duration of empiric antibiotics should be considered in patients with low suspicion for infection.
Interhospital Transfer of Patients With Acute Respiratory Failure in the United States: A Scoping Review
Authors: Ludwig Amy , Slota Jennifer , Nunes Denise A. , Vranas Kelly C. , Kruser Jacqueline M. , Scott Kelli S. , Huang Reiping , Johnson Julie K. , Lagu Tara C. , Nadig Nandita R.
Published: July 2024

OBJECTIVES:

Interhospital transfer of patients with acute respiratory failure (ARF) is relevant in the current landscape of critical care delivery. However, current transfer practices for patients with ARF are highly variable, poorly formalized, and lack evidence. We aim to synthesize the existing evidence, identify knowledge gaps, and highlight persisting questions related to interhospital transfer of patients with ARF.

DATA SOURCES:

Ovid Medline, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Embase, CINAHL Plus, and American Psychological Association.

STUDY SELECTION:

We included studies that evaluated or described hospital transfers of adult (age > 18) patients with ARF between January 2020 and 2024 conducted in the United States. Using predetermined search terms and strategies, a total of 3369 articles were found across all databases. After deduplication, 1748 abstracts were screened by authors with 45 articles that advanced to full-text review. This yielded 16 studies that fit our inclusion criteria.

DATA EXTRACTION:

The studies were reviewed in accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews by three authors.

DATA SYNTHESIS:

Included studies were mostly retrospective analyses of heterogeneous patients with various etiologies and severity of ARF. Overall, transferred patients were younger, had high severity of illness, and were more likely to have commercial insurance compared with nontransferred cohorts. There is a paucity of data examining why patients get transferred. Studies that retrospectively evaluated outcomes between transferred and nontransferred cohorts found no differences in mortality, although transferred patients have a longer length of stay. There is limited evidence to suggest that patients transferred early in their course have improved outcomes.

CONCLUSIONS:

Our scoping review highlights the sparse evidence and the urgent need for further research into understanding the complexity behind ARF transfers. Future studies should focus on defining best practices to inform clinical decision-making and improve downstream outcomes.
Paediatric antiretroviral therapy challenges with emerging integrase resistance
Authors: Bamford Alasdair , Hamzah Lisa , Turkova Anna
Published: July 2024

Purpose of review

Universal antiretroviral (ART) coverage and virological suppression are fundamental to ending AIDS in children by 2030. Availability of new paediatric dolutegravir (DTG)-based ART formulations is a major breakthrough and will undoubtedly help achieve this goal, but treatment challenges still remain.

Recent findings

Paediatric formulations remain limited compared to those for adults, especially for young children, those unable to tolerate DTG or with DTG-based first-line ART failure. Tenofovir alafenamide is virologically superior to standard-of-care backbone drugs in second-line, but paediatric formulations are not widely available. The roles of resistance testing and recycling of backbone drugs following first-line ART failure remain to be determined. Results of trials of novel treatment strategies including dual therapy and long-acting agents are awaited. Although numbers are currently small, safe and effective ART options are urgently required for children developing DTG resistance.

The antiretroviral treatment gap between adults and children persists. The potential benefits from rollout of new paediatric DTG-based fixed-dose combination ART for first-line treatment are considerable. However, children remain disadvantaged when DTG-based first-line ART fails or cannot be used. Research efforts to address this inequity require prioritisation in order to ensure health outcomes are optimised for all ages in all settings.
Maternal Sepsis
Authors: Nieuwoudt Claudia , White Sarah E. , Heine R. Phillips , Widelock Talla Motakef
Published: July 2024

Sepsis is the second leading cause of pregnancy-related mortality in the United States. Early recognition, treatment, and escalation of care for the obstetric patient affected by sepsis mitigate the risk of mortality and improve patient outcomes. In this article, we provide an overview of maternal sepsis and address topics of maternal pathophysiology, early warning signs, diagnostic criteria, early goal-directed therapy, and contemporary critical care practices. We also present an overview of common etiologies of maternal sepsis and suggested treatment approaches.
The Concentration of Uranium-238 in Soil Samples from the Central Maysan Governorate Determined Using ICP-MS
Authors: Ahmed Anaheed , Salman Thaer M. , Algrifi Mostafa A.
Published: July 2024

In this particular investigation, 30 surface soil samples taken from various locations across the Middle Omara governorate in southeastern Iraq were analyzed using ICP-MS (inductively coupled plasma mass spectrometry), and several of these, as far as the researchers know, had never been analyzed previously. The results are presented and compared with those from a different study. The studied soil samples had <100 ppm of uranium, which shows they are composed of overloads and garbage rather than mineable stocks. This article describes and assesses the uranium content in the Middle Omara Governorates. Additionally, all 30 exposed earth samples had uranium below the detection threshold. The results show that the samples of surface soils under investigation have uranium concentrations below the permissible maximum (11.7 ppm) established by UNSCEAR in 1993.
Fluid aspiration from intraretinal cysts for refractory diabetic macular edema
Authors: Ishikawa Keijiro , Nakao Shintaro , Mori Kenichiro , Fukuda Yosuke , Kiyohara Kohei , Yasaka Yuta , Yuge Kodai , Notomi Shoji , Sonoda Koh-Hei
Published: July 2024

PURPOSE:

To report the surgical outcome of fluid aspiration in intraretinal cysts as a novel treatment approach for the refractory cystoid macular edema (CME) associated with diabetic retinopathy.

METHODS:

This retrospective consecutive case series examined eight patients with refractory CME who underwent intraretinal cyst fluid aspiration using a 38-gauge subretinal infusion needle during pars plana vitrectomy. We reviewed changes in central retinal thickness (CRT), best-corrected visual acuity (BCVA), and central sensitivity among patients followed up for 12 months post-surgery.

RESULTS:

CRT on optical coherence tomography (μm) significantly improved at 12 months post-surgery (308 ± 99) compared to before surgery (480 ± 141) (P < 0.005). During the follow-up period, CME relapsed in one eye. The BCVA (logarithm of the minimal angle of resolution) at 12 months post-surgery (0.23 ± 0.32, Snellen equivalent: 20/50) was significantly better than the preoperative BCVA (0.39 ± 0.29, Snellen equivalent: 20/63) (P < 0.01). The mean deviation value of central sensitivity did not significantly change between preoperative (-2.5 ± 2.1) and postoperative (-2.2 ± 2.2) assessments (P = 0.07).

CONCLUSIONS:

Fluid aspiration in intraretinal cysts may be a treatment option for refractory CME in eyes with diabetes.
APPLICATIONS OF MULTIMODAL GENERATIVE ARTIFICIAL INTELLIGENCE IN A REAL-WORLD RETINA CLINIC SETTING
Authors: Ghalibafan Seyyedehfatemeh , Taylor Gonzalez David J. , Cai Louis Z. , Graham Chou Brandon , Panneerselvam Sugi , Conrad Barrett Spencer , Djulbegovic Mak B. , Yannuzzi Nicolas A.
Published: July 2024

Purpose:

This study evaluates a large language model, Generative Pre-trained Transformer 4 with vision, for diagnosing vitreoretinal diseases in real-world ophthalmology settings.

Methods:

A retrospective cross-sectional study at Bascom Palmer Eye Clinic, analyzing patient data from January 2010 to March 2023, assesses Generative Pre-trained Transformer 4 with vision's performance on retinal image analysis and International Classification of Diseases 10th revision coding across 2 patient groups: simpler cases (Group A) and complex cases (Group B) requiring more in-depth analysis. Diagnostic accuracy was assessed through open-ended questions and multiple-choice questions independently verified by three retina specialists.

Results:

In 256 eyes from 143 patients, Generative Pre-trained Transformer 4-V demonstrated a 13.7% accuracy for open-ended questions and 31.3% for multiple-choice questions, with International Classification of Diseases 10th revision code accuracies at 5.5% and 31.3%, respectively. Accurately diagnosed posterior vitreous detachment, nonexudative age-related macular degeneration, and retinal detachment. International Classification of Diseases 10th revision coding was most accurate for nonexudative age-related macular degeneration, central retinal vein occlusion, and macular hole in OEQs, and for posterior vitreous detachment, nonexudative age-related macular degeneration, and retinal detachment in multiple-choice questions. No significant difference in diagnostic or coding accuracy was found in Groups A and B.

Conclusion:

Generative Pre-trained Transformer 4 with vision has potential in clinical care and record keeping, particularly with standardized questions. Its effectiveness in open-ended scenarios is limited, indicating a significant limitation in providing complex medical advice.
Optic Disc Coloboma May Trigger Multiple Evanescent White Dot Syndrome: Expanding the Clinical Spectrum
Authors: AlBloushi Abdulrahman F. , Almuwarraee Sarah Mohammed , Al Adel Fadwa
Published: July 2024

Purpose:

In this article, we reported a case of secondary multiple evanescent white dot syndrome (MEWDS) that occurred in a patient with optic disc coloboma

Methods:

A case report

Results:

A 23-year-old otherwise healthy man experienced decreased vision and photopsia in the right eye for one month. He reported poor visual acuity in the left eye because of refractive amblyopia. His best-corrected visual acuity was 20/100 in the right eye and 20/80 in the left eye. An examination of the right eye showed that the patient had optic disc coloboma. The results of multimodal imaging indicated MEWDS in the right eye. The patient was observed for four weeks. The MEWDS lesions improved, as determined by multimodal imaging, and his best-corrected visual acuity improved to 20/20 in the right eye.

Conclusion:

Reports of secondary MEWDS have increased, and optic disc coloboma may trigger a MEWDS-like reaction.
Different Thicknesses of Acellular Porcine Corneal Stroma on Prognosis of Fungal Corneal Ulcers Treated by Lamellar Keratoplasty: A 5-Year Retrospective Study
Authors: Chen Yingxin , Chen Yifeng , Wang Cuiyu , Gao Ruiyao , Zhang Kai
Published: July 2024

Purpose:

To compare the prognosis and efficacy of acellular porcine corneal stroma (APCS) with different thicknesses for the treatment of fungal corneal ulcers by lamellar keratoplasty (LKP).

Methods:

A total of 52 patients who underwent LKP with APCS for the treatment of fungal corneal ulcers were included in this retrospective study. Patients were divided into 2 groups according to the different thicknesses of APCS (0.30 ± 0.05 mm, L2 group, n = 20; 0.40 ± 0.05 mm, L3 group, n = 32). Observation indicators included best corrected visual acuity, graft transparency, corneal neovascularization, ocular irritation symptoms, corneal epithelial healing time, graft survival, central corneal thickness at 1 year after surgery, and postoperative complications.

Results:

Compared with the L3 group, the L2 group had better postoperative best corrected visual acuity and graft transparency (P < 0.001), less corneal neovascularization (P < 0.001), and lower incidence of complications (P < 0.05). There were significant differences in ocular irritation symptoms between the 2 groups (P < 0.05) at 3 and 6 months postoperatively, which might be related to the higher recurrence rate and graft rejection rate in the L3 group. The comparison of postoperative epithelial healing time also showed significant differences in 2 groups (P < 0.01). The 1-year survival rate was up to 63.5% in both groups, with no significant difference (P < 0.05). However, the risk of transplantation was less in the L2 group. Both APCS thicknesses could provide adequate central corneal thickness at 1 year after surgery (P > 0.05).

Conclusions:

APCS was safe and effective in the treatment of fungal corneal ulcers by LKP. Thinner grafts should be preferred for LKP for fungal corneal ulcers to reduce the risk of grafting.
Marginal Full Thickness Blepharotomy for Management of Orbital Compartment Syndrome
Authors: Dryden Stephen , Gabbard Ryan , Salloum George , Meador Andrew , Laplant Jacquelyn , Kruglov Aleksandr , Fowler Brian , Wilson Matthew , Fleming James
Published: July 2024

Purpose:

To assess the utility of a marginal full thickness blepharotomy (MFTB) for the treatment of orbital compartment syndrome.

Methods:

An experimental study design employing a cadaver model for orbital compartment syndrome was used to assess the efficacy of an MFTB. Elevated orbital compartment pressures were created in 12 orbits of 6 fresh cadaver heads. Intraocular pressure, as an analog of orbital pressure, was measured before and after inferior and superior MFTBs were performed. Statistical analysis was performed on the collected data to assess the efficacy of the procedure.

Results:

Both procedures were found to significantly lower the orbital compartment pressure. MFTB of the inferior lateral eyelid decreased orbital compartment pressure by an average of 62.2 mm Hg (95% CI, 56.9–67.5). MFTB of the superior lateral eyelid following MFTB of the inferior lateral eyelid decreased the orbital compartment pressure by an additional average of 10.3 mm Hg (total average reduction of 72.5 mm Hg; 95% CI, 68.1–76.9).

Conclusions:

Orbital compartment syndrome is a time-sensitive vision-threatening emergency that requires prompt diagnosis and intervention to prevent irreversible vision loss. The authors describe the MTFB, a simple one-step procedure that when performed correctly results in a significant decrease in orbital compartment pressure, making it a viable option when canthotomy and cantholysis fails or is unable to be performed.
The relationship between sustained hamstring pain and reorganisation of somatosensory representations: a randomised, controlled study
Authors: Lin Natalie , Cavaleri Rocco , Rio Ebonie , Stanton Tasha R. , Imam Jawwad , Moukhaiber Nadia , Thomson Daniel , Williamson Cody , Andary Toni , Summers Simon J.
Published: July 2024

Recurrent hamstring injuries are highly prevalent amongst sporting populations. It has been hypothesised that pain from an initial hamstring injury may induce reorganisation of somatosensory representations that could contribute to reinjury. However, because of the cross-sectional nature of existing research, it remains unknown whether somatosensory changes are a cause or effect of pain or if they are driven by other potentially confounding factors. Here, we explored the effect of experimentally induced sustained hamstring pain on tasks that interrogate somatosensory and spatial representations. Fifty healthy participants were randomly allocated to an experimental group that performed an eccentric exercise protocol on the right hamstring to induce delayed onset muscle soreness or a control group performing a repetition-matched concentric exercise protocol. The tactile cortical representation was assessed using two-point discrimination and tactile localisation, whereas the proprioceptive representation was assessed using a left–right judgement task. Peripersonal spatial representations were assessed using an auditory localisation task. Assessments were performed at baseline and day 2. No between-group differences in tactile acuity were observed. However, improvements in left–right judgments and worsening of auditory localisation occurred in the experimental group compared with the control group. This study provides preliminary evidence showing that somatosensory changes occur in response to sustained hamstring pain. Experimentally induced, sustained hamstring pain elicited enhancements in proprioceptive processing and deficits in peripersonal spatial processing, suggesting a shift in the allocation of attentional resources from the external (peripersonal) to internal (body) environment. These findings may hold important implications for reinjury risk and rehabilitation following hamstring pain.
Analgesia efficacy of erector spinae plane block in laparoscopic abdominal surgeries: a systemic review and meta-analysis
Authors: Sia Crystal Jin-Yang , Wee Sheila , Au-Yong Angie Phui-Sze , Lie Sui-An , Tan Winson J. , Foo Fung-Joon , Kam Juinn-Huar , Lee Daniel JK , Koh Frederick H.
Published: July 2024

Background:

Multimodal analgesia is now widely practised to minimise postoperative opioid consumption while optimising pain control. The aim of this meta-analysis was to assess the analgesic efficacy of erector spinae plane block (ESPB) in patients undergoing laparoscopic abdominal surgeries. This will be determined by perioperative opioid consumption, subjective pain scores, and incidences of postoperative nausea and vomiting.

Methods:

The authors systemically searched electronic databases for randomised controlled trials (RCTs) published up to February 2023 comparing ESPB with other adjuvant analgesic techniques in laparoscopic abdominal surgeries. Nine randomised controlled trials encompassing 666 subjects were included in our study.

Results:

ESPB was shown to reduce postoperative opioid consumption [mean difference (MD) of −5.95 mg (95% CI: −8.86 to −3.04; P<0.0001); I
2=89%], intraoperative opioid consumption MD of −102.4 mcg (95% CI: −145.58 to −59.21; P<0.00001); I
2=39%, and incidence of nausea [RR 0.38 (95% CI: 0.25–0.60; P<0.0001); I
2=0%] and vomiting [RR 0.32 (95% CI: 0.17–0.63; P=0.0009); I
2=0%] in laparoscopic abdominal surgeries. Subgroup analysis on laparoscopic colorectal surgeries further showed reduction in postoperative pain scores MD of −0.68 (95% CI: −0.94 to −0.41); P<0.00001; I
2=0%].

Conclusions:

This study concludes that ESPB is a valuable technique with proven efficacy to potentially promote faster postoperative recovery through optimising pain control while minimising opioid requirements.
Effects of Chronic Pain on Static and Dynamic Postural Control in Chronic Ankle Instability
Authors: Oh Minsub , Lee Hyunwook , Han Seunguk , Bruening Dustin A. , Seeley Matthew D. , Hopkins J. Ty
Published: July 2024

Objective:

To identify the effects of chronic pain levels on static and dynamic postural (DP) control in individuals with chronic ankle instability (CAI).

Design:

Cross-sectional study.

Setting:

Controlled laboratory.

Participants:

Sixty participants were divided into the following 3 groups: 20 high pain individuals with CAI (high pain), 20 low pain individuals with CAI (low pain), and 20 healthy controls (control).

Independent Variables:

Groups (CAI with high pain, CAI with low pain, and control) and visual conditions (eyes open and closed) for single-leg stance.

Main Outcome Measures:

Participants performed single-leg stance with eyes open and closed, the star excursion balance test, and single-leg hop to stabilization.

Results:

The high pain group experienced worse self-reported outcomes, including Foot and Ankle Ability Measure activities of daily living and sports, than the low pain and control groups. Regardless of visual condition, both the high and low pain groups exhibited decreased static postural control in mediolateral (ML) compared with the control group. Specifically, the high pain group showed decreased static postural control in ML under closed eyes compared with the low pain and the control groups. The high pain group showed less reach distance than the control group and increased DP control in vertical and overall DP stability index compared with the low and control groups.

Conclusions:

Chronic pain can significantly affect both static and DP control in individuals with CAI. Therefore, clinicians should consider chronic pain as one of the factors affecting postural control in individuals with CAI.
Big data in sarcoidosis
Authors: Rivera Natalia V.
Published: July 2024

Purpose of review

This review provides an overview of recent advancements in sarcoidosis research, focusing on collaborative networks, phenotype characterization, and molecular studies. It highlights the importance of collaborative efforts, phenotype characterization, and the integration of multilevel molecular data for advancing sarcoidosis research and paving the way toward personalized medicine.

Recent findings

Sarcoidosis exhibits heterogeneous clinical manifestations influenced by various factors. Efforts to define sarcoidosis endophenotypes show promise, while technological advancements enable extensive molecular data generation. Collaborative networks and biobanks facilitate large-scale studies, enhancing biomarker discovery and therapeutic protocols.

Sarcoidosis presents a complex challenge due to its unknown cause and heterogeneous clinical manifestations. Collaborative networks, comprehensive phenotype delineation, and the utilization of cutting-edge technologies are essential for advancing our understanding of sarcoidosis biology and developing personalized medicine approaches. Leveraging large-scale epidemiological resources and biobanks and integrating multilevel molecular data offer promising avenues for unraveling the disease's heterogeneity and improving patient outcomes.
Cohort differences between preschool development of in vitro fertilization and naturally conceived infants
Authors: Guo Chunyan , Wang Jingcai , Yang Lixin , Wu Yanqiu , Liu Xia , Zhou Qili
Published: July 2024

To explore the differential cohort situation between preschool development of in vitro fertilization (IVF) and naturally conceived infants. From April 2014 to June 2022, 60 preschool IVFs were selected as the research subjects for follow-up at the pediatric health clinic of hospital’s prevention and health department. They were set as the experimental group (Group S), and 60 naturally conceived infants of the same age were selected as the control group (Group Z). Data from both groups were collected through telephone follow-up and other methods. No significant difference showed between the 2 groups in age specific height, age specific weight, Gesell developmental score, Denver developmental screening test screening results, intellectual development index, and motor development index (P > .05). The influence of birth environment factors such as family background and maternal education level on children’s height and weight was not significant (P > .05), while maternal education level had a significant impact on children’s intellectual development index (P < .05). No significant difference showed in the development of preschool children in IVF compared to naturally conceived children, and the level of parental education has a significant impact on children’s mental and motor development.
Three-year epidemiological analysis of penetrating ocular traumatic endophthalmitis
Authors: Zhuang Xiaotong , Fu Bo , Dong Jie , Liu Qiushi , Jia Shiqiao , Xu Li
Published: July 2024

The characteristics of patients with endophthalmitis due to penetrating ocular trauma are still limited. The aim of the study was to fill these gaps among Chinese population. This retrospective study included patients diagnosed as penetrating ocular traumatic endophthalmitis between January 2016 to December 2018. During the past 3-year period, a total of 201 patients with antecedent penetrating eye injuries were evaluated. Of which, 42 (20.9%) patients presented a clinical course compatible with acute infectious endophthalmitis. 39 (92.86%) patients were males, and 15 (35.71%) patients had mechanical injuries from intraocular foreign body (IOFB), the rate of endophthalmitis due to IOFB was 13.43%, higher to the rate among patients without IOFB (7.46%). The duration between injury occurrence and endophthalmitis onset was 1 day in 10 (23,80%) patients; 2 to 7 days in 31 (73.80%) patients, and 7 to 14 days in 1 (2.38%) patient. After 1 year follow-up, best corrected visual acuity (BCVA) better than 20/400 was observed in 15 (35.71%) patients, counting fingers and hand move in 17 (40.48%) patients, light perception in 5 (11.9%) patients and no light perception in 5 (11.9%) patients, respectively. Patients with promising outcomes had better initial BCVA at baseline (P < .001). Endophthalmitis is a severe ocular infectious condition that may lead to irreversible vision loss. A greater attention must be paid to penetrating eye injuries within males, who had poor BCVA at baseline, particularly with obvious IOFB.
Maintenance therapy with anlotinib after induction therapy with platinum-based chemotherapy for advanced non-small-cell lung cancer: A pooled analysis of 2 single-arm trials
Authors: Liu Yiqian , Miao Liyun , Chen Xiao , Zhu Xiaoli , Li Yan , He Jingdong , Chen Ping , Dai Shengbin , Liu Ziling , Ma Kewei , Wang Nanya , Zhao Yuguang , Chen Naifei , Song Wei , Bai Rilan , Cui Jiuwei , Shu Yongqian
Published: July 2024

Background:

Maintenance therapy could significantly improve the prognosis of patients with advanced non-small cell lung cancer (NSCLC) receiving chemotherapy. Anlotinib is effective, tolerable, and convenient in administration as a third-line treatment for NSCLC. This study aimed to evaluate the efficacy and safety of maintenance therapy with anlotinib after platinum-based induction chemotherapy for patients with advanced NSCLC.

Methods:

This pooled analysis of 2 multicenter, open-label, single-arm, phase 2 clinical trials (ALTER-L014 and ALTER-L011) enrolled patients with locally advanced or metastatic NSCLC and without known sensitive mutations in China between September 2018 and January 2021. The primary outcome was progression-free survival. The secondary outcomes were objective response rate, disease control rate, overall survival, and safety.

Results:

The data of 23 patients were pooled, with 15 from ALTER-L014 and 8 from ALTER-L011. At the cutoff date of June 13, 2021, the median progression-free survival since the start of maintenance therapy was 5.95 (95% confidence interval, 4.30–8.80) months. Nineteen patients had stable disease, 1 had a partial response and 3 had progressive disease. The objective response rate was 4.35%, while disease control rate was 86.96%. The median overall survival of the patients since the start of maintenance therapy was 18.60 (95% confidence interval, 6.87–22.80) months. The incidence of adverse events of grade ≥ 3 was 21.7%.

Conclusion:

Anlotinib might offer a new option for maintenance treatment in patients with locally advanced or metastatic NSCLC without known sensitive mutations after standard first-line platinum-based chemotherapy.
Development of best evidence-based practice protocols for central venous catheter placement and maintenance to reduce CLABSI
Authors: Chi Xiu-wen , He Ru , Wu Xiao-heng , Wu Li-juan , Yang Yuan-li , Huang Zhen
Published: July 2024

Although evidence-based interventions can reduce the incidence of central line-associated bloodstream infection (CLABSI), there is a large gap between evidence-based interventions and the actual practice of central venous catheter (CVC) care. Evidence-based interventions are needed to reduce the incidence of CLABSI in intensive care units (ICU) in China. Professional association, guidelines, and database websites were searched for data relevant to CLABSI in the adult ICUs from inception to February 2020. Checklists were developed for both CVC placement and maintenance. Based on the Integrated Promoting Action on Research Implementation in Health Services framework, a questionnaire collected the cognition and practice of ICU nursing and medical staff on the CLABSI evidence-based prevention guidelines. From January 2018 to December 2021, ICU CLABSI rates were collected monthly. Ten clinical guidelines were included after the screening and evaluation process and used to develop the best evidence-based protocols for CVC placement and maintenance. The CLABSI rates in 2018, 2019, and 2020 were 2.98‰ (9/3021), 1.83‰ (6/3276), and 1.69‰ (4/2364), respectively. Notably, the CLABSI rate in 2021 was 0.38‰ (1/2607). In other words, the ICU CLABSI rate decreased from 1.69‰ to 0.38‰ after implementation of the new protocols. Additionally, our data suggested that the use of ultrasound-guidance for catheter insertion, chlorhexidine body wash, and the use of a checklist for CVC placement and maintenance were important measures for reducing the CLABSI rate. The evidence-based processes developed for CVC placement and maintenance were effective at reducing the CLABSI rate in the ICU.
TICRR as a potential prognostic biomarker for lung adenocarcinoma: A comprehensive analysis using TCGA database
Authors: Zhang Zhao , Huang Congcong , Wu Jun , Cheng Quan , Wang Shangning
Published: July 2024

To investigate the role of TopBP1-interacting checkpoint and replication regulator (TICRR) in the tumorigenesis and prognosis of lung adenocarcinoma (LUAD) patients. Wilcoxon signed-rank test and logistic regression were utilized to analyze the relationship between clinical characteristics and TICRR expression in LUAD from TCGA dataset. Kaplan–Meier plots and Cox regressions were used to assess the impact of TICRR impact on prognosis. ROC curves and nomograms were generated to further evaluate the relationship between TICRR expression and the risk of LUAD. Gene set enrichment analysis (GSEA) was conducted on TCGA dataset, and ssGSEA was employed to investigate the association between TICRR and immune infiltrates. The results showed that high TICRR expression was significantly associated with various clinical factors including gender, age, pathological stage, T stage, N stage, M stage, outcome of primary therapy and smoking status. ROC curves also demonstrated that TICRR was a promising biomarker for molecular pathology diagnosis in LUAD patients (AUC = 0.952). Further analysis using gene ontology (GO) term enrichment and GSEA revealed an abnormal correlation between TICRR expression and cell division. Interestingly, ssGSEA analysis showed that TICRR expression correlated with multiple immune cell types, such as Th2 cell, TFH cell, mast cell, iDC, eosinophils, and dendritic cell. Lastly, the KM-plotters indicated that LUAD patients with high TICRR expression obtained worse life expectancy (P < .001). TICRR has proven to be a valuable tool in predicting disease progression and prognosis in patients with LUAD, thereby establishing itself as a fitting biomarker for forecasting overall survival (OS) of LUAD patients.
Regular HbA1c examination and health outcomes in adult patients with type 2 diabetes in South Korea: A retrospective cohort study
Authors: Hong Jae-Seok , Kang Hee-Chung
Published: July 2024

Concerns have been raised about the effectiveness of using process-centered indicators to assess the quality of diabetes care in Korea. This study aims to examine the factors influencing the performance of regular HbA1c testing and to explore its association with health outcomes, including hospitalization and mortality. We utilized a retrospective cohort design with a 4-year follow-up period, involving 159,452 adult patients newly diagnosed with type 2 diabetes (E11 in International Classification of Diseases, 10th Edition) in 2011. We established a national population database by merging the Korea National Health Insurance (KNHI) claims database and the KNHI Qualification Database of South Korea. The proportion of diabetic patients who underwent regular HbA1c testing at least once a year in the first 3 years was determined to be 33.8%. In comparison, patients who did not receive regular tests during the same period exhibited significantly increased odds of hospitalization (diabetes/CVD/renal, OR, 1.23, 95% CI, 1.12–1.34; diabetes, OR, 1.36, 95% CI, 1.17–1.57). Additionally, this nonpatient group experienced a higher risk of mortality (OR: 1.56, 95% CI: 1.36–1.80). This study supports the positive impact of regular HbA1c testing on health outcomes for individuals with type 2 diabetes. To increase the current 33% rate of regular HbA1c testing, developing patient-customized management policies is essential. Priority should be given to diabetic patients aged 65 or older, living in rural areas, and those belonging to low-income families (medical aid).
The short-term effects of Jin’s three needles in conjunction with mirror therapy on brain function in patients with upper limb disability following an ischemic stroke were evaluated using ReHo analysis
Authors: Yang Yunqiu , Wang Zhen , Hu Qingmao , Long Xiaojing , Ma Guorui , Cui Shaoyang , Xu Mingzhu , Tang Chunzhi , Yang Chen
Published: July 2024

Background:

Jin’s three needle (JTN) is a commonly utilized treatment for ischemic stroke in China. Mirror therapy (MT) is also gradually transitioning from treating limb discomfort to restoring motor function in the damaged limb. Investigations into the 2 treatments’ mechanisms of action are still ongoing. We used functional magnetic resonance imaging (fMRI) technique in this study to examine the effects of JTN combined with mirror therapy MT on brain function in patients with upper limb dysfunction in ischemic stroke, as well as potential central mechanisms. The goal was to provide a solid evidence-based medical basis to support the continued use of JTN combination MT.

Methods:

This study will be a single-blind, randomized, and controlled experiment. Randomization was used to assign 20 patients who met the study’s eligibility requirements to the JTN + MT treatment group or the JTN control group. Each intervention will last for 4 weeks, with 6 days of treatment per week. The JTN acupuncture points are 3 temporal acupuncture points on the opposite side of the wounded limb, 3 hand acupuncture points on the injured upper limb, 3 shoulder acupuncture points, Renzhong and Baihui, The (JTN + MT) group simultaneously takes MT for 30 minutes. fMRI of the brain using BOLD and T1-weighted images was done both before and after therapy. Brain areas exhibiting changes in regional homogeneity during the pre and posttreatment periods were analyzed.

Results:

By the end of the treatment course, Jin three-needle therapy plus MT activated more relevant brain functional regions and increased cerebral blood oxygen perfusion than Jin three-needle therapy alone (P <.05).

Conclusion:

In patients with upper limb impairment following an ischemic stroke, JTN with MT may improve brain function reconstruction in the relevant areas.
Bacterial profiles, antibiotic susceptibility patterns, and associated factors of symptomatic urinary tract infections among symptomatic university students at Haramaya University, Eastern Ethiopia: Cross-sectional study
Authors: Fetene Genet , Marami Dadi , Ayele Firayad , Abate Degu
Published: July 2024

Urinary tract infection (UTI) is a highly prevalent infection that can affect individuals of all ages, posing a significant risk to global health in terms of both morbidity and mortality. The emergence of multidrug-resistant bacteria adds to the complexity of this public health issue. There is limited data on the current study area. Therefore, this study aimed to determine the bacterial profiles, antibiotic susceptibility patterns, and associated factors of UTIs among symptomatic university students at Haramaya University, Eastern Ethiopia from May 10 to June 15, 2021. A cross-sectional study was conducted among 281 Haramaya University students. A systematic random sampling technique was used to select the study participants. Data were collected using a self-administered questionnaire. Ten to 15 mL of midstream urine samples were collected aseptically from patients. Standard microbiological techniques were used for bacterial identifications and drug susceptibility testing. The association between dependent and independent variables was determined by the logistics regression model. Variables with a P-value of <.05 were considered statistically significant. The overall prevalence of UTI among university students was 18.1% (95% confidence interval [CI]: 13.5–23.1). The most frequently isolated bacteria were Escherichia coli (33.3%) and Staphylococcus epidermidis (29.4%). Gram-negative bacteria demonstrated high resistance against ceftazidime (100%), penicillin (96%), ampicillin (92%), and tetracycline (71%). Similarly, gram-positive bacteria exhibited significant resistance to ceftazidime (100%) and ampicillin (81%). Multidrug-resistant isolates constituted an overall prevalence of 35 (68.6%) (95% CI: 63.6–73.6). Furthermore, year of study (adjusted odds ratios [AOR] = 2.66; 95% CI: 1.23–5.76), history of UTI (AOR = 2.57; 95% CI: 1.10–6.00), and sexual activity (AOR = 0.08; 95% CI: 0.02–0.39) were identified as factors. In this study, university students exhibited a higher prevalence of UTI compared to previous studies conducted in Africa. The most commonly identified bacteria causing UTIs were E coli, followed by S epidermidis. Factors such as the year of the study, presence of flank pain, history of previous UTIs, and frequency of sexual activity were found to be associated with UTIs. All the isolates have acquired resistance to the majority of commonly prescribed antibiotics. It is crucial to regularly monitor UTIs and the proliferation of antibiotic-resistant bacteria among university students.
Three-dimensional exergaming conjunction with vestibular rehabilitation in individuals with Benign Paroxysmal Positional Vertigo: A feasibility randomized controlled study
Authors: Ozdil Aytul , Iyigun Gozde , Balci Birgul
Published: July 2024

Background:

To examine the effectiveness of 3D (dimensional)-vestibular rehabilitation therapy (VRT) on gait, balance problems, processing time speed and subjective complaints in patients with Benign Paroxysmal Positional Vertigo (BPPV) compared to a control group (CG). This study aimed to test the feasibility of virtual reality-based 3D exergaming conjunction with vestibular rehabilitation.

Methods:

Twenty-two patients with BPPV (negative DixHallpike/Roll test results, existing dizziness/balance complaints) were randomly allocated to the study group (SG, n:11 3D-VRT) or Control group (CG n:11, no exercise-rehabilitation) for 8 week. The SG performed 3D-VRT for 45 to 50 min/d, 3 times/wk, and the CG did receive only Canalith Repositioning Maneuver (CRM). CRM was applied in both groups before the study. Outcome measures included 10-Meter-Walk-Test (10-MWT) (with/without head turns), Dynamic Gait Index (DGI), Choice-Stepping-Reaction-Time-ped (CSRT-MAT), Fullerton Advanced Balance Scale (FAB), and Visual Analog Scale (VAS).

Results:

The SG showed significantly improvement in 10-MWT without (p5 = 0.00,η2 = 0.49), with horizontal (p5 = 0.00,η2 = 0.57),vertical (p5 = 0.01,η2 = 0.48) head turns, DGI (p5 = 0.00,η2 = 0.74), CSRT-MAT, FAB (p5 = 0.00,η2 = 0.78) and VAS-dizziness (p5 = 0.00,η2 = 0.65), VAS-balance problem (p5 = 0.00,η2 = 0.43), VAS-fear of falling (p5 = 0.00,η2 = 0.42) compared to the CG.

Conclusion:

The 3D-VRT were effective in improving gait, balance, processing speed and resolving the subjective complaints in BPPV. The 3D-VRT method is feasible for patients who suffer from residual dizziness or balance complaints after CRM. Furthermore, the 3D-VRT is more accessible and less expensive than other virtual reality applications, which may facilitate further research or clinical use.
Cardiac autonomic regulation following a 246-km mountain ultra-marathon: An observational study
Authors: Tsai I-Hsun , Kao Wei-Fong , How Chorng-Kuang , Li Li-Hua , Lin Yen-Kuang , Kung Lu-Chih , Chiu Yu-Hui , Chien Ding-Kuo , Chang Wen-Han
Published: July 2024

Physical exercise requires integrated autonomic and cardiovascular adjustments to maintain homeostasis. We aimed to observe acute posture-related changes in blood pressure, and apply a portable noninvasive monitor to measure the heart index for detecting arrhythmia among elite participants of a 246-km mountain ultra-marathon. Nine experienced ultra-marathoners (8 males and 1 female) participating in the Run Across Taiwan Ultra-marathon in 2018 were enrolled. The runners’ Heart Spectrum Blood Pressure Monitor measurements were obtained in the standing and supine positions before and immediately after the race. Their high-sensitivity troponin T and N-terminal proB-type natriuretic peptide levels were analyzed 1 week before and immediately after the event. Heart rate was differed significantly in the immediate postrace assessment compared to the prerace assessment, in both the standing (P = .011; d = 1.19) and supine positions (P = .008; d = 1.35). Postural hypotension occurred in 4 (44.4%) individuals immediately postrace. In 3 out of 9 (33.3%) recruited finishers, the occurrence of premature ventricular complex signals in the standing position was detected; premature ventricular complex signal effect was observed in the supine position postrace in only 1 participant (11.1%). Premature ventricular complex signal was positively correlated with running speed (P = .037). Of the 6 individuals who completed the biochemical tests postrace, 2 (33.3%) had high-sensitivity troponin T and 6 (100%) had N-terminal proB-type natriuretic peptide values above the reference interval. A statistically significant increase was observed in both the high-sensitivity troponin T (P = .028; d = 1.97), and N-terminal proB-type natriuretic peptide (P = .028; d = 2.91) levels postrace compared to prerace. In conclusion, significant alterations in blood pressure and heart rate were observed in the standing position, and postexercise (postural) hypotension occurred among ultra-marathoners. The incidence of premature ventricular complexes was higher after the race than before.
Nitroglycerin combined with NSAIDs for prevention of post-ERCP pancreatitis: A meta-analysis of prospective, randomized, controlled trials
Authors: Zhang Xuan , Zhang Jing-Ming , Wei Wan , Lin Hui
Published: July 2024

Background:

Acute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP), with an incidence of approximately 9.7% according to some literature reviews. Recent clinical guidelines propose that glyceryl trinitrate (GTN) can reduce the incidence of post-ERCP pancreatitis (PEP). However, currently, no guidelines provide an exact opinion on GTN and nonsteroidal anti-inflammatory drugs (NSAIDs) to prevent post-ERCP pancreatitis.

Objective:

A meta-analysis was performed of published, full-length, randomized controlled trials (RCTs) evaluating the effects of prophylactic use of GTN, including GTN alone or GTN in combination with NSAIDs, on the prevention of PEP.

Methods:

Literature searches were conducted using PubMed, Embase, Web of Science, and The Cochrane Library. Search terms included “endoscopic retrograde cholangiopancreatography” OR “ERCP,” “OR ‘PEP’ OR ‘post-endoscopic retrograde cholangiopancreatography pancreatitis’, pancreatitis,” “GTN” OR “glyceryl trinitrate” OR “nitroglycerin,” “NSAIDs” OR “Nonsteroidal Anti-inflammatory Drugs” and limited to RCT.

Results:

A total of 10 RCTs comprising 3240 patients undergoing ERCP were included. Meta-analysis revealed that the administration of GTN was associated with a significant reduction in the overall incidence of PEP. Moreover, PEP incidence was significantly lower in the GTN combined with the NSAIDs group than in the GTN alone group. GTN alone or GTN combined with NSAIDs may not reduce the severity of PEP (risk ratio = 0.64; 95% confidence interval: 0.41–0.99; P = .04). The difference in incidence between the 2 groups is 1.01% (6/594) in the GTN with NSAIDs group and 2.36% (14/592) in the placebo group.

Conclusion:

GTN has a significant benefit in preventing postoperative ERCP pancreatitis (P < .001). And neither GTN nor GTN plus NSAIDs reduces the incidence of non-mild ERCP postoperative pancreatitis. These conclusions need to be confirmed by high-quality randomized controlled studies with multicenter, large samples, and long-term follow-up.