bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful treatment of IgA vasculitis with prolonged cutaneous manifestation with colchicine in a 10-year-old boy
Authors: Okura Yuka , Hiramatsu Yasuyoshi , Shimomura Masaki , Taniguchi Kota , Nawate Mitsuru , Takahashi Yutaka , Kobayashi Ichiro 
Published: November 2021

ABSTRACT
We report a 10-year-old boy with immunoglobulin (Ig)A vasculitis (IgAV) with prolonged cutaneous manifestations who was successfully treated with colchicine. At the age of 9 years, he was diagnosed as having IgAV by typical purpura, abdominal pain, and haematochezia. Initially, his severe gastrointestinal manifestation subsided by prednisolone 60 mg/day and intravenous methylprednisolone pulse therapy. However, his gastrointestinal manifestation was glucocorticoid-dependent and refractory to factor XIII concentrate, intravenous IgG, and mycophenolate mofetil. His abdominal pain and haematochezia responded to the combination therapy with dapsone and low dose of prednisolone 5 mg/day and did not relapse even after discontinuation of dapsone. On the other hand, the effect of dapsone on his cutaneous manifestation was dose-dependent as well as dapsone had no glucocorticoid-sparing effect. Approximately 12 months after onset, colchicine treatment was started, which resulted in remission of his chronic cutaneous manifestation. After prednisolone was tapered off, his cutaneous manifestation is currently well-controlled on colchicine 0.5 mg/day without adverse events. He had never complicated kidney involvements. In conclusion, it is observed that colchicine treatment exerts a beneficial effect in IgAV patients with prolonged cutaneous manifestation refractory to multiple drugs.
Applying evidence-based intervention (EBI) mapping to identify the components and logic of colorectal cancer screening interventions
Authors: Szeszulski Jacob , Craig Derek W , Walker Timothy J , Foster Maya , Mullen Patricia Dolan , Fernandez Maria E 
Published: November 2021

Abstract
Implementation of evidence-based interventions (EBIs) can help to increase colorectal cancer screening (CRCS). Potential users of CRCS EBIs are often unclear about the specific features, logic, and core elements of existing EBIs, making it challenging to use or adapt them. We used EBI Mapping, a systematic process developed from Intervention Mapping that identifies an EBI’s components and logic, to characterize existing CRCS EBIs from the National Cancer Institute’s Evidence-Based Cancer Control Programs website. The resulting information can facilitate intervention adoption, adaptation, and/or implementation. Two trained coders independently coded intervention materials to describe intervention components and logic (n = 20). We display CRCS EBI components (potential mechanism of change) using evidence tables and heat maps. All EBIs addressed completion of at least one CRCS behavior (stool-based test, n = 9; stool-based test or another CRCS test, n = 8; colonoscopy, n = 3; colonoscopy or sigmoidoscopy, n = 1). The psychosocial determinants most frequently addressed by these interventions were knowledge (n = 19), attitudes (n = 17), risk perception/perceived susceptibility (n = 16), skills (n = 15), and overcoming barriers (n = 15). Multi-level EBIs (n = 9) attempted to change an average of 2.1 ± 1.1 conditions in the patients’ environment (e.g., accessibility of CRCS); only four EBIs used environmental change agents (e.g., providers, nurses). From the heat maps of EBIs, we describe common theoretical change methods’ (e.g., facilitation) used for addressing determinants (e.g., overcoming barriers). EBI Mapping can help users identify important components of a CRCS EBI’s logic; these proposed mechanisms of action can inform adoption, adaptation, and implementation in new settings, and facilitate scale up of EBIs.
Influence of Intervertebral Level of Stenosis on Neurological Recovery and Reduction of Neck Pain After Posterior Decompression Surgery for Cervical Spondylotic Myelopathy
Authors: Nori Satoshi , Nagoshi Narihito , Aoyama Ryoma , Ishihara Shinichi , Fujiyoshi Kanehiro , Shiono Yuta , Kitamura Kazuya , Ishikawa Masayuki , Suzuki Satoshi , Takahashi Yohei , Tsuji Osahiko , Yagi Mitsuru , Nakamura Masaya , Matsumoto Morio , Watanabe Kota , Ishii Ken , Yamane Junichi 
Published: November 2021

Study Design.
Retrospective multicenter study.

Objective.
To identify the impact of the intervertebral level of stenosis on surgical outcomes of posterior decompression for cervical spondylotic myelopathy (CSM).

Summary of Background Data.
As the upper affected cervical levels in elderly patients result from degenerative changes in the lower cervical levels with aging, it is usually difficult to determine the influence of the upper affected cervical levels on surgical outcomes after posterior decompression for CSM in older age.

Methods.
This study involved 636 patients with CSM who underwent posterior decompression. According to the most stenotic intervertebral level, patients were divided into upper (n = 343, the most stenotic intervertebral level was C2/3, C3/4, or C4/5) and lower (n = 293, the most stenotic intervertebral level was C5/6, C6/7, or C7/T1) cervical stenosis groups. Propensity score matching of the baseline factors (characteristics, comorbidities, and neurological function) was performed to compare surgical outcomes, the Japanese Orthopaedic Association (JOA) scores, and visual analog scale (VAS) for neck pain between the upper (n = 135) and lower (n = 135) cervical stenosis groups.

Results.
Before propensity score matching, age at surgery was older and pre- and postoperative JOA scores were lower in the upper cervical stenosis group (P < 0.001, P < 0.001, and P < 0.001, respectively). Following matching, baseline factors were comparable between the groups. Postoperative JOA scores, preoperative-to-postoperative changes in the JOA scores, and the JOA score recovery rate were not significantly different between the groups (P = 0.866, P = 0.825, and P = 0.753, respectively). No differences existed in postoperative VAS for neck pain and preoperative-to-postoperative changes in VAS for neck pain between the groups (P = 0.092 and P = 0.242, respectively).

Conclusion.
The intervertebral level of stenosis did not affect surgical outcomes after posterior decompression for CSM.

Level of Evidence: 3
Tick-Borne Infections
Authors: Fuchs Susan 
Published: November 2021

Abstract
There are many tick-borne infections that affect children and adolescents in the United States. These illnesses often begin with non-specific flulike symptoms such as fever, chills, headache, and myalgia, so obtaining a good travel history is important. Most people do not even realize that they were bitten by a tick, so identification of the specific tick is not necessary. Often, treatment should commence before formal illness identification, as delays may cause more severe disease, and rapid laboratory confirmation is difficult. One of the most important issues is prevention of tick bites with insect repellents, accompanied by thorough tick checks after being outdoors in a tick-infested region.
Nasogastric/nasoenteric catheter in the adult ICU: best practices implementation project
Authors: Pinheiro Patrícia A.P.C. , Brancaglione Bruna F. , Altino Denise M. , da Silva Santana Flávio H. , Silva Sidnei S. , Gomes Vanessa R. , de Brito Poveda Vanessa , de Araújo Püschel Vilanice A. 
Published: November 2021

ABSTRACT

Background:
Good-quality nursing care is usually associated with decreased risk of harms or adverse events and improved nutritional status in patients. It is important to prevent an increased risk of infection, mortality, and hospital costs in patients, along with a rework for the nursing team.

Objective:
To implement best evidence-based practices in the management of the nasogastric catheter in patients admitted to adult clinical intensive care.

Method:
The methodology used for this study was based on that of the Joanna Briggs Institute, using the audit and feedback tools JBI Practice Application of Clinical Evidence System and Getting Research into Practice. A base audit was performed, which screened for the education of the nursing team aimed at the knowledge of the best practices, approaching the barriers related to nonadherence to the best practices and a follow-up audit.

Results:
The results of the base and follow-up audit showed positive variation in the percentage of adherence to the best practices proposed after the education of the nursing team. The implemented criteria that showed the greatest impact in practice (P < 0.001) were related to insertion and checking of the catheter and maintenance of the device with adequate lavage technique.

Conclusion:
The results obtained from adherence to the best practices contributed to the enhancement of care related to catheter insertion, its maintenance, and withdrawal. Changes were made to the local care protocol, with care being taken to measure the exteriorized portion and to increase the frequency of catheter lavage. It is necessary to invest in the record in the chart of the care related to the management of the catheter to confirm the care provided and to assist in the clinical audit process. The results obtained can also be compared with the nutritional indicators.
Increasing patient participation in hand hygiene practices in adult surgical wards in a tertiary institution: a best practice implementation project
Authors: Choong Tze Lin , Lim Zhao Jun , Ho Alexander Guan Ting , Goh Mien Li 
Published: November 2021

ABSTRACT

Introduction:
The WHO states that hospital-acquired infections may be transmitted through contaminated hands. Practicing hand hygiene using alcohol-based handrub or soap and water reduces harmful organisms. The Joanna Briggs Institute (JBI) best practice recommends empowering patients with hand hygiene knowledge and engaging their involvement to strengthen hand hygiene practices.

Aims:
The aim of this project was to improve hand hygiene among surgical inpatients.

Methods:
This evidence-based quality improvement project was conducted in three phases: the baseline audit, implementing best practice, and the postimplementation audit. Participants were patients hospitalized in three surgical wards of a 1200-bed acute care tertiary hospital. This project utilized the online JBI Practical Application of Clinical Evidence System and The Getting Research into Practice program to identify barriers and strategies. Nurses provided patients with an education pamphlet and regularly reminded them to improve their hand hygiene practices.

Results:
Ninety-four patients were audited between April and June 2018. Patients’ hand hygiene practices improved from 19.1% at baseline audit to 61.7% (P < 0.01) at first follow-up audit. Patients’ hand hygiene improved from 48.9 to 72.3% (P = 0.03) before meals, and from 92.6 to 98.9% (P = 0.65) after toileting. The proportion of patients who received a hand hygiene information leaflet in an appropriate language increased from 64.9 to 89.4% (P < 0.01).

Conclusion:
Patients’ involvement in the hand hygiene program has significantly improved their hand hygiene practices. Patient education and patient information leaflet continue to be an effective strategy to improve knowledge and practices.
Evaluation of the implementation of a best practice gestational diabetes model of care in two Australian metropolitan services
Authors: Wilkinson Shelley A. , Palmer Michelle , Smith Shelley , Porteous Helen , McCray Sally 
Published: November 2021

ABSTRACT

Introduction and aims:
Dissemination and local adaptation of best practice models of care are often poorly achieved in knowledge translation processes. Understanding and documenting the iterative cycles of improvement can elucidate barriers, enablers and benefits of the process for future adoption and service integration improvements. This project examined the process of local adaptation for a third stage translation of a gestational diabetes dietetic model of care through collaboration with two Queensland (Australia) hospitals.

Methods:
Using a hub (research team)-spoke (sites) model, two Queensland Hospital and Health Service Districts were supported to assess and address evidence-practice dietetic model of care gaps in their gestational diabetes mellitus (GDM) services. Sites selected demonstrated strong GDM team cohesiveness and project commitment. The project phases were: Consultation; Baseline; Transition; Implementation; and Evaluation.

Results:
Despite strong site buy-in and use of a previously successful model of care dissemination and adoption strategy, unexpected global, organisational, team and individual barriers prevented successful implementation of the model of care at both sites. Barriers included challenges with ethics and governance requirements for health service research, capacity to influence and engage multidisciplinary teams, staff turnover and coronavirus disease 2019's (COVID-19's) disruption to service delivery.

Conclusion:
This third iteration of the dissemination of a best practice model of nutrition care for GDM in two Queensland Hospital and Health Service Districts did not achieve successful clinical or process outcomes. However, valuable learnings and recommendations regarding future clinical and research health service redesign aligned with best practice are suggested.
A review of the UK and British Channel Islands practical tidal stream energy resource
Authors: Coles Daniel , Angeloudis Athanasios , Greaves Deborah , Hastie Gordon , Lewis Matthew , Mackie Lucas , McNaughton James , Miles Jon , Neill Simon , Piggott Matthew , Risch Denise , Scott Beth , Sparling Carol , Stallard Tim , Thies Philipp , Walker Stuart , White David , Willden Richard , Williamson Benjamin 
Published: November 2021

This review provides a critical, multi-faceted assessment of the practical contribution tidal stream energy can make to the UK and British Channel Islands future energy mix. Evidence is presented that broadly supports the latest national-scale practical resource estimate, of 34 TWh/year, equivalent to 11% of the UK’s current annual electricity demand. The size of the practical resource depends in part on the economic competitiveness of projects. In the UK, 124 MW of prospective tidal stream capacity is currently eligible to bid for subsidy support (MeyGen 1C, 80 MW; PTEC, 30 MW; and Morlais, 14 MW). It is estimated that the installation of this 124 MW would serve to drive down the levelized cost of energy (LCoE), through learning, from its current level of around

240

£

/

MWh

to below

150

£

/

MWh

, based on a mid-range technology learning rate of 17%. Doing so would make tidal stream cost competitive with technologies such as combined cycle gas turbines, biomass and anaerobic digestion. Installing this 124 MW by 2031 would put tidal stream on a trajectory to install the estimated 11.5 GW needed to generate 34 TWh/year by 2050. The cyclic, predictable nature of tidal stream power shows potential to provide additional, whole-system cost benefits. These include reductions in balancing expenditure that are not considered in conventional LCoE estimates. The practical resource is also dependent on environmental constraints. To date, no collisions between animals and turbines have been detected, and only small changes in habitat have been measured. The impacts of large arrays on stratification and predator–prey interaction are projected to be an order of magnitude less than those from climate change, highlighting opportunities for risk retirement. Ongoing field measurements will be important as arrays scale up, given the uncertainty in some environmental and ecological impact models. Based on the findings presented in this review, we recommend that an updated national-scale practical resource study is undertaken that implements high-fidelity, site-specific modelling, with improved model validation from the wide range of field measurements that are now available from the major sites. Quantifying the sensitivity of the practical resource to constraints will be important to establish opportunities for constraint retirement. Quantification of whole-system benefits is necessary to fully understand the value of tidal stream in the energy system.
4-aminopyridine promotes accelerated skin wound healing via neurogenic-mediator expression
Authors: Jagadeeshaprasad Mashanipalya G. , Govindappa Prem Kumar , Nelson Amanda M. , Noble Mark D. , Elfar John C. 
Published: November 2021

AbstractWe discovered that 4-aminopyridine (4-AP), a potassium channel blocker approved by the FDA for improving walking ability in multiple sclerosis, greatly enhances skin wound healing. Benefits included faster wound closure, restoration of normal-appearing skin architecture, increased vascularization and reinnervation. Hair follicle neogenesis within the healed wounds was increased, both histologically and by analysis of K15 and K17 expression. 4-AP increased levels of vimentin (fibroblasts) and α-smooth muscle actin (α-SMA, collagen-producing myofibroblasts) in the healed dermis. 4-AP also increased neuronal regeneration with increased numbers of axons and S100+ Schwann cells (SCs), and increased expression of SRY-Box Transcription Factor 10 (SOX10). Treatment also increased levels of transforming growth factor-β (TGF-β), substance P and nerve growth factor (NGF), important promoters of wound healing. In-vitro studies demonstrated that 4-AP enhanced proliferation and migration of human keratinocytes and SCs, and that 4-AP enhanced cellular interactions between neuronal and non-neuronal cells to further accelerate wound healing. Thus, 4-AP enhanced many of the key attributes of successful wound healing and offers a promising new approach to enhance skin wound healing and tissue regeneration.
Effects of upgrading acquisition-techniques and harmonization methods: A multi-modal MRI study with implications for longitudinal designs
Authors: Itahashi Takashi , Aoki Yuta Y. , Yamashita Ayumu , Soda Takafumi , Fujino Junya , Ohta Haruhisa , Aoki Ryuta , Nakamura Motoaki , Kato Nobumasa , Tanaka Saori C. , Kokuryo Daisuke , Hashimoto Ryu-ichiro 
Published: November 2021

AbstractA downside of upgrading MRI acquisition sequences is the discontinuity of technological homogeneity of the MRI data. It hampers combining new and old datasets, especially in a longitudinal design. Characterizing upgrading effects on multiple brain parameters and examining the efficacy of harmonization methods are essential. This study investigated the upgrading effects on three structural parameters, including cortical thickness (CT), surface area (SA), cortical volume (CV), and resting-state functional connectivity (rs-FC) collected from 64 healthy volunteers. We used two evaluation metrics, Cohen’s d and classification accuracy, to quantify the effects. In classification analyses, we built classifiers for differentiating the protocols from brain parameters. We investigated the efficacy of three harmonization methods, including traveling subject (TS), TS-ComBat, and ComBat methods, and the sufficient number of participants for eliminating the effects on the evaluation metrics. Finally, we performed age prediction as an example to confirm that harmonization methods retained biological information. The results without harmonization methods revealed small to large mean Cohen’s d values on brain parameters (CT:0.85, SA:0.66, CV:0.68, and rs-FC:0.24) with better classification accuracy (>92% accuracy). With harmonization methods, Cohen’s d values approached zero. Classification performance reached the chance level with TS-based techniques when data from less than 26 participants were used for estimating the effects, while the Combat method required more participants. Furthermore, harmonization methods improved age prediction performance, except for the ComBat method. These results suggest that acquiring TS data is essential to preserve the continuity of MRI data.
Capturing Brain-Cognition Relationship: Integrating Task-Based fMRI Across Tasks Markedly Boosts Prediction and Test-Retest Reliability
Authors: Tetereva Alina , Li Jean , Deng Jeremiah D. , Stringaris Argyris , Pat Narun 
Published: November 2021

AbstractCapturing individual differences in cognition is central to human neuroscience. Yet our ability to estimate cognitive abilities via brain MRI is still poor in both prediction and reliability. Our study tested if this inability can be improved by integrating MRI signals across the whole brain and across modalities, including task-based functional MRI (tfMRI) of different tasks along with other non-task MRI modalities, such as structural MRI, resting-state functional connectivity. Using the Human Connectome Project (n=873, 473 females, after quality control), we directly compared predictive models comprising different sets of MRI modalities (e.g., seven tasks vs. non-task modalities). We applied two approaches to integrate multimodal MRI, stacked vs. flat models, and implemented 16 combinations of machine-learning algorithms. The stacked model integrating all modalities via stacking Elastic Net provided the best prediction (r=.57), relatively to other models tested, as well as excellent test-retest reliability (ICC=~.85) in capturing general cognitive abilities. Importantly, compared to the stacked model integrating across non-task modalities (r=.27), the stacked model integrating tfMRI across tasks led to significantly higher prediction (r=.56) while still providing excellent test-retest reliability (ICC=~.83). The stacked model integrating tfMRI across tasks was driven by frontal and parietal areas and by tasks that are cognition-related (working-memory, relational processing, and language). This result is consistent with the parieto-frontal integration theory of intelligence. Accordingly, our results contradict the recently popular notion that tfMRI is not reliable enough to capture individual differences in cognition. Instead, our study suggests that tfMRI, when used appropriately (i.e., by drawing information across the whole brain and across tasks and by integrating with other modalities), provides predictive and reliable sources of information for individual differences in cognitive abilities, more so than non-task modalities.HighlightsNon-task MRI (sMRI, rs-fMRI) are often used for the brain-cognition relationship.Task-based fMRI has been deemed unreliable for capturing individual differences.We tested if drawing task-based fMRI information across regions/tasks improves prediction and reliability of the brain-cognition relationship.Our approach boosts prediction of task-based fMRI over non-task MRI.Our approach renders task-based fMRI reliable over time.Our approach shows the importance of the fronto-parietal areas in cognition.