bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healthcare resource utilization in adult patients with relapsed/refractory FLT3 mutated acute myeloid leukemia: A retrospective chart review from Spain
Authors: Solana‐Altabella Antonio , Boluda Blanca , Rodríguez‐Veiga Rebeca , Cano Isabel , Acuña‐Cruz Evelyn , Blanco Albert , Marco‐Ayala Javier , de la Puerta Rosalía , Díaz‐González Álvaro , Piñana José L. , Sanz Jaime , Sempere Amparo , Cervera José , Barragán Eva , Sargas Claudia , Ballesta‐López Octavio , Megías‐Vericat Juan Eduardo , Martínez‐Cuadrón David , Sanz Miguel Á. , Montesinos Pau 
Published: February 2021

AbstractBackgroundInformation regarding impact on healthcare systems of relapsed or refractory (R/R) FLT3 mutated (FLT3mut) acute myeloid leukemia (AML) is scarce.ObjectiveTo assess the time and reimbursement associated with hospitalizations of patients with R/R FLT3mut AML in a tertiary Spanish hospital.MethodsRetrospective review of medical charts identified patients aged ≥ 18 years with R/R FLT3mut AML between 1998 and 2018. Data were collected from the date of first diagnosis of R/R FLT3mut AML (index) until death or loss to follow‐up. The primary end point was duration and frequency of hospitalization, use of outpatient resources and transfusion burden. Reimbursement associated with hospitalizations (including associated chemotherapy) was also assessed.ResultsThirty‐eight patients were eligible for inclusion. Their median age was 52 years, and 30 (79%) received intensive salvage chemotherapy; FLAG‐IDA‐based regimens were the most frequent (24 patients, 63%). Overall, there were 150 hospitalizations (mean 3.9/patient; mean duration 21 days). Patients spent a mean of 24% of the study period in hospital. Total mean reimbursement was €108 293 per patient; the majority (€89 834) attributable to inpatient stays (€22 576 /hospitalization). During chemotherapy period (prior to first alloHSCT), there were 73 hospitalizations (mean duration 22 days); mean reimbursement was €19 776 per hospitalization and €49 819 per patient. AlloHSCT (n = 16) involved 77 hospitalizations (mean duration 21 days), mean reimbursement €25 231/hospitalization and €131 515 per patient.ConclusionData from this study suggest that there is a substantial healthcare resource utilization and cost burden on R/R FLT3mut AML patients in Spain receiving active treatments.
Experimental manipulation of body size alters life history in hydra
Authors: Ngo Kha Sach , R‐Almási Berta , Barta Zoltán , Tökölyi Jácint 
Published: February 2021

AbstractBody size has fundamental impacts on animal ecology and physiology but has been strongly influenced by recent climate change and human activities, such as size‐selective harvesting. Understanding the ecological and life history consequences of body size has proved difficult due to the inseparability of direct effects of body size from processes connected to it (such as growth rate and individual condition). Here, we used the cnidarian Hydra oligactis to directly manipulate body size and understand its causal effects on reproduction and senescence. We found that experimentally reducing size delayed sexual development and lowered fecundity, while post‐reproductive survival increased, implying that smaller individuals can physiologically detect their reduced size and adjust life history decisions to achieve higher survival. Our experiment suggests that ecological or human‐induced changes in body size will have immediate effects on life history and population dynamics through a growth‐independent link between body size, reproduction and senescence.
Menopause does not modify disability trajectories in a longitudinal cohort of women with clinically isolated syndrome and multiple sclerosis followed from disease onset
Authors: Otero‐Romero Susana , Midaglia Luciana , Carbonell‐Mirabent Pere , Zuluaga María , Galán Ingrid , Río Jordi , Arrambide Georgina , Rodríguez‐Barranco Marta , Vidal‐Jordana Angela , Castillo Joaquin , Rodríguez‐Acevedo Breogán , Zabalza Ana , Nos Carlos , Comabella‐Lopez Manuel , Mulero Patricia , Auger Cristina , Sastre‐Garriga Jaume , Pérez‐Hoyos Santiago , Rovira Alex , Montalban Xavier , Tintoré Mar 
Published: February 2021

AbstractBackground and purposeTo evaluate the effect of menopause on disability accumulation in women followed from their clinically isolated syndrome (CIS).MethodsWe examined the longitudinal changes in Expanded Disability Status Scale (EDSS) scores from CIS until the last follow‐up in women belonging to the Barcelona CIS prospective cohort, followed through their menopausal transition. The analysis is based on 13,718 EDSS measurements, with an average of 28 EDSS measurements per patient. Differences in EDSS trajectories between menopausal and nonmenopausal women, controlling for age and disease duration, were evaluated. We performed two sensitivity analyses in women with confirmed MS and in those experiencing early menopause.ResultsFrom 764 eligible women, 496 (65%) responded to the questionnaire, and 74 (14.9%) reached menopause over the follow‐up. We did not find a significant inflection point in EDSS trajectories around menopause (slope change −0.009; 95% CI −0.066; 0.046). The annual increase in EDSS over the complete course of the disease was significantly higher in menopausal women (0.049; 95% CI, 0.026–0.074) versus nonmenopausal (0.019; 95% CI, 0.008–0.031; interaction p value 0.025). This difference was lost when controlling for age and disease duration (EDSS annual increase of 0.059; 95% CI, 0.025–0.094 vs. 0.038; 95% CI, 0.021–0.057, respectively; interaction p value 0.321). No inflection point was detected when the analysis was restricted to women with confirmed MS or with earlier menopause.ConclusionsMenopause is not associated with an increased risk of disability in a CIS population, considering EDSS trajectories throughout the course of the disease together with age and disease duration.
An attention‐driven videogame based on steady‐state motion visual evoked potentials
Authors: Perez‐Valero Eduardo , Lopez‐Gordo Miguel Angel , Vaquero‐Blasco Miguel A. 
Published: February 2021

AbstractIn Neuroscience, steady‐state visually evoked potentials (SSVEPs) have been generally used for the characterization of dynamic visual processes along the afferent pathway. In Neuroengineering, SSVEP‐based brain‐computer interfaces (SSVEP‐BCI) have been used in applications such as communications or entertainment for the detection of the overt attention to static‐flickering stimuli or other structured stimulation that involves motion (SSMVEP‐BCI). In this work, we propose an attention‐driven videogame controlled by an SSVEP‐BCI with mobile‐flickering stimuli. In this game, enemy avatars launch attacks that are presented as mobile ring‐shaped checkerboards that flicker at 15 Hz to the player, who must deflect them by exerting attention. We detected the attention of the participants based on the power spectral density of the elicited SSVEP and the adjacent electroencephalographic background noise. Twenty volunteers participated in this study. After completion, according to a game experience survey, the participants described the game as amusing and challenging. We also conducted a level survey that revealed a significant difference between the levels of attention exerted by the participants when they passed the levels with respect to when they missed (p‐value = 17 · 10−5). Additionally, the detection accuracy of the SSVEP‐BCI had a baseline level of 84%. The results suggest that mobile flickers can be robustly detected within few seconds by means of an SSVEP‐BCI. This principle could be used as a serious game to play or train the attention and the visual tracking capabilities to mobile target stimuli in special needs education schools or in centres dealing with attention disorders.
Medical imaging examination in psoriasis and early psoriatic arthritis patients: an updated systematic review and meta‐analysis
Authors: Qi Fei , Yao Amin , He Yanling 
Published: February 2021

AbstractPsoriatic arthritis appears in one in four skin psoriasis patients. Early detection of the presence of joint involvement and early interception of its developments may minimize long‐term functional disability, and the radiological methods may be a perfect choice. To summarize and compare different imaging methods for diagnosing early‐stage psoriatic arthritis and determine the necessity of joint examination in all psoriasis patients, several electronic databases, including MEDLINE and EMBASE, were searched for English language studies. A specific selection criterion followed the retrieval of studies. Thirteen studies were finally enrolled in the meta‐analysis, eight of which compared the bone changes presentat on medical imaging examination between psoriasis patients without psoriatic arthritis and healthy people; three studies focused on differences between psoriatic arthritis patients and free joint involvement psoriasis patients shown on medical imaging tests. Medical imaging examination, including ultrasound (US), high‐resolution peripheral quantitative CT scans (HR‐pQCT), and magnetic resonance imaging (MRI), can be good choices for detecting the start of asymptomatic joint inflammation in psoriasis patients, which is essential to early detection and interception of joint damage to lower joint deformities and improve the future quality of life for patients. Additionally, the examination for psoriasis patients with arthralgia is also highly recommended.
Immunity against Mycobacterium ulcerans: The subversive role of mycolactone
Authors: Demangel Caroline 
Published: February 2021

SummaryMycobacterium ulcerans causes Buruli ulcer, a neglected tropical skin disease manifesting as chronic wounds that can leave victims with major, life‐long deformity and disability. Differently from other mycobacterial pathogens, M ulcerans produces mycolactone, a diffusible lipid factor with unique cytotoxic and immunomodulatory properties. Both traits result from mycolactone targeting Sec61, the entry point of the secretory pathway in eukaryotic cells. By inhibiting Sec61, mycolactone prevents the host cell's production of secreted proteins, and most of its transmembrane proteins. This molecular blockade dramatically alters the functions of immune cells, thereby the generation of protective immunity. Moreover, sustained inhibition of Sec61 triggers proteotoxic stress responses leading to apoptotic cell death, which can stimulate vigorous immune responses. The dynamics of bacterial production of mycolactone and elimination by infected hosts thus critically determine the balance between its immunostimulatory and immunosuppressive effects. Following an introduction summarizing the essential information on Buruli ulcer disease, this review focuses on the current state of knowledge regarding mycolactone's regulation and biodistribution. We then detail the consequences of mycolactone‐mediated Sec61 blockade on initiation and maintenance of innate and adaptive immune responses. Finally, we discuss the key questions to address in order to improve immunity to M ulcerans, and how increased knowledge of mycolactone biology may pave the way to innovative therapeutics.
Diagnostic performance of COVID‐19 serological assays during early infection: A systematic review and meta‐analysis of 11 516 samples
Authors: Zhang John J. Y. , Lee Keng Siang , Ong Chee Wui , Chan Mae Yee , Ang Li Wei , Leo Yee Sin , Chen Mark I‐Cheng , Lye David Chien Boon , Young Barnaby Edward 
Published: February 2021

AbstractObjectiveThe use of coronavirus disease 2019 (COVID‐19) serological testing to diagnose acute infection or determine population seroprevalence relies on understanding assay accuracy during early infection. We aimed to evaluate the diagnostic performance of serological testing in COVID‐19 by providing summary sensitivity and specificity estimates with time from symptom onset.MethodsA systematic search of Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) and PubMed was performed up to May 13, 2020. All English language, original peer‐reviewed publications reporting the diagnostic performance of serological testing vis‐à‐vis virologically confirmed SARS‐CoV‐2 infection were included.ResultsOur search yielded 599 unique publications. A total of 39 publications reporting 11 516 samples from 8872 human participants met eligibility criteria for inclusion in our study. Pooled percentages of IgM and IgG seroconversion by Day 7, 14, 21, 28 and after Day 28 were 37.5%, 73.3%, 81.3%, 72.3% and 73.3%, and 35.4%, 80.6%, 93.3%, 84.4% and 98.9%, respectively. By Day 21, summary estimate of IgM sensitivity was 0.872 (95% CI: 0.784‐0.928) and specificity 0.973 (95% CI: 0.938‐0.988), while IgG sensitivity was 0.913 (95% CI: 0.823‐0.959) and specificity 0.960 (95% CI: 0.919‐0.980). On meta‐regression, IgM and IgG test accuracy was significantly higher at Day 14 using enzyme‐linked immunosorbent assay (ELISA) compared to other methods.ConclusionsSerological assays offer imperfect sensitivity for the diagnosis of acute SARS‐CoV‐2 infection. Estimates of population seroprevalence during or shortly after an outbreak will need to adjust for the delay between infection, symptom onset and seroconversion.
Three‐dimensional shape‐conformation performances of wound dressings tested in a robotic sacral pressure ulcer phantom
Authors: Lustig Adi , Gefen Amit 
Published: February 2021

AbstractEffective exudate retention by dressings requires close and intimate dressing‐wound contact, immediately and continuously after the dressing application. Any dressing‐wound spaces may allow for build‐up of non‐retained fluids, causing exudate pooling which forms a favourable environment for pathogen growth. Maceration may follow if the pooled exudates spread to peri‐wound skin. Dressings with a claimed 3D‐shape‐conformation technology are commercially available; however, their effectiveness in minimising dressing‐wound gaps has never been scientifically investigated. We present a novel bioengineering methodology for testing the effectiveness of such 3D‐shape‐conformation dressings, using our recently reported robotic phantom system of a sacral pressure ulcer. By means of 3D laser scanning and bespoke software, we reconstructed dressing shapes after simulated use and calculated the goodness‐of‐fit between each dressing (swelled to near‐saturation) and the corresponding wound geometry. Two dressing sizes (10 × 10 cm and 12.5 × 12.5 cm) and two wound depths (2.5 or 2 cm) were considered. All the tested dressings were far from reaching good contact with the (simulated) wounds: Approximately one‐third of the wound volume and nearly half of the wound surface were not in contact with the swelled dressings. Our present findings question whether 3D‐shape‐conformation dressings are effective, by revealing their swelling behaviour which was previously unknown.
Risking vulnerability: Enacting moral agency in the is/ought gap in mental health care
Authors: Musto Lynn , Schreiber Rita , Rodney Patricia (Paddy) 
Published: February 2021

AbstractAimTo explore how healthcare providers in acute care mental health settings navigate ethically challenging situations, enact moral agency, practice in congruence with ethical standards and mitigate moral distress (MD).DesignGrounded theory, a qualitative methodology.MethodsOver 18 months between 2015 and 2017, we reviewed documents, conducted observations and interviewed multidisciplinary participants (N = 27) from inpatient and emergency departments. Participants either provided direct care (N = 14) or were in leadership positions (N = 13). Data were analysed iteratively using constant comparison, coding, memoing and theorizing, which continued until saturation was reached in July 2016.FindingsThe basic social process of how healthcare professionals enacted moral agency, Risking Vulnerability, occurred in the context of Systemic Inhumanity, a constant source of MD. Participants Risked Vulnerability, balancing professional obligations, clinical expertise and organizational processes with their own vulnerability in the system as they strove to practice ethically. Risking Vulnerability was composed of Pushing Back, Working Through Team Relationships and Struggling with Inhumanity.ConclusionHealthcare professionals’ moral agency occurred at the nexus of structure (organizational constraints) and agency (persons). Given this, interventions for MD should be directed at all levels of healthcare to support moral agency, promote ethical practice and improve care.ImpactSociopolitical elements such as austerity measures undermined ethical practice at the level of direct care. Enactment of moral agency is dynamic, influencing experiences of MD: participants supported by leadership or colleagues to enact moral agency noted that they were not stuck in MD. Interventions supporting moral agency throughout the healthcare system are necessary to mitigate experiences of MD. Findings enhance our understanding of the role of action in the experience of MD.
Virtual reality and distraction cards to reduce pain during intramuscular benzathine penicillin injection procedure in adults: A randomized controlled trial
Authors: Basak Tulay , Demirtas Ayla , Yorubulut Sevde Melike 
Published: February 2021

AbstractAimThe aim of this study was to determine the effect of using three‐dimensional videos with virtual reality glasses and distraction cards including optical illusion pictures on patients’ pain and satisfaction levels during intramuscular benzathine penicillin injection.DesignA randomized controlled trial.MethodThe study population consisted of 91 patients who were prescribed intramuscular benzathine penicillin medication. The participants were stratified by gender and assigned to three groups (control, virtual reality and distraction cards groups). The visual analogue scale was used to assess pain and patient satisfaction. A one‐way analysis of variance and Dunnett's post hoc tests were used to compare the pain and satisfaction levels by group.ResultsThe mean pain was 6.67 (2.17) in the control group, 4.4 (2.71) in the distraction cards group and 4.93 (3.07) in the virtual reality group and the difference was statistically significant (F = 5.84, p ˂ .01). The average of the satisfaction levels in the groups was 3.57 (2.23) in the control group, 7.13 (2.86) in the distraction cards group and 8.07 (2.55) in the virtual reality group. The difference between the satisfaction levels was statistically significant (F = 25.77, p ˂ .01).ConclusionThe three‐dimensional videos with virtual reality glasses and distraction cards including optical illusion pictures were effective in reducing pain associated with intramuscular benzathine penicillin injection and increasing patient satisfaction.ImpactThe results of this study will contribute to evidence‐based nursing practices for the pain associated with intramuscular benzathine penicillin injection.Clinical Trial RegistryNCT04420559.
Examining nurses' role in Adult Protective Services related to safeguarding older people
Authors: Liu Pi‐Ju , Hernandez Chilatra Jessica Andrea , Phelan Amanda 
Published: February 2021

AbstractAimTo examine the role of Adult Protective Services' (APS's) nurses in helping abused, neglected and exploited older people, this study investigated how nurses' contribution differs from social workers. Though the majority of APS' workforce is staffed by social workers, some programmes also employ nurses.DesignSecondary data analysis using convergent parallel mixed‐method design was conducted.MethodsUsing survey data from the National Adult Protective Services Association, 99 nurses' responses between October 2014 and August 2015 were analysed to examine their agency characteristics, training and qualities, job responsibilities and interprofessional collaboration.ResultsThe majority of nurses work with social workers or other professionals using a multidisciplinary team (MDT) approach. Among those carrying a caseload, 69% (49 out of 71) of nurses work in conjunction with social workers. Out of all nurses, 64% (63 out of 99) indicated participation in at least one MDT. While the responsibilities nurses provided were similar to social workers, nurses were also able to provide healthcare related services, in their professional competencies, without referral.ConclusionNurses in APS are in a privileged position to investigate mistreatment and provide/coordinate direct care for victims.ImpactNot much was known about nurses who directly investigate elder mistreatment and provide services to victims. This study was the first to highlight the nursing workforce in APS, and described the nurses' unique contribution to the field. Nurses functioned as both social workers and healthcare professionals in APS. Since victims of elder mistreatment often suffer from negative physical, psychological and social consequences, having nurses in APS benefits victims to receive and the programmes in providing better care and services.
Managing and keeping control: A qualitative synthesis of nursing and care staff strategies to prevent older people from falling
Authors: De La Cuesta‐Benjumea Carmen , Lidón‐Cerezuela Beatriz , Abad‐Corpa Eva , Meseguer‐Liza Cristóbal , Arredondo‐González Claudia P. 
Published: February 2021

AbstractAimTo better understand formal care providers’ role in fall prevention.DesignQualitative synthesis as part of an integrative review.Data sourcesFifteen electronic databases were consulted with the time limit being December 2017. Studies included were qualitative primary studies on formal care providers and fall prevention of people over 65 years of age in health care facilities. 17 studies were included.Review MethodsQualitative researchers carried out a critical appraisal and abstraction of the studies retained. Primary studies were imported into Nvivo 12 software; grounded theory procedures of constant comparison, microanalysis, coding, development of memos and diagrams were completed concurrently in a continuous growing process of data conceptualization. Analysis was iterative; it started with open coding and ended with the development of an integrative memo.FindingsPrimary studies were synthesized with the emerging core category of “Managing and keeping control” and described by the emerging strategies of risk management, risk control and articulation work. These three categories account for the formal care providers’ role in fall prevention in health care facilities.ConclusionFall prevention is not given by a series of means and instruments; it is rather built in the interactions between formal care providers and the material and social world. The interactive character of prevention implies that outcomes cannot always be anticipated.Impact:

Although falls are one of the most researched clinical problems in nursing, the role played by nursing and care staff is dispersed and scantily documented.

Formal care providers alternate risk management with risk control strategies to prevent older people from falling in health care facilities, they also resort to the articulation of the health care team as a complementary strategy.

This review shows the dynamic character of fall prevention, which is something that has tended to go unnoticed in the literature and in policy.