bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Quality Improvement Initiative to Implement Focused Family Meetings in the Surgical Intensive Care Unit: Does It Matter?
Authors: Maniar Yesha , Chalasani Haarika , Messerole Kenneth , Beck Lindsay , Stright Adam , Petrone Patrizio , Islam Shahidul , Joseph D’Andrea K. 
Published: September 2024

Introduction: Communication with families is essential to improve satisfaction, especially in the critical care setting. We sought to identify patients who were not recovering as expected and to improve communication with their families. Methods: We implemented a novel algorithm, incorporating clinical and social criteria, to determine which patients could benefit from additional communication. Patients who qualified were randomized to the intervention of a structured interdisciplinary family meeting or to standard communication in the Intensive Care Unit at the discretion of the attending. Surveys were administered to both groups to determine the primary outcome of satisfaction with communication. Wilcoxon rank-sum, chi-square, or Fisher’s exact test as appropriate was used to compare baseline characteristics and survey items between groups. Results: There was no difference between the intervention (n = 25) and non-intervention groups (n = 33) in demographic or clinical characteristics ( P-value >.05). Surveys were able to be completed for 76% of the intervention group and 51% in the non-intervention group. There was no difference in the responses to the survey between the groups ( P-value >.05), signifying that families were satisfied with communication regardless of whether they had a structured interdisciplinary family meeting. Conclusion: Our results are contrary to the traditionally held belief that structured family meetings improve communication. A possible explanation is that implementing an algorithm to identify patients in need of additional communication predisposes providers to be more cognizant of family needs in the Surgical Intensive Care Unit. Future research should focus on qualitative research to elucidate what aspects of communication are most useful to families.
Learn@Lunch: Developing a continuing professional development programme to raise knowledge and awareness of drinking alcohol as an occupation in later life
Authors: Maclean Fiona , Breckenridge Jenna P , Schrag Anthony , Gray Joanna , McCormack Brendan , Kantartzis Sarah 
Published: September 2024

Introduction: Occupational therapists in acute practice are increasingly likely to work routinely with people in later life who drink alcohol. Therefore, this knowledge translation study aimed to evaluate the development of a continuing professional development Learn@Lunch programme, designed to enhance awareness and understanding of occupational therapists who work in an acute hospital setting, of drinking alcohol as an occupation in later life. Method: Guided by the Promoting Action of Research Implementation in Health Sciences framework, the continuing professional development programme was developed, and a qualitative evaluation undertaken. This included pre- and post-focus groups with occupational therapists ( n = 8) in an acute setting, where the programme was delivered, pre- and post-programme delivery interviews with the research champion recruited from the site, and one interview with the Allied Health Professions Service Lead. Findings: Findings indicate the Learn@Lunch continuing professional development programme enhanced therapist knowledge and understanding of the changing patterns of drinking alcohol in later life. However, practical barriers exist impacting how participants perceived the value and delivery of the programme. Conclusion: Learn@Lunch was an effective continuing professional development programme and supported enhanced knowledge and awareness of drinking alcohol as an occupation in later life, leading to changes in local acute occupational therapy practice.
Depurative capacity toward medium molecules of the dialyzer Toray NV-U® Hydrolink™: A new hydrophilic membrane to perform online hemodiafiltration
Authors: Kislikova Maria , Vega Almudena , Verde Eduardo , Abad Soraya , Vaca Marco , Acosta Adriana , González Angela , Bascuñana Arturo , Mijailova Antonia , Nava Coraima , Villa Miguel , Ruiz Juan Carlos , Goicoechea Marian 
Published: September 2024

Introduction: New dialysis membranes with new properties are being developed to improve efficacy and tolerance. The hemocompatibility of a polymeric biomaterial is influenced by the layer of water at the blood membrane interface. The new dialyzer TORAY NV-U® has a membrane Hydrolink™, designed to suppress platelet adhesion and to improve the hemocompatibility. Until now, there is no experience in online hemodiafiltration (OL-HDF). The objective of the present study is to evaluate the efficacy of this new membrane in OL-HDF therapy compared to another membrane commonly used. Other objectives are to evaluate the inflammatory response, hemodynamic tolerance, and the anticoagulation regimes. Methods: This is a prospective pilot study performed in five anuric patients receiving OL-HDF. For 1 month patients were kept with their usual dialyzer FX1000® (FMC). Subsequently, the dialyzer was changed to TORAY NV-U® (Hydrolink®) for 1 month. In the last dialysis session of each dialyzer, blood tests were performed to evaluate inflammation and depurative capacity. Results: We did not find differences in medium size removal molecules and convective volume: FX1000®: 31 ± 9 l per session and Hydrolink™ 30 ± 8 l; p = 0.7); β2microglobulin reduction ratio (RR) FX1000® FMC 83 ± 3%; Hydrolink™ 79 ± 4; p = 0.14; Myoglobin RR FX1000® FMC 72 ± 7%; Hydrolink™ 76 ± 4; p = 0.28. We did not find differences in inflammation parameters: serum IL6 with FX1000® 6.0 ± 4.2 pg/mL; Hydrolink™ 7.6 ± 5.0 pg/mL; p = 0.3. During all sessions with the two dialyzers there was adequate plasmatic filling, reaching 85 % filling. All patients had “good” dialyzer status in all dialysis sessions with TORAY NV-U®, while the dialyzer status with FX1000® was “good” in 20% of the sessions, “medium” in 30%, and “dirty” in the remaining 50% dialysis sessions. Conclusions: The new dialyzer Hydrolink™, TORAY NV-U® is not inferior to perform OL-HDF compared to dialyzers usually used for this therapy, and could allow decrease heparin doses. Further studies with a bigger sample size and longer follow-up will answer if Hydrolink improves inflammation and assess a better hemodynamic tolerance.
The global immune-nutrition-inflammation index (GINI) as a robust prognostic factor in glioblastoma patients treated with the standard stupp protocol
Authors: Topkan Erkan , Kilic Durankus Nilufer , Senyurek Sukran , Öztürk Duriye , Besen Ali Ayberk , Mertsoylu Huseyin , Pehlivan Berrin , Selek Ugur 
Published: September 2024

Background Systemic inflammation can significantly impact gliomas’ onset, progression, and prognosis. Glioblastoma multiforme (GBM) represents the glioma subtype characterized by the most profound inflammatory and immunosuppressive states. Consequently, various blood-borne biomarkers have been scrutinized concerning their prognostic value in GBM patients. Objective We sought to investigate whether the recently introduced Global Immune-Nutrition-Inflammation Index (GINI) holds prognostic significance for GBM patients treated with the standard Stupp protocol. Methods We retrospectively analyzed the data from a cohort of newly diagnosed GBM patients receiving the standard Stupp regimen using the propensity score-matching methodology. The GINI was computed using the original formula: GINI = [(C-reactive protein × Monocytes × Platelets × Neutrophils) ÷ (Albumin × Lymphocytes)]. We employed receiver operating characteristic (ROC) curve analysis to identify the optimal cutoff values for GINI, which could help distinguish between different survival outcomes. The primary and secondary objectives were the differences in overall survival (OS) and progression-free survival (PFS) between the GINI groups. Results The optimal GINI cutoff value was 1350. Out of 294 eligible patients, 211 were PSM-matched: GINI<1350 ( N = 95) and GINI≥1350 ( N = 116). Comparative Kaplan-Meier estimates indicated that the GINI≥1350 patients had substantially worse median PFS (8.0 vs 16.8 months; p < .001) and OS (14.3 vs 22.9 months; p < .001) durations than their GINI<1350 counterparts. Conclusion High pretreatment GINI values are robustly and independently associated with inferior PFS and OS outcomes in selected GBM patients who receive standard Stupp protocol. These findings suggest that if further confirmed, the novel GINI could serve as a valuable biological marker for the prognostic stratification of GBM patients.
Enhancing alginate dialdehyde-gelatin (ADA-GEL) based hydrogels for biofabrication by addition of phytotherapeutics and mesoporous bioactive glass nanoparticles (MBGNs)
Authors: Bider Faina , Gunnella Chiara , Reh Jana T , Clejanu Corina-Elena , Kuth Sonja , Beltrán Ana M , Boccaccini Aldo R 
Published: September 2024

This study explores the 3D printing of alginate dialdehyde-gelatin (ADA-GEL) inks incorporating phytotherapeutic agents, such as ferulic acid (FA), and silicate mesoporous bioactive glass nanoparticles (MBGNs) at two different concentrations. 3D scaffolds with bioactive properties suitable for bone tissue engineering (TE) were obtained. The degradation and swelling behaviour of films and 3D printed scaffolds indicated an accelerated trend with increasing MBGN content, while FA appeared to stabilize the samples. Determination of the degree of crosslinking validated the increased stability of hydrogels due to the addition of FA and 0.1% (w/v) MBGNs. The incorporation of MBGNs not only improved the effective moduli and conferred bioactive properties through the formation of hydroxyapatite (HAp) on the surface of ADA-GEL-based samples but also enhanced VEGF-A expression of MC3T3-E1 cells. The beneficial impact of FA and low concentrations of MBGNs in ADA-GEL-based inks for 3D (bio)printing applications was corroborated through various printing experiments, resulting in higher printing resolution, as also confirmed by rheological measurements. Cytocompatibility investigations revealed enhanced MC3T3-E1 cell activity and viability. Furthermore, the presence of mineral phases, as confirmed by an in vitro biomineralization assay, and increased ALP activity after 21 days, attributed to the addition of FA and MBGNs, were demonstrated. Considering the acquired structural and biological properties, along with efficient drug delivery capability, enhanced biological activity, and improved 3D printability, the newly developed inks exhibit promising potential for biofabrication and bone TE.
Palliative Care and the Self-Fulfilling Prophecy in Stroke Patients: is There Anything to Fear? A Retrospective Study of Patients Who Died During Hospitalization in a Quaternary Care Hospital
Authors: Tramonte Maiara Silva , Carvalho Ana Claudia Pires , Pucci Gabriela Figueiredo , Pinheiro Mariana Soares , Fornazari Ana Elisa Vayego , Villas Boas Gustavo Di Lorenzo , Lange Marcos Christiano , Minicucci Marcos Ferreira , Bazan Rodrigo , Lopes Laura Cardia Gomes 
Published: September 2024

Background and Purpose Primary palliative care (PC) aims to improve the quality of life for patients with acute ischemic stroke but is often misinterpreted as withdrawal of care. The self-fulfilling prophecy withdrawal bias is feared in this context of PC’s early implementation. This study evaluates stroke patients who died in the hospital to determine the impact of PC evaluation. Methods A retrospective descriptive analysis of patients who died from acute ischemic stroke was conducted. The study included patients aged ≥18 years admitted to the Stroke Unit of a quaternary hospital in Brazil from January 2017 to December 2018. The impact of PC assessment on outcomes was analyzed, with significance set at 5%. Results Among the patients who died during hospitalization as a result of an ischemic stroke (n = 77), 39 (%) were assessed by the palliative care team. There was no difference in the total length of stay or duration of antibiotic therapy. Logistic regression corrected for significant variables from the univariate analysis revealed that PC evaluation was associated with a 31-fold increase in opioid use ( P < 0.001), a nearly 14-fold increase in discharges to the ward, and a threefold reduction in ICU length of stay ( P = 0.011). Conclusion PC team involvement was associated with higher rates of discharge to the floors, inferring more time spent with family and increased opioid use, suggesting better symptom control, without reducing the overall length of stay or duration of antibiotic therapy. This underscores that PC does not equate to withdrawal of care.
Minimally Invasive Distal Metatarsal Diaphyseal Osteotomy (MIS-DMDO) for the Prevention and Treatment of Chronic Plantar Diabetic Foot Ulcers
Authors: Biz Carlo , Belluzzi Elisa , Rossin Alessandro , Mori Fabiana , Pozzuoli Assunta , Bragazzi Nicola Luigi , Ruggieri Pietro 
Published: September 2024

Background: Diabetic foot is one of the major complications of diabetes, affecting 15% of patients with diabetes. This study aims to evaluate and compare the clinical and radiographic outcomes of patients with diabetes affected by forefoot plantar preulcerative or ulcerative lesions who have undergone minimally invasive distal metatarsal diaphyseal osteotomy (MIS-DMDO) to assess its efficacy in the prevention and treatment of chronic plantar diabetic foot ulcers (CPDFUs). Methods: The study included 60 patients, 38 with preulcers and 22 with ulcers, with at least 2 years of clinical and radiologic follow-up. Clinical outcomes were assessed using the European Foot and Ankle Society (EFAS) score, the Foot Function Index (FFI), and the Manchester-Oxford Foot Questionnaire (MOXFQ). The radiographic evaluation was performed according to the Maestro criteria. Results: Both groups improved in clinical and radiologic outcomes when comparing baseline measurements to those at the final follow-up. There were no statistical differences between preulcer and ulcer groups in terms of both clinical and radiologic outcomes, with the only exception being FFI, which was lower in the preulcerative group. In multivariate analysis, gender and glycated hemoglobin (HbA1c) were predictors of better outcomes. Specifically, FFI and MOXFQ ( P < .05) exhibited larger improvements in females, while Maestro 1 and 2 were better in patients with lower HbA1c ( P < .05). All patients were considered healed at the final follow-up. Conclusion: Carefully performed minimally invasive distal metatarsal diaphyseal osteotomy can be an effective approach to the care of impending or chronically present plantar diabetic foot ulcers.
Comparative Efficacy and Long-Term Oncological Safety of Extended Right Hemicolectomy Versus Left Colectomy for Splenic Flexure Adenocarcinoma: A Systematic Review and Meta-Analysis
Authors: Chaouch Mohamed Ali , Krimi Bassem , Gouader Amine , Bhiri Hanen , Barel Elise , Akouz Faiza Khemissa 
Published: September 2024

Background Splenic flexure adenocarcinoma poses unique challenges in surgical management due to its location and lymphatic drainage. This study compared the efficacy and oncological safety of extended right hemicolectomy (ERC) and left colectomy (LC) for treating this condition. Methods This study followed the PRISMA and AMSTAR 2 guidelines. Key outcomes included postoperative mortality, morbidity, severe complications, operative results, pathological findings (R0 resection, lymph nodes), and oncological results (overall survival and disease-free survival at 3 and 5 years). Results Twelve non-randomised studies were included involving 1710 patients (713 ERC group, 997 LC group). The analysis showed that ERC was associated with more lymph nodes and a lower conversion rate. However, there were no significant differences between ERC and LC in terms of mortality, morbidity, severe complications, anastomotic leak, wound infection, ileus, reoperation, R0 resection, hospital stay, and overall and disease-free survival rates. Conclusions ERC and LC are comparable in terms of postoperative and long-term oncological outcomes for splenic flexure adenocarcinoma, with ERC potentially producing a higher lymph node harvest rate and a lower conversion rate. ERC could be suggested for a better stage of the disease and when the surgical team considers the laparoscopic approach.
Hybrid Biatrial Ablation Versus Catheter Ablation for Patients With Nonparoxysmal Atrial Fibrillation and Enlarged Left Atrium
Authors: Yu Chunyu , Li Haojie , Zeng Zhiwei , Zheng Lihui , Wu Lingmin , Ding Ligang , Yao Yan , Zheng Zhe 
Published: September 2024

Objective: There is no consensus on the optimal ablation strategy for nonparoxysmal atrial fibrillation (NPAF) with enlarged left atrium. We aimed to explore whether hybrid ablation (HA) of combined thoracoscopic surgical ablation with catheter ablation (CA) was superior to CA alone in these patients. Methods: Patients with NPAF and left atrial diameter (LAD) ≥45 mm who underwent hybrid biatrial ablation or CA procedure from June 2014 to July 2021 were included in this study. Propensity score matching was applied to select patients in each group. The primary endpoint was freedom from atrial tachyarrhythmias after procedures. Results: After propensity score matching, 52 patients with enlarged left atrium (median LAD = 51 mm) were enrolled in each group. The median follow-up was 36 months. The probability of freedom from atrial tachyarrhythmias at 12, 24, and 36 months on antiarrhythmic drugs (AADs) was 70.1%, 65.4%, and 62.6% in the HA group and 34.3%, 29.4%, and 22.0% in the CA group, respectively ( P < 0.001); off AADs was 57.1%, 52.7%, and 50.0% in the HA group and 25.0%, 16.2%, and 11.5% in the CA group ( P < 0.001); on AADs after redo CA was 76.2%, 73.7%, and 73.7% in the HA group and 43.6%, 43.6%, and 38.2% in the CA group, respectively ( P < 0.001); off AADs after redo CA was 62.5%, 60.1%, and 60.1% in the HA group and 30.4%, 25.1%, and 20.9% in the CA group, respectively ( P < 0.001). Conclusions: For patients with NPAF and enlarged left atrium, hybrid biatrial ablation was superior to CA in sinus rhythm maintenance even if redo CA was performed.
Incorporation of a specialist mental health clinical pharmacist within a primary care network: patient referrals, prescribing decisions, and clinical outcomes
Authors: Henry Rebecca , Baldwin David S. 
Published: September 2024

Background: The benefit of generalist pharmacists working within primary care networks (PCNs) and with general practitioners (GPs) is established. We wished to evaluate the contributions and potential benefits of a specialist mental health care prescribing pharmacist within PCNs. Method: We prospectively collected data, on clinical and demographic characteristics, referral sources, interventions, outcomes (objective and subjective), and patient feedback, from 466 completed patients, in one PCN by one specialist mental health pharmacist (working 0.5 whole time equivalent), over 15 months. Results: Referrals originated from multiple sources, including GPs, other members of the PCN mental health team, and community mental health teams (CMHTs). Two-thirds of treated patients were female; the most frequent age band was 18–30 years; the most common diagnosis was mixed depression and anxiety. Patients with diagnoses of mixed anxiety with depression or personality disorder needed more appointments than those with anxiety or depression. A range of evidence-based treatments were prescribed, including non-formulary medicines, and those medicines are more typically initiated or recommended in secondary care settings. The most frequently started medications were antidepressants (principally fluoxetine and duloxetine), followed by antipsychotics (principally quetiapine and aripiprazole): the most common dosage increases were for sertraline and quetiapine. Common non-medication recommendations were for cognitive behavioral therapy, cognitive behavioral therapy for insomnia, and other psychological therapies. Patient feedback was generally positive. Discussion: Developing and implementing a service incorporating a specialist mental health pharmacist within a PCN mental health team is potentially valuable in improving patient care quality, reducing workload for GPs and CMHTs, and enabling faster access to secondary care initiated and recommended medications. This innovative service addressed several national targets, including prevention, early intervention, and access to quality compassionate care.
Coadministration of isavuconazole and sirolimus in allogeneic hematopoietic stem cell transplant recipients
Authors: Farina Francesca , Acerbis Andrea , Oltolini Chiara , Chiurlo Matteo , Xue Elisabetta , Clerici Daniela , Marktel Sarah , Mastaglio Sara , Bruno Alessandro , Piemontese Simona , Diral Elisa , Orofino Giorgio , Campodonico Edoardo , Corti Consuelo , Teresa Lupo Stanghellini Maria , Scarpellini Paolo , Dell’Acqua Raffaele , Castagna Antonella , Peccatori Iacopo , Ciceri Fabio , Greco Raffaella 
Published: September 2024

Background: Invasive fungal infections (IFIs) represent a major cause of morbidity among allogeneic hematopoietic stem cell transplantation (allo-HSCT). Isavuconazole (ISA) is a broad-spectrum triazole with favorable safety profile. Objectives and design: Herein, we evaluate the real life coadministration of ISA and sirolimus in allo-HSCT recipients in a single-center retrospective analysis, describing clinical efficacy, safety, and therapeutic drug monitoring (TDM) of both drugs. Methods: All consecutive allo-HSCT recipients who received the coadministration of ISA and sirolimus for at least 2 weeks between July 2017 and December 2022 were included in this retrospective analysis. TDM was longitudinally performed during treatment. IFIs were classified according to the revised European Organization for Research and Treatment of Cancer/Mycoses Study Group consensus criteria. Results: A total of 51 recipients were included in the analysis. A total of 17 patients received ISA as continuous antifungal treatment for IFI diagnosed before transplant: one patient experienced a probable invasive pulmonary aspergillosis, and one patient switched from ISA to liposomal amphotericin B for a possible IFI. A total of 34 patients started ISA as antifungal therapy for IFI diagnosed after transplant. Sixteen of 34 were treated for a proven/probable breakthrough IFI during mold-active prophylaxis: 6/16 patients died for IFI after a median of 51 days of ISA. Eighteen of 34 started ISA as empirical therapy for a possible IFI: 15/18 patients were alive with resolution of infection after 6 weeks, 1 died for disease progression, and 2 had empirically changed antifungal therapy due to pneumonia progression. Clinical and radiological response rate was 68% after 90 days from IFI diagnosis. No toxicities related to drug–drug interaction have been registered in patients reaching concomitant therapeutic levels of ISA and sirolimus. Conclusion: The coadministration of ISA and sirolimus was safe and feasible in this cohort, confirming favorable clinical efficacy in patients with multiple-drug coadministration.