bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac sensing at a spinal cord stimulation lead: a promising on-device potential biomarker for pain and wellbeing
Authors: Brinda AnneMarie K. , Goudman Lisa , Moens Maarten , Hincapie Juan , Dinsmoor David A. , Litvak Leonid M. , Straka Małgorzata 
Published: August 2024

Introduction: In the search for objective measures of therapeutic outcomes for patients with spinal cord stimulation (SCS) devices, various metrics of cardiac performance have been linked to pain as well as overall health. To track such measures at home, recent studies have incorporated wearables to monitor cardiac activity over months or years. The drawbacks to wearables, such as patient compliance, would be obviated by on-device sensing that incorporates the SCS lead. This study sought to evaluate the feasibility of using SCS leads to record cardiac electrograms.Methods: The quality of signals sensed by externalized, percutaneous leads in the thoracic spine of 10 subjects at the end of their SCS trial were characterized across various electrode configurations and postures by detecting R-peaks and calculating signal-to-noise ratio (SNR). In a subset of 5 subjects, cardiac metrics were then compared to those measured simultaneously with a wearable.Results: The average signal quality was acceptable for R-peak detection (i.e., SNR &gt; 5) for all configurations and positions across all 10 subjects, with higher signal quality achieved when recording in resting positions. Notably, the spinal lead recordings enabled more reliable beat detection compared to the wearable (n = 29 recording pairs; p &lt; 0.001). When excluding wearable recordings with over 35% missed beats, the inter-beat intervals across devices were highly correlated (n = 22 recording pairs; Pearson correlation: R = 0.99, p &lt; 0.001). Further comparisons in these aligned wearable and corresponding spinal-lead recordings revealed significant differences in the frequency domain metrics (i.e., absolute and normalized high and low frequency HRV power, p &lt; 0.05), but not in time domain HRV parameters.Discussion: The ability of an implanted SCS system to record electrocardiograms, as demonstrated here, could provide the basis of automated SCS therapy by tracking potential biomarkers of the patient’s overall health state without the need for additional external devices.
Crisis of objectivity: using a personalized network model to understand maladaptive sensemaking in a patient with psychotic, affective, and obsessive-compulsive symptoms
Authors: Oblak Aleš , Kuclar Matic , Horvat Golob Katja , Holnthaner Alina , Battelino Urška , Škodlar Borut , Bon Jurij 
Published: August 2024

IntroductionPsychiatric comorbidities have proven a consistent challenge. Recent approaches emphasize the need to move away from categorical descriptions of symptom clusters towards a dimensional view of mental disorders. From the perspective of phenomenological psychopathology, this shift is not enough, as a more detailed understanding of patients’ lived experience is necessary as well. One phenomenology-informed approach suggests that we can better understand the nature of psychiatric disorders through personalized network models, a comprehensive description of a person’s lifeworld in the form of salient nodes and the relationships between them. We present a detailed case study of a patient with multiple comorbidities, maladaptive coping mechanisms, and adverse childhood experiences.MethodsThe case was followed for a period of two years, during which we collected multiple streams of data, ranging from phenomenological interviews, neuropsychological assessments, language analysis, and semi-structured interviews (Examination of Anomalous Self Experience and Examination of Anomalous World Experience). We analytically constructed a personalized network model of his lifeworld.ResultsWe identified an experiential category “the crisis of objectivity” as the core psychopathological theme of his lifeworld. It refers to his persistent mistrust towards any information that he obtains that he appraises as originating in his subjectivity. We can developmentally trace the crisis of objectivity to his adverse childhood experience, as well as him experiencing a psychotic episode in earnest. He developed various maladaptive coping mechanisms in order to compensate for his psychotic symptoms. Interestingly, we found correspondence between his subjective reports and other sources of data.DiscussionHernan exhibits difficulties in multiple Research Domain Criteria constructs. While we can say that social sensorimotor, positive valence, and negative valence systems dysfunctions are likely associated with primary deficit (originating in his adverse childhood experience), his cognitive symptoms may be tied to his maladaptive coping mechanisms (although, they might be related to his primary disorder as well).
Exploring the link between parents’ differentiation of self and children’s externalizing behavior problems: the mediating role of need-supportive vs. need-frustrating parenting practices
Authors: Klein Michal , Levy Tomer , Shulman Cory , Lwow Etan , Silberg Tamar 
Published: August 2024

ObjectiveExternalizing behavior problems (EBPs) are common in children, with significant long-term impact on the child and family members. Parents, particularly mothers, of children with EBPs often experience heightened emotional distress. One crucial factor affecting parents’ ability to manage this distress is their level of differentiation-of-self (DOS). Differentiated parents are more likely to engage in practices that meet their child’s psychological needs, thus supporting the self-determination theory principles vital for a child’s well-being. This study examined the impact of parental DOS on parenting practices and subsequently on the child’s EBPs, exploring possible differences between mothers and fathers.MethodsThirty-two mother–father dyads with children aged 6–14, diagnosed with EBPs participated. Parents completed the Differentiation of Self Inventory–Short Form, the Revised Parents as a Social Context Questionnaire, and the Strengths and Difficulties Questionnaire to assess parental DOS, practices, and child’s EBPs, respectively. Adjusted parallel mediation models examined the mediating role of parental practices in the relationship between parental DOS and a child’s EBPs.ResultsWhile no direct link between parental DOS and child’s symptoms was found, a complete mediation model indicated need-frustrating practices mediating between parental DOS and a child’s EBPs, for both mothers and fathers. Additionally, fathers’ need-supportive practices, but not mothers’, were negatively associated with the child’s symptoms.DiscussionThese findings highlight the interaction between parental traits, need-frustrating practices, and a child’s psychopathology. Notably, fathers’ supportive behaviors emerged as potential protective factors against child’s EBPs, suggesting promising directions for future research and interventions targeting fathers.
Clinical and cognitive outcomes in first-episode psychosis: focus on the interplay between cannabis use and genetic variability in endocannabinoid receptors
Authors: Oscoz-Irurozqui Maitane , Guardiola-Ripoll Maria , Almodóvar-Payá Carmen , Guerrero-Pedraza Amalia , Hostalet Noemí , Carrion María Isabel , Sarró Salvador , Gomar JJ , Pomarol-Clotet Edith , Fatjó-Vilas Mar 
Published: August 2024

IntroductionResearch data show the impact of the endocannabinoid system on psychosis through its neurotransmission homeostatic functions. However, the effect of the endocannabinoid system genetic variability on the relationship between cannabis use and psychosis has been unexplored, even less in first-episode patients. Here, through a case-only design, we investigated the effect of cannabis use and the genetic variability of endocannabinoid receptors on clinical and cognitive outcomes in first-episode psychosis (FEP) patients.MethodsThe sample comprised 50 FEP patients of European ancestry (mean age (sd) = 26.14 (6.55) years, 76% males), classified as cannabis users (58%) or cannabis non-users. Two Single Nucleotide Polymorphisms (SNP) were genotyped at the cannabinoid receptor type 1 gene (CNR1 rs1049353) and cannabinoid receptor type 2 gene (CNR2 rs2501431). Clinical (PANSS, GAF) and neuropsychological (WAIS, WMS, BADS) assessments were conducted. By means of linear regression models, we tested the main effect of cannabis use and its interaction with the polymorphic variants on the clinical and cognitive outcomes.ResultsFirst, as regards cannabis effects, our data showed a trend towards more severe positive symptoms (PANSS, p = 0.05) and better performance in manipulative abilities (matrix test-WAIS, p = 0.041) among cannabis users compared to non-users. Second, concerning the genotypic effects, the T allele carriers of the CNR1 rs1049353 presented higher PANSS disorganization scores than CC homozygotes (p = 0.014). Third, we detected that the observed association between cannabis and manipulative abilities is modified by the CNR2 polymorphism (p = 0.022): cannabis users carrying the G allele displayed better manipulative abilities than AA genotype carriers, while the cannabis non-users presented the opposite genotype-performance pattern. Such gene–environment interaction significantly improved the overall fit of the cannabis-only model (Δ-R2 = 8.4%, p = 0.019).DiscussionDespite the preliminary nature of the sample, our findings point towards the role of genetic variants at CNR1 and CNR2 genes in the severity of the disorganized symptoms of first-episode psychosis and modulating cognitive performance conditional to cannabis use. This highlights the need for further characterization of the combined role of endocannabinoid system genetic variability and cannabis use in the understanding of the pathophysiology of psychosis.
Medical malpractice in organ transplantation: public allegations and key legal outcomes
Authors: Arvanitis Panos , Davis Michel R. , London Abby , Farmakiotis Dimitrios 
Published: August 2024

IntroductionDespite significant advances in surgical techniques and patient outcomes, organ transplantation (OT) remains fraught with legal challenges and ethical dilemmas. This study aims to address the notable gap in literature on malpractice claims specifically related to OT, providing insights into litigation trends, outcomes, and implications for medical practice and patient care.MethodsWe retrospectively queried the Verdictsearch database from 1988 to 2023, and captured malpractice claims involving several organs. Data on demographics, organ types, and litigation outcomes were collected to compare compensation across different categories of malpractice and patient outcomes.ResultsOut of 292 malpractice cases identified, 62 met inclusion criteria, distributed across 19 states with kidney being the most implicated organ (46.8%). Defendants prevailed in 53.2% of cases, while settlements were reached in 29.0%, and plaintiffs won in 16.1% of cases. Surgical errors and complications were the most frequent allegations, followed by medication and treatment errors. The median compensation for deceased plaintiffs was significantly higher ($1,300,000) compared to living plaintiffs at litigation initiation ($128,000).DiscussionOur study sheds light on the challenges and trends in malpractice litigation within the field of OT. By identifying key areas of concern and the influence of patient outcomes on litigation resolution, this study offers valuable insights for healthcare providers, legal practitioners, and policymakers aimed at enhancing patient safety, reducing litigation risks, and fostering a deeper understanding of the ethical and legal complexities in OT.
Adaptive approach for tracking movements of biological targets: application to robot-based intervention for prostate cancer
Authors: Smahi Abdeslem , Lakhal Othman , Chettibi Taha , Sanz Lopez Mario , Pasquier David , Merzouki Rochdi 
Published: August 2024

IntroductionIn this paper, we introduce an advanced robotic system integrated with an adaptive optimization algorithm, tailored for Brachytherapy in prostate cancer treatment. The primary innovation of the system is the algorithm itself, designed to dynamically adjust needle trajectories in response to the real-time movements of the prostate gland during the local intervention.MethodsThe system employs real-time position data extracted from Magnetic Resonance Imaging (MRI) to ensure precise targeting of the prostate, adapting to its constant motion and deformation. This precision is crucial in Brachytherapy, where the accurate placement of radioactive seeds directly impacts the efficacy of the treatment and minimizes damage to surrounding safe tissues.ResultsOur results demonstrate a marked improvement in the accuracy of radiation seed placement, directly correlating to more effective radiation delivery. The adaptive nature of the algorithm significantly reduces the number of needle insertions, leading to a less invasive treatment experience for patients. This reduction in needle insertions also contributes to lower risks of infection and shorter recovery times.DiscussionThis novel robotic system, enhanced by the adaptive optimization algorithm, improves the coverage of targets reached by a traditional combinatorial approach by approximately 15% with fewer required needles. The improved precision and reduced invasiveness highlight the potential of this system to enhance the overall effectiveness and patient experience in prostate cancer Brachytherapy.
Osteogênese imperfeita: impacto prognóstico de um acompanhamento desde a suspeita pré-natal
Authors: Santos Maria Clara Barra de Paula , Schreider João Lucas da Silva , Valle Júlia Villaça , Oliveira Marina Cenachi Azedo de , Paixão Vitória Aparecida Vieira da 
Published: August 2024

Introdução: a osteogênese imperfeita (OI) configura quadro congênito raro de acometimento do tecido conjuntivo. Pode se apresentar em diferentes graus de gravidade, incluindo desde deformidades ósseas até sintomas extra-articulares. Relato de caso: lactente do sexo masculinonasceu de parto cesáreo com 40 semanas de idade gestacional devido a suspeita pré-natal de OI, com ultrassom obstétrico revelando fraturas em membros inferiores. Aos 5 meses, realizou pesquisa genética que confirmou o diagnóstico pela identificação de variante patogênica do gene COLA-1 (c.1678G>A). Como terapêutica, foi adotada suplementação de vitamina D, carbonato de cálcio e infusões intravenosas de pamidronato; apresentou melhora de mobilidade em membros inferiores e manteve-se sem fraturas de repetição por mais de 36 meses. Com 4 anos e 10 meses de idade passou por cirurgia ortopédica para alinhamento do fêmur com introdução de hastes metálicas. Discussão: a OI é ocasionada por defeitos genéticos que resultam em deformidades do colágeno tipo I. Dentre suas manifestações clínicas, destacam-se baixa estatura, anormalidades ósseas e fraturas recorrentes, em localidades atípicas e com baixo impacto. A OI deve ser considerada em pacientes com fraturas recorrentes ou por meio da detecção da diminuição no comprimento femoral fetal. A análise dos genes COL1A1/COL1A2 pode contribuir para o diagnóstico. O tratamento inclui abordagem multidisciplinar e, em alguns casos, o uso dos bifosfonatos promove diminuição da frequência de fraturas e da dor, com melhora da mobilidade. Conclusão: a OI é um distúrbio multissistêmico; logo, a abordagem multidisciplinar é essencial para o acompanhamento do quadro. Os avanços genéticos e no diagnóstico pré-natal têm papel crucial no prognóstico individual e familiar desse paciente.
Conhecimento, triagem, consequências e prevalência dos sintomas da síndrome da tríade da mulher atleta/ deficiência relativa de energia no esporte (RES-S): uma revisão integrativa
Authors: Ferreira Ana Laura Henriques Araujo , Silva Camila Alves Vieira , Prata Catarine Reis de Sousa , Vinhas Clara Banterli , Neves Milene Garcia 
Published: August 2024

Introdução: A Síndrome da Tríade da Mulher Atleta (STMA) acomete atletas do sexo feminino e consiste em baixo aporte energético (AE) com ou sem distúrbios alimentares concomitantes; disfunção menstrual e baixa densidade mineral óssea. O baixo AE prolongado é o principal fator associado e pode acarretar a Deficiência Relativa de Energia no Esporte (RED-S) que traz prejuízos, principalmente, para a função endócrina de atletas. Diante da prevalência considerável, evidencia-se a relevância de estudos que esclareçam a RED-S em atletas. Objetivos: Compilar dados da literatura sobre a STMA e a RED-S. Metodologia: Trata-se de uma revisão integrativa que utilizou como base artigos originais publicados nas plataformas MEDLINE, LILACS, PubMed e SciELO. Resultados: As ferramentas tríade e RED-S são capazes de detectar sintomas de comprometimento da função endócrino-metabólica e saúde óssea no sexo feminino e masculino com melhor precisão do que a avaliação da disponibilidade de energia (EA). Entretanto, a baixa EA é a principal razão para a supressão do metabolismo e eixo reprodutivo; a variável é avaliada indiretamente, com base no autorrelato dos registros da ingestão alimentar e estimativas do gasto energético. Atletas do sexo feminino com densidade mineral óssea (DMO) baixa demonstram níveis séricos de BDNF e E2 significativamente mais baixos do que as com DMO normal, reforçando a relação entre as variáveis e a importância de monitorização. Conclusão: É importante a difusão sobre esse tema nos principais centros esportivos, para que o profissional de saúde saiba intervir de maneira mais assertiva.
Importância de biomarcadores no diagnóstico e prognóstico da Amiloidose Cardíaca: revisão de escopo
Authors: Borges Isabela Caracas Machado , Medeiros Airine Machado Eugenio de , Machado Janiffer Miranda Lacet Vieira , Borges Marcela Caracas Machado , Sobrinho Caroline Magalhães Tenório da Rocha , Costa Carlos Manoel Tenório da , Eugênio Igor Guedes , Cirqueira Maria Eduarda Ferreira 
Published: August 2024

A Amiloidose Cardíaca (AC) é uma patologia que necessita de um alto índice de suspeição clínica e de uma investigação de alto custo para confirmar o seu diagnóstico. Assim, muitos casos de AC são identificados tardiamente, o que impacta de forma negativa no seu prognóstico, já desfavorável. Biomarcadores como NT-pró BNP e Troponinas Cardíacas se apresentam como opções de fácil acesso e baixo custo para a avaliação inicial e prognóstica destes pacientes. Este estudo busca entender qual é a eficácia destes biomarcadores cardíacos no diagnóstico e prognóstico da Amiloidose Cardíaca. Para tanto, foi realizada uma revisão de escopo utilizando a estratégia de busca “Amyloidosis”, “Biomarkers”, “Heart failure”, “Diagnosis” associados ao operador booleano “AND”. A pesquisa foi realizada nas bases de dados Medline (via PubMed) e BVS, sendo encontrados 272 artigos no total. Destes, 16 artigos foram selecionados após aplicação de filtros, critérios de inclusão e exclusão, leitura de títulos, resumos e, finalmente, da análise do estudo completo. Os resultados destacam a excelente atuação do biomarcador NT-proBNP como indicador prognóstico e de eficácia terapêutica, se revelando como preditor de mortalidade independente. Já a aplicabilidade da troponina cardíaca T de forma isolada se demonstra incerta na AC. Desse modo, o uso criterioso desses biomarcadores pode auxiliar os profissionais de saúde, possibilitando uma monitorização mais precisa da evolução da doença e da eficácia do tratamento.
Effect of early prone positioning among critically ill patients admitted with acute respiratory distress syndrome during the COVID-19 pandemic: A comparative retrospective observational study
Authors: Abdelhamid Seyam Sameh Hamdy , Abdelgawad Ahmed Ismail Mohammed 
Published: August 2024

Background and objective: COVID-19 has offered an opportunity to the clinicians to try and study various oxygenation enhancing maneuvers in the patients. These included lung protective measures and prone positioning of participants admitted to the ICU with acute respiratory distress syndrome. We aimed to identify the effects of early prone positioning on the length of stay, discharge rate, and frequency of tracheostomies in the ICU patients.
Methodology: This retrospective study was conducted on critically ill patients needing mechanical ventilation with lung protective strategy, admitted to the Intensive Care Units of Al-Azhar University Hospitals between March 2020 to April 2022. All patients in the study were interpreted retrospectively by examining the patient's records. Group A (n = 39) included patients who had been early placed in prone positions within 24 h of intubation, and Group B (n = 31) included patients who had not been placed in prone positions. All patients received a lung protective strategy for ARDS. In both groups, PaO2, PaCO2, pH, SpO2, and PaO2/FiO2 ratio were checked initially and later every 24 h for 6 days. Data was evaluated for the total days of both hospital and ICU length of stay, number of successful discharges to home from the hospital, and the total number of tracheostomized patients.
Results: After prone positioning, lower SOFA and APACHE II scores were noticed in the prone group. There was no significant difference in the rate of discharge between the two groups. We observed non-significant shorter hospital and ICU stays and higher frequency of tracheostomy procedures in the prone group. We noticed a significant improvement in PaO2/FiO2 ratios in the prone group starting from day 2 to day 6. We observed a significant improvement in PO2 in the prone group in comparison to the non-prone group.
Conclusions: Early prone positioning of patients admitted to the ICU with acute respiratory distress syndrome during COVID-19 pandemic led to a significant improvement in both PaO2 and PaO2/FiO2 ratio with a non-significant decrease in both hospital and ICU length of stay as shown by the collected data over consecutive six days.
Abbreviations: ARDS- acute respiratory distress syndrome; FiO2: The fraction of inspired oxygen; CPAP: Continuous Positive Airway Pressure; PaO2: Arterial oxygen partial pressure; PEEP: Positive End-Expiratory Pressure; SOFA- Sequential Organ Failure Assessment
Keywords: Prone; Lung protective measures; ARDS; APACHI II; SOFA
Citation: Seyam SHA, Ahmed IMA. Effect of early prone positioning among critically ill patients admitted with acute respiratory distress syndrome during the COVID-19 pandemic: a comparative retrospective observational study. Anaesth. pain intensive care 2024;28(4):626−632; DOI: 10.35975/apic.v28i4.2504
Received: February 12, 2024; Reviewed: May 14, 2024; Accepted: May 15, 2024
ANÁLISE DA EFETIVIDADE DO GRUPO DE GESTANTES DO PRÉ-NATAL NA MODALIDADE ONLINE COMO FERRAMENTA DE APRENDIZAGEM NO CICLO GRAVÍDICO PUERPERAL
Authors: Rocha Rhayanne Rayssa dos Santos , Cavalcante Ribeiro Kelly Da Silva 
Published: August 2024

Objetivo: Analisar a efetividade do grupo de gestantes na modalidade online como ferramenta de aprendizagem. Método: Estudo epidemiológico, transversal, observacional e descritivo. As participantes foram pacientes que participaram do grupo de gestantes, em um centro de parto normal, na modalidade presencial ou online. Os dados foram coletados através de um questionário estruturado, contendo 16 perguntas fechadas, acerca dos assuntos abordados no curso. Resultado: Verificamos a predominância de maiores acertos de questões no grupo presencial em comparação ao grupo online. Porém, observou-se que a média de acertos do grupo online gira em torno de 12,44 de um total de 16 questões, o que é muito efetivo. Conclusão: O grupo de gestante na modalidade online, se mostra como uma ferramenta efetiva no processo de ensino-aprendizagem, na medida que os ensinamentos e compartilhamentos de informações são absorvidos em sua maioria pelas gestantes.