bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subcutaneous sodium valproate in palliative care: A systematic review
Authors: Tan Sheryn , Ng Jeng Swen , Tang Charis , Stretton Brandon , Kovoor Joshua , Gupta Aashray , Delloso Thomson , Zhang Tony , Goh Rudy , El-Masri Shaddy , Kiley Michelle , Maddocks Ian , Harroud Adil , Stacpoole Sybil , Crawford Gregory , Bacchi Stephen 
Published: March 2024

Background: Seizures are an important palliative symptom, the management of which can be complicated by patients’ capacity to swallow oral medications. In this setting, and the wish to avoid intravenous access, subcutaneous infusions may be employed. Options for antiseizure medications that can be provided subcutaneously may be limited. Subcutaneous sodium valproate may be an additional management strategy. Aim: To evaluate the published experience of subcutaneous valproate use in palliative care, namely with respect to effectiveness and tolerability. Design: A systematic review was registered (PROSPERO CRD42023453427), conducted and reported according to PRISMA reporting guidelines. Data sources: The databases PubMed, EMBASE and Scopus were searched for publications until August 11, 2023. Results: The searches returned 429 results, of which six fulfilled inclusion criteria. Case series were the most common study design, and most studies included <10 individuals who received subcutaneous sodium valproate. There were three studies that presented results on the utility of subcutaneous sodium valproate for seizure control, which described it to be an effective strategy. One study also described it as an effective treatment for neuropathic pain. The doses were often based on presumed 1:1 oral to subcutaneous conversion ratios. Only one study described a local site adverse reaction, which resolved with a change of administration site. Conclusions: There are limited data on the use of subcutaneous sodium valproate in palliative care. However, palliative symptoms for which subcutaneous sodium valproate have been used successfully are seizures and neuropathic pain. The available data have described few adverse effects, supporting its use with an appropriate degree of caution.
Centre variation in home dialysis uptake: A survey of kidney centre practice in relation to home dialysis organisation and delivery in England
Authors: Damery Sarah , Lambie Mark , Williams Iestyn , Coyle David , Fotheringham James , Solis-Trapala Ivonne , Allen Kerry , Potts Jessica , Dikomitis Lisa , Davies Simon J 
Published: March 2024

Background: Disparities in home dialysis uptake across England suggest inequity and unexplained variation in access. We surveyed staff at all English kidney centres to identify patterns in service organisation/delivery and explore correlations with home therapy uptake, as part of a larger study (‘Inter-CEPt’), which aims to identify potentially modifiable factors to address observed variations. Methods: Between June and September 2022, staff working at English kidney centres were surveyed and individual responses combined into one centre-level response per question using predetermined data aggregation rules. Descriptive analysis described centre practices and their correlation with home dialysis uptake (proportion of new home dialysis starters) using 2019 UK Renal Registry 12-month home dialysis incidence data. Results: In total, 180 responses were received (50/51 centres, 98.0%). Despite varied organisation of home dialysis services, most components of service delivery and practice had minimal or weak correlations with home dialysis uptake apart from offering assisted peritoneal dialysis and ‘promoting flexible decision-making about dialysis modality’. Moderate to strong correlations were identified between home dialysis uptake and centres reporting supportive clinical leadership (correlation 0.32, 95% Confidence Interval (CI): 0.05–0.55), an organisational culture that values trying new initiatives (0.57, 95% CI: 0.34–0.73); support for reflective practice (0.38, 95% CI: 0.11–0.60), facilitating research engagement (0.39, 95% CI: 0.13–0.61) and promoting continuous quality improvement (0.29, 95% CI: 0.01–0.53). Conclusions: Uptake of home dialysis is likely to be driven by organisational culture, leadership and staff attitudes, which provide a supportive clinical environment within which specific components of service organisation and delivery can be effective.
Perceived Health Status, Quality of Life and Treatment-Seeking Behaviour Among People Living with HIV/AIDS (PLHIV) Attending Antiretroviral Therapy Clinic at a Tertiary Care Centre of North India
Authors: Kaur Mandeep , Kaur Sukhpal , Sharma Aman , Sachdeva Ravinder Kaur 
Published: March 2024

HIV is a major health issue globally. Though highly effective antiretroviral therapy has improved the life expectancy, people living with HIV (PLHIV) suffer from many physical and psychological issues. The present study assessed perceived health status, quality of life (QOL) and treatment-seeking behaviour among PLHIV. The study was carried out among 75 PLHIV attending ART clinic of a tertiary care centre of North India. Convenience sampling technique was used. Ethical approval for the study was obtained from the Institute Ethics Committee. Participants were asked to rate their current state of health as perceived by them on a five-point scale ranging from poor to excellent. QOL was assessed by using WHOQOL-BREF (Hindi version). Treatment-seeking behaviour was assessed by a structured questionnaire developed by researchers. A total of 45.3% ( n = 34) rated it as fair, 22.7% ( n = 17) rated it as good 13.3% ( n = 10) rated it as poor, 10.7% ( n = 8) rated it as excellent and 8% ( n = 6) rated it as very good. QOL score was highest in physical health domain with a mean ± S.D. of 12.3 ± 4.1 (median 13) and lowest in the social relationships domain with a mean of 8.6 ± 2.9 (median = 8) ( p = .001). Most common reason of going for HIV testing was being symptomatic ( n = 21) followed by spouse testing positive for HIV ( n = 19). HIV impacts QOL of the PLHIV and treatment-seeking behaviour varies among the patients. There is a need to develop a multilevel approach involving all the stakeholders including patient, family and society.
Development and Evaluation of a Serious Game on Pressure Injury Prevention for the Training of Patient Relatives: A Quasi-Experimental Study
Authors: Çakar Vildan , Karadağ Ayişe 
Published: March 2024

Background In recent years, serious games have been used as an educational method in various fields such as economy, marketing, military, education, and health as a training method. Pressure injuries (PIs) are a significant health problem and clinical quality improvement issue throughout the world. Implementation of prevention strategies has gained importance in all healthcare settings due to the negative effects of PIs. Educating patient relatives on PI prevention is essential. Aims This study aimed to develop a serious game for the training of patient relatives on PI prevention and evaluate the game in terms of knowledge acquisition and its features. Methods The study was carried out as a single-group quasi-experimental pre-test and post-test design in three stages between August 1, 2020-April 30, 2022. In the first stage educational content, knowledge assessment test, and game evaluation questionnaire were prepared. A web-based serious game (PreSore: Pressure Injury Prevention Game) was developed in the second stage. The participants played the game in the third stage, and data was collected. The study sample consisted of patient relatives (n=55). A knowledge assessment test (pre-test, post-test, and re-test) and a game evaluation questionnaire were administered for the data collection. Results It was determined that there was a significant increase in knowledge scores after the PreSore game implementation ( p < .001). Most of the participants indicated that the information in the game was easy to understand (98.2%), they wanted to share their educational experience with others with the digital game method (96.4%), and they found the game was authentic (94.5%). Conclusions The study revealed that the PreSore game is a method that could be used to train patient relatives on PI prevention. Integrating the PreSore into daily practice in healthcare institutions and conducting prospective studies are recommended.
The Risk Factors of Mitral Regurgitation Deterioration After Secundum Atrial Septal Defect Closure
Authors: Swandita Garniswara , Arso Irsad Andi , Anggrahini Dyah Wulan , Hartopo Anggoro Budi , Cipta Cindy Elica , Dinarti Lucia Kris 
Published: March 2024

Background: Association between secundum Atrial Septal Defect (ASD) and mitral valve (MV) disease has been recognized for decades. Secundum ASD closure can reduce mitral regurgitation (MR) degree. However, in some patients, deterioration of MR after ASD closure has been observed. We aimed to identify the risk factors of MR deterioration after ASD closure. Methods: This was an observational retrospective cohort study. Data were collected from the registry and echocardiogram report. We evaluated all patients with ASD closure by surgery and transcatheterization without MR intervention from January 2012 until June 2021 at Dr. Sardjito General Hospital, Yogyakarta. We excluded patients with multiple ASD and ASD with severe MR requiring MV intervention. Risk factors for MR deterioration were evaluated using multivariate logistic regression. Results: A total of 242 patients who underwent post-secundum ASD closure were included. In multivariate analysis, ASD closure by surgery, large left atrial (LA) diameter (>40 mm), low left ventricular ejection fraction (LVEF; <55%), and MV regurgitation degree were significant risk factors for MR worsening after ASD closure, with OR of 2.103 (95% CI 1.124-3.937); 2.871 (95% CI 1.032-7.985); 5.531 (95% CI 1.368-22.366); and 2.490 (95% CI 1.339-4.630) respectively. Conclusion: ASD closure by surgery, large LA diameter (>40 mm), low LVEF (<55%), and MV regurgitation degree are independent significant risk factors for MR deterioration in post-secundum ASD closure patients. In adult ASD patients with reduced LV function, it is recommended to perform balloon testing and consider fenestrated closure, as low LVEF <55% has the highest risk of causing new or deteriorating MR.
Community-based palliative care in two primary care settings – nursing homes and home care: a national survey
Authors: Raunkiaer Mette , Mikkelsen Tina B. , Shabnam Jahan , Christiansen Sofie R. , Jarlbaek Lene 
Published: March 2024

Aims: Based on selected themes from a national survey, the study aims to describe and analyse similarities and differences in community-based palliative care provided to people living at home in two different care settings – the nursing home setting and the home care setting. Methods: Responses from four palliative care themes covered by a national survey sent to 717 managers in municipality-based care units were used. The themes were: (a) target groups in palliative care; (b) wishes for end-of-life care; (c) tools/guidelines in palliative care; and (d) palliative care provided to relatives. Results: The response rates were 53% in the nursing home setting and 69% in the home care setting (69%). Both settings had target groups for palliative care, in which significantly more units in the home care settings cared for people with other cultural backgrounds or children. Wishes for end-of-life care were addressed by more than 90% of the units in both settings. There were significantly more nursing home units that addressed questions regarding resuscitation, decision making when you are incapable of making decisions for yourself, and the level of medication. In both settings, around half of the units did not use or did not know if they used tools/guidelines to identify palliative care needs. Half of home care and 65% of nursing home settings did not/were unaware of providing palliative care to relatives. Conclusions: Both settings serve target populations for palliative care with few differences. Identifying palliative care needs seemed to be a low priority in both settings. A difference was found between the settings regarding end-of-life care questions and palliative care promotion to relatives.
Review of Herbal Medicinal Plants Used in the Management of Cancers in the East Africa Region from 2019 to 2023
Authors: Kudamba Ali , Kasolo Josephine N. , Bbosa Godfrey S. , Lugaajju Allan , Wabinga Henry , Kafeero Hussein M. , Ssenku Jamilu E. , Alemu Shaban O. , Walusansa Abdul , Niyonzima Nixon , Muwonge Haruna 
Published: March 2024

Background: In the East African region, herbal plants are essential in the treatment and control of cancer. Given the diverse ecological and cultural makeup of the regional states, it is likely that different ethnic groups will use the same or different plants for the same or different diseases. However, since 2019, this has not been compiled into a single study. Purpose: The study aimed to compile and record the medicinal plants utilized in East Africa from April 2019 to June 2023 to treat various cancer types. Materials and methods: The study examined 13 original studies that included ethnobotanical research conducted in East Africa. They were retrieved from several internet databases, including Google Scholar, Scopus, PubMed/Medline, Science Direct, and Research for Life. The study retrieved databases on plant families and species, plant parts used, preparation methods and routes of administration, and the country where the ethnobotanical field surveys were conducted. Graphs were produced using the GraphPad Prism 8.125 program (GraphPad Software, Inc., San Diego, CA). Tables and figures were used to present the data, which had been condensed into percentages and frequencies. Results: A total of 105 different plant species from 45 different plant families were identified, including Asteraceae (14), Euphorbiaceae (12), Musaceae (8), and Apocynaceae (7). Uganda registered the highest proportion (46% of the medicinal plants used). The most commonly mentioned medicinal plant species in cancer management was Prunus africana. Herbs (32%), trees and shrubs (28%), and leaves (45%) constituted the majority of herbal remedies. Most herbal remedies were prepared by boiling (decoction) and taken orally (57%). Conclusion: East Africa is home to a wide variety of medicinal plant species that local populations and herbalists, or TMP, frequently use in the treatment of various types of cancer. The most frequently used families are Asteraceae and Euphorbiaceae, with the majority of species being found in Uganda. The most frequently utilized plant species is Prunus africana. Studies on the effectiveness of Prunus africana against other malignancies besides prostate cancer are required.
Delayed ulnar artery pseudoaneurysm presentation after percutaneous cardiac intervention: A case report and review of the literature
Authors: Osilama Eshiemomoh , Satchell Emma K , Ballehaninna Umashankar K 
Published: March 2024

Purpose Here we present a case of a 62-year-old female with a delayed ulnar artery pseudoaneurysm presentation after cardiac catheterization. Case Report A 62-year-old woman with multiple medical comorbidities including end-stage renal disease (ESRD) on hemodialysis (HD) and atrial fibrillation on tablet apixaban who presented 8 weeks after cardiac catheterization through right ulnar artery access with a pulsatile mass, pain, and tingling of her right-hand fingers. Ultrasound exam confirmed presence of ulnar artery pseudoaneurysm with >2 cm active chamber. This pseudoaneurysm was repaired via forearm exploration, evacuation of hematoma, and primary repair with non-absorbable sutures. Conclusion We report a case of delayed ulnar artery pseudoaneurysm presentation following cardiac catheterization through the right ulnar artery. Open surgical repair offers a definitive addressal of ulnar artery pseudoaneurysm and removes ulnar nerve compressive neuropathy with less risk of distal embolization in patients with delayed pseudoaneurysm presentation whenever ultrasound-guided thrombin injection (UGTI) is contraindicated.
A Machine Learning Model for Week-Ahead Hypoglycemia Prediction From Continuous Glucose Monitoring Data
Authors: Giammarino Flavia , Senanayake Ransalu , Prahalad Priya , Maahs David M. , Scheinker David 
Published: March 2024

Background:Remote patient monitoring (RPM) programs augment type 1 diabetes (T1D) care based on retrospective continuous glucose monitoring (CGM) data. Few methods are available to estimate the likelihood of a patient experiencing clinically significant hypoglycemia within one week.Methods:We developed a machine learning model to estimate the probability that a patient will experience a clinically significant hypoglycemic event, defined as CGM readings below 54 mg/dL for at least 15 consecutive minutes, within one week. The model takes as input the patient’s CGM time series over a given week, and outputs the predicted probability of a clinically significant hypoglycemic event the following week. We used 10-fold cross-validation and external validation (testing on cohorts different from the training cohort) to evaluate performance. We used CGM data from three different cohorts of patients with T1D: REPLACE-BG (226 patients), Juvenile Diabetes Research Foundation (JDRF; 355 patients) and Tidepool (120 patients).Results:In 10-fold cross-validation, the average area under the receiver operating characteristic curve (ROC-AUC) was 0.77 (standard deviation [SD]: 0.0233) on the REPLACE-BG cohort, 0.74 (SD: 0.0188) on the JDRF cohort, and 0.76 (SD: 0.02) on the Tidepool cohort. In external validation, the average ROC-AUC across the three cohorts was 0.74 (SD: 0.0262).Conclusions:We developed a machine learning algorithm to estimate the probability of a clinically significant hypoglycemic event within one week. Predictive algorithms may provide diabetes care providers using RPM with additional context when prioritizing T1D patients for review.
Antimicrobial and antitumor activities of an alginate-based membrane loaded with bismuth nanoparticles and cetylpyridinium chloride
Authors: Cabral-Romero Claudio , Hernández-Delgadillo Rene , Nakagoshi-Cepeda Sergio Eduardo , Sánchez-Najéra Rosa Isela , Escamilla-García Erandi , Solís-Soto Juan Manuel , García-Cuellar Claudia María , Sánchez-Pérez Yesennia , Flores-Treviño Samantha Maribel , Pineda-Aguilar Nayely , Cauich-Rodríguez Juan Valerio , Meester Irene , Chellam Shankararaman 
Published: March 2024

Objective: To evaluate the antitumor and antimicrobial properties of an alginate-based membrane (ABM) loaded with bismuth lipophilic nanoparticles (BisBAL NPs) and cetylpyridinium chloride (CPC) on clinically isolated bacteria and a pancreatic cancer cell line. Material and methods: The BisBAL NP-CPC ABM was characterized using optical and scanning electron microscopy (SEM). The antimicrobial potential was measured using the disk-diffusion assay, and antibiofilm activity was determined through the live/dead assay and fluorescence microscopy. The antitumor activity was analyzed on the pancreatic cell line (Panc 03.27) using the MTT assay and live/dead assay with fluorescence microscopy. Results: After a 24-h exposure (37°C, aerobic conditions), 5 µM BisBAL NP reduced the growth of K. pneumoniae by 77.9%, while 2.5 µM BisBAL NP inhibited the growth of Salmonella, E. faecalis and E. faecium by 82.9%, 82.6%, and 78%, respectively ( p < 0.0001). The BisBAL NPs-CPC ABM (at a ratio of 10:1; 500 and 50 µM, respectively) inhibited the growth of all isolated bacteria, producing inhibition halos of 9.5, 11.2, 7, and 10.3 mm for K. pneumoniae, Salmonella, E. faecalis, and E. faecium, respectively, in contrast to the 6.5, 9.5, 8.5, and 9.8 mm obtained with 100 µM ceftriaxone ( p < 0.0001). The BisBAL NPs-CPC ABM also reduced bacterial biofilms, with 81.4%, 74.5%, 97.1%, and 79.5% inhibition for K. pneumoniae, E. faecium, E. faecalis, and Salmonella, respectively. Furthermore, the BisBAL NPs-CPC ABM decreased Panc 03.27 cell growth by 76%, compared to 18% for drug-free ABM. GEM-ABM reduced tumoral growth by 73%. The live/dead assay confirmed that BisBAL NPs-CPC-ABM and GEM-ABM were cytotoxic for the turmoral Panc 03.27 cells. Conclusion: An alginate-based membrane loaded with BisBAL NP and CPC exhibits dual antimicrobial and antitumoral efficacy. Therefore, it could be applied in cancer treatment and to diminish the occurrence of surgical site infections.
Clinical Outcomes and Return to Preinjury Sports After Anatomic Reconstruction With a Gracilis Autograft Versus the Modified Broström Procedure in Patients With Generalized Joint Laxity
Authors: Wang Anhong , Jiang Yanfang , Su Tong , Xie Xing , Jiao Chen , Hu Yuelin , Zhang Zhu , Guo Qinwei , Jiang Dong 
Published: March 2024

Background: Generalized joint laxity (GJL) is a risk factor for inferior outcomes after the modified Broström procedure for chronic lateral ankle instability, while anatomic reconstruction with tendons is more inclined to be recommended. However, whether anatomic reconstruction could achieve better results than the modified Broström procedure in patients with GJL is unknown. Purpose: To compare clinical outcomes and return to sports between anatomic reconstruction and the modified Broström procedure in patients with GJL. Study Design: Cohort study; Level of evidence, 3. Methods: Patients with GJL (Beighton score ≥4) who underwent either the modified Broström procedure or anatomic reconstruction with gracilis autografts between 2017 and 2020 were reviewed. Included were 19 patients who underwent anatomic reconstruction (reconstruction group) and 49 patients who underwent the modified Broström procedure (MBP group). Clinical outcomes were compared using the Foot and Ankle Outcome Score (FAOS) and the Karlsson score. The rates of return to preinjury level in high-demand sports, sprain recurrence, and range of motion between the 2 groups were also compared. Results: The mean follow-up duration was 38.3 months in the reconstruction group and 43.7 months in the MBP group. The FAOS and Karlsson scores improved significantly after surgery in both groups ( P < .001 for all), with the reconstruction group having significantly higher postoperative FAOS-Sports scores (87.9 ± 8.9 vs 80.5 ± 11.6; P = .015) and Karlsson scores (86.9 ± 6.1 vs 82 ± 8.4; P = .025) than the MBP group. The rate of return to preinjury high-demand sports was higher in the reconstruction group than in the MBP group (73.3% vs 38.9%; P = .034). The MBP group had a significantly higher rate of sprain recurrence (22.4% vs 0%; P = .027). More patients reported dorsiflexion restriction in the reconstruction group (n = 4; 21.1%) than in the MBP group (n = 1; 2%) ( P = .019); nonetheless, there was no noticeable effect on daily life and sports. Conclusion: Better clinical outcomes, less sprain recurrence, and a higher rate of return to preinjury high-demand sports were found after anatomic reconstruction with free tendons compared with the modified Broström procedure in patients with GJL. Anatomic tendon reconstruction can be recommended for such patients, especially those participating in high-demand sports.