bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design of a Multiple-Behavior Change Intervention for Supporting Self-management in Patients With Chronic Heart Failure
Authors: Dam Joëlle , Eijsvogels Thijs M. H. , Verdijk Marjolein H. I. , Janssen Anna M. , van Bakel Bram M. A. , Baltussen Lisette E. H. J. M. , Westert Gert P. , de Bruin Marijn 
Published: March 2024

BackgroundNonadherence to medication and low physical activity contribute to morbidity, mortality, and decreased quality of life among patients with chronic heart failure (CHF). Effective interventions that can be delivered during routine clinical care are lacking.ObjectiveWe aimed to adapt the feasible and cost-effective Adherence Improving self-Management Strategy (AIMS) for patients with human immunodeficiency virus (HIV) to CHF treatment. Subsequently, we determined its acceptability and feasibility.MethodsAdherence Improving self-Management Strategy is a systematic, nurse-delivered counseling intervention blended with eHealth to facilitate patient self-management. We used the intervention mapping framework to systematically adapt AIMS-HIV to AIMS-CHF, while preserving essential intervention elements. Therefore, we systematically consulted the scientific literature, patients with CHF and nurses, and pretested intervention materials.ResultsAdherence Improving self-Management Strategy–HIV was modified to AIMS-CHF: a multiple-behavior change intervention, focused on medication adherence and physical activity. Key self-management determinants (such as attitudes, self-efficacy, and self-regulatory skills) and organization of care (such as specialized nurses delivering AIMS) were similar for HIV and heart failure care. The AIMS protocol, as well as material content and design, was systematically adapted to CHF. Preliminary testing suggests that AIMS-CHF is likely feasible and acceptable to patients with CHF and care providers.ConclusionUsing the intervention mapping protocol, AIMS-HIV could be systematically adapted to AIMS-CHF and seems acceptable and feasible. Evidence from the literature, behavioral theory, and input from nurses and patients were essential in this process. Adherence Improving self-Management Strategy–CHF should now be tested for feasibility and effectiveness in routine care.
Smartphone Application Versus Standard Instruction for Colonoscopic Preparation
Authors: Patel Sunil V. , Yu David , Taylor Connie , McKay Jackie , Hookey Lawrence 
Published: March 2024

Objective:
To compare smartphone application (Colonoscopic Preparation) instructions versus paper instructions for bowel preparation for colonoscopy.

Background:
Adhering to bowel preparation instructions is important to ensure a high-quality colonoscopy.

Patients and Methods:
This randomized controlled trial included individuals undergoing colonoscopy at a tertiary care hospital. Individuals were randomized (1:1) to receive instructions through a smartphone application or traditional paper instructions. The primary outcome was the quality of the bowel preparation as measured by the Boston Bowel Preparation Score. Secondary outcomes included cecal intubation and polyp detection. Patient satisfaction was assessed using a previously developed questionnaire.

Results:
A total of 238 individuals were randomized (n = 119 in each group), with 202 available for the intention-to-treat analysis (N = 97 in the app group and 105 in the paper group). The groups had similar demographics, indications for colonoscopy, and type of bowel preparation. The primary outcome (Boston Bowel Preparation Score) demonstrated no difference between groups (Colonoscopic Preparation app mean: 7.26 vs paper mean: 7.28, P = 0.91). There was no difference in cecal intubation (P = 0.37), at least one polyp detected (P = 0.43), or the mean number of polyps removed (P = 0.11). A higher proportion strongly agreed or agreed that they would use the smartphone app compared with paper instructions (89.4% vs 70.1%, P = 0.001).

Conclusions:
Smartphone instructions performed similarly to traditional paper instructions for those willing to use the application. Local patient preferences need to be considered before making changes in the method of delivery of medical instructions.
Gynura segetum induces hepatic sinusoidal obstruction syndrome in a child: A case report
Authors: Zheng Qian , Zhang Haiyang 
Published: March 2024

Rationale:
Hepatic sinusoidal obstruction syndrome (HSOS), which includes hepatic stasis and portal hypertension, is a rare vascular disorder of the liver. It is often associated with hematopoietic stem cell transplantation. It is also possible to treat this disease using Chinese herbal medicines that contain pyrrolizidine alkaloids (PAs). This disease is extremely rare in children and poses a serious threat to their health. To our knowledge, this is the first case of HSOS in a child with PAs.

Patient concerns:
We report a 4-year-old boy suffering from abdominal pain, hepatomegaly, massive ascites, elevated liver enzyme level, and severe portal hypertension as a result of the consumption of Gynura segetum (also known as Tusanqi in Chinese, a traditional herbal medicine containing PAs).

Diagnoses:
The child was finally diagnosed with PA-HSOS based on pathological diagnosis and imaging examination.

Intervention:
With active symptomatic and supportive care and sequential anticoagulation therapy, the abdominal distension and liver function improved in the patient.

Outcomes:
The patient was eventually recovered. The levels of liver enzymes, hemoglobin, and bilirubin were normal, and the international normalized ratio fluctuated between 2.0 and 3.0 during 1-year follow-up after discharge.

Lessons:
This case report emphasizes the prevention of Chinese herb-induced liver injury in children and the importance of active long-term sequential anticoagulant therapy to reduce the progressive damage of PA-HSOS in the liver.
Impact of delayed diagnosis and treatment on tuberculosis infection within families: A case report
Authors: Liu Jian-Jun , Feng Yin-Ping , Liu Zhong-Da , Guo Jing 
Published: March 2024

Background:A 32-year-old male patient was diagnosed with a 30% left pneumothorax on November 5, 2020, during which chest imaging indicated abnormalities. Despite this, pulmonary tuberculosis (TB) was not diagnosed or treated at that time due to a negative result in the MGIT960 culture. The patient experienced symptoms of cough and expectoration on April 24, 2022. Upon repeating the chest imaging, the condition had worsened, confirming the presence of pulmonary TB, leading to the patient’s hospitalization. On September 1, 2022, the 11-year-old daughter of the patient was diagnosed with pulmonary tuberculosis accompanied by bronchial tuberculosis and tuberculous pleurisy.Methods:The diagnosis of pulmonary tuberculosis was confirmed through sputum smears and Gene Xpert MTB/RIF testing, for the patient and his 11-year-old daughter in 2022. The patient underwent a 6-month combination therapy (2HRZE/4HR) comprising isoniazid, rifampicin, pyrazinamide, and ethambutol. His daughter with pulmonary tuberculosis accompanied by bronchial tuberculosis and tuberculous pleurisy underwent a 12-month combination therapy.Results:Late diagnosis and treatment delays contribute to tuberculosis infections within families. Fortunately, after more than 3 months of antituberculosis treatment, the patient experienced relief from cough and sputum secretion, and there was improvement observed in the chest CT scan. Six months later, the patient was successfully cured of TB. 12 months later, his daughter also was successfully cured of TB.Conclusion subsections:Early diagnosis and treatment of tuberculosis (TB) is vital to reduce transmission, morbidity, and mortality.
A randomized controlled study investigating the efficacy of electro-acupuncture and exercise-based swallowing rehabilitation for post-stroke dysphagia: Impacts on brainstem auditory evoked potentials and cerebral blood flow
Authors: Zhang Wen , Jin Hai-Tao , Wang Fei , Zhang Jing-Lan , Bao Yuan , Wang Song 
Published: March 2024

Background:
Swallowing rehabilitation behavioral therapy and traditional Chinese acupuncture therapy are widely used in the treatment of post-stroke dysphagia (PSD). This study investigated the therapeutic effect of electro-acupuncture combined with exercise-based swallowing rehabilitation on PSD and its effect on brainstem auditory evoked potential (BAEP) and cerebral blood flow.

Methods:
The 120 PSD patients were divided into 2 groups (n = 60 each) by simple random grouping method, that is, an experimental and control group, receiving routine swallowing training, or additional intervention with electro-acupuncture at a frequency of 5 times/week. Data in swallowing function, BAEP, and cerebrovascular color Doppler ultrasound parameters were collected before treatment, as well as after treatment. An intergroup comparison was conducted using an independent sample t-test, and an intra-group comparison was conducted among different time points using a paired t-test. The data were analyzed using the SPSS Statistics 22.0 software; P < .05 was considered statistically significant.

Results:
The therapeutic effects were significantly better in the experimental group compared with the control group (P < .05). The standard swallowing function assessment scores were significantly lower in both groups after treatment (P < .05), and the score in the observation group was lower than in the control group (P < .05). The peak latency of BAEP waves III and IV, and the inter-peak latency between peaks III to V and I to V in the 2 groups changed significantly (P < .05). The peak systolic velocity (PSV), end-diastolic velocity (EDV), and mean velocity (MV) were significantly increased in both groups after treatment (P < .05). The pulsatility index decreased significantly in both groups (P < .05), and the PSV, EDV, and MV were higher in the experimental group than in the control group (P < .05).

Conclusion:
Electro-acupuncture, combined with swallowing training in the treatment of Post-stroke Dysphagia, effectively improved cerebral microcirculation and conduction velocity, enhanced the motor function of swallowing muscles, and promoted the recovery of swallowing function.
A comparison of symptoms and quality of life between medial flap and coblation turbinator of inferior turbinate reduction in endoscopic septoturbinoplasty: an analysis of 108 cases
Authors: Nguyen Nguyen , Nguyen Ngoc Quang , Trinh Le Nam Phuong , Duong Thi My , Ton Nu Thi Nhu Quynh , Dang Thanh 
Published: March 2024

Introduction:
The combination of septoplasty and turbinoplasty is a common surgical and accepted intervention to correct the nasal obstruction. The coblation submucosal reduction turbinator is a new surgical device, and it started to be used recently. On the other hand, the medial flap inferior turbinoplasty is not a conservative technique, but it provides a reliable and robust reduction.

Objective:
This study aims to compare the symptoms as well as health-related quality of life (HQOL) in 55 patients who underwent septoplasty with concomitent medial flap inferior turbinoplasty (group 1), 53 patients who patients underwent septoplasty with concomitent coblation turbinator (group 2).

Patients and methods:
The authors performed a prospective, randomized study of 108 patients who consulted the otorhinolaryngology department at the university hospital for surgery of septoturbinoplasty.

Results:
Preoperatively, the two patient groups had quite similar symptoms and health-related quality of life, and the anterior width of the inferior turbinate showed significant differences between the contralateral and deviated sides but not the posterior part. The significant difference (P<0.05) was noted for postoperatively improved symptom scores on visual analogue scale (VAS), nasal obstruction septoplasty effectiveness (NOSE) and better HQOL [Sino-Nasal Outcome Test-22 (SNOT-22)] in all patient groups. In addition, the NOSE and SNOT-22 scores in group 2 had significantly greater improvement than group 1 (P<0.05).

Conclusions:
Septoturbinoplasty treatment of septum deviation and inferior turbinate hypertrophy led to less symptoms as well as better HQOL for all two patient groups. Therefore, these techniques were an effective intervention for turbinate reduction, and they are equally efficient in the long term.
A case report of vaping-associated sudden cardiac arrest in a young healthy patient
Authors: Ahmed Hasaan , Ismayl Mahmoud , Palicherla Anirudh , May Joshua , Goldsweig Andrew M. , Thirumalareddy Joseph 
Published: March 2024

Introduction and importance:
While vaping has increased significantly among young individuals, the effects of vape aerosol constituents on cardiac electrophysiological dynamics remain unknown.

Case presentation:
A 22-year-old female with a history of energy vaping presented with cardiac arrest. Found to have no pulse, CPR was started and an initial rhythm of ventricular tachycardia was obtained. Shock was administered with a follow-up rhythm of ventricular fibrillation. She was emergently defibrillated and entered atrial fibrillation with rapid ventricular response. Toxicology and troponins were all negative. Left heart catheterization and cardiac MRI were unremarkable. She was discharged with an external defibrillation vest and a tentative plan for outpatient electrophysiology study in the setting of negative work-up for cardiopulmonary arrest.

Clinical discussion:
Vaping-induced sudden cardiac arrest may be attributed to a reduction in cardiac repolarization reserve. Exposure to vegetable glycerin and propylene glycol, substances present in nearly all vape products, have been found to incite arrhythmias and disrupt cardiac conduction in animals. Acrolein, an aldehyde byproduct of glycerin, has also been found to induce arrhythmias due to autonomic dysfunction. Increased intracellular calcium concentration and free radical damage, which occur as a result of inhaling particulate matter generated from e-cigarettes, further propagates the risk of arrhythmia.

Conclusion:
The effects of inhaling vape aerosols remain not fully understood. While there is a perceived notion that nicotine-free aerosols may be harmless, that remains unclear. Further studies are needed to evaluate proarrhythmogenic effects and autonomic dysfunction from the various chemical substances present in vape aerosols.
Incidental diagnosis of primary appendiceal signet-ring cell adenocarcinoma after appendectomy for acute appendicitis: a case report
Authors: Xie Miao , Li Fei 
Published: March 2024

Introduction:
Appendiceal signet-ring cell adenocarcinoma (ASCA) is rare and more aggressive in malignant appendiceal neoplasms. The presentation can be appendicitis, which is lack of specific symptom and makes early diagnosis difficult. There is no effective surveillance. Prognosis largely relies on timely detection. We report a case of ASCA incidentally diagnosed through pathological examination after appendectomy for appendicitis.

Case presentation:
The patient presented to our department with a progressive right lower quadrant abdominal pain lasting for 3 days. Physical examination revealed rigidity, tenderness, and rebound tenderness on the right lower quadrant. A computed tomography scan showed a thickened, inflamed appendix with peri-appendiceal fat stranding without noticeable appendiceal mass at initial evaluation. The diagnosis was considered acute appendicitis, and an appendectomy was performed. The appendix was inflamed, gangrenous and perforated, and no mass was found during the surgery. Surgical specimen was sent for physiological examination, which incidentally detected signet-ring cell in H&E staining. And immunohistochemistry confirmed the diagnosis of ASCA with small amount of neuroendocrine neoplasms.

Conclusion:
Early diagnosis of ASCA can incidentally be made on pathological specimen following appendectomy for appendicitis. A routine pathological examination should be emphasized, and appendectomy may not be the endpoint of the treatment. Hemicolectomy and adjuvant therapy might ensue upon the diagnosis of appendiceal neoplasm. The poor prognosis of ASCA makes a timely diagnosis significant. Basic research is promising to unravel the molecular mechanisms of pathogenesis, finding typical tumor markers for screening and novel effective therapies for advanced cases.
Retrospective Cohort Study on the Impact of the COVID-19 Pandemic on Pregnancy Outcomes for Women Living With HIV in British Columbia
Authors: Fu Winnie , McClymont Elisabeth , Av-Gay Gal , Dorling Marisa , Atkinson Andrea , Azampanah Arezou , Elwood Chelsea , Sauvé Laura , van Schalkwyk Julie , Sotindjo Tatiana , Money Deborah 
Published: March 2024

Background:
For pregnant women living with HIV (WLWH), engagement in care is crucial to maternal health and reducing the risk of perinatal transmission. To date, there have been no studies in Canada examining the impact of the COVID-19 pandemic on pregnant WLWH.

Methods:
This was a retrospective cohort study assessing the impact of the pandemic on perinatal outcomes for pregnant WLWH using data from the Perinatal HIV Surveillance Program in British Columbia, Canada. We compared maternal characteristics, pregnancy outcomes, and clinical indicators related to engagement with care between a prepandemic (January 2017–March 2020) and pandemic cohort (March 2020–December 2022). We investigated preterm birth rates with explanatory variables using logistic regression analysis.

Results:
The prepandemic cohort (n = 87) had a significantly (P < 0.05) lower gestational age at the first antenatal encounter (9.0 vs 11.8) and lower rates of preterm births compared with the pandemic cohort (n = 56; 15% vs 37%). Adjusted odds of preterm birth increased with the presence of substance use in pregnancy (aOR = 10.45, 95% confidence interval: 2.19 to 49.94) in WLWH. There were 2 cases of perinatal transmission of HIV in the pandemic cohort, whereas the prepandemic cohort had none.

Conclusions:
The pandemic had pronounced effects on pregnant WLWH and their infants in British Columbia including higher rates of preterm birth and higher gestational age at the first antenatal encounter. The nonstatistically significant increase in perinatal transmission rates is of high clinical importance.
Machine Learning in Acute Stroke Care: A Novel Model for Assessing the Need for Enteral Nutrition
Authors: Okamoto Kazuhiro , Irie Keisuke , Hoyano Kengo , Matsushita Isao 
Published: March 2024

AbstractAimEarly enteral nutrition is often recommended for patients with acute stroke who have difficulty with oral intake. This study aimed to develop a predictive model to assess the need for enteral nutrition in older patients with acute cerebrovascular disorders. The model employs a machine learning algorithm using observational parameters related to swallowing ability.MethodsNinety patients experiencing a cerebrovascular accident for the first time were included in this study. Swallowing function was assessed using the Food Intake LEVEL Scale. Nine specific variables were used to create a model for determining the need for enteral nutrition. Initially, variable selection was conducted through correlation analysis. Subsequently, the data were randomly divided into training and test groups. Five machine learning methods were applied to identify the most effective algorithm: logistic regression, decision tree, random forest, support vector machine, and XG Boost.ResultsThrough correlation analysis, we identified the independent variables Functional Independence Measure, motor and cognitive scores and speech intelligibility. The logistic regression model demonstrated high performance (accuracy, 0.82; area under the curve, 0.82).ConclusionWe demonstrated that a predictive model, employing machine learning and integrating Functional Independence Measure motor and cognitive scores and speech intelligibility, exhibits superior predictive efficacy and ascertains the necessity for enteral nutrition. This model can be expediently appraised even by individuals not specialized in dysphagia. Additionally, it is applicable to patients who are incapable of adhering to conventional swallowing assessment protocols owing to compromised consciousness or cognitive impairments, or those with an exceptionally elevated risk of aspiration.
Is delirium after stroke associated with dysregulation of Hypothalamic pituitary axis?
Authors: Barugh AJ , MacLullich AMJ , Shenkin SD , Allerhand M , Mead GE 
Published: March 2024

AbstractDelirium after stroke is a serious condition associated with poorer longer term cognition. However the mechanism of delirium is poorly understood. The aberrant stress response has been postulated as a mechanism for delirium.AimTo explore the relationship between cortisol dysregulation and delirium over the first year after stroke in a prospective cohort study of patients admitted to an acute stroke unit.MethodsConsecutive patients admitted to an acute stroke unit over a one year period were identified and recruited if they were aged 65 or over and not taking steroids. Patients with incapacity were included if proxy consent could be obtained. Baseline data included stroke severity, cognition, illness severity, and pre-stroke cognition. Patients were assessed at 1, 3, 5, 7, 14, 21, 28 days, 4 months and 12 months for delirium. Salivary samples were taken morning and evening for cortisol analysis.ResultsOf the 831 patients screened, 304 met inclusion criteria and of these 95 agreed to participant. Twenty-six (27%) had delirium at some point during the 12 months follow-up. Delirium was associated with increasing age (mean age 83.5 years vs 74 years, p<0.001), being female (62% vs 23%, p=0.013), not independent in pre-stroke activities of daily living (35% vs 33%), higher IQCODE score median 3.56 vs 3.19), worse stroke severity (median National Institute of Stroke Scale 5 vs 8.5) p=0.009) and having had a total anterior circulation stroke (p<0.001). Univariable analyses identified several associations between delirium and cortisol in the first 28 days but not at 4 or 12 months. However, on multivariable analyses there were no significant associations between delirium and cortisol at any time point e.g. odds ratio for median 9am cortisol 0.95 (95% CI 0.89 to 1.01, p=0.08).ConclusionThere was no independent association between delirium and cortisol dysregulation after stroke. If an association does exist, it is likely to be small.