bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ethical issues in pain and palliation
Authors: Cascella Marco , Laudani Alessandro , Scarpati Giuliana , Piazza Ornella 
Published: January 2024

Purpose of review
Increased public awareness of ethical issues in pain and palliative care, along with patient advocacy groups, put pressure on healthcare systems and professionals to address these concerns.
Our aim is to review the ethics dilemmas concerning palliative care in ICU, artificial intelligence applications in pain therapy and palliative care, and the opioids epidemics.

Recent findings
In this focus review, we highlighted state of the art papers that were published in the last 18 months, on ethical issues in palliative care within the ICU, artificial intelligence trajectories, and how opioids epidemics has impacted pain management practices (see Visual Abstract).

Summary
Palliative care in the ICU should involve a multidisciplinary team, to mitigate patients suffering and futility. Providing spiritual support in the ICU is an important aspect of holistic patient care too.
Increasingly sophisticated tools for diagnosing and treating pain, as those involving artificial intelligence, might favour disparities in access, cause informed consent problems, and surely, they need prudence and reproducibility.
Pain clinicians worldwide continue to face the ethical dilemma of prescribing opioids for patients with chronic noncancer pain. Balancing the need for effective pain relief with the risk of opioid misuse, addiction, and overdose is a very controversial task.
Child and Parent Risk and Resilience Factors as Predictors of Long-term Recovery in Youths Undergoing Spinal Fusion Surgery
Authors: Thorsell Cederberg Jenny , Bartels Sara Laureen , Thulin Måns , Beeckman Melanie , Wicksell Rikard K. , Goubert Liesbet 
Published: January 2024

Objectives:
Undertreated pediatric post-surgical pain negatively affects quality-of-life and functioning and may lead to chronic post-surgical pain (CPSP). Predictors of recovery have been identified but more research is needed, particularly regarding resilience and social factors, and long-term effects. The aim of the present study was to investigate child and parent risk and resilience factors as predictors of long-term post-surgical recovery for adolescents.

Methods:
Participants were patients with Adolescent Idiopathic Scoliosis (AIS),12-18 years, undergoing spinal fusion, and their parents. Recruitment occurred at the orthopaedic units at four hospitals in Belgium. Data were collected before surgery (T0), at three (T1) and six weeks (T2), six months (T3) and one year (T4) post-surgery. Multiple regression models were used to evaluate the predictive effect of pain intensity, pain catastrophizing, psychological flexibility, and pain acceptance on long-term functioning, quality-of-life, and pain.

Results:
The sample comprised 100 adolescents and 61 parents. Pain at T0, T1, and T3 and adolescent pain catastrophizing (T0) predicted quality-of-life, functioning, and pain at T4 (while pain at T2 predicted quality-of-life and pain). Parent pain catastrophizing predicted pain at T4. Adolescent and parental psychological flexibility predicted quality-of-life, and parent psychological flexibility also predicted pain at T4. Adolescent acceptance at T1 predicted pain, and acceptance at T2 predicted quality-of-life, at T4.

Discussion:
The study identified pain and adolescent pain catastrophizing as risk factors, and adolescent and parental psychological flexibility and adolescent pain acceptance as resilience factors, for long-term recovery in youths undergoing spinal fusion. Post-surgical pain management targeting these factors may therefore promote recovery for these adolescents.
The use of tier three therapies in acute brain injured patients
Authors: Iaquaniello Carolina , Gallo Fabio , Cinotti Raphael , Citerio Giuseppe , Taccone Fabio S. , Pelosi Paolo , Badenes Rafael , Robba Chiara ,   for the ENIO Investigators§
Published: January 2024

BACKGROUND
In patients with acute brain injury (ABI) and refractory intracranial hypertension, the so-called ‘tier three therapies’ (TTT) (hypothermia, metabolic suppression with barbiturates, and decompressive craniectomy) may be used.

OBJECTIVE
We aimed to describe the incidence of use of TTT, and to assess their effect on outcome.

DESIGN
A secondary analysis of the ENIO observational study.

SETTING
Seventy-three intensive care units (ICUs) in 18 countries worldwide between June 2018 and November 2020.

PATIENTS
One thousand five hundred and twelve adult patients admitted to an intensive care unit (ICU) with ABI were included and categorised according to use or not of one or more TTT.

RESULTS
Three hundred and ninety-six patients (26.2%) received at least one TTT during the ICU stay. Five patients (0.3%) received all three TTT. TTT patients were younger (P < 0.0001), less likely to have a preinjury history of hypertension (P = 0.0008), and less frequently anisocoric within 24 h from ICU admission (P < 0.0001) than those with no tier three therapy. TTT were used less frequently in high-income countries than in upper income and lower middle-income countries (no TTT in 78% of patients in high-income countries, in 60.6% of patients in upper middle-income countries, and in 56.6% of patients in lower middle-income countries; P < 0.0001). TTT were more frequent in patients with traumatic brain injury (TBI) compared with other types of ABI and in patients with invasive intracranial pressure (ICP) monitoring (P < 0.0001). TTT use was associated with a higher incidence of ventilator-associated pneumonia (P < 0.0001), need for tracheostomy (P = 0.0194), and prolonged ICU length of stay (LOS; P < 0.0001) but not with increased ICU or hospital mortality (P = 0.999).

CONCLUSION
Patients with ABI are frequently managed using at least one TTT. Their use varies according to a country's economic resources, the type of ABI, and ICP monitoring and is associated with a higher risk of complications but not with ICU or hospital mortality.
Physical Activity, Sleeping Problems, Weight, Feelings of Social Isolation, and Quality of Life of Older Adults After Coronavirus Infection: A Longitudinal Cohort Study
Authors: Kuijpers Thomas G. , Gerkema Maartje H. , Engels Gwenda , Schipper Maarten , Herber Gerrie-Cor M. 
Published: January 2024

Background:
There is debate as to whether a coronavirus infection (SARS-CoV-2) affects older adults’ physical activity, sleeping problems, weight, feelings of social isolation, and quality of life (QoL). We investigated differences in these outcomes between older adults with and without coronavirus infection over 180 days following infection.

Methods:
We included 6789 older adults (65+) from the Lifelines COVID-19 cohort study who provided data between April 2020 and June 2021. Older adults (65+) with and without coronavirus infection were matched on sex, age, education, living situation, body mass index, smoking status, vulnerable health, time of infection, and precoronavirus health outcome. Weighted linear mixed models, adjusted for strictness of governmental policy measures, were used to compare health outcomes after infection between groups.

Results:
In total, 309 participants were tested positive for coronavirus. Eight days after infection, older adults with a coronavirus infection engaged in less physical activity, had more sleeping problems, weighed less, felt more socially isolated, and had a lower QoL than those without an infection. Differences in weight, feelings of social isolation, and QoL were absent after 90 days. However, differences in physical activity were still present at 90 days following infection and sleeping problems were present at 180 days.

Conclusion:
Our findings found negative associations of coronavirus infection with all the examined outcomes, which for physical activity persisted for 90 days and sleeping problems for 180 days. Magnitudes of estimated effects on physical activity and sleeping problems remain uncertain.
Risk Factors and Inequities in Transportation Injury and Mortality in the Canadian Census Health and Environment Cohorts (CanCHECs)
Authors: Branion-Calles Michael , Winters Meghan , Rothman Linda , Harris M. Anne 
Published: January 2024

Background:
Road traffic injury contributes substantially to morbidity and mortality. Canada stands out among developed countries in not conducting a national household travel survey, leading to a dearth of national transportation mode data and risk calculations that have appropriate denominators. Since traffic injuries are specific to the mode of travel used, these risk calculations should consider travel mode.

Methods:
Census data on mode of commute is one of the few sources of these data for persons aged 15 and over. This study leveraged a national data linkage cohort, the Canadian Census Health and Environment Cohorts, that connects census sociodemographic and commute mode data with records of deaths and hospitalizations, enabling assessment of road traffic injury associations by indicators of mode of travel (commuter mode). We examined longitudinal (1996–2019) bicyclist, pedestrian, and motor vehicle occupant injury and fatality risk in the Canadian Census Health and Environment Cohorts by commuter mode and sociodemographic characteristics using Cox proportional hazards models within the working adult population.

Results:
We estimated positive associations between commute mode and same mode injury and fatality, particularly for bicycle commuters (hazard ratios for bicycling injury was 9.1 and for bicycling fatality was 11). Low-income populations and Indigenous people had increased injury risk across all modes.

Conclusions:
This study shows inequities in transportation injury risk in Canada and underscores the importance of adjusting for mode of travel when examining differences between population groups.
Update Lessons from PET Imaging Part II: A Systematic Critical Review on Therapeutic Plasma Concentrations of Antidepressants
Authors: Hart Xenia M. , Spangemacher Moritz , Defert Julie , Uchida Hiroyuki , Gründer Gerhard 
Published: January 2024

Background:
Compared with antipsychotics, the relationship between antidepressant blood (plasma or serum) concentrations and target engagement is less well-established.

Methods:
We have discussed the literature on the relationship between plasma concentrations of antidepressant drugs and their target occupancy. Antidepressants reviewed in this work are citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, venlafaxine, duloxetine, milnacipran, tricyclic antidepressants (amitriptyline, nortriptyline, and clomipramine), bupropion, tranylcypromine, moclobemide, and vortioxetine. Four electronic databases were systematically searched.

Results:
We included 32 articles published 1996–2022. A strong relationship between serotonin transporter (SERT) occupancy and drug concentration is well established for selective serotonin reuptake inhibitors. Lower limits of recommended therapeutic reference ranges largely corroborate with the findings from positron emission tomography studies (80% SERT occupancy). Only a few novel studies have investigated alternative targets, that is, norepinephrine transporters (NETs), dopamine transporters (DATs), or monoamine oxidase A (MAO-A). For certain classes of drugs, positron emission tomography study data are inconclusive. Low DAT occupancy after bupropion treatment speculates its discussed mechanism of action. For MAO inhibitors, a correlation between drug concentration and MAO-A occupancy could not be established.

Conclusions:
Neuroimaging studies are critical in TDM-guided therapy for certain antidepressants, whereas for bupropion and MAO inhibitors, the available evidence offers no further insight. Evidence for selective serotonin reuptake inhibitors is strong and justifies a titration toward suggested ranges. For SNRIs, duloxetine, and venlafaxine, NETs are sufficiently occupied, well above the SERT efficacy threshold. For these drugs, a titration toward higher concentrations (within the recommended range) should be considered in case of no response at lower concentrations.
Predictive Performance of a Gentamicin Pharmacokinetic Model in Term Neonates with Perinatal Asphyxia Undergoing Controlled Therapeutic Hypothermia
Authors: van der Veer Marlotte A. A. , de Haan Timo R. , Franken Linda G. W. , Groenendaal Floris , Dijk Peter H. , de Boode Willem P. , Simons Sinno , Dijkman Koen P. , van Straaten Henrica L.M. , Rijken Monique , Cools Filip , Nuytemans Debbie H. G. M. , van Kaam Anton H. , Bijleveld Yuma. A. , Mathôt Ron A. A. ,   for the PharmaCool Study Group
Published: January 2024

Background:
Model validation procedures are crucial when population pharmacokinetic (PK) models are used to develop dosing algorithms and to perform model-informed precision dosing. We have previously published a population PK model describing the PK of gentamicin in term neonates with perinatal asphyxia during controlled therapeutic hypothermia (TH), which showed altered gentamicin clearance during the hypothermic phase dependent on gestational age and weight. In this study, the predictive performance and generalizability of this model were assessed using an independent data set of neonates with perinatal asphyxia undergoing controlled TH.

Methods:
The external data set contained a subset of neonates included in the prospective observational multicenter PharmaCool Study. Predictive performance was assessed by visually inspecting observed-versus-predicted concentration plots and calculating bias and precision. In addition, simulation-based diagnostics, model refitting, and bootstrap analyses were performed.

Results:
The external data set included 323 gentamicin concentrations of 39 neonates. Both the model-building and external data set included neonates from multiple centers. The original gentamicin PK model predicted the observed gentamicin concentrations with adequate accuracy and precision during all phases of controlled TH. Model appropriateness was confirmed with prediction-corrected visual predictive checks and normalized prediction distribution error analyses. Model refitting to the merged data set (n = 86 neonates with 935 samples) showed accurate estimation of PK parameters.

Conclusions:
The results of this external validation study justify the generalizability of the gentamicin dosing recommendations made in the original study for neonates with perinatal asphyxia undergoing controlled TH (5 mg/kg every 36 or 24 h with gestational age 36–41 and 42 wk, respectively) and its applicability in model-informed precision dosing.
Fluorescence-Based Lateral Flow Immunoassay for Quantification of Infliximab: Analytical and Clinical Performance Evaluation
Authors: Kim Eun Sil , Chon Hyangah , Kwon Yiyoung , Lee Misook , Kim Mi Jin , Choe Yon Ho 
Published: January 2024

Background:
Therapeutic drug monitoring of infliximab (IFX) can improve treatment outcomes; however, the temporal gap between drug concentration monitoring and subsequent availability restricts its practical application. To address this issue, an automated monitoring method, AFIAS IFX, was developed to rapidly and accurately analyze IFX concentration in blood. The analytical and clinical performances of this method were assessed to establish its clinical utility.

Methods:
The analytical performance of AFIAS IFX was evaluated according to Clinical and Laboratory Standard Institute guidelines. For clinical validation, AFIAS IFX was compared with 3 established enzyme-linked immunosorbent assay kits (LISA TRACKER, RIDASCREEN, and ImmunoGuide) using 100 consecutive samples from 28 patients treated with IFX. Passing–Bablok regression and Bland–Altman analyses were performed to compare the methods.

Results:
The detection and quantification limits of AFIAS IFX were 0.12 and 0.20 mcg/mL, respectively. Furthermore, AFIAS IFX analyzed samples within 10 minutes for concentrations up to 50 mcg/mL, exhibiting reproducibility (coefficient of variation [CV] ≤7.8%) and accuracy (recovery 98%–101%) with serum, plasma, and whole blood samples. Clinically, it exhibited a good correlation with the 3 established enzyme-linked immunosorbent assay kits. For patients treated with Remicade (IFX), the Passing–Bablok regression slope was 1.001–1.259, with a mean difference of −1.48 to 0.28 mcg/mL. For patients treated with CT-P13, the Passing–Bablok regression slope was 0.974–1.254, with a mean difference of −2.44 to 0.15 mcg/mL.

Conclusions:
AFIAS IFX, a novel fluorescence-based lateral flow assay, exhibited excellent performance in analyzing IFX trough levels and is a potentially powerful tool for therapeutic drug monitoring in clinical settings, with opportunities for further development.
Bibliometric Analysis of the Relationship between Gut Microbiota and Chronic Kidney Disease from 2001–2022
Authors: Tao Pengyu , Huo Jinlin , Chen Ling 
Published: January 2024

ABSTRACT

Background:
The gut microbiota is closely associated with chronic kidney disease (CKD) development and prognosis. However, a comprehensive understanding of publication trends and research focuses within this domain remains limited. This study aimed to elucidate the relationship between the gut microbiota and CKD through a bibliometric analysis.

Methods:
Literature published between 2001 and 2022 on gut microbiota and CKD was obtained from the Web of Science Core Collection database. Bibliometric analysis tools such as VOSviewer and CiteSpace were used to analyze research trends in this area.

Results:
We extracted 758 articles for further analysis. China ranked first with 240 published documents, followed by the USA with 211. However, the USA ranked first regarding citation frequency with 11,380 citations, while China ranked second. The University of California Irvine and Kidney International emerged as the leading institution and journal, respectively, with the former leading in document production and citations. Although Kidney International featured fewer documents than other journals, it exhibited the highest citation count. The keywords representing the research interests mainly included: (1) gut microbiota influences the development of CKD, (2) application of probiotics in the treatment of CKD, and (3) potential mechanism of gut microbiota in CKD.

Conclusion:
Our analysis indicates significant advancements in understanding the association between gut microbiota and CKD. It also provides a comprehensive overview of publication trends, research hotspots, and frontiers, which may provide guidelines for future research.
Trio Rounding: Perceptions of Acute Inpatient Rehabilitation Nurses and Physicians
Authors: Mannaye Tigist , Mowery Bernice , Friesen Mary Ann , Jones Emily 
Published: January 2024

Abstract

Purpose
The purpose of this study was to explore the process, benefits, and challenges of patient-centered Trio rounding in acute inpatient rehabilitation from the perspectives of nurses and physicians.

Design
A descriptive qualitative design was used in this study.

Methods
Focus group interviews (FGIs) involving 27 nurses and physicians were thematically analyzed using Dedoose. A descriptive survey of rounding practices was conducted.

Findings
Five primary themes were identified: (1) interprofessional team collaboration; (2) patient safety and quality of care; (3) communication, education, and patient/family partnering; (4) synchronicity of workflow; and (5) participants’ recommendation to develop rehabilitation Trio rounding standard process. Themes were consistent with Picker’s patient-centered care principles. Findings from a survey on current rounding practice done prior to the FGI reinforced participants’ discussion on challenges in conducting patient-centered Trio rounding.

Conclusions
Trio rounding in acute inpatient rehabilitation is a complex process challenged by asynchronous workflow and patients’ therapy schedules. Nurses and physicians reported benefits outweighed challenges for Trio rounding in acute rehabilitation.

Clinical Relevance
The study provided valuable recommendations to develop acute inpatient rehabilitation Trio rounding standard process.
Effect of a Nurse-Led Rehabilitation Program: A Quasi-Experimental Study Examining Functional Outcomes in Patients With Hand Burns
Authors: Sofar Samah Mahmoud , Wazqar Dhuha Youssef , Syam Narges Mohammed 
Published: January 2024

Abstract

Purpose
The model of early rehabilitation for people with burns is still relatively novel in developing countries such as Egypt. The study examined the effect of a nurse-led rehabilitation program on functional outcomes in patients with severe hand burns.

Design
A quasi-experimental design was used in this study.

Methods
The study was completed in the burn unit of a teaching university hospital in Alexandria, Egypt, with a convenience sample of 80 patients with severe hand burns. Participants were consecutively assigned to one of two groups: control (n = 40), which received only routine hospital care and clinical interventions, or intervention (n = 40), which received routine hospital care and clinical interventions and a 4-week nurse-led rehabilitation program (health education including audiovisual aids and burn rehabilitation education booklet, social support, and hand rehabilitation exercises). To assess functional outcomes, both groups were given pre- and posttests of the Disabilities of the Arm, Shoulder and Hand outcome and the Hand Motor Function Observational Checklist questionnaires. Descriptive and inferential statistics were conducted.

Results
Functional outcomes were significantly improved in the intervention participants compared to the control participants (t = 5.710, p < .001). The differences in index scores between the two groups were statistically significant (p < .001).

Clinical Relevance
The study provides information for burn rehabilitation nurses in developing countries to develop and test early interventions that improve functional outcomes in this population.

Conclusions
A 4-week nurse-led program can be a beneficial intervention for improving functional outcomes in adult patients with severe hand burns who are undergoing rehabilitation.