bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interobserver Variations in Target Delineation in Intensity-Modulated Radiation Therapy for Nasopharyngeal Carcinoma and its Impact on Target Dose Coverage
Authors: Liu Xu , Huang Huixian , Zhu Chaohua , Gan Qihuan , Jiang Hailan , Liu Pei , Qi Xin , Fan Fangfang , Xiao Jinru , Pang Qiang , Lu Zhiping , Lu Heming 
Published: April 2023

Background To investigate the differences between physicians in target delineation in intensity-modulated radiation therapy for nasopharyngeal carcinoma as well as their impact on target dose coverage. Methods Ninety-nine in-hospital patients were randomly selected for retrospective analysis, and the target volumes were delineated by 2 physicians. The target volumes were integrated with the original plans, and the differential parameters, including the Dice similarity coefficient (DSC), Hausdorff distance (HD), and Jaccard similarity coefficient (JSC) were recorded. The dose–volume parameters to evaluate target dose coverage were analyzed by superimposing the same original plan to the 2 sets of images on which the target volumes were contoured by the 2 physicians. The significance of differences in target volumes and dose coverage were evaluated using statistical analysis. Results The target dose coverage for different sets of target volumes showed statistically significant differences, while the similarity metrics to evaluate geometric target volume differences did not. More specifically, for PGTVnx, the median DSC, JSC, and HD were 0.85, 0.74, and 11.73, respectively; for PCTV1, the median values were 0.87, 0.77, and 11.78, respectively; for PCTV2, the median values were 0.90, 0.82, and 16.12, respectively. For patients in stages T3-4, DSC, and JSC were reduced but HD was increased compared to those in stages T1-2. Dosimetric analysis indicated that, for the target volumes, significant differences between the 2 physicians were found in D95, D99, and V100 for all the target volumes (ie, PGTVnx, PCTV1, and PCTV2) across the whole group of patients, as well as in patients with disease stages T3-4 and T1-2. Conclusions The target volumes delineated by the 2 physicians had a high similarity, but the maximal distances between the outer contours of the 2 sets were significantly different. In patients with advanced T stages, significant differences in dose distributions were found, stemming from the deviations of target delineation.
Effects of Neurofeedback on Cognitive Function, Productive Activity, and Quality of Life in Patients With Traumatic Brain Injury: A Randomized Controlled Trial
Authors: Chen Pin-Yuan , Su I-Chang , Shih Chun-Ying , Liu Yen-Chun , Su Yu-Kai , Wei Li , Luh Hui-Tzung , Huang Hui-Chuan , Tsai Pei-Shan , Fan Yen-Chun , Chiu Hsiao-Yean 
Published: April 2023

Background Cognitive impairment is common in patients with traumatic brain injury (TBI). Studies that have examined the effectiveness of neurofeedback (NFB) on cognitive function following TBI have had poor study designs and small sample sizes. Objectives This randomized controlled trial assessed the effects of low-resolution tomography Z-score NFB (LZNFB) and theta/beta NFB on cognitive impairment, return to productive activity, and quality of life in patients with TBI. Methods We randomly assigned 87 patients with TBI with cognitive impairment to LZNFB, theta/beta NFB, or usual care (UC) groups. Patients in both NFB groups received weekly 60-minute treatment for 10 weeks, and those in the control group received UC and telephone interviews for 10 weeks. The primary outcome was cognitive function as measured by performance on cognitive tasks; the secondary outcomes included productive activity and quality of life based on the Community Integration Questionnaire-revised (CIQ-R) and the Quality of Life after Brain Injury (QOLIBRI), respectively, at baseline and immediately after the last intervention. Results The LZNFB group exhibited significantly greater improvements in immediate recall, delayed recall, recognition memory, and selective attention compared with the UC group; the theta/beta NFB group exhibited improvements in only immediate memory and selective attention ( P < .05). The total CIQ-R scores of the LZNFB group after treatment were significantly improved than those of the UC group were. Conclusion Consecutive LZNFB achieved therapeutic effects in memory, attention, and productive activity, whereas theta/beta NFB improved memory and attention in patients with TBI. This trial was prospectively registered at ClinicalTrial.gov (registration number: NCT03515317; https://clinicaltrials.gov/ct2/show/NCT03515317 ).
Area Deprivation Index Is Not Associated With the Severity of Carpal Tunnel Syndrome
Authors: Aloi Nicholas F. , Rahman Haris , Fowler John R. 
Published: April 2023

Background: While living in a socially disadvantaged neighborhood is linked with numerous health outcomes, its effect on patient-reported outcome scores and diagnostic measures in carpal tunnel syndrome (CTS) is not fully understood. This study examines the effect of neighborhood socioeconomic deprivation on CTS severity as measured by the Boston Carpal Tunnel Questionnaire (BCTQ), 6-item Carpal Tunnel Symptoms Scale (CTS-6), and diagnostic testing modalities. Methods: This was a retrospective analysis of patients who presented to the hand clinic at a single hospital system with symptoms consistent with CTS. Ultrasound cross-sectional area (CSA) of the median nerve, CTS-6, Symptom Severity Scale (SSS) and Functional Status Scale (FSS) of the BCTQ, and the Area Deprivation Index (ADI) national rank percentile were collected. Patients were grouped into 4 quartiles based on their ADI national percentile. Analyses of variance (ANOVAs) were conducted to test for statistical differences between the 4 quartiles based on the average values of median nerve CSA, CTS-6, SSS, and FSS score. The bottom quartile was compared with the upper 75% of the sample (26th-100th percentile) and to the upper quartile via Student t test. Statistical significance was set at P < .05. Results: Analyses of variance revealed no statistically significant differences between the 4 quartiles for either median nerve CSA, CTS-6, SSS, or FSS. When comparing the bottom quartile with the upper 75% of the sample and the upper quartile, no significant statistical differences were identified. Conclusions: No relationships were found between social deprivation (ADI) and patient-reported outcomes, CTS-6 scores, or median nerve CSA.
Erdosteine effects cell barriers causing decreased inflammation and increased pulmonary function in asthmatic mice exposed to nanoparticulate pollution
Authors: An Min-Hyeok , Lee Pureun-Haneul , Choi Seon-Muk , Hwang DaYeon , Park Shinhee , Baek Ae-Rin , Jang An-Soo 
Published: April 2023

Objectives: Erdosteine, an oral mucoactive anti-oxidant molecule, interferes with the pathological processes seen in respiratory disorders including thickened or increased mucus production, increased oxidative stress, and chronic inflammation; however, its efficacy as an asthma therapy remains to be fully clarified. Therefore, the aim of this study was to assess the effects of erdosteine on epithelial barrier function in asthma. Methods: To investigate the effects of erdosteine on cell barrier expression in a mouse model of asthma, BALB/c mice ( n = 8 per group; total of 40 mice) were exposed to saline (Sham), ovalbumin (OVA), or OVA plus TiO2 inhalation (200 μg/m3; OVA + TiO2). The mice were then treated with erdosteine orally (OVA + TiO2 + Erdos) or intraperitoneal dexamethasone (OVA + TiO2 + Dex). Bronchoalveolar lavage and histology were performed. Enhanced pause was used as an indicator of pulmonary function, and samples were collected. The effect of erdosteine on cell barrier expression was assessed by immunoblotting and immunohistochemical analyses. Results: OVA + TiO2 + erdosteine mice exhibited decreased inflammation, and mucous gland hyperplasia, and increased pulmonary function compared with OVA + TiO2 mice. Levels of claudin (CLDN)-4 and nectin-4 protein were higher in lung tissue from OVA + TiO2 mice than Sham and OVA mice, and were reduced by erdosteine treatment. In contrast, CLDN14 and CLDN18 protein levels were lower in lung tissue from OVA + TiO2 mice than those from control mice, but were increased by treatment with erdosteine. Conclusion: Cell barriers are involved in airway inflammation in asthma patients, and erdosteine reduces airway inflammation by changing the cell barrier.
A perioperative overview of a retained surgical swab in spinal surgery: Case report and prevention protocol
Authors: Haleem Shahnawaz , Mahmoud Mohamed Hassan , Kainth Gurvinder Singh , Botchu Rajesh , Hassan Md Faizul , Rehousek Petr 
Published: April 2023

Introduction: Retained wound swabs although classified as a ‘never event’ and well documented in many surgical specialties are uncommon in spinal surgery. The aim of this article is to highlight the perioperative circumstances of an incident of a retained surgical swab and present a prevention protocol, in an attempt to eliminate its incidence. Case Report: The perioperative management of a 53-year-old male undergoing spinal surgery in whom a surgical swab was retained is reported. In addition to existing safety procedures such as the World Health Organization checklist, a Retained Surgical Swab-Prevention Protocol was implemented in our hospital and is presented to eliminate the occurrence of this ‘never event’ occurring again. Conclusion: Retained surgical swabs or instruments are rare in spinal surgery occurring mostly in the lumbar spine, during emergency and prolonged procedures in patients with high body mass index. Maintaining a high index of suspicion and utilising a prevention protocol will prevent further harm to the patient.
biomArker-guided Duration of Antibiotic treatment in hospitalised Patients with suspecTed Sepsis (ADAPT-Sepsis): A protocol for a multicentre randomised controlled trial
Authors: Dark Paul , Perkins Gavin D , McMullan Ronan , McAuley Danny , Gordon Anthony C , Clayton Jonathan , Mistry Dipesh , Young Keith , Regan Scott , McGowan Nicola , Stevenson Matt , Gates Simon , Carlson Gordon L , Walsh Tim , Lone Nazir I , Mouncey Paul R , Singer Mervyn , Wilson Peter , Felton Tim , Marshall Kay , Hossain Anower M. , Lall Ranjit 
Published: April 2023

Aim: To describe the protocol for a multi-centre randomised controlled trial to determine whether treatment protocols monitoring daily CRP (C-reactive protein) or PCT (procalcitonin) safely allow a reduction in duration of antibiotic therapy in hospitalised adult patients with sepsis. Design: Multicentre three-arm randomised controlled trial. Setting: UK NHS hospitals. Target population: Hospitalised critically ill adults who have been commenced on intravenous antibiotics for sepsis. Health technology: Three protocols for guiding antibiotic discontinuation will be compared: (a) standard care; (b) standard care + daily CRP monitoring; (c) standard care + daily PCT monitoring. Standard care will be based on routine sepsis management and antibiotic stewardship. Measurement of outcomes and costs. Outcomes will be assessed to 28 days. The primary outcomes are total duration of antibiotics and safety outcome of all-cause mortality. Secondary outcomes include: escalation of care/re-admission; infection re-lapse/recurrence; antibiotic dose; length and level of critical care stay and length of hospital stay. Ninety-day all-cause mortality rates will also be collected. An assessment of cost effectiveness will be performed. Conclusion: In the setting of routine NHS care, if this trial finds that a treatment protocol based on monitoring CRP or PCT safely allows a reduction in duration of antibiotic therapy, and is cost effective, then this has the potential to change clinical practice for critically ill patients with sepsis. Moreover, if a biomarker-guided protocol is not found to be effective, then it will be important to avoid its use in sepsis and prevent ineffective technology becoming widely adopted in clinical practice.
Evaluation of Multisensory Interactions Between the Healing Built Environment and Nurses in Healthcare Nursing Stations: Case Study of Tehran Hospitals
Authors: Eftekhari Maryam , Ghomeishi Mohammad 
Published: April 2023

Background: Nursing stations are important features of medical centers that are constantly in use. As nursing is an inherently stressful occupation, nursing stations should be designed to minimize stress on those who must spend time there. Aim: This study evaluated the effect of environmental design factors on mitigating the stress levels on nurses in nursing stations by determining the environmental factors that most influence the perceptual senses that affect physical and psychological comfort. Methods: A quantitative approach was used to evaluate the parameters that affect the sensory perceptions of nurses in nursing stations at four hospitals in Tehran. A survey was conducted to identify environmental design parameters that affect the visual, auditory, tactile, kinesthetic, and olfactory senses. Results: The results revealed that the olfactory category scored highest, followed by the auditory, visual and tactile categories, which had similar scores, and kinesthetic was ranked last. Conclusion: A connection was revealed between the educational level of the nurses and environmental factors affecting their sensory perception in terms of materials, aesthetics and the appropriate number of windows as a visual sense, and ergonomics as a kinesthetic sense. Significantly, the gender variable differed in the Furniture variable based on comfort of seating with respect structure. Based on the results of this study, a combination of olfactory, visual, and auditory factors should be required at the nursing stations to decrease the stress level of nurses.
FGF Ligands and Receptors in Osteochondral Tissues of the Temporomandibular Joint in Young and Aging Mice
Authors: Dutra Eliane H. , Chen Po-Jung , Kalajzic Zana , Wadhwa Sunil , Hurley Marja , Yadav Sumit 
Published: April 2023

Objective Fibroblast growth factors (FGFs) are a family of 22 proteins and 4 FGF receptors (FGFRs) that are crucial elements for normal development. The contribution of different FGFs and FGFRs for the homeostasis or disease of the cartilage from the mandibular condyle is unknown. Therefore, our goal was to characterize age-related alterations in the protein expression of FGF ligands and FGFRs in the mandibular condyle of mice. Method Mandibular condyles of 1-, 6-, 12-, 18-, and 24-month-old C57BL/6J male mice (5 per group) were collected and histologically sectioned. Immunofluorescence for FGFs that have been reported to be relevant for chondrogenesis (FGF2, FGF8, FGF9, FGF18) as well as the activated/phosphorylated FGFRs (pFGFR1, pFGFR3) was carried out. Results FGF2 and FGF8 were strongly expressed in the cartilage and subchondral bone of 1-month-old mice, but the expression shifted mainly to the subchondral bone as mice aged. FGF18 and pFGFR3 expression was limited to the cartilage of 1-month-old mice only. Meanwhile, pFGFR1 and FGF9 were mostly limited to the cartilage with a significant increase in expression as mice aged. Conclusions Our results indicate FGF2 and FGF8 are important growth factors for mandibular condylar cartilage growth in young mice but with limited role in the cartilage of older mice. In addition, the increased expression of pFGFR1 and FGF9 and the decreased expression of pFGFR3 and FGF18 as mice aged suggest the association of these factors with aging and osteoarthritis of the cartilage of the mandibular condyle.
Exploring the lived experiences of debilitating period pain management in the UK
Authors: Vafapour Parmis , Murray Esther 
Published: April 2023

Background Five to ten percent of women experience period pains that disrupt their lives yet 4 in 5 women believe that their claims for their dysmenorrhea are not taken seriously. Within the process of seeking support and understanding about their pain, they face various barriers that prevent them from finding the answers they deserve. Methods Semi-structured interviews were conducted with 8 women aged 20–28 to discuss their experiences with dysmenorrhea throughout their time since menarche. Results Using Scheper-Hughes and Lock understanding of the mindful body, this research explores women’s experiences of dysmenorrhea through their physical body (relationship with the body and needing control), the social body (cultural concepts and comparisons to others) and the body politic (medicalisation, the medical team and the transvaginal ultrasound). Conclusions The impact of these aspects of their mindful bodies developed arguments showing how different actors had an impact on preventing them obtaining the patient-centred care they required without resistance. More must be done to honour the experience of pain women have regarding their periods, especially by healthcare professionals. There must be consistency in the way women are approached for their dysmenorrhea to prevent discrepancies of support. This must be done with clearer guidance on what is offered to women with dysmenorrhea, especially in the primary care setting.
Association of multimorbidity with the use of health information technology
Authors: Manning Sydney E , Wang Hao , Dwibedi Nilanjana , Shen Chan , Wiener R Constance , Findley Patricia A , Mitra Sophie , Sambamoorthi Usha 
Published: April 2023

Objective To examine the association of multimorbidity with health information technology use among adults in the USA. Methods We used cross-sectional study design and data from the Health Information National Trends Survey 5 Cycle 4. Health information technology use was measured with ten variables comprising access, recent use, and healthcare management. Unadjusted and adjusted logistic and multinomial logistic regressions were used to model the associations of multimorbidity with health information technology use. Results Among adults with multimorbidity, health information technology use for specific purposes ranged from 37.8% for helping make medical decisions to 51.7% for communicating with healthcare providers. In multivariable regressions, individuals with multimorbidity were more likely to report general use of health information technology (adjusted odds ratios  =  1.48, 95% confidence intervals  =  1.01–2.15) and more likely to use health information technology to check test results (adjusted odds ratios  =  1.85, 95% confidence intervals  =  1.33–2.58) compared to adults with only one chronic condition, however, there were no significant differences in other forms of health information technology use. We also observed interactive associations of multimorbidity and age on various components of health information technology use. Compared to younger adults with multimorbidity, older adults (≥ 65 years of age) with multimorbidity were less likely to use almost all aspects of health information technology. Conclusion Health information technology use disparities by age and multimorbidity were observed. Education and interventions are needed to promote health information technology use among older adults in general and specifically among older adults with multimorbidity.
Following New Philanthropy by Network Ethnography: How Did the Varkey Foundation Land and Expand in Latin America?
Authors: Matovich Iván , Esper Tomás 
Published: April 2023

Purpose New philanthropy develops new forms of policy “problem-solving” through the influx of private actors’ money and ideas. It adopts singular configurations across different policy spaces, with implications for education governance. We address this phenomenon by analyzing the Varkey Foundation's (VF) “landing” and “expansion” in Latin America. VF is a global philanthropic organization registered in the United Kingdom in 2011 with a main hub in Argentina, where it landed in 2017. Design/Approach/Methods We use network ethnography to examine the influence of new philanthropy on education governance as this phenomenon demands new methods to grasp the “realities” of governing beyond conventional ways and understanding policy mobilities. Findings Results indicate how VF “landed” in a little pro-market space via productive uses of policy networks. The second phase of data collection and analysis presents further consolidation of VF in Argentina, its expansion into Latin America, and its establishment as a legitimate education policy actor. Originality/Value This study provides new evidence and insights into how policy networks enable new philanthropy to land and consolidate within national boundaries and, later, across the region as a legitimate actor in education.
Rapid Inter-maxillary Fixation Using a Single Wire: A Technical Note
Authors: Mishra Madan , Singh Gaurav , Mathur Vartika 
Published: April 2023

Study Design Technical note Objective To introduce a new technique for the purpose inter-maxillary fixation (IMF) that is simple, quick, and minimally invasive. Method -IMF with wire has been used for treating fractures pertaining to the maxillomandibular complex for both closed reduction and as an adjunct to open reduction. Here we present a new type of technique using 24 gauge stainless steel wires providing stabilization from lingual side which gives 3-dimensional stability. Result This technique is rapid and simple for IMF. Conclusion This technique can be effectively used in cases of simple facial fracture, orthognathic surgery, tumor resection, or where prolonged post-operative IMF is not required.
Aminoglycoside Pharmacokinetics in Patients with AIDS
Authors: Katz Roya B. , Lawson Lisa A. , Johnson Nelda E. , Schechter Leslie N. 
Published: April 2023

Objective To determine the pharmacokinetic parameters of aminoglycosides in patients with AIDS and to compare these parameters with those of a control group of patients not infected with HIV. Design Retrospective, chart-review study. Patients Nineteen AIDS patients and 19 non-HIV-infected patients (control) were identified through a review of pharmacokinetic monitoring cards. Methods Patients’ charts were reviewed for demographic data, aminoglycoside (gentamicin, tobramycin, and amikacin) dosing schedule, and steady-state peak and trough concentrations. Pharmacokinetic parameters were calculated using a one-compartment open model. Results Significant differences were found in the elimination rate constant (Ke) between the two groups (mean ± SD, 0.20 ± 0.084/h in the AIDS group and 0.26 ± 0.095/h in the control group). Half-life was significantly longer in the AIDS group versus controls (4.3 ± 2.5 and 2.99 ± 1.15/h, respectively). The volume of distribution (Vd), expressed in terms of liters and liters per kilogram total body weight (TBW), was significantly larger in the AIDS group than in the control group (28.3 ± 14 L [0.43 ± 0.21 L/kg TBW] and 19.2 ± 4.95 L [0.28 ± 0.07 L/kg TBW], respectively). Clearance in terms of liters per hour and Vd in terms of L/kg ideal body weight were not significantly different between the two groups. Albumin was similar in both groups (34 ± 7 g/L, control group; 28 ± 7 g/L, AIDS group). Conclusions Aminoglycoside pharmacokinetics were found to be altered in the patients with AIDS. When calculating an initial dose of an aminoglycoside in AIDS patients, use of estimated normal population parameters may result in lower peaks in these individuals. Pharmacokinetic parameters may need to be adjusted in AIDS patients because of their large Vd and slower Ke.