bluuebunny/crossref_metadata_2025_split huggingface dataset:
Culturally safe interventions in primary care for the management of chronic diseases of urban Indigenous People: a scoping review
Authors: Poitras Marie-Eve , T Vaillancourt Vanessa , Canapé Amanda , Boudreault Amélie , Bacon Kate , Hatcher Sharon 
Published: May 2022

ObjectivesChronic conditions represent an important source of major health issues among Indigenous People. The same applies to those, who live off-reserve and in urban areas. However, very few healthcare services are considered culturally safe, resulting in some avoidance of the public healthcare system. Our goal was to review the literature on culturally safe practices available to urban Indigenous People who suffer from chronic diseases.DesignWe conducted a scoping review to determine what culturally safe healthcare services are currently offered for the management of chronic conditions in urban Indigenous populations, to contribute to a tailored, holistic and safe space in mainstream healthcare systems.Eligibility criteriaPeer-reviewed original research articles had to be published by 27 October 2020, in English or French.Information source: In October 2020, we searched five academic databases (EBSCO, PsycArticles, SocINDEX, MEDLINE and PsycINFO) and also reviewed grey literature and the websites of organisations or governments. The data were extracted and collected in an EXCEL spreadsheet. Two reviewers independently screened 326 titles and abstracts, followed by an independent evaluation of 48 full text articles. A total of 19 studies were included in this scoping review, as well as 5 websites/documents from the grey literature.ResultsIn total, 19 studies were included in our analysis. We found that Elders, family and the assistance of an interpreter are crucial elements to include to make urban Indigenous feel safe when they seek healthcare services. With this scoping review, we report interventions that are successful in terms of healthcare delivery for this population. Our findings provide insight on what services should be in place in mainstream healthcare settings to create a culturally safe experience for urban Indigenous People.ConclusionsIn recent years, there appears to be a growing awareness of the need to provide culturally safe health services. This scoping review identified multiple strategies to promote cultural safety in this context, as well as barriers and facilitators to their implementation. These elements, which have been extensively documented in the literature, should be included in the chronic diseases management interventions to be developed by urban and primary care settings.
Diagnostic and prognostic role of the electrocardiogram in patients with pericarditis
Authors: Imazio Massimo , Squarotti Gabriele Barberi , Andreis Alessandro , Agosti Alessandra , Millesimo Michele , Frea Simone , Giustetto Carla , Deferrari Gaetano Maria 
Published: May 2022

ObjectiveThe ECG has been traditionally used to support the diagnosis of pericarditis. However, the pericardium is electrically silent and ECG changes may imply concurrent myocardial involvement rather than simple pericarditis. The aim of the present paper is to analyse the frequency, type and clinical implication of ECG changes in patients with pericarditis compared with those with myocarditis.MethodsConsecutive patients with pericarditis and/or myocarditis were included in a prospective cohort study from January 2017 to December 2020. A clinical and echocardiographic follow-up was performed at 1, 3, 6 months and then every 6 months. Cardiac magnetic resonance was used to diagnose concurrent myocarditis.Results166 patients (median age 47 years, 95% CI 44 to 51) with 66 men (39.8%) were included: 110 cases with pericarditis (mean age 47.7 years, 29.1% male) and 56 cases with myocarditis (mean age 44.8, 60.7% male). ECG changes were reported in 61 of 166 (36.7%) patients: 27 of 110 (24.5%) among those with pericarditis and 34 of 56 (60.7%) among those with myocarditis (p<0.0001). In multivariate logistic regression analysis, ECG changes were associated with troponin elevation (risk ratio 1.97; 95% CI 1.13 to 3.43), suggesting myocardial involvement. ECG changes were not associated with increased risk of adverse events.ConclusionsECG changes, mainly widespread ST-segment elevation, can be recorded in about one-quarter of patients with pericarditis, and were not associated with a worse prognosis. These changes may reflect concurrent myocarditis that should be ruled out.
Effects of traditional mind–body movement therapy on chronic cardiopulmonary dyspnoea: a systematic review and meta-analysis
Authors: Zhang Tiange , Zhou Rui , Wang Ting , Xin Yijun , Liu Xiaohong , Huang Huiting 
Published: May 2022

PurposeTo evaluate whether traditional mind–body movement therapy (TMBM) can be used as a complementary or alternative therapy for exercise-based cardiopulmonary rehabilitation (EBCR) on chronic cardiopulmonary dyspnoea.MethodsPubMed, Embase, Scopus, Web of Science and China National Knowledge Infrastructure were searched from their inception to 2 July 2021. Randomised clinical trials evaluating the effectiveness of TMBM versus EBCR, and TMBM +EBCR versus TMBM in the treatment of chronic cardiopulmonary dyspnoea were selected. The outcomes were exercise capacity (6 min walk distance, 6MWD) and quality of life (QoL).ResultsThirty-four randomised clinical trials with 2456 patients were included. For TMBM vs EBCR alone, statistically significant improvements in the 6MWD favoured the TMBM for chronic obstructive pulmonary disease (COPD) (mean difference(MD)=12.22 m; 95% CI 5.94 to 18.50; I2=56%) and heart failure (HF) patients (MD=43.65 m; 95% CI 7.91 to 79.38; I2=0%). Statistically significant improvements in QoL also favoured TMBM over EBCR for patients with HF(MD=−9.19; 95% CI −11.05 to −7.32; I2=0%) but non-significant trend for COPD (standardised mean difference (SMD)=−0.31; 95% CI −0.62 to 0.01; I2=78%). Comparisons of TMBM +EBCR versus EBCR alone revealed significant improvements in the QoL for COPD (SMD=−0.52; 95% CI −0.94 to −0.10; I2=86%) and patients with HF (MD=−2.82; 95% CI −4.99 to −0.64; I2=0%). The 6MWD results favoured the TMBM +EBCR for patients with COPD (MD=16.76 m; 95% CI 10.24 to 23.29; I2=0%), but only showed a slight trend towards additional benefits of TMBM +EBCR in the HF studies (MD=13.77 m; 95% CI −1.01 to 28.54; I2=65%) .ConclusionsTMBM has positive effects on patients’ 6MWD and QoL, with similar or even better effects than EBCR. It may be beneficial to use TMBM as a supplementary or alternative strategy for EBCR in treatment plans.PROSPERO registration numberCRD42021241181.
Variability in opioid pain medication prescribing for adolescent trauma patients in a sample of US pediatric trauma centers
Authors: Mello Michael J , Baird Janette , Bromberg Julie R , Spirito Anthony , Zonfrillo Mark R , Lee Lois K , Christison-Lagay Emily R , Ruest Stephanie M , Pruitt Charles W , Lawson Karla A , Kiragu Andrew W , Nasr Isam , Aidlen Jeremy T , Ebel Beth E , Maxson R Todd , Scott Kelli , Becker Sara J 
Published: May 2022

ObjectivesThe primary objective of this study was to examine opioid prescription frequency and identify differences across a national cohort of pediatric trauma centers in rates of prescribing opioids to injured adolescents at discharge.MethodsThis was a retrospective observational study using electronic health records of injured adolescents (12–17 years) admitted to one of 10 pediatric trauma centers.ResultsOf the 1345 electronic health records abstracted, 720 (53.5%, 95% CI 50.8 to 56.2) patients received opioid prescriptions at discharge with variability across sites (28.6%–72%). There was no association between patient factors and frequency of prescribing opioids. Center’s trauma volume was significantly positively correlated with a higher rate of opioid prescribing at discharge (r=0.92, p=0.001). There was no significant difference between the frequency of opioid prescriptions at discharge among alcohol and other drugs (AOD)-positive patients (53.8%) compared with AOD-negative patients (53.5%).ConclusionsAcross a sample of 10 pediatric trauma centers, just over half of adolescent trauma patients received an opioid prescription at discharge. Prescribing rates were similar for adolescent patients screening positive for AOD use and those screening negative. The only factor associated with a higher frequency of prescribing was trauma center volume. Consensus and dissemination of outpatient pain management best practices for adolescent trauma patients is warranted.Level of evidenceIII—prognostic.Trial registration numberNCT03297060.
5-Year Survivorship and Outcomes of Robotic-Arm-Assisted Medial Unicompartmental Knee Arthroplasty
Authors: Gaudiani Michael A. , Samuel Linsen T. , Diana John N. , DeBattista Jennifer L. , Coon Thomas M. , Moore Ryan E. , Kamath Atul F. 
Published: May 2022

Purpose. While unicompartmental knee arthroplasty (UKA) has demonstrated benefits over total knee arthroplasty (TKA) in selected populations, component placement continues to be challenging with conventional surgical instruments, resulting in higher early failure rates. Robotic-arm-assisted UKA (RA-UKA) has shown to be successful in component positioning through preop planning and intraop adjustability. The purpose of this study is to assess the 5-year clinical outcomes of medial RA-UKA. Methods. This study was a retrospective review of a single-center prospectively maintained cohort of 133 patients (146 knees) indicated for medial UKA from 2009 to 2013. Perioperative data and 2- and 5-year Knee injury Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Score (WOMAC), and Forgotten Joint Score (FJS) outcome measures were collected. Five-year follow-up was recorded in 119 patients (131 knees). Results. Mean follow-up was

5.1
±
0.2

years. Mean age and BMI were

68.0
±
8.1

years and

29.3
±
4.7

kg/m2, respectively. At 2-year follow-up, mean KOOS, WOMAC, and FJS were

71.5
±
15.3

,

14.3
±
7.9

, and

79.1
±
25.8

, respectively. At 5-year follow-up, mean KOOS, WOMAC, and FJS were

71.6
±
15.2

,

14.2
±
7.9

, and

80.9
±
25.1

, respectively. Mean change in KOOS and WOMAC was

34.6
±
21.4

and

11.0
±
13.6

, respectively (

p
<
0.001

and

p
<
0.001

). For patient satisfaction at last follow-up, 89% of patients were very satisfied/satisfied and 5% were dissatisfied. For patient activity expectations at last follow-up, 85% met activity expectations, 52% were more active than before, 25% have the same level of activity, 23% were less active than before, and 89% were walking without support. All patients returned to driving after surgery at a mean

15.2
±
9.4

days. Survivorship was 95% (95% CI 0.91-0.98) at 5 years. One knee (1%) had a patellofemoral revision, two knees (1.3%) were revised to different partial knee replacements, and five knees (3.4%) were converted to TKA. Conclusion. Overall, medial RA-UKA demonstrated improved patient-recorded outcomes, high patient satisfaction, met expectations, and excellent functional recovery. Midterm survivorship was excellent. Longitudinal follow-up is needed to evaluate long-term outcomes of robotic-arm-assisted UKA procedures.
Effect of Age Alone on Outcome of Acute Surgical Conditions Among Healthy Patients (Non-smokers, Non-obese, and No Comorbid Conditions)
Authors: Sebekos Konstantinos , Guiab Keren , Stamelos George , Evans Teresa , Siddiqi Mahwash , Brigode William , Capron Gweniviere , Kaminsky Matthew , Bokhari Faran 
Published: May 2022

Background The impact of age alone in relation to postoperative outcomes needs to be further elucidated. This study investigated whether increasing age was associated with increased morbidity and mortality for patients with no comorbidities undergoing acute care surgery (ACS). Methods The 2016-2018 National Surgical Quality Improvement Project database was used to identify adult patients who underwent ACS performed on an urgent/emergent basis. Patients overweight or with pre-existing medical comorbidities were excluded. Patients were divided into age groups in decades. The association between outcomes and the different age groups, other patient characteristics, and perioperative factors was examined by multivariate logistic regression. Results 22,770 patients were identified, of which 73.5% were appendectomies, and 21.6% were open procedures. Increasing age correlated with higher unadjusted complication rates and mortality. Multivariate analyses revealed that compared to patients ≤ 30 years old, mortality was not different for patients 31-60 years old, but it was higher for the age groups > 61 years old. Patients aged 51-60 and from 71 and above were associated with higher risks of complications. Subset analysis on octogenarians revealed a 1.14-fold higher odds of mortality for every year of increasing age. Preoperative risk factors including open procedure, wound class, and American Society of Anesthesiology (ASA) class were also associated with greater risks of mortality in octogenarians. Conclusion Patients older than age 50 were at higher risk for postoperative complications, and mortality significantly increased for each decade past 60 years old in healthy individuals.
Socioeconomic Differences in North Carolina College Students’ Pathways Into STEM
Authors: Bottia Martha Cecilia , Jamil Cayce , Stearns Elizabeth , Mickelson Roslyn Arlin 
Published: May 2022

Background/Context: The underrepresentation of students from lower socioeconomic status (LSES) backgrounds among college graduates with science, technology, engineering, and mathematics (STEM) degrees, and consequently in STEM occupations, is a concern with respect to reducing, perpetuating, or increasing social inequality. The loss of their talent and creativity also poses a threat to the future of the U.S. economy, scientific knowledge generation, and national security. This study uses two theoretical frameworks—bounded rationality and effectively maintained inequality (EMI)—to identify the pathways toward STEM for students from lower and higher SES backgrounds, given the well-documented differences in their family resources and opportunities to learn, amount of cultural capital, and risk aversions. Purpose: The study identifies factors related to LSES students’ odds of declaring and graduating with a STEM degree and tests whether those factors work in similar ways for students from higher socioeconomic groups. The study contributes to understanding the roots of the underrepresentation of LSES students in STEM majors and occupations. Research Design: We use a mixed-method sequential explanatory design that draws from two complementary sources of data, one quantitative and one qualitative. Using multilevel logit models, the quantitative data set explores how SES influences students’ choices regarding whether to pursue a STEM degree. The qualitative data set further explores the relationships found in the quantitative data specifically for the case of LSES students through analysis of in-depth interviews. Findings: Quantitative analysis finds that LSES students’ socioeconomic background is related to their reduced opportunities to learn and reduced information resources, lessening their adequate academic preparation for success in STEM majors. Qualitative data indicate that risk avoidance—specifically, perceptions of risk and ideas of future income stability—play an important role in LSES students’ decisions to major in STEM. In addition, LSES students possess insufficient data to make informed decisions while in high school regarding course selection that would better enable their pathways into STEM, and to navigate into college success. Conclusions: To foster equity in access to postsecondary educational resources, it is crucial to offer all students access to high-quality academic opportunities before enrolling in college. Furthermore, high schools must ensure that students have access to explicit information about college and what various majors entail. We advocate that all students should have information on all options available so they can make well-informed decisions that match their abilities and preferences. Students’ access to and preferences for certain majors should not be conditioned on their socioeconomic background.
A novel deletion mutation accompanied by a point mutation in Lamin A/C gene: Screened from a dilated cardiomyopathy family
Authors: Jia Hao , Sun Yongxin , Yao Wangchao , Chen Zhenhang , Yang Shouguo , Wang Chunsheng , Lu Shuyang 
Published: May 2022

Background: There are 30%–40% of patients with dilated cardiomyopathy (DCM) having genetic causes, among which Lamin A and C gene (LMNA) mutation is the second most frequent DCM-related mutation, and Lamin A/C may be involved in the pathogenesis of DCM through the regulation of gene transcription or the direct effect of cell structure. Methods: Echocardiography and electrocardiogram were used to diagnose DCM and arrhythmia in a DCM family. Then, linked mutations on LMNA were screened out by high-throughput sequencing and verified by Sanger sequencing in all research individuals. Meanwhile, Human Genome Variation Society (HGVS) and Integrative Genomics Viewer (IGV) were used to analyse the characteristics of the mutated Lamin A/C protein. Finally, mutated-type and wild-type LMNA plasmid was transfected into AC-16 cardiomyocytes with the form of a lentivirus vector, and its effect on nucleus and actin was studied by immunofluorescence detection. Results In this study, we found a new frame-shifted mutation of LMNA (p.Ser414Alafs*66) linked with another point mutation from a DCM family by using High-throughput sequencing, and this deletion mutation led to a truncation of Lamin A/C. By analysing the clinical characteristics of this DCM family, we found that all DCM patients with arrhythmia were carriers of this co-segregation mutation. In the cytological experiment, we found that the mutated-type transfections showed weaker fluorescent intensities on both actin and cell nucleus. Conclusions: A co-segregation mutation of LMNA (Point mutation chr1 156107548 c.1712 G>A and truncated frame-shifted mutation chr1 156106086 c.1240delA) was found from a DCM family, and this type of mutation could participate in the pathogenesis of DCM by affecting the expression of actin.
Evaluation of the effects of three designs of oxygenators with integrated filters on clinical and haematological outcomes at an Australasian cardiothoracic unit
Authors: Prakash Minesh , Sharma Varun , Oh Timothy , Lo Casey , Parkinson Grant , McCormack David , Conaglen Paul , Lin Zaw , Kejriwal Nand , Meikle Felicity , Peplow Emma , Bhana Jack , El Gamel Adam 
Published: May 2022

Introduction: Cardiopulmonary bypass (CPB) machines have oxygenators with integrated filters and unique biocompatible coatings to combat systemic inflammatory response syndrome (SIRS) and mitigate coagulopathy. Contemporary oxygenators have undergone comparative studies; however, our study aimed to identify the most appropriate oxygenator for our regional Cardiothoracic unit in Australasia. Methods: A prospective audit consecutively recruited one-hundred and fifty patients undergoing cardiac surgery at Waikato Hospital, New Zealand between the periods of 29th January 2018 and 31st July 2018. Fifty patients were recruited for each oxygenator arm: Sorin INSPIRE’ (Group-S); Terumo CAPIOX’FX (Group-T); and Medtronic Affinity Fusion’ (Group-M). The clinical outcomes were transfusions, chest drain output, reoperation and length of hospital stay (LOHS). Routine blood testing protocol included: haemoglobin, protein, albumin, white cell count (WCC), C-reactive protein (CRP), platelet count and coagulations tests including international normalized ratio (INR). Results: Comparing Groups S, T and M there was no statistical difference in chest drain output (650 vs. 500 vs. 595 ml respectively, p = 0.45), transfusions (61 vs. 117 vs. 70 units, p = 0.67), reoperation (6 vs. 8 vs. 12%, p = 0.99) and LOHS (median 7.4 vs. 7.6 vs. 9.5 days, p = 0.42). Group-T had fewer SIRS cases but similar increase in CRP ( p = 0.12) and WCC ( p = 0.35). Group-M had a significant rise in post-op INR ( p = 0.005) but no associated increase in chest drain output ( p = 0.62). Group-S and -M required more 4%-albumin and Group-T had more transfusions. Only fresh frozen plasma (FFP) and red blood cell (RBC) transfusion had a significant relationship with LOHS ( p < 0.05). Conclusion: Biochemically, there was slight difference among the oxygenators which did not translate into clinical difference in outcomes. The oxygenator design and perfusionist choice aided in our decision-making process.
Innovative rehabilitating meal service programs for old people living at home: A randomized controlled pilot study
Authors: Due Anette , Beck Anne Marie , Birk Camilla Banke , Justesen Lise , Majgaard Maj , Lei Mette , Langsted S Sara Koldkær , Jensen Tilde Skjærlund 
Published: May 2022

Objective To test the feasibility of a pilot study for a future definitive trial investigating the effect of different meal service programs for old people living at home. Design An 8-week randomized controlled trial was performed. Setting Three municipalities in the Nordic country, Denmark. Subjects Danish participants (≥65y) with reduced functionality. Intervention Three different meal service programs 1) 24-h meals service, 2) Protein-rich meal service, and 3) Rehabilitation meal service, were developed and compared to standard care. Main Measures The main outcome was study feasibility. Dietary intake, anthropometry, physical function, quality of life, readmissions and adverse events were also evaluated. Comparisons between participants receiving a meal service program and standard care were done by one-way ANOVA, chi-square test and Fishers exact test Results A total of 592 subjects were assessed for eligibility and 13% (76/592) were recruited. Final analysis included 75% (57/76) of participants. The outcome measures seemed acceptable and feasible though eligibility, inclusion, and completion of the intervention were lower than expected. The 24-h meal service program managed to significantly increase the intake of protein (p = 0.049) and energy (p = 0.038) compared to the control group where reductions were seen. No other significant differences were found. Conclusions The pilot study was feasible and several benefits for completers were seen. However, in a future definitive trial, inclusion criteria should be wider, more effort should be put on the time, training and focus of the personal in close contact to the older subjects and the intervention should be less comprehensive and more flexible.