bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lidocaine Nerve Block Diminishes the Effects of Therapeutic Electrical Stimulation to Enhance Nerve Regeneration in Rats
Authors: Keane Grace C. , Marsh Evan B. , Hunter Daniel A. , Schellhardt Lauren , Walker Eric R. , Wood Matthew D. 
Published: May 2022

Background: Although electrical stimulation (ES) can improve nerve regeneration, the impact of nerve block, such as lidocaine (Lido), on the therapeutic benefits of ES remains unclear. We used a rat tibial nerve transection-and-repair model to explore how either preoperative (PreOp) or postoperative (PostOp) nerve block affects ES-related improvement in regeneration. Methods: Lewis rats were used in 1 of 2 studies. The first evaluated the effects of extraneural Lido on both healthy and injured nerves. In the second study, rats were randomized to 5 experimental groups: No ES (negative control), PreOp Lido, ES + PreOp Lido, PostOp + ES, and ES (positive control). All groups underwent tibial nerve transection and repair. In both studies, nerves were harvested for histological analysis of regeneration distal to the injury site. Results: Application of extraneural Lido did not damage healthy or injured nerve based on qualitative histological observations. In the context of nerve transection and repair, the ES group exhibited improved axon regeneration at 21 days measured by the total number of myelinated fibers compared with No ES. Fiber density and percentage of neural tissue in the ES group were greater than those in both No ES and PreOp Lido + ES groups. ES + PostOp Lido was not different from No ES or ES group. Conclusions: Extraneural application of Lido did not damage nerves. Electrical stimulation augmented nerve regeneration, but Lido diminished the ES-related improvement in nerve regeneration. Clinical studies on the effects of ES to nerve regeneration may need to consider nerve block as a variable affecting ES outcome.
Feasibility of Enhancing Skin Permeability of Acyclovir through Sterile Topical Lyophilized Wafer on Self-Dissolving Microneedle-Treated Skin
Authors: Nagra Uzair , Barkat Kashif , Ashraf Muhammad U , Shabbir Maryam 
Published: May 2022

Acyclovir is an antiviral drug that is frequently prescribed for the herpes virus. However, the drug requires frequent dosing due to limited bioavailability (10–26.7%). The rationale of the present study was to develop a self-dissolving microneedle system for local and systemic delivery of acyclovir using a topical lyophilized wafer on microneedle-treated skin to provide the drug at the site of infection. The microneedles prepared with hydroxypropyl methylcellulose (HPMC) (8% w/w) or HPMC (8% w/w)-polyvinyl pyrrolidone (PVP) (30% w/w) penetrated excised rat skin, showing sufficient mechanical strength and rapid polymer dissolution. The topical wafer was prepared with acyclovir (40% w/w; equivalent to 200 mg of drug), gelatin (10% w/w), mannitol (5% w/w), and sodium chloride (5% w/w). The uniform distribution of acyclovir within the wafer in an amorphous form was confirmed by differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA). No polymer–drug interaction was evident in the lyophilized wafer as per Fourier transform infrared spectroscopy (FTIR) analysis. The wafer showed a sufficiently porous structure for rapid hydration as per scanning electron microscopy (SEM) analysis. During ex-vivo analysis, the skin was pre-treated with a self-dissolving microneedle array for 5 minutes, and the wafer was placed on this microporated-skin. Topical wafer provided ∼7–11 times higher skin concentration than the ID99 reported with a lower lag-time. Based on in-vivo testing, ∼2.58 µg/ml of Cmax was achieved in rabbit plasma during 24 hours’ study. Our findings suggest that the self-dissolving microneedle-assisted topical wafer, proposed for the first time, would be efficacious against the infection residing in the skin layer and for systemic therapy.
What we have learned from in-vitro studies of the chimney endovascular technique for treatment of complex abdominal aortic aneurysms: A systematic review
Authors: Meekel Jorn P , Tran Bich L , van Schaik Theodorus G , Donas Konstantinos P , Taneva Gergana T , Jongkind Vincent , Yeung Kak K 
Published: May 2022

Background A considerable number of patients with abdominal aortic aneurysms (AAA) is not eligible for standard endovascular repair. These complex cases require alternative surgical approaches including the readily available chimney graft endovascular aneurysm repair (Ch-EVAR) or sealing (Ch-EVAS). The optimal configuration for Ch-EVAR or Ch-EVAS is important for success but not yet known. Objective The aim of the present study was to analyze current data of the outcomes of in-vitro chimney graft treatment in complex AAA. Methods A systematic review following PRISMA guidelines was conducted including studies reporting on gutter size, main graft compression, and chimney graft compression in in-vitro configurations. Results The search resulted in 285 articles. 11 studies considering 219 individual tests could be included. Gutter size was comparable between Ch-EVAR and Ch-EVAS configurations. In Ch-EVAR set-ups, the deployed BECG were Advanta V12, VIABAHN®, and BeGraft. One type of SECG was used: VIABAHN®. The four types of main grafts (MG) deployed were: Endurant™ I/II; EXCLUDER Conformable AAA Endoprosthesis and AAA Endoprosthesis, and AFX™ Endovascular AAA Delivery System. In the EVAS-configurations, the Nellix® EVAS system was deployed. In general, SECG presented smaller gutters with higher chimney graft compression. 30% main grafts oversizing seems to give the smallest gutters without high risk of infolding of MG. Oversizing, EndoAnchors, and secondary endobag filling (in Ch-EVAS) reduced gutter sizes. CG ballooning during the entire polymer injection in Ch-EVAS prevented CG compression. Conclusion In-vitro investigations provide insight in optimal Ch-EVAR and Ch-EVAS configurations for simulated complex AAA repair. The findings above might aid physicians in their planning to potential CG set-ups and can be used in future research to refine the most optimal configuration for chimney graft technique in complex AAA.
Efficacy of statins combined with amiodarone in the treatment of atrial fibrillation: A meta-analysis
Authors: Wu Yingbiao , Zhu Xi , Ning Zhongping 
Published: May 2022

Objectives: Atrial fibrillation (AF) is a common arrhythmia in clinics with a high mortality rate. Recently, statins combined with amiodarone and amiodarone alone were used in the treatment of AF. This systematic review study aims to investigate the clinical efficacy and usefulness of statins combined with amiodarone and amiodarone alone in treating AF. Methods: Pubmed, Embase, Web of Science, Medline, Cochrane Library, and China National Knowledge Infrastructure were used to search for the relevant studies and full-text articles involved in evaluating statin-amiodarone versus amiodarone alone for AF. All included articles were quality assessed, and the data analysis was conducted with Review Manager 5.4. Results: Eight (8) relevant studies with 758 AF patients were included in this analysis. In the Meta-analysis, Statin-amiodarone treatment reduced AF recurrence (RR, 0.61; 95% CI, 0.50–0.75; p < 0.00001), C-reactive protein (CRP) level (MD, 0.96; 95%CI, 0.64–1.29, p < 0.00001) and Left atrial diameter (LAD) (MD, 0.81; 95%CI, 0.06–1.56; p = 0.03) compared with amiodarone alone for AF. However, no difference was observed for change of total cholesterol (TC) (MD, 1.32; 95%CI, −0.24–2.88; p = 0.10). Conclusion: Statin-amiodarone effectively reduced CRP level, LAD and reduced the recurrence of AF than amiodarone alone.
UK obstetric sonographers’ experiences of the COVID-19 pandemic: Burnout, role satisfaction and impact on clinical practice
Authors: Skelton Emily , Harrison Gill , Rutherford Mary , Ayers Susan , Malamateniou Christina 
Published: May 2022

Introduction: The COVID-19 pandemic placed additional demands and stressors on UK obstetric sonographers, who were required to balance parent safety and service quality, alongside staff safety. Increased pressure can negatively impact a healthcare worker’s well-being and the provision of person-centred care. The aim of this study was to explore obstetric sonographers’ experiences of performing pregnancy ultrasound scans during the pandemic and to assess the impact on burnout, role satisfaction and clinical practice. Methods: An online, anonymous cross-sectional survey was created to capture sonographers’ experience alongside using the Oldenburg Burnout Inventory to evaluate burnout and Clinical Outcomes in Routine Evaluation 10 (CORE-10) to measure psychological distress. Results: Responses were received from 138 sonographers. Of those completing the Oldenburg Burnout Inventory ( n = 89), 92.1% and 91.0% met the burnout thresholds for exhaustion and disengagement, respectively. Sonographers with a higher burnout score also perceived that COVID-19 had a greater, negative impact on their practice ( p < 0.05). The mean CORE-10 score of 14.39 (standard deviation = 7.99) suggests mild psychological distress among respondents. A significant decrease in role satisfaction was reported from before to during the pandemic ( p < 0.001), which was associated with higher scores for burnout and psychological distress ( p < 0.001). Change in role satisfaction was correlated with sonographers’ perception of safety while scanning during the pandemic ( R2 = 0.148, p < 0.001). Sixty-five sonographers (73.9%) reported they were considering leaving the profession, changing their area of practice or working hours within the next 5 years. Conclusion: Job and context-specific interventions are required to mitigate burnout and its consequences on the workforce and service provision beyond the pandemic.
Cytokine network analysis in a community-based pediatric sample of patients with myalgic encephalomyelitis/chronic fatigue syndrome
Authors: Jason Leonard A. , Gaglio Caroline L. , Furst Jacob , Islam Mohammed , Sorenson Matthew , Conroy Karl E. , Katz Ben Z. 
Published: May 2022

Objectives Studies have demonstrated immune dysfunction in adolescents with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS); however, evidence is varied. The current study used network analysis to examine relationships between cytokines among a sample of pediatric participants with ME/CFS. Methods 10,119 youth aged 5–17 in the Chicagoland area were screened for ME/CFS; 111 subjects and controls were brought in for a physician examination and completed a blood draw. Youth were classified as controls (Cs, N = 43), ME/CFS (N = 23) or severe (S-ME/CFS, N = 45). Patterns of plasma cytokine networks were analyzed. Results All participant groups displayed a primary network of interconnected cytokines. In the ME/CFS group, inflammatory cytokines IL-12p70, IL-17A, and IFN-γ were connected and included in the primary membership, suggesting activation of inflammatory mechanisms. The S-ME/CFS group demonstrated a strong relationship between IL-17A and IL-23, a connection associated with chronic inflammation. The relationships of IL-6 and IL-8 in ME/CFS and S-ME/CFS participants also differed from Cs. Together, these results indicate pro-inflammatory responses in our illness populations. Discussion Our data imply biological differences between our three participant groups, with ME/CFS and S-ME/CFS participants demonstrating an inflammatory profile. Examining co-expression of cytokines may aid in the identification of a biomarker for pediatric ME/CFS.
Comparison of Menstrual Care Skills Training Programs Provided to Girls with Intellectual Disabilities By a Healthcare Professional and Caregivers: A Randomized Controlled Trial
Authors: Aktaş Gamze , Öncü Emine 
Published: May 2022

Objective: To compare the effectiveness of the training provided by the professional and caregivers in developing menstrual care skills of girls with intellectual disabilities. Methods: A randomized controlled trial was conducted with 22 moderate girls with intellectual disabilities randomly assigned to G-I and G-II. Both groups received training program using chaining technique and modeling on a doll and on itself for 8 weeks. Assessments were made on the 1, 15, 30 and 60 days. Results: The girls’ median age was 15 (14–18) years. Scores skill of menstrual care were significantly increased in both groups ( p < .05; effect size = 0.61). G-I’s a pad placement and changing dirty pad skill scores were higher than G-II ( p = 0.05; effect size = 0.44). Conclusion: The training process performing by caregivers can be affected by the complexity of the menstrual self-care skills. School-parents cooperation-based reproductive health programs may be facilitated the teaching of complex menstrual care skills of girls with intellectual disabilities.
2019 Touch World Cup: An analysis of movement demands by half and gender
Authors: Zaragoza Javier A , Prather Jessica , Florez Christine M , Goonan Justin , Tinnin Matthias R , Secrest Ariane H , Taylor Lem W , Elsworthy Nathan , Dalbo Vincent J 
Published: May 2022

Purpose Quantify and compare the movement demands of gameplay in a male only and a female only touch rugby team competing in the International Touch World Cup (2019). Methods Movement demands (male: n = 16; female: n = 15) were assessed across 16 games (male open's: 8; female open's: 8) with 10 Hz global positioning system devices. Separate linear mixed models and Cohen's effect size (ES) comparisons were used to analyze variables by half (1st vs. 2nd half) and gender (male vs. female). Results Within game comparisons revealed reductions in run distance (ES = -0.26; p = 0.003) and worst-case scenario one-minute relative distance (ES = -0.29; p = 0.019) from the first to second half in a male only team. The female only team experienced an increase in walk distance (ES = 0.42; p <0.001) and a reduction in run distance (ES = -0.27; p <0.001) from the first to second half. Gender comparisons revealed the male only team maintained a higher average speed (ES = -0.49; p = 0.006) while covering a greater run distance (ES = -1.03; p = <0.001) and sprint distance (ES = -0.98; p < 0.001) than the female only team. The male only team also achieved a higher peak speed than the female only team (ES = -0.70; p < 0.001). Conclusions Movement demands of touch games remain consistent from the first to second half in male only and female only teams. However, male only games appear to be played at a higher intensity than female only games. Results from our study suggest gender specific conditioning programs should be implemented to best prepare players for international competition.
Perceived barriers to mobility in the intensive care units of Singapore: The Patient Mobilisation Attitudes and Beliefs Survey for the intensive care units
Authors: Yeung Meredith T. , Tan Nicholas K. , Lee Gideon Z. , Gao Yuemian , Tan Chun Ju , Yan Clement C 
Published: May 2022

Purpose Prolonged bed rest and immobility in the intensive care units (ICU) increase the risk of ICU-acquired weakness (ICUAW) and other complications. Mobilisation has been shown to improve patient outcomes but may be limited by the perceived barriers of healthcare professionals to mobilisation. The Patient Mobilisation Attitudes and Beliefs Survey for the ICU (PMABS-ICU) was adapted to assess perceived barriers to mobility in the Singapore context (PMABS-ICU-SG). Methods The 26-item PMABS-ICU-SG was disseminated to doctors, nurses, physiotherapists, and respiratory therapists working in ICU of various hospitals across Singapore. Overall and subscale (knowledge, attitude, and behaviour) scores were obtained and compared with the clinical roles, years of work experience, and type of ICU of the survey respondents. Results A total of 86 responses were received. Of these, 37.2% (32/86) were physiotherapists, 27.9% (24/86) were respiratory therapists, 24.4% (21/86) were nurses and 10.5% (9/86) were doctors. Physiotherapists had significantly lower mean barrier scores in overall and all subscales compared to nurses (p < 0.001), respiratory therapists (p < 0.001), and doctors (p = 0.001). A poor correlation (r = 0.079, p < 0.05) was found between years of experience and the overall barrier score. There was no statistically significant difference in the overall barriers score between types of ICU (χ2(2) = 4.720, p = 0.317). Conclusion In Singapore, physiotherapists had significantly lower perceived barriers to mobilisation compared to the other three professions. Years of experience and type of ICU had no significance in relation to barriers to mobilisation.
Corrective osteotomy for distal condylar malunion of the proximal phalanx in adolescents: comparison of K-wire and locking plate fixation
Authors: Chen Kuan-Jung , Huang Yu-Po , Lo I-Ning , Huang Yi-Chao 
Published: May 2022

This retrospective study reviewed 28 patients, aged 10 to 17 years, who underwent corrective osteotomy for malunion of the proximal phalangeal distal condyles at a mean of 9 weeks (range 2–52) from injury. There were 19 patients treated with K-wire and nine patients with locking plates. The two groups were comparable for trauma mechanism, fracture type, time delay from injury and the type of initial treatment. The K-wire group had a shorter duration of operation and shorter time to union than the plating group. For both groups, postoperative radiographs showed significant correction, which remained unchanged until the final follow-up (minimum 12 months), although greater residual coronal angulation was found in the K-wire group. The outcomes in 17 of the 28 patients were graded as excellent or good according to the Al-Qattan classification, with no difference between the groups. The complication rate was also similar between the groups, while the locking plate group had a higher rate of secondary surgery. Level of evidence: III
Composite outcomes in observational studies of Crohn’s disease: a systematic review and meta-analysis
Authors: Magro Fernando , Sottomayor Catarina , Alves Catarina , Santiago Mafalda , Ministro Paula , Lago Paula , Correia Luís , Gonçalves Raquel , Carvalho Diana , Portela Francisco , Dias Cláudia Camila , Dignass Axel , Danese Silvio , Peyrin-Biroulet Laurent , Estevinho Maria Manuela , Leão Moreira Paula 
Published: May 2022

Background: This systematic review and meta-analysis aims to assess composite and aggregate outcomes of observational studies in Crohn’s disease and to evaluate whether the number and type of variables included affect the frequency of the outcome. Methods: MEDLINE [via PubMed], Scopus and Web of Science were searched to identify observational studies that enrolled patients with Crohn’s disease and evaluated a composite or aggregate outcome. The proportion of patients achieving the outcome was determined and a random-effects meta-analysis was performed to evaluate how the frequency of each outcome varies according to the reporting of predefined variables. Results: From 10,257 identified records, 46 were included in the qualitative analysis and 38 in the meta-analysis. The frequency for composite and aggregate outcomes was 0.445 [95% confidence interval (CI): 0.389–0.501] and 0.140 (95% CI: 0.000–0.211), respectively. When comparing composite outcomes by number of included variables, the frequency was 0.271 (95% CI: 0.000–0.405) and 0.698 (95% CI: 0.651–0.746), for one and six variables, respectively. The frequency of the composite outcome varied according to the identity of the variables being reported. Specific pairs of predefined variables had a significant effect in the frequency of composite outcomes. Conclusion: Composite outcomes with increasing number of predefined variables show an increase in frequency. Outcomes including variables such as ‘Surgery’ and ‘Steroids’ had higher frequencies when compared with the ones that did not include these variables. These results show that the frequency of composite outcomes is dependent on the number and type of variables being reported.
Practice guidance for the use of terlipressin for liver cirrhosis–related complications
Authors: Qi Xingshun , Bai Zhaohui , Zhu Qiang , Cheng Gang , Chen Yu , Dang Xiaowei , Ding Huiguo , Han Juqiang , Han Lei , He Yingli , Ji Fanpu , Jin Hongxu , Li Bimin , Li Hongyu , Li Yiling , Li Zhiwei , Liu Bang , Liu Fuquan , Liu Lei , Lin Su , Ma Dapeng , Meng Fanping , Qi Ruizhao , Ren Tianshu , Shao Lichun , Tang Shanhong , Tang Yufu , Teng Yue , Wang Chunhui , Wang Ran , Wu Yunhai , Xu Xiangbo , Yang Ling , Yuan Jinqiu , Yuan Shanshan , Yang Yida , Zhao Qingchun , Zhang Wei , Yang Yongping , Guo Xiaozhong , Xie Weifen 
Published: May 2022

Background: Liver cirrhosis is a major global health burden worldwide due to its high risk of morbidity and mortality. Role of terlipressin for the management of liver cirrhosis–related complications has been recognized during recent years. This article aims to develop evidence-based clinical practice guidance on the use of terlipressin for liver cirrhosis–related complications. Methods: Hepatobiliary Study Group of the Chinese Society of Gastroenterology of the Chinese Medical Association and Hepatology Committee of the Chinese Research Hospital Association have invited gastroenterologists, hepatologists, infectious disease specialists, surgeons, and clinical pharmacists to formulate the clinical practice guidance based on comprehensive literature review and experts’ clinical experiences. Results: Overall, 10 major guidance statements regarding efficacy and safety of terlipressin in liver cirrhosis were proposed. Terlipressin can be beneficial for the management of cirrhotic patients with acute variceal bleeding and hepatorenal syndrome (HRS). However, the evidence regarding the use of terlipressin in cirrhotic patients with ascites, post-paracentesis circulatory dysfunction, and bacterial infections and in those undergoing hepatic resection and liver transplantation remains insufficient. Terlipressin-related adverse events, mainly including gastrointestinal symptoms, electrolyte disturbance, and cardiovascular and respiratory adverse events, should be closely monitored. Conclusion: The current clinical practice guidance supports the use of terlipressin for gastroesophageal variceal bleeding and HRS in liver cirrhosis. High-quality studies are needed to further clarify its potential effects in other liver cirrhosis–related complications.
Investigation of healthcare-associated SARS-CoV-2 infection: Learning outcomes from an investigative process in the initial phase of the pandemic
Authors: Ramsay Isobel , Sharrocks Katherine , Warne Ben , Sithole Nyarie , Ravji Pooja , Bousfield Rachel , Jones Nick , Leong Clare E , Suliman Mohamed , Tsui Rachel , Toleman Michelle S , Moody Christine , Smith Richard , Whitehorn James , Gouliouris Theodore , Penciu Florentina , Hofling Christian , Cunningham Chris , Enoch David A , Moore Elinor 
Published: May 2022

Background Healthcare-associated (HCA) SARS-CoV-2 infection is a significant contributor to the spread of the 2020 pandemic. Timely review of HCA cases is essential to identify learning to inform infection prevention and control (IPC) policies and organisational response. Aim To identify key areas for improvement through rapid investigation of HCA SARS-CoV-2 cases and to implement change. Methods Cases were identified based on date of first positive SARS-CoV-2 PCR sample in relation to date of hospital admission. Cases were reviewed using a structured gap analysis tool to identify key learning points. These were discussed in weekly multidisciplinary meetings to gain consensus on learning outcomes, level of harm incurred by the patient and required actions. Learning was then promptly fed back to individual teams and the organisation. Findings Of the 489 SARS-CoV-2 cases admitted between 10th March and 23rd June 2020, 114 suspected HCA cases (23.3%) were reviewed; 58/489 (11.8%) were ultimately deemed to be HCA. Five themes were identified: individual patient vulnerability, communication, IPC implementation, policy issues and organisational response. Adaptations to policies based on these reviews were completed within the course of the initial phase of the pandemic. Conclusion This approach enabled timely learning and implementation of control measures and policy development.