bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safe administration of temozolomide in end-stage renal disease patients
Authors: Hundal Jasmin , Singh Aditi , Pereira Megan K , Vredenburg James 
Published: December 2022

Introduction Glioblastoma multiforme is the most common and aggressive type of central nervous system tumor. We present a novel case of the challenges of dosing temozolomide in a patient with end stage renal disease on peritoneal hemodialysis with unpredictable clearance and toxicities. Case report In this case, a 60-year-old male with a past medical history of hypertension and Stage V chronic kidney disease presented with worsening confusion and word-finding difficulty in the emergency department. Magnetic resonance imaging demonstrated a large intra-axial mass within the posterior left frontal lobe measuring 4.5 × 4.1 × 3.5 cm with irregularly, predominant peripheral tumoral enhancement. Management and outcome The patient underwent a surgical resection which confirmed the diagnosis of glioblastoma (grade 4). The standard treatment for glioblastoma is 6 weeks of radiation therapy and daily temozolomide. Given his history of renal dysfunction and limited data on the safety of temozolomide in patients on hemodialysis (HD), the patient was administered dose-reduced temozolomide and closely monitored for toxicities. Temozolomide was successfully up-titrated to the full dose. Discussion Renal replacement therapy is a life-saving treatment for end-stage kidney disease patients. A stepwise increase in the dosage of temozolomide did not increase the risk of toxicity with HD. There are no studies with patients on temozolomide and peritoneal dialysis. Our case transitioned to peritoneal dialysis from HD without significant toxicity from temozolomide. As a more substantial proportion of the population becomes dialysis-dependent in the coming years, we need further studies to understand the safety profiles of chemotherapeutic agents in this complex subset of patients.
Optical coherence tomography angiography in Bietti crystalline dystrophy
Authors: Montemagni Marina , Arrigo Alessandro , Battaglia Parodi Maurizio , Bianco Lorenzo , Antropoli Alessio , Malegori Angela , Bandello Francesco , Tranfa Fausto , Costagliola Ciro 
Published: December 2022

Purpose Bietti crystalline dystrophy (BCD) is a rare autosomal recessive retinal dystrophy caused by pathogenic variants of CYP4V2 gene and characterized by shiny yellow deposits in the retina and progressive atrophy of the retinal pigment epithelium (RPE) and choriocapillaris. The main aim of the present study is to describe the optical coherence tomography angiography (OCTA) characteristics of a patient affected by BCD. Methods A 59-years-old female with genetically confirmed BCD underwent an ophthalmological examination complete of OCTA performed in the atrophic retina, the junctional zone and the apparently normal retina. The area of choriocapillaris (CC) atrophy was compared to the area of RPE atrophy on fundus autofluorescence (FAF) imaging. Results A severe vessel density (VD) deficit at the level of superficial and deep capillary plexa as well as CC was registered in atrophic areas, which resulted deeper with respect to the junctional area, whereas the apparently preserved retina revealed VD values similar to that of control eyes. The area of RPE atrophy on FAF was larger (55.90 mm2 in right eye and 48.76 mm2 in left eye) than the area of CC atrophy on OCTA imaging (51.86 mm2 and 42.44 mm2 respectively in right and left eye). Conclusions Our findings suggest that VD impairment of retinal plexa and CC follows the degeneration of RPE as demonstrated by the greater size of the area of RPE atrophy compared to CC atrophy. Further investigations based on OCTA imaging are necessary to enhance our knowledge of this rare disease.
Particle Image Velocimetry Evaluation of Hemodynamics Proximal to the Kissing Stent Configuration in the Aorto-Iliac Bifurcation
Authors: Williamson Petra N. , Docherty Paul D. , Khanafer Adib , Yazdi Sina G. , Jermy Mark , Kabaliuk Natalia , Murton Benjamin 
Published: December 2022

Purpose: The kissing stent (KS) method is low-risk compared with open surgery techniques. It is often used to treat aorto-iliac occlusive disease (AIOD). Deployment of the KS geometry has a high technical success rate. However, stent patency reduces in the first 5 years potentially due to deleterious flow behavior. Potentially harmful hemodynamics due to the KS were investigated in vitro. Methodology: A compliant phantom of the aorto-iliac bifurcation was manufactured. Two surrogate stent-grafts were deployed into the phantom in the KS configuration to investigate effects of the presence of the stents, including the compliance mismatch they cause, on the hemodynamics proximal and distal to the KS. The investigation used pulsatile flow through a flow circuit to simulate abdominal aortic flow. Particle image velocimetry (PIV) was used to quantify the hemodynamics. Results: PIV identified peak proximal and distal velocity in vitro was 0.71 and 1.40m·s−1, respectively, which were within physiological ranges. Throughout systole, flow appeared normal and undisturbed. A lumen wall collapse in the sagittal plane formed during late systole and continued to early diastole proximal to the aorto-iliac bifurcation, distal to the inlet stent position. The wall collapse led to disturbed flow proximal to the stented region in early diastole producing potential recirculation zones and abnormal flow patterns. Conclusion: The normal systolic flow behavior indicates the KS configuration is unlikely to cause an inflammatory response of the arterial walls. The collapse has not been previously identified and may potentially cause long-term patency reduction. It requires further investigation. Clinical Impact The role of this article is to provide further insight into the haemodynamic behavior through a stented aorto-iliac artery. The results of this investigation will improve the understanding of the effects that using the kissing stent method may have on a patient and help to identify high risk regions that may require more detailed monitoring. This paper also develops the in vitro modelling techniques that will enable further research that cannot be carried out within patients.
May Dual Transcranial Direct Current Stimulation Enhance the Efficacy of Robot-Assisted Therapy for Promoting Upper Limb Recovery in Chronic Stroke?
Authors: Morone Giovanni , Capone Fioravante , Iosa Marco , Cruciani Alessandro , Paolucci Matteo , Martino Cinnera Alex , Musumeci Gabriella , Brunelli Nicoletta , Costa Carmelina , Paolucci Stefano , Di Lazzaro Vincenzo 
Published: December 2022

Objective To assess whether dual transcranial direct current stimulation (tDCS) may enhance the efficacy of exoskeleton robotic training on upper limb motor functions in patients with chronic stroke. Methods A prospective, bi-center, double-blind, randomized clinical trial study was performed. Patients with moderate-to-severe stroke (according to The National Institute of Health Stroke Scale) were randomly assigned to receive dual or sham tDCS immediately before robotic therapy (10 sessions, 2 weeks). The primary outcome was the Fugl–Meyer for Upper Extremity, assessed before, after, and at the 12-week follow-up. Neurophysiological evaluation of corticospinal projections to upper limb muscles was performed by recording motor evoked potentials (MEPs). ClinicalTrials.gov-NCT03026712. Results Two hundred and sixty individuals were tested for eligibility, of which 80 were enrolled and agreed to participate. Excluding 14 dropouts, 66 patients were randomly assigned into the 2 groups. Results showed that chronic patients were stable before treatment and significantly improved after that. The records within subject improvements were not significantly different between the 2 groups. However, a post-hoc analysis subdividing patients in 2 subgroups based on the presence or absence of MEPs at the baseline showed a significantly higher effect of real tDCS in patients without MEPs when compared to patients with MEPs ( F = 4.6, P = .007). Conclusion The adjunction of dual tDCS to robotic arm training did not further enhance recovery in the treated sample of patients with chronic stroke. However, a significant improvement in the subgroup of patients with a severe corticospinal dysfunction (as suggested by the absence of MEPs) suggests that they could benefit from such a treatment combination.
The forensic implications of food hypersensitivity – a review of cases in United Kingdom courts: January 2014–February 2020
Authors: Gowland MH , Walker MJ 
Published: December 2022

Aims: Food allergy is a major public health concern. Failures of food allergen avoidance and the consequences for those with food hypersensitivity (allergies, intolerances and coeliac disease) have a forensic context. The aim of this study was to collate and analyse the use of action in the United Kingdom (UK) courts as redress following adverse food allergy reactions or failures of allergen management. Methods: Details of prosecutions during the study period (1 January 2014 to 31 January 2020) were recorded from regular key word Internet searches. National and local news reports were primary sources, along with commentary from enforcement and regulatory professionals. Information was also collected from coroners’ inquests by attending hearings and direct contact with coroners and participants in the hearings. Freedom of Information requests were made to local authority enforcement departments. In several cases, the authors had direct involvement in investigations. Results: From 2014 to 2020, there was an increase in reports. Seventy prosecutions were recorded as well as two associated appeals and two applications for Hygiene Emergency Prohibition Notice. This resulted in 68 convictions; seven individuals received custodial sentences, three of which were suspended although one individual had a tagged curfew imposed. Fines ranged from £50 to £93,000. Details of the law applied and the evidence gathering processes are reported. Conclusion: Legal action, including landmark prosecutions for Gross Negligence Manslaughter and Preventing Future Deaths reports from coroners, with salience of criminal penalties, has led to changes in labelling law and improved allergen management practices better to protect the interests of patients with food hypersensitivities. A central system of collation of such data, and on ‘near misses’, will enable more focused root cause analysis to further improve allergen management and reduce patient risk.
Sport-related Structural Brain Injury in High School and College American Football Athletes, 2002-2020: Effect of Lystedt Law
Authors: Boden Barry P. , Brown Isaiah D.J. , Huckleby Jeremy M. , Ahmed Anwar E. , Anderson Scott A. 
Published: December 2022

Background: A previous report revealed an average of 7.2 (0.67 per 100,000 participants) sport-related structural brain injuries (SRSBIs) with macroscopic lesions per year in high school (HS) and college football players. The Lystedt law and other rule changes have been implemented with intent to reduce the risk of brain injury in football. Hypothesis: To update the profile of SRSBIs in HS and college football players and evaluate the efficacy of legislation intended to reduce brain injuries. Study Design: Descriptive epidemiology study. Level of Evidence: Level 4. Methods: We retrospectively reviewed 18 academic years (July 2002 through June 2020) of SRSBIs catalogued by the National Registry of Catastrophic Sports Injuries. The incidence of SRSBIs was assessed at the HS level during the pre (July 2002 through June 2009), transitional (July 2009 through June 2014), and post (July 2014 through June 2020) universal adoption time periods of the Lystedt law. In addition, the incidence of SRSBIs during the second half of the study (2011-2012 through 2019-2020) was compared with the first half of the study (2002-2003 through 2010-2011). Results: During the study period, there was a total of 228 SRSBIs (12.7 per year, 1.01 per 100,000 participants): 212 (93%, 11.8 per year, 1.00 per 100,000) in HS athletes and 16 (7%, 0.89 per year, 1.17 per 100,000) in college athletes. There were 52 fatalities (2.9 per year, 0.22 per 100,000 participants) with 46 (2.56 per year, 0.22 per 100,000) in HS athletes and 6 (0.33 per year, 0.43/100,000) in college athletes. There was no significant difference in risk of HS total SRSBIs or fatalities during the 3 Lystedt periods. The risk of combined SRSBI cases [relative risk (RR) = 1.22, P = 0.13] and fatalities (RR = 1.20, P = 0.52) was similar in the second half of the study compared with the first half of the study. Conclusion: Despite implementation of rule changes intended to reduce head injury, in particular the Lystedt law, the incidence of SRSBIs has remained unchanged. Further research is necessary to develop effective prevention programs for SRSBIs. Clinical Relevance: SRSBIs remain a persistent problem in HS and college American football. The recent head injury rule changes have not been effective at reducing SRSBIs.
Comparing the pharmacology knowledge and performance of nurses and nursing students in the use of information resources in pediatrics wards: An observational study
Authors: Shahzeydi Amir , Joonbakhsh Fatemeh , Ajoodaniyan Najmeh , Khaksar Sajjad , Kalhor Faramarz , Sabzghabaee Ali Mohammad , Kalhor Rohollah 
Published: December 2022

Objectives: One of the major duties of nurses is proper medication administration while maintaining patient safety, which requires sufficient knowledge and practice. Any gaps in knowledge used by nurses can lead to irreversible injury or death of the patient. This study is aimed to determine and compare the pharmacology knowledge and performance of nurses and nursing students in using the information resources in pediatrics wards. Method: This descriptive observational study was performed on 300 nurses and nursing students. Sources of knowledge and performance of nurses and nursing students were analyzed with researcher-made tools to determine their pharmaceutical knowledge, sources of knowledge, and attitudes by independent t-test, chi-square, one-way analysis of variance, Pearson, and Spearman tests. Result: Three hundred questionnaires were examined. The clinical experience of nurses and students was their most important source of information in drug challenges for 33.7% of the participants. About 24.6% of nurses obtained the required information from specialized books on pediatric medicine. About 17.1% of the participants attained their knowledge from multiple sources (e.g. various available sources such as the Internet, pharmacy books, software, and their experiences and colleagues), while electronic sources and the Internet were the sources of knowledge for 15.5% and 7.7% of the nurses, respectively. Concerning nursing students, 6.3% used books, 41.7% considered colleagues (clinical experiences), 20.8% employed electronic resources, 22.8% used the Internet, and 9.1% relied on multiple sources. There were significant differences in the knowledge and performance of the nurses based on their source of pharmacological knowledge (P < 0.05). Conclusion: Most of the resources used in the hospital are not up-to-date and evidence-base, and the majority of nurses tend to rely on their clinical experience or their collegues information for medication administration rather than reading books or searching for up-to-date approaches and information. Nursing students also trust nurses’ clinical experiences more than other sources provided for them including books and Internet. Some action should be taken by the managers for boosting the nurses’ tendency for using up-to-date information resources.
Knowledge and awareness of health professionals towards telemedicine services in Northwest, Ethiopia
Authors: Assaye Bayou Tilahun , Jemere Adamu Takele , Nigatu Araya Mesfin 
Published: December 2022

Background Understanding telemedicine technology is significantly important for the implementation of a telemedicine system in resource-limited areas. Specifically, in Ethiopia, the doctor-to-patient ratio was 0.003. This has made it difficult to access healthcare services remotely. Therefore, to maximize and facilitate telemedicine adoption, it is critical to have information about health professionals’ knowledge and awareness of telemedicine services. This study aimed to determine the Knowledge and Awareness of Health Professionals towards Telemedicine Services in Northwest, Ethiopia. Methods An institution-based cross-sectional study design was conducted among 423 health professionals working at referral hospitals from 12 February to 20 March 2020. Descriptive statistics, bivariable and multivariable logistic regression analysis were done. To identify associated factors, an odds ratio with a 95% confidence interval (CI) was used. Result With a response rate of 411 (97.2%), approximately 56.4% of professionals had good knowledge and 57.4% had high awareness of telemedicine services. Information sharing culture [AOR = 3.01, 95% CI: 1.89, 4.80], IT support staff [AOR = 1.87, 95% CI: 1.06, 3.29], internet as a source of information [AOR = 1.80, 95% CI: 1.1, 2.94], awareness [AOR = 1.35, 95% CI: 1.03, 2.40], and being male [AOR = 1.73, 95% CI:1.06], telemedicine training [AOR = 2.33, 95% CI: 1.15, 4.72] and computer accessibility in their hospitals [AOR = 1.54,95% CI: 1.01, 2.35] were significantly associated with respondents’ awareness of telemedicine services. Conclusion More than half of the participants were well-versed in and aware of telemedicine applications. Information sources, having IT support staff, information sharing culture, gender, and awareness were significant for telemedicine service knowledge, and telemedicine training and computer access were significant factors for health professionals’ awareness of telemedicine services. As a result, health professionals should receive appropriate and ongoing awareness-raising training on telemedicine systems.
Interventional Minimally Invasive Treatments for Chronic Low Back Pain Caused by Lumbar Facet Joint Syndrome: A Systematic Review
Authors: Ambrosio Luca , Vadalà Gianluca , Russo Fabrizio , Pascarella Giuseppe , De Salvatore Sergio , Papalia Giuseppe F. , Ruggiero Alessandro , Di Folco Marta , Carassiti Massimiliano , Papalia Rocco , Denaro Vincenzo 
Published: December 2022

Study design Systematic review. Objective To investigate the efficacy of nonsurgical interventional treatments for chronic low back pain (LBP) caused by facet joint syndrome (FJS). Methods A systematic review of the literature was conducted to identify studies that compared interventional treatments for LBP due to FJS among them, with usual care or sham procedures. Studies were evaluated for pain, physical function, disability, quality of life and employment status. The RoB-2 and MINORS tools were utilized to assess the risk of bias in included studies. Results Eighteen studies published between January 2000 and December 2021 were included (1496 patients, mean age: 54.31 years old). Intraarticular (IA) facet joint (FJ) injection of hyaluronic acid (HA) did not show significant difference compared to IA corticosteroids (CCS) in terms of pain and satisfaction. FJ denervation using radiofrequency (RF) displayed slightly superior or similar outcomes compared to IA CCS, physical therapy, or sham procedure. IA CCS showed better outcomes when combined with oral diclofenac compared to IA CCS or oral diclofenac alone but was not superior to IA local anesthetic and Sarapin. IA platelet-rich plasma (PRP) led to an improvement of pain, disability and satisfaction in the long term compared to IA CCS. Conclusion FJS is a common cause of LBP that can be managed with several different strategies, including nonsurgical minimally invasive approaches such as IA HA, CCS, PRP and FJ denervation. However, available evidence showed mixed results, with overall little short-term or no benefits on pain, disability, and other investigated outcomes.
What is the evidence of effectiveness of non-pharmaceutical, non-surgical, biopsychosocial interventions for body image and pain management in individuals with endometriosis? A systematic review
Authors: Falconer Laura , Hendricks Emma , Harcourt Diana 
Published: December 2022

Aim: To identify and review the success of non-pharmaceutical, non-surgical biopsychosocial interventions in individuals with endometriosis, in managing pain and improving body image. Methods: Cochrane, EBSCO, IBSS, NICE, Open Grey, OVID, Proquest, Scopus and Science Direct were searched in April 2021, using inclusion and exclusion criteria. Data collection and analysis: Five randomised control trials, and one controlled clinical trial resulted from the search. Study quality was assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool. Studies were synthesised by intervention type, into physical only, and physical and psychological. Results: Across the six papers, 323 participants were recruited, through medical records or self-referral, and treatments largely administered by specialist practitioners. From the EPHPP quality assessment,2 weak quality papers, and four moderate quality papers found improvements to pain, with large effect sizes in four papers. No studies used established body image measures to examine intervention effects on body image, and all lacked health psychology theoretical basis. There were common issues in selection bias, confounders and blinding. Conclusion: Without gold-standard methodology, evidence of effectiveness cannot be concluded. However, there is promising rationale if these issues are addressed.
Opportunities for Integrating Palliative Care in Ghana
Authors: Okyere Joshua , Kissah-Korsah Kwaku 
Published: December 2022

Introduction The integration of palliative care (PC) services is characterized by several barriers and challenges, which may include misperception of PC services as end-of-life care, poor referral systems, inadequate financial support, regulatory barriers, and the small size of PC professional workforce. Beyond these barriers, the question remains: what opportunities exist to facilitate the integration of PC in managing patients’ conditions? Notably, for a resource-constrained country like Ghana, unearthing existing facilitating factors would enable the country to leverage the opportunities these factors present to promote PC integration. Objective The aim of this study is to explore opportunities that exist to facilitate PC integration from the perspective of PC service providers. Methods An exploratory descriptive qualitative research design was used. Using semi-structured interview guides, seven face-to-face interviews were conducted with PC service providers in a tertiary hospital in Ghana. Data were managed using QSR NVivo-12. Inductive thematic analysis was carried out following Haase's modification of Colaizzi's approach to qualitative research analysis Results From the inductive thematic analysis, it was revealed that four main opportunities exist to facilitate PC integration. These included the availability of a PC team and teamwork, knowledge level of service providers, enabling attitudes of service providers, and the incorporation of PC in the medical school curriculum. Conclusion The study concludes that to facilitate the integration of PC in a tertiary health facility, there is a need to leverage on the supportive attitudes of service providers. Also, there is a need to expand the incorporation of PC education in the curriculum of all health and allied health courses. This could help create a pool of primary healthcare providers who can provide generalist PC services promptly. The study also underscores a need for continuous professional development.