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Bossuyt V, Provenzano E, Symmans WF, Webster F, Allison KH, Dang C, Gobbi H, Kulka J, Lakhani SR, Moriya T, Quinn CM, Sapino A, Schnitt S, Sibbering DM, Slodkowska E, Yang W, Tan PH, Ellis I. A dedicated structured data set for reporting of invasive carcinoma of the breast in the setting of neoadjuvant therapy: recommendations from the International Collaboration on Cancer Reporting (ICCR). Histopathology 2024; 84:1111-1129. [PMID: 38443320 DOI: 10.1111/his.15165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/11/2024] [Indexed: 03/07/2024]
Abstract
AIMS The International Collaboration on Cancer Reporting (ICCR), a global alliance of major (inter-)national pathology and cancer organisations, is an initiative aimed at providing a unified international approach to reporting cancer. ICCR recently published new data sets for the reporting of invasive breast carcinoma, surgically removed lymph nodes for breast tumours and ductal carcinoma in situ, variants of lobular carcinoma in situ and low-grade lesions. The data set in this paper addresses the neoadjuvant setting. The aim is to promote high-quality, standardised reporting of tumour response and residual disease after neoadjuvant treatment that can be used for subsequent management decisions for each patient. METHODS The ICCR convened expert panels of breast pathologists with a representative surgeon and oncologist to critically review and discuss current evidence. Feedback from the international public consultation was critical in the development of this data set. RESULTS The expert panel concluded that a dedicated data set was required for reporting of breast specimens post-neoadjuvant therapy with inclusion of data elements specific to the neoadjuvant setting as core or non-core elements. This data set proposes a practical approach for handling and reporting breast resection specimens following neoadjuvant therapy. The comments for each data element clarify terminology, discuss available evidence and highlight areas with limited evidence that need further study. This data set overlaps with, and should be used in conjunction with, the data sets for the reporting of invasive breast carcinoma and surgically removed lymph nodes from patients with breast tumours, as appropriate. Key issues specific to the neoadjuvant setting are included in this paper. The entire data set is freely available on the ICCR website. CONCLUSIONS High-quality, standardised reporting of tumour response and residual disease after neoadjuvant treatment are critical for subsequent management decisions for each patient.
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Affiliation(s)
- Veerle Bossuyt
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Elena Provenzano
- Department of Histopathology, Addenbrookes Hospital, Cambridge, UK
| | - W Fraser Symmans
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Fleur Webster
- International Collaboration on Cancer Reporting, Surry Hills, NSW, Australia
| | - Kimberly H Allison
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Chau Dang
- Memorial Sloan Kettering Cancer Center, West Harrison, NY, USA
| | - Helenice Gobbi
- Department of Surgical Clinic, Federal University of Triangulo Mineiro, Uberaba, MG, Brazil
| | - Janina Kulka
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary
| | - Sunil R Lakhani
- Centre for Clinical Research, and Pathology Queensland, University of Queensland, Brisbane, Qld, Australia
| | - Takuya Moriya
- Department of Pathology, Kawasaki Medical School, Okayama, Japan
| | - Cecily M Quinn
- Department of Histopathology, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine, University College, Dublin, Ireland
| | - Anna Sapino
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Stuart Schnitt
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | - D Mark Sibbering
- University Hospitals of Derby and Burton NHS Trust, Royal Derby Hospital, Derby, UK
| | - Elzbieta Slodkowska
- Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | | | - Ian Ellis
- Department of Histopathology, Nottingham City Hospital, London, UK
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Kvalsvik F, Larsen BH, Eilertsen G, Falkenberg HK, Dalen I, Haaland S, Storm M. Health Needs Assessment in Home-Living Older Adults: Protocol for a Pre-Post Study. JMIR Res Protoc 2024; 13:e55192. [PMID: 38635319 DOI: 10.2196/55192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/16/2024] [Accepted: 02/23/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Conducting a health needs assessment for older adults is important, particularly for early detection and management of frailty. Such assessments can help to improve health outcomes, maintain overall well-being, and support older adults in retaining their independence as they age at home. OBJECTIVE In this study, a systematic approach to health needs assessment is adopted in order to reflect real-world practices in municipal health care and capture the nuances of frailty. The aim is to assess changes in frailty levels in home-living older adults over 5 months and to examine the observable functional changes from a prestudy baseline (t1) to a poststudy period (t2). Additionally, the study explores the feasibility of conducting the health needs assessment from the perspective of home-living older adults and their informal caregivers. METHODS Interprofessional teams of registered nurses, physiotherapists, and occupational therapists will conduct 2 health needs assessments covering physical, cognitive, psychological, social, and behavioral domains. The study includes 40 home-living older adults of 75 years of age or older, who have applied for municipal health and care services in Norway. A quantitative approach will be applied to assess changes in frailty levels in home-living older adults over 5 months. In addition, we will examine the observable functional changes from t1 to t2 and how these changes correlate to frailty levels. Following this, a qualitative approach will be used to examine the perspectives of participants and their informal caregivers regarding the health needs assessment and its feasibility. The final sample size for the qualitative phase will be determined based on the participant's willingness to be interviewed. The quantitative data consist of descriptive statistics, simple tests, and present plots and correlation coefficients. For the qualitative analysis, we will apply thematic analysis. RESULTS The initial baseline assessments were completed in July 2023, and the second health needs assessments are ongoing. We expect the results to be available for analysis in the spring of 2024. CONCLUSIONS This study has potential benefits for not only older adults and their informal caregivers but also health care professionals. Moreover, it can be used to inform future studies focused on health needs assessments of this specific demographic group. The study also provides meaningful insights for local policy makers, with potential future implications at the national level. TRIAL REGISTRATION ClinicalTrials.gov NCT05837728; https://clinicaltrials.gov/study/NCT05837728. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55192.
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Affiliation(s)
- Fifi Kvalsvik
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Bente Hamre Larsen
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Grethe Eilertsen
- Research Group of Older Peoples' Health, University of South-Eastern Norway, Drammen, Norway
- Department of Nursing and Health Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Helle K Falkenberg
- Research Group of Older Peoples' Health, University of South-Eastern Norway, Drammen, Norway
- National Centre for Optics, Vision and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Ingvild Dalen
- Section of Biostatistics, Research Department, Stavanger University Hospital, Stavanger, Norway
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Stine Haaland
- Department of Health and Welfare services, Stavanger kommune, Stavanger, Norway
| | - Marianne Storm
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
- Research Group of Nursing and Health Sciences, Research Department, Stavanger University Hospital, Stavanger, Norway
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Jain HK, Das A, Dixit S, Kaur H, Pati S, Ranjit M, Dutta A, Bal M. Development and implementation of a strategy for early diagnosis and management of scrub typhus: an emerging public health threat. Front Public Health 2024; 12:1347183. [PMID: 38660358 PMCID: PMC11039949 DOI: 10.3389/fpubh.2024.1347183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/21/2024] [Indexed: 04/26/2024] Open
Abstract
Scrub typhus, caused by Orientia tsutsugamushi, is a re-emerging zoonotic disease in the tropics with considerable morbidity and mortality rates. This disease, which is mostly prevalent in rural areas, remains underdiagnosed and underreported because of the low index of suspicion and non-specific clinical presentation. Limited access to healthcare, diagnostics, and treatment in rural settings further makes it challenging to distinguish it from other febrile illnesses. While easily treatable, improper treatment leads to severe forms of the disease and even death. As there is no existing public health program to address scrub typhus in India, there is an urgent need to design a program and test its effectiveness for control and management of the disease. With this backdrop, this implementation research protocol has been developed for a trial in few of the endemic "pockets" of Odisha, an eastern Indian state that can be scalable to other endemic areas of the country, if found effective. The main goal of the proposed project is to include scrub typhus as a differential diagnosis of fever cases in every tier of the public health system, starting from the community level to the health system, for the early diagnosis among suspected cases and to ensure that individuals receive complete treatment. The current study aimed to describe the protocol of the proposed Scrub Typhus Control Program (STCP) in detail so that it can receive valuable views from peers which can further strengthen the attempt.
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Affiliation(s)
- Hitesh Kumar Jain
- Department of Molecular Epidemiology, Indian Council of Medical Research, Regional Medical Research Centre, Bhubaneswar, India
| | - Arundhuti Das
- Department of Molecular Epidemiology, Indian Council of Medical Research, Regional Medical Research Centre, Bhubaneswar, India
| | - Sujata Dixit
- Department of Molecular Epidemiology, Indian Council of Medical Research, Regional Medical Research Centre, Bhubaneswar, India
| | - Harpreet Kaur
- Department of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Sanghamitra Pati
- Department of Public Health, Indian Council of Medical Research, Regional Medical Research Centre, Bhubaneswar, India
| | - Manoranjan Ranjit
- Department of Molecular Epidemiology, Indian Council of Medical Research, Regional Medical Research Centre, Bhubaneswar, India
| | - Ambarish Dutta
- Department of Epidemiology, Public Health Foundation of India, Indian Institute of Public Health, Bhubaneswar, India
| | - Madhusmita Bal
- Department of Molecular Epidemiology, Indian Council of Medical Research, Regional Medical Research Centre, Bhubaneswar, India
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Tamrat T, Zhao Y, Schalet D, AlSalamah S, Pujari S, Say L. Exploring the Use and Implications of AI in Sexual and Reproductive Health and Rights: Protocol for a Scoping Review. JMIR Res Protoc 2024; 13:e53888. [PMID: 38593433 DOI: 10.2196/53888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/23/2024] [Accepted: 02/09/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Artificial intelligence (AI) has emerged as a transformative force across the health sector and has garnered significant attention within sexual and reproductive health and rights (SRHR) due to polarizing views on its opportunities to advance care and the heightened risks and implications it brings to people's well-being and bodily autonomy. As the fields of AI and SRHR evolve, clarity is needed to bridge our understanding of how AI is being used within this historically politicized health area and raise visibility on the critical issues that can facilitate its responsible and meaningful use. OBJECTIVE This paper presents the protocol for a scoping review to synthesize empirical studies that focus on the intersection of AI and SRHR. The review aims to identify the characteristics of AI systems and tools applied within SRHR, regarding health domains, intended purpose, target users, AI data life cycle, and evidence on benefits and harms. METHODS The scoping review follows the standard methodology developed by Arksey and O'Malley. We will search the following electronic databases: MEDLINE (PubMed), Scopus, Web of Science, and CINAHL. Inclusion criteria comprise the use of AI systems and tools in sexual and reproductive health and clear methodology describing either quantitative or qualitative approaches, including program descriptions. Studies will be excluded if they focus entirely on digital interventions that do not explicitly use AI systems and tools, are about robotics or nonhuman subjects, or are commentaries. We will not exclude articles based on geographic location, language, or publication date. The study will present the uses of AI across sexual and reproductive health domains, the intended purpose of the AI system and tools, and maturity within the AI life cycle. Outcome measures will be reported on the effect, accuracy, acceptability, resource use, and feasibility of studies that have deployed and evaluated AI systems and tools. Ethical and legal considerations, as well as findings from qualitative studies, will be synthesized through a narrative thematic analysis. We will use the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) format for the publication of the findings. RESULTS The database searches resulted in 12,793 records when the searches were conducted in October 2023. Screening is underway, and the analysis is expected to be completed by July 2024. CONCLUSIONS The findings will provide key insights on usage patterns and evidence on the use of AI in SRHR, as well as convey key ethical, safety, and legal considerations. The outcomes of this scoping review are contributing to a technical brief developed by the World Health Organization and will guide future research and practice in this highly charged area of work. TRIAL REGISTRATION OSF Registries osf.io/ma4d9; https://osf.io/ma4d9. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/53888.
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Affiliation(s)
- Tigest Tamrat
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Yu Zhao
- Department of Digital Health and Innovations, Science Division, World Health Organization, Geneva, Switzerland
| | - Denise Schalet
- Department of Digital Health and Innovations, Science Division, World Health Organization, Geneva, Switzerland
| | - Shada AlSalamah
- Department of Digital Health and Innovations, Science Division, World Health Organization, Geneva, Switzerland
- Information Systems Department, College of Computer and Information Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sameer Pujari
- Department of Digital Health and Innovations, Science Division, World Health Organization, Geneva, Switzerland
| | - Lale Say
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Xia JC, Huang YC, Wu K, Pang J, Shi Y. Efficacy of Electroacupuncture Combined with Chinese Herbal Medicine on Pain Intensity for Chronic Sciatica Secondary to Lumbar Disc Herniation: Study Protocol for a Randomised Controlled Trial. J Pain Res 2024; 17:1381-1391. [PMID: 38618296 PMCID: PMC11012699 DOI: 10.2147/jpr.s448631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/09/2024] [Indexed: 04/16/2024] Open
Abstract
Purpose Chinese herbal medicine and electroacupuncture (EA) have been used to control pain for many decades in China. We aim to explore the efficacy of intervening patients whose discogenic sciatica symptoms lasting longer than 3 months with these conservative treatments. Patients and Methods This is a single-center, parallel-group, patient-unblinded Randomized Controlled Trial (RCT) with blinded outcome assessment and statistician. One hundred and twenty-four patients will be assigned randomly into 2 groups including conservative treatment group (Shenxie Zhitong capsule combined with EA treatment) and Nonsteroidal Anti-inflammatory Drugs (Nonsteroidal Anti-inflammatory Drugs, NSAIDs) control group (Celecoxib) in a 1:1 ratio. The trial involves a 4-week treatment along with follow-up for 6 months. The primary outcome is the leg pain intensity measured by the visual analogue scale (VAS) at 6 months after randomization. Secondary outcomes include leg pain intensity at other time points, back pain intensity, leg pain and back pain frequency, functional status, quality of life, return to work status and satisfaction of patients. Adverse events will also be recorded. Strengths and Limitations of This Study Through this study, we want to observe the efficacy of electroacupuncture combined with Chinese herbal medicine on pain intensity for chronic sciatica secondary to Lumbar Disc Herniation. If the final results are favorable, it is expected to be a safe, economical, and effective treatment for patients. The study design has the following limitations: the setup of control group was less than perfect; patients and doctors could not be blinded in this trial; we skipped the feasibility study. We have tried our best to minimize adverse impacts. Trial Registration ChiCTR2300070884 (Chinese Clinical Trial Registry, http://www.chictr.org.cn, registered on 25th April 2023).
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Affiliation(s)
- Jing-Chun Xia
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
- Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Yu-Cheng Huang
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
- Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Ke Wu
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
- Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Jian Pang
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
- Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Ying Shi
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
- Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People’s Republic of China
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Awindaogo F, Acheamfour-Akowuah E, Doku A, Kokuro C, Agyekum F, Owusu IK. Assessing and Improving the Care of Patients With Heart Failure in Ghana: Protocol for a Prospective Observational Study and the Ghana Heart Initiative-Heart Failure Registry. JMIR Res Protoc 2024; 13:e52616. [PMID: 38588528 PMCID: PMC11036190 DOI: 10.2196/52616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 12/23/2023] [Accepted: 12/24/2023] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Heart failure (HF) is a leading cause of morbidity and mortality globally, with a high disease burden. The prevalence of HF in Ghana is increasing rapidly, but epidemiological profiles, treatment patterns, and survival data are scarce. The national capacity to diagnose and manage HF appropriately is also limited. To address the growing epidemic of HF, it is crucial to recognize the epidemiological characteristics and medium-term outcomes of HF in Ghana and improve the capability to identify and manage HF promptly and effectively at all levels of care. OBJECTIVE This study aims to determine the epidemiological characteristics and medium-term HF outcomes in Ghana. METHODS We conducted a prospective, multicenter, multilevel cross-sectional observational study of patients with HF from January to December 2023. Approximately 5000 patients presenting with HF to 9 hospitals, including teaching, regional, and municipal hospitals, will be recruited and evaluated according to a standardized protocol, including the use of an echocardiogram and an N-terminal pro-brain natriuretic peptide (NT-proBNP) test. Guideline-directed medical treatment of HF will be initiated for 6 months, and the medium-term outcomes of interventions, including rehospitalization and mortality, will be assessed. Patient data will be collated into a HF registry for continuous assessment and monitoring. RESULTS This intervention will generate the necessary information on the etiology of HF, clinical presentations, the diagnostic yield of various tools, and management outcomes. In addition, it will build the necessary capacity and support for HF management in Ghana. As of July 30, 2023, the training and onboarding of all 9 centers had been completed. Preliminary analyses will be conducted by the end of the second quarter of 2024, and results are expected to be publicly available by the middle of 2024. CONCLUSIONS This study will provide the necessary data on HF, which will inform decisions on the prevention and management of HF and form the basis for future research. TRIAL REGISTRATION ISRCTN Registry (United Kingdom) ISRCTN18216214; https:www.isrctn.com/ISRCTN18216214. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52616.
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Affiliation(s)
| | | | - Alfred Doku
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Collins Kokuro
- Department of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Francis Agyekum
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Isaac Kofi Owusu
- Department of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Belfrage E, Ek S, Johansson Å, Brauner H, Sonesson A, Drott K. Predictive and Prognostic Biomarkers in Patients With Mycosis Fungoides and Sézary Syndrome (BIO-MUSE): Protocol for a Translational Study. JMIR Res Protoc 2024; 13:e55723. [PMID: 38436589 PMCID: PMC11027051 DOI: 10.2196/55723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Cutaneous T-cell lymphoma (CTCL) is a rare group of lymphomas that primarily affects the skin. Mycosis fungoides (MF) is the most common form of CTCL and Sézary syndrome (SS) is more infrequent. Early stages (IA-IIA) have a favorable prognosis, while advanced stages (IIB-IVB) have a worse prognosis. Around 25% of patients with early stages of the disease will progress to advanced stages. Malignant skin-infiltrating T-cells in CTCL are accompanied by infiltrates of nonmalignant T-cells and other immune cells that produce cytokines that modulate the inflammation. Skin infection, often with Staphylococcus aureus, is frequent in advanced stages and can lead to sepsis and death. S. aureus has also been reported to contribute to the progression of the disease. Previous reports indicate a shift from Th1 to Th2 cytokine production and dysfunction of the skin barrier in CTCL. Treatment response is highly variable and often unpredictable, and there is a need for new predictive and prognostic biomarkers. OBJECTIVE This prospective translational study aims to identify prognostic biomarkers in the blood and skin of patients with MF and SS. METHODS The Predictive and Prognostic Biomarkers in Patients With MF and SS (BIO-MUSE) study aims to recruit 120 adult patients with MF or SS and a control group of 20 healthy volunteers. The treatments will be given according to clinical routine. The sampling of each patient will be performed every 3 months for 3 years. The blood samples will be analyzed for lactate dehydrogenase, immunoglobulin E, interleukins, thymus and activation-regulated chemokine, and lymphocyte subpopulations. The lymphoma microenvironment will be investigated through digital spatial profiling and single-cell RNA sequencing. Microbiological sampling and analysis of skin barrier function will be performed. The life quality parameters will be evaluated. The results will be evaluated by the stage of the disease. RESULTS Patient inclusion started in 2021 and is still ongoing in 2023, with 18 patients and 20 healthy controls enrolled. The publication of selected translational findings before the publication of the main results of the trial is accepted. CONCLUSIONS This study aims to investigate blood and skin with a focus on immune cells and the microbiological environment to identify potential new prognostic biomarkers in MF and SS. TRIAL REGISTRATION ClinicalTrials.gov NCT04904146; https://www.clinicaltrials.gov/study/NCT04904146. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55723.
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Affiliation(s)
- Emma Belfrage
- Division of Dermatology and Venereology, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Sara Ek
- Department of Immunotechnology, Faculty of Engineering, Lund University, Lund, Sweden
| | - Åsa Johansson
- Clinical Genetics and Pathology, Division of Hematology and Transfusion Medicine, Department of Laboratory Medicine, Skåne University Hospital, Lund, Sweden
| | - Hanna Brauner
- Division of Dermatology and Venereology, Department of Medicine and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Dermatology and Venereology, Karolinska University Hospital, Stockholm, Sweden
| | - Andreas Sonesson
- Division of Dermatology and Venereology, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Kristina Drott
- Department of Hematology and Transfusion Medicine, Skåne University Hospital, Lund, Sweden
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Li W, Xu X, Liu R. The efficacy of silver needle therapy for treating low back pain: a protocol for meta-analysis of randomized controlled trials. Front Med (Lausanne) 2024; 11:1355262. [PMID: 38633316 PMCID: PMC11022203 DOI: 10.3389/fmed.2024.1355262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/29/2024] [Indexed: 04/19/2024] Open
Abstract
Background As population aging and unhealthy living habits may exacerbate the prevalence and burden of low back pain (LBP), effective treatment and improvement of patient quality of life are particularly critical. Silver needle therapy (SNT), having evolved from traditional acupuncture, involves placing silver needles into muscles, tendons, and fascia for treatment. However, it still lacks robust clinical evidence to substantiate its effectiveness. Therefore, it is necessary to conduct more emphasis on meta-analysis to evaluate the clinical efficacy of SNT for treating LBP. Methods We will search PubMed, Medline, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang Databases up until December 2023 to identify randomized controlled trials of SNT treatment in adult patients with LBP. The primary outcome will be the intensity of pain after pain management. Secondary outcomes will include the Oswestry Disability Index, Japanese Orthopedic Association Back Pain Evaluation Questionnaire, requirement for analgesic drugs, and treatment-related adverse reactions. Two investigators conducted the literature search, selected studies that might meet the inclusion criteria based on the title and abstract, and extracted data from the eligible literature independently and will independently assess the risk of bias using the Revised Cochrane Risk-of-Bias (RoB2) tool. Multivariate analyses (including subgroup analysis, trial sequential analysis (TSA), sensitivity analysis, etc.) will be conducted to improve the quality of evidence. Clinical trial registration Registration: PROSPERO Registration Number: CRD42023466207, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023466207.
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Affiliation(s)
| | | | - Rongguo Liu
- Department of Pain Management, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China
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Arsenault V, Lieberman L, Akbari P, Murto K. Canadian tertiary care pediatric massive hemorrhage protocols: a survey and comprehensive national review. Can J Anaesth 2024; 71:453-464. [PMID: 38057534 DOI: 10.1007/s12630-023-02641-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/27/2023] [Accepted: 07/09/2023] [Indexed: 12/08/2023] Open
Abstract
PURPOSE Hemorrhage is the leading cause of pediatric death in trauma and cardiac arrest during surgery. Adult studies report improved patient outcomes using massive hemorrhage protocols (MHPs). Little is known about pediatric MHP adoption in Canada. METHODS After waived research ethics approval, we conducted a survey of Canadian pediatric tertiary care hospitals to study MHP activations. Transfusion medicine directors provided hospital/patient demographic and MHP activation data. The authors extracted pediatric-specific MHP data from requested policy/procedure documents according to seven predefined MHP domains based on the literature. We also surveyed educational and audit tools. The analysis only included MHPs with pediatric-specific content. RESULTS The survey included 18 sites (100% response rate). Only 13/18 hospitals had pediatric-specific MHP content: eight were dedicated pediatric hospitals, two were combined pediatric/obstetrical hospitals, and three were combined pediatric/adult hospitals. Trauma was the most common indication for MHP activation (54%), typically based on a specific blood volume anticipated/transfused over time (10/13 sites). Transport container content was variable. Plasma and platelets were usually not in the first container. There was little emphasis on balanced plasma/platelet to red-blood-cell ratios, and most sites (12/13) rapidly incorporated laboratory-guided goal-directed transfusion. Transfusion thresholds were consistent with recent guidelines. All protocols used tranexamic acid and eight sites used an audit tool. DISCUSSION/CONCLUSION Pediatric MHP content was highly variable. Activation demographics suggest underuse in nontrauma settings. Our findings highlight the need for a consensus definition for pediatric massive hemorrhage, a validated pediatric MHP activation tool, and prospective assessment of blood component ratios. A national pediatric MHP activation repository would allow for quality improvement metrics.
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Affiliation(s)
- Valérie Arsenault
- Division of Transfusion Medicine, Department of Laboratory Medicine, University of Montreal, Montreal, QC, Canada
- Centre Hospitalier Universitaire (CHU) Sainte-Justine, Mother and Child Hospital of Montreal, Montreal, QC, Canada
| | - Lani Lieberman
- Department of Laboratory Medicine and Pathology, University of Toronto, Toronto, ON, Canada
- University Health Network, Toronto General Hospital, Toronto, ON, Canada
| | - Pegah Akbari
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Kimmo Murto
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada.
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd., Ottawa, ON, K1H 8L1, Canada.
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10
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Bian H, Wang X, Liu L, Yan F, Lu S, Hui W, Zhou C, Duan J, Li M, Chen J, Meng R, Cao L, Wang L, Ji X. Multicenter registry study of cerebral venous thrombosis in china (RETAIN-CH): Rationale and design. Brain Behav 2024; 14:e3353. [PMID: 38622893 PMCID: PMC11019244 DOI: 10.1002/brb3.3353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 10/30/2023] [Accepted: 11/26/2023] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND AND RATIONALE Cerebral venous thrombosis (CVT) is a rare cerebrovascular disorder that mainly affects young and middle-aged adults. Epidemiological data on the incidence, risk factors, diagnosis, treatment, and prognosis of CVT are lacking in China. In addition, there is a lack of evidence from large, multicenter, real-world studies on the efficacy and safety of endovascular. AIM To understand the incidence, diagnosis and treatment status of CVT in China and to estimate the effectiveness and safety of endovascular treatment in the real-world. METHODS A multicenter, retrospective observational cohort study will be conducted on CVT patient records from 104 hospitals, between January 1, 2018 and June 30, 2022, identified using a 2-stage cluster sampling design based on per capita gross domestic product. Each enrolled participant is required to complete a further follow-up, which includes the current situation and the assessment at 3 and 12 months after discharge. STUDY OUTCOMES The outcomes of this study will include the current status of the incidence, pathogenesis, etiology, clinical symptoms, diagnosis, and treatment of CVT in China, as well as the effectiveness and safety of endovascular treatment in the real-world. DISCUSSION Results from this study will provide evidence on the incidence, specific risk factors, symptomatic and imaging features, and clinical outcomes of CVT in China as well as indicate whether endovascular treatment is superior to medical management alone for patients with acute CVT in the real-world. TRIAL REGISTRATION http://www. CLINICALTRIALS gov. IDENTIFIER NCT05448248.
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Affiliation(s)
- Hetao Bian
- Beijing Institute for Brain DisordersCapital Medical UniversityBeijingChina
| | - Xia Wang
- The George Institute for Global HealthUniversity of New South WalesSydneyAustralia
| | - Lan Liu
- School of StatisticsUniversity of Minnesota at Twin CitiesMinneapolisMinnesotaUSA
| | - Feng Yan
- Department of NeurosurgeryXuanwu Hospital of Capital Medical UniversityBeijingChina
| | - Shan Lu
- Department of Neurology and PsychiatryBeijing Shijitan HospitalCapital Medical UniversityBeijingChina
| | - Wen Hui
- Department of Science and TechnologyWest China Hospital of Sichuan UniversityChengduSichuanChina
| | - Chen Zhou
- Beijing Institute for Brain DisordersCapital Medical UniversityBeijingChina
| | - Jiangang Duan
- Department of EmergencyXuanwu Hospital of Capital Medical UniversityBeijingChina
| | - Min Li
- Department of NeurologyXuanwu Hospital of Capital Medical UniversityBeijingChina
| | - Jian Chen
- Department of NeurosurgeryXuanwu Hospital of Capital Medical UniversityBeijingChina
| | - Ran Meng
- Department of NeurologyXuanwu Hospital of Capital Medical UniversityBeijingChina
| | - Lei Cao
- The General Office of Stroke Prevention Project CommitteeNational Health Commission of the People's Republic of ChinaBeijingChina
| | - Longde Wang
- The General Office of Stroke Prevention Project CommitteeNational Health Commission of the People's Republic of ChinaBeijingChina
| | - Xunming Ji
- Beijing Institute for Brain DisordersCapital Medical UniversityBeijingChina
- Department of NeurosurgeryXuanwu Hospital of Capital Medical UniversityBeijingChina
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Bhadra K, Baleeiro C, Patel S, Condra W, Bader BA, Setser RM, Youngblood S. High Tidal Volume, High Positive End Expiratory Pressure and Apneic Breath Hold Strategies (Lung Navigation Ventilation Protocol) With Cone Beam Computed Tomography Bronchoscopic Biopsy of Peripheral Lung Lesions: Results in 100 Patients. J Bronchology Interv Pulmonol 2024; 31:105-116. [PMID: 37459049 PMCID: PMC10984636 DOI: 10.1097/lbr.0000000000000938] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/31/2023] [Indexed: 04/04/2024]
Abstract
BACKGROUND A dedicated anesthesia protocol for bronchoscopic lung biopsy-lung navigation ventilation protocol (LNVP)-specifically designed to mitigate atelectasis and reduce unnecessary respiratory motion, has been recently described. LNVP demonstrated significantly reduced dependent ground glass, sublobar/lobar atelectasis, and atelectasis obscuring target lesions compared with conventional ventilation. METHODS In this retrospective, single-center study, we examine the impact of LNVP on 100 consecutive patients during peripheral lung lesion biopsy. We report the incidence of atelectasis using cone beam computed tomography imaging, observed ventilatory findings, anesthesia medications, and outcomes, including diagnostic yield, radiation exposure, and complications. RESULTS Atelectasis was observed in a minority of subjects: ground glass opacity atelectasis was seen in 30 patients by reader 1 (28%) and in 18 patients by reader 2 (17%), with good agreement between readers (κ = 0.78). Sublobar/lobar atelectasis was observed in 23 patients by reader 1 and 26 patients by reader 2, also demonstrating good agreement (κ = 0.67). Atelectasis obscured target lesions in very few cases: 0 patients (0%, reader 1) and 3 patients (3%, reader 2). Diagnostic yield was 85.9% based on the AQuIRE definition. Pathology demonstrated 57 of 106 lesions (54%) were malignant, 34 lesions (32%) were benign, and 15 lesions (14%) were nondiagnostic. CONCLUSION Cone beam computed tomography images confirmed low rates of atelectasis, high tool-in-lesion confirmation rate, and high diagnostic yield. LNVP has a similar safety profile to conventional bronchoscopy. Most patients will require intravenous fluid and vasopressor support. Further study of LNVP and other ventilation protocols are necessary to understand the impact of ventilation protocols on bronchoscopic peripheral lung biopsy.
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Affiliation(s)
| | | | | | | | | | | | - Sloan Youngblood
- American Anesthesia of Tennessee, CHI Memorial Hospital, Chattanooga, TN
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12
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Dybdahl D, Roberson T, Rasor E, Kline L, Pershing M. Impact of a Hyperkalemia Protocol Tailored to Glucose Concentration and Renal Function on Insulin-Induced Hypoglycemia in Patients with Low Pretreatment Glucose. J Emerg Med 2024; 66:e421-e431. [PMID: 38462394 DOI: 10.1016/j.jemermed.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/01/2023] [Accepted: 12/08/2023] [Indexed: 03/12/2024]
Abstract
BACKGROUND Hyperkalemia is a common electrolyte abnormality that requires urgent treatment. Insulin is an effective treatment for hyperkalemia, but risk factors for developing insulin-induced hypoglycemia exist (e.g., low pretreatment glucose or renal impairment). OBJECTIVE This study evaluated the impact of a hyperkalemia protocol tailored to glucose concentration and renal function on insulin-induced hypoglycemia. METHODS This was a retrospective cohort study of emergency department patients with glucose ≤ 100 mg/dL treated with insulin for hyperkalemia. The primary outcome was incidence of hypoglycemia in patients treated prior to (July 1, 2018-June 30, 2019) vs. after (January 1, 2020-December 31, 2020) the protocol update, which individualized insulin and dextrose doses by glucose concentration and renal function. Secondary outcomes included change in potassium and protocol safety. We assessed factors associated with hypoglycemia using multiple logistic regression. RESULTS We included 202 total patients (preimplementation: 114, postimplementation: 88). Initial insulin dose was lower in the postimplementation group (p < 0.001). We found a nonsignificant reduction in hypoglycemia in the postimplementation group (42.1% vs. 30.7%, p = 0.10). Degree of potassium reduction was similar in patients who received insulin 5 units vs. 10 units (p = 0.72). Higher pretreatment glucose (log odds ratio [OR] -0.05, 95% confidence interval [CI] -0.08 to -0.02) and additional insulin administration (log OR -1.55, 95% CI -3.01 to -0.25) were associated with reduced risk of developing hypoglycemia. CONCLUSION A hyperkalemia protocol update was not associated with a significant reduction in hypoglycemia, and the incidence of hypoglycemia remained higher than anticipated. Future studies attempting to optimize treatment in this high-risk population are warranted.
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Affiliation(s)
- Daniel Dybdahl
- Department of Pharmacy, OhioHealth Grant Medical Center, Columbus, Ohio
| | - Taylor Roberson
- Department of Pharmacy, OhioHealth Grant Medical Center, Columbus, Ohio
| | - Emily Rasor
- Department of Pharmacy, OhioHealth Grant Medical Center, Columbus, Ohio
| | - Laura Kline
- Department of Pharmacy, OhioHealth Riverside Methodist Hospital, Columbus, Ohio
| | - Michelle Pershing
- Department of Research, OhioHealth Research Institute, Columbus, Ohio
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Magi CE, Bambi S, Rasero L, Longobucco Y, El Aoufy K, Amato C, Vellone E, Bonaccorsi G, Lorini C, Iovino P. Health Literacy and Self-Care in Patients with Chronic Illness: A Systematic Review and Meta-Analysis Protocol. Healthcare (Basel) 2024; 12:762. [PMID: 38610184 PMCID: PMC11011384 DOI: 10.3390/healthcare12070762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/22/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
Self-care plays a critical role in symptom recognition, management, and risk factor modification for patients with chronic illnesses. Despite its significance, self-care levels in this population are generally poor. Health literacy (HL) is pivotal for promoting effective self-care, yet the association across specific chronic illnesses remains fragmented and conflicting. Therefore, a systematic review and meta-analysis will be conducted. Inclusion criteria encompass quantitative studies involving adult patients with at least one chronic illness reporting on the association between a measure of HL and one or more elements of self-care behaviors as outcomes. Databases to be searched include PubMed, CINAHL, APA PsycINFO, Embase, Web of Science, and Cochrane Central Register of Controlled Trials. The studies will undergo risk of bias and certainty of evidence assessment using ROBINS-E and GRADE. Extracted data will include authors, publication date, aim(s), study location, design, sample characteristics, chronic illness type, study length, HL, and self-care measures. Understanding the link between HL and self-care can aid healthcare providers in implementing strategies to enhance health-promoting behaviors, contributing valuable insights to the scientific community and fostering nuanced discussions. This protocol ensures methodological transparency, stimulates discourse, and paves the way for informed interventions to improve overall health outcomes.
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Affiliation(s)
- Camilla Elena Magi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
- Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Stefano Bambi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Laura Rasero
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Yari Longobucco
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Khadija El Aoufy
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Carla Amato
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
- Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Ercole Vellone
- Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
- Department of Nursing and Obstetrics, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Guglielmo Bonaccorsi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Paolo Iovino
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
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Leducq S, Zaki F, Hollestein LM, Apfelbacher C, Ponna NP, Mazmudar R, Gran S. The majority of observational studies in leading peer-reviewed medicine journals are not registered and do not have a publicly accessible protocol: a scoping review. J Clin Epidemiol 2024:111341. [PMID: 38556099 DOI: 10.1016/j.jclinepi.2024.111341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES Observational studies are not subject to the same requirements as randomised controlled trials such as as registration or publishing a protocol. The aim of this scoping review was to estimate the registration rate of observational studies in leading peer-reviewed medicine journals and to evaluate whether protocols were available in the public domain. STUDY DESIGN AND SETTING In March 2023, we searched OVID Medline for observational studies published in 2022 in the top five general medicine journals according to impact factor (The Lancet, The British Medical Journal, The Journal of the American Medical Association, The New England Journal of Medicine and Annals of Internal Medicine). We defined an observational study as a cohort study, case-control study, cross-sectional study, or case series. Information on i) the proportion of observational studies that have been registered, and ii) the proportion of observational studies that have a protocol available in the public domain was extracted from a random sample of studies. RESULTS Our search identified 699 studies, 290 studies were selected as full text and a random sample of 200 studies were included. For half of the studies, the first author worked in an USA institution. Most studies were cohort studies (n=126, 63.0%) and used administrative healthcare records, electronic healthcare records and registries. Of the 200 observational studies, 20 (10.0%) were registered. Among those, 14 were prospectively registered. Twenty-four studies (12.0%) had a protocol available in the public domain. Studies that were registered or had a protocol, were more frequently published in the BMJ (n=12/28, 42.9%), had a 1st author working in the UK (n=10/28, 35.1%) and used electronic health records (n=13/28, 46.4%) compared to studies with no registration and no protocol. CONCLUSION The rate of prospectively registered observational studies is worryingly low. Prospective registration of observational studies should be encouraged and standardized to ensure transparency in clinical research and reduce research wastage.
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Affiliation(s)
- Sophie Leducq
- Centre of Evidence Based Dermatology, School of Medicine, Faculty of Medicine & Health Sciences, University of Nottingham, United Kingdom; Department of Dermatology, University Hospital of Tours, Tours, France; INSERM, SPHERE, U1246, Tours University, Nantes University, Tours, France.
| | - Faaris Zaki
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Loes M Hollestein
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands; Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Christian Apfelbacher
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands; Institute of Social Medicine and Health Systems Research, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | | | - Rishabh Mazmudar
- Case Western Reserve University School of Medicine, Cleveland, OH, United States of America
| | - Sonia Gran
- Centre of Evidence Based Dermatology, School of Medicine, Faculty of Medicine & Health Sciences, University of Nottingham, United Kingdom
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15
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Stachelska MA, Ekielski A, Karpiński P, Żelaziński T, Kruszewski B. New Genetic Determinants for qPCR Identification and the Enumeration of Selected Lactic Acid Bacteria in Raw-Milk Cheese. Molecules 2024; 29:1533. [PMID: 38611811 PMCID: PMC11013805 DOI: 10.3390/molecules29071533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/21/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Lactic acid bacteria (LAB) play an important role in the ripening of cheeses and contribute to the development of the desired profile of aroma and flavor compounds. Therefore, it is very important to monitor the dynamics of bacterial proliferation in order to obtain an accurate and reliable number of their cells at each stage of cheese ripening. This work aimed to identify and conduct a quantitative assessment of the selected species of autochthonous lactic acid bacteria from raw cow's milk cheese by the development of primers and probe pairs based on the uniqueness of the genetic determinants with which the target microorganisms can be identified. For that purpose, we applied real-time quantitative PCR (qPCR) protocols to quantify Lactobacillus delbrueckii subsp. bulgaricus, Streptococcus thermophilus, and Lactococcus lactis subsp. cremoris cells in cheese directly after production and over three-month and six-month ripening periods. While L. lactis subsp. cremoris shows good acidification ability and the ability to produce antimicrobial compounds, L. delbrueckii subsp. bulgaricus has good proteolytic ability and produces exo-polysaccharides, and S. thermophilus takes part in the formation of the diacetyl flavor compound by metabolizing citrate to develop aroma, they all play an important role in the cheese ripening. The proposed qPCR protocols are very sensitive and reliable methods for a precise enumeration of L. delbrueckii subsp. bulgaricus, S. thermophilus, and L. lactis subsp. cremoris in cheese samples.
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Affiliation(s)
- Milena Alicja Stachelska
- Faculty of Computer Science and Technology, University of Lomza, Akademicka 14, 18-400 Lomza, Poland;
| | - Adam Ekielski
- Department of Production Engineering, Institute of Mechanical Engineering, Warsaw University of Life Sciences-SGGW, Nowoursynowska 164, 02-787 Warsaw, Poland; (A.E.); (T.Ż.)
| | - Piotr Karpiński
- Faculty of Computer Science and Technology, University of Lomza, Akademicka 14, 18-400 Lomza, Poland;
| | - Tomasz Żelaziński
- Department of Production Engineering, Institute of Mechanical Engineering, Warsaw University of Life Sciences-SGGW, Nowoursynowska 164, 02-787 Warsaw, Poland; (A.E.); (T.Ż.)
| | - Bartosz Kruszewski
- Department of Food Technology and Assessment, Institute of Food Sciences, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159 C, 02-776 Warsaw, Poland
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16
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Bull JJ, Wichman HA, Krone SM, Molineux IJ. Controlling Recombination to Evolve Bacteriophages. Cells 2024; 13:585. [PMID: 38607024 PMCID: PMC11011186 DOI: 10.3390/cells13070585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/07/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024] Open
Abstract
Recombination among different phages sometimes facilitates their ability to grow on new hosts. Protocols to direct the evolution of phage host range, as might be used in the application of phage therapy, would then benefit from including steps to enable recombination. Applying mathematical and computational models, in addition to experiments using phages T3 and T7, we consider ways that a protocol may influence recombination levels. We first address coinfection, which is the first step to enabling recombination. The multiplicity of infection (MOI, the ratio of phage to cell concentration) is insufficient for predicting (co)infection levels. The force of infection (the rate at which cells are infected) is also critical but is more challenging to measure. Using both a high force of infection and high MOI (>1) for the different phages ensures high levels of coinfection. We also apply a four-genetic-locus model to study protocol effects on recombinant levels. Recombinants accumulate over multiple generations of phage growth, less so if one phage outgrows the other. Supplementing the phage pool with the low-fitness phage recovers some of this 'lost' recombination. Overall, fine tuning of phage recombination rates will not be practical with wild phages, but qualitative enhancement can be attained with some basic procedures.
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Affiliation(s)
- James J. Bull
- Department of Biological Sciences, University of Idaho, Moscow, ID 83844, USA;
- Institute for Modeling Collaboration and Innovation, University of Idaho, Moscow, ID 83844, USA;
| | - Holly A. Wichman
- Department of Biological Sciences, University of Idaho, Moscow, ID 83844, USA;
- Institute for Modeling Collaboration and Innovation, University of Idaho, Moscow, ID 83844, USA;
| | - Stephen M. Krone
- Institute for Modeling Collaboration and Innovation, University of Idaho, Moscow, ID 83844, USA;
- Department of Mathematics and Statistical Science, University of Idaho, Moscow, ID 83844, USA
| | - Ian J. Molineux
- Institute for Cell and Molecular Biology, Department of Molecular Biosciences, LaMontagne Center for Infectious Diseases, The University of Texas, Austin, TX 78712, USA;
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Qiu J, Xu J, Cai Y, Li M, Peng Y, Xu Y, Chen G. Catgut embedding in acupoints combined with repetitive transcranial magnetic stimulation for the treatment of postmenopausal osteoporosis: study protocol for a randomized clinical trial. Front Neurol 2024; 15:1295429. [PMID: 38606276 PMCID: PMC11008468 DOI: 10.3389/fneur.2024.1295429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 03/11/2024] [Indexed: 04/13/2024] Open
Abstract
Background To date, the clinical modulation for bone metabolism based on the neuro-bone mass regulation theory is still not popular. The stimulation of nerve systems to explore novel treatments for Postmenopausal osteoporosis (PMOP) is urgent and significant. Preliminary research results suggested that changes brain function and structure may play a crucial role in bone metabolism with PMOP. Thus, we set up a clinical trial to investigate the effect of the combination of repetitive transcranial magnetic stimulation (rTMS) and catgut embedding in acupoints (CEA) for PMOP and to elucidate the central mechanism of this neural stimulation in regulating bone metabolism. Method This trial is a prospective and randomized controlled trial. 96 PMOP participants will be randomized in a 1:1:1 ratio into a CEA group, an rTMS group, or a combined one. Participants will receive CEA, rTMS, or combined therapy for 3 months with 8 weeks of follow-up. The primary outcomes will be the changes in Bone Mineral Density scores, total efficiency of Chinese Medicine Symptoms before and after treatment. Secondary outcomes include the McGill Pain Questionnaire Short-Form, Osteoporosis Symptom Score, Mini-Mental State Examination, and Beck Depression Inventory-II. The leptin, leptin receptor, and norepinephrine levels of peripheral blood must be measured before and after treatment. Adverse events that occur during the trial will be recorded. Discussion CEA achieves brain-bone mass regulation through the bottom-up way of peripheral-central while rTMS achieves it through the top-down stimulation of central-peripheral. CEA combined with rTMS can stimulate the peripheral-central at the same time and promote peripheral bone mass formation. The combination of CEA and rTMS may play a coordinating, synergistic, and side-effect-reducing role, which is of great clinical significance in exploring better treatment options for PMOP.Clinical trial registration: https://www.chictr.org.cn/, identifier ChiCTR2300073863.
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Affiliation(s)
- Jingjing Qiu
- Shenzhen Bao'an Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - JiaZi Xu
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yingyue Cai
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Minghong Li
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yingsin Peng
- Shenzhen Bao'an Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Yunxiang Xu
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Guizhen Chen
- Shenzhen Bao'an Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, China
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Simmet A, Ehret J, Schleicher R, Teut M, Hummel G, Bschaden A, Stroebele-Benschop N. Multidisciplinary study of the health and nutritional status of persons living in households at risk of poverty with children in Germany (MEGA_kids): Study design and methods. Nutr Health 2024:2601060241242159. [PMID: 38532716 DOI: 10.1177/02601060241242159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Background: In Germany, the nutritional situation of adults and children living in households at risk of poverty has been insufficiently studied so far. Aim: The aim of the mixed-methods study MEGA_kids is to gain a deeper understanding of the nutritional situation including socioeconomic, behavioral, and attitudinal factors and health characteristics among persons living in families at risk of poverty. Method: MEGA_kids is a mixed-methods cross-sectional study consisting of four modules combining quantitative and qualitative methods. The first module (A) applies self-administered questionnaires to assess the individual's diet, household food insecurity, and several other factors among adults and children of 500 households. Cash receipts are used to assess household's food expenses. For the second module (B), a semistructured interview guide is used to identify factors influencing food security and nutritional quality from the perspective of a subsample of module A (n = 20). The third module (C) applies the participatory World Café technique to explore experiences and generate ideas for tailored support measures for a healthy diet from the perspective of 40 parents participating in module A. Finally, the fourth module (D) investigates the knowledge and usage of existing nutrition-related preventive measures among 200 parents at risk of poverty by using an online questionnaire. Conclusion: By providing a comprehensive picture of nutritional aspects of families living at risk of poverty, MEGA_kids will guide officials to target and prioritize public health nutrition measures, inform policy makers to implement and improve healthy policies and, finally, identify research gaps to be prioritized.
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Affiliation(s)
- Anja Simmet
- Department of Nutritional Psychology, Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Janine Ehret
- Department of Nutritional Psychology, Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Romy Schleicher
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Michael Teut
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gerrit Hummel
- Department of Nutritional Psychology, Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Andreas Bschaden
- Department of Nutritional Psychology, Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Nanette Stroebele-Benschop
- Department of Nutritional Psychology, Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
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Bedard-Gilligan M, Lindgren K, Dworkin E, Tristao T, Kaysen D, Rhew I. A randomized controlled trial testing theory-driven enhancements to increase the efficacy of and engagement in a brief cognitive-behavioural therapy text-message intervention for co-occurring posttraumatic stress disorder symptoms and alcohol misuse. Br J Clin Psychol 2024. [PMID: 38532251 DOI: 10.1111/bjc.12463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/27/2024] [Accepted: 03/07/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE Engaging individuals with co-occurring posttraumatic stress disorder (PTSD) and alcohol misuse (AM) in effective treatments is difficult. Brief, self-directed approaches that deliver empirically supported intervention techniques, such as cognitive-behavioural therapy (CBT) strategies, via technology may be effective and easier-to-access alternatives to traditional in-person therapy approaches for PTSD + AM. This paper describes the protocol for an intervention development study (NCT05372042) that evaluates a text-message intervention combining CBT texts with techniques from cognitive psychology (message framing) and social psychology (growth mindsets) for treatment of PTSD + AM. METHOD The study uses a 3 (message framing: gain vs. loss vs. no framing) × 2 (mindset: growth mindsets vs. not) factorial design to test enhancements to CBT texts. Individuals age 18+, who report symptoms of PTSD and AM, will be recruited to participate. Participants will complete screening, verification, and baseline measures. They will be randomized to condition and receive 3 text messages per week for 4 weeks. Participants will be assessed at post-, 1-, and 3-month follow-up. RESULTS Analyses will evaluate whether framing and growth mindsets enhance the efficacy of CBT texts. A priori decision rules will be applied to select the intervention condition that is both the most effective and the simplest, which will be tested in a follow-up randomized controlled trial. CONCLUSIONS This study will identify the simplest, most efficacious CBT intervention for PTSD + AM. Its use of cognitive and social psychology-based enhancement and of a factorial decision can serve as examples of how to enhance and increase engagement in brief, self-directed CBT interventions.
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Affiliation(s)
- Michele Bedard-Gilligan
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Kristen Lindgren
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Emily Dworkin
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Ty Tristao
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Isaac Rhew
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
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20
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Yao J, Roth H, Anderson D, Lu H, Rong H, Baird K. Comparison of Spontaneous Pushing and Directed Pushing During the Second Stage of Labor Among Chinese Women Without Epidural Analgesia: Protocol for a Noninferior Feasibility Study. JMIR Res Protoc 2024; 13:e55701. [PMID: 38530330 PMCID: PMC11005428 DOI: 10.2196/55701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/18/2024] [Accepted: 02/26/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Maternal pushing during the second stage of labor could influence labor progress and maternal-neonatal outcomes. Although the image of health care providers directing the laboring women to push during the second stage of labor could be commonly observed globally, this practice is not sufficiently researched and is questioned regarding its effectiveness and outcomes on the mother and baby. Meanwhile, a strategy referred to as "spontaneous pushing," which supports women to push by following their bodily urges, has been evaluated in several trials. However, in China, spontaneous pushing is not common practice. Notwithstanding the evaluation of spontaneous pushing, there is a lack of high-quality evidence to support either strategies of directed pushing or spontaneous pushing. OBJECTIVE This study aims to test the feasibility of a future randomized controlled trial to compare the effects of spontaneous pushing and directed pushing during the second stage of labor for maternal and neonatal outcomes in China. METHODS A nonrandomized, single-group, noninferiority feasibility study will be conducted in a public hospital in Hebei Province, China. In total, 105 women meeting the selection criteria will be recruited to receive the intervention (spontaneous pushing), while 105 sets of medical notes from women who received routine care (directed pushing) will be identified and reviewed to compare outcomes for both cohorts. A mixed methods approach will be used to assess primary outcomes (feasibility and acceptability) and secondary outcomes (effectiveness). RESULTS Data collection took place between May and October 2023. A total of 110 women were invited to participate in the intervention of spontaneous pushing. Midwives' interviews were conducted and will be transcribed for analysis in March 2024. The data analysis is planned to be completed by May 2024. CONCLUSIONS This feasibility study will provide important information by conducting a full-scale clinical trial in the future as well as the potential facilitators and barriers of it. A future randomized controlled trial is likely to have considerable policy and funding impacts regarding pushing management during the second stage of labor and improvement in women's childbirth experience. TRIAL REGISTRATION Chinese Clinical Trial Register ChiCTR2300071178; https://tinyurl.com/mudtnbft. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55701.
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Affiliation(s)
- Jiasi Yao
- School of Nursing, Hebei Medical University, Shijiazhuang, China
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Heike Roth
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, Australia
- Collective for Midwifery, Child and Family Health, School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Debra Anderson
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Hong Lu
- School of Nursing, Peking University, Beijing, China
| | - Huijuan Rong
- Department of Nursing, The Fourth Hospital of Shijiazhuang, Shijiazhuang, China
| | - Kathleen Baird
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, Australia
- Collective for Midwifery, Child and Family Health, School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, Australia
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21
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Thebridge L, Fisher C, Puttaswamy V, Pollock C, Clarke J. Intra-operative duplex ultrasound scanning in renal transplantation: protocol and service requirements. J Med Radiat Sci 2024. [PMID: 38530020 DOI: 10.1002/jmrs.786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 03/13/2024] [Indexed: 03/27/2024] Open
Abstract
Intra-operative duplex ultrasound in renal transplantation was first described in 1998 and whilst reported in problematic cases, there are few reports of its routine use and no current published protocols. Since 2013, we have used intra-operative ultrasound in all renal transplants. The formal protocol used since August 2020 is presented as a reference document for other transplant centres. A Canon Aplio 800 ultrasound system with an i22LH8 hockey-stick transducer is used to image the renal cortex and major vessels, and an i8CX1 matrix transducer to image the graft during and after fascial closure. These transducers are fully sterilised with Sterrad and no sheathing of transducers is required. The transplant surgeon scans within the sterile field with the sonographer guiding imaging and adjusting machine settings. Ultrasound findings are discussed between team members including any requirement for interventions. Ultrasound is performed at three stages of the operation: Stage 1: after clamp release identifying issues of graft vascularity including otherwise unrecognised major vessel and anastomotic abnormalities. Stage 2: following ureteric implantation identifying compromised perfusion due to graft rotation or vessel kinking. Stage 3: after fascial closure identifying compromised perfusion due to external compression. Post-operative scanning, including assessment of the collecting system and bladder, is performed routinely on days 1, 3, 7 and 30. The intervention is effective with no early graft losses or peri-operative vascular thromboses. The requirements for service provision are significant including the availability of additional transducers, and sonographers with expertise in intra-operative scanning able to attend after-hours for extended periods.
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Affiliation(s)
- Linda Thebridge
- Department of Vascular Surgery, Royal North Hospital, St Leonards, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Charles Fisher
- Department of Vascular Surgery, Royal North Hospital, St Leonards, New South Wales, Australia
| | - Vikram Puttaswamy
- Department of Vascular Surgery, Royal North Hospital, St Leonards, New South Wales, Australia
| | - Carol Pollock
- Department of Vascular Surgery, Royal North Hospital, St Leonards, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Jillian Clarke
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
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Ochoa S, Espinosa V, López-Carrilero R, Martinez I, Barrera ADH, Birulés I, Barajas A, Pélaez T, Díaz-Cutraro L, Coromina M, González-Rodríguez A, Verdaguer-Rodríguez M, Gutiérrez-Zotes A, Palma-Sevillano C, Montes C, Gallego J, Paya B, Casanovas F, Roldán M, Noval E, Varela Casals P, Salas-Sender M, Aznar A, Ayesa-Arriola R, Pousa E, Canal-Rivero M, Garrido-Torres N, Montserrat C, Muñoz-Lorenzo L, Crosas JM. Effectiveness of family metacognitive training in mothers with psychosis and their adolescent children: a multicenter study protocol. Front Psychol 2024; 15:1359693. [PMID: 38586292 PMCID: PMC10997187 DOI: 10.3389/fpsyg.2024.1359693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/07/2024] [Indexed: 04/09/2024] Open
Abstract
Background More than half of women with psychosis take care of their children despite the difficulties caused by the disease. Additionally, these kids have a higher risk of developing a mental health disorder. However, no interventions have been developed to meet these needs. Metacognitive Training (MCT) is a psychological intervention that has demonstrated its efficacy in improving cognitive insight, symptom management and social cognition in people with first-episode psychosis (FEP). Additionally, MCT has shown better results in women than men with FEP. This study aims to adapt and evaluate the efficacy of MCT-F in mothers and adolescent children in an online group context with the main purpose of improving family relationships, cognitive awareness and symptoms in women with psychosis and increase their children's knowledge of the disease and their functioning. As secondary objectives, it also aims to evaluate improvements in metacognition, social cognition, symptoms, protective factors and self-perception of stigma. Materials and methods A quasi-experimental design with participants acting as their own control will be carried out. Forty-eight mothers with psychosis and their adolescent children (between 12 and 20 years old) recruited from a total of 11 adult mental health care centers will receive MCT-F. Participants will be evaluated 11 weeks before the intervention (T1), at baseline (T2), and post-intervention (T3) with a cognitive insight scale, as a primary outcome. Measures of metacognitive and social cognition, symptoms, cognitive functioning, family and social functioning, protective factors (self-esteem, resilience, and coping strategies) and self-perceived stigma will be addressed as secondary outcomes. Assessment will also address trauma and attachment in mothers and, lastly, the feasibility and acceptability of MCT-F in both participant groups. Discussion This will be the first investigation of the efficacy, acceptability, and viability of the implementation of MCT-F. The results of this study may have clinical implications, contributing to improving mothers' with psychosis and adolescents' functioning and better understanding of the disease, in addition to the possible protective and preventive effect in adolescents, who are known to be at higher risk of developing severe mental disorders.Clinical trial registration:https://clinicaltrials.gov/, identifier [NCT05358457].
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Affiliation(s)
- Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Victoria Espinosa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Raquel López-Carrilero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Irene Martinez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | | | - Irene Birulés
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Facultat de Psicologia Departament de Cognició, Desenvolupament i Psicologia de l'Educació, Universistat de Barcelona, Barcelona, Spain
| | - Ana Barajas
- Departament de Psicologia, Facultat de Psicologia Clínica I de la Salut. Serra Húnter Programme, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Trinidad Pélaez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Luciana Díaz-Cutraro
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Department of Psychology, FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Marta Coromina
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Alexandre González-Rodríguez
- Department of Mental Health, CIBERSAM, Mutua Terrassa University Hospital, Fundació Docència i Recerca Mutua Terrassa, University of Barcelona, Terrassa, Spain
| | - Marina Verdaguer-Rodríguez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - Alfonso Gutiérrez-Zotes
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitari Institut Pere Mata, Institut d’Investigació Sanitària Pere Virgili-CERCA, Universitat Rovira i Virgili, Reus, Spain
| | - Carolina Palma-Sevillano
- Department of Psychology, FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, Spain
- Hospital de Mataró, Consorci Sanitari del Maresme, Barcelona, Spain
| | - Cristian Montes
- Virgen del Rocío University Hospital, Network Centre for Biomedical Research in Mental Health (CIBERSAM), Institute of Biomedicine of Seville (IBiS), First-episode Psychosis Research Network of Andalusia (Red PEPSur), University of Seville, Seville, Spain
| | | | - Beatriz Paya
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, Santander, Spain
| | - Francesc Casanovas
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM) of Barcelona, Autonomous University of Barcelona, Barcelona, Spain
| | - María Roldán
- Hospital del Mar Medical Research Institute (IMIM) of Barcelona, Autonomous University of Barcelona, Barcelona, Spain
| | - Emma Noval
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, Santander, Spain
| | | | | | - Ana Aznar
- Centre d’Higiene Mental Les Corts, Barcelona, Spain
| | - Rosa Ayesa-Arriola
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, Santander, Spain
| | - Esther Pousa
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Manuel Canal-Rivero
- Virgen del Rocío University Hospital, Network Centre for Biomedical Research in Mental Health (CIBERSAM), Institute of Biomedicine of Seville (IBiS), First-episode Psychosis Research Network of Andalusia (Red PEPSur), University of Seville, Seville, Spain
| | - Nathalia Garrido-Torres
- Virgen del Rocío University Hospital, Network Centre for Biomedical Research in Mental Health (CIBERSAM), Institute of Biomedicine of Seville (IBiS), First-episode Psychosis Research Network of Andalusia (Red PEPSur), University of Seville, Seville, Spain
| | - Clara Montserrat
- Hospital del Mar Medical Research Institute (IMIM) of Barcelona, Autonomous University of Barcelona, Barcelona, Spain
| | | | - Josep María Crosas
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain
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23
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Kanan M, Abdulrahman S, Alshehri A, AlSuhaibani R, Alotaibi NM, Alsaleh A, Nasser B, Baowaydhan R, Alredaini I, Khalid T, Almukhtar F, Altoaimi N, Alhneshel A, Alanazi S, Algmaizi S. Factors Underlying Vaccine Hesitancy and Their Mitigations in Saudi Arabia: Protocol for a Systematic Review. JMIR Res Protoc 2024; 13:e54680. [PMID: 38517463 PMCID: PMC10998176 DOI: 10.2196/54680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Vaccine hesitancy is a growing concern in Saudi Arabia, impacting even well-educated parents. The decision-making process involves various factors such as accessibility, trustworthy information, and the influence of social networks, reflecting a complex interplay of emotional, cultural, social, spiritual, and political dimensions. OBJECTIVE This review seeks to evaluate the prevalence and trends of vaccine hesitancy, identify contributing factors, and explore potential solutions to enhance immunization rates. This review aligns with global concerns, as the World Health Organization has identified vaccine hesitancy as a top global health threat. METHODS Our systematic review will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and PICOS (Population, Intervention, Comparison, Outcomes, and Study) criteria for comprehensive assessment. We will conduct a thorough search across various databases, encompassing a wide range of vaccines, and pay special attention to vaccination campaigns and refusals. Inclusion criteria involve descriptive, observational, and analytical studies focusing on factors influencing vaccine acceptance or hesitancy. The study will use the Crowe Critical Appraisal Tool for quality assessment and perform a narrative synthesis to summarize findings thematically. RESULTS This systematic review is expected to unveil the prevalence and trends of vaccine hesitancy in diverse populations in Saudi Arabia, shedding light on cultural, religious, and social factors contributing to hesitancy. It aims to assess the effectiveness of implemented strategies, enable regional and global comparisons, and provide implications for tailored vaccination policies. Additionally, the review may pinpoint research gaps, guiding future investigations to address and mitigate vaccine hesitancy effectively. CONCLUSIONS The findings are expected to have direct policy implications and guide interventions to strengthen vaccination programs and improve public health outcomes. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/54680.
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Affiliation(s)
- Mohammed Kanan
- Department of Clinical Pharmacy, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | | | - Renad AlSuhaibani
- Department of Medicine, Imam Mohammed Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Nawaf M Alotaibi
- Department of Clinical Pharmacy, Northern Border University, Rafha, Saudi Arabia
| | - Azhar Alsaleh
- Department of Nursing, Prince Saud Bin Jalawi Hospital, Alhasa, Saudi Arabia
| | - Bushra Nasser
- Department of Clinical Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Rana Baowaydhan
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Taif Khalid
- Department of Clinical Laboratory, Al-Jawf University, Al-Jawf, Saudi Arabia
| | - Fatima Almukhtar
- Department of Medicine, Ministry of Health, Dammam, Saudi Arabia
| | - Nourah Altoaimi
- Department of Pharmacy, Qassim University, Qassim, Saudi Arabia
| | - Almaha Alhneshel
- Department of Medicine, Suliman Alrajhi University, Qassim, Saudi Arabia
| | - Shouq Alanazi
- Department of Medicine, Northern Border University, Northern Borders, Arar, Saudi Arabia
| | - Shahad Algmaizi
- Department of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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24
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Ayala-Garcia A, Soldevila-Domenech N, Yi SY, de la Torre R, Steffen LM. Diet patterns associated with cognitive decline: methods to harmonize data from European and US cohort studies. Front Nutr 2024; 11:1379531. [PMID: 38577153 PMCID: PMC10992460 DOI: 10.3389/fnut.2024.1379531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/11/2024] [Indexed: 04/06/2024] Open
Abstract
The impact of dietary intake on cognitive outcomes and dementia prevention is a topic of increasing interest. Meta-analyses of observational studies, mostly conducted within US and European populations, have reported benefits of healthy diet patterns on cognitive performance, but results from individual studies have been inconsistent. These inconsistencies are likely due to the diverse methodology used in studies, including different diet and cognitive function assessment instruments, follow-up periods, and analytical methods, which make drawing conclusions relevant to dietary guidance challenging. The objective of this project is to describe a protocol to conduct a retrospective harmonization study on dietary intake and cognitive health using data from European and US studies. The recommendations resulting from the project can be used to support evidence-based synthesis for future iterations of the Dietary Guidelines for Americans or other population-based dietary guidance. Additionally, this study will serve as a harmonization guide for future research on the relationship between diet patterns and cognition. The approach outlined ultimately aims to optimize resources and expedite research efforts for dementia prevention.
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Affiliation(s)
- Amaia Ayala-Garcia
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Research Institute (HMRI), Barcelona, Spain
| | - Natalia Soldevila-Domenech
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Research Institute (HMRI), Barcelona, Spain
| | - So-Yun Yi
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States
| | - Rafael de la Torre
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Research Institute (HMRI), Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Lyn M. Steffen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States
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25
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Zhao HH, Haddad G. Brain organoid protocols and limitations. Front Cell Neurosci 2024; 18:1351734. [PMID: 38572070 PMCID: PMC10987830 DOI: 10.3389/fncel.2024.1351734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/19/2024] [Indexed: 04/05/2024] Open
Abstract
Stem cell-derived organoid technology is a powerful tool that revolutionizes the field of biomedical research and extends the scope of our understanding of human biology and diseases. Brain organoids especially open an opportunity for human brain research and modeling many human neurological diseases, which have lagged due to the inaccessibility of human brain samples and lack of similarity with other animal models. Brain organoids can be generated through various protocols and mimic whole brain or region-specific. To provide an overview of brain organoid technology, we summarize currently available protocols and list several factors to consider before choosing protocols. We also outline the limitations of current protocols and challenges that need to be solved in future investigation of brain development and pathobiology.
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Affiliation(s)
- Helen H. Zhao
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, United States
| | - Gabriel Haddad
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, United States
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
- The Rady Children's Hospital, San Diego, CA, United States
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Cugnetto ML, Morris EMJ, Bonfield SF, Gates J, Morrison I, Newman ER, Nicholls JD, Soares LM, Antonucci MT, Clemente JR, Garratt CLM, Goldstone E, Pavone DA, Farhall J. Group Acceptance and Commitment Therapy for Recovery From Psychosis: Protocol for a Single-Group Waitlist Trial. JMIR Res Protoc 2024; 13:e49849. [PMID: 38498035 PMCID: PMC10985603 DOI: 10.2196/49849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/19/2023] [Accepted: 01/09/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Psychological interventions, along with antipsychotic medications, are recommended for adults diagnosed with a psychotic disorder. While initially designed to mitigate positive symptoms, psychological interventions targeting personal recovery were developed and aligned with the recovery framework that many mental health services have adopted. Acceptance and Commitment Therapy (ACT) for psychosis is one such intervention that shows promise when delivered in an individual format. There is preliminary evidence that ACT for psychosis in a group format improves recovery. OBJECTIVE This trial aims to evaluate the effectiveness of the "Recovery ACT" group program on personal recovery among adults living with a psychotic disorder. METHODS Our unfunded study is a multiagency, prospective, nonrandomized, waitlist control, single-group trial of the Recovery ACT group program. The program involves 7 weekly group sessions of 90 minutes duration and a 90-minute booster session held 1 month later. We intend to recruit 160 adults living with a psychotic disorder who enroll in a group that is offered as a routine clinical service at participating public mental health services in Melbourne, Victoria, Australia. The 4 assessment time points are 4-6 weeks before the start of the group program, at the start of the group program, at the end of the group program, and at the booster session. There is an optional midgroup assessment and follow-up study. The primary outcome is personal recovery. Secondary outcomes include participants' well-being and psychological flexibility processes. Qualitative data are also collected from participants and facilitators. RESULTS Recruitment began in September 2019 and is ongoing until 2024, subsequent to a 24-month disruption due to the COVID-19 pandemic. As of the submission of this paper, 93 participants consented to the evaluation, 65 completed T1 measures, and 40 had a complete data set for the proposed analyses. CONCLUSIONS This is the first trial evaluating the effectiveness of the Recovery ACT group program on personal recovery for adults living with a psychotic disorder. Findings will contribute to knowledge about psychosocial interventions for adults living with psychosis. This trial may also serve as an example of a partnership between clinicians and academics that can facilitate the translation of research into practice. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12620000223932; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000223932. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49849.
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Affiliation(s)
- Marilyn L Cugnetto
- Mental Health Division, Northern Health, Epping, Victoria, Australia
- Department of Psychology, Counselling & Therapy, School of Psychology & Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Eric M J Morris
- Mental Health Division, Northern Health, Epping, Victoria, Australia
- Department of Psychology, Counselling & Therapy, School of Psychology & Public Health, La Trobe University, Bundoora, Victoria, Australia
| | | | - Jesse Gates
- Department of Psychology, Counselling & Therapy, School of Psychology & Public Health, La Trobe University, Bundoora, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
| | | | - Ellie R Newman
- Department of Psychology, Counselling & Therapy, School of Psychology & Public Health, La Trobe University, Bundoora, Victoria, Australia
- Peninsula Health Mental Health Service, Frankston, Victoria, Australia
- Alfred Mental and Addiction Health, Melbourne, Victoria, Australia
| | - Julia D Nicholls
- Department of Psychology, Counselling & Therapy, School of Psychology & Public Health, La Trobe University, Bundoora, Victoria, Australia
- Alfred Mental and Addiction Health, Melbourne, Victoria, Australia
| | - Lisa M Soares
- NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | | | | | | | - Eliot Goldstone
- NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - David A Pavone
- Mental Health Division, Northern Health, Epping, Victoria, Australia
| | - John Farhall
- Department of Psychology, Counselling & Therapy, School of Psychology & Public Health, La Trobe University, Bundoora, Victoria, Australia
- NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia
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Black AC, Edmond SN, Frank JW, Abelleira A, Snow JL, Wesolowicz DM, Becker WC. Pain Care at Home to Amplify Function: Protocol Article. Subst Use Addctn J 2024:29767342241236032. [PMID: 38469833 DOI: 10.1177/29767342241236032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Guidelines recommend strategies to optimize opioid medication safety, including frequent reassessment of the benefits and harms of long-term opioid therapy. Prescribers, who are predominantly primary care providers (PCPs), may lack the training or resources to implement these guideline-concordant practices. Two interventions have been designed to assist PCPs and tested within the Veterans Health Administration (VHA). Telemedicine Collaborative Management (TCM) provides primarily medication management support via care manager-prescriber teams. Cooperative Pain Education and Self-Management (COPES) promotes self-management strategies for chronic pain via cognitive behavior therapy techniques. Each intervention has been shown to improve prescribing and/or patient outcomes. The added value of combining these interventions is untested. With funding and central coordination by the Integrative Management of Chronic Pain and Opioid Use Disorder for Whole Recovery (IMPOWR) Network of the National Institutes of Health Helping to End Addiction Long-term (HEAL) Initiative, we will conduct a multisite patient-level randomized hybrid II effectiveness-implementation trial within VHA to compare TCM to TCM + COPES on the primary composite outcome of pain interference and opioid safety, secondary outcomes of alcohol use, anxiety, depression, and sleep, and other consensus IMPOWR Network measures. Implementation facilitation strategies informed by interviews with healthcare providers will target site-specific needs. The impact of these strategies on TCM implementation will be assessed via established formative and summative evaluation techniques. Economic analyses will evaluate intervention cost-effectiveness.
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Affiliation(s)
- Anne C Black
- VA Connecticut Healthcare System, West Haven, CT, USA
- Yale School of Medicine, New Haven, CT, USA
| | - Sara N Edmond
- VA Connecticut Healthcare System, West Haven, CT, USA
- Yale School of Medicine, New Haven, CT, USA
| | - Joseph W Frank
- VA Eastern Colorado Health Care System, Denver, CO, USA
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Audrey Abelleira
- VA Connecticut Healthcare System, West Haven, CT, USA
- Yale School of Medicine, New Haven, CT, USA
| | | | - Danielle M Wesolowicz
- VA Connecticut Healthcare System, West Haven, CT, USA
- Yale School of Medicine, New Haven, CT, USA
| | - William C Becker
- VA Connecticut Healthcare System, West Haven, CT, USA
- Yale School of Medicine, New Haven, CT, USA
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Bevilacqua R, Stara V, Amabili G, Margaritini A, Benadduci M, Barbarossa F, Maranesi E, Rigaud AS, Dacunha S, Palmier C, Moller J, Browne R, Ogawa T, Wieching R. e-VITA study protocol: EU-Japan virtual coach for smart aging. Front Public Health 2024; 12:1256734. [PMID: 38544729 PMCID: PMC10968892 DOI: 10.3389/fpubh.2024.1256734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/16/2024] [Indexed: 04/26/2024] Open
Abstract
Aim The aim of this study is to report a trial protocol for assessing the improvement of older adults' well-being, promoting active and healthy aging, and reducing the risks of social exclusion, using a virtual coach. Background Increased longevity brings with it reduced autonomy and independence, and it is therefore necessary to act with preventive measures that can promote active and healthy aging. With the development of technology, new tools have appeared, including virtual coaches, which can enable people to lead a healthy lifestyle by identifying individual needs and goals and providing personalized recommendations and advice. However, it is important that these coaches take into consideration the inter-individual and cross-cultural differences of each person. Design A randomized controlled trial is proposed. Methods This study will recruit 240 healthy subjects aged 65 years and older. Participants will be assigned to an experimental group that will receive the e-VITA system or to the control group that will receive an information booklet only. The primary outcome measure is the person's quality of life (QoL). Data will be collected at baseline, 3 months after the trial, and at the end of the trial, after 6 months. Discussion This study will evaluate the effectiveness of the e-VITA system, consisting of a virtual coach, several sensors for monitoring, a smartphone for use at home, and a booklet, in improving the older person's quality of life. The increased perceived well-being will also be linked to improvements in other areas of the person's life, psychological and cognitive status, the area of sociality, nutrition, and eHealth literacy.
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Affiliation(s)
| | - Vera Stara
- Scientific Direction, IRCCS INRCA, Ancona, Italy
| | | | | | | | | | | | - Anne-Sophie Rigaud
- Université de Paris, Maladie d’Alzheimer, Paris, France
- Services de Gériatrie 1 & 2, AP-HP, Hôpital Broca, Paris, France
| | - Sébastien Dacunha
- Université de Paris, Maladie d’Alzheimer, Paris, France
- Services de Gériatrie 1 & 2, AP-HP, Hôpital Broca, Paris, France
| | - Cecilia Palmier
- Université de Paris, Maladie d’Alzheimer, Paris, France
- Services de Gériatrie 1 & 2, AP-HP, Hôpital Broca, Paris, France
| | - Johanna Moller
- Diocesan Caritas Assosiation of the Archdiocese of Cologne e.V., Cologne, Italy
| | - Ryan Browne
- Smart-Aging Research Center, Tohoku University, Sendai, Japan
| | - Toshimi Ogawa
- Smart-Aging Research Center, Tohoku University, Sendai, Japan
| | - Rainer Wieching
- Institute for New Media & Information Systems, University Siegen, Siegen, Germany
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Fogel EL, Easler JJ, Yuan Y, Yadav D, Conwell DL, Vege SS, Han SY, Park W, Patrick V, White FA. Safety, Tolerability, and Dose-Limiting Toxicity of Lacosamide in Patients With Painful Chronic Pancreatitis: Protocol for a Phase 1 Clinical Trial to Determine Safety and Identify Side Effects. JMIR Res Protoc 2024; 13:e50513. [PMID: 38451604 PMCID: PMC10958339 DOI: 10.2196/50513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Chronic abdominal pain is the hallmark symptom of chronic pancreatitis (CP), with 50% to 80% of patients seeking medical attention for pain control. Although several management options are available, outcomes are often disappointing, and opioids remain a mainstay of therapy. Opioid-induced hyperalgesia is a phenomenon resulting in dose escalation, which may occur partly because of the effects of opioids on voltage-gated sodium channels associated with pain. Preclinical observations demonstrate that the combination of an opioid and the antiseizure drug lacosamide diminishes opioid-induced hyperalgesia and improves pain control. OBJECTIVE In this phase 1 trial, we aim to determine the safety, tolerability, and dose-limiting toxicity of adding lacosamide to opioids for the treatment of painful CP and assess the feasibility of performance of a pilot study of adding lacosamide to opioid therapy in patients with CP. As an exploratory aim, we will assess the efficacy of adding lacosamide to opioid therapy in patients with painful CP. METHODS Using the Bayesian optimal interval design, we will conduct a dose-escalation trial of adding lacosamide to opioid therapy in patients with painful CP enrolled in cohorts of size 3. The initial dose will be 50 mg taken orally twice a day, followed by incremental increases to a maximum dose of 400 mg/day, with lacosamide administered for 7 days at each dose level. Adverse events will be documented according to Common Terminology Criteria for Adverse Events (version 5.0). RESULTS As of December 2023, we have currently enrolled 6 participants. The minimum number of participants to be enrolled is 12 with a maximum of 24. We expect to publish the results by March 2025. CONCLUSIONS This trial will test the feasibility of the study design and provide reassurance regarding the tolerability and safety of opioids in treating painful CP. It is anticipated that lacosamide will prove to be safe and well tolerated, supporting a subsequent phase 2 trial assessing the efficacy of lacosamide+opioid therapy in patients with painful CP, and that lacosamide combined with opiates will lower the opioid dose necessary for pain relief and improve the safety profile of opioid use in treating painful CP. TRIAL REGISTRATION Clinicaltrials.gov NCT05603702; https://clinicaltrials.gov/study/NCT05603702. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/50513.
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Affiliation(s)
- Evan L Fogel
- Department of Medicine, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Jeffrey J Easler
- Department of Medicine, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Ying Yuan
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Dhiraj Yadav
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Darwin L Conwell
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | | | - Samuel Y Han
- Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Walter Park
- Department of Medicine, Stanford University Medical Center, Stanford, CA, United States
| | - Vanessa Patrick
- Department of Medicine, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Fletcher A White
- Department of Anesthesia, School of Medicine, Indiana University, Indianapolis, IN, United States
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Achten J, Marques EMR, Pinedo-Villanueva R, Whitehouse MR, Eardley WGP, Costa ML, Kearney RS, Keene DJ, Griffin XL. The FAME trial study protocol: In younger adults with unstable ankle fractures treated with close contact casting, is ankle function not worse than those treated with surgical intervention? Bone Jt Open 2024; 5:184-201. [PMID: 38447595 PMCID: PMC10924289 DOI: 10.1302/2633-1462.53.bjo-2023-0099.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024] Open
Abstract
Aims Ankle fracture is one of the most common musculoskeletal injuries sustained in the UK. Many patients experience pain and physical impairment, with the consequences of the fracture and its management lasting for several months or even years. The broad aim of ankle fracture treatment is to maintain the alignment of the joint while the fracture heals, and to reduce the risks of problems, such as stiffness. More severe injuries to the ankle are routinely treated surgically. However, even with advances in surgery, there remains a risk of complications; for patients experiencing these, the associated loss of function and quality of life (Qol) is considerable. Non-surgical treatment is an alternative to surgery and involves applying a cast carefully shaped to the patient's ankle to correct and maintain alignment of the joint with the key benefit being a reduction in the frequency of common complications of surgery. The main potential risk of non-surgical treatment is a loss of alignment with a consequent reduction in ankle function. This study aims to determine whether ankle function, four months after treatment, in patients with unstable ankle fractures treated with close contact casting is not worse than in those treated with surgical intervention, which is the current standard of care. Methods This trial is a pragmatic, multicentre, randomized non-inferiority clinical trial with an embedded pilot, and with 12 months clinical follow-up and parallel economic analysis. A surveillance study using routinely collected data will be performed annually to five years post-treatment. Adult patients, aged 60 years and younger, with unstable ankle fractures will be identified in daily trauma meetings and fracture clinics and approached for recruitment prior to their treatment. Treatments will be performed in trauma units across the UK by a wide range of surgeons. Details of the surgical treatment, including how the operation is done, implant choice, and the recovery programme afterwards, will be at the discretion of the treating surgeon. The non-surgical treatment will be close-contact casting performed under anaesthetic, a technique which has gained in popularity since the publication of the Ankle Injury Management (AIM) trial. In all, 890 participants (445 per group) will be randomly allocated to surgical or non-surgical treatment. Data regarding ankle function, QoL, complications, and healthcare-related costs will be collected at eight weeks, four and 12 months, and then annually for five years following treatment. The primary outcome measure is patient-reported ankle function at four months from treatment. Anticipated impact The 12-month results will be presented and published internationally. This is anticipated to be the only pragmatic trial reporting outcomes comparing surgical with non-surgical treatment in unstable ankle fractures in younger adults (aged 60 years and younger), and, as such, will inform the National Institute for Health and Care Excellence (NICE) 'non-complex fracture' recommendations at their scheduled update in 2024. A report of long-term outcomes at five years will be produced by January 2027.
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Affiliation(s)
- Juul Achten
- Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | | | - Rafael Pinedo-Villanueva
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | | | | | - Matthew L. Costa
- Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | | | - David J. Keene
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Xavier L. Griffin
- Barts Bone and Joint Health, Blizard Institute, Queen Mary University of London, London, UK
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Main A, McCartney H, Ibrar M, Rai HK, Muirhead F, Mavroeidi A, Maguire R. Patients' Experiences of Digital Health Interventions for the Self-Management of Chronic Pain: Protocol for a Systematic Review and Thematic Synthesis. JMIR Res Protoc 2024; 13:e52469. [PMID: 38451694 PMCID: PMC10958340 DOI: 10.2196/52469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Chronic pain is a highly prevalent condition that requires multidisciplinary treatment. However, in the United Kingdom, access to specialist pain clinics where patients can receive medical multidisciplinary treatment is limited, and provision varies between health boards. As such, self-management of chronic pain using digital tools has been gaining traction recently, but evidence of its effectiveness from clinical-based trials focuses mainly on quantitative outcomes. OBJECTIVE This systematic review aims to identify, appraise, and synthesize qualitative evidence on patients' experiences with digital health interventions (DHIs) for the management of chronic pain. METHODS This systematic review will consider qualitative and mixed methods studies that explore the experience of patients (aged 18 years and older) with chronic pain engaging in DHIs to manage their pain. MEDLINE Ovid, PubMed, Embase, CINAHL, PsycINFO, and Scopus databases will be searched for published studies. The systematic review will be conducted in accordance with the ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) guidelines. Following the 3-step thematic synthesis methodology of Thomas and Harden, titles and abstracts will be screened by 2 independent reviewers (AM and HM), and a third reviewer (MI or FM) will resolve any conflict that arises before the full-text screening. The Critical Appraisal Skills Programme checklist tool will be used to critically appraise the included studies. The extracted data will be imported to NVivo (QSR International), where thematic synthesis will be used to derive analytical themes from the included studies. RESULTS Themes that encapsulate the patient experience will be identified from qualitative evidence, and these themes will shed light on the perceived benefits and disadvantages, usability, acceptability, and the overall impact digital tools can have on the lives of those with chronic pain. CONCLUSIONS This systematic review will identify, appraise, and synthesize the overall experience of patients engaging in DHI to manage a diverse range of chronic pain conditions. By elaborating the patient experience through qualitative analysis, the findings from this review will enhance our current understanding of the experiences of patients with chronic pain using digital tools for the self-management of their pain and highlight what person-centered elements are essential for future DHI development. TRIAL REGISTRATION PROSPERO CRD42023445100; http://tinyurl.com/4z77khfs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52469.
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Affiliation(s)
- Ashleigh Main
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Haruno McCartney
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Maryam Ibrar
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Harleen Kaur Rai
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Fiona Muirhead
- Physical Activity for Health, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
| | - Alexandra Mavroeidi
- Department of Occupational Therapy and Human Nutrition and Dietetics, School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Roma Maguire
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
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Allwang C, Frank T, Bruckmann P, Dinkel A, Binneboese M, Wallis H, Elgner M, Giel KE, Schurr M, Gündel H, Wedekind L, Kuhn J, Lahmann C, Müller AM, Beckmann P, Massag J, Mikolajczyk R, Junne F. Addressing psychosocial needs in patients with Long-COVID (PsyLoCo-Study): study protocol of a pilot-study of a specialized modular intervention. Front Psychiatry 2024; 15:1305691. [PMID: 38510801 PMCID: PMC10951091 DOI: 10.3389/fpsyt.2024.1305691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/14/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction After an acute infection with the corona virus 10-20% of those affected suffer from ongoing or new symptoms. A causal therapy for the phenomenon known as Long/Post-COVID is still lacking and specific therapies addressing psychosocial needs of these patients are imperatively needed. The aim of the PsyLoCo-study is developing and piloting a psychotherapeutic manual, which addresses Long/Post-COVID-related psychosocial needs and supports in coping with persistent bodily symptoms as well as depressive or anxiety symptoms. Methods and analysis This pilot trial implements a multi-centre, 2-arm (N=120; allocation ratio: 1:1), parallel group, randomised controlled design. The pilot trial is designed to test the feasibility and estimate the effect of 1) a 12-session psychotherapeutic intervention compared to 2) a wait-list control condition on psychosocial needs as well as bodily and affective symptoms in patients suffering from Long/Post-COVID. The intervention uses an integrative, manualized, psychotherapeutic approach. The primary study outcome is health-related quality of life. Outcome variables will be assessed at three timepoints, pre-intervention (t1), post-intervention (t2) and three months after completed intervention (t3). To determine the primary outcome, changes from t1 to t2 are examined. The analysis will be used for the planning of the RCT to test the efficacy of the developed intervention. Discussion The pilot study will evaluate a 12-session treatment manual for Long/Post-COVID sufferers and the therapy components it contains. The analysis will provide insights into the extent to which psychotherapeutic treatment approaches improve the symptoms of Long/Post-COVID sufferers. The treatment manual is designed to be carried out by psychotherapists as well as people with basic training in psychotherapeutic techniques. This approach was chosen to enable a larger number of practitioners to provide therapeutic support for Long/Post-COVID patients. After completion of the pilot study, it is planned to follow up with a randomized controlled study and to develop a treatment guideline for general practitioners and interested specialists. Trial registration The pilot trial has been registered with the German Clinical Trials Register (Deutsches Register Klinischer Studien; Trial-ID: DRKS00030866; URL: https://drks.de/search/de/trial/DRKS00030866) on March 7, 2023.
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Affiliation(s)
- Christine Allwang
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Tamara Frank
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Paul Bruckmann
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Marius Binneboese
- Department of Psychosomatic Medicine and Psychotherapy, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Hannah Wallis
- Department of Psychosomatic Medicine and Psychotherapy, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Melanie Elgner
- Department of Psychosomatic Medicine and Psychotherapy, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Katrin E. Giel
- Department of Psychosomatic Medicine and Psychotherapy, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Marisa Schurr
- Department of Psychosomatic Medicine and Psychotherapy, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany
| | - Lisa Wedekind
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany
| | - Julia Kuhn
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany
| | - Claas Lahmann
- Department of Psychosomatic Medicine and Psychotherapy, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Anne-Maria Müller
- Department of Psychosomatic Medicine and Psychotherapy, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Pauline Beckmann
- Department of Psychosomatic Medicine and Psychotherapy, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Janka Massag
- Medical Faculty, Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Rafael Mikolajczyk
- Medical Faculty, Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- German Center for Mental Health (DZPG), partner site Halle-Jena-Magdeburg, Halle, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- German Center for Mental Health (DZPG), partner Site Halle-Jena-Magdeburg, Magdeburg, Germany
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O’Connor K, Weissenbacher D, Elyaderani A, Lautenbach E, Scotch M, Gonzalez-Hernandez G. Patient-Related Metadata Reported in Sequencing Studies of SARS-CoV-2: Protocol for a Scoping Review and Bibliometric Analysis. medRxiv 2024:2023.07.14.23292681. [PMID: 37503241 PMCID: PMC10371180 DOI: 10.1101/2023.07.14.23292681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Background There has been an unprecedented effort to sequence the SARS-CoV-2 virus and examine its molecular evolution. This has been facilitated by the availability of publicly accessible databases, the Global Initiative on Sharing All Influenza Data (GISAID) and GenBank, which collectively hold millions of SARS-CoV-2 sequence records. Genomic epidemiology, however, seeks to go beyond phylogenetic analysis by linking genetic information to patient characteristics and disease outcomes, enabling a comprehensive understanding of transmission dynamics and disease impact.While these repositories include fields reflecting patient-related metadata for a given sequence, inclusion of these demographic and clinical details is scarce. The extent to which patient-related metadata is reported in published sequencing studies and its quality remains largely unexplored. Methods The NIH's LitCovid collection will be used for automated classification of articles reporting having deposited SARS-CoV-2 sequences in public repositories, while an independent search will be conducted in PubMed for validation. Data extraction will be conducted using Covidence. The extracted data will be synthesized and summarized to quantify the availability of patient metadata in the published literature of SARS-CoV-2 sequencing studies. For the bibliometric analysis, relevant data points, such as author affiliations and citation metrics will be extracted. Discussion This scoping review will report on the extent and types of patient-related metadata reported in genomic viral sequencing studies of SARS-CoV-2, identify gaps in this reporting, and make recommendations for improving the quality and consistency of reporting in this area. The bibliometric analysis will uncover trends and patterns in the reporting of patient-related metadata, including differences in reporting based on study types or geographic regions. Co-occurrence networks of author keywords will also be presented. The insights gained from this study may help improve the quality and consistency of reporting patient metadata, enhancing the utility of sequence metadata and facilitating future research on infectious diseases.
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Affiliation(s)
- Karen O’Connor
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Davy Weissenbacher
- Department of Computational Biomedicine, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | - Amir Elyaderani
- Biodesign Center for Environmental Health Engineering, Arizona State University, Tempe, AZ, USA
| | - Ebbing Lautenbach
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Matthew Scotch
- Biodesign Center for Environmental Health Engineering, Arizona State University, Tempe, AZ, USA
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
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Cao J, Du Y, Yin X, Zheng N, Han J, Chen L, Jia L. Understanding the mechanism of acupuncture in acute cerebral infraction through a proteomic analysis: protocol for a prospective randomized controlled trial. Front Neurosci 2024; 18:1365598. [PMID: 38505769 PMCID: PMC10948497 DOI: 10.3389/fnins.2024.1365598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/08/2024] [Indexed: 03/21/2024] Open
Abstract
Background Acute cerebral infarction (ACI), being the predominant form of stroke, presents challenges in terms of the limited effectiveness of various treatments in improving the neurological function. Although acupuncture shows promise in addressing ACI, the availability of high-quality evidence regarding its efficacy, safety, and underlying mechanism remains insufficient. In this study, we design a multicenter, prospective, single-blind, randomized controlled trial with the aim of evaluating the efficacy and safety of acupuncture for ACI, making an attempt to unveil the molecular mechanisms by proteomic. Methods A total of 132 patients involving four hospitals will be randomized at a 1:1:1 ratio in the acupuncture group, control group, and sham acupuncture group. All the patients will receive basic treatment, and the patients in the acupuncture and sham acupuncture groups will also receive either acupuncture or sham acupuncture treatment, respectively, at six sessions each week for a 2 weeks period, followed by 3 months of follow-up. The primary outcome will be the change in the National Institute of Health Stroke Scale (NIHSS) scores after treatment. The secondary outcomes will include the Fugl-Meyer Assessment (FMA) scale scores and the Barthel Index (BI). Adverse events that occur during the trial will be documented. To discover differentially expressed proteins (DEPs) and their roles between the ACI subjects and healthy controls, we will also perform 4D-DIA quantitative proteomics analysis, and the DEPs will be confirmed by enzyme-linked immunosorbent assay (ELISA). This study was approved by the institutional review board of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine (TYLL2023043). Written informed consent from patients is required. This trial is registered in the Chinese Clinical Trial Registry (ChiCTR2300079204). Trial results will be published in a peer-reviewed academic journal. Discussion The results of this study will determine the preliminary efficacy and safety of acupuncture in ACI patients and whether the mechanism of this form of non-pharmacologic stimulation is mediated by a novel therapeutic target for neurorehabilitation through our proteomic analysis. Clinical trial registration https://www.chictr.org.cn, identifier ChiCTR2300079204.
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Affiliation(s)
- Jiangpeng Cao
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yuanhao Du
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiumei Yin
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Na Zheng
- Department of Traditional Chinese medicine, Tianjin Huanhu hospital, Tianjin, China
| | - Jiawei Han
- Department of Traditional Chinese Medicine, First Hospital of Jilin University, Changchun, China
| | - Linling Chen
- Department of Traditional Chinese Medicine, Huzhou Central Hospital, Zhejiang, China
| | - Lanyu Jia
- Department of Geriatric Medicine, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
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Guo ZN, Qu Y, Abuduxukuer R, Zhang P, Wang L, Liu Y, Teng RH, Gao JH, Jin F, Wang HF, Cao Y, Xue YQ, Zhao JF, Selim MH, Nguyen TN, Yang Y. Safety and efficacy of remote ischemic conditioning for spontaneous intracerebral hemorrhage (SERIC-ICH): A multicenter, randomized, parallel-controlled clinical trial study design and protocol. Eur Stroke J 2024; 9:259-264. [PMID: 37752799 PMCID: PMC10916805 DOI: 10.1177/23969873231201712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/30/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Previous studies have revealed that remote ischemic conditioning (RIC) may have a neuroprotective function. However, the potential benefit of RIC for patients with ICH remain unclear. OBJECTIVE The primary aim of this study is to assess the safety and efficacy of RIC for patients with ICH. METHODS The Safety and Efficacy of RIC for Spontaneous ICH (SERIC-ICH) is an ongoing prospective, randomized, multicenter, parallel-controlled, and blinded-endpoint clinical trial. The study will enroll an estimated 2000 patients aged ⩾18 years within 24 h after ICH onset, with National Institutes of Health Stroke Scale ⩾6 and Glasgow Coma Scale ⩾8 upon presentation. The patients will be randomly assigned to the RIC or control groups (1:1) and will be treated with cuffs inflated to a pressure of 200 or 60 mmHg, respectively, twice daily for 7 days. Each RIC treatment will consist of four cycles of arm ischemia for 5 min, followed by reperfusion for another 5 min, for a total procedure time of 35 min. The primary efficacy outcome measure is the proportion of patients with good functional outcomes (modified Rankin scale 0-2) at 180 days. The safety outcome measures will include all adverse events and severe adverse events occurring in the course of the study. DISCUSSION RIC is an inexpensive intervention and might be a strategy to improve outcomes in patients with ICH. The SERIC-ICH trial will investigate whether RIC treatment can be applied as an adjuvant treatment in the acute phase of ICH and identify safety issues.
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Affiliation(s)
- Zhen-Ni Guo
- Stroke Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, China
- Neuroscience Research Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, China
| | - Yang Qu
- Stroke Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, China
| | - Reziya Abuduxukuer
- Stroke Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, China
| | - Peng Zhang
- Stroke Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, China
| | - Lijuan Wang
- Department of Neurology, Songyuan Central Hospital, Songyuan, China
| | - Ying Liu
- Department of Neurology, Tonghua Liuhe Hospital, Tonghua, China
| | - Rui-Hong Teng
- Department of Neurology, Dongliao First People’s Hospital, Liaoyuan, China
| | - Jian-Hua Gao
- Department of Neurology, Jilin Neuropsychiatric Hospital, Siping, China
| | - Feng Jin
- Department of Neurology, Dongfeng County Hospital, Liaoyuan, China
| | - Hai-Feng Wang
- Department of Neurosurgery, Liaoyuan City Central Hospital, Liaoyuan, China
| | - Yu Cao
- Department of Neurology, Nongan People Hospital, Changchun, China
| | - Yong-Quan Xue
- Department of Neurology, Dunhua City Hospital, Yanbian, China
| | - Jun-Feng Zhao
- Stroke Center, Department of Neurology, Siping Central People’s Hospital, Siping, China
| | - Magdy H Selim
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Thanh N Nguyen
- Neurology, Radiology, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, USA
| | - Yi Yang
- Stroke Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, China
- Neuroscience Research Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, China
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Yunus RA, Saeed S, Levy N, Di Fenza R, Sharkey A, Pobywajlo S, Liang P, Schermerhorn M, Mahmood F, Matyal R, Neves S. A Multidisciplinary Protocolized Approach for Ruptured Abdominal Aortic Aneurysm Management: A Retrospective Before-After Study. J Cardiothorac Vasc Anesth 2024; 38:755-770. [PMID: 38220517 DOI: 10.1053/j.jvca.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/01/2023] [Accepted: 12/11/2023] [Indexed: 01/16/2024]
Abstract
OBJECTIVES To investigate whether implementation of a multidisciplinary protocol for ruptured abdominal aortic aneurysm (rAAA) management reduces rates of adverse complications. DESIGN A retrospective before-after study. SETTING A tertiary-care academic hospital. PARTICIPANTS Adult patients who underwent open or endovascular rAAA repair; data were stratified into before-protocol implementation (group 1: 2015-2018) and after-protocol implementation (group 2: 2019-2022) groups. INTERVENTION The protocol details the workflow for vascular surgery, anesthesia, emergency department, and operating room staff for a rAAA case; training was accomplished through yearly workshops. MEASUREMENTS AND MAIN RESULTS The primary outcome was in-hospital mortality. Secondary outcomes included all-cause morbidity and other major complications. Differences in postoperative complication rates between groups were assessed using Pearson's χ2 test. Of the 77 patients included undergoing rAAA repair, 41 (53.2%) patients were in group 1, and 36 (46.8%) patients were in group 2. Patients in group 2 had a significantly shorter median time to incision (1.0 v 0.7 hours, p = 0.022) and total procedure time (180.0 v 160.5 minutes, p = 0.039) for both endovascular and open repair. After protocol implementation, patients undergoing endovascular repair exhibited significantly lower rates of mortality (46.2% v 20.0%, p = 0.048), all-cause morbidity (65.4% v 44.0%, p = 0.050), and renal complications (15.4% v 0.0%, p = 0.036); patients undergoing open repair for a rAAA exhibited significantly lower rates of mortality (53.3% v 27.3%, p = 0.018) and bowel ischemia (26.7% v 0.0%, p = 0.035). CONCLUSIONS Implementation of a multidisciplinary protocol for the management of a rAAA may reduce rates of adverse complications and improve the quality of care.
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Affiliation(s)
- Rayaan A Yunus
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA
| | - Shirin Saeed
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA
| | - Nadav Levy
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA
| | - Raffaele Di Fenza
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA
| | - Aidan Sharkey
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA
| | - Susan Pobywajlo
- The CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, MA
| | - Patric Liang
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA
| | - Marc Schermerhorn
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA
| | - Feroze Mahmood
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA
| | - Robina Matyal
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA.
| | - Sara Neves
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA
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Klebe S, Judge M, Brcic L, Dacic S, Galateau-Salle F, Nicholson AG, Roggli V, Nowak AK, Cooper WA. Mesothelioma in the pleura, pericardium and peritoneum: Recommendations from the International Collaboration on Cancer Reporting (ICCR). Histopathology 2024; 84:633-645. [PMID: 38044849 DOI: 10.1111/his.15106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/19/2023] [Accepted: 11/12/2023] [Indexed: 12/05/2023]
Abstract
AIMS Mesothelioma is a rare malignancy of the serosal membranes that is commonly related to exposure to asbestos. Despite extensive research and clinical trials, prognosis to date remains poor. Consistent, comprehensive and reproducible pathology reporting form the basis of all future interventions for an individual patient, but also ensures that meaningful data are collected to identify predictive and prognostic markers. METHODS AND RESULTS This article details the International Collaboration on Cancer Reporting (ICCR) process and the development of the international consensus mesothelioma reporting data set. It describes the 'core' and 'non-core' elements to be included in pathology reports for mesothelioma of all sites, inclusive of clinical, macroscopic, microscopic and ancillary testing considerations. An international expert panel consisting of pathologists and a medical oncologist produced a set of data items for biopsy and resection specimens based on a critical review and discussion of current evidence, and in light of the changes in the 2021 WHO Classification of Tumours. The commentary focuses particularly upon new entities such as mesothelioma in situ and provides background on relevant and essential ancillary testing as well as implementation of the new requirement for tumour grading. CONCLUSION We recommend widespread and consistent implementation of this data set, which will facilitate accurate reporting and enhance the consistency of data collection, improve the comparison of epidemiological data, support retrospective research and ultimately help to improve clinical outcomes. To this end, all data sets are freely available worldwide on the ICCR website (www.iccr-cancer.org/data-sets).
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Affiliation(s)
- Sonja Klebe
- Department of Anatomical Pathology, Flinders University and SA Pathology, Adelaide, SA, Australia
| | - Meagan Judge
- International Collaboration on Cancer Reporting, Sydney, NSW, Australia
| | - Luka Brcic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Sanja Dacic
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Andrew G Nicholson
- Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Victor Roggli
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Anna K Nowak
- Medical School, University of Western Australia, Crawley, WA, Australia
| | - Wendy A Cooper
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- Sydney Medical School, University of Sydney, Camperdown, NSW, Australia
- Discipline of Pathology, School of Medicine, Western Sydney University, Sydney, NSW, Australia
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Cliteur MP, van der Kolk AG, Hannink G, Hofmeijer J, Jolink WMT, Klijn CJM, Schreuder FHBM. Anakinra in cerebral haemorrhage to target secondary injury resulting from neuroinflammation (ACTION): Study protocol of a phase II randomised clinical trial. Eur Stroke J 2024; 9:265-273. [PMID: 37713268 PMCID: PMC10916813 DOI: 10.1177/23969873231200686] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/10/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Inflammation plays a vital role in the development of secondary brain injury after spontaneous intracerebral haemorrhage (ICH). Interleukin-1 beta is an early pro-inflammatory cytokine and a potential therapeutic target. AIM To determine the effect of treatment with recombinant human interleukin-1 receptor antagonist anakinra on perihematomal oedema (PHO) formation in patients with spontaneous ICH compared to standard medical management, and investigate whether this effect is dose-dependent. METHODS ACTION is a phase-II, prospective, randomised, three-armed (1:1:1) trial with open-label treatment and blinded end-point assessment (PROBE) at three hospitals in The Netherlands. We will include 75 patients with a supratentorial spontaneous ICH admitted within 8 h after symptom onset. Participants will receive anakinra in a high dose (loading dose 500 mg intravenously, followed by infusion with 2 mg/kg/h over 72 h; n = 25) or in a low dose (loading dose 100 mg subcutaneously, followed by 100 mg subcutaneous twice daily for 72 h; n = 25), plus standard care. The control group (n = 25) will receive standard medical management. OUTCOMES Primary outcome is PHO, measured as oedema extension distance on MRI at day 7 ± 1. Secondary outcomes include the safety profile of anakinra, the effect of anakinra on serum inflammation markers, MRI measures of blood brain barrier integrity, and functional outcome at 90 ± 7 days. DISCUSSION The ACTION trial will provide insight into whether targeting interleukin-1 beta in the early time window after ICH onset could ameliorate secondary brain injury. This may contribute to the development of new treatment options to improve clinical outcome after ICH.
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Affiliation(s)
- MP Cliteur
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - AG van der Kolk
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - G Hannink
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J Hofmeijer
- Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands
- Department of Clinical Neurophysiology, University of Twente, Enschede, The Netherlands
| | - WMT Jolink
- Department of Neurology, Isala Hospital, Zwolle, The Netherlands
| | - CJM Klijn
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - FHBM Schreuder
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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Lussier M, Couture M, Giroux S, Aboujaoudé A, Ngankam HK, Pigot H, Gaboury S, Bouchard K, Bottari C, Belchior P, Paré G, Bier N. Codevelopment and Deployment of a System for the Telemonitoring of Activities of Daily Living Among Older Adults Receiving Home Care Services: Protocol for an Action Design Research Study. JMIR Res Protoc 2024; 13:e52284. [PMID: 38422499 PMCID: PMC10940984 DOI: 10.2196/52284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Telemonitoring of activities of daily living (ADLs) offers significant potential for gaining a deeper insight into the home care needs of older adults experiencing cognitive decline, particularly those living alone. In 2016, our team and a health care institution in Montreal, Quebec, Canada, sought to test this technology to enhance the support provided by home care clinical teams for older adults residing alone and facing cognitive deficits. The Support for Seniors' Autonomy program (SAPA [Soutien à l'autonomie des personnes âgées]) project was initiated within this context, embracing an innovative research approach that combines action research and design science. OBJECTIVE This paper presents the research protocol for the SAPA project, with the aim of facilitating the replication of similar initiatives in the future. The primary objectives of the SAPA project were to (1) codevelop an ADL telemonitoring system aligned with the requirements of key stakeholders, (2) deploy the system in a real clinical environment to identify specific use cases, and (3) identify factors conducive to its sustained use in a real-world setting. Given the context of the SAPA project, the adoption of an action design research (ADR) approach was deemed crucial. ADR is a framework for crafting practical solutions to intricate problems encountered in a specific organizational context. METHODS This project consisted of 2 cycles of development (alpha and beta) that involved cyclical repetitions of stages 2 and 3 to develop a telemonitoring system for ADLs. Stakeholders, such as health care managers, clinicians, older adults, and their families, were included in each codevelopment cycle. Qualitative and quantitative data were collected throughout this project. RESULTS The first iterative cycle, the alpha cycle, took place from early 2016 to mid 2018. The first prototype of an ADL telemonitoring system was deployed in the homes of 4 individuals receiving home care services through a public health institution. The prototype was used to collect data about care recipients' ADL routines. Clinicians used the data to support their home care intervention plan, and the results are presented here. The prototype was successfully deployed and perceived as useful, although obstacles were encountered. Similarly, a second codevelopment cycle (beta cycle) took place in 3 public health institutions from late 2018 to late 2022. The telemonitoring system was installed in 31 care recipients' homes, and detailed results will be presented in future papers. CONCLUSIONS To our knowledge, this is the first reported ADR project in ADL telemonitoring research that includes 2 iterative cycles of codevelopment and deployment embedded in the real-world clinical settings of a public health system. We discuss the artifacts, generalization of learning, and dissemination generated by this protocol in the hope of providing a concrete and replicable example of research partnerships in the field of digital health in cognitive aging. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/52284.
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Affiliation(s)
- Maxime Lussier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Université de Montréal, Montreal, QC, Canada
- École de réadaptation, Faculté de médecine, Université de Montréal, Montréal, QC, Canada
| | - Mélanie Couture
- Centre for Research and Expertise in Social Gerontology, Integrated Health and Social Services University Network for West-Central Montreal, Côte- Saint-Luc, QC, Canada
- School of Social Work, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Sylvain Giroux
- Computer Science Department, Faculty of Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Aline Aboujaoudé
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Université de Montréal, Montreal, QC, Canada
- École de réadaptation, Faculté de médecine, Université de Montréal, Montréal, QC, Canada
| | - Hubert Kenfack Ngankam
- Computer Science Department, Faculty of Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Hélène Pigot
- Computer Science Department, Faculty of Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Sébastien Gaboury
- Department of Mathematics and Computer Science, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Kevin Bouchard
- Department of Mathematics and Computer Science, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Carolina Bottari
- École de réadaptation, Faculté de médecine, Université de Montréal, Montréal, QC, Canada
| | - Patricia Belchior
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Université de Montréal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Guy Paré
- Research Chair in Digital Health, HEC Montréal, Montréal, QC, Canada
| | - Nathalie Bier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Université de Montréal, Montreal, QC, Canada
- École de réadaptation, Faculté de médecine, Université de Montréal, Montréal, QC, Canada
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Kulkarni T, Criner GJ, Kass DJ, Rosas IO, Scholand MB, Dilling DF, Summer R, Duncan SR. Design of the STRIVE-IPF Trial- Study of Therapeutic Plasma Exchange, Rituximab, and Intravenous Immunoglobulin for Acute Exacerbations of Idiopathic Pulmonary Fibrosis. Res Sq 2024:rs.3.rs-3962419. [PMID: 38464052 PMCID: PMC10925430 DOI: 10.21203/rs.3.rs-3962419/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Background Acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF) affect a significant proportion of patients with IPF. There are limited data to inform therapeutic strategies for AEIPF, despite its high mortality. We discuss the rationale and design of STRIVE-IPF, a randomized, multi-center, open-label Phase IIb clinical trial to determine the efficacy of combined therapeutic plasma exchange (TPE), rituximab, and intravenous immunoglobulin (IVIG), in comparison to treatment as usual (TAU), among patients with acute IPF exacerbations. Methods The STRIVE-IPF trial will randomize 51 patients among five sites in the United States. The inclusion criteria have been designed to select a study population with AE-IPF, as defined by American Thoracic Society criteria, while excluding patients with an alternative cause for a respiratory decompensation. The primary endpoint of this trial is six-month survival. Secondary endpoints include supplement oxygen requirement and six-minute walk distance which will be assessed immediately prior to treatment and after completion of therapy on day 19, as well as at periodic subsequent visits. Discussion The experimental AE-IPF therapy proposed in this clinical trial was adapted from treatment regimens used in other antibody-mediated diseases. The regimen is initiated with TPE, which is expected to rapidly reduce circulating autoantibodies, followed by rituximab to reduce B-cells and finally IVIG, which likely has multiple effects, including affecting feedback inhibition of residual B-cells by Fc receptor occupancy. We have reported potential benefits of this experimental therapy for AE-IPF in previous anecdotal reports. This clinical trial has the potential to profoundly affect current paradigms and treatment approaches to patients with AE-IPF.Trial Registration ClinicalTrials.gov identifier: NCT03286556.
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Affiliation(s)
- Tejaswini Kulkarni
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Gerard J Criner
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Daniel J Kass
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ivan O Rosas
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Mary Beth Scholand
- Pulmonary Division, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Daniel F Dilling
- Division of Pulmonary and Critical Care Medicine, Loyola University Chicago, Stritch School of Medicine, Maywood, IL
| | - Ross Summer
- Section of Pulmonary and Critical Care, Thomas Jefferson University, Philadelphia, PA
| | - Steven R Duncan
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
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Fizikova A, Subcheva E, Kozlov N, Tvorogova V, Samarina L, Lutova L, Khlestkina E. Agrobacterium Transformation of Tea Plants ( Camellia sinensis (L.) KUNTZE): A Small Experiment with Great Prospects. Plants (Basel) 2024; 13:675. [PMID: 38475520 DOI: 10.3390/plants13050675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/16/2024] [Accepted: 02/24/2024] [Indexed: 03/14/2024]
Abstract
Tea has historically been one of the most popular beverages, and it is currently an economically significant crop cultivated in over 50 countries. The Northwestern Caucasus is one of the northernmost regions for industrial tea cultivation worldwide. The domestication of the tea plant in this region took approximately 150 years, during which plantations spreading from the Ozurgeti region in northern Georgia to the southern city of Maykop in Russia. Consequently, tea plantations in the Northern Caucasus can serve as a source of unique genotypes with exceptional cold tolerance. Tea plants are known to be recalcitrant to Agrobacterium-mediated transfection. Research into optimal transfection and regeneration methodologies, as well as the identification of tea varieties with enhanced transformation efficiency, is an advanced strategy for improving tea plant culture. The aim of this study was to search for the optimal Agrobacterium tumefaciens-mediated transfection protocol for the Kolkhida tea variety. As a result of optimizing the transfection medium with potassium phosphate buffer at the stages of pre-inoculation, inoculation and co-cultivation, the restoration of normal morphology and improvement in the attachment of Agrobacterium cells to the surface of tea explants were observed by scanning electron microscopy. And an effective method of high-efficiency Agrobacteria tumefaciens-mediated transfection of the best local tea cultivar, Kolkhida, was demonstrated for the first time.
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Affiliation(s)
- Anastasia Fizikova
- Plant Biology and Biotechnology Department, Sirius University of Science and Technology, Olympic Avenue, 1, 354340 Sochi, Russia
- Federal Research Centre the Subtropical Scientific Centre of the Russian Academy of Sciences, 2/28, Yana Fabritsiusa Street, 354002 Sochi, Russia
| | - Elena Subcheva
- Plant Biology and Biotechnology Department, Sirius University of Science and Technology, Olympic Avenue, 1, 354340 Sochi, Russia
| | - Nikolay Kozlov
- Department of Genetics and Biotechnology, Saint Petersburg State University, Universitetskaya Emb 7/9, 199034 Saint-Petersburg, Russia
| | - Varvara Tvorogova
- Plant Biology and Biotechnology Department, Sirius University of Science and Technology, Olympic Avenue, 1, 354340 Sochi, Russia
- Department of Genetics and Biotechnology, Saint Petersburg State University, Universitetskaya Emb 7/9, 199034 Saint-Petersburg, Russia
| | - Lidia Samarina
- Plant Biology and Biotechnology Department, Sirius University of Science and Technology, Olympic Avenue, 1, 354340 Sochi, Russia
- Federal Research Centre the Subtropical Scientific Centre of the Russian Academy of Sciences, 2/28, Yana Fabritsiusa Street, 354002 Sochi, Russia
| | - Ludmila Lutova
- Plant Biology and Biotechnology Department, Sirius University of Science and Technology, Olympic Avenue, 1, 354340 Sochi, Russia
- Department of Genetics and Biotechnology, Saint Petersburg State University, Universitetskaya Emb 7/9, 199034 Saint-Petersburg, Russia
| | - Elena Khlestkina
- Plant Biology and Biotechnology Department, Sirius University of Science and Technology, Olympic Avenue, 1, 354340 Sochi, Russia
- N.I. Vavilov All-Russian Research Institute of Plant Genetic Resources (VIR), B. Morskaya Street, 42-44, 190000 St. Petersburg, Russia
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Kovacs Burns K, Bhatia Z, Gill B, van der Nest D, Knox J, Mouneimne M, Buck T, Charbonneau R, Aiello K, Loyola Sanchez A, Kamran R, Olayinka O, Ho C. Measures for Persons with Spinal Cord Injury to Monitor Their Transitions in Care, Health, Function, and Quality of Life Experiences and Needs: A Protocol for Co-Developing a Self-Evaluation Tool. Healthcare (Basel) 2024; 12:527. [PMID: 38470643 PMCID: PMC10930772 DOI: 10.3390/healthcare12050527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/30/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
Evaluating the experiences of persons with spinal cord injury (PwSCI) regarding their transitions in care and changes in health, function, and quality of life is complex, fragmented, and involves multiple tools and measures. A staged protocol was implemented with PwSCI and relevant expert stakeholders initially exploring and selecting existing measures or tools through a modified Delphi process, followed by choosing one of two options. The options were to either support the use of the 10 selected tools from the Delphi method or to co-develop one unique condensed tool with relevant measures to evaluate all four domains. The stakeholders chose to co-develop one tool to be used by persons with SCI to monitor their transition experiences across settings and care providers. This includes any issues with care or support they needed to address at the time of discharge from acute care or rehabilitation and in the community at 3, 6, and 12 months or longer post-discharge. Once developed, the tool was made available online for the final stage of the protocol, which proposes that the tool be reliability tested prior to its launch, followed by validation testing by PwSCI.
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Affiliation(s)
- Katharina Kovacs Burns
- Clinical Quality Metrics/Primary Data Support, Data & Analytics, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Zahra Bhatia
- Spinal Cord Injury Alberta, Calgary, AB T2H 1H7, Canada
| | - Benveet Gill
- ReYu Paralysis Recovery Centre, Edmonton, AB T5S 1G8, Canada
| | - Dalique van der Nest
- Slave Lake Healthcare Centre (North Zone), Alberta Health Services, Slave Lake, AB T0G 2A2, Canada
| | - Jason Knox
- Tertiary Neurorehabilitation, Foothills Medical Centre, Calgary, AB T2N 2T9, Canada
| | - Magda Mouneimne
- Tertiary Neurorehabilitation, Foothills Medical Centre, Calgary, AB T2N 2T9, Canada
| | - Taryn Buck
- Glenrose Rehabilitation Hospital, Edmonton, AB T5G 0B7, Canada
| | - Rebecca Charbonneau
- Physical Medicine and Rehabilitation, Foothills Medical Centre, Calgary, AB T2N 2T9, Canada
| | - Kasey Aiello
- Patient Liaison to Neurosciences, Foothills Medical Centre, Calgary, AB T2N 2T9, Canada
| | - Adalberto Loyola Sanchez
- Division of Physical Medicine & Rehabilitation, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2S2, Canada
- Department of Clinical Neurosciences, Glenrose Rehabilitation Hospital, Edmonton, AB T5G 0B7, Canada
| | - Rija Kamran
- Rehabilitation Sciences, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T2N 1N4, Canada
| | - Olaleye Olayinka
- Division of Physical Medicine & Rehabilitation, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2S2, Canada
| | - Chester Ho
- Glenrose Rehabilitation Hospital, Edmonton, AB T5G 0B7, Canada
- Division of Physical Medicine & Rehabilitation, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2S2, Canada
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Cheng HS, You WC, Chen NW, Hsieh MC, Tsai CF, Ho CJ, Chen CC. Enhancing the Efficiency of a Radiation Oncology Department Using Electronic Medical Records: Protocol for Preparing Radiotherapy. JMIR Res Protoc 2024; 13:e51002. [PMID: 38393753 PMCID: PMC10924260 DOI: 10.2196/51002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/30/2023] [Accepted: 01/23/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Electronic medical records (EMRs) streamline medical processes, improve quality control, and facilitate data sharing among hospital departments. They also reduce maintenance costs and storage space needed for paper records, while saving time and providing structured data for future research. OBJECTIVE This study aimed to investigate whether the integration of the radiation oncology information system and the hospital information system enhances the efficiency of the department of radiation oncology. METHODS We held multidisciplinary discussions among physicians, physicists, medical radiation technologists, nurses, and engineers. We integrated paper records from the radiation oncology department into the existing hospital information system within the hospital. A new electronic interface was designed. A comparison was made between the time taken to retrieve information from either the paper records or the EMRs for radiation preparation. A total of 30 cases were randomly allocated in both the old paper-based system and the new EMR system. The time spent was calculated manually at every step during the process, and we performed an independent 1-tailed t test to evaluate the difference between the 2 systems. RESULTS Since the system was launched in August 2020, more than 1000 medical records have been entered into the system, and this figure continues to increase. The total time needed for the radiation preparation process was reduced from 286.8 minutes to 154.3 minutes (P<.001)-a reduction of 46.2%. There was no longer any need to arrange for a nurse to organize the radiotherapy paper records, saving a workload of 16 hours per month. CONCLUSIONS The implementation of the integrated EMR system has resulted in a significant reduction in the number of steps involved in radiotherapy preparation, as well as a decrease in the amount of time required for the process. The new EMR system has provided numerous benefits for the department, including a decrease in workload, a simplified workflow, and conserving more patient data within a confined space.
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Affiliation(s)
| | | | - Ni-Wei Chen
- Taichung Veterans General Hospital, Taichung, Taiwan
| | - Mu-Chih Hsieh
- Taichung Veterans General Hospital, Taichung, Taiwan
| | - Che-Fu Tsai
- Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chia-Jing Ho
- Taichung Veterans General Hospital, Taichung, Taiwan
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Cai Y, Zhang Y, Fang Y, Hu H, Li X, Fang L. Evaluating the efficacy and acceptability of vagus nerve stimulation for fibromyalgia: a PRISMA-compliant protocol for a systematic review and meta-analysis. Front Neurol 2024; 15:1367295. [PMID: 38450074 PMCID: PMC10914987 DOI: 10.3389/fneur.2024.1367295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 02/12/2024] [Indexed: 03/08/2024] Open
Abstract
Background Fibromyalgia has imposed substantial burdens on patients' health and well-being, yet effective therapeutic options for this condition remain limited. Recently, vagus nerve stimulation (VNS) has emerged as a promising therapy for fibromyalgia. Nonetheless, despite the increasing number of randomized clinical trials (RCTs), current evidence remains inconclusive. Therefore, this protocol of a systematic review and meta-analysis aims to synthesize the existing evidence to clarify the efficacy and acceptability of VNS for treating fibromyalgia. Methods A comprehensive search for eligible RCTs will be conducted across nine bibliographic databases, namely PubMed, Cochrane Library, Embase, AMED, PsycINFO, PEDro, Chinese BioMedical Literature Database, Chinese National Knowledge Infrastructure, and Wangfang database. Data obtained from the included studies will be synthesized quantitively using RevMan 5.4.1 for meta-analyses. The methodological soundness of included RCTs will be assessed via the Cochrane's updated risk of bias tool (version 2.0). Additionally, sensitivity analyses, publication bias assessment, and subgroup analyses will be conducted as appropriate. Finally, we will utilize the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to evaluate the certainty for the body of evidence. Conclusion The findings of our study are anticipated to ascertain the efficacy and acceptability of VNS as a promising treatment option for fibromyalgia. This will not only fill current research gap but also identify potential areas for future research. The findings will provide essential guidance for evidence-based treatment decisions for fibromyalgia, benefiting both patients and clinicians.
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Affiliation(s)
- Yunhuo Cai
- Department of Rehabilitation, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yajun Zhang
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yiyan Fang
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Hantong Hu
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Xingling Li
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Lianqiang Fang
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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Berry K, Postlmayr L, Shiltz D, Parker J, Ice C. Impact of an inpatient pharmacist-driven renal dosing policy on order verification time and patient safety. SAGE Open Med 2024; 12:20503121241233223. [PMID: 38379810 PMCID: PMC10878201 DOI: 10.1177/20503121241233223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/31/2024] [Indexed: 02/22/2024] Open
Abstract
Research regarding pharmacist-driven renal dosing policies has focused on cost savings or prevention of adverse drug events. However, little is known about how these policies influence time from order signature to order verification or how this efficiency may reduce the incidence of adverse outcomes. Objectives: The primary endpoint compared time from prescriber electronic order signature to pharmacist electronic order verification between pre- and post-renal dosing policy implementation. The secondary endpoint evaluated electrocardiogram QTc prolongation attributed to fluconazole accumulation in renal impairment. Methods: This retrospective analysis included adults with a creatine clearance ⩽50 mL/min who received at least two inpatient doses from a 34-medication renal dosing protocol between January-February 2020 and April-May 2020. Results: 502 patients met eligibility for the primary outcome. The pre- and post-policy cohorts shared similar baseline characteristics. Time from order signature to verification was 9 and 8 min in the pre- and post-policy groups, respectively (p = 0.0861). In all, 56 patients met inclusion criteria for the secondary outcome. The QTc interval during fluconazole increased relative to baseline in 3 of 7 (43%) pre-policy and 4 of 5 (80%) post-policy. The QTc interval exceeded 500 ms in two patients, both in the post-policy cohort. Conclusions: There was no difference in order signature to verification time. Post-policy fluconazole renal adjustment did not reduce QTc prolongation.
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Affiliation(s)
- Kayla Berry
- Michigan Medicine, University of Michigan Health, Ann Arbor, MI, USA
| | - Laura Postlmayr
- Sinai-Grace Hospital—Detroit Medical Center, Detroit, MI, USA
| | - Dane Shiltz
- College of Pharmacy, Ferris State University, Grand Rapids, MI, USA
- Butterworth Hospital Pharmacy, Spectrum Health, Grand Rapids, MI, USA
| | - Jessi Parker
- Scholarly Activity and Scientific Support Spectrum Health, Grand Rapids, MI, USA
| | - Calvin Ice
- Butterworth Hospital Pharmacy, Spectrum Health, Grand Rapids, MI, USA
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Bjerrum K, Grove LMD, Mortensen SS, Fabricius J. Development and Effect Evaluation of an Action-Oriented Interdisciplinary Weaning Protocol for Cuffed Tracheostomy Tubes in Patients with Acquired Brain Injury. Healthcare (Basel) 2024; 12:480. [PMID: 38391855 PMCID: PMC10887695 DOI: 10.3390/healthcare12040480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/24/2024] Open
Abstract
The objective was to develop an interdisciplinary weaning protocol (IWP) for patients with tracheostomy tubes due to acquired brain injury, and to effect evaluate implementation of the IWP on decannulation rates and weaning duration. An expert panel completed a literature review in 2018 to identify essential criteria in the weaning process. Based on consensus and availability in clinical practice, criteria for guiding the weaning process were included in the protocol. Using the IWP, dysphagia is graded as either severe, moderate, or mild. The weaning process is guided through a protocol which specified the daily duration of cuff deflation until decannulation, along with recommendations for treatment and rehabilitation interventions. Data from 337 patient records (161 before and 176 after implementation) were included for effect evaluation. Decannulation rate during hospitalization was unchanged at 91% vs. 90% before and after implementation (decannulation rate at 60 days was 68% vs. 74%). After implementation, the weaning duration had decreased compared to before implementation, hazard ratio 1.309 (95%CI: 1.013; 1.693), without any increased risk of tube-reinsertion or pneumonia. Furthermore, a tendency toward decreased length of stay was seen with median 102 days (IQR: 73-138) and median 90 days (IQR: 58-119) (p = 0.061) before and after implementation, respectively. Scientific debate on weaning protocols for tracheostomy tubes are encouraged.
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Affiliation(s)
- Katje Bjerrum
- Hammel Neurorehabilitation Centre and University Research Clinic, Department of Clinical Medicine, Aarhus University, 8450 Hammel, Denmark
| | - Linda-Maria Delgado Grove
- Hammel Neurorehabilitation Centre and University Research Clinic, Department of Clinical Medicine, Aarhus University, 8450 Hammel, Denmark
| | - Sine Secher Mortensen
- Hammel Neurorehabilitation Centre and University Research Clinic, Department of Clinical Medicine, Aarhus University, 8450 Hammel, Denmark
| | - Jesper Fabricius
- Hammel Neurorehabilitation Centre and University Research Clinic, Department of Clinical Medicine, Aarhus University, 8450 Hammel, Denmark
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Liu L, Zhu F, Xin Y, Zhang L, Hu C, Xu Y, Zhang J, Liu L, Chen G. Real-world effects of Yishen Tongbi decoction for rheumatoid arthritis: protocol for a prospective, observational, multicenter cohort study with validation against double-blind, randomized, controlled trial. Front Pharmacol 2024; 15:1320578. [PMID: 38410132 PMCID: PMC10895057 DOI: 10.3389/fphar.2024.1320578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/23/2024] [Indexed: 02/28/2024] Open
Abstract
Introduction: Rheumatoid arthritis (RA) is a globally challenging and refractory autoimmune disease, constituting a serious menace to human health. RA is characterized by recurrent pain and is difficult to resolve, necessitating prolonged medication for control. Yishen Tongbi decoction is a traditional Chinese herbal compound prescribed for treating RA. We have completed a 3-year RCT study that confirmed the clinical efficacy of Yishen Tongbi decoction for RA. Notably, we observed a faster clinical remission rate compared to MTX by week 4 of treatment. In our forthcoming study, we intend to conduct a comprehensive assessment of the efficacy and safety of Yishen Tongbi decoction in the real-world treatment of RA through a prospective study. Methods and analysis: This prospective, multicenter, real-world observational study will be conducted at two designated centers in China from October 2023 to August 2025. The study will include 324 patients with active rheumatoid arthritis. One group will receive Yishen Tongbi decoction combined with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). The other group will receive standard treatment. Standard treatment can be further divided into subgroups: csDMARDs, targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs), and biologic disease-modifying antirheumatic drugs (bDMARDs). In each group, the number of tender joints, number of swollen joints, pain score, patient global assessment, physician global assessment, disease activity index (DAS28-ESR or DAS28-CRP), clinical disease activity index (cDAI), simplified disease activity index (sDAI) and relevant laboratory data will be compared. Clinical indicators and disease activity of the patients will be assessed at baseline, week 4 and week 12 after the initiation of treatment. The primary outcome will be the American College of Rheumatology 20% improvement criteria (ACR20) attainment rate among patients at week 12 after treatment. Every adverse event will be reported. Ethics and dissemination: This study has been approved by the Ethics Committee of the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine (NO.K-2023-009). The results of the study will be published in national and international peer-reviewed journals and at scientific conferences. The researchers will inform participants and other RA patients of the results through health education. Clinical Trial Registration: https://www.chictr.org.cn/index.html, identifier ChiCTR2300076073.
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Affiliation(s)
- Lijuan Liu
- Department of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fangfang Zhu
- Department of Gynecology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Yijun Xin
- First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lu Zhang
- Shantou Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Shantou, China
| | - Congqi Hu
- Baiyun Hospital of The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yanping Xu
- Baiyun Hospital of The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jinming Zhang
- First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lingjie Liu
- First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Guangxing Chen
- Department of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Baiyun Hospital of The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Ebaid NY, Assy MM, Eldin AMA. Diagnostic validity of abbreviated breast MRI in the diagnosis of breast cancer: a comparative study to the full breast MRI protocol using BI-RADS. Pol J Radiol 2024; 89:e80-e87. [PMID: 38510549 PMCID: PMC10953509 DOI: 10.5114/pjr.2024.135474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 01/25/2024] [Indexed: 03/22/2024] Open
Abstract
Purpose This work aimed to determine the diagnostic performance of the magnetic resonance imaging (MRI) breast abbreviated protocol (AP) in diagnosing malignant breast lesions using BI-RADS compared with the diagnostic accuracy of the full diagnostic protocol (FDP). Material and methods A prospective single-centre study was conducted. A total of 125 female patients with suspicious breast masses underwent MRI with the AP and the FDP. The images of AP and FDP were independently interpreted by 2 radiologists with 10 years of experience in breast imaging, and any disagreement was resolved with a third one. Using the histopathological examination as a reference test, the diagnostic effectiveness of both FDP and AP in breast cancer screening was calculated. ROC curve was utilised to estimate the optimal BI-RADS cut-off for prediction of malignancy. The difference in image interpretation time between both protocols was estimated using the Mann-Whitney test. Moreover, the inter-test agreement between both protocols was assessed using Cohen's κ test. Results The study included 83 malignant and 42 benign lesions. AP indicated a specificity, sensitivity, and accuracy of 90.5%, 96.4%, and 94.4%, while the FDP showed a specificity, sensitivity, and accuracy of 92.9%, 100%, and 97.6%, respectively. BI-RADS 3 category was the best cut-off for prediction of malignancy. There was a significant difference between both protocols concerning the interpretation time (p < 0.001). There was excellent agreement between both protocols, with a κ of 0.915. Conclusions Breast MRI AP may be employed instead of FDP to identify breast cancer with similar diagnostic performance. Moreover, it reduces the interpretation time and the scan cost.
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Affiliation(s)
- Noha Yahia Ebaid
- Department of Radiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mostafa Mohamad Assy
- Department of Radiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed M. Alaa Eldin
- Department of Radiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Ghasemi-Gujani M, Savabi-Esfahani M, Noroozi M, Satari M. Development of mobile application for cervical cancer screening in women: Protocol of a multi-phase study. J Educ Health Promot 2024; 13:5. [PMID: 38525208 PMCID: PMC10959268 DOI: 10.4103/jehp.jehp_1603_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/30/2023] [Indexed: 03/26/2024]
Abstract
BACKGROUND Cervical cancer is one of the most common cancers in women. It is considered preventable due to the possibility of screening. The common barriers to cervical cancer screening include lack of knowledge, lack of time, and wrong beliefs. The use of e-Health technologies is one of the approaches for health promotion. The present study is aimed to the development of a mobile application for cervical cancer screening in women. MATERIALS AND METHOD This is a multi-phase study. In the first step, a literature review will be conducted to examine factors related to cervical cancer screening and existing applications related to cervical cancer and its screening. Then, in the second step, a cross-sectional study will be conducted to investigate the factors related to cervical cancer screening in 246 women referred to comprehensive health centers and women's clinics in teaching hospitals in Isfahan, Iran. The comprehensive health centers and women's clinics in teaching hospitals will be randomly selected using a lottery method. Using convenience sampling, women who meet the inclusion criteria will be included in the study, provided they provide informed consent. The data will be collected using a questionnaire, and then the descriptive and inferential statistical tests and SPSS18 software will be used to analyze the data. In the third step, specialists (gynecologists, reproductive health specialists, and midwives) will prioritize the application content by filling out a questionnaire. Then, the research team will compile the application content draft, and this draft will be reviewed and approved by experts on the expert panel. The prototype of the application will be prepared, and experts will evaluate it in the fifth step. DISCUSSION The results of this study will result in the development of applications for cervical cancer screening. The use of mobile applications can be useful in lifting some of the barriers to screening. Therefore, developing such applications may help improve cervical cancer screening.
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Affiliation(s)
- Marzieh Ghasemi-Gujani
- PhD Candidate, Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mitra Savabi-Esfahani
- Department of Midwifery and Reproductive Health, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahnaz Noroozi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Satari
- Department Health Information Technology, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Sun K, Li Y, Zhai Z, Yin H, Liang S, Zhai F, Cui Y, Zhang G. Effects of transcutaneous auricular vagus nerve stimulation and exploration of brain network mechanisms in children with high-functioning autism spectrum disorder: study protocol for a randomized controlled trial. Front Psychiatry 2024; 15:1337101. [PMID: 38374975 PMCID: PMC10875019 DOI: 10.3389/fpsyt.2024.1337101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 01/19/2024] [Indexed: 02/21/2024] Open
Abstract
Background Autism Spectrum Disorders (ASD) are a collection of neurodevelopmental diseases characterized by poor social interaction and communication, a limited range of interests, and stereotyped behavior. High-functioning autism (HFA) indicates a subgroup of individuals with autism who possess cognitive and/or language skills that are within the average to above-normal range for their age. Transcutaneous auricular vagus nerve stimulation (taVNS) holds promise in children with HFA. However, few studies have used randomized controlled trials to validate the effectiveness of taVNS. Therefore, in this study, we intend to provide a study protocol to examine the therapeutic effects of taVNS in individuals diagnosed with HFA and to investigate the process of brain network remodeling in individuals with ASD using functional imaging techniques to observe alterations in large-scale neural networks. Methods and design We planned to employ a randomized, double-blind experimental design, including 40 children receiving sham stimulation and 40 children receiving real stimulation. We will assess clinical scales and perform functional imaging examinations before and after the stimulation. Additionally, we will include age- and gender-matched healthy children as controls and conduct functional imaging examinations. We plan first to observe the therapeutic effects of taVNS. Furthermore, we will observe the impact of taVNS stimulation on the brain network. Discussion taVNS was a low-risk, easy-to-administer, low-cost, and portable option to modulate the vagus system. taVNS may improve the social performance of HFA. Changes in the network properties of the large-scale brain network may be related to the efficacy of taVNS. Clinical trial registration http://www.chictr.org.cn, identifier ChiCTR2300074035.
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Affiliation(s)
- Ke Sun
- Functional Neurosurgery Department, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Ying Li
- Department of Psychiatry, Beijing Children’s Hospital, Beijing, China
| | - Zhenhang Zhai
- Functional Neurosurgery Department, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Heqing Yin
- Functional Neurosurgery Department, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Shuli Liang
- Functional Neurosurgery Department, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Feng Zhai
- Functional Neurosurgery Department, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Yonghua Cui
- Department of Psychiatry, Beijing Children’s Hospital, Beijing, China
| | - Guojun Zhang
- Functional Neurosurgery Department, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
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