Final Review Research Articles

A Systematic Review of Short-Term Outcomes of Minimally Invasive Thoracoscopic Surgery for Lung Cancer after Neoadjuvant Systemic Therapy.

Minimally invasive surgeries for non-small cell lung cancers (NSCLCs) such as video-assisted thoracoscopic surgeries (VATSs) and robotic-assisted thoracoscopic surgeries (RATSs) have become standard of care for patients needing surgical resection in early stages. The role for neoadjuvant systemic therapy has increased with patients receiving neoadjuvant systemic chemotherapy and immunotherapy. However, there has been some equipoise over the intraoperative and overall outcomes for these patients. Here, we review the current data regarding outcomes of patients undergoing minimally invasive thoracic surgical resection after systemic chemotherapy, immunotherapy, or both. A systematic literature review of randomized controlled trials and observational studies presenting data on patients with NSCLC that underwent neoadjuvant systemic therapy followed by minimally invasive surgery was performed assessing complications, conversion rates, and lymph node yield. Our search strategy and review of references resulted in 239 publications to screen with 88 full texts assessed and 21 studies included in our final review. VATS had a statistically significant higher lymph node yield in five studies. The reported conversion rates ranged from 0 to 54%. Dense adhesions, bleeding, and difficult anatomy were the most common reported reasons for conversion to open surgeries. The most common complications between both groups were prolonged air leak, arrythmia, and pneumonia. VATS was found to have significantly fewer complications in three papers. The current literature supports VATS as safe and feasible for patients with NSCLC after neoadjuvant systemic treatment. Surgeons should remain prepared to convert to open surgeries in those patients with dense adhesions and bleeding risk.

Epidemiology and demographics of head and neck cancer in Africa: A scoping review.

Low- to middle-income countries account for 70% of global cancer deaths. Evidence of the changing prevalence of head and neck cancer in Africa in terms of gender, race and epidemiology will inform future research and health planning. To synthesise epidemiological literature for head and neck cancer in Africa from 2010 to 2020. A scoping review was completed. The Joanna Briggs Institute Population, context and concept framework confirmed the inclusion criteria. Studies from Africa that included participant demographics, the types, stages, signs and symptoms of head and neck cancer were selected. Five databases were used. Descriptive statistics was completed. The Preferred Reporting Items for Systematic Reviews and MetaAnalysis guided the reporting of the findings. Of the 1891 articles downloaded, 66 were included in the final review. Nigeria produced the most studies and oral cancer at 74% was most prevalent. Substance abuse was the most prevalent cause. Diagnosis of head and neck cancers were in the late stage (stage IV) when signs and symptoms were severe. Males of lower socioeconomic status tended to have less health seeking behaviour. Countries from North Africa produce the most research outputs on head and neck cancers. Gender differences were noted and may be linked to lifestyle choices. A range of head and neck cancers (HNCs) are prevalent however late diagnosis and severe symptomatology impact treatment options.Contribution: Earlier diagnosis and intervention to prevent late-stage diagnosis is necessary. Awareness campaigns linked to evidence on causes, habits and lifestyle choices, signs and symptoms are needed.

Total femoral arthroplasty for non-oncological indications.

Total femoral arthroplasty (TFA) is a rare procedure used in cases of significant femoral bone loss, commonly from cancer, infection, and trauma. Low patient numbers have resulted in limited published work on long-term outcomes, and even less regarding TFA undertaken for non-oncological indications. The aim of this study was to evaluate the long-term clinical outcomes of all TFAs in our unit. Data were collected retrospectively from a large tertiary referral revision arthroplasty unit's database. Inclusion criteria included all patients who underwent TFA in our unit. Preoperative demographics, operative factors, and short- and long-term outcomes were collected for analysis. Outcome was defined using the Musculoskeletal Infection Society (MSIS) outcome reporting tool. Overall, 38 TFAs were identified. The mean age was 73 years (42 to 80). All patients underwent TFA for non-oncological indications, most commonly as a consequence of infection (53%) and periprosthetic fracture (26%). The mean follow-up time was ten years (0 to 26); 63% of TFAs were considered a success based upon the MSIS outcome reporting tool. The mean time between TFA and death was 8.5 years (0.2 to 19.2), with two patients dying within one year of surgery. Within the cohort, 66% suffered at least one complication, dislocation being most common (37%); 55% of the total cohort required at least one subsequent operation. In total, 70% of TFAs undertaken for infection were considered infection-free at time of final follow-up. The percentage of mobile patients improved from 52% to 65% between pre- and postoperation, with all patients being able to at least transfer from bed to chair at time of final review. This study is the largest in the UK assessing the use of TFA in patients with bone loss secondary to non-oncological conditions. It demonstrates that TFA has a significant complication profile, however it is favourable in terms of mortality and rehabilitation when compared to amputation and disarticulation.

An Overview of Reviews to Inform Organization-level Interventions to Address Burnout in Rheumatologists.

To identify organization-directed strategies that could be implemented to prevent burnout among rheumatologists. A search of English language articles published 2011 or later was conducted on Cochrane Database of Systematic Reviews, Embase, Medline, and PsycInfo on January 25, 2022. Included reviews had one or more primary studies with ≥10% physician participants, captured burnout as an outcome, and described an organization-directed intervention to prevent burnout. Overlap of primary studies across reviews was assessed. The final review inclusion was determined by study quality, minimization of overlap, and maximization of intervention breadth. The AMSTAR 2 tool was used for quality assessment. Included studies and interventions were assessed by rheumatologists for their applicability to rheumatology. A total of 17 reviews, including 15 systematic reviews, 1 realist review, and 1 umbrella review were included. AMSTAR 2 quality ratings classified 5 systematic reviews as low quality, 1 as moderate, and 9 as critically low. There was significant heterogeneity between and within reviews. Six conducted a meta-analysis and 11 provided a qualitative summary of findings. The following intervention types were identified as having possible applicability to rheumatology: physician workflow and organizational strategies, peer support and formal communication training, leadership support, and addressing stress, mental health, and mindfulness. Across interventions, mindfulness had the highest quality of evidence to support its effectiveness. While the quality of evidence for interventions to prevent burnout in physicians is low, promising strategies such as mindfulness have been identified.

An Ontology-Driven Machine Learning Applications for Public Policy Analysis from Social Media Data: A Systematic Literature Review

With the widespread use of social media platforms for various purposes, including political discussions, public opinion on policy issues can be inferred from social media data. Ontology-driven machine learning techniques have been applied to extract relevant information from such data for public policy analysis. In this systematic literature review (SLR), we aim to identify the current state-of-the-art ontology-driven machine learning applications for public policy analysis from social media data. We conducted a comprehensive search for relevant studies published in peer-reviewed journals and conference proceedings up to May 2023. After screening and selection, we included 35 studies in the final review. Our review revealed that ontology-based approaches are commonly used for information extraction and entity recognition, while machine learning algorithms are employed for sentiment analysis, topic modeling, and policy issue identification. The review also highlighted the importance of domain-specific ontologies and labeled training datasets in achieving higher accuracy in policy analysis. Furthermore, we identified research gaps in the application of ontology-driven machine learning techniques for public policy analysis in non-English languages and for policy evaluation. Overall, this SLR provides insights into the current research trends, challenges, and opportunities in ontology-driven machine learning applications for public policy analysis from social media data. A preprint has previously been published by (Abtew et al., 2023).

Strategies that support cultural safety for First Nations people in aged care in Australia: An integrative literature review.

The 2019 Royal Commission into Aged Care Quality and Safety highlighted the need for First Nations peoples to have improved, culturally safe care. This paper is a call to action for First Nations peoples to be involved in developing culturally safe care and services to be embedded within Australian aged care services. The first screening examined the Australian literature (peer-reviewed articles published since 2010 in English) detailing key aspects relevant to Cultural Safety for First Nations peoples supported by aged care services in Australia. The second screening assessed whether the findings of these studies aligned with the key aspects of Cultural Safety of First Nations peoples in aged care. The initial literature search yielded 198 papers, of which 13 met the inclusion criteria for the final review. Topics that required further interrogation included barriers to communication, racism and discrimination, impacts on health outcomes, health-care workforce education needs and the importance of cultural connections to Country and kin. These topics influenced the perception of First Nations peoples feeling culturally safe when supported by aged care services. The literature identified a need to recruit more First Nations peoples into the aged care workforce, involve more First Nations family and community members in aged care and retain a consistent workforce overall. Together these strategies were seen to address the barriers that continue to affect aged care provision for First Nations peoples.

Effects of succinates on the inflammatory response: a review

INTRODUCTION: Endogenous succinate functions as a pro-inflammatory factor, while exogenous succinate — as an anti-inflammatory factor. The mechanisms of effect of succinates on the inflammatory response are not fully understood. OBJECTIVE: Generalization of the current scientific knowledge on the use of exogenous succinate in inhibition of the inflammatory response. MATERIALS AND METHODS: The PubMed, Web of Science, Google Scholar, Scopus, and eLibrary international databases were used to search for relevant articles. The search keywords were: “succinic acid”, “amber acid”, “inflammation”, “meglumine sodium/solution”. The search was limited to articles published between 2012 and December 2022. The inclusion criteria were: 1) research focused on the cellular energy supply in inflammation; 2) effects of succinate on the inflammatory response intensity due to changes in the cellular energy supply; 3) correlation of the cellular energy supply with clinical and laboratory inflammatory indicators when succinate-containing drugs are used; 4) original studies. RESULTS: The initial identification analysis included over 200 published studies. After the screening, 84 full-text articles meeting the selection criteria were included in the final review: 31 literature reviews, 24 of which are dedicated to the pro-inflammatory effects of endogenous succinate, and 7 — to the anti-inflammatory effect of exogenous succinate in succinate-containing agents; and 53 original scientific articles: 27 articles are dedicated to the research of molecular mechanisms of endogenous succinate, and 26 articles are dedicated to the study of the clinical use of succinate-containing drugs. CONCLUSIONS: Endogenous succinate is defined as the most important pro-inflammatory factor. Exogenous succinate has a pronounced anti-inflammatory effect mediated by normalization of the immune cell energy supply in hypoxia. No studies have been found on the differences in the mechanism of action of endogenous and exogenous succinate.

Trends Of Adult Height in India Using National Family Health Survey Data: A Systematic Review

The national family health survey (NFHS) is a multi-round, large scale, survey conducted throughout India in a customary sample of households. It was first conducted in 1992-93, till then five surveys have been conducted. The survey was done using four types of questionnaires namely Men’s, Women’s, Biomarker, and household. The survey was funded by many international Funding agencies likeUnited States Agency for International Development (USAID), United Nations Children's Fund (UNICEF) etc. In India department of Ministry of Health and Family Welfare (MOHFW) has delegated the International Institute for Population Sciences (IIPS), Mumbai as a nodal agency for mutual support in the survey. Each survey of NFHS has two definite goalsi.ei) to anticipate data on family welfare and health for program and policy purposes and ii) to contribute an information on important family welfare and emerging health issues. Systematic review was conducted as per PRISMA guidelines, we carried out an extensive electronic search of PubMed, Google and Google Scholar to identify published studies on trends in adult height using NFHS India data. Out of a total 43 potential studies 38 were excluded and 5 relevant studies were used for final review. There is a decrease in average adult height in India. Despite of genetic, non-genetic factors like social, nutritional, and environmental plays a very important role in adult height.

Modelling for design and evaluation of industrial exoskeletons: A systematic review

Industrial exoskeletons are developed to relieve workers’ physical demands in the workplace and to alleviate ergonomic issues associated with work-related musculoskeletal disorders. As a safe and economical alternative to empirical/experimental methods, modelling is considered as a powerful tool for design and evaluation of industrial exoskeletons. This systematic review aims to provide a comprehensive understanding of the current literature on the design and evaluation of industrial exoskeletons through modelling. A systematic study was conducted by general keyword searches of five electronic databases over the last two decades (2003–2022). Out of the 701 records initially retrieved, 33 eligible articles were included and analyzed in the final review, presenting a variety of model inputs, model development, and model outputs used in the modelling. This systematic review study revealed that existing modelling methods can evaluate the biomechanical and physiological effects of industrial exoskeletons and provide some design parameters. However, the modelling method is currently unable to cover some of the main evaluation metrics supported by experimental assessments, such as task performance, user experience/discomfort, change in metabolic costs etc. Standard guidelines for model construction and implementation, as well as validation of human-exoskeleton interactions, remain to be established.

The effects of exercise training on knee repositioning sense in people with knee osteoarthritis: a systematic review and meta-analysis of clinical trials

ObjectiveOsteoarthritis (OA) of the knee is one of the most common global joint disorders, especially in aging population, and is among leading health-related concerns of societies. Therefore, this systematic review and meta-analysis was done to investigate the results related to the effects of exercise interventions on knee repositioning sense in patients with knee OA.MethodsAn extensive search was independently performed in electronic databases including PubMed, MEDLINE, Web of Science, SCOPUS, and Google Scholar, to identify randomized clinical trials (RCTs) conducted on knee OA and to evaluate knee repositioning sense before and after different exercise interventions. After extracting relevant data from eligible studies, results of the studies were pooled using a random-effects model of meta-analysis. The Physiotherapy Evidence Database (PEDro) of clinical trials was used for quality assessment of eligible studies.ResultsAmong 2702 studies identified in the initial search, 17 studies were eligible for final systematic review and meta-analysis. The results showed that the patients who participated in different exercise interventions had significantly less knee repositioning error (mean differences: -1.141 degrees (95%CI: -1.510, -0.772, P < .001) compared to those who did not undergo exercise interventions. The eligible studies exhibited publication bias (Intercept: -6.69, P = .002), and the data showed significant heterogeneity (I2 = 85.633%, Q = 153.125, P < .001). Moreover, meta regression showed more prolonged exercise duration might have more effects on knee repositioning error (Coefficient=-0.860, 95% CI=-1.705, -0.016, Z=-2.00, P = .045).ConclusionThere is strong evidence that exercise interventions may effectively reduce knee repositioning error. Moreover, it seems that more prolonged exercise duration may be associated with the greater effect size.

Predicting Student Dropout based on Machine Learning and Deep Learning: A Systematic Review

Student dropout is one of the most complex challenges facing the education system worldwide. In order to evaluate the success of Machine Learning and Deep Learning algorithms in predicting student dropout, a systematic review was conducted. The search was carried out in several electronic bibliographic databases, including Scopus, IEEE, and Web of Science, covering up to June 2023, having 246 articles as search reports. Exclusion criteria, such as review articles, editorials, letters, and comments, were established. The final review included 23 studies in which performance metrics such as accuracy/precision, sensitivity/recall, specificity, and area under the curve (AUC) were evaluated. In addition, aspects related to study modality, training, testing strategy, cross-validation, and confounding matrix were considered. The review results revealed that the most used Machine Learning algorithm was Random Forest, present in 21.73% of the studies; this algorithm obtained an accuracy of 99% in the prediction of student dropout, higher than all the algorithms used in the total number of studies reviewed.

Do peer-based education interventions effectively improve vaccination acceptance? a systematic review

BackgroundVaccination efforts are a vital part of controlling the spread of diseases, however, lack of vaccine acceptance undermines the efficacy of this public health effort. Current evidence suggests that the most effective interventions to support vaccination uptake and positive vaccination beliefs are multicomponent, and dialogue based. Peer-based education interventions are such a strategy that involves an individual within the same group to act as the vaccine educator.ObjectiveThis review aims to consolidate the quantitative evidence surrounding the effectiveness and experience of peer-based education initiatives to improve vaccination beliefs and behaviors.MethodsWe conducted a systematic search of PubMed, Web of Science, and a hand reference search. The search was conducted between April and June 2022. The inclusion criteria encompassed using peers, being education based, and being an intervention that addresses vaccination beliefs and behaviors (e.g. vaccination uptake).ResultsSystematic screening revealed 16 articles in the final review. Half of the studies focused on students as their study population. The human papillomavirus vaccine was the most common vaccine assessed in the studies, followed by COVID and influenza vaccines. 11 out of 16 of the articles reported a positive impact of the peer intervention and two studies had mixed results. Six studies suggest a mixed peer- healthcare expert approach.ConclusionsDespite reported positive effects of using peer-education based initiatives to improve vaccine uptake and beliefs, this systematic review reveals that there is limited existing research in support of this strategy. The strategies that initially appear the most effect are those with a combined peer and health-expert approach, and those that have more group specific and long-term peer interventions. More research is needed to confirm these results and to assess the effectiveness of a peer-based education intervention in a wider variety of settings and for other vaccine types.

Factors That Affect Knowledge-Sharing Behaviors in Medical Imaging Departments in Cancer Centers: Systematic Review.

Knowledge management plays a significant role in health care institutions. It consists of 4 processes: knowledge creation, knowledge capture, knowledge sharing, and knowledge application. The success of health care institutions relies on effective knowledge sharing among health care professionals, so the facilitators and barriers to knowledge sharing must be identified and understood. Medical imaging departments play a key role in cancer centers. Therefore, an understanding of the factors that affect knowledge sharing in medical imaging departments should be sought to increase patient outcomes and reduce medical errors. The purpose of this systematic review was to identify the facilitators and barriers that affect knowledge-sharing behaviors in medical imaging departments and identify the differences between medical imaging departments in general hospitals and cancer centers. We performed a systematic search in PubMed Central, EBSCOhost (CINAHL), Ovid MEDLINE, Ovid Embase, Elsevier (Scopus), ProQuest, and Clarivate (Web of Science) in December 2021. Relevant articles were identified by examining the titles and abstracts. In total, 2 reviewers independently screened the full texts of relevant papers according to the inclusion and exclusion criteria. We included qualitative, quantitative, and mixed methods studies that investigated the facilitators and barriers that affect knowledge sharing. We used the Mixed Methods Appraisal Tool to assess the quality of the included articles and narrative synthesis to report the results. A total of 49 articles were selected for the full in-depth analysis, and 38 (78%) studies were included in the final review, with 1 article added from other selected databases. There were 31 facilitators and 10 barriers identified that affected knowledge-sharing practices in medical imaging departments. These facilitators were divided according to their characteristics into 3 categories: individual, departmental, and technological facilitators. The barriers that hindered knowledge sharing were divided into 4 categories: financial, administrative, technological, and geographical barriers. This review highlighted the factors that influenced knowledge-sharing practices in medical imaging departments in cancer centers and general hospitals. In terms of the facilitators and barriers to knowledge sharing, this study shows that these are the same in medical imaging departments, whether in general hospitals or cancer centers. Our findings can be used as guidelines for medical imaging departments to support knowledge-sharing frameworks and enhance knowledge sharing by understanding the facilitators and barriers.

Efficacy of interpersonal psychotherapy in mainland China: a systematic review and meta-analysis.

Interpersonal Psychotherapy (IPT) is an evidence-based therapy. There have been increasing demand and training opportunities of IPT in China. Reviewing current evidence on its use in Chinese patients can help us understand the applicability of IPT in China and identify knowledge gaps to encourage and better future research in this field. We did a comprehensive search of three major electronic databases: PubMed (English), Chinese National Knowledge Infrastructure (CNKI) and WanFang Data (Chinese). We examined overall study design, outcome measures, data analyses and other parameters. We only selected articles of Randomized Clinical Trials (RCT) for this review. All study findings were grouped and summarized per psychiatric diagnoses. The meta-analysis and forest plots were performed whereas studies could be combined. After a full text review of 132 articles, 40 were selected for the final review. Comparing with control groups, evidences supported the efficacy of IPT in Chinese patients with Major Depressive Disorder (MDD), Postpartum depression, Generalized Anxiety Disorder (GAD), Social Anxiety Disorder, Post Stress Traumatic Disorder (PTSD), and Post-psychotic Depression. It was also beneficial to college students and Chinese first-time mothers. Meta-analysis using a random-effects model consistently yielded significant score differences between the IPT and control groups (p < 0.0001) on MDD. This systematic review has identified the current best evidence for IPT efficacy in Chinese population. The findings support IPT as an effective treatment in Chinese with certain psychiatric conditions, consistent with those from many other studies throughout the world.

Understanding the effects of overnight vital signs monitoring on sleep duration and disruptions in hospitalized children: A scoping review

ProblemOvernight vital signs are typically taken every four hours on pediatric acute care units, despite limited evidence supporting the efficacy of this practice. Vital signs are often ordered and collected without considering the patient's clinical status or potential impact that they may have on sleep. We sought to understand the impact that overnight vital sign monitoring has on sleep duration and disruptions among hospitalized children in an acute care setting. Eligibility criteriaWe conducted a scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols extension for scoping reviews (PRISMA-ScR). Studies were included if they addressed the relationship between vital signs monitoring and sleep among children hospitalized in an acute care unit. SampleEleven studies from 2012 to 2022 were included in the final review. ResultsVital signs monitoring is the most common sleep disruptor among hospitalized children in acute care units and early evidence suggests that minimizing overnight vital signs may be a safe intervention for clinically stable children. Methods for measuring sleep duration and disruptions are heterogenous and validated tools are not often used. Finally, nurses report comfort with forgoing overnight vital signs when their patient's clinical status is stable. ConclusionDespite a lack of evidence regarding the efficacy of every 4 h vital signs, overnight vital signs monitoring is consistently the greatest disruptor to sleep for hospitalized children. ImplicationsNurses should play a central role in guiding vital signs monitoring that maintains safety and improves sleep in hospitalized children.

Most Patients With Bone Sarcomas Seek Emotional Support and Information About Other Patients' Experiences: A Thematic Analysis.

Online discussion forums allow individuals who otherwise may be strangers to create a community where they can seek and share information. Patients with bone sarcomas and their support networks use discussion forums dedicated to cancer support. There is a paucity of published reports regarding the care experience of patients with bone sarcomas because studies on online discussion groups have primarily focused on some of the more common cancers, including breast and prostate cancer. Understanding commonly discussed themes among patients with bone sarcomas would allow treating physicians to have a better understanding of patient concerns when providing patient education and counseling. We performed this study to review posts from bone sarcoma internet discussion boards to establish common themes related to the care experience of patients with sarcomas. Online discussion forums were identified using the search term "sarcoma discussion forum." After identifying 12 websites, we excluded closed forum groups, websites with missing or invalid links to forums, and nonpublic forums, such as groups on Facebook. These websites include profiles and photos that are personal, and sufficient author anonymity could not be achieved for this study. Posts written between January 1, 2012, and May 1, 2022, posted on five discussion boards were reviewed and collected until we reached a point of data saturation in which we agreed that the collection of additional posts would not reveal new themes. Discussion threads were filtered to identify posts pertaining to the most common bone sarcomas: chondrosarcoma, Ewing sarcoma, and osteosarcoma. Grounded theory-the methodology of repeated analyses of qualitative data to identify recurring themes or concepts-was used to analyze posts. Caregiver posts were delineated from patient posts and categorized separately for subgroup analysis. Grounded theory, although a qualitative method, endeavors to integrate the strengths inherent in quantitative methods with qualitative approaches. Grounded theory categorizes words, language, and the meanings these imply and seeks to organize and reduce the data gathered into themes or essences, which, in turn, can be fed into descriptions, models, or theories. Our analysis used three reviews of text to assign and group codes based on repeating ideas or concepts. The first review (open coding) aims to assign codes based on the verbatim text included by the author to capture the specific thoughts and ideas of the post. The second review (axial coding) aims to consolidate the ideas of posts by applying broader concepts to each post. The third and final review (selective coding) aims to further consolidate the themes of each post by trying to embody the main message contained in a post. A total of 570 posts from 139 threads were collected and analyzed using grounded theory. Twenty-five axial codes and four selective codes were created. We defined data saturation by the absence of a new open code in the analysis of a block of 50 posts to ensure that signals of saturation were not accepted too early in the analysis. The four selective codes included emotional aspects or connecting with others, information support: diagnosis, information support: treatment, and information support: recovery. Of these four codes, emotional aspects and connecting with others was the most prevalent theme (78% [445 of 570] of posts) followed by information support: treatment (49% [282 of 570] of posts). Information support: diagnosis and information support: recovery were each captured in 15% of posts. Analysis of posts reveals that the two most common themes involve seeking out emotional support and information about the experiences of others with various treatment modalities. Although most of the posts we assessed contained experiential information and emotional support rather than directed medical advice, future studies should assess the accuracy of information shared among online sarcoma forums. Physicians caring for patients with sarcomas should not only address patient concerns related to medical care, but also provide emotional support directly and assist patients by providing resources to peer support outlets, including online discussion forums. Although we cannot ascertain the proportion of patients who use online sites given the anonymity of posts included, these findings suggest common experiential themes across patients with sarcomas outside their doctors' offices. It is important that providers be aware of reputable forums to provide as resources for their patients. The Musculoskeletal Tumor Society may further benefit from endorsing one or more of these forums and providing physician oversight to monitor misinformation.

Clinical Presentation and Management of Malignant Psoas Syndrome: A Scoping Review of Case Reports and Case Series.

Malignant psoas syndrome (MPS) is a rare and underreported clinical syndrome that significantly impacts the quality of life of cancer patients throughmetastatic infiltration of the iliopsoas muscle. Patients suffering from MPS often present with painful hip flexion, loss of mobility, and immense pain in their legs and back. The current literature describing the clinical presentation, management, and prognosis of MPS is limited primarily to case reports and outdated literature reviews. There remains a gap in the current knowledge of MPS and in the management of this complex cancer-related pain syndrome. Thus, this scoping review aimed to map current case reports and case series on MPS for clinical presentation, treatment modalities, and resulting prognoses of MPS in late-stage cancer patients. A systemized search using the databases Embase and PubMed (Medline) was conducted to access case reports and case series published between January 1990 and October 2022 that met the study's inclusion criteria: (1) adult patients with metastatic cancer; (2) MPS symptoms secondary to infiltration of iliopsoas; (3) clinical presentation, treatment modality, and prognosis; and (4) English-language text. Our search strategy yielded 1926 citations. After removing 629 duplicates, 1,283 reports were excluded due to failure to meet eligibility criteria (n=1,271) or inaccessibility (n=12). Using the JBI appraisal tools for case reports and case series, a total of 14 articles remained for the final review. With histories of either genitourinary, hepatic, gastric, or skin cancer, each case reported new onset intense pain in the legs, back, abdomen, or pelvis with associated symptoms such as flexion of the hip or gait disorder. A computerized tomography (CT) scan, magnetic resonance imaging (MRI), orpositron emission tomography (PET) scantypically confirmed metastasis into the iliopsoas causing these symptoms, which suggested MPS. Each case utilized two to seven different pain management strategies to alleviate MPS symptoms. Many cases first used opioids for pain relief. Following a necessitated increase in morphine equivalent daily dose, a subsequent increase in the strength of analgesic, change in route of administration, and integration of combination drug therapy were generally added to the treatment regime. Many cases reported successful management of symptoms through utilizing methadone, radiation therapy, botulinum toxin injection, increased opioid dosage, or epidural catheter administration of opioids. A unified clinical definition of MPS may be required to inform physicians of this syndrome to help support clinical decisions regarding treatments for patients. The studies indicated that a clearer guideline for treatment protocol may be warranted as most cases reported utilizing various treatment medication dosages and procedures with vastly differing results.

MRI-Based Radiomics in Bladder Cancer: A Systematic Review and Radiomics Quality Score Assessment.

(1): Background: With the recent introduction of vesical imaging reporting and data system (VI-RADS), magnetic resonance imaging (MRI) has become the main imaging method used for the preoperative local staging of bladder cancer (BCa). However, the VI-RADS score is subject to interobserver variability and cannot provide information about tumor cellularity. These limitations may be overcome by using a quantitative approach, such as the new emerging domain of radiomics. (2) Aim: To systematically review published studies on the use of MRI-based radiomics in bladder cancer. (3) Materials and Methods: We performed literature research using the PubMed MEDLINE, Scopus, and Web of Science databases using PRISMA principles. A total of 1092 papers that addressed the use of radiomics for BC staging, grading, and treatment response were retrieved using the keywords "bladder cancer", "magnetic resonance imaging", "radiomics", and "textural analysis". (4) Results: 26 papers met the eligibility criteria and were included in the final review. The principal applications of radiomics were preoperative tumor staging (n = 13), preoperative prediction of tumor grade or molecular correlates (n = 9), and prediction of prognosis/response to neoadjuvant therapy (n = 4). Most of the developed radiomics models included second-order features mainly derived from filtered images. These models were validated in 16 studies. The average radiomics quality score was 11.7, ranging between 8.33% and 52.77%. (5) Conclusions: MRI-based radiomics holds promise as a quantitative imaging biomarker of BCa characterization and prognosis. However, there is still need for improving the standardization of image preprocessing, feature extraction, and external validation before applying radiomics models in the clinical setting.

Application of concept maps as an assessment tool in engineering education: Systematic literature review

AbstractBackgroundConcept maps are a valid assessment tool to explore student understanding of diverse topics. Many types of academic programs have integrated concept mapping into their courses, resulting in various activities and scoring methods to understand student perceptions.PurposeFew prior reviews of concept mapping have addressed their use within engineering education. This systematic literature review examines articles that use concept mapping as an assessment tool in engineering education contexts and provides suggestions for future research.Scope/MethodWe conducted a literature search using terms related to concept map and engineering education. Articles were screened by their title, abstract, section, and then full paper, resulting in 53 articles for the final review. Two researchers examined the topic, activity type, and scoring method of the maps.ResultsConcept mapping topics fit into three categories, and the activity structures fit into four types. Of seven scoring methods, “Traditional” was the most used. Studies that compared multiple scoring methods showed that the “Holistic” and “Categorical” methods were better able to capture the content of the maps. All types of scoring demonstrated positive outcomes, suggesting that concept maps can demonstrate understanding of the topic and can assess learning.ConclusionsConcept maps have been applied in a number of ways. All types of concept mapping scores were shown to be useful and can lead to a better understanding of the students' learning outcomes. However, more research is needed to determine which scoring methods are recommended for specific applications.

The Association of Moral Injury and Healthcare Clinicians’ Wellbeing: A Systematic Review

Research focused on elucidating moral injury amongst healthcare workers (HCWs) is essential due to the deep connection with morality and individuals’ overall wellbeing. Examining moral injury provides an avenue through which researchers can connect individual experiences with systemic level causes (i.e., structural power imbalances between clinicians and health systems) to better study workplace wellbeing. The omnipresence of the COVID-19 pandemic has amplified the need to study moral injury. This paper describes a systematic review conducted using PRISMA-P guidelines to answer the question, “what is the association between moral injury and professional wellbeing and mental health amongst healthcare workers.” Twelve databases were searched to identify specified studies. This study’s criteria included: (1) articles published through December 2022; (2) qualitative and quantitative empirical studies; (3) articles written in English; (4) articles including moral injury; and (5) articles including at minimum one other measure of professional or personal wellbeing. The initial search produced 248 articles, and 18 articles were ultimately included in the final review. To confirm that no articles were left out of this study, the first author of each included article was contacted to inquire about any additional works that met the inclusion criteria of this study. The elements of the 18 included articles described in this review are discussed. The results indicate that moral injury is associated with both professional wellbeing factors and mental health outcomes. Further theoretical development, including (professional- and identity-based) exploratory research on moral injury, and evidenced-based interventions for moral injury are needed.