Qualifying Criteria Research Articles

Social Media Influences on Dietary Awareness in Children.

Social media platforms have become increasingly influential channels for discussing various aspects of children's health, including dietary habits and food choices. This research explores the impact of social media on childhood dietary habits regarding the foods children consume by analyzing published findings about online videos and other social media platforms. From a pool of 9646 articles available on Google Scholar, Science Direct, Web of Science, and ProQuest, 25 were selected for inclusion in this systematic literature review after meeting the qualifying criteria. The screened papers contained clinical studies, cross-sectional studies, and editorials published in English. A review of these articles revealed that individuals' communication with friends via social media significantly enhanced their comprehension of conversations related to weight management. The results of this research inform efforts to combat poor diets and promote overall well-being among children at an earlier stage when personal interactions are likely limited. To promote the healthy growth of children, it is essential that the videos they engage with offer them appropriate guidance on maintaining a nutritious diet. Ultimately, this research provides insights into how social media creates environments conducive to the well-being of children. As a result, social media can serve as a valuable resource to help mitigate the prevalence of obesity in this vulnerable population.

Small rural tourism businesses’ experience of the COVID-19 Tourism Relief Fund: A case of Coffee Bay

The rapid spread of the coronavirus (COVID-19) has brought economies around the world to a complete halt. Given the restrictive measures implemented by governments to mitigate the damage caused by the virus, many sectors of the economy have been severely affected, with tourism being one of the hardest hit. This article aims to explore and evaluate the experiences of small tourism businesses operating on the outskirts in relation to the Tourism Relief Fund provided by the South African government during the COVID-19 pandemic. Drawing from an interpretive research paradigm, the study adopted a qualitative approach, using semi-structured interviews to gather data. The resulting data was then analysed using NVivo version 12, which generated a comprehensive observation report. The findings indicated that the South African government made concerted efforts to assist tourism businesses in surviving the worst humanitarian crisis of the 21st century. However, the findings also revealed numerous shortcomings that confirmed existing literature, particularly with regard to unconstitutional qualifying criteria. Furthermore, the study found that businesses, especially informal ones that cater to tourists and provide employment, were frustrated by their ineligibility for the Tourism Relief Fund due to qualifying criteria such as registration. In conclusion, the study recommends that the government and policymakers implement more flexible transformation policies, especially during times of crisis.

The optimal measurement method considering reliability and validity in the anterior knee laxity of anterior cruciate ligament tears.

To seek an optimal measurement method with high reliability and high validity for evaluation of the anterior knee laxity on stress radiographs and comparing the translation values to those of KT-2000 arthrometer. Anterior knee laxity in 77 patients was measured preoperatively using the TelosTM and the KT-2000 arthrometer. Side-to-side difference measurements were taken using three conventional measuring methods and one proposed method (Modified Lateral). The knee position on the stress radiograph was evaluated and scored based on the stress radiograph qualifying criteria depending on stress film correctiveness. Intraclass correlation coefficients were analyzed to evaluate the reliability of the measurement methods and were compared between high (Group H) and low (Group L) radiograph quality score groups for each method. Validity was assessed by comparing the KT-2000 and the TelosTM using Pearson correlation (r value). The Modified Lateral method showed the best Intraclass Correlation Coefficients (ICCs), followed by Center to Center, and Medial to Medial and Lateral to Lateral methods without considering the quality of Telos. In the comparison between groups based on Telos quality for intra-rater reliability, the Medial to Medial (MM) method demonstrated the best reliability in both groups (MM: ICCs, Group H = 0.942, Group L = 0.917, P = 0.693). As for inter-rater reliability, the Modified Lateral (ML) method exhibited the best reliability in both groups (ML: ICCs, Group H = 0.923, Group L = 0.882, P = 0.547). The value measured using the ML method in Telos showed the highest correlation coefficient with the KT-2000 measured value in both groups H and L. There were no statistically significant differences among the correlation coefficient values. The Modified Lateral method is recommended for its high reliability, taking into account the differences in bilateral knee positions and anatomical discriminability on stress radiographs when evaluating anterior knee translation with Telos. It also best reflected the KT-2000 arthrometer. Case Series, Level IV.

The Impact of Graduate Record Exam Threshold Scores in Disqualifying Underrepresented Ethnic-Racial Minority Applicants for Admission to a Doctor of Physical Therapy Program.

A growing number of graduate-level health professions education programs in the United States are discontinuing the use of the Graduate Record Exam (GRE) in their admissions requirements amidst concerns that its use puts Underrepresented Racial Minority (URRM) applicants at a disadvantage. This retrospective cross-sectional study analyzes the association between ethnic-racial selection and the reasons for disqualification among applicants to a public Doctor of Physical Therapy (DPT) program that used a minimum grade point average (GPA), and Analytic Writing and Quantitative Reasoning GRE minimum threshold scores to qualify applicants. There is evidence across the health professions literature that both GRE scores and GPA are associated with success on licensure examinations and academic performance. However, these variables also tend to disadvantage URRM applicants in gaining admissions to postgraduate health care fields, including physical therapy. All applicants (N = 4,797) to a single DPT program from a 9-year period were included. Racial and ethnic self-selections, GRE scores, and prerequisite GPA were coded for each applicant and classified for meeting qualifying criteria. The URRM applicants were disqualified based on GRE scores alone (P < .001) and in combination of GRE and GPA at a statistically significantly (P < .001) higher rate than Overrepresented Racial Group (ORRG) applicants, although the associations were negligible or weak. Compared with ORRG applicants, URRM applicants were at a statistically significant disadvantage because of the GRE threshold scores requirement. Furthermore, this study demonstrated that use of GRE minimum threshold scores disproportionately reduced URRM applicants in the qualified applicant pool. This investigation can be used as a model to inform holistic admission decisions regarding the use of academic variables to achieve the diversity and success goals of the program.

Prevalence of Independence at Home–Qualifying Beneficiaries in Traditional Medicare, 2014-2021

The Centers for Medicare & Medicaid Services Innovation Center Independence at Home (IAH) demonstration, a test of home-based primary care operating in a value-based shared-savings payment model, ended December 2023 after a decade of consistently showing savings to Medicare. It is important to assess whether high-need, IAH-qualified beneficiaries continue to pose a growing challenge to traditional Medicare (TM) or if Medicare Advantage (MA), with programmatic features favorable to caring for this subset of the general Medicare population, can disproportionately provide such care. To examine the size and share of IAH-qualified beneficiaries in TM and MA. This cohort study used all Medicare claims data and MA encounter data for 2014 and 2021. IAH qualifying criteria were applied to the TM populations enrolled in Parts A and B in 2014 and 2021, and to MA enrollees in 2021. Growth in the number of IAH-qualified TM beneficiaries from 2014 to 2021 was calculated, and the proportions and numbers of IAH-qualified enrollees in the total 2021 TM and MA populations were compared. Data were analyzed between April and June 2023. The number and share of beneficiaries meeting IAH criteria in TM and MA; the share of TM spending among IAH-qualified beneficiaries. Among 64 million Medicare beneficiaries in 2021, there were 30.55 million beneficiaries in TM with Parts A and B coverage, down from 33.82 million in 2014. The number of IAH-qualified beneficiaries in TM grew 51%, from 2.16 million to 3.27 million, while their proportionate share in TM grew 67% from 6.4% to 10.7% of TM between 2014 and 2021. IAH-qualified beneficiaries represented $155 billion in 2021 Medicare Parts A and B spending, 44% of all TM spending, up from 29% of total spending in 2014. In 2021, 2.15 million IAH-qualified beneficiaries represented 8.0% of Medicare Advantage enrollees. Combining TM and MA, 5.42 million IAH-qualified beneficiaries represented 9.3% of all Medicare beneficiaries, with 3.27 million (60.3%) being insured by TM. In this cohort study of IAH-qualified Medicare beneficiaries, the share of IAH-qualified beneficiaries in TM grew between 2014 and 2021, with 60% of Medicare high-need beneficiaries accounting for 44% of TM spending. The Centers for Medicare & Medicaid Services should continue to operate value-based programs like IAH that are specifically designed for these high-needs individuals.

Public Evaluations of Misinformation and Motives for Sharing It

Concerns around the definition of misinformation hamper ways of addressing purported problems associated with it, along with the fact that public understanding of the concept is often ignored. To this end, the present pilot survey study examines three broad issues, as follows: (1) contexts where the concept most applies to (i.e., face-to-face interactions, social media, news media, or all three contexts), (2) criteria people use to identify misinformation, and (3) motivations for sharing it. A total of 1897 participants (approximately 300 per country) from six different countries (Chile, Germany, Greece, Mexico, the UK, the USA) were asked questions on all three, along with an option to provide free text responses for two of them. The quantitative and qualitative findings reveal a nuanced understanding of the concept, with the common defining characteristics being claims presented as fact when they are opinion (71%), claims challenged by experts (66%), and claims that are unqualified by evidence (64%). Moreover, of the 28% (n = 538) of participants providing free text responses further qualifying criteria for misinformation, 31% of them mentioned critical details from communication (e.g., concealing relevant details or lacking evidence to support claims), and 41% mentioned additions in communication that reveal distortions (e.g., sensationalist language, exaggerating claims). Rather than being exclusive to social media, misinformation was seen by the full sample (n = 1897) as present in all communication contexts (59%) and is shared for amusement (50%) or inadvertently (56%).

The relationship between adipose tissue RAAS activity and the risk factors of prediabetes in different ethnicities: A protocol for a systematic review and meta-analysis.

The incidence and prevalence of prediabetes has become a global concern. The risk factors of prediabetes, such as insulin resistance, adiposity, lipotoxicity and obesity, in conjunction with the alteration of the renin-angiotensin-aldosterone system (RAAS), have been positively correlated with the high morbidity and mortality rate. Thus, this systematic review seeks to establish the relationship between the risk factors of prediabetes, namely insulin resistance adiposity, lipotoxicity, obesity and the RAAS. Therefore, a synthesis of these risk factors, their clinical indicators and the RAAS components will be compiled in order to establish the association between the RAAS alteration and obesity in prediabetic patients. This protocol for a systematic review was developed in compliance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) standards. This will be accomplished by searching clinical Medical Subject Headings categories in MEDLINE with full texts, EMBASE, Web of Science, PubMed, Cochrane Library, Academic Search Complete, ICTRP and ClinicalTrial.gov. Reviewers will examine all of the findings and select the studies that meet the qualifying criteria. To check for bias, the Downs and Black Checklist will be used, followed by a Review Manager v5. A Forrest plot will be used for the meta-analysis and sensitivity analysis. Furthermore, the strength of the evidence will be assessed utilizing the Grading of Recommendations Assessment, Development, and Evaluation procedure (GRADE). The protocol has been registered with PROSPERO CRD42022320252. This systematic review and meta-analysis will include published randomized clinical trials, observational studies and case-control studies from the years 2000 to 2022.

Pengembangan Video Animasi tentang Manfaat Sekolah untuk Siswa Sekolah Dasar

Awareness of the importance of school is a challenge for the present generation. Knowledge of the benefits of school is one thing that every student should know. Therefore, this research aims to develop animated videos of school benefits to enhance the knowledge of students about school benefits. At the stage of video design this animation was made using the renderforest website continued with the addition of audio using the capcut application. The type of research used is R&amp;D (Research and Development) with its development model ADDIE, data collection technique of media expert validation test and student response test. An animated video that has been developed by the researchers tested practiced at the Elementary School. The result of this study is that the animated video was declared “valid” based on an average rating with a presentation of 85.3% with the criterion “very qualified”, after the validity test was subsequently tested practiced in three categories namely the individual test with the presentation of 94% with the highly qualified criteria, the small group trial with the Presentation of 93.44% with the very qualified Criterion, the large group trials with the presentation of 90.15% with very qualifying criteria. Based on practical tests that have been conducted, these animated videos will be more effective if used by students individually than in groups. The results of the research showed that the development of this animated video is very worthy to be applied in the process of improving the education of students.

The Efficacy of Drug-Coated Balloons and Drug-Eluting Stents in Infrapopliteal Revascularization: A Meta-analysis.

The study aimed to compare the effectiveness of drug-coated balloon (DCB) and drug-eluting stents (DESs) to standard endovascular techniques like percutaneous transluminal angioplasty (PTA) and bare metal stent (BMS) for treating infrapopliteal artery disease. Including 8 DCB trials and 4 DES trials, this meta-analysis of 12 recent randomized controlled trials (RCTs) is comprehensive. We searched MEDLINE, EMBASE, Science of Web, Cochrane, and PubMed for this meta-analysis. We searched these databases for papers from their inception to February 2023. We also analyzed the references given in the listed studies and any future study that cited them. No language or publication date restrictions were applied to the 12 RCTs. The experimental group includes 8 DCB studies and 4 DES investigations, the DCB group is primarily concerned with the paclitaxel devices, whereas the DES group is preoccupied with the "-limus" devices. Key clinical outcomes in this study were primary patency and binary restenosis rates. This study's secondary outcomes are late lumen loss (LLL), clinically-driven target lesion revascularization (CD-TLR), limb amputation, and all-cause mortality. The evidence quality was assessed using Cochrane risk-of-bias. The PROSPERO registration number for this study is CRD42023462038. Only 108 of 1152 publications found satisfied qualifying criteria and contained data. All 13 RCTs have low to moderate bias. Drug-coated balloons and DESs were compared in the excluded study. The analysis comprised 2055 participants from 12 RCTs that met the inclusion criteria, including 1417 DCB patients and 638 DES patients. Drug-coated balloons outperform traditional methods in short-term monitoring of primary patency, binary restenosis, and CD-TLR. The benefits fade over time, and the 2 techniques had similar major amputation rates, mortality rates, and LLL. Drug-eluting stents outperform conventional procedures in primary patency, binary restenosis, and CD-TLR during medium-term to short-term follow-up. Comparing the 2 methods, major and minor amputations, death rate, and LLL were similar. Comparison of DES and DCB with PTA or BMS shows that DES had better follow-up results. DCB has positive short-term results, but long-term effects differ, however, more research is needed to determine when DES and DCB should be used in medical procedures. The provision of additional evidence to substantiate the advancement of drug-coated balloon (DCB) therapy in the treatment of lower limb arteriosclerosis obliterans, particularly in the below-the-knee area characterized by high calcium load and significant occlusion, is comparable in efficacy to conventional procedures. This finding is advantageous for the progress of interventional revascularization. The advancement and efficacy of DCB have resulted in improved treatment outcomes for medical practitioners in clinical settings. Our research incorporates the most recent randomized experiments.

A National Platform and Scoring System Allocates CAR-T Treatment Slots for Multiple Myeloma to Patients with High Likelihood of Complete Remission

Introduction Therapy of relapsed and refractory multiple myeloma (MM) with Ide-Cel is superior to alternative treatments, but availability is lower than the number of patients in need. Treatment slots are distributed by the manufacturer per country. Their allocation to individual patients is a medical, logistical and ethical challenge. Ideally, such allocation should be inclusive, fair, transparent, effective, and base on prospectively confirmed objective outcome criteria. Methods Swiss Blood Stem Cell Transplantation and Cellular Therapy (SBST) has established the national SBST-CAR-T MM board for allocation of Ide-Cel treatment slots. Allocation process and triage criteria were developed by clinical experts in exchange with the ethical board of the Swiss academy for medical sciences and health insurers, approved by all JACIE-accredited national centers for cellular therapies, and agreed that Ide-Cel therapy in Switzerland is only available through this allocation system. Patients are registered in parallel with request for insurance coverage in one key document. Patients had to meet qualifying approval criteria for Ide-Cel in Switzerland (relapsed and refractory MM, &amp;gt;2 prior therapy lines, triple-class-exposed). Reaching CR after Ide-Cel is associated with superior PFS. We therefore developed an algorithm to select patients with high likelihood for CR. Patient factors negatively associated with CR derived from the KarMMa trial were complemented by factors prospectively associated with inferior overall survival after CAR-T in malignant lymphoma. High tumor burden (bone marrow infiltration &amp;gt; 50% or high tumor load by PET-CT), inflammatory activity (increasede ferritin or D-dimers), ECOG patient status and comorbidities were used as negative predictive factors and combined to a sum score of 0-4. All registered patients are presented at the monthly virtual meeting and ranked according to this score. Ranking is refined based on availability of alternative treatment options, resulting in a final national ranking agreed by all board members. Because no patients with severe comorbidities were registered, this dimension was later excluded. Results Between May 2022 and April 2023 all 48 Ide-Cel regular treatment slots in Switzerland were allocated in 12 virtual meetings lasting median 55 minutes (25-70) with the participation of median 7 centers (6-8), 8 physicians (6-15), discussing in total 72 patients (median 5.5 per meeting, range 4-10) to distribute 4 slots monthly. All therapy slots were successfully allocated, including short-notice changes in availability of slots or patients requiring immediate allocation of substituting patients. 74.2% of all patients registered with the SBST CART MM board received Ide-Cel. Patient, treatment and outcome parameters were centrally collected to SBST database from 37 treated patients per April 2023. (1 patient each had cell collection failure, Ide-Cel production failure, missing outcome data). Patients were 65% triple refractory, 65 % penta refractory, 14% received prior BCMA-targeted therapy, 8% prior bispecifc antibodies and 67% had high risk cytogenetics. Best response achieved so far was CR or better in 57% of patients, PR-VGPR 16%, PD 13%, not stated/too early 13%. A low SBST-MM CAR-T Score was prospectively associated with CR (table 1, p=0.048). Each scoring dimension (ECOG, tumor load, inflammation) significantly correlated inversely with CR, while conventional characteristics for poor MM outcomes (HR CG, penta refractory disease) did not correlate. PFS and OS data is pending. Cross cohort comparison with the Real-World Experience from the US Myeloma CAR-T Consortium (Hansen et al., JCO 2023) revealed a strong trend towards higher CR rates (57% vs. 23%, p=0.10). Conclusion This algorithm prospectively selects MM patients for BCMA-CAR-T treatment to maximize CR rate. Also, this national real world cohort demonstrates the feasibility of triaging the allocation of CAR-T therapy slots based on a, fair, objective, transparent, consensual algorithm using predefined criteria. The SBST scoring system prospectively reflects differential likelyhood of CR (100&amp;gt;64&amp;gt;53&amp;gt;33%), and the scoring dimensions (ECOG, tumor load, inflammation) prospectively correlate with a CR rate of 57 %, supporting the selection process. The SBST CAR-T scoring system may be used to allocate CAR-T treatment slots to maximize benefit from this treatment.

An Alarmingly High Number of Candidates for Bariatric Procedures among Professionally Active Poles and Its Strong Relationship with Cardiovascular Co-Morbidities-POL-O-CARIA 2022 Study.

Over recent years, the global healthcare system has experienced a notable increase in the prevalence of obesity and its associated health complications such as hypertension, type 2 diabetes, lipid disorders, etc. What is more, one of the significant phenomena is the increasing demand for bariatric procedures among individuals of working age due to the high prevalence of type III obesity and type II obesity with co-morbidities. This trend is pronounced in Poland, due to the increasing number of patients meeting the qualifying criteria for surgery among professionally active and inactive patients. The aim of this study is to characterize the alarmingly high number of candidates for bariatric procedures among professionally active Poles. In total, the results of 2,056,861 initial, control, and periodic visits as part of the occupational medicine certificate were analyzed-collected from 1,342,749 unique patients (51.7% men; mean age of whole group: 36.81, SD = 10.91). Statistical calculations were performed, qualitative data were assessed using percentage and occurrence counts, while qualitative data were described using mean (M), standard deviation (SD), median, skewness, kurtosis, and range values. Results with p < 0.05 were deemed significant. Chi-square analysis and one-way ANOVA (with Scheffe's post hoc test) were employed. Charts were created in the R program. It was noticed that there was a consistent rise in the proportion of individuals classified as candidates for bariatric procedures (an increase of 0.3%) alongside a notable decrease in the percentage of individuals maintaining a healthy body weight. Moreover, it is imperative to conduct yearly evaluations of the prevalence of obesity and its associated health conditions. It should be noted that hypertension occurred in 42.2% of patients, type 2 diabetes in 6.2% of patients, and lipid disorders in 8.4% of patients with third-degree obesity. This proactive approach is essential in order to adequately equip the healthcare system to address the increasing population of obese individuals, especially candidates for bariatric procedures.

Editor's Choice – Management of Lower Extremity Venous Outflow Obstruction: Results of an International Delphi Consensus

The endovascular treatment of venous obstruction has expanded significantly in recent years. Best practices for optimal patient outcomes are not well established and the evidence base is poor. The purpose of this study was to obtain consensus on management criteria for patients with lower extremity venous outflow obstruction. The study was conducted as a two round Delphi consensus. Statements addressed imaging, symptoms and other baseline measures, differential diagnosis, treatment algorithm, indications for stenting, inflow and outflow assessment, successful procedural outcomes, post-procedure therapies and stent surveillance, and clinical success factors. Statements were prepared by six expert physicians (round 1, 40 statements) and an expanded panel of 24 physicians (round 2, 80 statements) and sent to a pre-identified group of venous experts who met qualifying criteria. A 9 point Likert scale was used and consensus was defined as ≥ 70% of respondents rating a statement between 7 and 9 (agreement) or between 1 and 3 (disagreement). Round 1 results were used to guide rewording and splitting compound statements for greater clarity in round 2. In round 1, 75 of 110 (68%) experts responded, and 91 of 121 (75%) experts responded in round 2. Round 1 achieved consensus in 32/40 (80%) statements. Consensus was not reached in the treatment algorithm section. Round 2 achieved consensus in 50/80 (62.5%). Statements reaching consensus were imaging (2/3, 66%), symptoms and other baseline measures (12/24, 50%), differential diagnosis (2/8, 25%), treatment algorithm (10/17, 59%), indications for stenting (10/10, 100%), inflow and outflow assessment (2/2, 100%), procedural outcomes (2/2, 100%), post-procedure therapies and stent surveillance, (5/7, 71%), and clinical success factors (5/7, 71%). This study demonstrated that considerable consensus was achieved between venous experts on the optimal management of lower extremity venous outflow obstruction. There were multiple domains where consensus is lacking, highlighting important areas for further investigation and research.

Trzysta lat historii Suwałk

In her article, Katarzyna Zimnoch reviews the first volume of a book titled Suwałki Biographical Dictionary. The researcher highlights that this volume contains 459 biographies of individuals connected to Suwałki. The qualifying criteria included being born in Suwałki, playing an important role or holding a significant position, as well as contributing to the town. The chronological scope of the dictionary covers the past three centuries. This publication coincided with the three-hundredth anniversary of Suwałki receiving its city rights. The dictionary’s release marks the culmination of long-standing efforts by individuals dedicated to the history of the city and its residents. This compilation is intended for a wide audience and can serve both scholarly and popularization purposes. It’s worth mentioning that this dictionary was selected for the 29th edition of the Nationwide Review of Travel and Tourist Books, underscoring its potential social function. Every city and region deserves such a work.

A Physical Rehabilitation Approach for Parkinson's Disease: A Systematic Literature Review.

Parkinson's disease (PD) is one of the most common neurological ailments. With diverse motor affectations (postural instability, resting tremor, bradykinesia, and rigidity), people with Parkinson's disease (PwP) have a broad spectrum of non-motor symptoms. These include autonomic function changes, cognitive deterioration, neuropsychiatric difficulties, and sleep interruptions. Psychological disturbances, such as anxiety and sadness, are common among PwP. This discomfort is often accompanied by a decrease in general functioning, both at work and in social contacts. Furthermore, people who are experiencing psychological distress have a quick decrease in both physical and cognitive capacities. Furthermore, Pwp who also suffer from anxiety and depression are more likely to acquire dementia. It is worth noting that studies have shown good outcomes in the treatment of physical disabilities in PWP and the various therapeutics available for each affected body part, such as in the legs when they have walking problems, resting tremor in their hands, or micrography, which is a common symptom in these patients. The medical researchdatabases PubMed/Medline, Google Scholar, and the Cochrane Library were used to look for relevant materials. Upon meticulous scrutiny, a thorough investigation was conducted on the papers at hand. A total of 10 publications were meticulously selected based on stringent qualifying criteria. The present investigation examines various perspectives regarding the physical rehabilitation of individuals diagnosed with PD. The majority of therapeutic interventions employed revolve around cutting-edge technologies, such as virtual reality (VR), combined with exercise regimens. These interventions have demonstrated notable statistical significance in terms of enhancing various physical aspects, including endurance, performance, gait capacity, perception, and overall independence in daily life activities. One of the gathered studies makes use of the therapeutic benefits of yoga to help PwP deal with their anxiety and improve their mental health.Based on the aforementioned information, further investigation is required to ascertain the optimal approach for physical rehabilitation management and develop diverse strategies aimed at assisting individuals with PD in attaining physical autonomy.

Effectiveness of Mesalamine in Patients With Ulcerative Colitis: A Systematic Review.

Ulcerative colitis (UC) management has changed significantly in the past decade. The goal is to treat the symptoms, aid tissue healing, and change the disease course to improve future outcomes. Oral or topical mesalamine (5-ASA) is a well-known UC treatment. It is the standard for starting and maintaining recovery in mild-to-moderate illnesses. The majority of patients start the treatment in the first year after diagnosis and continue it for long periods. In this review article, PubMed/Medline, Google Scholar, and the Cochrane Library were used to search medical databases for relevant medical literature. After the articles were gathered and evaluated, 10 publications were compiled and selected using the qualifying criteria. The included articles aimed to provide an overview of 5-ASA in UC patients. According to several studies, there was no statistical relevance between various 5-ASA doses or the number of times they were taken. One study showed that 5-ASA cream preparation is better than oral preparation for patients with proctitis and proctosigmoiditis. The majority of the studies performed a follow-up to assess remission based on the use of endoscopy, fecal calprotectin, and patient symptoms during the investigations. Based on the aforementioned information, further investigation is required to ascertain the optimal approach for managing UC, with the aim of incorporating it into routine clinical procedures and enhancing our understanding of the subject matter.

The Effectiveness of Ablation Therapy for Atrial Fibrillation: A Systematic Review.

It is expected that the prevalence of atrial fibrillation (AF), the most prevalent cardiac arrhythmia among people aged 65 to 85, would be mostly classified using the CHAS2DS2-VASc approach for anticoagulation therapy. A high number of people in the entire world will be living with AF by 2030. Long-term follow-up data are sparse, although radiofrequency catheter ablation (CA) for symptomatic AF patients has the potential to be a curative therapy. Although women are referred later and less often than men, the outcomes following ablation are comparable across both genders. Health-related quality of life suffers from AF, and patients often find themselves less active as a result of their condition. AF may have a wide variety of symptoms and signs from the clinic's point of view. Women are more likely to exhibit symptoms than men; one reason for this is that women have an average QT interval that is 10-20 milliseconds longer than men, which is more likely to exacerbate tachycardia symptoms. In search of medical databases for relevant medical literature, we looked at PubMed/Medline, the Cochrane Library, and Google Scholar. Ten publications were gathered after the papers were located, assessed, and qualifying criteria applied were used to select them. The finished articles were done to give an overview of the effectiveness of ablation therapy for AF. Some studies showed that there was no statistical significance between invasive and pharmacological treatments. Other research found no difference in the recurrence of atrial arrhythmia between pulmonary vein isolation (PVI) CA alone and PVI + enhancement magnetic resonance imaging (MRI)-guided fibrosis ablation in individuals with persistent AF. The oldest individuals in studies comparing CA to medical treatment for AF demonstrated no improvement in prognosis after CA. Also, complications from therapy and CA's efficacy in preventing future atrial arrhythmias were similarly low across all age groups. Based on the above, we concluded that more studies are required to establish the most effective approach to treating AFto apply it in daily practice and gain more knowledge about it.

Effect of Oral Clonidine and Gabapentin as Premedication on Intraoperative Hemodynamic Responses and Postoperative Analgesia Requirement in Laparoscopic Cholecystectomy

Background: Laparoscopic cholecystectomy pain is a sensory and emotional experience connected with actual or potential tissue damage. Effective pain control is quite important, with around 70% of patients still complaining of moderate-to-severe pain postoperatively. Uncontrolled perioperative pain may raise patient morbidity and mortality rates. Both gabapentin and clonidine as premeditated can be easily administered have minimal side effects, are easily available at a low price, both them have a sedative effect that can decrease anxiety and they can blunt the stress response. Moreover, both drugs have anti-nociceptive effects that may be beneficial for controlling postoperating pain which is the basis of our current study. Aims: This study aims to compare the efficacy of oral clonidine with gabapentin before induction of anesthesia in attenuating hemodynamic stress response to laryngoscopy, intubation, and carbon dioxide pneumoperitoneum in laparoscopic cholecystectomy and to compare the efficacy of oral clonidine with oral gabapentin for postoperative pain control. Materials and Methods: Hundred patients undergoing laparoscopic surgery and qualifying inclusion criteria were randomly allocated into two groups each containing 50 patients. Group I patients were given Tab. Clonidine (300 μg) and Group II patients were given tablet Gabapentin (600 mg) orally 60 min before induction of general anesthesia. Hemodynamic changes and the incidence of postoperative pain in both groups were measured and compared. Results: Hemodynamic blunting to pressor stress of laryngoscopy and intubation was seen in both groups with better results obtained in the group receiving clonidine in the form of lesser variations in heart rate, systolic blood pressure, and diastolic blood pressure. Postoperative analgesia was achieved in both groups but gabapentin showed a better analgesic profile in the form of lesser Visual Analog Scale scoring and decreased utilization of rescue analgesia. Conclusion: Clonidine (300 μg) cause a greater attenuation of intraoperative hemodynamic stress responses, whereas gabapentin (600 mg) provides superior postoperative analgesia.

Sudden Cardiac Death: A Systematic Review.

Sudden cardiac death (SCD) is a condition that accounts for a high percentage of cardiovascular fatalities, with ventricular tachyarrhythmias being the most common cause. There are signs and symptoms of SCD that occur spontaneously without any warning and are deadly. Despite preventative efforts focusing on the use of subcutaneous implanted cardioverter defibrillators (S-ICD) in the highest-risk population categories, a high number of SCDs occur in the normal population and in people who do not have a documented cardiac condition. Therefore, primary prevention for SCD should be a more viable strategy for the general population, considering measures in the form of preventive medicine such as knowing more about any genetic predisposition, family history of any fatal arrhythmia, continuous surveillance after any syncope with unknown causes, etc. However, little data about SCD risk factors are known in comparison with other well-known diseases like ischemic heart disease and stroke.In search of medical databases for relevant medical literature, we looked at PubMed/Medline, the Cochrane Library, and Google Scholar. Thirteen publications were discovered after the papers were located, assessed, and qualifying criteria were applied. The finished articles were done to give an overview of SCD. Some others have shown that the major predisposition for SCD is related to the male gender, which increases the incidence if they have a family history of SCD. We described the importance of obstructive sleep apnea (OSA) as a comorbid condition. Patients with S-ICD and young athletes with a history of ventricular arrhythmia showed us that the predisposition for SCD can be higher than in the normal population. Based on the above, we concluded that more study is required to establish the most important approach for eachof the risk factors mentioned in this systematic review in order to apply them in daily practice and have more knowledge about how to apply preventive and therapeutic medicine to the population at risk and the ones that already develop the disease.

Free Online Decision Tools to Support Parents Making Decisions About Their Children's Chronic Health Condition: An Environmental Scan.

Medical decisions parents make on their children's behalf can be challenging. Free online decision support tools are created to help parents faced with these decisions. We used an environmental scan to identify free, online tools that support parents in making decisions about their children's chronic health condition. We described the tools and assessed their potential to harm, content, development process, readability, and whether their use changed decision makers' knowledge and alignment of their preferences with their final decision. Decision aid repositories, Google searches, and key informants identified decision support tools. Eligible tools were freely available online and for parents of children with chronic health conditions. Two reviewers independently assessed the tools' quality based on the International Patient Decision Aid Standards (IPDAS). Tool readability was assessed using the Flesch Reading Ease test. From 21 free, online decision support tools, 14 (67%) provided sufficient detail for making a specific decision (IPDAS qualifying criteria). None sufficiently met IPDAS certification criteria necessary to reduce the possibility of patient harms when using the tool. Three (14%) were fairly easy or easy to read. Of those evaluated by developers (n=6), 2 improved knowledge and 4 improved alignment of preferences with the available options. Google searches and key informant sources are not replicable. Free, online decision support tools for parents of children with chronic health conditions are of variable quality, most are difficult to read, and there is limited evidence their use achieves intended outcomes. Registered with Open Science Framework 20 July 2021(AEST) osf.io/b94yj.

Patient decision aid for chemotherapy or exclusion in cisplatin-intolerant patients with locally advanced cervical cancer (CECIL): Development, alpha testing, and peer-validation.

e13506 Background: In locally advanced cervical cancer (LACC), adding chemotherapy (ChT) to radiotherapy (RT) improves survival but increases toxicity. In the Philippines, about 33% of cervical cancers are diagnosed in the elderly and about 36% present with ureteral obstruction. RT compliance may be compromised by cisplatin toxicity. Shared decision-making (SDM) better engages the patient in the decision-making and implementation planning process. Patient decision aids (PtDA) may increase knowledge and self-efficacy, thereby decreasing decisional conflict and attitudinal barriers and improving treatment compliance. Methods: The Interprofessional Shared Decision-Making Model was used as a conceptual framework. The PtDA defines the index decision, facilitates information exchange and examination of values and preferences, towards the determination of a practicable choice. Using a mixed-methods design and following International Patient Decision Aid Standards (IPDAS) guidelines, a steering panel consisting of radiation oncologists (RO) (2), gynecologic oncologists (GO) (1), oncology nurse (1), clinical psychologist (1), cancer survivor (1), and caregiver (1) developed the CECIL prototype, a PtDA for cisplatin-intolerant LACC patients faced with the decision of adding ChT to RT. The elements were based on the Decision Support Framework and the content, on current international and local guidelines, and a recent systematic review. The prototype was alpha-tested by the steering committee using the e-Delphi method. The PtDR Ottawa Acceptability Practitioner and Patient Questionnaires were used to evaluate comprehensibility, length, amount of information, neutrality, and overall suitability for decision-making. The prototype was then independently evaluated by local internal (RO, 1) and external (GO, 1), and international (RO, 1) reviewers using the IPDAS checklist version 4, which covers 9 relevant domains: information, probabilities, values, guidance, development, evidence, disclosure, plain language, and evaluation. Results: Alpha testing showed high practitioner acceptability (all items with mean and median scores ≥4; overall mean score 4.70/5) and good patient acceptability (all items good to excellent). Content validation showed that the PtDA satisfied all IPDAS qualifying (6) and certification (6) criteria, with high overall mean score (3.63/4) for applicable quality (17) criteria. All reviewers' comments were considered in the subsequent revision of the prototype. Conclusions: The CECIL prototype shows good practitioner and patient acceptability, and content validity on peer review. It will be pilot-tested and subjected to the phase 2 of the clinical trial (NCT05701735) to determine its utility in preparation for decision-making and effectiveness in reducing decisional conflict. Clinical trial information: NCT05701735 .