Visual Analogue Research Articles

Comparison of Efficacy of Coumarin and Chymotrypsin/Trypsin in Patients Undergoing Surgical Removal of Lower Third Molars: A Prospective Study.

Background Third-molar surgeries are very commonly done by oral and maxillofacial surgeons. Pain and swelling that is associated with this procedure is a frequent reason for the patient's discomfort and apprehension. There is a need to look for a drug that can substantially reduce postoperative swelling amongst the patients. Pain, swelling, and trismus are common complications that are encountered after third molar surgery. These complications have a major impact on the quality of life of patients undergoing minor surgical procedures. Aim The aim of this study was to compare the effectiveness of coumarin and trypsin/chymotrypsinin the reduction of postoperative sequelae for mandibular third molar surgeries. Materials and methods The research was carried out at Saveetha Dental College and Hospital in the Department of Oral and Maxillofacial Surgery. The study consisted of 50 individuals, 25 individuals received tablets of coumarin, and 25 individuals received tablets containing a combination of trypsin/chymotrypsin postoperatively. Patients were evaluated postoperatively for pain and swelling. Postoperative pain was measured on days one, three, and seven after surgery using a visual analog scale.The postoperative swelling was measured on postoperative days three and day seven via a four-point technique.Data were analyzed using IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States). P-values less than 0.05 were considered statistically significant. The independent samples t-test was used to compare the outcomes between the two groups. Results It was found that study participants in the trypsin/chymotrypsin group reported statistically significantlyless pain postoperatively than participants receiving coumarin (p=0.001). There was more reduction in swelling postoperatively in patients who were given trypsin/chymotrypsin as compared to the participants who were given coumarin, and the results were statistically significant. Conclusion Based on the data obtained, it can be inferred that the trypsin/chymotrypsin combination was more effective in reducing postoperative sequelae like pain and swelling than coumarin in the mandibular third molar surgeries.

The Effect of Spinning Exercise on Dysmenorrhoea for Vocational Midwifery Students at The Health Polytechnic of Palangka Raya

Dysmenorrhea is pain that resembles cramps in the lower abdominal area during menstruation. Symptoms of dysmenorrhea appear in the form of pain in the midline of the lower abdomen, which begins to appear several hours before or at the same time as menstrual bleeding. This research aims to determine the effect of spinning exercise on dysmenorrhea and analyze the reduction in pain symptoms for dysmenorrhea. This research used a quasi-experimental design using a pre-post-test approach in the control and intervention groups. Data was collected on 32 students, 16 respondents in the spinning and 16 respondents in the control group-intensity measurement of spinning exercise using a cycling ergometer and measuring dysmenorrhea pain using visual analogic. The results of the statistical test between the control group and the spinning group obtained p-value = 0.027 < 0.05, which shows that group with medium and heavy-intensity spinning exercise is more effective in reducing dysmenorrhea than group with light-intensity spinning exercise. Adolescents are a group that has high activity in physical exercise. This characteristic is one of the factors for using spinning exercise treatment to treat dysmenorrhea in adolescents. This intervention becomes easier for adolescents to carry out.

Assessment of the acute subjective psychedelic experience: A review of patient-reported outcome measures in clinical research on classical psychedelics.

The classical psychedelics psilocybin, peyote, ayahuasca/ N, N-dimethyltryptamine, and lysergic acid diethylamide can temporarily produce altered states of consciousness, characterized by changes in sensory perception, thought, mood, and the sense of self-reality and meaning. It is important to have reliable instruments for quantifying these altered states in trials, due to a plausible link between the acute subjective experience and treatment outcome. We conducted a review of outcome measures applied in research on classical psychedelics to assess one or more dimensions of the acute subjective psychedelic experience. Three relevant databases were searched electronically. Two reviewers independently conducted article selection and data extraction regarding the instruments, dimensions, geography, population, and psychedelic substance investigated in the included studies. We identified the five most utilized instruments for the most recent 6 years, as well as the five most utilized instruments for each psychedelic. We included 93 papers, which reported on 93 unique trials and utilized 17 different rating scales. Of these, the most utilized were the Five-Dimensional Altered States of Consciousness Questionnaire, visual analog or Likert scales specially developed for the trials, the Hallucinogen Rating Scale, the States of Consciousness Questionnaire, and the Abnormer Psychischer Zustand. Considerable variability was found in the instruments utilized in clinical trials on classical psychedelics. We advise and encourage the development of a core outcome set for psychedelic research to enable altered state comparisons across compounds, participants, and settings. We further advise that instruments be designed to assess the "setting" of a psychedelic experience.

A Case Report of Korean Medicine Treatment for an Intractable Hiccup Patient with Unknown Cause after a Traffic Accident

Objectives: The purpose of this study was to report a case of a woman with intractable hiccups after a traffic accident through Korean medicine treatment.Methods: A combination of treatments, including herbal medicine (<i>Soshiho-tang</i>), pharmacopuncture, acupuncture, Chuna, cupping, and moxibustion, was administered to the patient for 21 days. The frequency and duration of hiccups, the degree of body shaking, and total sleep time were measured daily. The accompanying symptoms were measured daily using the Visual Analogue Scale.Results: After Korean medicine treatment, Hiccup symptoms disappeared. Further, the degree of clinical symptoms and QOL improved significantly after Korean medicine treatment. No adverse events were observed.Conclusions: This study suggests that Korean medicine treatment can be an effective treatment for intractable hiccups after traffic accidents.

Arthroscopic Capsular Release for Post-traumatic Elbow Stiffness.

Post-traumatic elbow stiffness (PTES) may substantially affect the patient's functional range of motion and quality of life. Open elbow release has been extensively studied, but arthroscopic techniques are limited, particularly in differentiating between post-traumatic and non-traumatic stiffness. The purpose of this study is to assess the clinical outcomes after arthroscopic release of PTES regarding the range of motion (ROM), pain, functional assessment, and complications. A prospective cohort was conducted on adult patients who underwent arthroscopic arthrolysis for PTES, with 32 patients included in the final analysis. The ROM was measured using the orthopedic goniometer. Grip strength was measured using the Camry digital hand dynamometer (Camry, CA, USA) and compared to their contralateral side. The functional status of the patients was evaluated using the American Shoulder and Elbow Surgeons Score (ASES)andthe Mayo Elbow Performance Index (MEPI). All measurements were done before surgery and at the last follow-up visit. Pre-operative and post-operative changes in MEPI, ASES, and visual analog (VAS) scores were compared with the paired t-test. After surgery, the ROM significantly improved from 74 ± 11 to 110 ± 15 degrees (p<0.001). Additionally, the ASES score and MEPI index both significantly improved from 69 ± 3.4 to 79 ± 6.3 and from 64 ± 5.7 to 82 ± 8, respectively (p<0.001). VAS scores also significantly improved from 1.1 ± 0.87 to 0.31 ± 0.53 at rest (p<0.001). The complication rate was 12%, including three transient ulnar nerve paresthesia and one superficial infection. Post-traumatic elbow release was more offered in distal humerus fractures (53%), followed by proximal ulna fracture/dislocations (25%). We believe that arthroscopic arthrolysis is a safe and reliable treatment of PTES, which improves joint visibility and reduces pain. Patients can be counseled regarding the risk of a secondary surgery following distal humerus or proximal ulna fractures, including the expected recovery and complication rate.

SoTL in Human Movement Sciences: Moving Forward in South Africa

The Scholarship of Teaching and Learning (SoTL) is an emerging focus within South Africa (SA). In Human Movement Sciences (HMS) in SA, research is primarily discipline-specific, and many researchers are unfamiliar with SoTL. To explore how we (as HMS lecturers) could integrate SoTL into our research, we formed a community of practice (CoP). The SoTL unicycle depiction of Swart et al. (2016) suited our visual analogy since the focus of HMS is on the human body that is in motion. For us, the unicycle represented HMS SoTL in motion. Swart et al. (2016) viewed the SoTL movement as an academic’s individual journey, whereas we saw SoTL from a CoP perspective. Therefore, we adapted the unicycle into a tandem bicycle, representing our collaborative engagements. Participatory action learning and action research (PALAR) formed our theoretical framework. Through our dialogue, each tandem wheel’s focus emerged. The back wheel was about deciding to SoTL (or not). This became a linchpin of our critical dialogue during the relationship-building phase of our CoP. Once we committed, we needed to learn how to keep our CoP moving forward. This became the middle wheel of our tandem bicycle. Next, the front wheel and handlebar became our guide into what the future of SoTL would be for us. The tandem bicycle, therefore, represents our collective cycles of learning as we became SoTL researchers. We believe our learning can support others transitioning from discipline-specific research to engaging in SoTL. *Please note that this poster is best viewed in Adobe on a computer/laptop for interactivity. Click here to read the corresponding ISSOTL blog post.

Pain perception and expectation related to interradicular mini-implants insertion: a systematic review and meta-analysis.

The aim of this systematic review was to compare the expectation and perception of pain reported by patients before and after the installation of interradicular mini-implants. Electronic search was performed in six databases. Inclusion criteria were randomized controlled trials (RCTs) or non-randomized controlled clinical trials (nRCTs); studies using mini-implants in the interradicular region; assessment of pain intensity by visual analogue or numerical scale. The risk of bias assessment was based on the Rob 2 tool and Robins-I. A total of 1566 articles were retrieved, and 21 met the eligibility criteria. Six were classified as high risk, one as critical and the other one as uncertain, according to the Robins-I tool. In articles evaluated by the Rob2 tool, ten were classified as serious risk and three as moderate risk. A meta-analysis was also performed. Weighted means were calculated among the studies using the random-effects model and forest plots were generated. Heterogeneity was assessed through the Q test and I2 statistics. It was observed, with moderate evidence, that on a scale of 0 to 10, the pain expectation (effect size 4.75) is higher than that effectively pain generated by the procedure (effect size 1.94). Pain expectation was greater than that actually generated by the procedure, being almost non-existent 7 days postoperatively. This study may help the clinician to reassure the patient regarding the sensations that could be experienced during and after the installation.

Increased Salivary IL-1 Beta Level Is Associated with Poor Sleep Quality in University Students.

Poor sleep quality is a major public health concern for all ages. In particular, university students often face stress levels and changes in social life habits that negatively influence their quality of sleep. This could be associated with psychological well-being in terms of anxiety and depressive symptoms, stress levels, and a poor self-perceived health status. The increases in the pro-inflammatory cytokine interleukin 6 (IL-6), IL-1 beta (IL-1β), and tumor necrosis factor alpha (TNFα), in blood have been linked to poor sleep quality in many diseases, but data on salivary cytokine levels in students are missing or are seldom analyzed. In this study we determined the quality of sleep in a sample of university students and the role of psychological assessment and factors affecting sleep (alcohol intake, tobacco, consumption of stimulant drinks, exercise, and body mass index). We also aimed to shed new light on the associations between sleep quality and salivary inflammatory cytokines (IL-1β, IL-6, and TNFα). Sleep quality was measured with the Athens Insomnia Scale (AIS) and Pittsburgh Sleep Quality Index (PSQI). Perceived stress was assessed using Cohen's Perceived Stress Scale (PSS), and the Goldberg Anxiety and Depression Scale (GADS) was used to assess the level of anxiety or depression. Perceived health status was measured with a visual analogue. Saliva samples was taken in the morning and the inflammatory cytokines was measured via enzyme-linked immunoassay. There was a direct and significant association between the salivary IL-1β concentration and AIS score (r = 0.248; p = 0.038, Pearson correlation) and Pittsburgh scale score (r = 0.274; p = 0.022, Pearson correlation). The relationship between IL-1β and AIS controlling for sex, age, and chronic disease, is still significant (r = 0.260; p = 0.033). The relationship between IL-1β and PSQI controlling for the influence of these variables is also significant (r = 0.279; p = 0.022). Salivary IL-1β concentrations were not significantly associated with any of the scores of the other psychological assessments (PSS, anxiety, depression symptoms, or self-perceived health). Salivary TNFα was significantly and inversely associated with self-perceived health (r = -0.259; p = 0.033, Pearson correlation), but the salivary IL-6 concentration was not associated with any of the sleep quality scale or psychological assessment scores. Our results provide a novel relationship between pro-inflammatory cytokine IL-1β in saliva and poor sleep quality. However, the role of inflammation in poor sleep quality requires further study to identify strategies that could lower inflammation and thus, likely improve sleep quality.

Efficacy of Jiao's scalp acupuncture in combination with Xiangshao granules on chronic tension-type headache with concomitant nonalcoholic fatty liver disease in climacteric women.

This study aimed to assess the efficacy of Jiao's scalp acupuncture in combination with Xiangshao granules on chronic tension-type headache (CTTH) with concomitant nonalcoholic fatty liver disease (NAFLD) in climacteric women. In this study, we enrolled 150 climacteric women with CTTH and concomitant NAFLD. The participants were divided into three groups based on the random number table: medication group, acupuncture group, and acupuncture-medication group. Treatment continued for 2 months. The efficacy of CTTH was assessed based on the visual analog scale/score (VAS). The influence on NAFLD was assessed based on body mass index (BMI), controlled attenuation parameter (CAP), and the ratio of hepatic-splenic computed tomography (CT) value. The Participant Health Questionnaire-9 (PHQ-9) score was compared among the three groups. A total of 123 participants completed the trial, including 37 participants in the medication group, 41 participants in the acupuncture group, and 45 participants in the acupuncture-medication group. Results are summarized hereinafter. (1) The total clinical efficiency rates of the medication group, acupuncture group, and acupuncture-medication group were 89.19% (33 of 37), 90.24% (37 of 41), and 95.65% (44 of 46), respectively. (2) Except for the BMI of the medication group (P = 0.063), a significant difference in VAS, BMI, CAP, the ratio of hepatic-splenic CT value, and PHQ-9 score was found in the three groups (P < 0.01). (3) There was a significant difference in VAS, BMI, CAP, and PHQ-9 among the three groups (P < 0.01), with those in the acupuncture-medication group being superior. No difference in the ratio of hepatic-splenic CT value was found (P = 0.440). (4) The efficacy differed significantly among the three groups (χ2 = 8.130, P = 0.017), and it was significantly superior in the acupuncture-medication group (P = 0.008, P = 0.013). Jiao's scalp acupuncture, in combination with Xiangshao granules, was superior in treating CTTH in climacteric women compared with either acupuncture or medication. Jiao's scalp acupuncture, in combination with Xiangshao granules, was superior in subsiding the negative moods in participants with CTTH and concomitant NAFLD.

The effect of 3 commonly used surgical approaches for total hip arthroplasty on mid- to long-term patient-reported outcome measures.

The most effective surgical approach for total hip arthroplasty (THA) remains controversial. Comparisons of surgical approach based on patient-reported outcome measures (PROMs) have been limited to short- to mid-term outcomes or the comparison of only 2 approaches. The aim of this study was to compare PROMs for the 3 main approaches for THA with up to 10 years follow-up. A total of 906 patients who underwent primary THA at a single hospital between 2009 and 2020 through an anterior (312), lateral (211) or posterior (383) approach were evaluated using the Oxford Hip Score (OHS), EuroQoL-5-Dimension (EQ-5D-5L) and visual analogue scale/verbal rating scale for pain (VAS/VRS). PROMs were prospectively collected before surgery and routinely at 6 weeks, 6 months and 1, 2, 5 and 10 years after surgery. There was no significant difference in demographics or comorbidities between the 3 groups. All 3 approaches resulted in a significant improvement in overall PROMs after THA, and plateaued after 6 months postoperatively, with no difference between the approaches (OHS, p < 0.01;EQ-5D-5L Index, p < 0.01;VAS/VRS, p < 0.01). The EQ-5D-5L mobility dimension showed that the lateral approach resulted in 20% more patients reporting problems with mobility than the posterior and anterior approaches at the 6-week, 6-month, 2-year and 10-year follow-up. This study shows that all 3 common THA approaches substantially and similarly improve the OHS, EQ-5D-5L Index and VRS between 6 months and 10 years postoperatively. However, patient-reported mobility was poorer after a lateral approach and continued to be so at long-term follow-up.

Comparison of efficacy between unilateral biportal endoscopic lumbar fusion versus minimally invasive transforaminal lumbar fusion in the treatment of lumbar degenerative diseases: A systematic review and meta-analysis.

To evaluate the clinical efficacy and prognosis of unilateral biportal endoscopic lumbar fusion (ULIF) and minimally invasive transforaminal lumbar fusion (MIS-TLIF) for lumbar degenerative diseases. Chinese and English databases were retrieved for the period from database creation to December 31, 2022. Case-control studies on unilateral biportal endoscopic lumbar fusion were collected. The observation indexes consisted of operation times, intraoperative blood loss, postoperative drainage volume, length of hospital stay, postoperative pain score, postoperative oswestry disability index score, postoperative MacNab excellent and good rate, imaging fusion rate at the last follow-up, and complications. The NO rating table was employed to assess the quality of the included literature, and a meta-analysis was conducted using Revman5.4.1 and Stata17. Ten studies with 738 surgical patients were considered, including 347 patients in the ULIF group and 391 in the MIS-TLIF group. This Meta-analysis demonstrated statistically significant differences in mean operation duration, intraoperative blood loss, postoperative drainage volume, length of hospital stay, and early postoperative (1-2W) visual analogue scale/score (VAS) scores for back pain. No significant differences were observed in the final follow-up postoperative VAS scores for back pain, postoperative leg VAS score, postoperative oswestry disability index score, excellent and good rate of postoperative modified MacNab, imaging fusion rate, and complications. Compared with the MIS-TLIF group, the ULIF group had longer operation time, lower intraoperative blood loss and postoperative drainage volume, lower lumbar VAS score in the early postoperative period, and shorter hospital stay. ULIF is less invasive than traditional MIS-TLIF, making it a trustworthy surgical option for lumbar degenerative diseases with comparable fusion efficiency, superior MacNab rate, and complication rate.

Effect of Tan Tui combined with kinesio taping on the posture control of patients with PFPS: protocol for a randomized controlled trial

BackgroundPatellofemoral pain syndrome (PFPS) is a chronic disease. Its early symptoms are mild and can be relieved by rest after the pain. If there is no effective rehabilitation, it may develop into patellofemoral arthritis. Physiotherapy and appropriate exercise intervention can improve PFPS and postural control during exercise. Tan Tui (TT) is an effective means to improve postural control. Whether combined kinesio taping (KT) can be used as an effective treatment for PFPS patients’ recovery has not yet been confirmed.Methods/designSeventy-two eligible patients with early-stage PFPS will be recruited and randomized into 4 groups: TT + KT group (n = 18), TT + KTp group (n = 18), KT group (n = 18), and CON group (n = 18). The TT + KT group was treated with TT combined with KT intervention; the TT + KTp group was treated with TT and KT placebo technical intervention; the KT group was treated with KT intervention alone; the CON group was treated with routine activities. All 4 groups received 30 min, three times a week, for a total of 6 weeks of intervention training. Measurements will be performed at baseline, mid-intervention (4 weeks), and post-intervention (6 weeks) with visual analog scale/score, (VAS), Knee joint Lysholm function score (Lysholm), UniPedal Stance Test (UST), Star Excursion Balance Test ( SEBT), Relative Peak Torque, (RPT), and Knee joint Position PercePtion (KJPP), to check the maintenance of the effect of any intervention.DiscussionFor the first time in this trial, the impact will be evaluated. If the results are the same as expected, they will provide evidence that TT combined with KT sticking intervention can promote the posture control of patients with early PFPS.Trial registrationChinese Clinical Trial Registry ChiCTR2100051166. Registered on 15 September 2021.

Comparison of Topical Anesthesia, Intracameral 1% Lignocaine and Topical Anesthesia and Intravenous Acetaminophen and Topical Anesthesia for Phacoemulsification in Cataract Surgery

Objective: To compare the effectiveness of topical Proparacaine 0.5%, topical Proparacaine 0.5% and topical Proparacaine 0.5% for intraoperative analgesia and surgeon’s score undergoing simple cataract surgery. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Anaesthesia, Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan,from Sep 2022 to Mar 2023. Methodology: Sixty patients aged 40 years and more, ASA-l and ll, undergoing elective simple cataract surgeries were observed by taking 20 patients in all three groups (n=20). Group-T: Topical Anesthesia group, 0.5% Proparacaine Group-I: Topical Anesthesia &amp; Intracameral 1% Lignocaine Group-A: Topical Anesthesia and IV Acetaminophen groups were randomly allocated for pretreatment to either receive the 0.5% Proparacaine Eye drops (Group-T) or 0.5%Proparacaine eye drops with Intracameral 1ml 1% Lignocaine (I group) or 0.5% Proparacaine Eye drops with intravenous Acetaminophen 15ml/kg (A group). Incidence of pain by Visual analogue scale/wong-baker faces scale was noted. The surgeon’s comfort was assessed by using Gupta’s surgeon score questionnaire. Results: The results showed Group-I had better analgesic score than Group-T with only 1(5%) patient had a score of 4 but even more significant efficacy of intravenous acetaminophen plus topical anesthesia (Group-A) was shown as compared to rest of the groups with none (0%) patient had a VAS score of 4 (p-value=0.002). The results also showed Group-I had better surgeon comfort score than both Group-T and Group-A, with only 1(5%) patient had a score of 7 or above as compared to Group-T, 9(45%) patients and Group-A 7(35%) patients. (p-value=0.005). Conclusion: Intravenous acetaminophen plus topical

Comparison of the effect of vaginal misoprostol and evening primrose oil capsule with misoprostol alone on the consequences of abortion in women with intrauterine fetal death: a randomized clinical trial

BackgroundMisoprostol is the choice drug for inducing an abortion with intrauterine fetal death, but it has several side effects that increase with accumulating the dose received. Induction abortion with cheap and non-invasive methods with minimal complications is essential. This study aimed to compare the effect vaginal misoprostol plus vaginal evening primrose oil capsule with vaginal misoprostol alone on the consequences of abortion in pregnant women with intrauterine fetal death at 12–20 weeks of pregnancy.MethodsThis study is a randomized, triple-blind clinical trial with two parallel groups at a ratio of 1:1. We randomized 82 women with indications of termination of pregnancy due to intrauterine fetal death into two groups. The experimental group (n = 42) received 200 mcg of misoprostol tablet with 1000 mg evening primrose oil capsule intravaginal. The control group (n = 40) received 200 mcg of misoprostol tablet with 1000 mg evening primrose oil placebo capsule intravaginal. Both groups received the drugs every 4 h for up to five doses. The primary outcome was the mean induction-to-fetal expulsion interval. Secondary outcomes were the mean dose of misoprostol, the highest pain intensity in the induction-to-fetal expulsion interval, the frequency of participants requiring blood transfusion, curettage, and the frequency of side effects of misoprostol or evening primrose oil. Pain intensity was measured through the Visual Analog Scale.ResultsThe mean age of the experimental group was 32.30 ± 6.19 years, and the control group was 30.27 ± 7.68 years. The mean gestational age of the experimental group was 15.29 ± 2.26 weeks, and the control group was 15.10 ± 1.89 weeks. The mean induction-to-fetal expulsion interval in the experimental group (3.12 ± 2.17 h) was significantly lower than that in the control group (8.40 ± 4.1 h) (p < 0.001). The mean dose of misoprostol received in the experimental group (271.42 ± 115.39 mcg) was significantly lower than that in the control group (520 ± 201.53 mcg) (p < 0.001). Also, the mean pain intensity in the experimental group (5.02 ± 0.60) was significantly lower than that in the control group (8.65 ± 1.001) (p < 0.001). The two groups were not significantly different in the frequency of blood transfusion requirements, analgesia and drug side effects. The need for curettage in the experimental group (4.8%) was significantly lower than that in the control group (47.5%) (p < 0.001).ConclusionsVaginal administration of evening primrose oil with misoprostol reduced duration of time of fetal expulsion, pain intensity, mean dose of misoprostol received, and the need for curettage in participants. Therefore, we suggest this method for induced abortion in women with intrauterine fetal death.Trial registrationIRCT20181207041873N3. Dated 16/2/2021 prospectively registered https://en.irct.ir/user/trial/53681/view.

Effect of lidocaine spray on relieving non-coring needle puncture-related pain in patients with totally implantable venous access port: a randomized controlled trial

PurposePatients with the placement of a totally implantable venous access port (TIVAP) commonly suffer from pain caused by inserting a non-coring needle. At present, lidocaine cream and cold spray are extensively used for pain management, but they are complex to manage in busy medical environments and developing countries. The lidocaine spray combines the analgesic effect of lidocaine cream and the rapid onset of cold spray, which can effectively alleviate the pain related to non-coring needle puncture in patients with TIVAP. This randomized-controlled trial aimed to explore the effectiveness, acceptability, and safety of lidocaine spray in relieving the pain of non-coring needle puncture in patients with TIVAP.MethodsA total of 84 patients who were hospitalized in the oncology department of a Grade III Level-A hospital in Shanghai from January 2023 to March 2023 and were implanted with TIVAP and required non-coring needle puncture were selected as the study subjects. The recruited patients were randomly assigned to the intervention group and the control group (n=42). Before routine maintenance, the intervention group received lidocaine spray 5 min before disinfection, while the control group received water spray 5 min before disinfection. The main clinical outcome was pain, and the degree of puncture pain in both groups was evaluated using the visual analogue scale.ResultsThere were no significant differences between the two groups in age, gender, educational level, body mass index, port implantation time, and disease diagnosis (P>0.05). The pain score in the intervention and control groups was 15.12±6.61mm and 36.50±18.79mm, respectively (P<0.001). There were 2 (4.8%) patients with moderate pain in the intervention group and 18 (42.9%) patients with moderate pain in the control group (P<0.001). In the control group, 3 (7.1%) patients reported severe pain. The median comfortability score for the two groups of patients was 10, but there was a difference between the two groups (P<0.05) because the intervention group tilted to the right. The successful puncture rate of the first time puncture had no difference between the two groups, both being 100%. Moreover, 33 patients (78.6%) in the intervention group and 12 patients (28.6%) in the control group reported that they would choose the same spray for intervention in the future (P<0.001). During the 1 week of follow-up, 1 patient in the intervention group developed skin itching (P>0.05).ConclusionsThe local use of lidocaine spray in patients with TIVAP is effective, acceptable, and safe to alleviate the pain caused by non-coring needle puncture.Trial registrationChinese Clinical Trial Registry (registration number: ChiCTR2300072976)

Image/text/cliché/insight: analogical practices in the global art world

The special issue Analogical Practices in the Global Art World systematically examines for the first time the widespread practice of constructing global art and architectural histories through analogy. In addition to summarizing the essays presented and the pertinent literature on analogy across several fields, this Introduction marshals primary research alongside scholarship and observations from diverse disciplines to advance two overarching arguments. First, we claim that art world analogies both disclose and influence the axes along which art-historical and museological thinking is habitually oriented: national groupings or “schools” above all, but also chronology, gender, race, cultural identification, art media, and style. Second, we argue that the art world analogy paradigmatically involves collaborations of textual iteration with works of visual art. Proposing, ultimately, that visual analogy is never just visual, we build a theory of analogy-as-discourse for the visual arts.

An Esthetic Scoring System for Scaphocephaly Assessment and Outcomes: A Pilot Study.

Scaphocephaly is the commonest form of craniosynostosis with a varied presentation consisting of many morphological components and a range of possible surgical interventions. However, with regard to esthetic assessment, there is no universally applied assessment system. The aim was to develop a simple assessment tool encompassing multiple phenotypic components of scaphocephaly. This was done by piloting a red/amber/green (RAG) scoring system to judge esthetic outcomes following scaphocephaly surgery using photographs and experienced observers. Standard photographic views of 20 patients who had undergone either passive or anterior 2/3 vault remodelling were scored by 5 experienced assessors. Using a RAG scoring system before and after scaphocephaly correction according to 6 morphological characteristics: visual impression of cephalic index, calvarial height, bitemporal pinching, frontal bossing, posterior bullet, and displacement of the vertex. All 5 assessors were asked to score the preoperative and postoperative views independently. The RAG scores were each assigned a number (1-3) and added to give a composite score (range 6-18) and these were averaged between the 5 assessors. There was a highly statistically significant difference between both preoperative and postoperative composite scores ( P <0.0001). A subgroup analysis of the postoperative composite score between the 2 surgical techniques showed no significant difference ( P =0.759). The RAG scoring system can be used to assess esthetic change following scaphocephaly correction and it provides both a visual analogue and a numerical indicator of change. This assessment method needs further validation but is a potentially reproducible way to score and compare esthetic outcomes in scaphocephaly correction.

Simultaneous assessment and training of an upper-limb amputee using incremental machine-learning-based myocontrol: a single-case experimental design

BackgroundMachine-learning-based myocontrol of prosthetic devices suffers from a high rate of abandonment due to dissatisfaction with the training procedure and with the reliability of day-to-day control. Incremental myocontrol is a promising approach as it allows on-demand updating of the system, thus enforcing continuous interaction with the user. Nevertheless, a long-term study assessing the efficacy of incremental myocontrol is still missing, partially due to the lack of an adequate tool to do so. In this work we close this gap and report about a person with upper-limb absence who learned to control a dexterous hand prosthesis using incremental myocontrol through a novel functional assessment protocol called SATMC (Simultaneous Assessment and Training of Myoelectric Control).MethodsThe participant was fitted with a custom-made prosthetic setup with a controller based on Ridge Regression with Random Fourier Features (RR-RFF), a non-linear, incremental machine learning method, used to build and progressively update the myocontrol system. During a 13-month user study, the participant performed increasingly complex daily-living tasks, requiring fine bimanual coordination and manipulation with a multi-fingered hand prosthesis, in a realistic laboratory setup. The SATMC was used both to compose the tasks and continually assess the participant’s progress. Patient satisfaction was measured using Visual Analog Scales.ResultsOver the course of the study, the participant progressively improved his performance both objectively, e.g., the time required to complete each task became shorter, and subjectively, meaning that his satisfaction improved. The SATMC actively supported the improvement of the participant by progressively increasing the difficulty of the tasks in a structured way. In combination with the incremental RR-RFF allowing for small adjustments when required, the participant was capable of reliably using four actions of the prosthetic hand to perform all required tasks at the end of the study.ConclusionsIncremental myocontrol enabled an upper-limb amputee to reliably control a dexterous hand prosthesis while providing a subjectively satisfactory experience. The SATMC can be an effective tool to this aim.

“Extrafine single inhaler triple therapy effect on health status, lung function and adherence in COPD patients: A Panhellenic prospective non-interventional study – The TRIBUNE study”

The extrafine single inhaler triple therapy (efSITT) containing beclometasone dipropionate/formoterol fumarate/glycopyrronium 87/5/9 μg has proved to be efficacious in patients with Chronic Obstructive Pulmonary Disease (COPD) in randomized control trials. TRIBUNE study aimed to assess the efSITT effectiveness on health status, lung function, adherence and rescue medication use in COPD patients in Greece in a real-world setting.This was a 24-week prospective, multicenter, observational study in 1,195 patients with moderate/severe COPD and history of at least one exacerbation during the previous year despite dual therapy. Health status (COPD Assessment Test/CAT), lung function parameters and rescue medication use were recorded at baseline, 3 (Visit 2/V2) and 6 months (Visit 3/V3) after treatment. Adherence (Test of Adherence to Inhalers/TAI) and self-reported overall impression of health condition change (Visual Analogue Scale/VAS) were recorded at V2 and V3.Mean CAT score decreased from 20.9 points at V1, to 15.1 at V2 and 13 at V3 (p < 0.001, all pair comparisons). 85.9% of patients achieved a CAT decrease of minimal clinically important difference (MCID) or more (≥2) at V3, compared to V1. Mean FEV1 increased from 1.4 ± 0.5 L on V1, to 1.6 ± 0.5 L on V3 (p < 0.001, N = 275). The percentage of patients with “good adherence” increased from 58.4% (V2) to 64.0% (V3). Rescue medication use and VAS also significantly improved.The efSITT achieves improved outcomes on health status, lung function and rescue medication use as well as satisfactory adherence and patient-reported improvement of health condition, in moderate/severe COPD patients previously treated with a dual combination in a Greek real-world setting.

Analgesic Efficacy of Acupuncture on Chronic Pelvic Pain: A Systemic Review and Meta-Analysis Study.

Chronic pelvic pain (CPP) is the pain occurred in the pelvic region longer than six months. The monotherapy of medicine may not adequate for the pain management of CPP and multidisciplinary approaches have been more recommended. The aim of this study is to evaluate the pain management efficacy of acupuncture compared with a control group on CPP. The articles of randomized controlled trial on CPP in PubMed and Embase databases were screened between January 2011 and September 2022 without language restriction to evaluate the treatment efficacy of acupuncture. The visual analogue scale/numerical rating scale (VAS/NRS) and total pain scores of National Institutes of Health-chronic prostatitis symptom index (NIH-CPSI) were served as outcome variables. Post-intervention mean scores were extracted and pooled for meta-analysis. Seventeen studies including 1455 patients were selected for meta-analysis. Both total pain scores of NIH-CPSI and VAS/NAS data revealed significant lower pain level in the acupuncture group than in the control group. Moreover, monotherapy with acupuncture revealed a significantly lower pain level than in the control group in both total pain scores of NIH-CPSI and VAS/NRS. These results indicated that acupuncture may have beneficial effects on pain management for CPP, even when administrated as a monotherapy.