Journal of Multidisciplinary Healthcare最新文献

The aim of this mixed methods systematic review was to synthesize contemporary evidence on effectiveness of community-based allied health (AH) services on acute care utilizations and views from relevant stakeholders. An a priori protocol was registered with PROSPERO [CRD42023437013]. Inclusion criteria were: (a) stand-alone interventions led by practitioners/graduates from one or more target AH professions (audiology, exercise physiology, diabetes educator, nutrition and dietetics, occupational therapy, physiotherapy, podiatry, psychology, social work, and speech pathology); (b) examined acute care utilization-related outcomes with/without perceptions of relevant stakeholders; and (c) published after 2010 and in English. Eligible studies were identified from: (a) bibliographic databases (MEDLINE, Embase, EmCare, PsycINFO, CINAHL complete, and the Cochrane Library) (September 19, 2023); (b) online databases (ProQuest Central and ProQuest Dissertations & Theses Global) and theses repository (Trove) (September 20, 2023); (c) Google and Google Scholar (October 17-18, 2023); and (d) citation searching. A modified version of McMaster Critical Appraisal Tools and McGill Mixed Methods Appraisal Tool were used to assess methodological quality. Data synthesis was through convergent segregated approach. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation. There were 67 included papers. The integrated quantitative and qualitative findings demonstrated mixed evidence, likely influenced by the heterogeneity of the evidence base, for the effectiveness of AH services on acute care utilizations. Patients and their carers were largely positive about these services, highlighting opportunities to build on these experiences. The certainty of evidence for patient-important outcomes was however "very low", emphasizing cautious interpretation. The findings of this review shed light on the breadth and scope of AH in the community sector, and its potential impact on the acute sector. Further investment in, and ongoing research on, community-based AH can strengthen primary healthcare and relieve pressure on the acute sector.

Introduction: Cardiovascular diseases (CVDs) stand as the foremost global cause of mortality, accounting for 32% of total deaths in 2019, with 85% attributed to heart attacks and strokes. Individuals with Type 2 Diabetes Mellitus (T2DM) exhibit an elevated susceptibility to coronary heart disease (CHD). In numerous studies, it has been established that genetic polymorphism of genes influences the onset, progression, and complications of coronary heart disease (CHD) and type 2 diabetes mellitus (T2DM). The aims of this study are to employ bibliometric analysis methods for mapping the array of research on genome variability concerning the development of coronary heart disease in individuals with type 2 diabetes mellitus.

Methods: We derived the data from the Web of Science (WoS) Core Collection database and Scopus on January 6, 2023. All publications from 1987 to 2023 are exported in plain text format for WoS-CC and BibTeX format for Scopus, containing bibliographic information, keywords, and citation information. RStudio v.4.1.2 software (RStudio, PBC, Boston, MA, USA) was used for conducting bibliometric analysis.

Results: Our analysis of 241 articles published between 1987 and 2023 revealed a consistent increase in research output, especially after 2004, highlighting a growing academic focus on genome variability's role in coronary heart disease (CHD) development among Type 2 Diabetes Mellitus (T2DM) patients. Key contributing journals include The Lancet and Nature Genetics, indicating high-impact interest in this domain. The United States leads in research productivity and collaboration, with China also emerging as a notable contributor in recent years. Prominent authors such as S. Humphries have significantly shaped the field, contributing to a cumulative knowledge base that underscores the role of genetic factors in CHD among T2DM patients.

Discussion: Our findings underscore the value of bibliometric studies in guiding future research directions. This increasing scholarly attention to genome variability in CHD and T2DM may encourage deeper investigation into specific genetic polymorphisms and their mechanistic roles in disease progression. Additionally, these insights can help prioritize collaboration across leading research hubs and potentially drive innovation in therapeutic interventions targeting genetic risk factors in CHD and T2DM. Future research could build on these trends by focusing on comparative studies across populations, advancing precision medicine approaches for at-risk individuals with T2DM.

Background: Elderly patients, due to their complex medical conditions and extensive care needs, are at risk of experiencing low-quality or fragmented care during transitions between different healthcare settings. After transitioning from hospital to home, inadequate self-care abilities may result in further health deterioration and increased risks of adverse outcomes. Currently, China lacks effective transitional support services from hospital to home, hindering the smooth transition for elderly patients. Therefore, understanding the specific care needs of elderly patients during this period provides a scientific basis for establishing reasonable transitional support services.

Objective: This study aims to explore the transitional care needs of elderly patients during the hospital-to-home transition, as perceived by key stakeholders-patients, caregivers, and nurses-using Shanxi Province as a case example.

Methods: A descriptive phenomenological method was employed in this study. Purposeful sampling selected 10 elderly patients, 5 caregivers, and 5 nursing staff from a tertiary hospital in Shanxi Province, China, for semi-structured in-depth interviews. The Colaizzi's analysis was used in data analysis.

Results: The transitional care needs of elderly patients from hospital to home can be summarized into four themes: the need to enhance self-care abilities, the need for professional guidance, the need for social and psychological support, and the need for healthcare service resources.

Conclusion: Elderly patients have diverse care needs during the hospital-to-home transition, which require urgent attention and support. To address these needs, healthcare professionals should conduct comprehensive assessments during the patients' hospitalization, accurately identifying care issues and implementing team-based interventions. By fulfilling these needs, healthcare providers can ensure that elderly patients are well-prepared psychologically, possess sufficient knowledge and self-care skills, and have access to comprehensive support services from hospitals and communities as they transition from professional hospital care to home self-care.

Objective: The aim of this study was to evaluate the impact of hyperbaric oxygen therapy (HBOT) on patients with SARS-CoV-2 infection and determine its efficacy and safety in reducing treatment failure events.

Methods: A retrospective cohort study involving patients with COVID-19 was conducted. Inverse probability of treatment weighting (IPTW) was used to balance covariates between the HBOT and non-HBOT groups. The primary endpoint was the occurrence of a clinical treatment failure event, defined as all-cause mortality, abandonment of treatment, or transfer to the Intensive Care Unit due to worsening condition.

Results: A total of 720 patients with COVID-19 were enrolled in the study, with 27 patients receiving HBOT and 693 patients not receiving HBOT. The occurrence of treatment failure was significantly lower in the HBOT group compared to the non-HBOT group, with no treatment failure events in the HBOT group versus 36 events in the non-HBOT group. The IPTW database analysis results showed that in comparison to the non-HBOT group, the hazard ratio (HR) for treatment failure in the HBOT group was less than 0.001 (95% CI: <0.001 ~ <0.001, p<0.001). Lymphocyte count >0.8×10⁹/L and HBOT was associated with a significantly lower risk of treatment failure. Glucocorticoid use was associated with a higher risk of treatment failure. The incidence of venous thrombosis events was significantly higher in the HBOT group compared to the non-HBOT group.

Conclusion: This study revealed that adjunctive HBOT significantly reduces the risk of treatment failure in patients with COVID-19 and is associated with satisfactory safety. HBOT shows promise as a beneficial therapy for improving outcomes in COVID-19-infected patients.

Prediabetes, as an intermediary stage between normal glucose homeostasis and overt diabetes, affects an estimated 720 million individuals worldwide, highlighting the urgent need for proactive intervention strategies. Continuous glucose monitoring (CGM) emerges as a transformative tool, offering unprecedented insights into glycemic dynamics and facilitating tailored therapeutic interventions. This perspective scores the clinical significance of even slightly elevated fasting blood glucose levels and the critical role of early intervention. CGM technology provides real-time, continuous data on glucose concentrations, surpassing the constraints of conventional monitoring methods. Both retrospectively analyzed and real-time CGM systems offer valuable tools for glycemic management, each with unique strengths. The integration of CGM into routine care can detect early indicators of type 2 diabetes, inform the development of personalized intervention strategies, and foster patient engagement and empowerment. Despite challenges such as cost and the need for effective utilization through training and education, CGM's potential to revolutionize prediabetes management is evident. Future research should focus on refining CGM algorithms, exploring personalized intervention strategies, and leveraging wearable technology and artificial intelligence advancements to optimize glycemic control and patient well-being.

Purpose: Colorectal cancer (CRC) is among the most prevalent malignancies worldwide, with rising incidence and mortality rates presenting substantial public health challenges. Traditional detection methods have inherent limitations, which has led to growing interest in liquid biopsy technologies for the identification of circulating tumor DNA (ctDNA). The aim of this study is to explore the developmental trends and future prospects of ctDNA in colorectal cancer through bibliometric analysis.

Methods: This bibliometric analysis examines the literature on ctDNA in CRC from 2004 to 2024, utilizing the Web of Science Core Collection database to identify research trends, key areas of interest, and potential future directions. The R package "bibliometrix" and VOSviewer software were employed for bibliometric analysis and visualization. The analysis encompassed an evaluation of publication volume, contributing authors, influential journals, country and institutional contributions, and citation metrics.

Results: The analysis encompassed a total of 1,054 publications, demonstrating a marked escalation in research activity since 2015. The journal "Cancers" has been identified as the most prolific publisher within this domain. Prominent researchers, including Bardelli A and Sartore-Bianchi A, have made substantial contributions to the field. The United States is the leading country in terms of both publication volume and citation frequency, followed by China and Italy. A keyword analysis identified seven conceptual clusters, with "circulating tumor DNA" and "liquid biopsy" emerging as predominant themes.

Conclusion: This study emphasizes the evolving emphasis on the clinical applications of ctDNA, encompassing early detection, treatment monitoring, and prognostic assessment in CRC, thereby underscoring its potential as a non-invasive biomarker in oncology.

Purpose:  The association between the Alberta Stroke Programme Early CT Score (ASPECTS) and intracranial hemorrhage (ICH) in acute ischemic stroke (AIS) patients undergoing thrombolysis remains unclear. This study aimed to determine the relationship between ASPECTS and thrombolysis-associated outcomes, focusing on symptomatic (sICH) and asymptomatic (aICH) ICH.

Patients and methods:  AIS patients with middle cerebral artery (MCA) territory treated with thrombolysis were enrolled. Patients were categorized into favorable (8-10) and unfavorable (7 or less) ASPECTS. The primary outcomes were sICH and aICH. Secondary outcomes included ICH management, modified Rankin Scale (mRS), and mortality. Multivariable logistic regression analysis evaluated the risk of unfavorable ASPECTS and its association with study outcomes.

Results:  We included 622 patients (mean age 66.1 ± 13.5 years; 50.5% male); 95 (15.3%) had unfavorable ASPECTS. Patients with unfavorable ASPECTS had higher sICH but not aICH (21.1% vs 4.9%, P < 0.001 and 16.9% vs 17.3%, P = 1.00). Unfavorable ASPECTS was associated with sICH (adjusted odds ratio 5.1; 95% confidence interval 2.7-9.7, P < 0.001). Factors associated with lower ASPECTS included age ≥ 65 years, body weight < 60 kg, atrial fibrillation, onset-to-needle time ≥ 120 minutes, and anemia. Patients with lower ASPECTS had higher mortality and unfavorable mRS (>2) at discharge, 14 days, and 90 days (74.7% vs 50.1%, P < 0.001 for 90-day mRS >2).

Conclusion:  ASPECTS is a simple tool to predict thrombolysis-associated sICH but not aICH. Patients with unfavorable ASPECTS are at higher risk of complications and poor functional outcomes. Alternative treatments, such as mechanical thrombectomy, might be advisable for these patients.

This study offers new insights into college students' health education (CSHE) regarding its research status, hot spots, and trends by conducting a comprehensive bibliometric analysis of this field in the past decade (2014 to 2024). Specifically, we analyzed publication trends and used the bibliometric method with CiteSpace software to explore collaborative networks, detailed co-citation status, and co-occurrence dynamics based on 1358 Web of Science Core Collection articles. Our results indicate increased relevant publications and the collaboration networks show complex institutional and regional partnerships. At the same time, co-citation and co-occurrence analyses highlight interdisciplinary research themes that encompass public health. The study particularly underscores the emerging importance of mental health, global health, and innovative educational approaches. These findings reveal trends in CSHE research and provide crucial insights for future studies, stressing the need for interdisciplinary collaboration and creative strategies to tackle student health challenges. Moreover, in practice, this study contributes to promoting and practicing targeted health intervention policies and countermeasures aimed at enhancing student well-being, such as establishing dedicated health education courses, providing specialized training for teachers, conducting regular health assessments, and providing funding for CSHE.

Objective: This study aimed to examine the global scientific output of research on patient delay and explore the hotspots and frontiers from 2000 to 2023 through bibliometric analysis.

Methods: Publications regarding patient delay published from 2000 to 2023 were extracted from the Web of Science Core Collection (WOSCC). Subsequently, CiteSpace, VOSviewer, and Bibliometrix Online Analysis Platform were used to analyze publications, countries, institutions, authors, journals, and keywords.

Results: A total of 721 papers were included in the study. The publication output increased from 20 papers in 2000 to 64 papers in 2023, a remarkable 220.00% growth. The USA (138 papers) and University of California San Francisco (21 papers) were identified as the most productive country and institution, respectively. Moser (10 papers), and Dracup (10 papers) are the most productive authors. "BMC Public Health" (24 publications) is the most productive journal. "Patient Delay" was the most cited keyword, with high-frequency keywords such as "Prehospital Delay", "Symptoms", "Time", "Care", "Diagnosis", "Acute Myocardial-infarction", and "Mortality" signaling hot topics in Patient Delay.

Conclusion: There are increasingly many papers on patient delay. However, there has been limited development of cooperation between countries and institutions. In the future, collaboration between countries and institutions should be strengthened. In addition, 3 hotspots and 3 frontiers are summarized in this study to provide researchers with future research directions.

Objective: Restrictive cardiomyopathy (RCM) is a heterogenous cardiomyopathy with various causes, and genetic variants take an important part of the pathogenesis. Whole-exome sequencing (WES) is effective to discover genes that cause genetic diseases. By using WES, we attempted to identify the genetic cause of an RCM family and clarify the clinical diagnosis of the patient and then provide a personalized treatment plan.

Materials and methods: Blood samples were obtained from the proband and his healthy parents. WES and Sanger sequencing were performed to identify the possible pathogenic gene. Co-segregation analysis was conducted for candidate variants, and the allele frequency was checked in databases including Ensembl, Exome Aggregation Consortium (ExAC) and Human Gene Mutation Database (HGMD). Furthermore, the potential effect of variant was predicted using various-free software such as SIFT, Polyphen-2 and Mutation Taster and the conservation was tested using multiple sequence alignments by ClustalX.

Results: The proband was a 20 years old boy with severe heart failure symptoms including dyspnea, massive ascites, edema of both lower limbs and chest congestion. Echocardiography showed significant biatrial enlargement, normal left ventricular wall thickness and preserved systolic function of both ventricles. A missense mutation in FLNC (c.6451G>A, p.G2151S), encoded filamin-C was detected in proband by WES and Sanger sequencing, while it was not be found in his parents, we supposed that the FLNC mutation (c.6451G>A, p.G2151S) may be a de-novo mutation. Through multiple functional predictions, we found that it is a deleterious mutation and the mutation in filamin-C could alter its structure and normal function, contributing to RCM.

Conclusion: Here, an FLNC missense mutation (c.6451G>A, p.G2151S) known to be pathogenic in hypertrophic cardiomyopathy, was found to be associated with RCM, indicating the genetic overlap among cardiomyopathies. This study provides insights into Phenotype-Genotype Correlations of RCM in patients with FLNC mutations.