Adverse Events of Massage Therapy in Pain-Related Conditions: A Systematic Review

Pain-related massage, important in traditional Eastern medicine, is increasingly used in the Western world. So the widening acceptance demands continual safety assessment. This review is an evaluation of the frequency and severity of adverse events (AEs) reported mainly for pain-related massage between 2003 and 2013. Relevant all-languages reports in 6 databases were identified and assessed by two coauthors. During the 11-year period, 40 reports of 138 AEs were associated with massage. Author, year of publication, country of occurrence, participant related (age, sex) or number of patients affected, the details of manual therapy, and clinician type were extracted. Disc herniation, soft tissue trauma, neurologic compromise, spinal cord injury, dissection of the vertebral arteries, and others were the main complications of massage. Spinal manipulation in massage has repeatedly been associated with serious AEs especially. Clearly, massage therapies are not totally devoid of risks. But the incidence of such events is low

Effect of acupuncture on lung cancer-related fatigue: study protocol for a multi-center randomized controlled trial

BACKGROUND: Fatigue is one of the primary symptoms in lung cancer, with a prevalence of 88.0% in survivors of cancer, and an even higher prevalence post resection surgery. Effective fatigue control after lung cancer surgery is important for patient recovery and quality of life. Some studies have shown that acupuncture might be effective in treating cancer-related fatigue; however, randomized controlled trials (RCTs) of suitable sample size are limited. METHOD/DESIGN: This is a multi-center, patient-blinded RCT. A total of 320 eligible patients will be recruited in four centers and randomly assigned to either the acupuncture group or the sham acupuncture group in a 1:1 ratio. Treatment will be given twice per week for 12 sessions. Treatment will be given at acupoints GV20, GV29, CV12, CV6, CV4, and bilateral LI4, LR3, SP6, ST36. The primary outcome will be assessed using the Chinese version of The Brief Fatigue Inventory. The secondary outcomes will be measured using The European Organization for Research and The Treatment of Cancer Quality of Life Questionnaire, and the Hamilton Rating Scale for Depression. The primary outcome will be assessed at all main points (baseline, the 3rd week, the 6th week, and at follow up time points) and the secondary outcomes will be assessed at baseline and the 6th week. Intention-to-treat analysis will be used in this RCT. DISCUSSION: This trial protocol provides an example of the clinical application acupuncture treatment in the management of lung cancer-related fatigue. If the acupuncture treatment protocol confirms that acupuncture is an effective and safe option for lung cancer-related fatigue, it can be adopted as a standardized treatment. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1900022831. Registered on 27 April 2019. URL: http://www.chictr.org.cn/showproj.aspx?proj=37823

Efficacy and Safety of Electroacupuncture on Treating Depression Related Sleep Disorders: Study Protocol of a Randomized Controlled Trial

Background. Depression is frequently accompanied by sleep disturbances including insomnia. Insomnia may persist even after mood symptoms have been adequately treated. Acupuncture is considered to be beneficial to adjust the state of body and mind and restore the normal sleep-awake cycle. This trial is aimed at evaluating the efficacy and safety of electroacupuncture on treating insomnia in patients with depression. Methods. We describe a protocol for a randomized, single-blinded, sham controlled trial. Ninety eligible patients will be randomly assigned to one of 3 treatment groups: treatment group (acupuncture), control A group (superficial acupuncture at sham points), and control B group (sham acupuncture). All treatment will be given 3 times per week for 8 weeks. The primary outcome is the Pittsburgh Sleep Quality Index (PSQI). The secondary outcomes are sleep parameters recorded in the Actigraphy, Hamilton Rating Scale for Depression (HAMD), and Self-Rating Depression Scale (SDS). All adverse effects will be accessed by the Treatment Emergent Symptom Scale (TESS). Outcomes will be evaluated at baseline, 4 weeks after treatment, 8 weeks after treatment, and 4 weeks of follow-up. Ethics. This trial has been approved by the Ethics Committee of Shanghai Municipal Hospital of Traditional Chinese Medicine (2015SHL-KY-21) and is registered with ChiCTR-IIR-16008058

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

A Spatiotemporal Multi-View-Based Learning Method for Short-Term Traffic Forecasting

Short-term traffic forecasting plays an important part in intelligent transportation systems. Spatiotemporal k-nearest neighbor models (ST-KNNs) have been widely adopted for short-term traffic forecasting in which spatiotemporal matrices are constructed to describe traffic conditions. The performance of the models is closely related to the spatial dependencies, the temporal dependencies, and the interaction of spatiotemporal dependencies. However, these models use distance functions and correlation coefficients to identify spatial neighbors and measure the temporal interaction by only considering the temporal closeness of traffic, which result in existing ST-KNNs that cannot fully reflect the essential features of road traffic. This study proposes an improved spatiotemporal k-nearest neighbor model for short-term traffic forecasting by utilizing a multi-view learning algorithm named MVL-STKNN that fully considers the spatiotemporal dependencies of traffic data. First, the spatial neighbors for each road segment are automatically determined using cross-correlation under different temporal dependencies. Three spatiotemporal views are built on the constructed spatiotemporal closeness, periodic, and trend matrices to represent spatially heterogeneous traffic states. Second, a spatiotemporal weighting matrix is introduced into the ST-KNN model to recognize similar traffic patterns in the three spatiotemporal views. Finally, the results of traffic pattern recognition under these three spatiotemporal views are aggregated by using a neural network algorithm to describe the interaction of spatiotemporal dependencies. Extensive experiments were conducted using real vehicular-speed datasets collected on city roads and expressways. In comparison with baseline methods, the results show that the MVL-STKNN model greatly improves short-term traffic forecasting by lowering the mean absolute percentage error between 28.24% and 46.86% for the city road dataset and, between 53.80% and 90.29%, for the expressway dataset. The results suggest that multi-view learning merits further attention for traffic-related data mining under such a dynamic and data-intensive environment, which owes to its comprehensive consideration of spatial correlation and heterogeneity as well as temporal fluctuation and regularity in road traffic

Spatial Characteristics and Factor Analysis of Pollution Emission from Heavy-Duty Diesel Trucks in the Beijing–Tianjin–Hebei Region, China

Heavy-duty diesel trucks (HDDTs) contribute significantly to NOX and particulate matter (PM) pollution. Although existing studies have emphasized that HDDTs play a dominant role in vehicular pollution, the spatial distribution pattern of HDDT emissions and their related socioeconomic factors are unclear. To fill this research gap, this study investigates the spatial distribution pattern and spatial autocorrelation characteristics of NOX, PM, and SO2 emissions from HDDTs in 200 districts and counties of the Beijing–Tianjin–Hebei (BTH) region. We used the spatial lag model to calculate the significances and directions of the pollutants from HDDTs and their related socioeconomic factors, namely, per capita GDP, population density, urbanization rate, and proportions of secondary and tertiary industries. Then, the geographical detector technique was applied to quantify the strengths of the significant socioeconomic factors of HDDT emissions. The results show that (1) NOX, PM, and SO2 pollutants emitted by HDDTs in the BTH region have spatial heterogeneity, i.e., low in the north and high in the east and south. (2) The pollutants from HDDTs in the BTH region have significant spatial autocorrelation characteristics. The spatial dependence effect was obvious; for every 1% increase in the HDDT emissions in the surrounding districts and counties, the local HDDT emissions increased by 0.39%. (3) Related factors analysis showed that the proportion of tertiary industries had a significant negative correlation, whereas the proportion of secondary industries and urbanization rate had significant positive correlations with HDDT emissions. Population density and per capita GDP did not pass the significance test. (4) The order of effect intensities of the significant socioeconomic factors was proportion of tertiary industry > proportion of secondary industry > urbanization rate. This study guides scientific decision making for pollution control of HDDTs in the BTH region