bluuebunny/crossref_metadata_2025 huggingface dataset:
Fenestrated Aortic Aneurysm Repair in Patients Treated Inside Versus Outside of Instructions for Use
Authors: Stern Jordan R. , Deslarzes-Dubuis Céline , Tran Kenneth , Lee Jason T.
Published: January 2022

Objectives:

The aim of this study was to compare outcomes of patients treated with the Cook Zenith Fenestrated (ZFEN) device for juxtarenal aortic aneurysms inside versus outside the IFU.

Methods:

We retrospectively reviewed our institutional ZFEN database for cases performed between 2012 and 2018, with analysis performed in 2020 in order to report midterm outcomes. The cohort was stratified based on treatment inside (IFU group) and outside (non-IFU group) the IFU for criteria involving the proximal neck: neck length 4 to 14 mm, neck diameter 19 to 31 mm, and neck angulation ≤45°. Patients with thoracoabdominal aneurysms or concurrent chimney grafting were excluded. The primary outcomes in question were mortality, type 1a endoleak, and reintervention. Univariate and multivariate analyses were performed to determine associations between adherence to IFU criteria and outcomes.

Results:

We identified 100 consecutive patients (19% female, mean age 73.6 years) for inclusion in this analysis. Mean follow-up was 21.6 months. Fifty-four patients (54%) were treated outside the IFU because of inadequate neck length (n=48), enlarged neck diameter (n=10), and/or excessive angulation (n=16). Eighteen patients were outside IFU for two criteria, and one patient was outside IFU for all three. Non-IFU patients were exposed to higher radiation doses (3652 vs 5445 mGy, p=0.008) and contrast volume (76 vs 95 mL, p=0.004). No difference was noted between IFU and non-IFU groups for 30-day mortality (0% vs 3.7%, p=0.18), or type 1a endoleak (0% vs 1.9%, p=0.41). Reintervention was also similar between cohorts (13% vs 27.8%, p=0.13). Being outside IFU for neck diameter or length was each borderline significant for higher reintervention on univariate analysis (p=0.05), but this was not significant on multivariate Cox proportional hazard modeling (HR 1.82 [0.53–6.25]; 2.03 [0.68–7.89]), respectively. No individual IFU deviations were associated with the primary outcomes on multivariate analysis, nor being outside IFU for multiple criteria.

Conclusions:

Patients with juxtarenal aortic aneurysms may be treated with the ZFEN device with moderate deviations from the IFU. While no differences were seen in mortality or proximal endoleak, larger studies are needed to examine the potential association between IFU nonadherence and reinterventions and close follow-up is warranted for all patients undergoing such repair.
Implementing quantile selection models in Stata
Authors: Muñoz Ercio , Siravegna Mariel
Published: January 2022

In this article, we describe qregsel, a community-contributed command that implements a copula-based sample-selection correction for quantile regression recently proposed by Arellano and Bonhomme (2017, Econometrica 85: 1–28). The command allows the user to model selection in quantile regressions by using either a Gaussian or a one-dimensional Frank copula. We illustrate the use of qregsel with two examples. First, we apply the method to the fictional dataset used in the Stata Base Reference Manual for the heckman command. Second, we replicate part of the empirical application of the original article using data for the United Kingdom that cover the period 1978–2000 to compare wages of males and females at different quantiles.
Meeting assumptions in the estimation of reliability
Authors: Shaw Brian P.
Published: January 2022

Researchers and psychometricians have long used Cronbach’s α as a measure of reliability. However, there have been growing calls to replace Cronbach’s α with measures that have more defensible assumptions. One of the most common and straightforward recommended reliability estimates is ω. After a review of reliability and its estimation in Stata, I introduce the community-contributed command omegacoef. This command reports McDonald’s ω in a format similar to the base alpha command. omegacoef provides Stata users the ability to easily compute estimates of reliability with the confidence that the necessary statistical assumptions are met.
Curando La Comunidad [Healing the Community]: Community-Centered STEM Identity
Authors: Herrera Felisha , Kovats Sánchez Gabriela
Published: January 2022

This article highlights the role of community among Latina/o/x students pursuing degrees in science, technology, engineering, and mathematics (STEM) at 2- and 4-year Hispanic Serving Institutions (HSI). Community-based perspectives are often missing from traditional STEM disciplinary contexts; however, our Community-Centered STEM Identity model recognizes how Latinx students develop STEM identities by grounding, engaging, and bridging community. Implications for HSIs include cultivating community-based partnerships and perspectives as these are critical for the retention of Latinx students in STEM.
A Popliteal Vein Aneurysm Accompanied by Lower Persistent Sciatic Vein
Authors: Kim Suh Min
Published: January 2022

Popliteal venous aneurysms (PVAs) are rare. Surgical treatment is recommended because of the risk of deep vein thrombosis and fatal pulmonary embolism. A persistent sciatic vein (PSV) is also a rare anomaly. We report a case of a PVA accompanied by a lower PSV. A 70-year-old man was admitted due to left leg heaviness. He had undergone ablation of both great saphenous veins 6 years prior to the admission. Duplex ultrasound showed a PVA on his left leg, which was 3.2 × 2.4 cm in size. The patient was treated with tangential aneurysmectomy with lateral venorrhaphy. His symptom gradually resolved. He received warfarin at a therapeutic range for 3 months. Duplex ultrasound at 6 months later showed no evidence of any recurrent aneurysm or venous reflux. His follow-up has revealed no complications for 18 months. Surgical treatment and perioperative therapeutic anticoagulation are recommended for treating PVAs. Tangential aneurysmectomy with venorrhaphy is the most common and the simplest surgical method.
Edward Hickling Bradford (1848-1926): The Founder of Pediatric Orthopedics in America
Authors: Zachariou Eleftherios , Galanis Athanasios , Mavrommatis Evangelos
Published: January 2022

Edward Hickling Bradford (1848-1926) is considered as 1 of the most important figures in American and world orthopedics during 19th and early 20th century. His teaching ability, his gifted surgical skills and his innovations in orthopedics attracted the interest of the world orthopedic’s community and gave him a long lasting reputation. But most of all he is considered as the founder of pediatric orthopedics in America.
Are Orthopedic Hand Surgeons Undercompensated for Time Spent in the Operating Room? A Study of Relative Value Units
Authors: Simcox Trevor , Safi Sakib , Becker Jacob , Kreinces Jason , Wilson Adam
Published: January 2022

Background:

This study aims to investigate whether compensation is equitable among the most commonly performed orthopedic hand surgeries and when compared with general orthopedic procedures.

Methods:

The National Surgical Quality Improvement Program database was queried for all orthopedic procedures, from 2016 to 2018, performed more than 150 times using Current Procedural Terminology (CPT) codes. Physician work relative value unit (wRVU) data were obtained from the 2020 US Centers for Medicare and Medicaid Services fee schedule. Linear regressions were used to determine whether there was an association among wRVU, operative time, and wRVU per hour (wRVU/h). Reimbursement for hand surgery CPT codes was compared with that of nonhand orthopedic CPT codes. The CPT codes were stratified into quartile cohorts based on mean operative time, major complication rate, mortality rate, American Society of Anesthesiologists class, reoperation rate, and readmission rate. Student t tests were used to compare wRVU/h between cohorts.

Results:

Forty-two hand CPT codes were identified from 214 orthopedic CPT codes, accounting for 32 333 hand procedures. The median wRVU/h was significantly lower for procedures in the longest operative time quartile compared with the shortest operative time quartile ( P < .001). Compared with hand procedures, nonhand procedures were found to have significantly higher mean operative time ( P < .001), mean complication rate ( P < .001), mean wRVU ( P = .001), and mean wRVU/h ( P = .007).

Conclusions:

The 2020 Physician wRVU scale does not allocate proportional wRVUs to orthopedic hand procedures with longer mean operative times. There is a decrease in mean reimbursement rate for hand procedures with longer mean operative time. When compared with general orthopedic procedures, hand procedures have a lower mean wRVU/h and complication rate.
A survey of patients with laryngotracheal stenosis on future clinical trial design
Authors: Lina Ioan , Berges Alexandra , Ospino Rafael , Motz Kevin , Davis Ruth , Anderson Catherine , Stroud Mary , Rodweller Casey , Gelbard Alexander , Hillel Alexander T
Published: January 2022

Background/Aims

Laryngotracheal stenosis is a rare but devastating proximal airway fibrosis that restricts a patient’s ability to breathe. Treatment is primarily surgical and to date, there has never been a multi-institutional, randomized, prospective, and interventional clinical trial for a medical therapy to treat laryngotracheal stenosis. Therefore, we aimed to obtain patient feedback to guide successful trial design, recruitment, retention, and for identifying potential barriers to study participation.

Methods

Over 1000 members of an international laryngotracheal stenosis online support community (the Living with Idiopathic Subglottic Stenosis Facebook group) were sent two questionnaires for a proposed interventional double-blinded, randomized, placebo-controlled clinical trial.

Results

A total of 317 and 558 participants responded to the first and second surveys, respectively. The majority of participants (77%) were willing to consider enrollment, regardless of having a 50% chance of receiving placebo versus treatment (78%). The majority (84%) of participants were willing to travel 200 miles to participate for up to six in-person visits over 50 days. Specific side effects, including anemia/thrombocytopenia (72%) or risk of infection (69.3%) had the greatest impact on clinical trial participation with other side effects (peripheral edema (53%), oral ulcers (51%), and gastrointestinal side effects (41%)) having less impact.

Conclusion

Patients with laryngotracheal stenosis possess nuanced insight into their disease and treatment options. As a group, they are extremely motivated for better therapies. Future laryngotracheal stenosis clinical trials should focus on providing excellent side effect -related education and utilizing feedback from online advocacy groups to optimize recruitment and retention.
A Short History of Bernard Fisher’s Contributions to Randomized Clinical Trials
Authors: Anderson Stewart
Published: January 2022

Dr. Bernard Fisher (1918-2019) was an early proponent of evidence-based medicine using the mechanism of prospective, multicenter, randomized clinical trials to test biological and clinical hypotheses. In this article, I trace how his early scientific work in striving to understand the nature of cancer metastasis through animal experiments led to a new, testable, clinical hypothesis: that surgery to remove only the tumor and a small amount of tissue around it was as effective as the more disfiguring operations that were then the standard treatment. Fisher’s work with the National Surgical Adjuvant Breast and Bowel Project (NSABP) using large, randomized clinical trials to demonstrate the veracity of this hypothesis led to a new paradigm in which the emphasis was placed on how systemic therapies used at an early stage of disease could effectively eradicate breast cancer for many patients. This new therapeutic approach led to the successful development of new treatments, many of which are widely used today. Ultimately, the new paradigm led to successfully preventing breast cancer in women who were at high risk for the disease but who had not yet been diagnosed with the disease. Throughout his entire career, Fisher championed the use of large prospective, randomized clinical trials despite criticism from many in the medical community who strongly criticized his use of randomization as a mechanism for testing clinical hypotheses. The approach he and the NSABP employed is still considered to be the highest standard of evidence in conducting clinical studies.
Optimal Data Collection Period for Continuous Glucose Monitoring to Assess Long-Term Glycemic Control: Revisited
Authors: Cichosz Simon Lebech , Jensen Morten Hasselstrøm , Hejlesen Ole
Published: January 2022

Background and Objective:

It is not clear how the short-term continuous glucose monitoring (CGM) sampling time could influence the bias in estimating long-term glycemic control. A large bias could, in the worst case, lead to incorrect classification of patients achieving glycemic targets, nonoptimal treatment, and false conclusions about the effect of new treatments. This study sought to investigate the relation between sampling time and bias in the estimates.

Methods:

We included a total of 329 type 1 patients (age 14-86 years) with long-term CGM (90 days) data from three studies. The analysis calculated the bias from estimating long-term glycemic control based on short-term sampling. Time in range (TIR), time above range (TAR), time below range (TBR), correlation, and glycemic target classification accuracy were assessed.

Results:

A sampling time of ten days is associated with a high bias of 10% to 47%, which can be reduced to 4.9% to 26.4% if a sampling time of 30 days is used ( P < .001). Correct classification of patients archiving glycemic targets can also be improved from 81.5% to 91.9 to 90% to 95.2%.

Conclusions:

Our results suggest that the proposed 10-14 day CGM sampling time may be associated with a high correlation with three-month CGM. However, these estimates are subject to large intersubject bias, which is clinically relevant. Clinicians and researchers should consider using assessments of longer durations of CGM data if possible, especially when assessing time in hypoglycemia or while testing a new treatment.
In Vitro Evaluation of Miniaturized Amperometric Enzyme Sensor Based on the Direct Electron Transfer Principle for Continuous Glucose Monitoring
Authors: Inoue Yutaro , Kusaka Yasuhide , Shinozaki Kotaro , Lee Inyoung , Sode Koji
Published: January 2022

Background:

The bacterial derived flavin adenine dinucleotide (FAD)-dependent glucose dehydrogenase (FADGDH) is the most promising enzyme for the third-generation principle-based enzyme sensor for continuous glucose monitoring (CGM). Due to the ability of the enzyme to transfer electrons directly to the electrode, recognized as direct electron transfer (DET)-type FADGDH, although no investigation has been reported about DET-type FADGDH employed on a miniaturized integrated electrode.

Methods:

The miniaturized integrated electrode was formed by sputtering gold (Au) onto a flexible film with 0.1 mm in thickness and divided into 3 parts. After an insulation layer was laminated, 3 openings for a working electrode, a counter electrode and a reference electrode were formed by dry etching. A reagent mix containing 1.2 × 10−4 Unit of DET-type FADGDH and carbon particles was deposited. The long-term stability of sensor was evaluated by continuous operation, and its performance was also evaluated in the presence of acetaminophen and the change in oxygen partial pressure (pO2) level.

Results:

The amperometric response of the sensor showed a linear response to glucose concentration up to 500 mg/dL without significant change of the response over an 11-day continuous measurement. Moreover, the effect of acetaminophen and pO2 on the response were negligible.

Conclusions:

These results indicate the superb potential of the DET-type FADGDH-based sensor with the combination of a miniaturized integrated electrode. Thus, the described miniaturized DET-type glucose sensor for CGM will be a promising tool for effective glycemic control. This will be further investigated using an in vivo study.
Evaluating the Validity and Reliability of the Persian Version of American Orthopedic Foot and Ankle Society Midfoot Scale
Authors: Vosoughi Amir Reza , Yoosefinejad Amin Kordi , Dehbarez Yasaman Safaei , Kargarshouraki Zeinab , Mahdaviazad Hamideh
Published: January 2022

Background

The use of a valid and reliable outcome scoring system is crucial for evaluating the result of different treatment interventions. The aims of this study were to translate and culturally adapt the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scoring system into the Persian language and assess its validity and reliability.

Method

In total, 57 patients with midfoot injuries were enrolled. Forward-backward translation and cultural adaptation methods were used to develop the Persian version of AOFAS midfoot scoring system. Reliability and internal consistency were assessed using intraclass correlation coefficient (ICC) and Cronbach’s alpha. The discriminant and convergent validities of the scoring system were assessed using the total score of the mental and physical component of SF-36.

Results

The mean age of the participants was 46.2 ± 16.3 years. The intra-observer reliability of the totals core of the Persian version of AOFAS midfoot scoring system was 0.96 (confidence interval [CI]: 0.92-0.97) and the inter-observer reliability of the scoring system was 0.90 (CI: 0.86-0.95). The Persian version of AOFAS midfoot scoring system had acceptable convergence with physical component scoring system of SF-36 and its subscales (0.57); moreover, it had acceptable discriminant validity with the mental component of SF-36 and its subscales (0.36).

Conclusion

The Persian version of AOFAS midfoot is a reliable and valid instrument and could be used by Persian language clinicians and researchers.

Level of Clinical Evidence:

3
Do Local Newspapers Mitigate the Effects of the Polarized National Rhetoric on COVID-19?
Authors: Bailard Catie Snow
Published: January 2022

This analysis tests two distinct predictions regarding local newspapers’ coverage of the COVID-19 pandemic in the United States. A public service view of local newspapers predicts that a robust local newspaper sector would mitigate the politicized national partisan rhetoric surrounding COVID-19; reducing the disparity in social-distancing behaviors between predominantly Republican and predominantly Democratic counties by increasing compliance in Republican counties. The alternative hypothesis, informed by a demand-side view of the market pressures local newspapers face, predicts that increased competition between local newspapers will increase the degree to which local newspapers amplify the rhetoric of national officials in line with the partisan composition of their community, further polarizing adherence to social-distancing behaviors across predominantly Republican versus predominantly Democratic counties. The results of this analysis offer strong support for the second hypothesis; but, an additional analysis of vaccination rates offers a more nuanced perspective than a simple public service versus demand-side dichotomy would imply.
Temporal pole blurring in temporal lobe epilepsy revealed by 3D Edge-Enhancing Gradient Echo MRI
Authors: Okromelidze Lela , Gupta Vivek , Jain Ayushi , Gopal Neethu , Feyissa Anteneh M , Tatum William O , Quiñones-Hinojosa Alfredo , Grewal Sanjeet S , Middlebrooks Erik H
Published: January 2022

While abnormalities of the hippocampus have been well characterized in temporal lobe epilepsy, various additional temporal lobe abnormalities have also been described. One poorly understood entity, the so-called temporal pole blurring (TPB), is one of the more frequently described neocortical abnormalities in TLE and is thought to represent dysmyelination and axonal loss due to chronic electrical perturbations in early age-onset temporal lobe epilepsy. In this study, we describe the first reported cases of TPB diagnosed by a recently described MRI sequence known as 3D Edge-Enhancing Gradient Echo (3D-EDGE), which has an effective “myelin weighting” making it exquisitely sensitive to this temporal pole dysmyelination. The value of detection of TPB lies in lateralizing seizure onset, as well as predicting a lower baseline neuropsychological performance compared to temporal lobe epilepsy without TPB. Additionally, it is critical to not mistake TPB for alternative diagnoses, such as focal cortical dysplasia or neoplasm.
The impact of intensive care unit physician staffing change at a community hospital
Authors: Adams Christopher D , Brunetti Luigi , Davidov Liza , Mujia Jose , Rodricks Michael
Published: January 2022

Objectives:

A high-intensity staffing model has been defined as either mandatory intensivist consultation or a closed intensive care unit in which intensivists manage all aspects of patient care. In the current climate of limited healthcare resources, transitioning to a closed intensive care unit model may lead to significant improvements in patient care and resource utilization.

Methods:

This is a single-center, retrospective cohort study of all mechanically ventilated intensive care unit admissions in the pre-intensive care unit closure period of 1 October 2014 to 30 September 2015 as compared with the post-intensive care unit closure period of 1 November 2015 to 31 October 2016. Patient demographics as well as outcome data (duration of mechanical ventilation, length of stay, direct costs, complications, and mortality) were abstracted from the electronic health record. All data were analyzed using descriptive and inferential statistics. Regression analyses were used to adjust outcomes for potential confounders.

Results:

A total of 549 mechanically ventilated patients were included in our analysis: 285 patients in the pre-closure cohort and 264 patients in the post-closure cohort. After adjusting for confounders, there was no significant difference in mortality rates between the pre-closure (40.7%) and post-closure (38.6%) groups (adjusted odds ratio = 0.82; 95% confidence interval = 0.56–1.18; p = 0.283). The post-closure cohort was found to have significant reductions in duration of mechanical ventilation (3.71–1.50 days; p < 0.01), intensive care unit length of stay (5.8–2.7 days; p < 0.01), hospital length of stay (10.9–7.3 days; p < 0.01), and direct hospital costs (US $16,197–US $12,731; p = 0.009). Patient complications were also significantly reduced post-intensive care unit closure.

Conclusion:

Although a closed intensive care unit model in our analysis did not lead to a statistical difference in mortality, it did demonstrate multiple beneficial outcomes including reduced ventilator duration, decreased intensive care unit and hospital length of stay, fewer patient complications, and reduced direct hospital costs.
Risk stratification for renal deterioration in the neurogenic bladder patient: Should it be a prerequisite for patient selection in video-urodynamic studies?
Authors: Pace Keith , Farrugia Michaela
Published: January 2022

Objective:

The aim of this retrospective review is to determine whether risk stratification for renal deterioration in neuro-urology patients is supported by urodynamic findings in terms of bladder safety and whether urodynamic findings affect bladder management in this patient group. The primary endpoints are to determine any statistically significant differences between the high and low risk for renal deterioration groups in terms of urodynamic findings regarding bladder safety, and the frequency of changes in bladder management following video-urodynamics (VUDs).

Methods:

VUDs, which were performed between March 2015 and March 2021 in view of neurogenic lower urinary tract dysfunction, were included in the study. These were divided into those performed in patients with high risk and those in patients with low risk for renal deterioration categories according to criteria specified in the National Institute of Clinical Excellence (NICE) Urinary Incontinence in Neurological Disease guidelines. The two groups were then statistically compared in terms of urodynamic parameters for bladder safety and changes in management thereafter.

Results:

In total, 69 VUDs were included, 49.3% were classified as having been performed in high risk for renal deterioration patients, and 50.7% as low risk. 50% of those in the former group were found to have an unsafe bladder versus 31.4% in the latter group ( p = 0.12). Meanwhile, 65.2% of VUDs resulted in a change in bladder management, with no difference in change in management frequency between the two risk stratification groups ( p = 0.36).

Conclusion:

The lack of statistically significant difference in urodynamic bladder safety findings and change in frequency of bladder management for the low and high risk for renal deterioration categories in this cohort bring into question the need for risk stratification in the clinical decision to perform VUDs in the neurogenic bladder patient.

Level of evidence:

2c
A scoping review to inform care coordination strategies for youth with traumatic brain injuries: Care coordination personnel
Authors: Palusak Cara , Shook Brandy , Davies Susan C. , Lundine Jennifer P.
Published: January 2022

Introduction & Importance: Effective, patient-centered care coordination has been shown to improve outcomes for children with special healthcare needs (CSHCN), who often have complex, long-term involvement with multiple service providers. Traumatic brain injury (TBI) can result in long-term physical, intellectual, social, and emotional disabilities that persist long after acute treatment. Yet, even though it is a chronic condition, TBI remains an area with scarce standardization and research surrounding the complex, long-term care coordination need in this population. The purpose of this scoping review is to summarize current research on outcomes in CSHCN after implementation of care coordinators, whether individual or teams, to inform future research for youth with TBI.

Methods: OVID/Medline, CINAHL, PsycINFO, EMBASE, and ERIC databases were searched for articles relevant to care coordination and CSHCN.

Results: 31 articles met inclusion criteria. Outcomes for children and families were grouped into 5 major categories: healthcare utilization, cost of care, disease status, parent and child quality of life, and healthcare satisfaction and perception of care.

Discussion: Implementation of care coordinators, whether in the form of individuals, dyads, or teams, resulted in overall positive outcomes for CSHCN and their families across all 5 major outcome domains. Future research should be focused on the efficacy of care coordinators differing in profession, qualifications, and educational attainment specifically for the unique needs of children with TBI. Additionally, the application of care coordination within medical homes should be further investigated to increase proactive, preventative care of children with TBI and further reduce reactive, need-based treatment only.
The Chilling Effects of Digital Dataveillance: A Theoretical Model and an Empirical Research Agenda
Authors: Büchi Moritz , Festic Noemi , Latzer Michael
Published: January 2022

People's sense of being subject to digital dataveillance can cause them to restrict their digital communication behavior. Such a chilling effect is essentially a form of self-censorship in everyday digital media use with the attendant risks of undermining individual autonomy and well-being. This article combines the existing theoretical and limited empirical work on surveillance and chilling effects across fields with an analysis of novel data toward a research agenda. The institutional practice of dataveillance—the automated, continuous, and unspecific collection, retention, and analysis of digital traces—affects individual behavior. A mechanism-based causal model based on the theory of planned behavior is proposed for the micro level: An individual's increased sense of dataveillance causes their subjective probability assigned to negative outcomes of digital communication behavior to increase and attitudes toward this communication to become less favorable, ultimately decreasing the intention to engage in it. In aggregate and triggered through successive salience shocks such as data scandals, dataveillance is accordingly hypothesized to lower the baseline of free digital communication in a society through the chilling effects mechanism. From the developed theoretical model, a set of methodological consequences and questions for future studies are derived.
Digitally enabled flash glucose monitoring for inpatients with COVID-19: Feasibility and pilot implementation in a teaching NHS Hospital in the UK
Authors: Robbins Tim , Hopper Adam , Brophy Jack , Pearson Elle , Suthantirakumar Risheka , Vankad Maariyah , Igharo Natalie , Baitule Sud , Clark Cain CT , Arvanitis Theodoros N , Sankar Sailesh , Kyrou Ioannis , Randeva Harpal
Published: January 2022

Background

COVID-19 placed significant challenges on healthcare systems. People with diabetes are at high risk of severe COVID-19 with poor outcomes. We describe the first reported use of inpatient digital flash glucose monitoring devices in a UK NHS hospital to support management of people with diabetes hospitalized for COVID-19.

Methods

Inpatients at University Hospitals Coventry & Warwickshire (UHCW) NHS Trust with COVID-19 and diabetes were considered for digitally enabled flash glucose monitoring during their hospitalization. Glucose monitoring data were analysed, and potential associations were explored between relevant parameters, including time in hypoglycaemia, hyperglycaemia, and in range, glycated haemoglobin (HbA1c), average glucose, body mass index (BMI), and length of stay.

Results

During this pilot, digital flash glucose monitoring devices were offered to 25 inpatients, of whom 20 (type 2/type 1: 19/1; mean age: 70.6 years; mean HbA1c: 68.2 mmol/mol; mean BMI: 28.2 kg/m2) accepted and used these (80% uptake). In total, over 2788 h of flash glucose monitoring were recorded for these inpatients with COVID-19 and diabetes. Length of stay was not associated with any of the studied variables (all p-values >0.05). Percentage of time in hyperglycaemia exhibited significant associations with both percentage of time in hypoglycaemia and percentage of time in range, as well as with HbA1c (all p-values <0.05). The average glucose was significantly associated with percentage of time in hypoglycaemia, percentage of time in range, and HbA1c (all p-values <0.05).

Discussion

We report the first pilot inpatient use of digital flash glucose monitors in an NHS hospital to support care of inpatients with diabetes and COVID-19. Overall, there are strong arguments for the inpatient use of these devices in the COVID-19 setting, and the findings of this pilot demonstrate feasibility of this digitally enabled approach and support wider use for inpatients with diabetes and COVID-19.
Cervical Spinal Cord Atrophy can be Accurately Quantified Using Head Images
Authors: Taheri Kamyar , Vavasour Irene M , Abel Shawna , Lee Lisa Eunyoung , Johnson Poljanka , Ristow Stephen , Tam Roger , Laule Cornelia , Ackermans Nathalie Chantal , Schabas Alice , Cross Helen , Chan Jillian Katrina , Sayao Ana-Luiza , Bhan Virender , Devonshire Virginia , Carruthers Robert , Li David KB , Traboulsee Anthony L , Kolind Shannon H , Dvorak Adam Vladimir
Published: January 2022

Background

Spinal cord atrophy provides a clinically relevant metric for monitoring MS. However, the spinal cord is imaged far less frequently than brain due to artefacts and acquisition time, whereas MRI of the brain is routinely performed.

Objective

To validate spinal cord cross-sectional area measurements from routine 3DT1 whole-brain MRI versus those from dedicated cord MRI in healthy controls and people with MS.

Methods

We calculated cross-sectional area at C1 and C2/3 using T2*-weighted spinal cord images and 3DT1 brain images, for 28 healthy controls and 73 people with MS. Correlations for both groups were assessed between: (1) C1 and C2/3 using cord images; (2) C1 from brain and C1 from cord; and (3) C1 from brain and C2/3 from cord.

Results and Conclusion

C1 and C2/3 from cord were strongly correlated in controls ( r = 0.94, p<0.0001) and MS ( r = 0.85, p<0.0001). There was strong agreement between C1 from brain and C2/3 from cord in controls ( r = 0.84, p<0.0001) and MS ( r = 0.81, p<0.0001). This supports the use of C1 cross-sectional area calculated from brain imaging as a surrogate for the traditional C2/3 cross-sectional area measure for spinal cord atrophy.
MicroRNA-30 inhibits the growth of human ovarian cancer cells by suppressing RAB32 expression
Authors: Zhang Yan , Zhou Min , Li Kun
Published: January 2022

Introduction

MicroRNAs (miRs) exhibit the potential to act as therapeutic targets for the management of human cancers including ovarian cancer. The role of microRNA-30 (miR-30) via modulation of RAB32 expression has not been studied in ovarian cancer. Consistently, the present study was designed to characterize the molecular role of miR-30/RAB32 axis in human ovarian cancer.

Methods

Cell viability was determined by MTT assay. Expression analysis was carried out by qRT-PCR. Dual luciferase assay was used to confirm the interaction between miR-30 and RAB32. Scratch-heal and transwell chamber assays were used to monitor the cell migration and invasion. Western blotting and immunofluorescence assays were used to determine the protein expression.

Results

The results revealed significant ( p < 0.05) downregulation of miR-30 in human ovarian cancer cell lines. Overexpression of miR-30 in ovarian SK-OV-3 and A2780 cancer cells significantly ( p < 0.05) inhibited their proliferation. Besides, ovarian cancer cells overexpressing miR-30 showed significantly ( p < 0.05) lower migration and invasion. The miR-30 upregulation also altered the expression pattern of marker proteins of epithelial–mesenchymal transition in ovarian cancer cells. In silico analysis predicted RAB32 as the molecular target of miR-30 at post-transcriptional level. The silencing of RAB32 mimicked the tumor-suppressive effects of miR-30 overexpression in ovarian cancer cells. Nonetheless, overexpression of RAB32 could prevent the tumor-suppressive effects of miR-30 on SK-OV-3 and A2780 cancer cells.

Conclusion

Taken together, the results suggest the tumor-suppressive role of miR-30 and point towards the therapeutic utility of miR-30/RAB32 molecular axis in the management of ovarian cancer
Catastrophic antiphospholipid syndrome presented with coronary thrombosis, renal impairment, and suspected diffuse alveolar hemorrhage treated with rituximab biosimilar (CT-P10)
Authors: Kim Changgon , Kim Hyun-Sook
Published: January 2022

Catastrophic antiphospholipid syndrome (CAPS) is a lethal disease that occurs suddenly and progresses to multi-organ failure. We present a case of CAPS successfully treated with the rituximab biosimilar CT-P10. A 38-year-old man was referred with a sustained fever and unexplained elevated creatinine levels. Cardiac arrest by ventricular fibrillation occurred upon arrival at the hospital. We diagnosed probable CAPS because of coronary thrombus, renal impairment, suspected diffuse alveolar hemorrhage, and positive anticardiolipin antibody immunoglobulin G. We performed percutaneous coronary intervention for the cardiac arrest, and treated him with extracorporeal membrane oxygenation, mechanical ventilation, and continuous renal replacement therapy. When CAPS was diagnosed, we administered CT-P10 after administering high-dose glucocorticoid. Our case suggests that the use of a rituximab biosimilar is economically efficient in the treatment of CAPS, as in other rheumatic diseases. The patient was cured without recurrence at the 2-year follow-up.
Evolution of a concept with enzymatic debridement and autologous in situ cell and platelet-rich fibrin therapy (BroKerF)
Authors: Waldner Matthias , Ismail Tarek , Lunger Alexander , Klein Holger J , Schweizer Riccardo , Alan Oramary , Breckwoldt Tabea , Giovanoli Pietro , Plock Jan A
Published: January 2022

Background

Deep partial-thickness burns are traditionally treated by tangential excision and split thickness skin graft (STSG) coverage. STSGs create donor site morbidity and increase the wound surface in burn patients. Herein, we present a novel concept consisting of enzymatic debridement of deep partial-thickness burns followed by co-delivery of autologous keratinocyte suspension and plated-rich fibrin (PRF) or fibrin glue.

Material and methods

In a retrospective case study, patients with deep partial-thickness burns treated with enzymatic debridement and autologous cell therapy combined with PRF or fibrin glue (BroKerF) between 2017 and 2018 were analysed. BroKerF was applied to up to 15% total body surface area (TBSA); larger injuries were combined with surgical excision and skin grafting. Exclusion criteria were age <18 or >70 years, I°, IIa°-only, III° burns and loss of follow-up.

Results

A total of 20 patients with burn injuries of 16.8% ± 10.3% TBSA and mean Abbreviated Burn Severity Score 5.45 ± 1.8 were identified. Of the patients, 65% (n = 13) were treated with PRF, while 35% (n = 7) were treated with fibrin glue. The mean area treated with BroKerF was 7.5% ± 0.05% TBSA, mean time to full epithelialization was 21.06 ± 9.2 days and mean hospitalization time was 24.7 ± 14.4 days. Of the patients, 35% (n = 7) needed additional STSG, 43% (n = 3) of whom had biopsy-proven wound infections.

Conclusion

BroKerF is an innovative treatment strategy, which, in our opinion, will show its efficacy when higher standardization is achieved. The combination of selective debridement and autologous skin cells in a fibrin matrix combines regenerative measures for burn treatment.

Lay Summary

Patients suffering from large burn wounds often require the use of large skin grafts to bring burned areas to heal. Before the application of skin grafts, the burned skin must be removed either by surgery or using enzymatic agents. In this article, we describe a method where small areas of skin are taken and skin cells are extracted and sprayed on wound areas that were treated with an enzymatic agent. The cells are held in place by a substance extracted from patients’ blood (PRF) that is sprayed on the wound together with the skin cells. We believe this technique can be helpful to reduce the need of skin grafts in burned patients and improve the healing process.
Improving Child Development Screening: Implications for Professional Practice and Patient Equity
Authors: Meurer John , Rohloff Robert , Rein Lisa , Kanter Ilya , Kotagiri Nayanika , Gundacker Constance , Tarima Sergey
Published: January 2022

Introduction and Objectives:

A pediatric group with 25 clinics and 150 providers used multifaceted approaches to implement workflow processes and an electronic health record (EHR) flowsheet to improve child developmental screening. The key outcome was developmental screening done for every patient during 3 periods between ages 8 and 36 months. Identification of developmental concerns was the secondary study outcome. Screening rates and referrals were hypothesized to be optimized for children regardless of demographic backgrounds.

Methods:

During preventive visits, developmental screens targeted patients in age groups 8 to 12, 13 to 24, and 25 to 36 months. EHRs were analyzed for screening documentation, results, and referrals by patient demographics. Fifteen pediatric professionals were interviewed about their qualitative experiences. Quality improvement interventions included appointing clinic champions, training staff about the screening process and responsibilities, using a standardized tool, employing plan-do-study-act cycles, posting EHR prompts, providing financial incentives, and monitoring screening rates using control charts.

Results:

Within 25 months, screening rates improved from 60% to >95% within the 3 preventive visit age groups for a total of more than 30 000 children. Professionals valued the team process improvements. Children enrolled in Medicaid, black children, and those living in lower income zip codes had lower screening rates than privately insured, white children, and those living in higher income areas. Ages and Stages Questionnaire 3rd edition results were significantly different by gender, race/ethnicity, insurance, and income categories across all groups. Referral rates varied by race/ethnicity and zip code of residence.

Conclusions:

This project resulted in an effective and efficient process to improve child developmental screening that was valued by pediatric professionals. Analyses of patient demographics revealed disparities in services for the most vulnerable families. Ongoing quality improvement, health services research, and advocacy offer hope to improve health equity.
Consumption of Alcoholic Beverages Associated With Physical Health Status in Adults: Secondary Analysis of the Health Information National Trends Survey Data
Authors: Ramos-Vera Cristian , Serpa Barrientos Antonio , Calizaya-Milla Yaquelin E. , Carvajal Guillen Claudia , Saintila Jacksaint
Published: January 2022

Introduction:

Alcohol consumption constitutes one of the main modifiable risk factors that contribute to the increase in the global burden of non-communicable diseases (NCDs). The objective of this study was to determine the effects of the consumption of alcoholic beverages on the state of physical health and its equivalence according to gender.

Methods:

Cross-sectional data from the Health Information National Trends Survey (HINTS) of the National Cancer Institute (NCI) (n = 3865), collected during 2020 were used. Structural equation modeling was applied to assess the fit of the model, which included the prediction of measures of alcohol consumption in physical health and the equivalence of measurements of the proposed structural model in men and women.

Results:

The proposed structural model reported adequate goodness-of-fit indices (SBχ²/gl = 3.817, CFI = 0.984, TLI = 0.968, RMSEA [90% CI] = 0.027 [0.016-0.039]; SRMR = 0.016). Frequent alcohol consumption had a negative effect on physical health ( b = −0.13, P < .01). Similarly, occasional alcohol consumption negatively predicted elevated BMI and chronic conditions such as, diabetes, hypertension, CVD, and cancer ( b = −0.09, P < .01). In addition, drinking patterns of alcoholic beverages affect physical health in equal ways for men and women.

Conclusion:

The findings highlight that frequent and occasional alcohol consumption significantly affected physical health in a negative way. Future interventions could address ways to encourage the adoption of a healthy lifestyle to reduce the risks of chronic conditions derived from excessive alcohol consumption.
Assessing the Efficiency of Venture Capital Functioning in the Transforming Economy in UAE and China by a Mathematical Model
Authors: Wahdan Husam , Tian Zeng Rui
Published: January 2022

This article examines the evolution of approaches to the content of venture capital based on the evolution of venture capital and venture capital investment, post-industrial society, institutional theory, and experience of forming the venture capital market in developing economies. Hypotheses of the functioning of venture capital in the transforming economy of the UAE and China are proposed and tested. An economical and mathematical model for assessing the efficiency of venture capital functioning has been developed. It was found that there is a particular relationship between the national characteristics of the country’s venture capital industry and the capital invested in innovative industries, as well as the production efficiency of these industries. Moreover, the attractiveness of venture capital investments somehow increases with investments in other sectors in both countries. Since the Chinese market evolved earlier than UAE, it has the most remarkable characteristics, including higher capital workforce ratios and higher exports of science and technology-intensive products. In addition, the Chinese market has a high level of development and focuses on a sustainable financing cycle than UAE.
Contested Indigeneities: “Adivasi” Politics Historically and in Contemporary Times
Authors: Prasad Archana
Published: January 2022

This article focuses on the development and transformations of adivasi political identity and its articulations with indigenous consciousness in India since the advent of colonial capitalism. The apogee of adivasi politics and the “politics of indigeneity” since the 1970s has coincided with the networking among indigenous groups within the United Nations. The history of such politics will be traced in order to illustrate the forms in which social identities appear over a long historical process. In other words, the changing character of the antagonistic contradictions between the hegemon and different sections of the oppressed will be illustrated, including the articulation of “indigeneity” and “ adivasi” consciousness. Methodologically, the article promotes a dialectical interpretation of the phenomenon and counters a metaphysical analysis of identity politics.
The Use of Humor in Employee-to-Employee Workplace Communication: A Systematic Review With Thematic Synthesis
Authors: Taylor Stephen , Simpson Jane , Hardy Claire
Published: January 2022

The aim of this systematic review was to develop a thematic synthesis of existing qualitative studies to explore the use of humor in employee-to-employee workplace communication and provide a greater understanding of this area of research through the experiences of employees. A number of databases were searched using key terms and papers were selected using pre-specified criteria. The thematic synthesis approach of Thomas and Harden was used to review the final 23 papers. The findings from the thematic synthesis resulted in four temporal themes that described how humor was utilized during an employee’s organizational transition: (1) initiation into organizational humor, (2) joining a “tribe”—in-groups and out-groups, (3) exerting influence—humor as power, and (4) using the safety valve—humor to relieve tension. The temporal themes described in this study crossed organizational and cultural divides, where humor formed an essential part of work-based dialog.
Effect of Educational Guideline on Nurses Performance Regarding Postnatal Care of Mothers and Neonates
Authors: said Samah Abd Elhaleim , Elbana Hemmat Mostafe , Salama Amira Mohammed
Published: January 2022

Background

Postnatal periods are very sensitive periods for both the mother and the neonates where morbidity and mortality are high. Post natal care knowledge has significant role in reducing such complications. The research aimed to determine the educational guideline's effect on nurses’ performance regarding mothers and neonates’ postnatal care.

Design

A quasi-experimental design was decided to fulfil the aim of this study.

Setting

The study was conducted in the obstetric skill lab of faculty of nursing, Benha university.

Sample

A purposive sample was used to recruit 140 maternity nurses from Maternal and child health centres at kalioubia governorate. data collection: Two tools were used: Tool (I) Structured Questionnaire sheet. It is composed of these parts: Part I: Socio-demographic characteristics and Part II: nurses’ knowledge about postpartum care. Tool (II) postpartum care observation checklist.

Results

knowledge and practices about postpartum care showed highly statistically significant differences between pre and post- implementation phases, and total knowledge score regarding post-partum care were improved from 34.52% pre implementation to 45.65% after implementation with (t = 8.11 and p <0.01**) and total practice were improved from 38.52% pre implementation to 54.21% after implementation with highly significant difference (t = 12.75 and p < 0.01**).

Conclusion

Nurses’ knowledge and practice show a significant improvement post-implementation of health educational guideline regarding the care of postnatal mothers and neonates compared to pre-implementation.