bluuebunny/crossref_metadata_2025 huggingface dataset:
Health care utilization after enrollment in an outpatient structured clinical program for children with medical complexity
Authors: Cook Stacey , Hall Matt , Stringfellow Isabel , Berry Jay G
Published: February 2024

Objectives

Although children with medical complexity (CMC) with high health resource utilization use outpatient structured clinical programs (SCP) to optimize their health, little is known about variation in trends of their health service use shortly after enrollment. We measured these trends and assessed the utility of patient characteristics to predict them.

Methods

Retrospective analysis of 506 CMC newly enrolled in an outpatient, academic SCP. We measured outpatient and inpatient health service use for the first 6 months following enrollment. Using cluster analysis, we categorized CMC with similar trends by health service. We assessed patient demographic (e.g., age) and clinical [type and number of complex chronic conditions (CCC)] characteristics with the cluster categories.

Results

Most (90.3%) CMC enrolled had ≥1 CCCs; 53.8% had ≥3 CCCs. For all CMC, outpatient specialty visits, phone calls, and hospitalizations (not involving ICU) decreased significantly over the first 6 months after enrollment. For example, the hospitalization rate decreased from 9.7% to 4.5% in the 1st and 6th months, respectively, (P < 0.001). Cluster analysis revealed four categories of hospitalization trends, 6 months after enrollment: 72.9% of CMC had no hospital use; 16.0% had increased then decreased use; 8.3% had decreased use; and 2.8% had increased use. No patient and clinical characteristics clearly distinguished which hospitalization trend CMC experienced.

Conclusions

Although the overall population of CMC experienced decreased outpatient and inpatient health services utilization over time, this decrease was not uniformly experienced. Fundamental patient demographic and clinical characteristics did not predict health service trends.
Independent metabolism of oligosaccharides is the keystone of synchronous utilization of cellulose and hemicellulose in Myceliophthora
Authors: Liu Jia , Chen Meixin , Gu Shuying , Fan Rui , Zhao Zhen , Sun Wenliang , Yao Yonghong , Li Jingen , Tian Chaoguang
Published: February 2024

The effective utilization of cellulose and hemicellulose, the main components of plant biomass, is a key technical obstacle that needs to be overcome for the economic viability of lignocellulosic biorefineries. Here, we firstly demonstrated that the thermophilic cellulolytic fungus Myceliophthora thermophila can simultaneously utilize cellulose and hemicellulose, as evidenced by the independent uptake and intracellular metabolism of cellodextrin and xylodextrin. When plant biomass serviced as carbon source, we detected the cellodextrin and xylodextrin both in cells and in the culture medium, as well as high enzyme activities related to extracellular oligosaccharide formation and intracellular oligosaccharide hydrolysis. Sugar consumption assay revealed that in contrast to inhibitory effect of glucose on xylose and cellodextrin/xylodextrin consumption in mixed-carbon media, cellodextrin and xylodextrin were synchronously utilized in this fungus. Transcriptomic analysis also indicated simultaneous induction of the genes involved in cellodextrin and xylodextrin metabolic pathway, suggesting carbon catabolite repression (CCR) is triggered by extracellular glucose and can be eliminated by the intracellular hydrolysis and metabolism of oligosaccharides. The xylodextrin transporter MtCDT-2 was observed to preferentially transport xylobiose and tolerate high cellobiose concentrations, which helps to bypass the inhibition of xylobiose uptake. Furthermore, the expression of cellulase and hemicellulase genes was independently induced by their corresponding inducers, which enabled this strain to synchronously utilize cellulose and hemicellulose. Taken together, the data presented herein will further elucidate the degradation of plant biomass by fungi, with implications for the development of consolidated bioprocessing-based lignocellulosic biorefinery.
Epidemiology of antiphospholipid syndrome: macro- and microvascular manifestations
Authors: Gaspar Pedro , Sciascia Savino , Tektonidou Maria G
Published: February 2024

Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombotic and non-thrombotic macro- and microvascular manifestations and pregnancy complications in the setting of persistent antiphospholipid antibodies (aPL), namely anticardiolipin antibodies, anti-β2 glycoprotein-I antibodies and lupus anticoagulant. Four decades after its first description, APS prevalence and incidence are still not completely understood due to the limited number of well-designed, population-based multi-ethnic studies. Furthermore, despite decades of efforts to standardise aPL immunoassays, considerable intraassay and interlaboratory variances in aPL measures still exist. Large multicentre APS cohorts have shown a 10-year survival of ∼91% and the presence of catastrophic APS occurs in about 1% of the entire population, associated with a 50% mortality rate. Clinically, any organ can be affected in the context of large, medium or small vessel (artery and/or vein) thrombosis. Macrovascular thrombosis is the hallmark of the disease and veins are more frequently affected than arteries. Deep vein thrombosis/pulmonary embolism thromboembolic disease is the most common APS manifestation, while stroke and transient ischaemic attack are the most frequent arterial thrombosis events. Myocardial infarction can also occur and contributes to increased mortality in APS. A minority of patients present with thrombosis affecting the intraabdominal organs, including the liver, spleen, small and large bowel, and the kidneys. Microvascular thrombosis, including APS nephropathy, chronic skin ulcers and livedoid vasculopathy represent a diagnostic challenge requiring histologic confirmation. In this narrative review we summarize the available evidence on APS epidemiology, focusing on the description of the prevalence of macro- and microvascular manifestations of the disease.
Comparison of retention of biologics in Japanese patients with elderly-onset rheumatoid arthritis—the ANSWER cohort study
Authors: Jinno Sadao , Onishi Akira , Hattori Shuhei , Dubreuil Maureen , Ueda Yo , Nishimura Keisuke , Okano Takaichi , Yamada Hirotaka , Yamamoto Wataru , Murata Koichi , Onizawa Hideo , Ebina Kosuke , Maeda Yuichi , Son Yonsu , Amuro Hideki , Hara Ryota , Hata Kenichiro , Shiba Hideyuki , Katayama Masaki , Watanabe Ryu , Hashimoto Motomu , Saegusa Jun
Published: February 2024

Objectives

This multicentre, retrospective study aimed to compare retention and reasons for discontinuation between Janus kinase inhibitors (JAKi) and biologic DMARDs in patients with elderly-onset rheumatoid arthritis (EORA).

Methods

Patients with RA enrolled in a Japanese multicentre observational registry between 2015 and 2022 were included. EORA was defined as RA with onset at age 60 or over. To adjust confounding factors by indication for initiation of TNF inhibitors (TNFi), IL-6 inhibitors (IL-6i), cytotoxic T-lymphocyte associated antigen 4 immunoglobulin (CTLA4-Ig) blockers, or JAKi, a propensity score based on baseline characteristics was used to compare drug retention. To assess the reasons for discontinuation, retention rates for ineffectiveness, adverse events and remission were analysed as secondary outcomes.

Results

A total of 572 patients with 835 treatment courses were identified (314 TNFi, 175 IL-6i, 228 CTLA4-Ig and 118 JAKi). After adjusting for differences in baseline characteristics, drug retention was significantly higher for IL-6i (hazard ratio [HR] = 0.38; 95% CI: 0.27, 0.55; P < 0.01) as compared with TNFi. Discontinuation due to lack of effectiveness was lower with JAKi (HR = 0.38; 95% CI: 0.22, 0.66; P < 0.01) and IL-6i (HR = 0.29; 95% CI: 0.19, 0.46; P < 0.01) as compared with TNFi although CTLA4-Ig had a similar HR to TNFi. The adjusted incidence of discontinuation due to adverse events was higher for JAKi (HR = 2.86; 95% CI: 1.46, 5.59; P < 0.01) than for TNFi.

Conclusion

In EORA patients, IL-6i and JAKi had longer retention and less discontinuation due to ineffectiveness than TNFi. The potential risks of JAKi should be approached with an individualized perspective.
Arthroplasty rates and risk in familial Mediterranean fever patients: a large population-based study
Authors: Ben-Shabat Niv , Fisher Lior , Maixner Nitzan , Arow Mohamad , Ozeri David J , Patt Yonatan Shneor , Watad Abdulla , Amital Howard , Gendelman Omer
Published: February 2024

Background

FMF is a genetic disorder characterized by recurrent episodes of fever and inflammation in various organs, including the joints. Traditionally, the arthritis of FMF has been considered relatively harmless. However, anecdotal evidence has suggested that it may contribute to long-term joint damage, which may necessitate surgical joint replacement. This study aimed to investigate the rates of arthroplasty among FMF patients and compare it with those of the general population.

Methods

The study used the electronic database of the largest health-care organization in Israel to identify 9769 FMF patients diagnosed between 2000 and 2016. A similar number of age-, gender-, and residency-matched controls were also identified. The rates of arthroplasty were compared between the two groups. A logistic regression model predicting the need for arthroplasty within the FMF group was formed to identify potential risk factors.

Results

Of the 9769 FMF patients, 114 (1.2%) underwent arthroplasty, compared with 64 (0.7%) of the control group [unadjusted odds ratio (OR) = 1.79, 95% CI 1.32–2.43; partially adjusted OR = 1.97, 95% CI 1.40–2.77; fully adjusted OR = 1.92, 95% CI 1.35–2.72]. Within the FMF cohort, those of North African origin had a significantly higher risk of arthroplasty (OR = 6.89, 95% CI 5.09–9.33; P < 0.001).

Conclusion

FMF patients can experience long-term joint damage that may require arthroplasty. Although this complication is relatively uncommon in FMF patients, it occurs almost twice as frequently as compared with the general population. FMF patients of North African origin are at an even higher risk.
Diffuse Associations Between Drosophila suzukii and Filamentous Fungal Microbes May Alter Caneberry Disease Dynamics
Authors: Lewis Margaret T. , Miller Logan , Hu Mengjun , Hamby Kelly A.
Published: February 2024

Interactions between microorganisms and frugivorous insects can modulate fruit rot disease epidemiology. Insect feeding and/or oviposition wounds may create opportunities for fungal infection. Passive and active dispersal of fungal inoculums by adult insects also increases disease incidence. In fall-bearing raspberries and blackberries, such vectoring interactions could increase crop damage from the invasive pestiferous vinegar fly Drosophila suzukii (spotted-wing drosophila). Periods of peak D. suzukii activity are known to overlap with several species of primary fruit rot pathogen, particularly Botrytis cinerea and Cladosporium cladosporioides, and previous work indicates that larvae co-occur with and feed on various filamentous fungi at low rates. To further our understanding of the epidemiological consequences that may emerge from these associations, we surveyed the filamentous fungal community associated with adult D. suzukii, isolating and molecularly identifying fungi externally and internally (indicating feeding) from field-collected adults over 3 years. We isolated and identified 37 unique genera of fungi in total, including known raspberry pathogens. Most fungi were detected infrequently, and flies acquired and carried fungi externally at higher richness, frequency, and density relative to internally. In a worst-case scenario laboratory vectoring assay, D. suzukii adults were able to transfer B. cinerea and C. cladosporioides to sterile media at 0, 24, 48, and 72 h after exposure to sporulating cultures in Petri dishes. These results collectively suggest an adventitious vectoring association between D. suzukii and fruit rot fungi that has the potential to alter caneberry disease dynamics.
Innate Immunity Activation in Newly Diagnosed Ileocolonic Crohn’s Disease: A Cohort Study
Authors: Angriman Imerio , Bordignon Giovanni , Kotsafti Andromachi , Mescoli Claudia , Scarpa Melania , Ruffolo Cesare , Fassan Matteo , Dei Tos Angelo Paolo , D’Incà Renata , Savarino Edoardo , Zingone Fabiana , Pucciarelli Salvatore , Bardini Romeo , Castagliuolo Ignazio , Scarpa Marco
Published: February 2024

BACKGROUND:

Recent studies showed that early surgery for Crohn’s disease leads to a lower recurrence rate. However, the underlying mechanism is unknown.

OBJECTIVE:

The study aims to analyze the innate immunity microenvironment in ileal mucosa according to Crohn’s disease duration.

DESIGN:

A prospective cohort study.

SETTINGS:

Tertiary referral center for IBD surgery.

PATIENTS:

A total of 88 consecutive Crohn’s disease patients undergoing ileocolonic resection were prospectively enrolled. Mucosal samples were obtained from both healthy and inflamed ileum. Data from a public dataset were analyzed as an external validation cohort.

MAIN OUTCOME MEASURES:

Neutrophil infiltration was evaluated at histology and macrophage subpopulation at immunohistochemistry. Expression of TLR2, TLR4, TLR5, DEFB1, DEFB4A, DEFB103, DEFA5 and DEFA6 was quantified by Real-Time qPCR. Concentrations of BDNF, CCL11, ICAM1, IL1A, IL1B, IL1RN, IL12 p40, IL12 p70, IL15, IL17A, IL23A, MMP3, CCL3, KITLG, VEGFA were determined with immunometric assay.

RESULTS:

Neutrophil infiltration is inversely correlated with disease duration. DEFB4A mRNA expression tended to be higher in late-stage Crohn’s disease (p = 0.07). A higher number of macrophages expressed CD163 at low intensity in the late stage (p = 0.04). The concentration of IL15 (p = 0.02) and IL23A (p = 0.05) was higher in healthy ileal mucosa of early-stage patients. In the external cohort, expression of DEFB1 (p = 0.03) and DEFB4A (p = 0.01), IL2 (p = 0.04), and IL3 (p = 0.03) increased in late-stage patients.

LIMITATIONS:

A relatively small number of patients, especially in the newly diagnosed group.

CONCLUSIONS:

In newly diagnosed Crohn’s disease, high levels of IL-15 and IL-23 in healthy mucosa suggest that innate immunity is the starter of acute inflammation. Moreover, M2 macrophages increase in healthy mucosa of late-stage Crohn’s disease patients suggesting that reparative and profibrotic processes are predominant in the long term and in this phase, anti-inflammatory therapy may be less efficient. See Video Abstract.
A multicenter case–controlled study on laparoscopic hepatectomy versus microwave ablation as first-line therapy for 3–5 cm hepatocellular carcinoma in patients aged 60 and older
Authors: Wang Zhen , Zhang Hua , Meng Qiong , Zhang De-zhi , Wu Song-song , Hong Zhi-xian , He Guang-bin , Yang Hong , Xiang Bang-de , Li Xiao , Jiang Tian-an , Li Kai , Tang Zhe , Huang Fei , Lu Man , Liu Cun , Yu Xiao-ling , Cheng Zhi-gang , Liu Fang-yi , Han Zhi-yu , Dou Jian-ping , Yu Jie , Liang Ping
Published: February 2024

Background:

There is currently a lack of convincing evidence for microwave ablation (MWA) and laparoscopic liver resection (LLR) for patients ≥60 years old with 3–5 cm hepatocellular carcinoma.

Materials and methods:

Patients were divided into three cohorts based on restricted cubic spline analysis: 60–64, 65–72, and ≥73 years. Propensity score matching (PSM) was performed to balance the baseline variables in a 1:1 ratio. Overall survival (OS) and disease-free survival (DFS) were assessed, followed by a comparison of complications, hospitalization, and cost.

Results:

Among 672 patients, the median age was 66 (IQR 62–71) years. After PSM, two groups of 210 patients each were selected. During the 36.0 (20.4–52.4) month follow-up period, the 1-year, 3-year, and 5-year OS rates in the MWA group were 97.6, 80.9, and 65.3% and 95.5, 78.7, and 60.4% in the LLR group (HR 0.98, P=0.900). The corresponding DFS rates were 78.6, 49.6, and 37.5% and 82.8, 67.8, and 52.9% (HR 1.52, P=0.007). The 60–64 age cohort involved 176 patients, with no a significant difference in OS between the MWA and LLR groups (HR 1.25, P=0.370), MWA was associated with a higher recurrence rate (HR 1.94, P=0.004). A total of 146 patients were matched in the 65–72 age cohort, with no significant differences in OS and DFS between the two groups (OS (HR 1.04, P=0.900), DFS (HR 1.56, P=0.110)). In 76 patients aged ≥73 years after PSM, MWA provided better OS for patients (HR 0.27, P=0.015), and there were no significant differences in DFS between the two groups (HR 1.41, P=0.380). Taken together, for patients older than 65 years, the recurrence rate of MWA was comparable with LLR. Safety analysis indicated that LLR was associated with more postoperative bleeding (P=0.032) and hypoproteinemia (P=0.024).

Conclusions:

MWA was comparable to LLR in patients aged 65 years and older. MWA could be an alternative for the oldest old or the ill patients who cannot afford LLR, while LLR is still the first option of treatments for early-stage 3–5 cm hepatocellular carcinoma in capable elderly’s.
Efficacy and safety of stem cell therapy in patients with dilated cardiomyopathy: an umbrella review of systematic reviews
Authors: Ran Jun , Dziedzic Arkadiusz , Naser Israa Habeeb , Itumalla Ramaiah , Gupta Jeetendra Kumar , Rustagi Sarvesh , Satapathy Prakasini , Khatib Mahalaqua Nazli , Gaidhane Shilpa , Zahiruddin Quazi Syed , Gaidhane Abhay M , Sah Ranjit
Published: February 2024

Background:

Stem cell therapy (SCT) has emerged as a potential therapeutic avenue, with various cell types being explored for their efficacy in treating dilated cardiomyopathy (DCM). However, the safety and efficacy of these therapies have been the subject of numerous systematic reviews. This umbrella review aims to consolidate the existing evidence on stem cell interventions for DCM, providing a comprehensive overview of the current research landscape.

Methods:

This review was conducted following the JBI and PRISMA guidelines. Systematic reviews and meta-analyses of randomized controlled trials (RCTs) evaluating the safety and efficacy of SCT for DCM were included. Outcomes such as 6-minute walk test (6-MWT), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), major adverse cardiovascular events (MACE), New York Heart Association (NYHA), and quality of life (QoL), among others, were considered. A literature search was executed across databases like PubMed, Embase, Web of Science, and Cochrane Database up to 7 October 2023. The quality of the included reviews was assessed using the JBI Checklist for Systematic Reviews and Research Syntheses. Data synthesis was carried out in both narrative and tabular formats, with the GRADE criteria guiding the determination of evidence certainty.

Results:

Nine systematic reviews met the inclusion criteria. LVEF found to be significantly improved with SCT. LVEDD and LVEDV assessments yielded mixed results, with some reviews observing significant changes. Left ventricular end-systolic volume showed consistent reductions across multiple studies. B-type natriuretic peptide concentrations post-interventions were explored in several studies, with mixed findings. Health-related quality of life (HRQL) showed varied results, with some studies noting improvements and others finding no significant differences. NYHA classifications and 6-MWT results indicated potential benefits from stem cell treatments. SCT was observed to be generally safe. The certainty of evidence was low or very low for most of outcomes.

Conclusion:

SCT showed has shown promise in treating DCM, with many studies highlighting its safety and potential benefits. Nonetheless, the existing data has its limitations due to biases in the RCTs studies. To truly establish the benefits of SCT for DCM, future high-quality RCTS, are crucial.
Educational, Exercise, and Occupational Therapy-Based Telerehabilitation Program Versus “Wait-and-See” for Improving Self-perceived Exertion in Patients With Post-COVID Fatigue and Dyspnea
Authors: Calvo-Paniagua José , Díaz-Arribas María José , Valera-Calero Juan Antonio , Ramos-Sánchez Mabel , Fernández-de-las-Peñas César , Navarro-Santana Marcos José , del Corral Tamara , Plaza-Manzano Gustavo
Published: February 2024

Objective

The aim of the study was to compare the effectiveness of a telerehabilitation exercise program versus “wait-and-see” on physical exertion, quality of life, dyspnea severity, heart rate, and oxygen saturation in patients with post-COVID fatigue and dyspnea.

Design

Sixty-four patients were enrolled in this randomized clinical trial. A telerehabilitation program based on patient education, physical activity, airway clearing, and breathing exercise interventions was conducted. Self-perceived physical exertion during daily living activities, dyspnea severity, health-related quality of life and physiological outcomes, and the 6-min walking test were assessed at baseline, after the program and at 1- and 3-mo follow-up periods.

Results

The experimental group experienced greater improvements in self-perceived physical exertion during daily living activities, dyspnea severity, health-related quality of life, and 6-min walking test (all, P < 0.001). In addition, patients undergoing the telerehabilitation program reported lower exertion scores at rest and after the 6-min walking test (both, P < 0.001). Between-group oxygen saturation differences were found at rest (P < 0.001), but not after the 6-min walking test (P = 0.024). Finally, significant between-group differences were found for heart rate after the 6-min walking test (P < 0.001).

Conclusions

Although both groups showed a significant improvement after 3 mos of follow-up, the group receiving the telerehabilitation program described a greater improvement compared with the group receiving no intervention.
Additional Effect of Interfascial Hydrodissection With Dextrose on Shoulder and Neck Function in Patients With Myofascial Pain Syndrome
Authors: Hsu Chih Yang , Hsu TingHsuan , Lin Yen-Nung , Cheng Yu-Hsuan
Published: February 2024

Objective

The aim of the study is to evaluate whether the application of an interfascial injection with dextrose water could result in reduced pain and improved shoulder function and range of motion.

Design

This is a double-blind randomized controlled trial. Thirty-five patients with chronic shoulder pain were randomly assigned to receive either an interfascial injection of 10 mL of 10% dextrose water guided by ultrasound or a sham injection of 0.5 mL of 10% dextrose water into the subcutaneous layer. All patients received education on a home program of self-massage and self-stretching. Shoulder pain, shoulder range of motion, and neck and shoulder function were measured before injection and at 4 and 12 wks after injection.

Results

Both groups showed significant improvements in visual analog scale scores at 12-wk follow-up. The interfascial injection group exhibited a significant pain reduction compared with the sham group at the 12-wks follow-up. No between-group differences were observed in shoulder range of motion, pain threshold, and neck and shoulder function.

Conclusions

Interfascial injection is effective in decreasing pain in patients with myofascial pain syndrome.
Intention-to-Treat Analysis in Clinical Research
Authors: Armijo-Olivo Susan , Barbosa-Silva Jordana , de Castro-Carletti Ester Moreira , de Oliveira-Souza Ana Izabela Sobral , Pelai Elisa Bizetti , Mohamad Norazlin , Baghbaninaghadehi Fatemeh , Dennett Liz , Steen Jeremy P. , Kumbhare Dinesh , Ballenberger Nikolaus
Published: February 2024

This review presents a comprehensive summary and critical evaluation of intention-to-treat analysis, with a particular focus on its application to randomized controlled trials within the field of rehabilitation. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a methodological review that encompassed electronic and manual search strategies to identify relevant studies. Our selection process involved two independent reviewers who initially screened titles and abstracts and subsequently performed full-text screening based on established eligibility criteria. In addition, we included studies from manual searches that were already cataloged within the first author’s personal database. The findings are synthesized through a narrative approach, covering fundamental aspects of intention to treat, including its definition, common misconceptions, advantages, disadvantages, and key recommendations. Notably, the health literature offers a variety of definitions for intention to treat, which can lead to misinterpretations and inappropriate application when analyzing randomized controlled trial results, potentially resulting in misleading findings with significant implications for healthcare decision making. Authors should clearly report the specific intention-to-treat definition used in their analysis, provide details on participant dropouts, and explain upon their approach to managing missing data. Adherence to reporting guidelines, such as the Consolidated Standards of Reporting Trials for randomized controlled trials, is essential to standardize intention-to-treat information, ensuring the delivery of accurate and informative results for healthcare decision making.
Patient-Specific Implant Customization for Treatment of Internal Orbital Fractures Using Office-Based Three-Dimensional Printing
Authors: Yoon Joshua S. , Rao Manaahil , Dunlow Ryan , Wasicek Philip , Ha Michael , Le Paulina , Rasko Yvonne M. , Liang Fan , Grant Michael P. , Nam Arthur J.
Published: February 2024

Objective:

Three-dimensional (3D) modeling technology aids the reconstructive surgeon in designing and tailoring individualized implants for the reconstruction of complex craniofacial fractures. Three-dimensional modeling and printing have traditionally been outsourced to commercial vendors but can now be incorporated into both private and academic craniomaxillofacial practices. The goal of this report is to present a low-cost, standardized office-based workflow for restoring bony orbital volume in traumatic orbital fractures.

Methods:

Patients with internal orbital fractures requiring open repair were identified. After the virtual 3D models were created by iPlan 3.0 Cranial CMF software (Brainlab), the models were printed using an office-based 3D printer to shape and modify orbital plates to correctly fit the fracture defect. The accuracy of the anatomic reduction and the restored bony orbital volume measurements were determined using postoperative computed tomography images and iPlan software.

Results:

Nine patients fulfilled the inclusion criteria: 8 patients had unilateral fractures and 1 patient had bilateral fractures. Average image processing and print time were 1.5 hours and 3 hours, respectively. The cost of the 3D printer was $2500 and the average material cost to print a single orbital model was $2. When compared with the uninjured side, the mean preoperative orbital volume increase and percent difference were 2.7 ± 1.3 mL and 10.9 ± 5.3%, respectively. Postoperative absolute volume and percent volume difference between the orbits were −0.2 ± 0.4 mL and −0.8 ± 1.7%, respectively.

Conclusions:

Office-based 3D printing can be routinely used in the repair of internal orbital fractures in an efficient and cost-effective manner to design the implant with satisfactory patient outcomes.
Proposed revision of the American Association for Surgery of Trauma Renal Organ Injury Scale: Secondary analysis of the Multi-institutional Genitourinary Trauma Study
Authors: Matta Rano , Keihani Sorena , Hebert Kevin J. , Horns Joshua J. , Nirula Raminder , McCrum Marta L. , McCormick Benjamin J. , Gross Joel A. , Joyce Ryan P. , Rogers Douglas M. , Wang Sherry S. , Hagedorn Judith C. , Selph J. Patrick , Sensenig Rachel L. , Moses Rachel A. , Dodgion Christopher M. , Gupta Shubham , Mukherjee Kaushik , Majercik Sarah , Broghammer Joshua A. , Schwartz Ian , Elliott Sean P. , Breyer Benjamin N. , Baradaran Nima , Zakaluzny Scott , Erickson Bradley A. , Miller Brandi D. , Askari Reza , Carrick Matthew M. , Burks Frank N. , Norwood Scott , Myers Jeremy B. ,   in conjunction with the Trauma and Urologic Reconstruction Network of Surgeons
Published: February 2024

BACKGROUND

This study updates the American Association for the Surgery of Trauma (AAST) Organ Injury Scale (OIS) for renal trauma using evidence-based criteria for bleeding control intervention.

METHODS

This was a secondary analysis of a multicenter retrospective study including patients with high-grade renal trauma from seven level 1 trauma centers from 2013 to 2018. All eligible patients were assigned new renal trauma grades based on revised criteria. The primary outcome used to measure injury severity was intervention for renal bleeding. Secondary outcomes included intervention for urinary extravasation, units of packed red blood cells transfused within 24 hours, and mortality. To test the revised grading system, we performed mixed-effect logistic regression adjusted for multiple baseline demographic and trauma covariates. We determined the area under the curve (AUC) to assess accuracy of predicting bleeding interventions from the revised grading system and compared this to 2018 AAST OIS.

RESULTS

Based on the 2018 OIS grading system, we included 549 patients with AAST grades III to V injuries and computed tomography scans (III, 52% [n = 284]; IV, 45% [n = 249]; and V, 3% [n = 16]). Among these patients, 89% experienced blunt injury (n = 491), and 12% (n = 64) underwent intervention for bleeding. After applying the revised grading criteria, 60% (n = 329) of patients were downgraded, and 4% (n = 23) were upgraded; 2.8% (n = 7) downgraded from grade V to IV, and 69.5% (n = 173) downgraded from grade IV to III. The revised renal trauma grading system demonstrated improved predictive ability for bleeding interventions (2018 AUC, 0.805; revised AUC, 0.883; p = 0.001) and number of units of packed red blood cells transfused. When we removed urinary injury from the revised system, there was no difference in its predictive ability for renal hemorrhage intervention.

CONCLUSION

A revised renal trauma grading system better delineates the need for hemostatic interventions than the current AAST OIS renal trauma grading system.

LEVEL OF EVIDENCE

Diagnostic Test/Criteria; Level III.
Robust demarcation of the family Peptostreptococcaceae and its main genera based on phylogenomic studies and taxon-specific molecular markers
Authors: Bello Sarah , McQuay Sarah , Rudra Bashudev , Gupta Radhey S.
Published: February 2024

The family Peptostreptococcaceae, which contains 15 genera including Clostridioides, presently lacks proper circumscription. Using 52 available genomes for Peptostreptococcaceae species, we report comprehensive phylogenomic and comparative analyses to reliably discern their evolutionary relationships. In phylogenetic trees based on core genome proteins and 16S rRNA gene sequences, the examined species formed a strongly supported clade designated as Peptostreptococcaceae sensu stricto. This clade encompassed the genera Peptostreptococcus (type genus), Asaccharospora, Clostridioides, Intestinibacter, Paeniclostridium, Paraclostridium, Peptacetobacter, Romboutsia and Terrisporobacter, and two misclassified species (viz. Eubacterium tenue and ‘Clostridium dakarense’). The distinctness of this clade is strongly supported by eight identified conserved signature indels (CSIs), which are specific for the species from this clade. Based on the robust evidence provided by presented studies, we are proposing the emendment of family Peptostreptococcaceae to only the genera within the Peptostreptococcaceae sensu stricto clade. We also report 67 other novel CSIs, which reliably demarcate different Peptostreptococcaceae species clades and clarify the classification of some misclassified species. Based on the consistent evidence obtained from different presented studies, we are making the following proposals to clarify the classification of Peptostreptococcaceae species: (i) transfer of Eubacterium tenue, Paeniclostridium ghonii and Paeniclostridium sordellii as comb. nov. into the genus Paraclostridium; (ii) transfer of Clostridioides mangenotii as a comb. nov. into Metaclostridioides gen. nov.; (iii) classification of ‘Clostridium dakarense’ as a novel species Faecalimicrobium dakarense gen. nov., sp. nov. (type strain FF1T; genome and 16S rRNA accession numbers GCA_000499525.1 and KC517358, respectively); (iv) transfer of two misclassified species, Clostridium paradoxum and Clostridium thermoalcaliphilum, into Alkalithermobacter gen. nov.; and (v) proposals for two novel families, Peptoclostridiaceae fam. nov. and Tepidibacteraceae fam. nov., to accommodate remaining unclassified Peptostreptococcaceae genera. The described CSIs specific for different families and genera provide novel and reliable means for the identification, diagnostics and biochemical studies on these bacteria.
Develop and Validate a Computable Phenotype for the Identification of Alzheimer’s Disease Patients Using Electronic Health Record Data
Authors: He Xing , Wei Ruoqi , Huang Yu , Chen Zhaoyi , Lyu Tianchen , Bost Sarah , Tong Jiayi , Li Lu , Zhou Yujia , Guo Jingchuan , Tang Huilin , Wang Fei , DeKosky Steven , Xu Hua , Chen Yong , Zhang Rui , Xu Jie , Guo Yi , Wu Yonghui , Bian Jiang
Published: February 2024

INTRODUCTION

Alzheimer’s Disease (AD) are often misclassified in electronic health records (EHRs) when relying solely on diagnostic codes. This study aims to develop a more accurate, computable phenotype (CP) for identifying AD patients by using both structured and unstructured EHR data.

METHODS

We used EHRs from the University of Florida Health (UF Health) system and created rule-based CPs iteratively through manual chart reviews. The CPs were then validated using data from the University of Texas Health Science Center at Houston (UT Health) and the University of Minnesota (UMN).

RESULTS

Our best-performing CP is “patient has at least 2 AD diagnoses and AD-related keywords” with an F1-score of 0.817 at UF, and 0.961 and 0.623 at UT Health and UMN, respectively.

DISCUSSION

We developed and validated rule-based CPs for AD identification with good performance, crucial for studies that aim to use real-world data like EHRs.
Anomalous thermal relaxation and pump-probe spectroscopy of two-dimensional topologically ordered systems
Authors: McGinley Max , Fava Michele , Parameswaran S. A.
Published: February 2024

We study the behavior of linear and nonlinear spectroscopic quantities in two-dimensional topologically ordered systems, which host anyonic excitations exhibiting fractional statistics. We highlight the role that braiding phases between anyons have on the dynamics of such quasiparticles, which as we show dictates the behavior of both linear response coefficients at finite temperatures, as well as nonlinear pump-probe response coefficients. These quantities, which act as probes of temporal correlations in the system, are shown to obey distinctive universal forms at sufficiently long timescales. As well as providing an experimentally measurable fingerprint of anyonic statistics, the universal behavior that we find also demonstrates anomalously fast thermal relaxation: correlation functions decay as a “squished exponential” C(t)∼exp(−[t/τ]3/2) at long times. We attribute this unusual asymptotic form to the nonlocal nature of interactions between anyons, which allows relaxation to occur much faster than in systems with quasiparticles interacting via local, nonstatistical interactions. While our results apply to any Abelian or non-Abelian topological phase in two-dimensions, we discuss in particular the implications for candidate quantum spin liquid materials, wherein the relevant quantities can be measured using pre-existing time-resolved terahertz-domain spectroscopic techniques.

Published by the American Physical Society
2024
Quantitative Nonclassicality of Mediated Interactions
Authors: Ganardi Ray , Panwar Ekta , Pandit Mahasweta , Woloncewicz Bianka , Paterek Tomasz
Published: February 2024

In a plethora of physical situations, one can distinguish a mediator—a system that couples other, noninteracting, systems. Often, the mediator itself is not directly accessible to experimentation, yet it is interesting and sometimes crucial to understand if it admits nonclassical properties. An example of this sort that has recently been enjoying considerable attention is that of two quantum masses coupled via a gravitational field. It has been argued that the gain of quantum entanglement between the masses indicates nonclassicality of the states of the whole tripartite system. Here, we focus on the nonclassical properties of the involved interactions rather than the states. We derive inequalities the violation of which indicates noncommutativity and nondecomposability (open-system generalization of noncommuting unitaries) of interactions through the mediators. The derivations are based on properties of general quantum formalism and make minimalistic assumptions about the studied systems; in particular, the interactions can remain uncharacterized throughout the assessment. Furthermore, we also present conditions that solely use correlations between the coupled systems, excluding the need to measure the mediator. Next, we show that the amount of violation places a lower bound on suitably defined degree of nondecomposability. This makes the methods quantitative and at the same time experiment ready. We give applications of these techniques in two different fields: for detecting the nonclassicality of gravitational interaction and in bounding the Trotter error in quantum simulations.

Published by the American Physical Society
2024
Do women on boards break the glass ceiling or face the glass cliff?
Authors: Poma Erica , Pistoresi Barbara
Published: February 2024

Purpose

This paper aims to appraise the effectiveness of gender quotas in breaking the glass ceiling for women on boards (WoBs) in companies that are legally obliged to comply with quotas (listed companies and state-owned companies, LP) and in those that are not (unlisted companies and nonstate-owned companies, NLNP). Furthermore, it investigates the glass cliff phenomenon, according to which women are more likely to be appointed to apical positions in underperforming companies.

Design/methodology/approach

A balanced panel data of the top 116 Italian companies by total assets, which are present in both 2010 and 2017, is used for estimating ANOVA tests across sectors and fixed-effects panel regression models.

Findings

WoBs significantly increased in both the LP and the NLNP companies, and this increase was greater in the financial sector. Furthermore, the relationship between the percentage of WoBs and firm performance is not linear but depends on the financial corporate health. Specifically, the situation in which a woman ascends to a leadership position in challenging circumstances where the risk of failure is high (glass cliff phenomenon) is only present in companies with the lowest performance in the sample, in other words, when negative values of Roe and negative or zero values of Roa occur together.

Practical implications

These findings have relevant policy implications that encourage the adoption of gender quotas even in specific top positions, such as CEO or president, as this could lead to a “double spillover effect” both vertically, that is, in other job positions, and horizontally, toward other companies not targeted by quotas. Practical interventions to support women in glass cliff positions, on the other hand, relate to the extent of supervisor mentoring and support to prevent women from leaving director roles and strengthen their chances for career advancement.

Originality/value

The authors explore the ability of gender quotas to break through the glass ceiling in companies that are not legally obliged to do so, and to the best of the authors’ knowledge, for the first time, the glass cliff phenomenon in the Italian context.
UClean scaling up dilemma: towards building a laundromat mosaic in India
Authors: Swarup Kriti , Mathur Anshul
Published: February 2024

Learning outcomes

This case study outlines the strategic and organisational issues faced by an entrepreneurial firm operating in an emerging economy. This case study has been written to equip students with how entrepreneurs can overcome certain barriers and use technology to achieve product–market fit, taking the Indian laundry sector as an example. The following are the key learnings for the case: start-ups need to continuously assess the product–market fit to organise a highly unorganised sector; market entry and expansion modes require proper evaluation of available entry and expansion modes before pursual; franchising decisions require firm-specific and location-specific considerations; and careful consideration given to celebrity endorsement will result in increased sales.

Case overview/synopsis

The Indian laundry market was a highly unorganised market and presented an untapped opportunity. While the market opportunity was enormous, the existing solutions comprised local vendors that may not provide end-to-end services (washing, ironing, etc.). The case study described how a young entrepreneur, Arunabh Sinha, overcame certain challenges to achieve a product–market fit for metro cities and later expanded to Tier 2 and Tier 3 cities in India as well. However, the challenges remained, as the firm expanded by using a franchise model, and other modes of business were required to be evaluated as well.

Complexity academic level

The case study is suitable for students pursuing MBA courses in marketing, service marketing and entrepreneurship development.

Supplementary materials

Teaching notes are available for educators only.

Subject code

CSS3: Entrepreneurship.
Understanding corruption in India: determinants, nonlinear dynamics and policy implications
Authors: Shaurav Kumar , Deheri Abdhut , Rath Badri Narayan
Published: February 2024

Purpose

The purpose of this research is to evaluate corruption in the context of India, spanning the period between 1988 and 2021. Additionally, it aims to provide an in-depth comprehension of the factors that drive its prevalence and to propose policy directives for addressing these underlying issues.

Design/methodology/approach

The study instead of relying on perception-based measures, takes a distinct approach by formulating a corruption index derived from reported instances, thus ensuring a more objective assessment. Furthermore, we employ stochastic frontier analysis to tackle the issue of under-reporting within the corruption index based on reported cases. Subsequently, an auto regressive distributed lag (ARDL) methodology is applied to ascertain the principal drivers of corruption, encompassing both long and short factors.

Findings

This study reveals that corruption in India is notably influenced by economic growth and income inequality. Conversely, government effectiveness and globalization display a tendency to mitigate corruption. However, our rigorous analysis demonstrates that financial development does not wield a substantial influence in our study. Moreover, our inquiry uncovers a nonlinear relationship between economic growth and corruption. Additionally, we ascertain that the long run and short run impacts of corruption remain relatively stable across both models utilized in our study.

Originality/value

This study differs from previous research in the subsequent manners. Primarily, we employed an objective measure to formulate the corruption index, coupled with addressing the underreporting issues via stochastic frontier analysis. Moreover, this study pioneers the identification of a non-linear relationship between corruption and economic growth within the Indian context, a facet unexplored in previous investigations.
A systematic literature review and bibliometric analysis of leadership influence on employee unethical pro-organisational behaviour
Authors: Manelkar Shekhar , Mishra Dharmesh K.
Published: February 2024

Purpose

Since the idea of “Unethical Pro-organisational Behaviour” (UPB) was introduced in 2010, a substantial corpus of empirical research has contributed to its expanding, contemporary knowledge. This includes research studies on how leadership exerts an influence on UPB. This paper aims to consolidate the current understanding of organisational leadership’s impact on employee UPB and offer future research agendas.

Design/methodology/approach

A systematic literature review (SLR) using the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA) guidelines was adopted for the study. Literature that satisfied the search conditions was examined. The factors determining leadership’s influence on UPB were studied, and the findings were thematically synthesised.

Findings

Leader behaviour plays a large part in influencing UPB in organisations. Leader-member exchange and organisational belonging create favourable circumstances for UPB in organisations. UPB is moderated by the employee’s personal moral orientation.

Originality/value

UPB is unethical behaviour that benefits the organisation and is likely to be rewarded. However, there is a cost that other stakeholders pay. UPB has been researched since 2010, as well as the role of leaders in perpetuating UPB. However, there has not been an SLR of this study. This paper seeks to capture the essence of the research so far and pave a path for future research on the subject. These insights would prove valuable to management practitioners and academic experts.
Igniting work innovation: performance pressure, extraversion, feedback seeking and innovative behavior
Authors: Arun Kumar P. , Lavanya V.
Published: February 2024

Purpose

This study investigates how performance pressure affects feedback-seeking and innovative work behaviors. The study also examines the effect of extraversion on the performance pressure–FSB relationship.

Design/methodology/approach

The hypotheses in this study were tested by analyzing two-wave data collected from a sample of employees in the information technology sector in India using the PLS-SEM approach.

Findings

Our findings revealed that individuals possessing extraverted personality traits exhibited a positive response to performance pressure, thereby enhancing their FSB. Moreover, our results demonstrated that FSB mediates the relationship between performance pressure and IWB.

Research limitations/implications

The results underscore the importance of individual variations in personality traits, particularly extraversion, in influencing how employees respond to performance pressure. By providing insights into the mediating mechanism of feedback-seeking behavior, our study contributes to a deeper understanding of the interplay between performance pressure, feedback-seeking behavior and innovative work behavior.

Practical implications

Managers should consider extraversion as a factor in the relationship between performance pressure and FSB, adapting strategies and support systems accordingly. Creating a feedback-oriented culture and providing resources for extroverts during high-pressure periods can enhance their coping mechanisms.

Originality/value

Previous research has provided a limited exploration of the mechanisms that establish the connection between job demands and innovative work behaviors. This study contributes by uncovering the previously unexplored relationship between performance pressure, extraversion, feedback-seeking behavior and, subsequently, innovative work behavior.