bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementation of Healthcare Financing Based on Diagnosis-related Group in Three WHO Regions; Western Pacific, South East Asia and Eastern Mediterranean: A Systematic Review
Authors: Mehmood Asim , Ahmed Zafar , Ghailan Khalid , Dohare Sushil , Varghese Joe , Azeez Fahad Khan
Published: June 2023

Payment methods based on a controlled or adjusted prospective payment system rather than ‘Fee for Services’ or direct payment are considered beneficial to access the healthcare delivery services. The purpose of this review was to identify technical challenges faced by three WHO regions, namely, Western Pacific, South East Asia Eastern and the Mediterranean while establishing or adopting a diagnosis-related group (DRG)/case-mix grouper and report the extent of implementing this system for reimbursement and healthcare financing in three WHO regions, namely, Western Pacific, South East Asia Eastern and the Mediterranean. The study followed PRISMA guidelines, and 33 articles published from 1st January 2009 to 31st December 2019 were selected for critical appraisal after systematic filtration. The objectives of the implementation of the DRG system in most developed and developing countries in these regions were to bring transparency in the payment system and reduce treatment costs by avoiding unnecessary healthcare services. The countries in the study regions were at different levels of economic and social development status, therefore the implementation and adaptation status of DRG/case-mix system/grouper varied in these countries

The findings revealed that most of the countries faced challenges related to inequalities and inefficiencies in the healthcare system, shortage of funding, poor documentation related to diagnosis and procedures, incomplete medical record files and lack of primary data required for the case-mix system during the DRG/case-mix adaptation phase.

The results also pointed to the importance of initial pilot testing of the DRG/case-mix system/grouper and careful manipulation and adaptation to the local context, especially when the DRG system/grouper imported from other countries.
Steroids in Headache: A Comprehensive Review of Recent Research
Authors: Kashyap Priyanka V. , Chabri Sounak
Published: June 2023

Background

Headache is an extremely common symptom of the general outpatient department and also the headache clinic, with prevalence of 48.9% in the general population. None has ever experienced headache in life time. Headache is seen in 1 patient out of 10 general practitioner (GP) consultations, 1 referral out of 3 is headache in neurology OPD, and 1 in 5 of all emergency medical admissions. Of all headaches, around 98% constitute primary headache: migraine without aura, tension headache, and cluster headache. With advancement in various drug modalities, certain headache forms respond less well to the regular approved medications, and some headaches are complicated by the analgesic itself. Steroids have been tried in many subtypes of headache, especially in primary forms of headache with dysautonomia, headache with trigeminal pathway activation and disinhibition, and in certain medication-culprit headaches. This subgroup of headaches is almost a challenge in an emergency for the headache expert as well. So, we need to assess the role of steroids in less well-responsive headaches.

Current reviewed evidence on the role of steroids in primary headache suggests that steroids have a role in status migrainosus and medication overuse headache when used in the mentioned and monitored manner. Consideration and further exploration of its role in other primary headaches may reveal insight into steroid efficacy as a treatment modality in various subtypes of headache.

Key message

Steroids, when used cautiously in specifically selected primary headaches under supervision, proved miraculous where other modalities failed.
The clear expectation of cultural betterment in the face of rising living standards
Authors: Murphy Ryan H
Published: June 2023

Rising Real Gross Domestic Product Per Capita data indicates rises in living standards. Nonetheless, cultural pessimism is the received view. This paper makes a series of arguments that we should expect our cultural products (e.g. art or cuisine) to be on an upwards trajectory, just as RGDP per capita is. To do so, I expand on Bill James’s “Peripheral Quality Indicia” in order to argue that analogous indicators for our cultural products strongly suggest that they have improved. I also claim that RGDP per capita is itself a peripheral quality indicium for essentially any good in the economy. I then sketch the conditions under which cultural products are actually lower in quality today than they were in previous periods in order to demonstrate the general unlikelihood of quality declining.
Who Benefits More From IBMS or Qigong? Clinical Data-Mining RCT Data
Authors: Ng S.M. , Fung M.H.Y. , Yin M.X.C. , Chan C.L.W. , Epstein I.
Published: June 2023

Purpose: A recent three-arm randomized controlled trial (RCT) with depressed Hong Kong adults demonstrated the comparable effectiveness of integrative Body-Mind-Spirt (IBMS) and Qigong interventions in relieving sleep disturbance and depression, but not which is best for whom? Guided by concept and theory-based hypotheses, clinical data-mining (CDM), the RCT data answers the more clinically relevant question: who responds best to which intervention? Method: Paired-sample t-tests and Wilcoxon signed-ranked tests were adopted to compare the within-subgroup differences; linear mixed models for normally distributed outcomes and generalized linear mixed models for non-normally distributed outcomes were used to compare the between-subgroup differences. Results: Results indicate that IBMS is more efficacious for older, more educated females, suffering from physical pain and illness; whereas younger, less educated males, not in full-time employment benefit more from Qigong. Discussion: This productive joining together of RCT and CDM recommends itself to both past and future RCTs, further informing evidence-based practice decision making.
No clinically significant differences in patient-reported outcome measures across total hip arthroplasty approaches
Authors: Kim Andrew G , Rizk Adam A , Chiu Austin M , Zuke William , Acuña Alexander J , Kamath Atul F
Published: June 2023

Introduction:

As recent studies demonstrate an ongoing debate surrounding outcomes and complications with respect to different total hip arthroplasty (THA) approaches, patient-reported outcome measures (PROMs) may provide valuable information for clinician and patient decision-making. Therefore, our systematic review aimed to assess how surgical approach influences patient-reported outcomes.

Methods:

5 online databases were queried for all studies published between January 1, 1997 and March 4, 2022 that reported on PROMs across various surgical approaches to THA. Studies reporting on PROMs in primary THA patients segregated by surgical approach were included. Articles reporting on revision THA, hip resurfacing, and arthroscopy were excluded. Mantel-Haenszel (M-H) models were utilised to calculate the pooled mean difference (MDs) and 95% confidence interval (CIs).

Results:

No differences between the DAA and other approaches were observed when evaluating HOOS (MD −0.28; 95% CI, −1.98–1.41; p = 0.74), HHS (MD 2.38; 95% CI, −0.27–5.03; p = 0.08), OHS (MD 1.35; 95% CI, −2.00–4.71; p = 0.43), FJS-12 (MD 5.88; 95% CI, −0.36–12.12; p = 0.06), VAS-pain (MD −0.32; 95% CI, −0.68–0.04; p = 0.08), and WOMAC-pain (MD −0.73; 95% CI, −3.85–2.39; p = 0.65) scores. WOMAC (MD 2.47; 95% CI, 0.54–4.40; p = 0.01) and EQ-5D Index (MD 0.03; 95% CI, 0.01–0.06; p = 0.002) scores were found to significantly favour the DAA cohort over the other approaches. Only the EQ-5D index score remained significant following sensitivity analysis.

Conclusions:

Superiority of any 1 approach could not be concluded based on the mixed findings of the present analysis. Although our pooled analysis found no significant differences in outcomes except for those measured by the EQ-5D index, a few additional metrics, notably the WOMAC, HHS, FJS-12, and VAS-pain scores, leaned in favour of the DAA.
The Nexus between tourism-energy-environmental degradation: Does financial development matter in GCC countries?
Authors: Farooq Umar , Tabash Mosab I , Saleh Al-Faryan Mamdouh Abdulaziz , Işık Cem , Dogru Tarik
Published: June 2023

Environmental sustainability, energy consumption, and tourism are the most discussed topics in the literature. However, limited studies have catered to the relationship among these variables. From this perspective: the current study aims to find the nexus between tourism, energy alternatives, financial development, and pollution emissions by targeting the Gulf Cooperation Council (GCC) economies. We employ the data of six GCC economies for the years 2000–2019 and adopt fully modified ordinary least square and generalized least square approaches to establish the regression. The findings reveal a positive impact on the number of tourist arrivals (ITAs) while a negative impact on tourism receipts on pollution emissions. Similarly, fossil fuel energy (FFE) shows a positive while renewable energy depicts a negative relationship with CO2 emissions. This positive impact of tourist arrivals and fossil fuel energy was moderated by financial development. In addition to individual analysis, the developed financial sector can help to reduce the negative externalities of ITA and FFE. The empirical analysis further documents the positive impact of all control variables including foreign investment, economic growth, and gross capital formation on CO2 emissions. Based on empirical results, it is recommended to bring financial development into the picture to reduce the negative impact of ITA and FFE on environmental quality. This study put forward the literature by adding innovative thoughts regarding the moderating role of financial development in the nexus between tourism, energy alternatives, and CO2 emissions.
Outcomes in patients discharged with extended venous thromboembolism prophylaxis after hospitalization with COVID-19
Authors: Patel Love , Stenzel Ashley , Van Hove Christopher , Sidebottom Abbey , Kethireddy Rajesh , Ha Ngoc , Beddow David , Manunga Jesse , Qadri Ghaziuddin , Kirven Justin , Skeik Nedaa
Published: June 2023

Background:

Venous thromboembolism (VTE) is a known complication of coronavirus disease (COVID-19) in patients requiring hospitalization and intensive care. We examined the association between extended pharmacological VTE prophylaxis and outcomes among patients hospitalized with COVID-19.

Methods:

This was a retrospective cohort study of patients with an index positive SARS-CoV-2 polymerase chain reaction (PCR) test at the time of, or during hospitalization. Patients who were prescribed extended pharmacological VTE prophylaxis were compared against patients who were not. Multivariable logistic regression was used to produce odds ratio (OR) estimates and Cox proportional hazard models for hazard ratios (HR) with 95% CI to examine the association between pharmacological VTE prophylaxis and outcomes of interest. Primary outcomes were 30- and 90-day VTE events. Secondary outcomes included 30- and 90-day mortality, 30-day superficial venous thrombosis (SVT), acute myocardial infarction (MI), acute ischemic stroke, critical limb ischemia, clinically significant bleeding, and inpatient readmissions.

Results:

A total of 1936 patients were included in the study. Among them, 731 (38%) were discharged on extended pharmacological VTE prophylaxis. No significant difference was found in 30- and 90-day VTE events among groups. Patients discharged on extended VTE prophylaxis showed improved survival at 30 (HR: 0.35; 95% CI: 0.21–0.59) and 90 days (HR: 0.36; 95% CI: 0.23–0.55) and reduced inpatient readmission at 30 days (OR: 0.12; 95% CI: 0.04–0.33) when compared to those without.

Conclusion:

Patients discharged on extended VTE prophylaxis after hospitalization due to COVID-19 had similar thrombotic events on follow-up. However, use of extended VTE prophylaxis was associated with improved 30- and 90-day survival and reduced risk of 30-day inpatient readmission.
Mesenteric and renal arterial duplex ultrasound: A review
Authors: Kupinski Ann Marie
Published: June 2023

Duplex ultrasound examinations of the mesenteric and renal circulations are commonly used to detect disease as well as to follow up patients after open surgery or endovascular intervention. The aims of this review were to present essential elements of these duplex ultrasound examinations as well as conduct a literature review of diagnostic criteria. Documentation of appropriate images and data will aid in an accurate interpretation. Spectral Doppler waveforms from various segments of these arterial systems can contribute both direct and indirect evidence of the presence of disease. Various studies have validated the duplex ultrasound diagnostic criteria which more recently have expanded to include specific criteria for stented vessels. This review presents a summary of the fundamental exam components and diagnostic criteria utilized for mesenteric and renal duplex ultrasound.
Developing ‘fresh perspectives’ on ‘entrepreneurial intuition’
Authors: Fleckenstein Kristopher , Smith Robert
Published: June 2023

This note presents a fresh perspective on Entrepreneurial Intuition, which developed between the main author, a serial entrepreneur-doctoral student and his supervisor, an experienced entrepreneurship professor. Using their combined knowledge, they utilise their personal experiences and entrepreneurial logic to draft a practical conceptual model. The note reviews extant literature, contextualises and outlines the key argument advanced that because Entrepreneurial Intuition involves ‘praxis’ any model developed must take cognisance of it, reports on the development of the model – taking cognisance of entrepreneurial praxis and extant theory whilst shedding light on intuitive behaviour.
An intersectional reflexive account on positionality: researching Pakistani and Bangladeshi Muslim lone motherhood
Authors: Baz Sarah A
Published: June 2023

Engaging in ‘reflexive practice’ throughout the research process (Benson and O’Reilly, 2022) and a ‘reflexivity of discomfort’ (Hamdan, 2009) through an intersectional lens, this article presents a reflective account of accessing and conducting observations and interviews at a South Asian women’s organisation, in North England, to explore Pakistani and Bangladeshi Muslim (PBM) lone motherhood. It critically explores how researchers’ own subjectivities and intersecting identities – in this case, my intersecting identities and positionalities as a young British Pakistani Muslim women, researcher and volunteer – impact interactions in different circumstances with different groups of participants and the importance of having continuous critical self-awareness. Moving beyond simplistic insider–outsider debates, the paper contributes towards further developing reflexivity debates taking an ‘intersectional reflexivity’ approach. It argues for thinking about the research process and engagements in the field as socially constructed, changing, adapting and negotiated overtime and to utilise intersectionality to unpick broader categories. Finally, it encourages researchers to adopt reflexivity in their research practices.
Illumi’s world: A mini-game development with parametric BIM-based simulations
Authors: Kim Jong Bum , Oprean Danielle , Cole Laura , Zangori Laura
Published: June 2023

The research investigates the design and development of a serious game to teach green building design and energy literacy in rural middle schools in the United States. The paper presents a pilot study, education mini-game development integrated with parametric BIM and energy simulations. The game scenario was built on the developed science curriculum modules in our funded research, teaching building energy technologies such as daylighting, artificial lighting, window configurations, building materials, solar panels, etc. The mini-game, Illumi’s World, presents a baseline science lab and a media library of typical public schools in the United States. The players have the opportunity to improve energy literacy in several ways: manipulating the building configurations and the energy options, reviewing energy costs and emission level changes, and monitoring the performance from the game dashboards. This paper presents background theory, curriculum design, the mini-game development framework, methods and tools for energy simulation and BIM visualization, and the findings and challenges.
Making Complexity Measurable in Practice: A Formal Analysis of Gamble-Play media
Authors: Denoo Maarten , Dupont Bruno , Zaman Bieke , Grosemans Eva , Malliet Steven
Published: June 2023

Over the past decade, videogames have become increasingly gambling-like in their design. Scientific and regulatory attempts to unravel such design seem particularly oriented towards the effects and regulatory treatment of paid-for loot boxes, favoring either measurability or complexity. Departing from gamble-play theory, this paper, therefore, attempts to make complexity measurable in practice. We conduct a formal analysis of 20 videogames that include loot boxes, social casino games, optional gambling-themed activities and token wagering by identifying and mapping interactions between their features. Having uncovered 51 features across 11 categories, we then reinterpret previously established notions of gambling. In doing so, we aim to contribute to a future-proof understanding of gambling in videogames.
The Gift of Interruption: Saint John of the Cross and Covid-19
Authors: Trementozzi David
Published: June 2023

This article contends that St. John of the Cross provides a helpful perspective on envisioning the redemptive possibilities of COVID-19 through the paradigm of “interruption.” After reflecting on Old and New Testament stories of traumatic disruption, a biblical and theological foundation is established for redemptive outcomes of life-altering interruption. Next, John’s dark night of the soul theology is discussed in relation to persistent seasons of physical and emotional challenge. Three interruptive qualities of his night—discomfort, disillusionment, and discouragement—reveal his perspective on its redeeming potential for Christian faith. Then, through interrogating contemporary notions of (1) happiness, (2) success, and (3) self-worth, John shows how they often work against the transforming capacity of faith. In doing so, COVID-19 can be envisioned as a gift of redemptive interruption. The article concludes with a summary of key points.
Omega-3 Fatty Acid Supplementation for the Treatment of Persistent COVID-Related Olfactory Dysfunction
Authors: Lerner David K. , Garvey Katherine L. , Arrighi-Allisan Annie , Kominsky Evan , Filimonov Andrey , Al-Awady Abdurrahman , Filip Peter , Liu Katherine , Ninan Sen , Spock Todd , Tweel Benjamin , van Gerwen Maaike , Schaberg Madeleine , Colley Patrick , Del Signore Anthony , Govindaraj Satish , Iloreta Alfred Marc
Published: June 2023

Objective

To evaluate the efficacy of omega-3 fatty acid (O3FA) supplementation in the treatment of COVID-related olfactory dysfunction (OD).

Methods

Patients with laboratory-confirmed or clinically-suspected COVID-19 infection and new-onset OD from August 2020 to November 2021 were prospectively recruited. Patients with quantitative OD, defined as a brief smell identification test (BSIT) score of 9 or less, were eligible for study inclusion. The experimental group received 2 g of O3FA supplementation, while the control group received an identical placebo to be taken daily for 6 weeks. The primary outcome was a change in BSIT score between the initial and 6-week follow-up tests.

Results

One hundred and seventeen patients were included in the analysis, including 57 patients in the O3FA group and 60 in the placebo group. O3FA group patients demonstrated a mean BSIT improvement of 1.12 ± 1.99 compared to 0.68 ± 1.86 in the placebo group ( p = 0.221). Seventy-seven patients, 42 within the O3FA group and 35 in the placebo group, completed a follow-up BSIT survey at an average of 717.8 days from study onset. At long-term follow-up, there was an average BSIT score improvement of 1.72 within the O3FA group compared to 1.76 within the placebo group ( p = 0.948).

Conclusion

Among patients with persistent COVID-related OD, our study showed no clear evidence of relative short-term or long-term olfactory recovery among patients receiving high doses of O3FA supplementation.
WeChat-based mobile health management for short-stature children with long-term growth hormone therapy: A nonexperimental study
Authors: Zhu Qingling , Li Ying , Su Yajun , Huang Liuhong , Liu Jiajia , Lin Weihua
Published: June 2023

Objective

To evaluate the role of a WeChat-based mobile platform in growth hormone therapy.

Method

Growth hormone therapy and health education information for height growth were embedded in a WeChat-based mobile platform, and the platform was evaluated through medical staff assessments, patient volunteer assessments and quantitative scoring criteria.

Results

In the medical staff evaluation, both clinicians and nurses had a positive attitude towards the mobile platform, believing that the design of the mobile platform was clearly visualized and easy to operate. In family volunteers’ evaluations, the summary of β-testing results showed that 90–100% of parents had a positive attitude towards the WeChat-based mobile platform. Parents of the patients and doctors and nurses assessed the mobile platform by reviewing quantitative scoring standards developed by professional researchers. All scores were >16 (the average score was 18–19.3). Children treated with growth hormone therapy were included for compliance tracking for one year, and patient adherence was described in this study.

Conclusion

The interaction based on the WeChat platform and the health education of the public have greatly increased the interaction between doctors and patients, and improved patient satisfaction and compliance.
Effects of Malpositioning of the Knee on Radiographic Measurements: The Influence of Adduction, Abduction, and Malrotation on Measured Tibial Slope
Authors: Bixby Elise C. , Tedesco Liana J. , Confino Jamie E. , Mueller John D. , Redler Lauren H.
Published: June 2023

Background:

Increased posterior tibial slope (PTS) is a risk factor for knee pathology. Accurate measurement of PTS is predicated on a quality lateral knee radiograph; however, little is known about how the quality of the radiograph affects the measured PTS.

Purposes:

To (1) describe a method for measuring malalignment on lateral knee radiographs, (2) assess the effects of malpositioning of the knee on radiographic measures of malalignment, and (3) determine any correlations between malalignment and the measured PTS.

Study Design:

Descriptive laboratory study.

Methods:

Using a setup similar to that of a standard radiology suite, 25 sets of radiographs were taken using 5 sawbone models. Each set included a true lateral view and separate malpositioned radiographs at 5°, 10°, and 15° of adduction, abduction, internal rotation, and external rotation. Malalignment for each radiograph was quantified as the anterior-posterior distance (APD) and proximal-distal distance (PDD) between femoral condyles. The medial PTS was measured in duplicate, and the interrater reliability was calculated.

Results:

The interrater reliability was excellent, with intraclass correlation coefficients of 0.92, 0.91, and 0.96 for the APD, PDD, and PTS, respectively. Malrotation significantly affected the APD ( P < .001), with a mean change of 5.6 mm per 5°. Malpositioning in abduction/adduction significantly affected the PDD ( P < .001), with a mean change of 5.1 mm per 5°. There was no significant impact of rotation or APD on the PTS. Abduction/adduction did affect the PTS ( P < .001) above a threshold of 5° of malpositioning. The PTS decreased as the PDD increased, moving from adduction to abduction ( R 2 = 0.5687).

Conclusion:

The measured PTS was more sensitive to malpositioning by abduction/adduction than by malrotation. Malrotation affected the APD, while abduction/adduction affected the PDD. Thus, the accuracy of the measured PTS was compromised more by poorly aligned distal femoral condyles than it was by poorly aligned posterior femoral condyles.

Clinical Relevance:

To minimize the effects of malpositioning, we recommend utilizing radiographs with a |PDD| of <5 mm and an |APD| of <15 mm when measuring the PTS.
MRI Findings Associated With Anterior Cruciate Ligament Tears in National Football League Athletes
Authors: Brophy Robert H. , Baker Jon C. , Crain Jana M. , Herzog Mackenzie M. , Stollberg Ben , Wojtys Edward M. , Mack Christina D.
Published: June 2023

Background:

Anterior cruciate ligament (ACL) tears are a high-frequency injury requiring a lengthy recovery in professional American football players. Concomitant pathology associated with ACL tears as identified on magnetic resonance imaging (MRI) is not well understood in these athletes.

Purpose:

To describe the MRI findings of concomitant injuries associated with ACL tears among athletes in the National Football League (NFL).

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Of 314 ACL injuries in NFL athletes from 2015 through 2019, 191 complete MRI scans from the time of primary ACL injury were identified and reviewed by 2 fellowship-trained musculoskeletal radiologists. Data were collected on ACL tear type and location, as well as presence and location of bone bruises, meniscal tears, articular cartilage pathology, and concomitant ligament pathology. Mechanism data from video review were linked with imaging data to assess association between injury mechanism (contact vs noncontact) and presence of concomitant pathology.

Results:

Bone bruises were evident in 94.8% of ACL tears in this cohort, most often in the lateral tibial plateau (81%). Meniscal, additional ligamentous, and/or cartilage injury was present in 89% of these knees. Meniscal tears were present in 70% of knees, lateral (59%) more than medial (41%). Additional ligamentous injury was present in 71% of all MRI scans, more often a grade 1/2 sprain (67%) rather than a grade 3 tear (33%), and most often involving the medial collateral ligament (MCL) (57%) and least often the posterior cruciate ligament (10%). Chondral damage was evident in 49% of all MRI scans, with ≥1 full-thickness defect in 25% of all MRI scans, most often lateral. Most (79%) ACL tears did not involve direct contact to the injured lower extremity. Direct contact injuries (21%) were more likely to have a concomitant MCL tear and/or medial patellofemoral ligament injury and less likely to have a medial meniscal tear.

Conclusion:

ACL tears were rarely isolated injuries in this cohort of professional American football athletes. Bone bruises were almost always present, and additional meniscal, ligamentous, and chondral injuries were also common. MRI findings varied by injury mechanism.
Analysis of Trustworthiness and Readability of English and Spanish Hypo- and Hyperthyroid-Related Online Patient Education Information
Authors: Parikh Chitra , Ostrovsky Adam M
Published: June 2023

This study aims to determine the readability and trustworthiness of English and Spanish hypo- and hyperthyroid-related online information. Google searches were conducted for four search terms: hypothyroidism, Hashimoto's Disease, hyperthyroidism, and Graves’ Disease. For each search term, the first 10 websites were analyzed with a total of 40 websites analyzed. Readability formulas were used to determine English and Spanish readability. Trustworthiness was determined using HONcode status, JAMA Benchmark Criteria, and NLM Trustworthy Score. Overall readability largely exceeded recommended grade levels. Only 1 website (2.5%) presented information below the eighth-grade reading level based on overall Readability Consensus score, while 31 websites (77.5%) exceeded this threshold for all measures. The mean (SD) English readability grade level was 9.6 (3.44); the mean (SD) Spanish grade was 8.5 (4.58). No significant relationships were found between the JAMA Benchmark Criteria, NLM Trustworthy Score, HONcode status, and readability. 67.5% of websites analyzed (n = 27) were certified with the Health on the Net Foundation's code of conduct. Websites about common thyroid-related conditions have overall poor readability. The availability of resources for Spanish-speaking patients is also poor. Steps should be taken to ensure that online health-related materials are comprehensible. Physicians should recognize that patients may have few trustworthy and easy-to-understand sources to access information. The readability and trustworthiness of sources should be considered when providing patients suggested sources for further reading. It may be particularly helpful for physicians to utilize websites with favorable readability scores such as the American Thyroid Association website.
Unintended Pregnancy and Domestic Violence Among Pregnant Women in Regions of India: Evidence from Large Scale Survey Data
Authors: Raushan Rajesh
Published: June 2023

The study examined effect of domestic violence (DV) on pregnancy intendedness among pregnant women across geographical regions in India. Using fourth wave of National Family Health Survey data, the study is confined to experience of physical/sexual violence within 12 months preceding the survey. Close to 6% of the women were found pregnant with high in the central region. Among them, 12% were having unintended pregnancy (UIP), with highest in the central (17.4%) region. UIP found 7% higher among victims of DV compared to those who did not face it (11%). Significantly, regional variation is much persisting as the regions having high prevalence of DV are also at an increased risk of UIP which hampers the notion of dignified reproductive rights. This needs region-specific policy and programme. Study push for interventions on minimising DV and reducing burden of high UIP in regions of India.
Determinants of Discrimination in Access to Housing for Marginalised Social Groups in India
Authors: Mishra Vinod Kumar , Khan Khalid
Published: June 2023

Equal and non-discriminatory access to housing is imperative to ensure right to housing for all. Inter-group inequality in access to housing continues to persist in both rural and urban areas in India. Housing is the highest household expenditure for a majority of households. Marginalised social groups experience discrimination in access to housing: both rental and owned. Despite having affordability, equal access to housing is denied for marginalised social groups. This article attempts to understand the inter-group inequality in access to housing based on NSSO 76th round, 2018. The article also measures the role of discrimination in denial of equal access to housing for marginalised social groups based on the decomposition analysis. The results of the article indicate that apart from income and other economic variables, discrimination based on social group identity determines the access to quality of housing. In comparison to dominant social groups, scheduled caste and religious minority households have lower access to good quality of housing despite similar incomes.
Posterior Medial Meniscus Root Repair With Peripheral Stabilization Stitch
Authors: Liechti Daniel J. , Kennedy Nicholas , Kramer Riley , LaPrade Robert F.
Published: June 2023

Background:

Posteromedial meniscal root tears occur when the meniscal root detaches from the tibial plateau, which limits the native functionality of the meniscus, alters tibiofemoral contact forces, and can progress to meniscal extrusion. Untreated meniscal root tears with meniscal extrusion have been associated with significant articular cartilage loss and accelerated progression of osteoarthritis. Recent biomechanical evidence suggests restoring the contact area with the use of a peripheral stabilization suture at the posteromedial aspect of the tibial plateau.

Indications:

Meniscal root repair with a peripheral stabilization suture is indicated by clinical and radiographic evidence of complete detachment of the posteromedial meniscus root with significant meniscal extrusion outside the joint.

Technique Description:

This technique uses 2 tunnels for the meniscal root repair as well as a single additional transtibial tunnel for the peripheral stabilization suture. The described technique demonstrates a peripheral release along the meniscocapsular junction to allow the meniscus to be reapproximated to its anatomical attachment site. This is followed by transtibial tunnel preparation to allow suture passage for the meniscal root repair and an additional transtibial tunnel is created for the peripheral stabilization suture. After stabilization of the extruded meniscus, the suture is tied down over a cortical fixation device on the anteromedial tibia.

Results:

Significant improvement has been reported by clinical studies after the transtibial pullout repair method; however, structural outcomes have shown conflicting results. Kaplan et al reported patients treated with transtibial suture pullout technique with 2 locking cinch sutures had improved clinical outcomes, but increased extrusion of the medial meniscus compared with the preoperative state, whereas Kim et al reported a decrease in meniscal extrusion following pullout suture repair technique.

Discussion:

Posteromedial meniscus root repair using a peripheral stabilization suture is an effective surgical technique to restore the contact pressures of the knee and limit the amount of meniscal extrusion. This allows for appropriate correction of hoop stress to prevent further cartilage loss and progression of osteoarthritis.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Technological frontier, urban–rural frontier: Dracula urbanism in no man's land
Authors: Hudalah Delik
Published: June 2023

Extending Wilson & Wyly's concept of Dracula urbanism, I examine interactions between technological, social, and political forces in fueling global capitalists’ addiction to metropolitan expansion in urban-rural frontiers. This expansion contributes to fulfilling Lefebre's complete urbanization thesis at the planetary scale. To my understanding, building frontier technological enclaves and megaprojects on the urban-rural frontier of metropolises and megaregional intermediate places entails “destructive creation” rather than standard “creative destruction.” Crucial to their survival, global capital networks build parasitic relationships with incompetent governments. Wilson & Wyly's Dracula urbanism uses “accumulation by seduction” (and degeneration) strategies, rather than brute “accumulation by dispossession” strategies, to kill the underserved sections of the societies and jeopardize the state's capacities silently and slowly.
Metabolite profiling of susceptible and resistant wheat (Triticum aestivum) cultivars responding to Puccinia striiformis f. sp. tritici infection
Authors: Mashabela Manamele Dannies , Tugizimana Fidele , Steenkamp Paul Anton , Piater Lizelle Ann , Dubery Ian Augustus , Mhlongo Msizi Innocent
Published: June 2023

Background

Puccinia striiformisf. sp.tritici(Pst) is an economically devasting disease that is prominent in cereal crops such as wheat (Triticum aestivum). The fungal pathogen can cause approximately 30–70% losses in crop productivity and yields.Psthas become difficult to manage due to its ease of transmission through wind dispersal over long distances, and intercontinental dispersal has been previously reported. The ease of transmission has resulted in further destruction because of new and more virulent strains infecting crops previously resistant to a different strain.

Results

In this study, a liquid chromatography-mass spectrometry-based untargeted metabolomics approach, in combination with multivariate data analytical tools, was used to elucidate the mechanistic nature of the defence systems of aPst-resistant and a susceptible wheat cultivar infected withP. striiformis. We also investigated the time-dependant metabolic reconfiguration of infected plants over a four-week period. The untargeted metabolomic analysis revealed a time-course metabolic reprogramming involving phenylpropanoids (majority flavonoids), amino acids, lipids, benzoic acids, TCA cycle intermediates and benzoxazinoids responding toPstinfection. Interestingly, the results do not show a linear course for the decrease and increase (up-/down-regulation) of said classes of metabolites, but rather the up- or down-regulation of specific metabolites in response to the pathogen infection. The resistant Koonap cultivar had an abundance of phenolic compounds such as rutin, isoorintin-7-O-glucoside and luteolin-6-C-hexoside-O-hexoside. These compounds showed a decrease over time in control Koonap plants compared to an increase inPst-infected plants. These metabolites were down-regulated in the susceptible Gariep cultivar, which could serve as biomarkers for plant responses to biotic stress and resistance againstPst.

Conclusions

Overall, an LC-MS-based metabolomics approach allowed for the metabolic profiling and analysis of the impact of plant-pathogen interactions on the overall plant metabolome and provided a real-time snapshot of the differential significant metabolic perturbations occurring in wheat plants responding to thePstpathogen. ThePst-resistant Koonap cultivar showed a rapid accumulation of defence metabolites in response to pathogen infection compared to the susceptible Gariep cultivar. These findings provide insight into the mechanistic biochemical nature of plant-microbe interactions and the prospects of metabolic engineering for improved plant tolerance and resistance to biotic stresses.
Anesthesia management for pericardiectomy- a case series study
Authors: Shi Chunxia , Dong Chao , Yao Lan , Weiss Nicole , Liu Hong
Published: June 2023

Background

Constrictive pericarditis (CP) is an uncommon disease that limits both cardiac relaxation and contraction. Patients often present with right-sided heart failure as the pericardium thickens and impedes cardiac filling. Pericardiectomy is the treatment of choice for improving hemodynamics in CP patients; however, the procedure carries a high morbidity and mortality, and the anesthetic management can be challenging. Acute heart failure, bleeding and arrhythmias are all concerns postoperatively.

Methods

After IRB approval, we performed the retrospective analysis of 66 consecutive patients with CP who underwent pericardiectomy from July 2018 to May 2022.

Results

Most patients had significant preoperative comorbidities, including congestive hepatopathy (75.76%), New York Heart Association Type III/IV heart failure (59.09%) and atrial fibrillation (51.52%). Despite this, 75.76% of patients were extubated within the first 24 h and all but 2 of the patients survived to discharge (96.97%).

Conclusions

Anesthetic management, including a thorough understanding of the pathophysiology of CP, the use of advanced monitoring and transesophageal echocardiography (TEE) guidance, all played an important role in patient outcomes.
Scoring system for predicting 90-day mortality of in-hospital liver cirrhosis patients at Cipto Mangunkusumo Hospital
Authors: Hasan Irsan , Nababan Saut Horas Hatoguan , Handayu Anugrah Dwi , Aprilicia Gita , Gani Rino Alvani
Published: June 2023

Background

Liver cirrhosis is the final stage of chronic liver disease. Complications due to progression of liver disease may deteriorate the liver function and worsen prognosis. Previous studies have shown that patients with liver cirrhosis are at increased risk of death within 90-day after hospitalization. It is necessary to identify patients who are at higher risk of early mortality. This study aims to develop a scoring system to predict the 90-day mortality among hospitalized patients with liver cirrhosis that could be used for modification of treatment plan according to the scores that have been obtained. By using this scoring system, crucial care of plans can be taken to reduce the risk of mortality.

Method

This prospective cohort study was conducted on hospitalized cirrhotic patients at Cipto Mangunkusumo National General Hospital, Jakarta. Demographic, clinical, and laboratory data were recorded. Patients were monitored for up to 90-day after hospitalization to determine their condition. Cox regression analysis was performed to obtain predictor factors contributing to mortality in liver cirrhosis patients. The scoring system that resulted from this study categorized patients into low, moderate, and high-risk categories based on their predicted mortality rates. The sensitivity and specificity of the scoring system were evaluated using the AUC (area under the curve) metric.

Result

The study revealed that liver cirrhosis patients who were hospitalized had a 90-day mortality rate of 42.2%, with contributing factors including Child-Pugh, MELD, and leukocyte levels. The combination of these variables had a good discriminative value with an AUC of 0.921 (95% CI: 0.876–0.967). The scoring system resulted in three risk categories: low risk (score of 0–3) with a 4.1-18.4% probability of death, moderate risk (score of 5–6) with a 40.5-54.2% probability of death, and high risk (score of 8–11) with a 78.1-94.9% probability of death.

Conclusion

The scoring system has shown great accuracy in predicting 90-day mortality in hospitalized cirrhosis patients, making it a valuable tool for identifying the necessary care and interventions needed for these patients upon admission.
Case Management-based Collaborative Care Model Associated with improvement in neuropsychiatric outcomes in community-dwelling people living with dementia
Authors: Hung Yu-Hsuan , Wang Wen-Fu , Chang Ming-Che , Jhang Kai-Ming
Published: May 2023

Background

This study aimed to explore the association between adherence of collaborative care model and short-term deterioration of BPSD after controlling patient and caregiver factors.

Methods

This retrospective case–control study enrolled 276 participants who were newly diagnosed with dementia and BPSD. A dementia collaborative care team interviewed patients and caregivers to form a care plan and provided individualized education or social resource referrals. A multivariate logistic regression model with backward selection was used to test factors associated with BPSD deterioration, defined as worse neuropsychiatric inventory (NPI) scores 1 year after joining the care model.

Results

Male sex (odds ratio [OR] = 0.45; 95% confidence interval [CI] = 0.25–0.84) and higher clinical dementia rating scale sum of boxes scores (CDR-SOB) (OR = 0.90; 95% CI = 0.83–0.98) were protective factors, whereas spouse caregivers and withdrawals from the care model (OR = 3.42; 95% CI = 1.28–9.15) were risk factors for BPSD deterioration.

Conclusions

Our study showed that both patient and caregiver factors were associated with deterioration of BPSD. The case manager-centered dementia collaborative care model is beneficial for the management of BPSD. Healthcare systems may consider implementing a case management model in clinical dementia care practice.
Identification of triple-negative breast cancer and androgen receptor expression based on histogram and texture analysis of dynamic contrast-enhanced MRI
Authors: Xu Wen-juan , Zheng Bing-jie , Lu Jun , Liu Si-yun , Li Hai-liang
Published: June 2023

Background

Triple-negative breast cancer (TNBC) is highly malignant and has a poor prognosis due to the lack of effective therapeutic targets. Androgen receptor (AR) has been investigated as a possible therapeutic target. This study quantitatively assessed intratumor heterogeneity by histogram analysis of pharmacokinetic parameters and texture analysis on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to discriminate TNBC from non-triple-negative breast cancer (non-TNBC) and to identify AR expression in TNBC.

Methods

This retrospective study included 99 patients with histopathologically proven breast cancer (TNBC: 36, non-TNBC: 63) who underwent breast DCE-MRI before surgery. The pharmacokinetic parameters of DCE-MRI (Ktrans, Kepand Ve) and their corresponding texture parameters were calculated. The independent t-test, or Mann-Whitney U-test was used to compare quantitative parameters between TNBC and non-TNBC groups, and AR-positive (AR+) and AR-negative (AR-) TNBC groups. The parameters with significant difference between two groups were further involved in logistic regression analysis to build a prediction model for TNBC. The ROC analysis was conducted on each independent parameter and the TNBC predicting model for evaluating the discrimination performance. The area under the ROC curve (AUC), sensitivity and specificity were derived.

Results

The binary logistic regression analysis revealed that Kep_Range(p = 0.032) and Ve_SumVariance(p = 0.005) were significantly higher in TNBC than in non-TNBC. The AUC of the combined model for identifying TNBC was 0.735 (p < 0.001) with a cut-off value of 0.268, and its sensitivity and specificity were 88.89% and 52.38%, respectively. The value of Kep_Compactness2(p = 0.049), Kep_SphericalDisproportion(p = 0.049), and Ve_GlcmEntropy(p = 0.008) were higher in AR + TNBC group than in AR-TNBC group.

Conclusion

Histogram and texture analysis of breast lesions on DCE-MRI showed potential to identify TNBC, and the specific features can be possible predictors of AR expression, enhancing the ability to individualize the treatment of patients with TNBC.
Effect of leukoaraiosis on collateral circulation in acute ischemic stroke treated with endovascular therapy: a meta-analysis
Authors: Chen Wang , Qin Yijie , Yang Shuna , Yang Lei , Hou Yutong , Hu Wenli
Published: June 2023

Background and objective

The recruitment of collateral circulation correlates with a balance of the microvasculature. Uncertainty remains to be made about the association of leukoaraiosis with leptomeningeal collaterals. To explore the effect of leukoaraiosis on leptomeningeal collaterals in patients treated with endovascular therapy.

Methods

Observational studies exploring the correlation between leukoaraiosis and leptomeningeal collaterals in large vessel occlusion treated with endovascular therapy were searched from PubMed, EMBASE, and Cochrane Libraries databases. Two independent reviewers retrieved eligible literature, extracted purpose-related data, and utilized the Newcastle–Ottawa Scale to evaluate the risk of bias. A Mantel–Haenszel method was used to calculate the odds ratio (OR). Meta-regression and subgroup analyses were conducted to clarify heterogeneity.

Results

Data from 10 studies with 1606 patients were extracted for pooled analysis. Compared to non-severe leukoaraiosis, patients with severe leukoaraiosis showed significant relevance to poor leptomeningeal collaterals (OR, 2.13; 95% confidence interval [1.27–3.57]; P = 0.004). Meta-regression indicated that sample size (coefficient = -0.007299, P = 0.035) and the number of female patients (coefficient = -0.0174709, P = 0.020) were sources of heterogeneity. Furthermore, all of the countries (USA versus France versus China, Q = 3.67, P = 0.159), various assessment scales of leukoaraiosis (the Fazekas scale versus Non-Fazekas scales, Q = 0.77, P = 0.379), and different imaging methods of leukoaraiosis (computed tomography versus magnetic resonance imaging, Q = 2.12, P = 0.146) and leptomeningeal collaterals (computed tomography angiography versus digital subtraction angiography, Q = 1.21, P = 0.271) showed no contribution to the effect size.

Conclusion

Severe leukoaraiosis is associated with poor leptomeningeal collaterals in patients treated with endovascular therapy. Further studies may focus on whether the finding applies to different stroke subtypes.