bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of protein supplementation and pasture maintenance on the growth, parasite burden, and economic return of pasture-raised lambs
Authors: Campbell Braden J , Marsh Antoinette E , Parker Elizabeth M , McCutcheon Jefferson S , Fluharty Francis L , Parker Anthony J
Published: June 2021

The objective of this experiment was to evaluate the impact of protein supplementation and pasture contamination with gastrointestinal nematodes on the mitigation of parasitic infection in grazing lambs. We hypothesized that there would be no difference between protein supplementation and newly sown pasture in evaluating lamb growth and health parameters associated with parasitism. Furthermore, we questioned if there would be an interaction between protein supplementation and pasture type. A total of 192, 60-d-old lambs (28.3 ± 5.1 kg) were randomly assigned to one of four treatments: 1) new pasture without supplementation (NN); 2) new pasture with supplementation (NS); 3) established pasture without supplementation (EN); and 4) established pasture with supplementation (ES) and grazed for 112 d. Lambs were supplemented at a rate of 1% body weight/d. Supplemented lambs had greater body weight (BW) and average daily gain (ADG) when compared with non-supplemented lambs (P < 0.04). Additionally, lambs on newly sown pasture demonstrated greater BW and ADG when compared with lambs grazing on established pasture (P < 0.05). For lamb health, lambs in the EN treatment group had the greatest FAMACHA eye scores and lowest packed cell volume (PCV) over the course of the 112-d grazing period (P < 0.05). Moreover, NS and ES treatment lambs demonstrated similar FAMACHA eye scores when compared with NN treatment lambs; however, NN treatment lambs showed lower PCV when compared with NS and ES treatment lambs (P < 0.05). In evaluating fecal egg counts (FEC), lambs on new pasture or given supplement demonstrated lesser FEC when compared with those lambs on established pasture or not given supplement (P < 0.05). Sixty-four lambs were harvested to evaluate total abomasum nematode counts which demonstrated that Haemonchus contortus represented approximately 80% of total nematodes. Furthermore, based upon gross margin analysis, lambs given a protein rich supplement on pasture had a 9.3 kg increase in lamb BW whereas newly sown pasture had a 1.3 kg increase in lamb BW. A protein rich supplement given to lambs grazing pastures contaminated primarily with H. contortus or placing lambs on newly sown pasture increases lamb BW and improves parasite resiliency. Selection of parasite management strategies may be influenced by cost of production and market opportunities.
Wealth Inequality in South Africa, 1993–2017
Authors: Chatterjee Aroop , Czajka Léo , Gethin Amory
Published: June 2021

This article estimates the distribution of personal wealth in South Africa by combining microdata covering the universe of income tax returns, household surveys, and macroeconomic balance sheet statistics. South Africa is characterized by unparalleled levels of wealth concentration. The top 10 percent own 86 percent of aggregate wealth and the top 0.1 percent close to one-third. The top 0.01 percent of the distribution (3,500 individuals) concentrate 15 percent of household net worth, more than the bottom 90 percent as a whole. Such levels of inequality can be accounted for in all forms of assets at the top end, including housing, pension funds, and financial assets. There has been no sign of decreasing inequality since the end of apartheid.
Surgical Outcomes of Human Immunodeficiency Virus–positive Patients Undergoing Lumbar Degenerative Surgery
Authors: Varshneya Kunal , Wadhwa Harsh , Ho Allen L. , Medress Zachary A. , Stienen Martin N. , Desai Atman , Ratliff John K. , Veeravagu Anand
Published: June 2021

Study Design:

This was a retrospective cohort studying using a national administrative database.

Objective:

The objective of this study was to determine the postoperative complications and quality outcomes of the human immunodeficiency virus (HIV)-positive patients undergoing surgical management for lumbar degenerative disease (LDD).

Methods:

This study identified patients with who underwent surgery for LDD between 2007 and 2016. Patients were stratified based on whether they were HIV positive at the time of surgery. Multivariate regression was utilized to reduce the confounding of baseline covariates. Patients who underwent 3 or more levels of surgical correction were under the age of 18 years, or those with any prior history of trauma or tumor were excluded from this study. Baseline comorbidities, postoperative complication rates, and reoperation rates were determined.

Results:

A total of 120,167 patients underwent primary lumbar degenerative surgery, of which 309 (0.26%) were HIV positive. In multivariate regression analysis, the HIV-positive cohort was more likely to be readmitted at 30 days [odds ratio (OR)=1.9, 95% confidence interval (CI): 1.2–2.8], 60 days (OR=1.7, 95% CI: 1.2–2.5), and 90 days (OR=1.5, 95% CI: 1.0–2.2). The HIV-positive cohort was also more likely to experience any postoperative complication (OR=1.7, 95% CI: 1.2–2.3). Of the major drivers identified, HIV-positive patients had significantly greater odds of cerebrovascular disease and postoperative neurological complications (OR=3.8, 95% CI: 1.8–6.9) and acute kidney injury (OR=3.4, 95% CI: 1.3–7.1). Costs of index hospitalization were not significantly different between the 2 cohorts ($30,056 vs. $29,720, P=0.6853). The total costs were also similar throughout the 2-year follow-up period.

Conclusion:

Patients who are HIV positive at the time of LDD surgery are at a higher risk for postoperative central nervous system and renal complications and unplanned readmissions.
Outcome Measures of Medicare Patients With Diabetes Mellitus Undergoing Thoracolumbar Deformity Surgery
Authors: Varshneya Kunal , Bhattacharjya Anika , Sharma Jigyasa , Stienen Martin N. , Medress Zachary A. , Ratliff John K. , Veeravagu Anand
Published: June 2021

Study Design:

This was a retrospective study.

Objective:

The objective of this study was to identify the impact of diabetes on postoperative outcomes in Medicare patients undergoing adult spinal deformity (ASD) surgery.

Methods:

We queried the MarketScan Medicare database to identify patients who underwent ASD surgery from 2007 to 2016. Patients were then stratified based on diabetes status at the time of the index operation. Patients not enrolled in the Medicare dataset and those with any prior history of trauma or tumor were excluded from this study.

Results:

A total of 2564 patients met the inclusion criteria of this study, of which n=746 (29.1.%) were diabetic. Patients with diabetes had a higher rate of postoperative infection than nondiabetic patients (3.1% vs. 1.7%, P<0.05) within 90 days. Renal complications were also more elevated in the diabetic cohort (3.2% vs. 1.3%, P<0.05). Readmission rates were significantly higher in the diabetes cohort through of 60 days (15.2% vs. 11.8%, P<0.05) and 90 days (17.0% vs. 13.4%, P<0.05). When looking specifically at the outpatient payments, patients with diabetes did have a higher financial burden at 60 days ($8147 vs. $6956, P<0.05) and 90 days ($10,126 vs. $8376, P<0.05).

Conclusions:

In this study, diabetic patients who underwent ASD surgery had elevated rates of postoperative infection, outpatient costs, and rates of readmissions within 90 days. Further research should investigate the role of poor glycemic control on spine surgery outcomes.
Aidi injection combined with chemotherapy in the treatment of cancer patients: a systematic review of systematic reviews and meta-analyses
Authors: Zhao Dehua , Long Xiaoqing , Chen Jing , Wang Jisheng
Published: June 2021

The objective of the study was to evaluate and summarize the evidence from systematic reviews and meta-analyses regarding the efficacy and safety of Aidi injection combined with chemotherapy in the treatment of cancer patients. PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Chong qing VIP databases, and Wanfang databases were searched for systematic reviews/meta-analyses on the topic of Aidi treating cancer patients published from inception to 20 December 2020. Google Scholar and OpenGrey were searched for grey literature and International Prospective Register of Systematic Reviews for ongoing reviews. Two investigators independently selected eligible studies, extracted data, and assessed the methodological quality of included systematic reviews/meta-analyses using the measurement tool to assess systematic reviews 2 (AMSTAR-2) tool, and the strength of evidence was assessed with the grade of recommendation, assessment, development, and evaluation (GRADE) system. Twenty-seven systematic reviews/meta-analyses were identified in the study. The methodological quality of all 27 systematic reviews/meta-analyses were critically low when evaluated by AMSTAR-2, and the evidence quality of all outcomes rated as either low or very low based on the GRADE system. The available evidence is currently insufficient to support or refute the use of Aidi in the treatment of cancer patients, thus high-quality trials with large sample sizes are needed to explore its efficacy and safety in cancer patients.
Characteristics of U.S. Acute Care Hospitals That Have Implemented Telemedicine Critical Care
Authors: Ofoma Uchenna R. , Maddox Thomas M. , Perera Chamila , Waken R. J. , Drewry Anne M. , Liu Lei , Boyle Walter , Kollef Marin , Joynt Maddox Karen E.
Published: June 2021

OBJECTIVES:

Telemedicine critical care is associated with improved efficiency, quality, and cost-effectiveness. As of 2010, fewer than 5% of U.S. hospitals had telemedicine critical care, and fewer than 10% of ICU beds were covered. We evaluated recent telemedicine critical care implementation and bed coverage rates in the United States and compared characteristics of hospitals with and without telemedicine critical care.

DESIGN:

Cross-sectional study of 2018 American Hospital Association Annual Survey Database.

SETTING:

U.S. hospitals.

PATIENTS:

None.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

We obtained data regarding telemedicine critical care implementation, ICU capability (defined as ≥ 1 ICU bed), other hospital characteristics, and the Herfindahl-Hirschman Index, a measure of ICU market competition based on hospital referral regions. Among 4,396 hospitals (response rate 71%), 788 (17.9%) had telemedicine critical care, providing potential coverage to 27,624 (28% of total) ICU beds. Among 306 hospital referral regions, 197 (64%) had a respondent hospital with telemedicine critical care. Telemedicine critical care implementation was associated with being a nonprofit (odds ratio, 7.75; 95% CI, 5.18–11.58) or public (odds ratio, 4.16 [2.57–6.73]) compared with for-profit hospital; membership in a health system (odds ratio, 3.83 [2.89–5.08]; stroke telemedicine presence (odds ratio, 6.87 [5.35–8.81]); ICU capability (odds ratio, 1.68 [1.25–2.26]); and more competitive ICU markets (odds ratio per 1,000-point decrease in Herfindahl-Hirschman Index 1.11 [1.01–1.22]). Notably, rural critical access hospitals had lower odds of telemedicine critical care implementation (odds ratio, 0.49 [0.34–0.70]). Teaching status, geographic region, and rurality were not associated with telemedicine critical care implementation.

CONCLUSIONS:

About one fifth of respondent hospitals had telemedicine critical care by 2018, providing potential coverage of nearly one third of reported ICU beds. This represents a substantial increase in telemedicine critical care implementation over the last decade. Future expansion to include more rural hospitals that could benefit most may be aided by addressing hospital financial and market barriers to telemedicine critical care implementation.
Lung Abscess in Critically Ill Coronavirus Disease 2019 Patients With Ventilator-Associated Pneumonia: A French Monocenter Retrospective Study
Authors: Beaucoté Victor , Plantefève Gaëtan , Tirolien Jo-Anna , Desaint Paul , Fraissé Megan , Contou Damien
Published: June 2021

The pulmonary vascular endothelialitis together with the high rate of distal pulmonary embolism or thrombosis extensively reported in critically ill coronavirus disease 2019 patients may impair antibiotic diffusion in the lung parenchyma of coronavirus disease 2019 patients with ventilator-associated pneumonia leading to insufficient antibiotic concentration, thus promoting lung abscess formation. We report that 17 of 119 coronavirus disease 2019 patients (14%) with ventilator-associated pneumonia developed a lung abscess. Proportion of patients receiving corticosteroids did not differ between patients with and without lung abscess. Most of lung abscess were polymicrobial. Enterobacteriaceae, Pseudomonas aeruginosa, and Staphylococcus aureus were the leading causative bacteria. Most of lung abscesses involved the right lower lobe. Three patients had concomitant pulmonary embolism or thrombosis in the territory of lung abscess. Lung abscess was retrospectively visible on chest radiograph in 29% of the patients. As the occurrence of lung abscess impacts the duration of antibiotics therapy, chest CT scan should be easily performed in case of treatment failure of ventilator-associated pneumonia despite adequate antimicrobial therapy.
The association between diabetes and gastric cancer: results from the Stomach Cancer Pooling Project Consortium
Authors: Dabo Bashir , Pelucchi Claudio , Rota Matteo , Jain Harshonnati , Bertuccio Paola , Bonzi Rossella , Palli Domenico , Ferraroni Monica , Zhang Zuo-Feng , Sanchez-Anguiano Aurora , Thi-Hai Pham Yen , Thi-Du Tran Chi , Gia Pham Anh , Yu Guo-Pei , Nguyen Tin C. , Muscat Joshua , Tsugane Shoichiro , Hidaka Akihisa , Hamada Gerson S. , Zaridze David , Maximovitch Dmitry , Kogevinas Manolis , Fernàndez de Larrea Nerea , Boccia Stefania , Pastorino Roberta , Kurtz Robert C. , Lagiou Areti , Lagiou Pagona , Vioque Jesus , Camargo M. Constanza , Paula Curado Maria , Lunet Nuno , Boffetta Paolo , Negri Eva , La Vecchia Carlo , Luu Hung N.
Published: June 2021

Background

Prior epidemiologic studies on the association between diabetes and gastric cancer risk provided inconclusive findings, while traditional, aggregate data meta-analyses were characterized by high between-study heterogeneity.

Objective

To investigate the association between type 2 diabetes and gastric cancer using data from the ‘Stomach Cancer Pooling (StoP) Project’, an international consortium of more than 30 case–control and nested case–control studies, which is large and provides harmonized definition of participants’ characteristics across individual studies. The data have the potential to minimize between-study heterogeneity and provide greater statistical power for subgroup analysis.

Methods

We included 5592 gastric cancer cases and 12 477 controls from 14 studies from Europe, Asia, North America, and South America in a two-stage individual-participant data meta-analysis. Random-effect models were used to estimate summary odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) by pooling study-specific ORs.

Results

We did not find an overall association between diabetes and gastric cancer (pooled OR = 1.01, 95% CI, 0.94–1.07). However, the risk of cardia gastric cancer was significantly higher among individuals with type 2 diabetes (OR = 1.16, 95% CI, 1.02–1.33). There was no association between diabetes and gastric cancer risk in strata of Helicobacter pylori infection serostatus, age, sex, BMI, smoking status, alcohol consumption, fruit/vegetable intake, gastric cancer histologic type, and source of controls.

Conclusion

This study provides additional evidence that diabetes is unrelated to gastric cancer overall but may be associated with excess cardia gastric cancer risk.
Statin Initiation and Risk of Amyotrophic Lateral Sclerosis
Authors: Skajaa Nils , Bakos Istvan , Horváth-Puhó Erzsébet , Henderson Victor W. , Lash Timothy L. , Sørensen Henrik Toft
Published: June 2021

Background:

The evidence of an association between statins and amyotrophic lateral sclerosis (ALS) is heterogeneous and inconclusive.

Methods:

We performed a population-based cohort study consisting of 974,304 statin initiators ≥40 years of age and 1,948,606 matched general population comparators identified from Danish, nationwide registries (1996–2016). We computed incidence rates and hazard ratios (HRs) of a first-time hospital-based diagnosis of ALS. HRs were controlled for sex, birth year, calendar year, medically diagnosed comorbidities, and concomitant medications.

Results:

During a median follow-up of 7.7 years, 852 ALS events occurred among statin initiators (11.3 [95% confidence interval (CI) = 10.6, 12.1] events per 100,000 person-years) and 1,679 among noninitiators (11.4 [95% CI = 10.9, 12.0] events per 100,000 person years). The overall adjusted HR indicated a slight association between statin initiation and ALS (1.11 [95% CI = 1.00, 1.23]. In the first year after initiation, the HR was 1.40 (95% CI = 1.09, 1.79) for both sexes combined, 1.00 (95% CI = 0.70, 1.42) for men, and 1.92 (95% CI = 1.30, 2.82) for women. The associations diminished to approximately null after the first year of follow-up for both sexes combined and for men, but point estimates were above 1 for women until 10 years after initiation.

Conclusions:

Statin initiation was largely unassociated with ALS diagnosis but was associated with an elevated risk of ALS in women, especially in the first year after initiation. The association could be explained by reverse causation, detection bias, early neurotoxic effects of statins that affect women more than men, or a combination thereof.
Validation of a Claims-based Algorithm to Identify Pregestational Diabetes Among Pregnant Women in the United States
Authors: Wood Mollie E. , Chen Szu-Ta , Huybrechts Krista F. , Bateman Brian T. , Gray Kathryn J. , Seely Ellen W. , Zhu Yanmin , Mogun Helen , Patorno Elisabetta , Hernández-Díaz Sonia
Published: June 2021

Background:

Identifying pregestational diabetes in pregnant women using administrative claims databases is important for studies of the safety of antidiabetic treatment in pregnancy, but limited data are available on the validity of case-identifying algorithms. The purpose of this study was to evaluate the validity of an administrative claims-based algorithm to identify pregestational diabetes.

Methods:

Using a cohort of pregnant women nested within the Medicaid Analytic Extract (MAX) database, we developed an algorithm to identify pregestational type 1 and type 2 diabetes, distinct from gestational diabetes. Within a single large healthcare system in the Boston area, we identified women who delivered an infant between 2000 and 2010 and were covered by Medicaid, and linked their electronic health records to their Medicaid claims within MAX. Medical records were reviewed by two physicians blinded to the algorithm classification to confirm or rule out pregestational diabetes, with disagreements resolved by discussion. We calculated positive predictive values with 95% confidence intervals using the medical record as the reference standard.

Results:

We identified 49 pregnancies classified by the claims-based algorithm as pregestational diabetes that were linked to the electronic health records and had records available for review. The PPV for any pregestational diabetes was 92% [95% confidence interval (CI) 82%, 97%], type 2 diabetes 87% (68%, 95%), and type 1 diabetes 57% (37%, 75%).

Conclusions:

The claims-based algorithm for pregestational diabetes and type 2 diabetes performed well; however, the PPV was low for type 1 diabetes.
Hypophysitis from immune checkpoint inhibitors: challenges in diagnosis and management
Authors: Kotwal Anupam
Published: June 2021

Purpose of review

This review will summarize the most recent and pertinent evidence regarding immune checkpoint inhibitor (ICI)-induced hypophysitis to describe diagnostic and management algorithm with the help of a case report.

Recent findings

Hypophysitis is the most common endocrine adverse event from CTLA-4 inhibitors and much less with PD-1/PD-L1 inhibitors. Its pathophysiology appears to be lymphocytic, predominantly affecting the anterior pituitary. The utility of high-dose glucocorticoids for treatment has been questioned, as they do not influence recovery of hypopituitarism and may reduce survival. A survival benefit with hypophysitis has been suggested.

The nonspecific nature of symptoms underlies the importance of clinical and hormonal monitoring especially in the first 6 months of CTLA-4 inhibitor cancer therapy. Adrenal insufficiency can be a diagnostic and management challenge, which persists in most cases; hence, a multidisciplinary team of oncologists and endocrinologists is essential for providing high-quality care to these patients. High-dose glucocorticoids should be reserved for mass effect or optic chiasm impingement. The ICI may need to be temporarily withheld but not discontinued. A survival advantage in cancer patients that develop ICI-induced hypophysitis may be a silver lining, especially as ICIs are being investigated for advanced endocrine malignancies.
Insulin Concentration in Human Milk in the First Ten Days Postpartum
Authors: Mank Elise , van Toledo Letty , Heijboer Annemieke C. , van den Akker Chris H.P. , van Goudoever Johannes B.
Published: June 2021

Background & objectives:

Human milk (HM) is better tolerated than formula in preterm infants. Insulin, which is naturally present in HM but not in formula, has been suggested as a key factor for feeding tolerance, as it appears to stimulate intestinal maturation. Its precise concentrations during the early postnatal period, however, remains unknown. The objective of this study was to assess the natural timecourse of the HM insulin concentration during the first ten days postpartum. The effect of preterm delivery, maternal obesity, and diurnal rhythm were also assessed.

Method:

HM was collected from 31 non‐diabetic mothers (21 preterm [gestational age (GA) < 37 weeks]; 10 at‐term [GA ≥ 37 weeks]) on ≥ 4 time‐points per day during the first five days, and once on the tenth day postpartum.

Results:

The HM insulin concentration declined rapidly within the first three days postpartum (day 1: 516 [312–1058] pmol/L; day 3: 157 [87–299] pmol/L), after which the concentration remained relatively stable. The insulin concentrations were higher in HM from obese mothers than from non‐obese mothers (P < 0.001). Preterm delivery did not significantly affect HM insulin concentrations when adjusted for maternal pre‐pregnancy body mass index category (P = 0.270). Diurnal rhythm was characterized by an insulin concentration decline throughout the night (P = 0.001), followed by an increase in the morning (P = 0.001).

Conclusion:

The HM insulin concentration declines rapidly in the first three days postpartum, follows a diurnal rhythm, and is higher in obese mothers compared to non‐obese mothers. HM insulin concentrations are not affected by preterm delivery.
Extrauterine Mesonephric-like Neoplasms
Authors: Deolet Ellen , Arora Iteeka , Van Dorpe Jo , Van der Meulen Joni , Desai Sudha , Van Roy Nadine , Kaur Baljeet , Van de Vijver Koen , McCluggage W. Glenn
Published: June 2021

Mesonephric-like adenocarcinomas (MLA) are rare neoplasms arising in the uterine corpus and ovary which have been added to the recent 2020 World Health Organization Classification of Female Genital Tumors. They have similar morphology and immunophenotype and exhibit molecular aberrations similar to cervical mesonephric adenocarcinomas. It is debated as to whether they are of mesonephric or Mullerian origin. We describe the clinical, pathologic, immunohistochemical, and molecular features of 5 cases of extrauterine mesonephric-like proliferations (4 ovary, 1 extraovarian), all with novel and hitherto unreported features. These include an origin of MLA in extraovarian endometriosis, an association of ovarian MLA with high-grade serous carcinoma, mixed germ cell tumor and mature teratoma, and a borderline ovarian endometrioid tumor exhibiting mesonephric differentiation. Four of the cases exhibited a KRAS variant and 3 also a PIK3CA variant. In reporting these cases, we expand on the published tumor types associated with MLA and report for the first time a borderline tumor exhibiting mesonephric differentiation. We show the value of molecular testing in helping to confirm a mesonephric-like lesion and in determining the relationship between the different neoplastic components. We provide further evidence for a Mullerian origin, rather than a true mesonephric origin, in some of these cases. We also speculate that in the 2 cases associated with germ cell neoplasms, the MLA arose out of the germ cell tumor.
Radiation-Induced Meningioma in a Case of Medulloblastoma Treated 11 Years Ago—Detected on 68Ga-DOTANOC PET/CT
Authors: Dev Indraja D. , Puranik Ameya D. , Rangarajan Venkatesh , Gupta Tejpal , Purandare Nilendu C. , Agrawal Archi , Shah Sneha
Published: June 2021

Medulloblastomas, especially the sonic hedgehog subgroup, are treated aggressively with surgery and chemoradiotherapy, as they are associated with high local site recurrence rate and poor overall survival. Radiation-induced meningioma is the most common delayed complication of craniospinal irradiation. This needs to be differentiated from meningeal or ependymal metastases as the later need aggressive management. We report one such rare case, in a patient who completed treatment for medulloblastoma 11 years ago, was in remission, and now presented with dural-based lesions.
An Innovation of Postsurgical Nasal Retainer in a Unilateral Cleft Lip and Palate Patient
Authors: Phannarus Krisadi , Jaijakul Siraya
Published: June 2021

Postoperative nasal asymmetry is a notable problem following primary cleft lip repair and cleft rhinoplasty in patients with unilateral cleft lip and palate. Postsurgical nasal retainer could play an essential role in maintaining the corrected position of the nose during the healing process. However, the manufactured retainers are usually not affordable, nor individualized. The authors report the efficacy of our custom-made postoperative nasal retainer, made from an oxygen nasal cannula, acrylic resin, and orthodontic wire made of stainless steel, in a patient with complete unilateral cleft lip and palate.
A Distinct Technique of Intermaxillary Fixation Screw Application to Condylar Process to Fracture Reduction in Open Approach of Condylar Fracture Treatment
Authors: Yildiz Kemalettin , Yeniocak Ali , Ergün Selma Sönmez , Canter Halil Ibrahim
Published: June 2021

The aim of this letter is to present the surgical experience obtained from a patient, in whom the proximal segment was better manipulated for precise alignment after application of the intermaxillary fixation screw.
Mini-Incision Eyelidplasty in Single Eye to Correct Congenital Upper Eyelid Crease Asymmetry
Authors: Ninghua Liu , Aijuan He , Dan Wu , Nan Song
Published: June 2021

Objective:

This study aims to evaluate the clinical effect of mini-incision double eyelidplasty in single eye for correcting congenital upper eyelid crease asymmetry.

Methods:

Mini-incision double eyelidplasty was performed on 24 patients in single eye to treat congenital upper eyelid crease asymmetry between May 2016 and September 2018. The postoperative surgical results were classified as “excellent,” “fair,” and “poor.” The subjective satisfaction and incidence of complications were documented.

Results:

The mean patient age at the time of surgery was 24.6 ± 3.1 years (21–28 years), and the mean follow-up time was 15.4 ± 8.7 (12–34 months). All patients showed “excellent” surgical outcomes according to symmetry of upper eyelid creases. All patients are “very satisfied” with the cosmetic outcomes. There were no cases of recurrence or other complications.

Conclusions:

Mini-incision double eyelidplasty method in single eye was effective and endurable in the treatment of congenital upper eyelid crease asymmetry. The recovery rate was fast, and no cases of upper eyelid crease disappearance were observed in this study.
Trends in Surgical Patents Held by Surgeons From 1993 to 2018
Authors: Slatnick Brianna L. , Truche Paul , Wu Kyle C. , Crum Robert , Yang Alexander , Durgin Jonathan , Kim Heung Bae , Demehri Farokh R.
Published: June 2021

Objective:

This study aims to quantify the number of patent-holding surgeons and determine their specialty demographics.

Summary Background Data:

The number of intellectual property filings related to surgery has exponentially increased over the past 40 years, yet surgeon inventor status among these inventions remains poorly defined.

Methods:

A query of the United States Patent and Trademark Office (USPTO) Patent Full-Text and Image Database was performed over the years 1993 to 2018. Patents related to surgery were defined as surgical devices, implantables, dressings, introducers, and sterilization equipment based on Cooperative Patent Classification (CPC) code. Inventor names were cross-indexed with names of active Fellows in the American College of Surgeons (FACS) as of 2019. Surgeon inventors were identified and differences between specialty and sex were evaluated.

Results:

A total of 275,260 patents related to surgery were issued over the study period. The number of surgical patents has increased by 462% from 4593 per year to 21,241 per year. A total of 9008 patents were held by a total of 2164 surgeons (4% of FACS). This represents 3.3% of all surgical patents with a mean of 5 patents (range 1–346) per patent-holding surgeon. Specialties with the largest number of patent holders include neurosurgery (9%) and orthopedic surgery (8%). Ninety-seven percent of patent-holding surgeons were male.

Conclusions:

3.3% of patents related to surgery involve a surgeon inventor, and although the number of surgical patents has shown an exponential increase, surgeon involvement in these inventions has grown minimally. Surgical innovation training may offer an opportunity to reduce these discrepancies and increase surgeon involvement as patent holders.
SARS-CoV-2 During Abdominal Operations: Are Surgeons at Risk?
Authors: Romero-Velez Gustavo , Rodriguez Quintero Jorge H. , Pereira Xavier , Nussbaum Jeffrey E. , McAuliffe John C.
Published: June 2021

Background:

The safety of surgery in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients remains unclear. On the basis of data from other viral diseases, it has been assumed that coronavirus disease 2019 (COVID-19) has the potential risk of transmission during surgery. The presence of the virus within the peritoneal fluid and the peritoneal tissues is not known.

Materials and Methods:

This is a prospective cross-sectional study including adult patients with confirmed COVID-19 who underwent surgery at a single institution. Using specific real-time reverse transcriptase-polymerase chain reaction, the presence of SARS-CoV-2 was determined in abdominal fluid samples.

Results:

Six patients with COVID-19 underwent abdominal surgery. Five patients were asymptomatic, and 1 had severe disease. SARS-CoV-2 was tested in 20 different samples, all of which resulted negative.

Conclusions:

SARS-CoV-2 was not found in the peritoneal cavity of 6 patients undergoing abdominal surgery. The risk of transmissibility of COVID-19 during surgery is still unclear.
Succinylcholine is Equally Efficient as Rocuronium Bromide in terms of Major Adverse Cardiac Events (MACE)During Off Pump Coronary Artery Bypass Surgery: A Single Centre Study
Authors: Mudgalkar Nikhil , kandi venkata ramana
Published: June 2021

Introduction

Rapid and safe endotracheal intubation is of paramount importance in the general anaesthesia practices. Safety of such practices while performing surgical procedures in people with critical coronary lesions assumes increased significance.The use of succinylcholine and rocuronium are common but the association with the application of these medications and concomitant haemodynamic changes on major adverse cardiac events (MACE) has not been adequately studied. The aim of this study is to assess the safety and efficacy of succinylcholine in comparison with rocuronium for MACE in cardiac surgical population.

Methods

Retrospective analysis of data collected from administrative and surgical databases of a tertiary care centre. The patients were divided in two groups,wherein the Group A constituted patients who belonged to succinylcholine and Group B represents the patients who were treated with rocuronium.The baseline demographic characteristics, MACE including intubation difficulty score and Cormack Lahne grade of intubation were recorded.

Results

A total of 134 patients were included in the study. Baseline characters were similar in both the groups. There were 2 deaths in the succinylcholine group while 3 in the rocuronium group. The MACE was not statistically significant (p= 0.0505) in both groups. Cormack Lahane scale and intubation difficulty scale were similar in both groups.

Conclusion

Succinylcholine was found to be equally efficient and safe in comparison with rocuronium in terms of MACE during coronary artery bypass surgery.
Community Organizing for Indigenous People in the Philippines: A Proposed Approach
Authors: Bamba Jailah , Candelario Cristela , Gabuya Rosarie , Manongdo Lhearnie
Published: June 2021

Cognizant of the special needs of indigenous people in the Philippines, the Republic Act No. 8371 of 1997 was established to promote and protect their rights. Over the years, a number of community organizing efforts for the improvement of these communities were conducted by stakeholders from the private and public sectors. However, resistance has been reported due to poor understanding and integration of these indigenous populations’ varied cultures and traditions. This study aims to describe the predominant principles and frameworks used for community organizing among indigenous people. Specifically, it seeks to propose a community organizing approach that is culturally sensitive and appropriate for indigenous communities in geographically isolated and disadvantaged areas in the Philippines. A systematic review was conducted on four databases (PubMed, ScienceDirect, ResearchGate, Google Scholar) by four independent researchers. Inclusion criteria involved studies about community organizing protocols in the Philippines, published in peer-reviewed journals from 2010-2020, and written in the English language. Assessment of the quality of included studies was done using the Critical Appraisal Skills Program (CASP) checklist, and narrative synthesis was employed to summarize and report the findings. Thirteen studies met our inclusion criteria out of a total of fifty-five articles searched. Based on the evidence, our proposed approach builds on Groundwork, Indigenous Capacity Building, Community Participation and Ownership, Mobilization, and Sustainability. We highlight the emphasis of harnessing indigenous knowledge and Participatory Monitoring and Evaluation to involve them in all steps of the planning and decision-making processes. Furthermore, we distill tools and methodologies that could strengthen and precipitate successful community organizing endeavors.
Phosphorus and sulfur SAD phasing of the nucleic acid-bound DNA-binding domain of interferon regulatory factor 4
Authors: Agnarelli Alessandro , El Omari Kamel , Duman Ramona , Wagner Armin , Mancini Erika J.
Published: June 2021

Pivotal to the regulation of key cellular processes such as the transcription, replication and repair of DNA, DNA-binding proteins play vital roles in all aspects of genetic activity. The determination of high-quality structures of DNA-binding proteins, particularly those in complexes with DNA, provides crucial insights into the understanding of these processes. The presence in such complexes of phosphate-rich oligonucleotides offers the choice of a rapid method for the routine solution of DNA-binding proteins through the use of long-wavelength beamlines such as I23 at Diamond Light Source. This article reports the use of native intrinsic phosphorus and sulfur single-wavelength anomalous dispersion methods to solve the complex of the DNA-binding domain (DBD) of interferon regulatory factor 4 (IRF4) bound to its interferon-stimulated response element (ISRE). The structure unexpectedly shows three molecules of the IRF4 DBD bound to one ISRE. The sole reliance on native intrinsic anomalous scattering elements that belong to DNA–protein complexes renders the method of general applicability to a large number of such protein complexes that cannot be solved by molecular replacement or by other phasing methods.
Crystal structure of human brain-type fatty acid-binding protein FABP7 complexed with palmitic acid
Authors: Nam Ki Hyun
Published: June 2021

The brain-type fatty acid-binding protein FABP7, which is expressed in astrocytes and neural progenitors, is a member of the intracellular lipid-binding protein family. This protein is not only involved in various cellular functions such as metabolism, inflammation and energy homeostasis, but also in diseases such as cognitive disorders and tumors. Structures of unsaturated fatty acids, such as oleic acid (OA) and docosahexaenoic acid (DHA), bound to FABP7 have been elucidated; however, structures of saturated fatty acids bound to FABP7 remain unknown. To better understand fatty acid recognition, here the crystal structure of human brain-type fatty acid-binding protein FABP7 complexed with palmitic acid (PA), a saturated fatty acid, is reported at a resolution of 1.6 Å. The PA bound to the fatty acid-binding pocket of FABP7 assumed a U-shaped conformation. The carboxylate moiety of PA interacted with Tyr129, Arg127 and, via a water bridge, with Arg107 and Thr54, whereas its aliphatic chain was stabilized by hydrophobic interactions with Met21, Leu24, Thr30, Thr37, Pro39, Phe58 and Asp77. Structural comparison showed that PA, OA and DHA exhibited unique binding conformations in the fatty acid-binding pocket, stabilized by distinct amino-acid interactions. The binding of PA to FABP7 exhibits a unique binding conformation when compared with other human FABPs (FABP3–FABP5 and FABP8) expressed in other tissues. Based on the crystal and fatty acid structures, it was suggested that PA, which prefers a linear form in nature, required a greater conformational change in its aliphatic chain to bind to the fatty acid-binding pocket in a U-shaped conformation, compared with the cis configurations of OA or DHA. This, together with the length of the aliphatic chain, was considered to be one of the factors determining the binding affinity of PA to FABP7. These results provide a better understanding of fatty acid recognition by FABP7 and expand the knowledge of the binding of PA to FABPs.
Functional food consumption among older consumers in Malaysia: a Health Belief Model perspective
Authors: Febian Flaviana Ivy , Syed Annuar Sharifah Nurafizah , Memon Mumtaz Ali
Published: June 2021

Purpose

Functional foods and their association with health benefits and disease risk reduction open a promising possibility for consumers to pursue a healthier lifestyle and extend their life expectancy. This study aims to investigate the effect of perceived susceptibility, perceived barriers and intention to consume functional food among older consumers.

Design/methodology/approach

Data were collected from Malaysian older consumers using a structured questionnaire. A total of 250 usable questionnaires were used for final data analysis. Partial least squares structural equation modeling (PLS-SEM) was used to analyze the collected data.

Findings

The results show that perceived barriers and cue to action significantly affect older consumers' intention to consume functional foods. Nevertheless, perceived susceptibility does not influence older consumers' intention to consume functional food.

Originality/value

This study broadens our understanding of older consumers' intention to consume functional food. Importantly, the present study is one of the first studies that extend the application of the Health Belief Model (HBM) in the context of functional food consumption. The findings of the study provide pragmatic insights for both practitioners and researchers.
Oil revenue and agriculture value-added in oil-exporting countries: does the role of real exchange rate matter?
Authors: Abdlaziz Rizgar Abdlkarim , Naseem N.A.M. , Slesman Ly
Published: June 2021

Purpose

This study aims to investigate the contingent roles real effective exchange rates (REERs) play in mediating the effects of oil revenue on the agriculture sector value-added in 25 major and minor oil-exporting (MIOEC) countries during the period of 1975–2014.

Design/methodology/approach

The panel autoregressive distributed lag (ARDL) estimator proposed by Pesaran et al. (1999) was relied upon to achieve the objectives of the study. This estimator involves a pool of small cross-sectional units over a long-time span that covers for 25 oil-exporting countries over 39 years (1975–2014).

Findings

This paper reveals the following findings. Firstly, oil revenue has a direct negative effect on agricultural value-added in the short- and long-term. This finding holds for full sample and subsamples of major oil-exporting (MAOEC) and MIOEC countries. Further assessment reveals that the magnitude of the impact is larger for MAOEC than that of the MIOEC. Secondly, the finding for the long-run effect shows that the contingent effect of real exchange rate on the nexus between oil revenue and agricultural value-added is negative and statistically significant at the conventional level for the full sample. This suggests that, in the long-run, the appreciation in real exchange rates exacerbate the negative marginal effects of oil revenue on agricultural value-added in all oil-exporting countries. However, when sub-samples of MAOEC and MIOEC are considered, the contingent effect disappeared (become insignificant) in MAOEC while it is positive and statistically significant in MIOEC. Thus, in the long-run, the appreciation in real exchange rates diminishes the negative marginal effects of oil revenue on agricultural value-added in MIOEC. While oil revenue has a direct negative effect, its effect is also moderated by the variations in REERs in MIOEC in the long-run. Finally, in the short-run, fluctuations in the real exchange rate do not matter for the nexus of oil revenue and agriculture sector in these countries whether minor or MAOEC countries.

Originality/value

This study contributes to the debate in the empirical literature on the Dutch disease effect and “oil curse”. Using the appropriate panel ARDL empirical framework, it provides evidence on how exchange rate variations in the oil-exporting countries influence the nature of the effects of the oil revenue on agricultural sectors in the long-run but not in the short-run. Contingent effects of REERs only appear to exist in MIOEC in the long-run.
“It's not as simple as something like sugar”: values and conflict in the UK meat tax debate
Authors: Simmonds Philippa , Vallgårda Signild
Published: June 2021

Purpose

This paper qualitatively explores arguments in the UK meat tax debate, including how they align with values from specific political ideologies and perspectives on sustainable food security.

Design/methodology/approach

The authors conducted a scoping media analysis of articles published over 1 year in six leading UK newspapers, followed by semi-structured interviews with ten key stakeholders in late 2019. The authors identified categories of arguments, distilled the core conflicts and analysed how arguments reflected different ideas about human nature, the role of the state and solutions to food system challenges.

Findings

Arguments were categorised into five major topics: climate change and environment; human health; effects on animals; fairness; and acceptability of government intervention. Pro-meat tax arguments often aligned with modern liberal ideology, and sometimes echoed demand restraint or food system transformation perspectives on sustainable food security. Arguments against meat taxes were more likely to align with the efficiency perspective or classical liberal ideology.

Originality/value

To the authors’ knowledge, this is one of the first interpretive analyses of this controversial suggested policy. Despite having similarities with other debates around taxation – particularly taxes on sugar sweetened beverages – the meat tax debate contains unique complexities due to the prominence of environmental arguments, and differing values pertaining to animal welfare and rights. This study highlights the need for policy research exploring values, in addition to quantitative evidence.
Financial sustainability in Malaysian public universities: coping with or embracing change?
Authors: Mamat Suaniza , Nik Ahmad Nik Nazli , Mohd Said Julia
Published: June 2021

Purpose

This paper explores the institutionalisation of a financial sustainability agenda in Malaysian public universities.

Design/methodology/approach

The study uses semi-structured interviews and document analysis. New Institutional Sociology and the institutional logics perspective are utilised to frame the study and explain findings.

Findings

The findings reveal that universities manage the conflicting academic and financial logics to co-exist to ensure legitimacy and survival. By compartmentalising the functions of key divisions and through loose coupling, universities are able to support dual logics.

Research limitations/implications

The paper provides university management and policy makers with insights into how leading universities in Malaysia cope with a financial sustainability agenda.

Originality/value

The present study documents how universities cope with and respond to government reforms and budgetary cuts in the context of a developing country, Malaysia. Most prior research in the area focuses on individual or organisational responses. This paper examines organisational-level responses but goes deeper to understand how universities, through three key divisions; bursaries, corporate strategy divisions and faculties manage to enable the multiple logics to co-exist through compartmentalisation and loose coupling.
A deep neural network based context-aware smart epidemic surveillance in smart cities
Authors: Gill Harsuminder Kaur , Sehgal Vivek Kumar , Verma Anil Kumar
Published: June 2021

Purpose

Epidemics not only affect the public health but also are a threat to a nation's growth and economy as well. Early prediction of epidemic can be beneficial to take preventive measures and to reduce the impact of epidemic in an area.

Design/methodology/approach

A deep neural network (DNN) based context aware smart epidemic system has been proposed to prevent and monitor epidemic spread in a geographical area. Various neural networks (NNs) have been used: LSTM, RNN, BPNN to detect the level of disease, direction of spread of disease in a geographical area and marking the high-risk areas. Multiple DNNs collect and process various data points and these DNNs are decided based on type of data points. Output of one DNN is used by another DNN to reach to final prediction.

Findings

The experimental evaluation of the proposed framework achieved the accuracy of 87% for the synthetic dataset generated for Zika epidemic in Brazil in 2016.

Originality/value

The proposed framework is designed in a way that every data point is carefully processed and contributes to the final decision. These multiple DNNs will act as a single DNN for the end user.