bluuebunny/crossref_metadata_2025 huggingface dataset:
Exercise and Coping Mechanisms in Graduate Occupational Therapy Students During the COVID-19 Pandemic and Civil Unrest Period: A Descriptive Study
Authors: Hamed Razan , Duval Carla , Adrian Arianna , Almonte Stephanie , Carroll Michael , Gayle Jhannel , Kalik Jordan , Kashanian Yehuda , Patel Mehavi , Piskin Julie , Quintin Danver
Published: April 2023

Objective: The COVID-19 pandemic and the sociopolitical climate in the United States have imposed additional stress and anxiety for graduate students. We explored the stress level in graduate occupational therapy students, the role of exercise in reducing stress, and common coping mechanisms applied to manage academic and sociopolitical stress. Methods: A survey was created and distributed to graduate occupational therapy students in the U.S. Results: Most participants reported moderate to high levels of academic-related stress (n = 73, 97.33%), and more than half reported moderate levels of anger and frustration because of academic-related stress (n = 43, 57.33%). Half of the participants reported that they engage in physical exercise as a coping mechanism for academic stress (n = 38, 50.67%), and most participants thought that kickboxing would help reduce stress (n = 48, 64.00%) and reduce anger and frustration (n = 56, 74.67%). Conclusion: the well-being of graduate students over the past two years has increased after the COVID-19 pandemic and the sociopolitical tension in the U.S. Future research is needed to determine how this stress may affect graduation and employment outcomes and recommendations for burnout and suicide prevention.
L-kurtosis-based optimal wavelet filtering and its application to fault diagnosis of rolling element bearings
Authors: Ming Anbo , Zhang Wei , Fu Chao , Yang Yongfeng , Chu Fulei , Liu Yajuan
Published: April 2023

Repetitive transients are a key symptom for the occurrence of incipient fault of rolling element bearings. Therefore, an optimal wavelet filtering method is developed by maximizing the L-kurtosis through the genetic algorithm to extract the weak repetitive transients buried in the heavy noise and disturbed by the outliers. First, the capability of L-kurtosis for characterizing the impulsiveness and cyclostationary of repetitive transients is numerically studied at different degrees of noise. Then, the center frequency and band width of morlet wave filter are adaptively determined by the genetic algorithm and the maximization of L-kurtosis. Finally, both simulation and experiments are performed to validate the efficacy of the proposed method. Results show that the proposed method is more powerful and reliable than the other commonly used indexes-based optimal wavelet filtering methods.
Sexual Assault Labels, Compassion for Others, Self-Compassion, and Victim Blaming
Authors: Williamson Jessica
Published: April 2023

Two studies examined whether label preferences (survivor, victim, neither/other/both) and past assault experience (assaulted or not assaulted) are related to compassion for others, self-compassion, rape myth acceptance, and cognitive distortions surrounding rape. Findings indicate that a preference for a victim label is related to more negative outcomes (e.g., propensity to victim-blame, less compassion for others) compared to those advocating for a survivor label or falling into a neither/other/both category. Furthermore, those who experienced sexual assault have significantly lower self-compassion compared to those who do not experience sexual assault. Implications for the impact of labels are discussed.
Extended physicochemical stability of cetuximab in opened vials and infusion bags when stored at 4°C and 25°C
Authors: Vieillard Victoire , Le Guyader Guillaume , Jallades Alice , Astier Alain
Published: April 2023

Introduction

This study aimed to determine the stability of cetuximab: (1) under “in-use” conditions after dilution to 1 mg/mL in 0.9% sodium chloride in polyolefin bags and (2) as an undiluted solution (5 mg/mL) repackaged in polypropylene bags or kept in the vial after opening.

Methods

Ready-to-use 500 mg/100 mL vials of cetuximab solution were diluted to 1 mg/mL in 100 mL bags of 0.9% sodium chloride or repackaged as a 5 mg/mL solution into empty 100 mL bags. Bags and vials were stored at 4°C for 90 days and 25°C for 3 days. A syringe sample of 7 mL was taken from each bag for the initial determinations. The sampled bags were weighed to determine their initial weight and placed under the planned storage conditions. The physicochemical stability of cetuximab was estimated using validated methods.

Results

No changes in turbidity, no protein loss, and no changes in cetuximab tertiary structure were observed after 30 days of storage or when subjected to a temperature excursion of 3 days at 25°C and when stored at 4°C for up to 90 days, regardless of the concentrations and batches. The colligative parameters did not change under any of the tested conditions. No evidence of microbial growth was found in bags after 90 days of storage at 4°C.

Conclusion

These results support the extended in-use shelf-life of cetuximab vials and bags, which can be cost-effective for healthcare providers.
Learning From Consumers of Mandated Sex-Offending Programs: “It’s Not Treatment, I Wish It Was.”
Authors: Levenson Jill S. , Grady Melissa D. , Lasoski Heike , Collins Kyle T.
Published: April 2023

The purpose of this qualitative study was to explore clients’ perceptions of sex-offending treatment. The sample included 291 people required to register as sex offenders in the U.S. who answered an open-ended question in an online survey asking them to describe their positive and negative experiences in mandated treatment. Using qualitative analysis, three overarching themes (with several subthemes) were identified: (1) positive and (2) negative treatment experiences and (3) the affiliation between the criminal justice system and clinical services. Experiences in sex offending treatment were viewed as positive when clients had opportunities to learn about themselves, experience group cohesion, build a positive alliance with a caring therapist, learn tools and skills for emotional health, explore the roots of offense behavior, and create healthy life plans to reduce risk for re-offending. Negative themes emerged when treatments were viewed as coercive, confrontational, or demeaning; when therapists seemed inexperienced or unqualified; and when seemingly outdated or unscientific methods were emphasized without explanation or dialogue. The entanglement between court-mandated treatment providers and the criminal justice system led to concerns about confidentiality, conflicts of interest, and role ambiguity. Drawing upon literature related to therapeutic alliance, trauma-informed care, and Risk-Need-Responsivity models, we offer suggestions for integrating client feedback to improve treatment responsivity and prevent re-offending.
The Covariates of Children and Teen Firearm Homicide
Authors: Pelletier Karissa
Published: April 2023

Firearm-related deaths were the second leading cause of death in 2020 among U.S. children and teens. Despite this, recent scoping reviews have highlighted the limited knowledge surrounding the impact of risk factors for firearm homicide victimization for these groups. I examine correlates for children and teen firearm victimization. I examine two research questions: What are the significant individual and situational variables for firearm homicide among children and teens? How do the individual and situational covariates of firearm homicide differ for children relative to teens? Findings demonstrate differences at the individual and situational levels.
Bending response and failure characteristics of nomex honeycomb sandwich with continuous composite facesheet encasement
Authors: Ren Jianwei , Zhou Yilai , Gao Wenbo
Published: April 2023

In conventional sandwich construction, the core component is typically made of Nomex honeycomb and sandwiched between two facesheets, a lower and an upper facesheet. To enhance the load-bearing capacity of this Nomex honeycomb core sandwich (NHCS) construction, we propose a NHCS construction that is continuously encased by a composite fabric facesheet on all four sides. We experimentally and numerically examine the bending response of this encased NHCS construction through a three-point bending test. We consider and discuss the effect of the orientation of the honeycomb core component and the formation of the facesheet separately to reveal the mechanism by which the composite facesheet encasing enhances the construction. Our results demonstrate that composite facesheet encasing significantly improves the bending response of the NHCS construction, with a much greater advantage than the increase in mass compared to conventional sandwich construction. The superiority of the encased composite facesheet is significantly influenced by the orientation of the honeycomb cell and the direction of the fiber ply-stacked laminate facesheet. In addition, we compare the bending response of the encased honeycomb sandwich construction with that of competing sandwiches and show that the proposed sandwich with a continuously encased composite facesheet has a superior lightweight advantage.
Assessing the Impact of Indiana Public Law 194 on Curbing the Concurrent Opioid Prescribing for Indiana Medicaid Enrollees
Authors: Vivas-Valencia Carolina , Adams Nicole , Griffin Paul , Kong Nan
Published: April 2023

Background:

Several US states have introduced legislation to support the legitimate medical use of opioids while limiting misuse and diversion. One concern which has been addressed through legislation is preventing individuals from seeking opioid prescriptions concurrently from multiple providers. However, the impact of this legislation on the incidence of patients receiving concurrent prescriptions remains relatively unexplored. This study examines this phenomenon based on claims data from Medicaid enrollees and the enactment of legislation in Indiana.

Methods:

Indiana Medicaid claims data over the period of January 2014 to December 2019 were used to determine the changes in the percentage of individuals receiving opioid prescriptions from multiple providers within a 30-day period, that is, concurrent opioid prescription (COP) individuals. Indiana Medicaid enrollees with a diagnosis of opioid use disorder (OUD) receiving opioid prescriptions, that is, the OUD-group, were identified and separated from the enrollees without a diagnosis but receiving opioid prescriptions, that is, the non-OUD group. The mean percentages of COP individuals (with or without an OUD diagnosis) within the subset of individuals that received opioid prescriptions were compared before and after the passage of Indiana Public Law 194.

Results:

There were 5336 who met the criteria of COP individuals, and 2050 of those were in the OUD-group. In either group, there was a significant difference in the change in percentages (slope) before and after Indiana Public Law 194 passed. In addition, there was a significant decrease in the mean percentage of COP individuals in the non-OUD group, while the difference was not significant in the OUD group.

Conclusion:

Our study suggests that Indiana Public Law 194 had a positive impact on curbing COP. This study is limited by the level of details available from claims data and suggests additional studies to evaluate prescription use and prescribing practices are warranted.
Tissue Factor and Vascular Endothelial Growth Factor in Detecting Thromboembolic Complications in Diabetic Atherosclerotic Patients
Authors: Bozkaya Tijen Alkan , Ateş Şanser , Üstündağ Ünsal Veli , Çakıcı Çağrı , Keskin İlknur , Yiğit Pakize , Yiğitbaşı Ahmet , Emekli Nesrin
Published: April 2023

Background

Atherosclerosis, which is one of the leading causes of death all over the world, can create major or minor thromboembolic complications with the exponentially increasing diabetic status. Despite all the studies, the mechanism by which endothelial damage in atherosclerosis is triggered in diabetic setting is still not fully understood.

Methods

In this study, tissue factor (TF), which is thought to act together in the formation of vasular endothelial growth factor (VEGF-A) and coagulopathy in diabetic atherosclerotic patients, may be an important indicator in this regard, a total of 100 cases who were undergone off-pump coronary artery bypass (OPCAB) which were at same risk group examined by dividing into diabetic status. Early postoperative process and biochemical parameters analyzed in terms of TF and VEGF-A levels measured before and after the operation.

Results

TF and VEGF-A expression of the T1DM group were statistically high compared to non-diabetics. Significantly longer hospital stays with changes in TF and VEGF-A were found in patients in the diabetic group compared to pre- and postoperatively, respectively; TF (95% CI: 0.879–0.992; p = 0.025), VEGF-A (95% CI: 0.964–0.991; p = 0.001) and hospital stay (95% CI: 1.96–7.49; p = 0.0001). Preoperatively measured carotid intima-media thickness (CT) was higher in diabetics and was significantly associated with atrial fibrillation (AF), (r = 0.873). Surgical team and protocols were same and OPCAB procedures were routinely applied to all patients in our clinic. No minor or major events were observed in any of the cases.

Conclusion

TF and VEGF-A values in patients with diabetic atherosclerosis may be important in the early detection of thromboembolic complications.
Analysis of healthcare workers’ mental health during the COVID-19 pandemic: Evidence from a three-wave longitudinal study
Authors: Perego Gaia , Cugnata Federica , Brombin Chiara , Milano Francesca , Mazzetti Martina , Taranto Paola , Preti Emanuele , Di Pierro Rossella , De Panfilis Chiara , Madeddu Fabio , Di Mattei Valentina E
Published: April 2023

The “Healthcare workers’ wellbeing [Benessere Operatori]” project is an exploratory longitudinal study assessing healthcare workers’ mental health at three different time points over a 14-month period during the COVID-19 pandemic. We collected socio-demographic and work-related information and assessed the perceived social support, coping strategies, and levels of depression, anxiety, insomnia, anger, burnout, and PTSD symptoms. In total, 325 Italian healthcare workers (i.e. physicians, nurses, other healthcare workers, and clerks) participated in the first initial survey and either the second or third subsequent survey. Participants reported subclinical levels of psychiatric symptoms that remained mostly unchanged across time, except for an increase in stress, depression, state anger, and emotional exhaustion symptoms. Despite subclinical levels, healthcare workers’ distress can adversely affect the quality of care, patient satisfaction, and medical error rates. Therefore, implementing interventions to improve healthcare workers’ wellbeing is required.
Optical study of knocking phenomenon in a spark-ignition engine by using high-speed OH* chemiluminescence imaging: A multiple ignition sites approach
Authors: Uddeen Kalim , Shi Hao , Tang Qinglong , Magnotti Gaetano , Turner James
Published: April 2023

Knock in a spark-ignition (SI) engine is a complicated combustion phenomenon that stimulates high-pressure oscillations inside the combustion chamber and restricts engine performance. This study presents a high-speed OH* chemiluminescence imaging technique to investigate the knock mechanism resulting from firing multiple spark plugs. The experiment was performed using a customized liner having three spark plugs installed at equal spacing, and to compare the results with conventional SI conditions, in which one spark plug was mounted at the center of the cylinder head. In addition, multiple pressure transducers were used at various locations to record the frequencies induced by the pressure oscillations inside the cylinder during knocking events. The results showed that firing a single central spark plug generated mild knock with late combustion phasing and lower power output. However, adding more spark plugs could advance the initiation of autoignition and produce higher knock intensity along with lower combustion duration for the same operating conditions. Additionally, a weak OH* chemiluminescence intensity oscillation was monitored before the autoignition of the unburned charge occurred. The crank angle location of peak OH* intensity and peak HRR showed a good linear curve fit with a positive slope. Furthermore, the larger amount of unburned mass fraction produced stronger pressure waves due to multiple autoignition sites, and the unburned mass fraction exhibited a good linear relationship with unburned temperature and end-gas area at the knock onset point. Moreover, the frequency spectrum recorded by the multiple pressure sensors illustrated that in the case of a single central spark plug only circumferential acoustic waves were formed with low power intensity. However, multiple ignition sites promoted both circumferential and radial pressure waves inside the combustion chamber because of multiple autoignitions occurring both near the center and cylinder wall.
Effects of piston crown designs on in-cylinder flow and mixture formation in gasoline direct injection engine under the lean burn condition
Authors: Kim Jisoo , Shin Jisoo , Kim Donghwan , Son Yousang , Park Sungwook
Published: April 2023

In this study, the effects of piston shapes on in-cylinder flow characteristics and mixture formation in the lean condition was analyzed using the PIV method and CFD (CONVERGE v2.4). The four-piston geometries were concave, flat, convex, and base pistons, and the pistons were mounted on a GDI engine with transparent quartz. To quantify in-cylinder flow characteristics, the mean velocity, tumble ratio, turbulent kinetic energy, and tumble center were calculated. In addition, to analyze the effects of the difference in piston shapes in detail, the velocity fraction was calculated by dividing the cylinder area into three. In-cylinder flow was compared for the case without injection and the case with injection. There were four timed injections at C.A. 420°, 480°, 540°, and 600°, and the mixture characteristics were investigated in the cases of 480° and 600° injection. In the intake process and early compression process, there was no significant difference in the quantitative values for the shape of the piston regardless of the presence or absence of injection. However, the effects of the piston crown designs increased in the later compression process. As a result, the highest turbulent kinetic energy was found using a flat piston with a relatively high tumble ratio and swirl ratio in the absence of injection. The mixture formation was similar for all piston crown designs when injected at the crank angle of 480°. However, when the crank angle of 600° was injected, a stagnant fuel area was formed using the base-type piston, so it was difficult to secure sufficient fuel near the center of the cylinder.
“Those Who Would Have Drifted Off Somewhere…” promoting social advancement with new learning cultures in retail
Authors: Raemy Patric , Widmer Lona , Barabasch Antje
Published: April 2023

This study’s goal was to explore how new learning cultures might capture the many new needs of the retail industry sector and how apprentices can be trained for future work. Due to the inductive nature of this study, we found a rather implicit but important role of vocational education and training in retail that promotes the social advancement of apprentices with diverse social backgrounds. The narratives of 45 interviews with various actors involved in workplace training in one of the largest Swiss retail company revealed (1) how low-threshold and equitable access to training enables participatory engagement and self-determined success, (2) how trainers identify with social roles that are not explicitly required but are relevant for apprentices, and (3) how apprentices are given many opportunities during and after training to increase their social status. The study also revealed hindering factors such as the time and effort for the implementation of a new learning culture that affects all actors involved in workplace training. Second, are resistant negative social reproduction cycles and the heterogeneity of social backgrounds among the apprentices. Bridging this gap is simultaneously a goal and challenge for workplace training.
Prognostic Model and Nomogram for Early-Onset Adenoid Cystic Carcinoma of Head and Neck: A Retrospective SEER-Based Analysis
Authors: Dai Li , Zhang Shi-zhou , Wu Yi-hua
Published: April 2023

Background

Adenoid cystic carcinoma of head and neck (ACCHN) is an uncommon head and neck cancers, whose predilection age is 40 to 60. Some studies have revealed that early-onset cancers, such as colorectal cancers and esophageal adenocarcinoma, might present some unique clinicopathological features and have different prognosis with late-onset ones. However, little is known about the early-onset ACCHN. This study aimed to develop a prognostic nomogram for overall survival (OS) of patients younger than 40 with ACCHN.

Methods

Cases with ACCHN from 1975 to 2016 were retrieved from SEER-18 program. Demographic, clinical, and survival outcomes data of patients were identified for further analysis. The caret package was used to randomly divide early-onset patients into a training cohort and a validation cohort. A prognostic nomogram was constructed based on the univariate and multivariate Cox analysis. The discriminative ability and calibration power of the nomogram was evaluated by the concordance index (C-index), calibration curve, and receiver operating characteristic (ROC) curve.

Results

A total of 5858 cases with ACCHN were selectively retrieved from SEER program in this study. The number of patients younger than 40, which was defined as early-onset ACCHN in this study, was 825. Based on the outcomes of multivariate analysis, tumor size, chemotherapy, surgery, and stage were selected for the construction of nomogram to predict 10-year OS. The C-index was 0.792 (95%CI 0.760-0.823) and 0.776 (95%CI 0.720-0.832) in the training and validation set, respectively. The area under the ROC curve values were 0.875 (95%CI 0.810-0.940) and 0.833(95%CI 0.754-0.912). The calibration plot indicated that this nomogram had proper calibration in both the training and validation cohorts.

Conclusion

A novel prognostic nomogram for early-onset ACCHN was constructed and validated in this study. This nomogram could be applied for assisting clinicians to more accurately assess the prognosis of young patients, which might facilitate clinical decision-making and subsequent follow-up.
The Regulatory Mechanism and Research Progress of Ferroptosis in Gastric Cancer
Authors: Zhang Zaibo , Wang Bingyu , Liu Wenbo , Tan Bibo
Published: April 2023

Ferroptosis is a novel cell death modality discovered in recent years that is different from apoptosis and necrosis. It is usually associated with changes in the regulatory signaling in multiple organelles and depends on iron. It is caused by an imbalance between the generation and degradation of intracellular lipid reactive oxygen species (ROS). In addition to increased levels of cytoplasmic ROS and lipids, decreased mitochondrial volume and thickened mitochondrial membranes are markers of ferroptotic death. Gastric cancer is a common malignant tumor, but few studies on the possible role of ferroptosis in gastric cancer have been reported. Although ferroptosis is involved in multifactor-induced carcinogenesis, studies have also shown the role of ferroptosis in the selective killing of tumor cells, thereby inhibiting tumor progression and metastasis. In this paper, the definition, characteristics, and regulatory mechanism of ferroptosis and its potential role in gastric cancer are discussed. Therefore, this review is expected to provide a reference for the treatment of diseases based on ferroptosis and provide a direction for future research on the pathogenesis and development of gastric cancer and the development of anticancer drugs.
Antibodies Against Epstein–Barr Virus as Disease Markers of Gastric Cancer: A Systematic Review
Authors: Fontes-Lemus José I. , Zhao Isaac , Rabkin Charles S. , Fuentes-Pananá Ezequiel M.
Published: April 2023

Introduction: Gastric cancer is the fourth deadliest cancer worldwide. Due to the lack of specific early symptoms and noninvasive methods for early detection, the prognosis of gastric cancer patients is poor. Gastric cancer has a well-recognized infectious etiology, with Helicobacter pylori and Epstein–Barr Virus being the main associated infectious agents. Although other Epstein–Barr Virus-associated malignancies often manifest with abnormal levels of anti-Epstein–Barr Virus antibodies, it is not clear whether this is also true for gastric cancer. Potentially, these antibodies could serve as a noninvasive tool for gastric cancer screening or as markers for gastric cancer risk and provide a better understanding of the participation of Epstein–Barr Virus in the development of this neoplasm. Methods: We conducted a systematic review of articles analyzing anti-Epstein–Barr Virus serology in gastric cancer and precursor lesions following PRISMA guidelines. Patients were classified according to the Correa cascade of gastric lesions and whether they were positive or negative by EBER- in situ hybridization (Epstein–Barr Virus-associated gastric cancer and Epstein–Barr Virus-nonassociated gastric cancer, respectively). Results: We retrieved 16 articles involving 9735 subjects from 12 different countries and 4 databases, PubMed, SciELO, Scopus, and Google Scholar. Higher antibody titers were observed not only in Epstein–Barr Virus-associated gastric cancer than in Epstein–Barr Virus-nonassociated gastric cancer but also in Epstein–Barr Virus-nonassociated gastric cancer and gastric cancer–precursor lesions when compared with patients with mild dyspepsia or healthy controls. In all cases, the associations were predominantly with antibodies directed against lytic cycle antigens. Conclusion: Data support the role of Epstein–Barr Virus lytic reactivation in the development of advanced gastric lesions. However, more studies are needed to confirm these associations, particularly the association with lesions considered negative by EBER- in situ hybridization, and to establish a set of antibodies and thresholds indicative of enhanced risk to develop these lesions.
All-shot Aspirations in Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) Are Associated With Malignancy
Authors: Sun Xuefeng , Zhang Ting , Shao Chi , Wang Ping , Chen Minjiang , Zhao Jing , Wang Mengzhao
Published: April 2023

Background: Aspirations without a tissue core are common in endobronchial ultrasound-guided transbronchial needle aspiration procedures. However, the diagnostic value of all-shot aspirations and no-tissue-core aspirations is unclear. Patients and Methods: A retrospective analysis of patients who underwent endobronchial ultrasound-guided transbronchial needle aspiration with the description of all-shot or no-tissue-core aspirations was conducted at a tertiary hospital between January 2017 and March 2021. Patients’ pathologic and clinical diagnoses were retrieved and compared between all-shot patients (all aspirations had a tissue core) and no-tissue-core patients (at least one aspiration had no tissue core). Results: Among all 505 patients with 1402 aspirations, 356 (70.5%) patients, and 1184 (84.5%) aspirations were all-shot. Pathologic diagnosis after endobronchial ultrasound-guided transbronchial needle aspiration revealed neoplasms in 46.1% of all-shot patients, but 33.6% of no-tissue-core patients (odds ratio, 1.69; 95% confidence interval, 1.14-2.52; P = .009). Final clinical diagnosis revealed malignancy in 53.1% of all-shot patients, but 37.6% of no-tissue-core patients (odds ratio, 1.88; 95% confidence interval, 1.27-2.78; P = .001). In 133 patients with pathologic nonspecific findings, a clinical diagnosis of malignancy was proven in 25 of 79 (31.6%) of all-shot patients, but only 6 of 54 (11.1%) of no-tissue-core patients (odds ratio, 3.70; 95% confidence interval, 1.40-9.79; P = .006). Conclusions: Patients with all-shot aspirations in endobronchial ultrasound-guided transbronchial needle aspiration are more likely to have the pathologic and clinical diagnosis of malignancy. More measures should be taken to exclude malignancy in all-shot patients when the endobronchial ultrasound-guided transbronchial needle aspiration was nondiagnostic.
Threshold of Main Pancreatic Duct Diameter in Identifying Malignant Intraductal Papillary Mucinous Neoplasm by Magnetic Resonance Imaging
Authors: Zhang Huifeng , Cao Yingying , Ren Shuai , Guo Kai , Zhang Yaping , Lin Tingting , Wang Yaohui , Chen Xiao , Wang Zhongqiu
Published: April 2023

Objective: Intraductal papillary mucinous neoplasm (IPMN) is a rare pancreatic lesion. The identification of malignancy is critical for the establishment of treatment strategies. Main pancreatic duct (MPD) diameter is one critical feature for malignant IPMNs. However, the threshold of 1.0 cm is challenged. In this study, we explored independent risk factors and further calculated the threshold of MPD in identifying malignant IPMNs. Method: A total of 151 IPMN patients were included in this retrospective study. Demographic information, clinicopathological features, laboratory testing, and preoperative radiological characteristics by magnetic resonance imaging were collected. The receiver operating characteristic (ROC) curves were performed to determine the MPD diameter's cutoff levels and evaluate the predicted factors' diagnostic ability. Results: A cutoff value of 0.77 cm MPD (an area under the curve (AUC) = 0.746) in all IPMNs and 0.82 cm (AUC = 0.742) in the main duct involved IPMNs was obtained. MPD diameter (odds ratio (OR), 12.67; 95% confidence interval (CI), 4.80–33.48) and the mural nodule (OR, 12.98; 95% CI, 3.18–52.97) were the independent associated factors with high-risk IPMNs. The combined model with MPD and mural nodule showed a better predictive performance than mural nodule or MPD diameter alone (AUC = 0.803 vs 0.619, 0.746). A nomogram was developed and showed good performance (C index = 0.803). Conclusion: Our data show that mural nodule and MPD diameter are independent risk factors in identifying malignant intraductal papillary mucinous neoplasms. A cutoff value of 0.77 cm of MPD diameter may be a threshold value in identifying malignant intraductal papillary mucinous neoplasms or undergoing surgical resection.
Examining the impact of stochastic multi-year weather and air infiltration on hygrothermal moisture risks
Authors: Chung Daniel , Wen Jin , Lo Liang Chung James
Published: April 2023

The analysis of heat, air, and moisture (H.A.M.) transport for building envelopes are known to be highly dependent on climate loads and air infiltration rates. Moisture content within the assembly is often a key H.A.M. analysis outcome to assess risk and transport behavior. ASHRAE Standard 160-2016 states that building envelope H.A.M. analysis should be done using moisture design reference data or using a minimum of 10 consecutive years of weather. While there has been progress and methods for selecting or designing moisture reference years there has been a lack of study in the impact of multi-year (particularly 10-year) weather scenarios on simulation results in comparison to reference year simulations. This paper presents research using stochastic 1, 2, and 10-year weather data and air infiltration rates to study the range of simulated moisture content outcomes for four wall assemblies in Philadelphia and compares these to the outcomes when using reference years. Results from the study show that air infiltration, starting month, and multi-year duration have significant impacts on simulated moisture content, mold, and corrosion analysis results. Regression analysis using annual averages of climate input parameters did not yield useable models for selecting weather years, however an estimated mold index value using outdoor climate data may be useful in selecting weather years with varying starting months for mold growth assessment.
The influence of technical performance indicators on the results of the Chinese Football Super League at different stages of the season-based on evidence from the 2010–2019 seasons
Authors: Ma Xiaoni , Li Xiaotian , Quan Tao , Liu Hongyou , Liu Tianbiao
Published: April 2023

This study explored the different influences of technical indicators on match results in different stages of football league play. Sample data from 2400 Chinese Super League matches during 2010–2019 were divided into three season stages according to round sequence: the early stage (1–10 rounds), the middle stage (11–20 rounds), and the late stage (21–30 rounds). A two-way, fixed-effect ordered logit model was then constructed and used, together with Fisher’s combination test, to compare regression results. The study results showed that: (1) when controlling for other variables, as the league progresses, an increase in goals will gradually increase the possibility of better match results, and this increase shows significant differences between the early and late stages ( p < 0.05). The possibility of better match results by an extra goal is 0.075 times higher in the late stage than the early stage. (2) While maintaining all control variables, as the season progresses, the increase in red card penalties will gradually multiply the probability of worse match outcomes, and this increase is also significantly different between the early and middle stages and between the early and late stages ( p < 0.05). The possibility of worse match outcomes due to the presence of an extra red card is 0.377 times higher in the middle stage and 0.476 times higher in the late stage than the early stage.
Influencia de los hábitos y los conocimientos sobre alimentación en la sobrecarga ponderal según el ámbito de residencia: estudio transversal
Authors: Alvarez Alvarez Alejandro , van Leeuwen Sierra Mara , Alvarez Faedo Emma , Cernuda Martínez José Antonio
Published: April 2023

Objetivo:

comprobar la influencia de los conocimientos y los hábitos alimenticios en la sobrecarga ponderal según el ámbito de residencia (urbano o rural).

Método:

se administró un cuestionario a 451 personas, residentes en la zona básica de salud de Villaviciosa (Asturias, España), entre 35 y 65 años, distribuidas en zona rural y urbana, formulario compuesto por preguntas sobre datos sociodemográficos, hábitos y conocimientos nutricionales. Se calcularon frecuencias relativas (%) para las variables cualitativas, y medias aritméticas (desviaciones estándar) para las cuantitativas. Se empleó la correlación de Pearson para comprobar o descartar la relación entre la puntuación en el cuestionario de conocimientos sobre nutrición y el índice de masa corporal (IMC). Para estudiar la relación entre cada pregunta del cuestionario de hábitos y el ámbito de residencia se empleó la prueba chi-cuadrado. Para comparar las medias del IMC por ámbito se aplicó la prueba t para muestras independientes. Se realizaron regresiones logísticas para calcular las odds ratio (OR) entre la variable dependiente (sobrecarga ponderal) y las variables sociodemográficas.

Resultados:

la edad media de los encuestados fue de 49.96 años y el IMC promedio de 26.87 kg/m2, presentando sobrecarga ponderal el 57.6 % total. No leer las etiquetas nutricionales aumenta el riesgo de tener sobrecarga ponderal (OR = 2.2; p = 0.001); quienes consideran que comen en exceso muchas veces presentan mayor probabilidad de sobrecarga ponderal (OR = 8.6; p < 0.001); comer fuera de casa varias veces por semana (OR = 11.6; p = 0.019), así como el consumo de refrescos o zumos procesados (OR = 3.3; p = 0.013) y alcohol de baja graduación (OR = 2.8; p = 0.003) durante las comidas aumentan la probabilidad de sobrecarga ponderal.

Conclusiones:

los hábitos alimenticios y los patrones de actividad física son los principales responsables de sobrecarga ponderal. El adecuado conocimiento en la población puede ayudar a la elaboración de un plan preventivo que permita frenar el crecimiento del sobrepeso y la obesidad
Residential Environments for Older Persons: A Comprehensive Literature Review (2005–2022)
Authors: Verderber Stephen , Koyabashi Umi , Cruz Catherine Dela , Sadat Aseel , Anderson Diana C.
Published: April 2023

Background:

Independent noninstitutional and institutional residential long-term care environments for older persons have been the subject of significant empirical and qualitative research in the 2005–2022 period. A comprehensive review of this literature is reported, summarizing recent advancements in this rapidly expanding body of knowledge.

Purpose and Aim:

This comprehensive review conceptually structures the recent literature on environment and aging to provide conceptual clarity and identify current and future trends.

Method and Result:

Each source reviewed was classified as one of the five types—opinion piece/essay, cross-sectional empirical investigation, nonrandomized comparative investigation, randomized study, and policy review essay—within eight content categories: community-based aging in place; residentialism; nature, landscape, and biophilia; dementia special care units; voluntary/involuntary relocation; infection control/COVID-19, safety/environmental stress; ecological and cost-effective best practices; and recent design trends and prognostications.

Conclusions:

Among the findings embodied in the 204 literature sources reviewed, all-private room long-term care residential units are generally safer and provide greater privacy and personal autonomy to residents, the deleterious impacts of involuntary relocation continue, family engagement in policy making and daily routines has increased, multigenerational independent living alternatives are increasing, the therapeutic role of nature and landscape is increasingly well-documented, ecological sustainability has increased in priority, and infection control measures are of high priority in the wake of the coronavirus pandemic. Discussion of the results of this comprehensive review sets the stage for further research and design advancements on this subject in light of the rapid aging of societies around the globe.
The Modified Medial Maxillectomy as a Radical or Extended,—yet Still Functional,—Technique in Sinus Surgery
Authors: Wong Eugene H , Cavada Marina N , Orgain Carolyn A , Grayson Jessica W , Alvarado Raquel , Campbell Raewyn G , Harvey Richard , Sacks Raymond , Kalish Larry H
Published: April 2023

Background

Endoscopic sinus surgery with a middle meatal antrostomy is a common intervention in the treatment algorithm for maxillary sinus pathologies. However, this procedure has its origins in a time when simple ventilation of the sinus cavity was the primary (and only often) goal of surgery. In some patients, persistent mucociliary dysfunction occurs despite ventilatory surgery. Although the endoscopic modified medial maxillectomy (MMM) was originally described for tumour surgery, it provides a radical yet still functional option to overcome chronic sinus dysfunction.

Objective

The goal of this study was to describe the functional status of a post-MMM sinus cavity.

Methods

A consecutive series of patients who underwent at least a unilateral MMM by three tertiary rhinologists were retrospectively reviewed. Prospectively collected data included patient demographics (including age, gender, smoking status and comorbidities), disease-specific factors, microbiology, and preoperative patient-reported symptoms based on the 22-item Sinonasal Outcome Test-22 (SNOT-22) and radiology. The primary outcome of the study was the presence of sinus dysfunction, defined by mucostasis or pooling on endoscopic examination at the last follow-up. Secondary outcomes included the need for revision surgery as a result of sinus dysfunction and the improvement in SNOT-22 score.

Results

A total of 551 medial maxillectomies (47.0% female, 52.9 ± 16.8 years) were performed. Very few patients experienced post-operative sustained mucostasis following MMM (10.2%) and even fewer required revision surgery (5.0%). Chronic obstructive pulmonary disease (odds ratio (OR) = 6.82, P < 0.002.) and asthma (OR = 2.48, P = 0.03) were associated with mucostasis. Patients who underwent an MMM experienced a notable postoperative improvement in SNOT-22 score (45.9 ± 23.7 (pre-op) vs. 23.6 ± 19.4 (post-op); paired t-test, P < 0.0001).

Conclusion

The MMM, whether performed for access to pathology or with the intent to avoid mucous ‘sumping’ with the sinus, can provide a long-term functional maxillary sinus cavity with minimal morbidity.
A review of the effectiveness of interventions to reduce medication errors among older adults in Singapore
Authors: Sivasamy Vignesh , Yip King Fan , Mamun Kaysar , Lim Kiat Wee
Published: April 2023

Background

Medication errors (MEs) can lead to adverse effects and mortality, especially in older adults, due to physiological changes and accumulated multi-morbidities associated with ageing. Hence, interventions to reduce MEs among older adults are important and examining their effects will provide us with the impetus to improve upon current local measures to further reduce MEs.

Objectives

To review the effectiveness of the interventions that have been implemented locally to reduce MEs.

Methods

Using chosen keywords, searches were conducted in Pubmed and Google scholar. Based on their abstract, relevant articles were chosen from all retrieved articles that were published in English. Relevant online resources and other journal articles referenced in the chosen articles were also referenced in writing this narrative review.

Results and Conclusion

Although MEs occur globally, studies examining the prevalence of MEs within Asia are lacking and the impact of various local interventions to reduce MEs is also poorly understood. Electronic prescribing, a national electronic health records repository, education in geriatric pharmacotherapy, a more centralised pharmacist’s role and the use of prescribing assessment tools are local interventions whose effectiveness in reducing MEs are supported, instead, by overseas studies examining such similar interventions. Locally, more studies are needed to examine the effectiveness of interventions in reducing MEs in various settings.
Surgical management of multiple superior shoulder suspensory complex disruptions involving at least a coracoid fracture and an acromioclavicular dislocation: A report of five cases
Authors: Tuor Philipp , Dietrich Michael , Grüninger Patrick
Published: April 2023

A combination of coracoid fracture and acromioclavicular dislocation is rare. Detecting further pathologies that could cause multiple superior shoulder suspensory complex disruptions is mandatory. Literature regarding these injuries and their management is lacking. We report our diagnostic and surgical strategies, and the postoperative outcomes of superior shoulder suspensory complex disruptions. We present five cases, treated from 2011 to 2016, who had >2 disruptions of the superior shoulder suspensory complex, involving at least a coracoid fracture and an acromioclavicular joint dislocation. Surgical reconstruction was performed in all cases. The patients were postoperatively followed up for a year. There were no intraoperative or postoperative complications, and bone union was achieved in all fractures. Furthermore, all patients returned to their pre-surgery activity level and jobs. Thus, we could demonstrate that in multiple superior shoulder suspensory complex disruptions involving a coracoid fracture and an acromioclavicular joint dislocation, surgical treatment leads to a good functional outcome.
Hypertensive emergency occurred due to forgetting to take antihypertensive medication: A case study
Authors: Bereda Gudisa
Published: April 2023

A life-threatening condition known as a “hypertensive emergency” is marked by a severe increase in blood pressure together with acute or significant target-organ damage. On 1 June 2022, a 67-year-old black male farmer was admitted to the emergency department with a major chief complaint of breathing difficulty. The patient was traveling to the village for work and forgetting his medication at home, and he was losing consciousness and motor activity at his workplace. He presented with symptoms of shortness of breath, confusion, dizziness, nausea, vomiting, blurred vision, and faintness. An abnormal cardiac region was visible on chest X-rays, and there were no changes to the pulmonary parenchyma or fluid overload. Upon admission, hydralazine (5 mg) intravenously was administered immediately, and he was reassessed after 20 min and kept at the emergency department. The next day, sustained-release nifedipine (20 mg) was initiated orally twice a day for the patient, and he was transferred to the medical ward. In the medical ward, the patient was assessed for 4 days, and in those 4 days, he showed marked improvement. Hypertensive emergency treatment intends to reverse target-organ damage, readily lowering blood pressure, decreasing adverse clinical complications, and enhancing the quality of life.
Acute respiratory distress syndrome after treating ipsilateral femoral shaft and neck fracture with reamed intramedullary nailing in an asymptomatic COVID-19 patient
Authors: Jun Chungmu , Cho Young-Jae , Quinn Patrick Michael , Song Suk-Kyoon
Published: April 2023

Currently, it is quite difficult to determine the best timeframe of operative treatment, as well as conduct surgery on asymptomatic COVID-19 patients due to misunderstandings and unawareness of the patient’s inflammation state. Caution needs to be taken in specific patient cohorts, particularly those with femoral shaft fractures, who are more likely to develop diseases like acute respiratory distress syndrome after a procedure like intramedullary nailing. In this case report, a 36-year-old patient suffered a motorcycle accident in which he suffered an ipsilateral femoral shaft and neck fracture of the hip. The patient’s screening test for COVID-19 was positive before admission. Because the patient did not display any COVID-19-related symptoms upon arrival to the hospital, surgical fixation with a reamed intramedullary femoral nail was performed. Despite having a successful post-surgical outcome, the patient was diagnosed with acute respiratory distress syndrome 36 h after surgery, recovering fully after about 2 weeks. To prevent subsequent complications such as acute respiratory distress syndrome in a high inflammatory state patient like COVID-19, the respiratory status and the degree of systemic inflammation should be considered precisely when determining the surgical timing and method.
Possible nirmatrelvir/ritonavir-induced bradycardia in a patient with asymptomatic COVID-19
Authors: DeMarco Elizabeth , Turnipseed Matthew , Clarke Brian , Qadeer Farhan
Published: April 2023

COVID-19 emerged in 2019 and was declared a pandemic by the World Health Organization in March 2020. COVID-19 is highly transmissible and can lead to bilateral pneumonia with severe respiratory failure. COVID-19 has led to more than 6.5 million deaths worldwide. The significant morbidity and mortality due to COVID-19 have resulted in the development of treatment modalities, such as novel antivirals, to reduce hospitalizations and progression of disease. In 2021, the US Food and Drug Administration authorized nirmatrelvir/ritonavir for emergency use in nonhospitalized patients with COVID-19. Nirmatrelvir is a newly developed protease inhibitor and is combined with a commonly used pharmacokinetic boosting agent, ritonavir. Given the novelty of nirmatrelvir/ritonavir, potential adverse effects remain uncertain. In this case, we describe a patient who was initiated on a course of nirmatrelvir/ritonavir and developed symptomatic bradycardia.