bluuebunny/crossref_metadata_2025 huggingface dataset:
Massive Apixaban Overdose Confirmed with Blood Concentrations and Managed Without Bleeding: A Single Case Report
Authors: Harmouche Elie , Stueve Peter , Howland Mary Ann , Su Mark K
Published: May 2023

Background: Acute overdoses of apixaban, and other direct oral anticoagulants are relatively uncommon. The number of direct oral anticoagulants prescriptions in the United States is increasing, however reports on patient outcomes after documented overdose are sparse. Case report: A 76-year-old man with a past medical history of atrial fibrillation and taking apixaban 5 mg twice daily presented to the emergency department 10 hours after reportedly ingesting 60-70 of his pills. He was alert and had a normal physical examination. Blood tests demonstrated an INR of 12, platelets of 161 000 cells/mm3, hemoglobin 9.7 g/dL, and creatinine 1.81 mg/dL. He received 60 g of activated charcoal and 4 units of fresh frozen plasma prophylactically. Initial blood apixaban concentration was 4 000 ng/mL. Repeat blood apixaban concentrations were 3 000 ng/mL and 2 200 ng/mL at 7 and 14 hours, respectively (thrapeutic range 91-321 ng/mL for a 5 mg twice daily dose). The hybrid anti-factor Xa activity did not correlate with blood apixaban concentrations. Apixaban elimination followed first-order kinetics with an apparent elimination half-life of 14 hours in the presence of impaired renal function. He did not have any minor or major bleeding events.
Caring in the Gig Economy: A Relational Perspective of Decent Work
Authors: Khan Maria Hameed , Williams Jannine , Williams Penny , Mayes Robyn
Published: May 2023

The rapidly expanding gig economy has been criticized for creating precarious and indecent working conditions. These critiques draw on decent work debates centred on employment classification, regulation and platform fairness, with less focus on the interactions between workers, platforms and clients, which are central to the experience of platform-mediated work. This article adopts a worker-centric relational perspective to explore decent work in the gig economy. Drawing on the experiences of workers in platform-mediated domestic care work, the insights from this study highlight the importance of social interactions and relationships, using an ethics of care lens, to elucidate how relational aspects shape workers’ experiences. The findings reveal platform workers centre mutuality of interests, responsiveness and reciprocity, attentiveness and solidarity to maintain a balance of care (care-for-self and care-for-others) when negotiating platform-mediated care work. This article contributes relationality as a key dimension of decent work currently overlooked in studies exploring gig work arrangements.
Linear controller design approach for nonlinear systems by integrating gap metric and stability margin
Authors: Elkhalil Khouloud , Zribi Ali
Published: May 2023

In the past few years and in many applications, linear feedback control has proved to be adequate for the control of various nonlinear systems. Therefore, before attempting the controller design phase, it is natural to ask, “When is a linear controller adequate for a nonlinear system?” This article provides a new nonlinearity analysis method based on the gap metric and the stability margin that is able to quantify the nonlinearity degree of a system once it has an internal model control controller. The internal model control strategy is used since it provides a direct measure of the discrepancy between outputs from the nonlinear system and its internal model when both are subject to the same controller. It is shown that a feedback loop may exhibit much lower nonlinearity than an open-loop nonlinear system by a careful design of a single linear internal model control controller via the gap metric and stability margin, used as model-based analysis tools for linear time-invariant systems. Both simulations and an experimental validation on a semibatch reactor prove the effectiveness of the proposed method.
In Vivo Real-Time Quantum Dots Imaging to Track Transplanted Adipose Stem Cells in Different Inflammatory States of Acute Liver Failure Mice
Authors: Yamada Shota , Yukawa Hiroshi , Kitamura Koudai , Mizumaki Toshiki , Yoshizumi Yasuma , Oohara Tomomi , Nanizawa Eri , Hirano Fumika , Sato Kazuhide , Sugawara-Narutaki Ayae , Ishikawa Tetsuya , Baba Yoshinobu
Published: May 2023

Stem cell therapy plays an important role in regenerative therapy; however, there is little information on the in vivo dynamics of transplanted stem cells and the influence of the inflammation of affected tissues or organs on these dynamics. In this study, we revealed real-time dynamics of transplanted adipose tissue–derived stem cells (ASCs) and the influence of the inflammatory states on these dynamics in acute liver failure mice. Quantum dots (QDs) labeling did not affect the cytokine profile of ASCs, and intravenously transplanted ASCs labeled with QDs could be detected in real time with high efficiency without laparotomy. Until 30 min after ASC transplantation, no marked differences in the behavior or accumulation of transplanted ASCs in the liver were observed among the three groups with different degrees of liver damage (normal, weak, and strong). However, significant differences in the engraftment rate of transplanted ASCs in the liver were observed among the three groups from 4 h after transplantation. The engraftment rate was inversely correlated with the extent of the liver damage. These data suggested that QDs are useful for in vivo real-time imaging of transplanted cells, and the inflammatory state of tissues or organs may affect the engraftment rate of transplanted cells.
COVID-19 medicare benefits schedule telehealth for private psychiatric outpatient care in Victoria, Australia
Authors: Hewa Koneputugodage Evani , Reay Rebecca E , Looi Jeffrey CL
Published: May 2023

Objective

We explore telehealth use by private psychiatrists in Victoria during the first 12 months of COVID-19, in the context of: COVID-19 case numbers and restrictions; telehealth use in Victoria compared to national use; telehealth and face-to-face consultations during the first 12 months of COVID-19 compared to face-to-face consultations in the 12 months pre-COVID-19.

Method

Outpatient psychiatric face-to-face and telehealth consultations, from March 2020 to February 2021 in Victoria, were analysed using face-to-face consultations from March 2019 to February 2020 as a comparison group, and compared to national telehealth use and trends in COVID-19 case rates.

Results

Total psychiatric consultations increased by 16% from March 2020 to February 2021. Telehealth compromised 56% of total, peaking at 70% of consultations in August during the height of COVID-19 cases. Thirty-three percent of total consultations and 59% of telehealth consultations were via telephone. Telehealth consultations per capita in Victoria were consistently lower than the overall Australian level.

Conclusion

Telehealth usage during the first 12 months of COVID-19 in Victoria suggests it is a feasible alternative to face-to-face treatment. Telehealth-mediated increases in psychiatric consultations likely indicates an increased psychosocial need for support.
The Effects of Tax-Time Interventions on Savings Rate and Amount: A Systematic Review and Meta-Analysis
Authors: Birkenmaier Julie , Kim Youngmi , Maynard Brandy R. , Pigott Terri
Published: May 2023

Purpose: This systematic review examined the effects of tax-time saving interventions that promote saving with tax refunds from relevant experimental or quasi-experimental studies of interventions aimed toward low- and moderate-income adults delivered when filing U.S. income taxes. Method: A systematic review process was used to search for published and unpublished studies from sources through September 2021. Two reviewers screened studies, extracted data and assessed risk of bias, and effects on savings rate and amount were synthesized using robust variance estimation. Results: This review included 14 unique studies. Five studies reporting 13 effect sizes for savings amount found a small, statistically significant effect ( d  =  0.06, 95% CI [0.05, 0.08]). Nine studies reporting 35 effect sizes found no statistically significant effect for savings rate (LOR =  4.11, 95% CI [0.42, 40.44]). Discussion: Results suggest some evidence that tax-time savings can be a relatively simple method for increasing the amount low- to moderate-income adults save.
Comparison of Total Ankle Replacement and Ankle Arthrodesis for Ankle Arthropathy in Patients With Bleeding Disorders: A Systematic Review and Meta-Analysis
Authors: Arthur Rodney Y. , Mihas Alexander K. , Harris James , Reed Logan A. , Billings Rebecca , Patch David A. , Spitler Clay A. , Johnson Michael D.
Published: May 2023

Background:

There is limited literature comparing the publications on ankle arthrodesis (AA) and total ankle arthroplasty (TAA) in the setting of hemophilic arthropathy. Our objective is to systematically review the existing literature and to assess ankle arthroplasty as an alternative to ankle arthrodesis in this patient population.

Methods:

This systematic review was conducted and presented according to the PRISMA statement standards. A search was conducted on March 7-10, 2023, using MEDLINE (via PubMed), Embase, Scopus, ClinicalTrials.gov, CINAHL Plus with Full Text, and the Cochrane Central Register of Controlled Studies. This search was restricted to full-text human studies published in English, and articles were screened by 2 masked reviewers. Systematic reviews, case reports with less than 3 subjects, letters to the editor, and conference abstracts were excluded. Two independent reviewers rated study quality using the MINORS tool.

Results:

Twenty-one of 1226 studies were included in this review. Thirteen articles reviewed the outcomes associated with AA in hemophilic arthropathy whereas 10 reviewed the outcomes associated with TAA. Two of our studies were comparative and reviewed the outcomes of both AA and TAA. Additionally, 3 included studies were prospective. Studies showed that the degree of improvement in American Orthopaedic Foot & Ankle Society hindfoot-ankle score, visual analog scale pain scores, and the mental and physical component summary scores of the 36-Item Short Form Health Survey were similar for both surgeries. Complication rates were also similar between the 2 surgeries. Additionally, studies showed a significant improvement in ROM after TAA.

Conclusion:

Although the level of evidence in this review varies and results should be interpreted with caution, the current literature suggests similar clinical outcomes and complication rates between TAA and AA in this patient population.
Lymphocytes, Mean Platelet Volume, and Albumin in Critically Ill COVID-19 Patients with Venous Thromboembolism
Authors: Duan Rundan , Ni Qihong , Li Yinan , Zhu Mingli , Li Wen , Wang Peng , Yuan Kai , von Hundelshausen Philipp , Zhu Jingpu , Zhang Lan , Lv Lei
Published: May 2023

As one of the frequent complications leading to poor prognosis in hospitalized COVID-19 patients, a better understanding of venous thromboembolism (VTE) in COVID-19 patients is needed. We conducted a single-center, retrospective study on 96 COVID-19 patients admitted to the intensive care unit (ICU) from April to June 2022, in Shanghai Renji Hospital. Records of these COVID-19 patients upon admission were reviewed for demographic information, co-morbidities, vaccinations, treatment, and laboratory tests. VTE occurred in 11 (11.5%) cases among 96 COVID-19 patients despite the standard thromboprophylaxis since ICU admission. In COVID-VTE patients, a significant increase in B cells and a decrease in Ts cells were observed and a strong negative correlation ( r = −0.9524, P = .0003) was found between these two populations. In COVID-19 patients with VTE, increased MPV and decreased albumin levels were seen in addition to the common VTE indicators of D-dimer abnormalities. The altered lymphocyte composition in COVID-VTE patients is noteworthy. In addition to D-dimer, MPV and albumin levels might be novel indicators for the risk of VTE in COVID-19 patients.
Survey: Preferred practice patterns in the diagnosis of mucous membrane pemphigoid amongst cornea specialists
Authors: Moussa Sarah , Tong Maya , Robert Marie-Claude , Harissi-Dagher Mona , Ahmad Sajjad , Jabbour Samir
Published: May 2023

Purpose

To evaluate preferred diagnostic tools and treatment decision-making factors in cases suspicious of mucous membrane pemphigoid (MMP) amongst ophthalmologists and cornea specialists.

Methods

Web-based survey, consisting of 14 multiple choice questions, posted to the Cornea Society Listserv Keranet, the Canadian Ophthalmological Society Cornea Listserv, and the Bowman Club Listserv.

Results

One hundred and thirty-eight ophthalmologists participated in the survey. Eighty-six percent (86%) of respondents were cornea trained and practiced in either North America or Europe (83%). Most respondents (72%) routinely perform conjunctival biopsies for all suspicious cases of MMP. For those who do not, fear that biopsy will exacerbate inflammation was the most common reason to defer investigation (47%). Seventy-one percent (71%) performed biopsies from perilesional sites. Ninety-seven percent (97%) ask for direct (DIF) studies and 60% for histopathology in formalin. Most do not recommend biopsy at other non-ocular sites (75%), nor do they perform indirect immunofluorescence for serum autoantibodies (68%). Immune-modulatory therapy is started following positive biopsy results for most (66%), albeit most (62%) would not let a negative DIF influence the choice of starting treatment should there be clinical suspicion of MMP. Differences in practice patterns as they relate to level of experience and geographical location are contrasted to the most up-to-date available guidelines.

Conclusion

Responses to the survey suggest that there is heterogeneity in certain practice patterns for MMP. Biopsy remains an area of controversy in dictating treatment plans. Identified areas of need should be targeted in future research.
Impact of materialism on tourists’ green purchase behavior: Extended norm activation model perspective
Authors: Jhawar Anand , Kumar Prashant , Israel Duraipandian
Published: May 2023

In the context of tourists’ eco-friendly consumption behavior, this study examines the effects of materialism and the cardinal variables in the norm activation model (NAM; i.e. awareness of consequences, ascription of responsibility, and moral norms) on tourists’ green purchase behavior. Using an online structured questionnaire, useable data was collected from 405 tourists, and structural equation modeling in SmartPLS 3.0 was performed to examine the relationships. The results showed that materialism negatively affected awareness of consequences and moral norms but did not affect the ascription of responsibility. Interestingly, awareness of the consequences of environmental degradation did not significantly affect tourists’ green purchase behavior. Further, moral norms mediated the effects of materialism on tourists’ green purchase behavior. Thus, this study integrates materialism with the NAM and makes a novel contribution to adjoining literature on materialism and tourists’ green consumption literature. The role of materialism as an external locus-of-control to NAM and to predict tourists’ green consumption, along with subsequent managerial implications, are discussed further.
Effect of using client-accessible youth health records on experienced autonomy among parents and adolescents in preventive child healthcare and youth care: A mixed methods intervention study
Authors: Benjamins Janine , de Vet Emely , Jordaan Gerlinde , Haveman-Nies Annemien
Published: May 2023

Client autonomy is important in Dutch youth care. It correlates positively with mental and physical health and can be strengthened by professional autonomy-supportive behaviour. Aiming for client autonomy, three youth care organisations co-developed a client-accessible youth health record (EPR-Youth). Currently, limited research is available on how client-accessible records contribute to adolescent autonomy. We investigated whether EPR-Youth strengthened client autonomy and whether professional autonomy-supportive behaviour reinforced this effect. A mixed methods design combined baseline and follow-up questionnaires with focus group interviews. Different client groups completed questionnaires about autonomy at baseline ( n = 1404) and after 12 months ( n = 1003). Professionals completed questionnaires about autonomy-supportive behaviour at baseline ( n = 100, 82%), after 5 months ( n = 57, 57%) and after 24 months ( n = 110, 89%). After 14 months, focus group interviews were conducted with clients ( n = 12) and professionals ( n = 12). Findings show that clients using EPR-Youth experienced more autonomy than non-users. this effect was stronger among adolescents aged 16 and older than among younger adolescents. Professional autonomy-supporting behaviour did not change over time. However, clients reported that professional autonomy-supporting behaviour contributed to client autonomy, emphasising that professional attitude needs addressing during implementation of client-accessible records. Follow-up research with paired data needs to strengthen the association between using client-accessible records and autonomy.
From existing to living: Exploring the meaning of recovery and a sober life after a long duration of a substance use disorder
Authors: Pettersen Gunn , Bjerke Trond , Hoxmark Ellen Margrethe , Eikeng Sterri Njål Herman , Rosenvinge Jan H
Published: May 2023

Aim: The study explores how former patients with substance use disorder (SUD) experience the benefits and challenges of a reoriented identity and way of living. Methods: Semi-structured interviews were conducted with 10 participants who had completed treatment for SUD and considered themselves either recovered or in an ongoing rehabilitation process. Interview transcripts were analysed using the content analysis approach. Results: The analysis furthers our understanding of several purposeful aspects of a reorientation towards a sober life in terms of: (1) avoiding illegal drugs, (2) avoiding contact with the substance use relations and milieu, (3) renewing relations and social network, (4) daily occupation, (5) discovering the value of the great, little things in everyday life, (6) new coping strategies, and (7) developing a new identity. Conclusion: The study indicates that rehabilitation from SUDs should take a broader focus than just sobriety. With attention to the present findings, a focus on psychosocial aspects of recovery could contribute to a more overarching framework for SUD treatment.
Convergence of community social work practice, collective impact, and design thinking: What, why, and how?
Authors: Mandayam Gokul , Nandan Monica , Bowen Elizabeth
Published: May 2023

Social workers engage with marginalized communities impacted by challenges that are intensely complex and dynamic. This necessitates designing strategies and interventions that are sustainable, effective, nonduplicative and collaborative across systems and organizations. This article aims to provide a synthesis of three frameworks that can intersect to facilitate systems-level change: community practice, collective impact, and design thinking. Each framework provides unique contributions for bolstering contemporary macro social work practice.

Findings

The article provides an overview of the three frameworks and their distinctive features, limitations, and points of intersection. The integration of community practice with collective impact and design thinking frameworks for enabling social workers to come up with innovative solutions that include diverse stakeholder perspectives is elucidated with a case example.

Application

The article specifies the implications of integrating community practice, collective impact, and design thinking for further strengthening social work practice, education, and research.
The effects of different channel geometries in the displacer cylinder, working fluids, and engine speed on the energy and exergy performance characteristics of a β-type Stirling engine with a slider-crank drive mechanism
Authors: Doğan Battal , Erol Derviş , Yeşilyurt Murat Kadir , Yaman Hayri
Published: May 2023

Stirling engines are power generation systems working with the external heating principle and converting heat energy into mechanical energy. In this study, thermodynamic analyses were performed using the data of performance tests in which helium, nitrogen, and air were utilized as working fluids in a β-type Stirling engine with a swept volume of 365 cm3 and a slider-crank drive mechanism. Moreover, the impact of different channel geometries in the displacer cylinder on engine power was revealed. In the study, three displacer cylinders, smooth, 66-slot channel, and 120-slot channel displacer cylinders, were used. Performance tests were conducted at five charge pressures varying between 1 and 5 bar, with the hot end temperature of 1000 ± 10 K and the cold end temperature of 300 ± 5 K. The heat transferred to the hot zone, thermal losses and efficiency were calculated in the energy analysis. The highest thermal efficiency was 45.50% when a 120-slot channel displacer cylinder was used with helium as the working fluid. Thermal efficiency values were 32.87% and 32.60% for nitrogen and air, respectively, under the same conditions. Entropy generation, exergy destruction, and exergy efficiency were calculated in the exergy analysis. The lowest exergy destruction was obtained using a 120-slot channel displacer cylinder with helium as the working fluid. Furthermore, the impact of engine speed on exergy efficiency was determined.
Conducting team ethnography with African migrants in Mexico: The dynamics of gendered and racialised positionalies in the field
Authors: Serra Mingot Ester , González Zepeda Carlos Alberto
Published: May 2023

Based on the current trends in conducting ethnographies, with time and funding limitations and the need to reflect on the researcher's positionality, this article explores the implications of conducting ethnographic fieldwork in a mixed team (in terms of gender, race and nationality) with highly vulnerable populations in a context of crisis. To that end, the article analyses the experience of conducting a team ethnography with African migrants in Tijuana, Mexico. While the study did not start with a self-awareness of what a team ethnography implied, as fieldwork developed the gender, race and nationality of both interviewees and researchers became crucial elements to produce a meaningful multi-layered, multiply-positioned ethnography. This article argues that methodological flexibility and the researchers’ relationship with themselves and the respondents are vital elements that require further experimentation in ethnographic research.
Listening otherwise: From “silent tourism” soundscapes to privileged sonic ways of knowing
Authors: Frohlick Susan , Macevicius Celeste
Published: May 2023

This paper explores quests for silence in tourism in English-language online media. We offer a reading of media forms all articulating a soundscape of silence: a preferred sonic environment for tourists’ health and well-being. A relational and reflexive approach allows us to interrogate these taken-for-granted desired silences, and to emplace ourselves in the analysis. Using critical discourse analysis, we try to listen to the sounds produced in the texts, and to write with, and about, the sounds that resonate with us, to disrupt the naturalization implicit to the silent tourism soundscapes. Such calls for silent tourism use vocabularies that reproduce a universalistic aurality and binaries of wanted/unwanted, silence/noise, nonhuman/human, good/bad that moralize and objectify. Relational ontology and feminist critiques of “soundscape” help us to rethink silent tourism as ways of knowing. Ultimately, in the media we reflect on and are not separate from sonic ways of knowing seem very much entangled with wealth, privilege, individualism, and settler positionalities.
The very idea of rational irrationality
Authors: Paulson Spencer
Published: May 2023

I am interested in the “rational irrationality hypothesis” about voter behavior. According to this hypothesis, voters regularly vote for policies that are contrary to their interests because the act of voting for them isn’t. Gathering political information is time-consuming and inconvenient. Doing so is unlikely to lead to positive results since one's vote is unlikely to be decisive. However, we have preferences over our political beliefs. We like to see ourselves as members of certain groups (e.g. “rugged individualists”) and being part of those groups depends on having certain beliefs (e.g. about welfare spending). Even if a decrease in welfare spending would be bad for me, I might still benefit by believing in and, consequently, voting for a decrease since my vote is unlikely to make a difference but getting to see myself as a rugged individualist will make a noticeable difference to my wellbeing. It is sometimes argued that this hypothesis fails for empirical reasons. I will argue that things are worse: it is conceptually incoherent. I will do so by first showing that it is a rationalizing explanation and then argue that rationalizing explanations must be reflectively stable from the agent's perspective. The rational irrationality hypothesis is not.
Deep learning-based bridge damage identification approach inspired by internal force redistribution effects
Authors: Yang Kang , Ding Youliang , Jiang Huachen , Zhang Yun , Zou Zhengbo
Published: May 2023

Damage identification has always been one of the core functions of bridge structural health monitoring (SHM) systems. Damage identification techniques based on deep learning (DL) approaches have shown great promise recently. However, DL methods still need to be improved owing to their poor interpretability and generalization performance. The fundamental reason lies in the separation between physics-based mechanical principles and data-driven DL methods. To address this issue, this paper proposes a physics-inspired approach combining the data-driven method and the internal force redistribution effects to perform efficient damage identification. Firstly, the mechanical derivation of internal force redistribution is given based on a simplified three-span continuous bridge. Then, two types of typical damage scenarios including segment stiffness decrease and prestress loss are simulated to formulate the damage dataset with monitored field data noise added. Next, a modified Transformer model with multi-dimensional output is trained to obtain the complex dynamic spatiotemporal mapping among multiple measurement points from the intact structure as a benchmark model. Finally, the relationship between multiple damage patterns and the corresponding output regression residual distribution is studied, based on which the flexible combinations of the sensors are proposed as the test set to characterize the internal force redistribution due to damage. Validation on the extended dataset showed that this approach is effective to realize preliminary identification of damage patterns and resist interference from noise at the monitoring site.
Manage and make productive: The New Zealand National Party’s social investment policy
Authors: Stuart Margaret
Published: May 2023

New Zealand National Party’s 2022–2023 policy of Social Investment, which if adopted, will legitimise the management of young unemployed in the name of correcting and helping them. Zygmunt Bauman’s (1989) concept of ‘rational bureaucratic culture’ is used to examine the aims to bring the ‘abnormal’ citizen into the tax-paying fold. The policy will ‘manage and make productive’ young welfare recipients to avoid them ‘bludging’ and encourage them into ‘productive work’, no matter how menial. Using philanthropic monies alongside funding through Vote : Social Development is a new development which removes the state’s sole financing of its safety-net responsibility. It will see a new interpretation of Principal: Agency policy.
Are Thiol/Disulfide and 8-OHdG Levels in the Blood of Patients with Diabetic Foot a Risk Factor for Amputation?
Authors: İnce Kamil , Güner Savaş , Büyükbebeci Ayşegül , İnce Nursima
Published: May 2023

Objective

As diabetic patients live longer and there are more effective treatments available, the incidence of diabetes and its complications is increasing. The effects of oxidative stress and antioxidant processes on diabetes behavior, especially diabetic foot, are really direct. The goal of this research is to investigate the effects of oxidative stress and antioxidant mechanism on the outcome of amputation by examining the levels of 8-hydroxy-2′-deoxyguanosine (8-OHdG) and thiol/disulfide in the blood of patients diagnosed with diabetic foot.

Methods

The research consisted of 76 patients with type 2 diabetes with associated diabetic foot, ages 40–65 (51 men, 25 women). Patients with diabetic foot wounds and accompanying peripheral artery disease were not included in the study. After a mean follow-up of 9.6 months, 28 patients resulted in amputation. Between patients who required amputation and those who did not, the levels of 8-OHdG, native thiol, total thiol, disulfide, native thiol/total thiol ratio, disulfide/native thiol ratio, and disulfide/total thiol ratio were compared. Additionally, the age, sex, Wagner stage, and amputation outcome of these 2 patient groups were compared.

Results

The outcomes of amputation in diabetic foot patients were not related to the levels of native thiol, total thiol, disulfide, native thiol/total thiol ratio, disulfide/native thiol ratio, total thiol/disulfide ratio, or 8-OHdG ( P > .05). However, patients with diabetic foot who were male, older, and at a more advanced Wagner stage had a higher rate of amputations ( P < .05).

Conclusion

Oxidative stress and antioxidant mechanism are effective on diabetes complications. However, since there are many factors affecting the outcome of amputation, they are not directly effective in terms of resulting amputation in patients with diabetic foot ulcer.
Well-Being of Families with a Child with Profound Intellectual and Multiple Disabilities
Authors: Lahaije Siméon T. A. , Luijkx Jorien , Waninge Aly , van der Putten Annette A. J.
Published: May 2023

In disability research, there is an increased focus on the well-being of families with a child with a disability, also known as family quality of life (FQOL). However, the well-being of families with a child with profound intellectual and multiple disabilities (PIMD) has not yet been explored, even though their well-being may be affected by the pervasive support needs they need to manage. In turn, sufficient well-being of the family is necessary to guarantee adequate support and thus well-being for the person with PIMD. The purpose of this study was to examine the well-being of families with a child with PIMD, including possible differences between parents and siblings, and how individual and familial factors are related to FQOL. A total of 82 participants from 44 families with a child with PIMD in the Netherlands participated. Multilevel models were employed to analyze FQOL scores and which factors significantly affected scores. Families scored moderately high on both total score and subscales, scoring lowest on emotional well-being. There were significant differences between parents and siblings and a significant effect of age of the respondent on emotional well-being, material well-being, and disability-related support. Siblings scored higher than parents, and scores decreased with age on these domains. Although families with a child with PIMD scored, on average, satisfactory on their FQOL, they were least satisfied with the support for their emotional well-being, and may therefore require additional support for this aspect of their family life. Results of this study contribute to understanding the lives of families with a child with PIMD and their support needs.
Reducing the carbon footprint in carpal tunnel surgery inside the operating room with a lean and green model: a comparative study
Authors: Kodumuri Preetham , Jesudason Edwin Prash , Lees Vivien
Published: May 2023

The primary aim of our study was to assess the environmental impact of moving from a standard to a lean and green model for a carpal tunnel decompression. We objectively measured the clinical waste generated, the number of single use items and the number of sterile instruments required for a standard procedure, and then moved to smaller instrument trays, smaller drapes and fewer disposables. These two models were compared for waste generation, financial costs and carbon footprint. Information prospectively collected on seven patients in the standard model and 103 patients in the lean and green model in two hospitals over a 15-month period, demonstrated a reduction in CO2 emissions of 80%, clinical waste reduction of 65%, and an average aggregate cost saving of 66%. The lean and green model can deliver a safe, efficient, cost-effective and sustainable service for patients undergoing carpal tunnel decompression.

Level of evidence: III
Reactions and underlying mechanisms of customer mistreatment: An integrative review
Authors: Bellamkonda Neha , Sheel Rahul Chandra
Published: May 2023

Service sector employees often deal with mistreatment in their interactions with the customers. Mistreatment during the service interaction varies in severity and intensity ranging from incivility to bullying. However, the current reviews in this domain focus only on certain aspects of mistreatment, rather than looking at customer mistreatment as a holistic phenomenon encompassing a wide range of behaviors. This review provides a thematic synthesis of the literature on customer mistreatment outcomes on employees, identifies boundary conditions of these relationships as well as explains the underlying mechanisms. The review advances the customer mistreatment literature by providing a conceptual framework to explain how reactions towards mistreatment lead to various employee outcomes. Further, the review highlights significant methodological issues and gaps in the existing literature by organizing the customer mistreatment literature and providing agendas for future research.
Digital payment technology and consumer behaviour – Saving, spending patterns: Are saving and spending patterns a concern?
Authors: Gurusamy Ramasundaram , B Aiswarya
Published: May 2023

Do not save what is left after spending but spend what is left after saving. —Warren Buffet—Our spending habits are shaped by our upbringing, our values, ethics, our view of life, security, and one’s expectations of the future. However, the mode of payment also has an impact on the spending patterns of an individual. It is clear that the introduction of digital payments has affected spending patterns and subsequently savings habits. People generally aren’t getting better at saving through technology they are getting better at spending. The case examines and highlights the behavior of individuals who use cash and cashless digital payments in conjunction with their respective spending and saving patterns.
Adequacy Rate of Kisan Credit Card Scheme: An Empirical Study in the Budaun District of Uttar Pradesh (India)
Authors: Singh Shubham Pratap , Singh Vinitendra Pratap , Prakash Ved
Published: May 2023

The Kisan Credit Card (KCC) scheme intends to provide farmers with timely and sufficient credit in a cost-effective and flexible manner. Credit availability is a critical factor for boosting the agricultural sector’s performance and output. The study was carried out in the Budaun district of Uttar Pradesh (India) to determine the adequacy rate of the KCC scheme and its effectiveness in meeting the credit needs of farmer households. The research design used in the present research was Descriptive & Exploratory in nature which aims to determine the adequacy rate of credit under the KCC scheme. In the present study, the Stratified Random Sampling technique is used, which comes under the probability sampling techniques. The present study reveals that an adequate amount of credit is available to beneficiary farmers under the KCC scheme to fulfil their credit requirements. The study also reveals that the adequacy of credit has a significant impact on loan purpose(s) under the KCC scheme to beneficiary farmers. Very few research studies have been conducted on the adequacy rate of the credit available to farmer households under the KCC scheme and how much this scheme succeeds in providing an adequate amount of credit to farmer households. This study will be significantly important in taking necessary measures for the effective distribution of schemes like KCC scheme.
Food Insecurity Among Medicare Beneficiaries With Type 2 Diabetes: Implications for Diabetes Care and Education Specialists
Authors: Massey McKayla , Zhong YunYing , LaManna Jacqueline B. , Ng Boon Peng
Published: May 2023

Purpose:

The purpose of the study was to examine factors associated with food insecurity among Medicare beneficiaries with type 2 diabetes.

Methods:

The 2019 Medicare Current Beneficiary Survey Public Use File of beneficiaries ≥65 years old with type 2 diabetes (n = 1343) was analyzed. A binary variable was created to represent food insecurity (1 = food insecurity, 0 = without food insecurity) with ≥2 affirmative responses adapting an established algorithm of the United States Department of Agriculture food insecurity questionnaire. A survey-weighted logistic model was performed to examine factors (ie, sociodemographic characteristics, health status, and insurance coverage) associated with food insecurity.

Results:

Approximately 11.6% of study Medicare beneficiaries with type 2 diabetes reported food insecurity. Non-Hispanic Black beneficiaries were more likely to report food insecurity than non-Hispanic White beneficiaries. Beneficiaries with incomes < $25 000 were more likely to report food insecurity than those with higher incomes. Beneficiaries enrolled in Medicare Advantage programs (vs traditional Medicare), having Medicare-Medicaid dual eligibility (vs nondual), and living with instrumental activities of daily living or activities of daily living limitations (vs without) were also more likely to report food insecurity than their respective counterparts.

Conclusions:

Sociodemographic disparities in food insecurity were observed among Medicare beneficiaries with type 2 diabetes. Implementation of screening protocols, interventions related to social determinants of health, and the diabetes care continuum may mitigate the prevalence of food insecurity in this demographic.
Regional testing of triploid hybrid clones of populus tomentosa
Authors: Li Liang , Du Jiahua , Ma Lexun , Ding Changjun , Zhang Pingdong , Kang Xiangyang
Published: May 2023

Background

Triploid Populus tomentosa, a timber tree species, has been widely planted in northern China owing to its potential high yields and high wood quality. Though genetic variances in growth traits and wood properties have been reported across several planting sites, regional testing of triploid hybrid clones of P. tomentosa has not been conducted on a large scale.

Results

Ten 5-year clonal trials were used to evaluate the inheritance of growth traits, to determine suitable deployment zones, and to identify optimal triploid clones at each experimental site to determine the clones that would be suitable at all sites. A total of 2,430 trees from nine triploid hybrid clones were sampled during the ten trials. The clonal and site effects and clone × site interactions were highly significant (P < 0.001) for all the studied growth and yield traits. The estimated repeatability of means for diameter at breast height (DBH) and tree height (H) was 0.83, which was slightly higher than for stem volume (SV) and estimated stand volume (ESV) (0.78). The Weixian (WX), Gaotang (GT), and Yanzhou (YZ) sites were each considered to be suitable deployment zones, and the Zhengzhou (ZZ), Taiyuan (TY), Pinggu (PG), and Xiangfen (XF) sites were found to be the optimal deployment zones. The TY and ZZ sites were the best discriminative environments, and the GT and XF sites were the best representative environments. GGE pilot analysis revealed that yield performance and stability were significantly different among all the studied triploid hybrid clones across the ten test sites. It was therefore necessary to develop a suitable triploid hybrid clone that could do well at each site. Taking into account both yield performance and stability, the triploid hybrid clone S2 was determined to be an ideal genotype.

Conclusions

For triploid hybrid clones, the WX, GT, and YZ sites represented suitable deployment zones and the ZZ, TY, PG, and XF sites represented optimal deployment zones. Yield performance and stability were significantly different among all the studied triploid hybrid clones across the ten test sites. Developing a suitable triploid hybrid clone that could do well at all sites was therefore desirable.
A single-center prospective study evaluating the usefulness of artificial intelligence for the diagnosis of esophageal squamous cell carcinoma in a real-time setting
Authors: Tani Yasuhiro , Ishihara Ryu , Inoue Takahiro , Okubo Yuki , Kawakami Yushi , Matsueda Katsunori , Miyake Muneaki , Yoshii Shunsuke , Shichijo Satoki , Kanesaka Takashi , Yamamoto Sachiko , Takeuchi Yoji , Higashino Koji , Uedo Noriya , Michida Tomoki , Kato Yusuke , Tada Tomohiro
Published: May 2023

Background

Several pre-clinical studies have reported the usefulness of artificial intelligence (AI) systems in the diagnosis of esophageal squamous cell carcinoma (ESCC). We conducted this study to evaluate the usefulness of an AI system for real-time diagnosis of ESCC in a clinical setting.

Methods

This study followed a single-center prospective single-arm non-inferiority design. Patients at high risk for ESCC were recruited and real-time diagnosis by the AI system was compared with that of endoscopists for lesions suspected to be ESCC. The primary outcomes were the diagnostic accuracy of the AI system and endoscopists. The secondary outcomes were sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and adverse events.

Results

A total of 237 lesions were evaluated. The accuracy, sensitivity, and specificity of the AI system were 80.6%, 68.2%, and 83.4%, respectively. The accuracy, sensitivity, and specificity of endoscopists were 85.7%, 61.4%, and 91.2%, respectively. The difference between the accuracy of the AI system and that of the endoscopists was − 5.1%, and the lower limit of the 90% confidence interval was less than the non-inferiority margin.

Conclusions

The non-inferiority of the AI system in comparison with endoscopists in the real-time diagnosis of ESCC in a clinical setting was not proven.

Trial registration

Japan Registry of Clinical Trials (jRCTs052200015, 18/05/2020).
Impact of anti-VEGF therapy on distinctive retina layers in patients with macular edema secondary to branch retinal vein occlusion
Authors: Wang Hui , Wang Chanjuan , Zhang Shaochi , Liu Jun , Bi Xiaojun
Published: May 2023

Background

To explore the impact of anti-vascular epithelial growth factor (ant-VEGF) on the thickness of each retinal layer in patients with macular edema (ME) secondary to the branch retinal vein occlusion (BRVO).

Methods

This retrospective study included patients with ME secondary to monocular BRVO who received anti-VEGF therapy in Ningxia Eye Hospital between January-December 2020.

Results

Forty-three patients (25 males) were included, with 31 showed > 25% reduction in central retinal thickness (CRT) after anti-VEGF therapy (response group), and the others showed a ≤25% reduction in CRT (no-response group). The response group showed significantly smaller mean changes in the ganglion cell layer (GCL) (after 2 months) and inner plexiform layer (IPL) (after 1, 2, and 3 months) and significantly greater mean changes in the inner nuclear layer (INL) (after 2 and 3 months), outer plexiform layer (OPL) (after 3 months), outer nuclear layer (ONL) (after 2 and 3 months), and CRT (after 1 and 2 months) (all P < 0.05) as compared to the no-response group. The mean change in the thickness of each retinal layer IPL (P = 0.006) between the two groups was significantly different after controlling for a time and with a significant time trend (P < 0.001). Additionally, patients in the response group were more likely to have an improvement in IPL (43.68 ± 6.01 at 1 month and 41.52 ± 5.45 at 2 months vs. 39.9 ± 6.86 at baseline) after anti-VEGF therapy, while those in no response group might show improvement in GCL (45.75 ± 8.24 at 1 month, 40.00 ± 8.92 at 2 months, and 38.83 ± 9.93 at 3 months vs. 49.67 ± 6.83 at baseline).

Conclusions

Anti-VEGF therapy might help restore the retinal structure and function in patients with ME secondary to BRVO, and those who have a response after anti-VEGF therapy are more likely to improve IPL, while those having no response might show improvement in GCL.
Therapeutic outcome and long-term naturalistic follow-up of female adolescent outpatients with AN: clinical, personality and psychopathology evolution, process indicators and outcome predictors
Authors: Amianto Federico , Arletti Luca , Vesco Serena , Davico Chiara , Vitiello Benedetto
Published: May 2023

Background

Anorexia nervosa (AN) is a serious mental illness of growing prevalence in childhood and adolescence. Despite its severity, there are still no completely satisfactory evidence-based treatments. Follow-up studies represent the most effective attempt to enlighten treatment effectiveness, outcome predictors and process indicators.

Methods

Seventy-three female participants affected with AN were assessed at intake (T0) and at 6 (T1) and 12 (T2) months of an outpatient multimodal treatment program. Nineteen participants were assessed 15 years after discharge (T3). Changes in diagnostic criteria were compared with the chi-square test. Clinical, personality and psychopathology evolution were tested with ANOVA for repeated measures, using the t-test or Wilcoxon test as post-hoc. T0 features among dropout, stable and healed participants were compared. Healed and unhealed groups at long-term follow-up were compared using Mann-Whitney U test. Treatment changes were correlated to each other and with intake features using multivariate regression.

Results

The rate of complete remission was 64.4% at T2, and 73.7% at T3. 22% of participants maintained a full diagnosis at T2, and only 15.8% at T3. BMI significantly increased at each time-point. A significant decrease of persistence and increase in self-directedness were evidenced between T0 and T2. Interoceptive awareness, drive to thinness, impulsivity, parent-rated, and adolescent-rated general psychopathology significantly decreased after treatment. Lower reward dependence and lower cooperativeness characterized the dropout group. The healed group displayed lower adolescent-rated aggressive and externalizing symptoms, and lower parent-rated delinquent behaviors. BMI, personality and psychopathology changes were related with each other and with BMI, personality and psychopathology at intake.

Conclusion

A 12-months outpatient multimodal treatment encompassing psychiatric, nutritional and psychological approaches is an effective approach for the treatment of mild to moderate AN in adolescence. Treatment was associated not only with increased BMI but also with positive personality development, and changes in both eating and general psychopathology. Lower relational abilities may be an obstacle to healing. Approaches to treatment resistance should be personalized according to these finding.