bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Reason for Exam Imaging Reporting and Data System (RI-RADS) in inpatient diagnostic imaging referrals
Authors: Parillo Marco , Vaccarino Federica , Vertulli Daniele , Perillo Gloria , Montanari Edoardo , Mallio Carlo Augusto , Quattrocchi Carlo Cosimo
Published: November 2024

Objectives

To test the Reason for Exam Imaging Reporting and Data System (RI-RADS) in assessing the quality of radiology requests in an Italian cohort of inpatients; to evaluate the interobserver reliability of RI-RADS.

Methods

A single-center quality care study was designed to retrospectively identify consecutive radiology request forms for computed tomography, magnetic resonance imaging, and conventional radiography examinations. One radiologist scored the requests using the RI-RADS. The association between RI-RADS and clinical request variables (urgent request, on-call requests, indication for imaging, requesting specialty, imaging modality, and body region) was evaluated. We calculated interobserver agreement between four readers in a subset of 450 requests.

Results

We included 762 imaging requests. RI-RADS grades A (adequate request), B (barely adequate request), C (considerably limited request), D (deficient request), and X were assigned to 8 (1%), 49 (7%), 237 (31%), 404 (53%), and 64 (8%) of cases, respectively. In the multivariate analysis, the indication for imaging, body region, and requesting specialty significantly influenced the RI-RADS. Indications for imaging with a high risk of poor RI-RADS grade were routine preoperative imaging and device check requests. The upper extremity was the body region with the highest risk of poor RI-RADS grade. Requesting specialties with a high risk of poor RI-RADS grade were cardiovascular surgery, intensive care medicine, and orthopedics. The analysis of the interobserver agreement revealed substantial agreement for the RI-RADS grade.

Conclusion

The majority of radiology exam requests were inadequate according to RI-RADS, especially those for routine imaging. RI-RADS demonstrated substantial reliability, suggesting that it can be satisfactorily employed in clinical settings.

Critical relevant statement

The implementation of RI-RADS can provide a framework for standardizing radiology requests, thereby enabling quality assurance and promoting a culture of quality improvement.

Key Points

RI-RADS aims to grade the completeness of radiology requests.

Over half of the imaging requests were RI-RADS D grade; RI-RADS demonstrated substantial reliability.

Most radiology requests were inadequate and RI-RADS could classify them in clinical practice.

Graphical Abstract
How emergency departments are responding to the opioid crisis: Results from a statewide survey in Kentucky
Authors: Sugarman Olivia K. , Harris Samantha J. , Byrne Lauren , Flanagan Vivian , Gattine Sabrina , Desai Isha , Heidari Omeid , Gibbons Jason B. , Whaley Sara , Lucas David , Pugh Tracy , McBride Allison , Saloner Brendan
Published: November 2024

Objective

There is a rising effort for hospital emergency departments (EDs) to offer and expand substance use disorder (SUD) services. This state-wide evaluation studies SUD services offered along the continuum of implementation across Kentucky’s EDs to inform future state efforts to build ED bridge programs.

Methods

We conducted a mixed-methods study using an online survey of all Kentucky Emergency Department Directors between January and May of 2023. We created a hospital-level dataset which we used to summarize quantitative questions and thematically analyze open-ended responses.

Results

Our sample included 85 unique respondents (89% of all eligible Kentucky hospitals). Nine (11%) had active bridge programs to initiate opioid use disorder patients on buprenorphine. Respondents reported that the most challenging SUD-related services for EDs to implement were buprenorphine induction for opioid use disorder treatment (n = 36, 42%), referrals to community-based providers (n = 34, 40%), and providing social work services (n = 25, 29%). Respondents noted that the implementation and improvement of screening protocols were needed to better identify patients with SUD, expressed concerns about care continuity, and explicitly conveyed the need and desire for additional supports to provide SUD care.

Conclusions

The landscape of Kentucky’s ED SUD supports shows several hospitals that offer services along the continuum of SUD care, and highlights the importance of technical assistance and financial resources to ensure the continuum is broadly available. Kentucky’s experience speaks to broader national challenges in supporting SUD in EDs – specifically the need for financial resources, buy-in and education, and creating referral relationships to ensure care continuity.
ZnO-adipic acid composites as phase change material for latent heat thermal energy storage systems
Authors: Snekha N. R. , Hari Suthan V. , Suganthi K. S. , Naren Raggavendra S. , Sudharsan S. , Aishwarya R. , Rajan K. S.
Published: November 2024

This work evaluates the use of zinc oxide nanorods as intensifiers of a latent heat thermal energy storage system working with adipic acid as the phase change material (PCM). By virtue of not participating directly in the solid–liquid and liquid–solid phase transition, ZnO-adipic acid composites (ZnO-adipic acid) possessed lower specific heat and latent heat. Our results have shown that the overall heat transfer coefficient during the freezing of PCM through heat transfer to a well-mixed liquid bath is amplified by 61%, when adipic acid is replaced with 2 wt.% ZnO-adipic acid. Heterogenous nucleation due to well-dispersed, ZnO nanorods caused this enhancement. The large enhancement in discharge rate of 2 wt.% ZnO-adipic acid during freezing overweighs higher degree of latent heat loss due to its repeated thermal cycling. The enhancement in overall heat transfer coefficient reported here (61%) is the highest reported so far for any latent heat thermal energy system employing adipic acid or its composites.
EZH1/2 plays critical roles in oocyte meiosis prophase I in mice
Authors: Jiang Ting , Zhang Chengxiu , Cao Xinjing , Tian Yingpu , Cai Han , Kong Shuangbo , Lu Jinhua , Wang Haibin , Lu Zhongxian
Published: November 2024

Backgroud

abnormalities or defects in oocyte meiosis can result in decreased oocyte quality, reduced ovarian reserve, and female diseases. However, the mechanisms of oocyte meiosis remain largely unknown, especially epigenetic regulation. Here, we explored the role of EZH1/2 (histone methyltransferase of H3K27) in mouse oocyte meiosis by inhibiting its activity and deleting its gene.

Results

with embryonic ovary cultured in vitro, EZH1/2 was demonstrated to be essential for oocyte development during meiosis prophase I in mice. Activity inhibition or gene knockout of EZH1/2 resulted in cell apoptosis and a reduction in oocyte numbers within embryonic ovaries. By observing the expression of some meiotic marker protein (γ-H2AX, diplotene stage marker MSY2 and synapsis complex protein SCP1), we found that function deficiency of EZH1/2 resulted in failure of DNA double-strand breaks (DSBs) repair and break of meiotic progression in fetal mouse ovaries. Moreover, Ezh1/2 deficiency led to the suppression of ATM (Ataxia Telangiectasia Mutated kinase) phosphorylation and a decrease in the expression of key DNA repair proteins Hormad1, Mre11, Rad50, and Nbs1 in fetal mouse ovaries, underscoring the enzyme’s pivotal role in initiating DNA repair. RNA-seq analysis revealed that Ezh1/2-deletion induced abnormal expression of multiple genes involved into several function of oocyte development in embryonic ovaries. Knockout of Ezh1/2 in ovaries also affected the levels of H3K9me3 and H4K20me2, as well as the expression of their target genes L3mbtl4 and Fbxo44.

Conclusions

our study demonstrated that EZH1/2 plays a role in the DSBs repair in oocyte meiosis prophase I via multiple mechanisms and offers new insights into the physiological regulatory role of histone modification in fetal oocyte guardianship and female fertility.
Effects of famotidine use during pregnancy: an observational cohort study
Authors: Nishimura Ayako , Furugen Ayako , Kobayashi Masaki , Takekuma Yoh , Yakuwa Naho , Goto Mikako , Hayashi Masahiro , Murashima Atsuko , Sugawara Mitsuru
Published: November 2024

Background

Famotidine, a histamine2-receptor antagonist (H2Ras), is widely used to treat and prevent gastrointestinal symptoms during pregnancy. Although several studies have reported the use of H2Ras during pregnancy, limited data on famotidine were included in these reports. Therefore, we analyzed pregnancy outcome data to evaluate the effects of famotidine use during pregnancy on the fetus.

Methods

Pregnancy outcome data were used for females enrolled in two Japanese facilities that provided counseling on drug use during pregnancy between April 1988 and December 2017. For the primary endpoint, the incidence of congenital malformations was calculated from the data of live birth to pregnant women who took famotidine (n = 330) or drugs considered to exert no teratogenic risk (control, n = 1,407) during the first trimester of pregnancy. Considering secondary endpoints, the incidence of obstetric outcomes, including preterm delivery, was calculated from data on the use of famotidine (n = 347) and controls (n = 1,476) during the entire pregnancy. The crude odds ratios (cORs) for the incidence of congenital malformations were calculated using univariate logistic regression analysis, with the control group used as the reference. Adjusted ORs (aORs) were calculated using multivariate logistic regression analysis adjusted for various other factors.

Results

The incidences of congenital malformations in the famotidine and control groups were 3.9% and 2.8%, respectively. There was no significant difference between the famotidine and control groups (cOR: 1.40 [95% CI:0.68–2.71], aOR: 1.06 [95% CI:0.51–2.16]). Conversely, the preterm delivery rates were 8.1% and 3.8% in the famotidine and control groups, respectively, indicating a significant difference (cOR: 2.00 [95% CI:1.20–3.27]). However, the multivariate analysis eliminated famotidine use as a confounding factor.

Conclusions

This observational cohort study revealed that exposure to famotidine during the first trimester of pregnancy was not associated with an increased risk of congenital malformations in infants. Although a higher rate of preterm delivery was detected in famotidine users when compared with controls, this could be attributed to confounding factors, such as complications.
A qualitative study on the current status and problems of pharmacists in home healthcare from the viewpoint of care managers in medically underpopulated areas in Japan
Authors: Nakagawa Yuji , Kato Hideo , Iwamoto Takuya
Published: November 2024

Background

Unlike in urban areas, community healthcare in medically underpopulated areas in Japan is constantly challenged because of the uncertainty in effectively using the limited resources. However, no study has focused on human resources or identified the actual state of pharmacists’ support in the community. Therefore, our study identified the actual status and problems of pharmacists involved in home medical care in medically underpopulated areas and discussed the roles required of pharmacists and specific methods of support.

Methods

The content of semi-structured interviews with care managers involved in home healthcare in Misugi town, Tsu City, between November 10, 2023 and March 13, 2024, was analyzed qualitatively using the grounded theory approach.

Results

Five care managers participated in the study. Semi-structured interviews on the actual situation and challenges faced by pharmacists indicated that the following roles were required for pharmacists: as in other regions, it was observed that elderly people with dementia and those living alone managed their medicines, adjusted leftover medicines, collaborated with other professions, bridged with physicians, checked medication status through frequent visits, and adhered to internal medication regimens. Issues related to the characteristics of depopulated areas were identified including human resources, limitations of healthcare resources, economic burden, limits on the number of visits by pharmacists. As a characteristic of communities with no pharmacies and only in-hospital prescribing, pharmacists were expected by care managers to manage the problems caused by in-hospital prescribing.

Conclusions

Our findings suggest that pharmacists should ensure the number of visits and collaborate with attending physicians, visiting nurses, and care managers to conduct drug management for patients with dementia and older adults living alone. Community healthcare specialists and those involved in the healthcare planning system can also utilize these findings while planning home healthcare to those who live in medically underpopulated areas in Japan.
Granulomatous mastitis forming a well-defined large mass diagnosed by surgical excision: a case report
Authors: Hao Chisaki , Horimoto Yoshiya , Uomori Toshitaka , Shiraishi Akihiko , Orihata Gotaro , Onagi Hiroko , Hayashi Takuo , Watanabe Junichiro , Kutomi Goro
Published: November 2024

Background

Granulomatous mastitis is a relatively rare benign inflammatory disease of the breast, but it is sometimes difficult to distinguish from breast cancer by imaging. We experienced a case that was definitively diagnosed as granulomatous mastitis from the surgical specimen. The mass appeared as a large cystic lesion on imaging, which is unusual for granulomatous mastitis, and was initially suspected to be an encapsulated papillary carcinoma.

Case presentation

A 43-year-old woman presented with a painful mass in her right breast. Ultrasonography revealed a cystic mass lesion with internal solid components, with partially indistinct cyst walls and abundant blood flow. Additionally, lymphadenopathy of one axillary lymph node was observed. Magnetic resonance imaging findings showed irregularly spreading enhanced nodules within the cystic lesion, raising the suspicion of encapsulated papillary carcinoma. Although the histological findings from a needle biopsy were consistent with granulomatous mastitis, the possibility of malignancy could not be ruled out based on imaging, prompting a diagnostic probe lumpectomy. However, the surgical specimens did not reveal any tumorous lesions, and we reached a final diagnosis of granulomatous mastitis. Postoperatively, the patient was followed-up without steroid therapy and has been free from recurrence of mastitis for 22 months after surgery.

Conclusions

We report a case of granulomatous mastitis that was detected as a large cystic lesion with a well-defined border on imaging and a definitive diagnosis was made from a surgical specimen.
Microbial profile of diabetic foot osteomyelitis from the northwest of England
Authors: Metaoy Sara , Rusu Iulia , Pillai Anand
Published: November 2024

Background

Osteomyelitis of the diabetic foot is a common and challenging complication affecting patients with diabetic foot ulcers and infections. The complexity of these infections lies in their polymicrobial nature, high rates of persistence and recurrence. This study examined the microbiological profile of diabetic foot osteomyelitis from a teaching hospital in Northwest England and their resistance patterns to understand its impact on infection persistence and to direct effective treatment.

Methods

A retrospective review of 105 patients who underwent surgical management for diabetic foot osteomyelitis between 2019 and 2024. We analysed three consecutive culture samples for each patient to assess for the microbiological profile and resistance patterns of these infections and to monitor infection recurrence and persistence rates.

Results

A total of 105 patients were identified. Infection eradication was noted in 42% of the cohort, infection persistence in 18%, and late infection recurrence in 40%. Polymicrobial growth was evident in 72% of our study sample. Gram-positive bacteria made up the majority of the bacterial isolates in all 3 culture samples, 74.81% in sample 1, 69.31% in sample 2, and 55.1% in sample 3. Staphylococcus aureus was the most prevalent gram-positive bacteria, at 52.38% in sample 1, 36.19% in sample 2, and 18.09% in sample 3, followed by Haemolytic Streptococcus, Enterococcus and Corynebacterium. The frequently identified gram-negative bacteria were Pseudomonas in sample 1 (7.61%), E. coli and Proteus in sample 2 (5,71%), Pseudomonas and Proteus in sample 3 (2.85%). Gram-positive bacteria were resistant to penicillin and macrolides with resistance of staphylococcus aureus to clarithromycin identified among all 3 culture samples. Gram-negative bacteria were most resistant to amoxicillin. Staphylococcus aureus was responsible for infection persistence in most of our cohort (12/19) 63.15%. Among those patients, Staphylococcus was resistant to clarithromycin in 6 of the cases. The 5-year mortality rate for our study sample was 32.38%.

Conclusion

This study highlights the prevalence of polymicrobial growth and multi-drug resistant pathogens in the scope of diabetic foot osteomyelitis. It highlights the predominance of Staphylococcus aureus and its resistant strains among patients affected by diabetic foot osteomyelitis in Greater Manchester.
The status of dialysis patients in Asian countries under the coronavirus disease 2019 (COVID-19) disaster as of December 2019–June 2023: India
Authors: Hyodo Toru , Hirawa Nobuhito , Kuragano Takahiro , Takemoto Yoshiaki , Josi Cherin , Abraham Georgi , Hurmath Syeda , Matthew Milly , Thomas Tarun , Kumaraswami Latha A. , Lesli Nancy , Gopalakrishnan Natarajan
Published: November 2024

The coronavirus disease 2019 (COVID-19) pandemic affected the entire world with unprecedented impact on the health care and economy of countries. India, the most populous country, faced enormous challenges across its diverse population groups. The end-stage renal disease (ESRD) patients on dialysis, especially hemodialysis, were a high-risk group with inevitable regular hospital visits in contrast to the home peritoneal dialysis group. The unplanned lockdown and home confinement posed many risks to dialysis patients due to dialysis unit closures, logistical issues, and severe COVID-19-related morbidities. We have paucity of data on mortality of dialysis patients in India. We describe the reported and available data on COVID-19 in India from across different centers. The vaccination provided by two different pharmaceuticals such as Covaxin and Covishield in a small cohort of dialysis patients reduced infection and severity.
Introducing medical students to cultural psychiatry: perspectives and reflections on developing and delivering an elective module
Authors: Jokinen Tahir , Benachar Nawal , Rahim Arian
Published: November 2024

Cultural sensitivity, competence and curiosity are essential for clinicians. To promote these, we developed an elective module in cultural psychiatry for medical students, consisting of eight seminars. In seminar eight, we used film clips to teach mental state examination. We comment on the development and delivery of the module, and offer a selection of student feedback. Cultural psychiatry could be better integrated into core medical school curricula, and we call for research to explore this.
Carnalities
Authors: Ortega Mariana
Published: November 2024

In Carnalities, Mariana Ortega presents a phenomenological study of aesthetics grounded in the work of primarily Latinx artists. She introduces the idea of carnal aesthetics informed by carnalities, creative practices shaped by the self's affective attunement to the material, cultural, historical, communal, and spiritual. For Ortega, carnal aesthetics offers a way to think about the affective and bodily experiences of racialized selves. Drawing on Gloria Anzaldúa, Chela Sandoval, José Esteban Muñoz, Alia Al-Saji, Helen Ngo, Maurice Merleau-Ponty, Roland Barthes, and others, Ortega examines photographic works on Latinx subjects. She analyzes the photography of Laura Aguilar, Verónica Gabriela Cárdenas, and Susan Meiselas, among others, theorizing photography as a carnal, affective medium that is crucial for processes of self-formation, resistance, and mourning in Latinx life. She ends with an intimate reading of photography through a reflection of her own crossing from Nicaragua to the United States in 1979. Motivated by her experience of loss and exile, Ortega argues for the importance of carnal aesthetics in destabilizing and transforming normative, colonial, and decolonial subjects, imaginaries, and structures.
Neurosurgery Fellowships and the Residencies That Enfold Them: A Nationwide Correlational Analysis
Authors: Bashir Raahim , Gould Grahame C. , Miller Jonathan P.
Published: November 2024

BACKGROUND AND OBJECTIVES:

Accredited neurosurgery fellowship training is available in 10 subspecialties and can sometimes be completed during the postgraduate year (PGY)-7 residency year. However, it is not clear whether there are sufficient residency graduates to fill the number of positions available, and residency curriculum structure to support enfolded training is evolving.

METHODS:

Detailed information about the 117 accredited neurosurgery residency programs and the 282 accredited neurosurgery fellowships was obtained from the Accreditation Council for Graduate Medical Education and Committee on Advanced Subspecialty Training, respectively. Information about residency chief year structure (PGY-6 vs PGY-7) was obtained electronically from each program. An analysis was performed to correlate residency and fellowship training characteristics at each program.

RESULTS:

The total number of neurosurgery fellowship positions available per year (352) is much higher than the total number of residency positions (237). Eighty-eight (75%) institutions with a neurosurgery residency offer at least 1 fellowship, and 51 of these have more fellowships than graduating residents. The resident complement at each program correlates with the number of fellowships offered (r2= .56,P< .05), and the average institutional resident complement where fellowships are offered is greater than 2 per year. Thirty-eight residencies (32%) use a PGY-6 chief model (allowing for enfolded fellowships), and these programs offer significantly more fellowship programs on average than those using a traditional PGY-7 chief model (3.0 vs 2.1,P< .05). For most subspecialties, a minority of fellowships are offered in programs with a PGY-6 chief model.

CONCLUSION:

The number of accredited neurosurgery subspecialty fellowship slots in the United States far exceeds the number of graduating neurosurgery residents. There is no standard for residency curriculum or enfolded fellowships, but smaller programs offer fewer opportunities for subspecialty training. There may be advantages to a uniform approach that standardizes subspecialty training across programs and matches fellowship availability to demand.
Συστήματα-σε πραγματικό χρόνο
Authors: Φιλοπούλου Αικατερίνη
Published: November 2024

Με αφορμή το έργο του Γερμανού καλλιτέχνη Hans Haacke με τίτλο Κύβος Συμπύκνωσης (1962-65) στην ανά χείρας διατριβή προσεγγίζονται και μελετώνται τα κοινά σημεία της Θεσμικής Κριτικής και των Συστημάτων-σε πραγματικό χρόνο στην τέχνη. Ειδικότερα, διερευνάται η εσωτερική λειτουργία του Κύβου Συμπύκνωσης σε δύο επίπεδα. Πρώτον αυτό της ενδελεχούς παρατήρησης του φαινομένου που λαμβάνει χώρα στο εσωτερικό του Κύβου και δεύτερον αυτό της διερεύνησης της πρωταρχικής δομής του, της συνθήκης της ρευστότητας. Η έρευνα ισχυρίζεται ότι η μεταβλητότητα, τόσο στον Κύβο Συμπύκνωσης όσο και στο σύνολο του έργου του Haacke, αποτελεί την κυρίαρχη δομή του· ενώ το στοιχείο το οποίο την ενσωματώνει με τον πλέον χαρακτηριστικό τρόπο είναι η γλώσσα. Γι’ αυτό το λόγο, οργανώνεται μια αφηγηματική ξενάγηση στα παρακάτω επιλεγμένα παραδείγματα όπου εμφανίζεται: η γλώσσα ως χωρικότητα (GERMANIA (1993), WEST BANK: 1994, 27th Year of Occupation (2007-2009)), η γλώσσα ως οπτική ή/και οπτική απάτη (Oelgemaelde, Hommage à Marcel Broodthaers (1982)), η γλώσσα ως τεχνική (Shapolsky et. al. Manhattan Real Estate Holdings, a Real-Time Social System, as of May 1, 1971 (1971), MOMA-Poll (1970), New Museum Visitors Poll (2019), Photographic Notes Documenta 2 (1959)), η γλώσσα ως μετάφραση (Mixed Messages (2013), DER BEVÖLKERUNG (1999), We(all) are the people (2003-17)), η γλώσσα ως σύστημα (Gift Horse (2012)). Στο πλαίσιο της γλώσσας ως τεχνικής, επιπρόσθετα μελετάται το παράδειγμα του έργου των Andrea Robbins & Max Becher τόσο στο σύνολό του όσο και ειδικότερα το έργο τους με τίτλο Where do you think you are Bay of Pigs, Playa Giron, Cuba (1993). Στη διατριβή η ρευστότητα αναδεικνύεται στην κυρίαρχη αλληγορική δομή του Κύβου Συμπύκνωσης ο οποίος αποτελεί τη δομή-πρότυπο, την κεντρική ιδέα της στρατηγικής του Haacke. Επιχειρείται να δειχθεί ότι ο Κύβος Συμπύκνωσης αποτελεί το γενετικό μοντέλο, την ποιητική μεταφορά, όπου το παρελθόν γίνεται παρόν, περιλαμβάνοντας την καταγωγική λογική η οποία απασχολεί διαχρονικά το Haacke, ότι είναι ένα έργο αμιγώς πολιτικό, που αποτελεί την υλοποίηση μιας κριτικής διανοητικής τάσης. Τέλος, μέσα από τον Κύβο Συμπύκνωσης και τα υπόλοιπα έργα που μελετώνται εδώ, διαπιστώνεται ότι ο Haacke κάνει μια πολιτική χωρίς τίτλο, ασκώντας μια κριτική των θεσμών, εντός των θεσμών.
Εκτίμηση της αποτελεσματικότητας της συγχορήγησης ροπιβακαΐνης και θειικού μαγνησίου στην μετεγχειρητική αναλγησία μετά από τοπική διήθηση του τραύματος της θυρεοειδεκτομής/παραθυρεοειδεκτομής
Authors: Λάσκου Στυλιανή
Published: November 2024

Σκοπός: Σκοπός της μελέτης ήταν να διαπιστωθεί αν ο συνδυασμός ροπιβακαϊνης με θειϊκό μαγνήσιο οδηγεί σε καλύτερο αναλγητικό αποτέλεσμα μετά από την τοπική διήθηση του τραύματος της θυρεοειδεκτομής ή παραθυρεοειδεκτομής. Μέθοδος: Πρόκειται για μια τυχαιοποιημένη διπλά τυφλή μελέτη κατά την οποία ο ασθενής θα ανήκε σε μια από τις παρακάτω ομάδες: Ομάδα R: Διήθηση του τραύματος από το χειρουργό κατά την σύγκλειση με ροπιβακαϊνη 7.5%. Ομάδα MgR: Διήθηση του τραύματος από το χειρουργό κατά την σύγκλειση με συνδυασμό ροπιβακαϊνης 7.5% και θειϊκού μαγνησίου Ομάδα P (Placebo): Διήθηση του τραύματος από το χειρουργό κατά την σύγκλειση με N/S 0.9%. Μετεγχειρητικά κατά τις χρονικές στιγμές 30 λεπτα, 1,2,4,6,12,24 ώρες εκτιμήθηκε το άλγος με τη χρήση της κλίμακας VAS ενώ καταγράφηκε η συνολική κατανάλωση αναλγητικών σε ανάλογα μορφίνης. Τα επίπεδα κορτιζόλης, TNF-α και IL-6 υπολογίστηκαν τις χρονικές 30 λεπτά πριν τη διήθηση του τραύματος και στις 6 και 24 ώρες μετεγχειρητικά. Αποτελέσματα: Συνολικά 66 ασθενείς συμμετείχαν στη μελέτη. Η συνολική 24ωρη κατανάλωση αναλγητικών ήταν σημαντικά μικρότερη για τους ασθενείς της ομάδας MgR έλαβαν σε σύγκριση με τους ασθενείς της ομάδας R (7.53 ± 14.55 mg vs. 18.30 ± 13.16 mg, p < 0.01, αντίστοιχα). Οι ασθενείς της ομάδας P εμφάνισαν την μεγαλύτερη ανάγκη αναλγησίας σε σύγκριση με τις άλλες δυο ομάδες. (39.35 ± 19.93 mg vs. 7.53 ± 14.55 mg vs. 18.30 ± 13.16 mg, p < 0.001). Η ομάδα MgR εμφάνισε στατιστικά σημαντικά μικρότερο στην κλίμακα VAS τόσο κατά την ηρεμία όσο και την κίνηση σε όλες τις χρονικές στιγμές συγκρινόμενη με την ομάδα R και placebo (p<0.05). Ωστόσο, η ανάλυση των βιοχημικών δεικτών δεν κατέληξε σε καποια διαφορά. Η πιο συχνή ανεπιθύμητη ενέργεια ήταν η αίσθηση ξηρότητας (sore throat) χωρίς διαφορά μεταξύ των ομάδων. Συμπεράσματα: Η συγχορήγηση ροπιβακαϊνης και θειϊκού μαγνησίου φαίνεται αποτελεσματική στην ελάττωση του μετεγχειρητικού πόνου μετά από θυρεοειδεκτομή, ενώ παράλληλα σημειώνεται η ικανοποίηση των ασθενών.
Holistic approaches to living well with endometriosis
Authors: Desai Jessica , Strong Sophie , Ball Elizabeth
Published: November 2024

Endometriosis is a common chronic non curable neuro-inflammatory condition, which can cause endometriosis-related pelvic pain (ERPP). Sufferers may struggle with side effects and/or risks from conventional medical and surgical treatments, or not get pain relief. Increasing numbers of endometriosis patients wish to explore holistic management with fewer side effects, however it is important that medical professionals maintain an evidence-based practice for recommended treatments. We present up-to-date evidence of holistic strategies used for managing ERPP including nutrition, body and mind therapies, acupuncture, traditional Chinese medicine (TCM) and the use of adjunct devices such as phallus length reducers and transcutaneous electrical nerve stimulation (TENS). Recent findings: Nutrition: Gluten-free, low-nickel and high intake of omega-3 polyunsaturated fatty acids diets improve ERPP. Low FODMAP (fermentable oligo-, di-, monosaccharides and polyols), plant-based diet and antioxidant vitamin supplementation is helpful including those with concurrent irritable bowel syndrome. Body and Mind: Cognitive behaviour therapy (CBT) is beneficial in postoperative pain reduction, whilst mindfulness has been shown to reduce pain scores and dyschezia. Progressive muscle relaxation therapy and regular yoga sessions improve ERPP and Quality of life. Acupuncture: Acupuncture and moxibustion show improved pain scores compared to conventional therapies alone. Adjunct devices: TENS improves deep dyspareunia and reduces the number of days pain is experienced. Summary: Holistic management strategies for ERPP should be incorporated into routine counselling when discussing conservative, medical and or surgical treatments for endometriosis. The growing evidence presented for the use of holistic management strategies gives hope to those patients who cannot have, or don’t respond to conventional approaches and as an adjunct alongside standard treatments. These findings should be incorporated into the routine counselling when seeing patients in the gynaecology outpatient setting presenting with chronic pelvic pain.
Describing and optimising travel distances in amateur football and handball in Germany
Authors: Dittrich Michael , Resch Julian , Tcymbal Antonina , Völk Tobias , Ziemainz Heiko , Abu-Omar Karim
Published: November 2024

Background Humanity faces dual existential crises of biodiversity loss and global warming. Acknowledging the environmental impact of sports, the United Nations is calling on the sports sector to take the lead in fighting climate change and adopting climate-neutral practices. Research on the greenhouse gas emissions of amateur league play is evolving but to date there are few studies that have described the travel patterns for large samples of teams and explored ways to reduce travel. Methods Travel distances for the 2022/23 season were calculated for 339 amateur football and handball teams playing in different leagues in Bavaria. The program Gurobi was utilised to optimise the grouping of teams in order to reduce travel by car. Results The study showed that playing in a higher amateur league most often resulted in longer travel distances for both women’s and men’s sports. Some amateur teams had to travel up to 2,958 kilometres for one season of play. All 339 teams combined travelled a total of 474,231 km (1398.9 per team in average) for away matches in the 2022/23 season of play. Optimising the groups in which teams play can reduce total travel distances by up to 19.7% while keeping the number of games played constant. Conclusions Our findings indicate that travel distances in amateur football and handball, despite being shorter than those of professional teams, contribute significantly to carbon emissions. Due to the greater number of amateur teams and the necessity to reduce greenhouse gas emissions, it is crucial to explore ways of reducing travel in amateur sports. This touches on ethical issues regarding how much travel that causes greenhouse gas emissions is justified in amateur play. Algorithm based optimisation of which teams play against each other appears to be a straightforward, cost-effective, and scalable method for reducing travel emissions in amateur sports.
The Relationship Between Mental Health and Periodontal Disease: Insights from NHANES Data
Authors: AlJoghaiman Eman
Published: November 2024

Introduction and aim Periodontal disease, initiated by dental biofilm and influenced by various local and systemic factors, includes stress as a potential contributor to its progression. Despite associations with severe forms like acute necrotizing ulcerative gingivitis, a comprehensive large-sample study linking stress to periodontal disease is lacking. This study aims to investigate the relationship between mental health and periodontal disease. Materials and Methods Leveraging data (secondary dataset) from the National Health and Nutrition Examination Survey (NHANES) from 2011–2012 and NHANES 2013–2014 cycles, relevant information was extracted. Mental health was the exposure variable, and periodontal disease, assessed through indices following Eke et al.’s definition, served as the outcome. Covariates (demographical characteristics) impacting periodontal disease were considered, and disease status analyses employed the Rao-Scott chi-squared test. A logistic regression model assessed mental health’s impact on periodontal disease. Results Among the 2764 Participants, more than a quarter (29.1%) were aged over 60 years, 52% were females. Logistic regression indicated higher odds of periodontal disease among individuals feeling bad about themselves for more than half of the day (OR 1.170, 95% CI 0.533-2.474), though statistical significance was not reached. Periodontitis prevalence significantly varied based on marital status, with 6.6% of married and 10.8% of unmarried Participants affected. Notably, a statistically significant difference in periodontitis prevalence existed between Participants with health insurance (8.3%) and those without (16.5%). Conclusion Our findings suggest trends in periodontal disease prevalence linked to mental health, marital status, and access to health insurance. However, the absence of statistically significant findings calls for caution in interpreting these relationships. We recommend that future studies further investigate these potential associations to provide a clearer understanding.
Bibliometric analysis on the factors that affect the cycle of formulation, evaluation, and management of social project
Authors: Gonzalez-Mejia Francisco Javier , Acosta-Rangel Marha Lucia , Tobar-Dejesus Jorge Arbey
Published: November 2024

Background Projects enable the resolution of problems and alter societal realities, assuming they represent the optimal choices to modify living conditions positively. If projects are deemed intelligent solutions to problems, why do they fail? This question will be addressed in this article through bibliometric analysis. Methods A bibliometric analysis was conducted on the success or failure factors influencing social investment projects, through a descriptive study with search equations, utilizing a comparative matrix to analyze 32 articles from Scopus and 22 from Web of Science. Results As a result, the number of publications, the themes addressed, and their origins between 2018 and 2023 were identified. The VOSviewer software allowed for identifying keywords and their relationships; with this input, a review of scientific production was conducted to subsequently identify the factors influencing projects and how they have been addressed within their contexts. Conclusions In conclusion, it was found that both the factors influencing success or failure in projects are permeated by the environment and the impact of political, social, and economic factors, in addition to the interaction of elements related to soft and hard skills.
ecoSound-web: an open-source, online platform for ecoacoustics
Authors: Darras Kevin F.A. , Pérez Noemí , Dilong Liu , Hanf-Dressler Tara , Markolf Matthias , Wanger Thomas C , Cord Anna F.
Published: November 2024

Passive acoustic monitoring of soundscapes and biodiversity produces vast amounts of audio recordings, but the management and analyses of these raw data present technical challenges. A multitude of software solutions exist, but none can fulfil all purposes required for the management, processing, navigation, and analysis of acoustic data. The field of ecoacoustics needs a software tool that is free, evolving, and accessible. We take a step in that direction and present ecoSound-web: an open-source, online platform for ecoacoustics designed and built by ecologists and software engineers. ecoSound-web can be used for storing, re-sampling, organising, analysing, and sharing soundscape recording or metadata projects. Specifically, it allows manual annotation of soniferous animals and soundscape components, automatic annotation with deep-learning models for all birds and for UK bat species, peer-reviewing annotations, analysing audio in time and frequency dimensions, computing alpha acoustic indices, and providing reference sound libraries for different taxa. We present ecoSound-web’s structure and features, and describe its operation for typical use cases such as sampling bird and bat communities, using a primate call library, and the analysis of soundscape components and acoustic indices. ecoSound-web is available from: https://github.com/ecomontec/ecoSound-web
Spór o redukcjonizm w medycynie. Studium filozoficzne i metodologiczne
Authors: Juś Marcin
Published: November 2024

Książka przedstawia analizę problemu redukcjonizmu w medycynie z perspektywy filozofii nauki. Wskazuje na umiarkowany antyredukcjonizm jako stanowisko najbardziej wartościowe poznawczo w stosowanych naukach medycznych. Celem pracy jest również prześledzenie, jak filozoficzne debaty dotyczące wspominanego zagadnienia łączą się, jawnie lub niejawnie, z praktyczną nauką medyczną – w tym ze szczegółowymi dyrektywami metodologicznymi i z definiowaniem zdrowia. W książce proponuje się rozróżnienia na dwa paradygmaty medycyny: redukcjonistyczny i systemowo-holistyczny, u podstaw których leżą zarówno odmienne, jak i pewne wspólne założenia filozoficzno-metodologiczne. Wielu filozofów medycyny z rozmaitych przyczyn zdecydowanie odrzuca redukcjonizm. Przyjęta w monografii koncepcja umiarkowanego antyredukcjonizmu oraz różnych paradygmatu w naukach medycznych wiedzie jednak do możliwości łączenia badań prowadzonych według założeń redukcjonizmu z medycyną holistyczno-systemową. Aby taka integracja była możliwa, konieczne jest rozwiązanie problemu relacji międzypoziomowej – związku zdarzeń poziomu molekularnego z poziomem tkankowym, osobowym, społecznym itd. Wydaje się, że postawa umiarkowanego antyredukcjonizmu pozwala trafnie zdefiniować podstawowy cel medycyny – zdrowie, które okazuje się bardzo trudne do teoretycznego ujęcia jedynie w odniesieniu do założeń redukcjonistów.
Polityka pisarstwa historycznego. Refleksja teoretyczna Haydena White'a
Authors: Muchowski Jakub
Published: November 2024

Refleksja teoretyczna nad historią oferowana przez Haydena White’a na ogół pojawia się w dyskusjach o statusie poznawczym rezultatów pracy historyka, relacji między sztuką a historiografią i moralnych zobowiązaniach badaczy dziejów. Prezentowana książka skupia się za zaproponowanym przez amerykańskiego historyka opisie związków łączących pisarstwo historyczne i politykę. Podstawą myślenia White’a jest założenie o istnieniu ścisłej korelacji między poetyką a polityką pisarstwa historycznego. To, jak wypowiadamy się o przeszłości, określa nasz stosunek do teraźniejszości i nasze oczekiwania wobec przyszłości. Kształtuje bowiem sposoby postrzegania rzeczywistości, zmieniając lub zachowując ramy myślenia i działania. Ważnymi punktami dyskursy historycznego definiującymi te ramy są między innymi pojęcia: sprawczość, struktura, ideologia, realizm, modernizm, utopia, antycypacja i spełnienie. Ich użycie pozwoliło na wyeksponowanie i analizę teoretycznych działań White’a performujących przemianę pisarstwa historycznego w instrument emancypacji.
Ashwagandha and stress
Authors: Sobota Weronika , Piskorz Przemysław , Zemsta Katarzyna , Zwoliński Michał , Tyniec Mateusz , Morshed Kamal
Published: November 2024

Ashwagandha, also known as Withania somnifera, is an adaptogen gaining popularity as a natural stress reducer. Stress is a common phenomenon caused by factors such as lifestyle, work pressure or social conflict, and has a negative impact on both mental and physical health. In response to these challenges, more and more people are looking for natural solutions, and adaptogens such as ashwagandha offer support in dealing with stress without significant side effects. Scientific research shows that ashwagandha can lower levels of the stress hormone cortisol and improve results on tests assessing stress, anxiety and depression. Numerous studies conducted on both animals and humans confirm its beneficial effects on mental and physical health, including improvement of cognitive functions, sleep quality and emotional well-being. The mechanism of action of ashwagandha includes regulation of the HPA axis, reduction of glucocorticoids and modulation of the immune system. Despite promising results, further research is needed to fully understand its mechanism of action, assess long-term effects, and investigate possible interactions with other drugs. Ashwagandha seems to be a safe and effective agent in the fight against stress, but it is recommended to consult a doctor before starting supplementation.
In the Wild: Appreciative Inquiry with the Threshold Choir
Authors: Greenbaum Jill
Published: November 2024

While Appreciative Inquiry is often explicitly used in formal organizational settings, this case presentation highlights the effectiveness of its use, ‘on the quiet’, with a local Threshold Choir (a group dedicated to providing compassionate support through song to individuals nearing the end of life). By using AI principles to facilitate a collaborative meeting, the author helped the choir identify strengths, envision a desired future, and create a plan for positive change, demonstrating AI’s versatility and its potential to foster growth and improvement in diverse contexts.
Happy People: How an Eight-Year-Old Learned About Making Happy Things Happen
Authors: Marcinkevage Carrie
Published: November 2024

This article illustrates the transformative power of Appreciative Inquiry through the story of Josh, an eightyear- old learning to identify daily positives. He discovers that happy people don’t just experience happiness – they actively create it. This insight, which the author terms ‘Appreciative Impulsion’, highlights how focusing on positivity not only changes one’s internal outlook but also manifests in the external world.
Avaliação de necessidades para promover comportamentos pró-sociais na educação infantil
Authors: Freitas Iara da Silva , Da Silva Melo Márcia Helena
Published: November 2024

Diante da alta prevalência da violência escolar, mostra-se relevante o desenvolvimento de ações voltadas a prevenir esse problema e criar contextos escolares promotores de comportamentos pró-sociais desde a primeira infância. Nessa direção, faz-se importante a realização de estudos prévios e de avaliação de necessidades. Este estudo teve como objetivo avaliar necessidades relacionadas à promoção de comportamentos pró-sociais na educação infantil. Foi realizado estudo transversal, de avaliação com métodos mistos. Participaram 4 professoras e 67 crianças (com idade entre 4 e 5 anos, sendo 34 meninas e 33 meninos), de uma escola pública de educação infantil. Foram realizados procedimentos de observação, administração de inventário de habilidades sociais educativas e entrevistas. Os dados obtidos passaram por tratamentos específicos e foram submetidos à análise descritiva ou temática. Os resultados apontaram recursos que incluíram a existência de práticas potencialmente promotoras de comportamentos pró-sociais nos repertórios das professoras e dos referidos comportamentos nos repertórios das crianças; além de dificuldades que envolveram lacunas na formação do professor, repertório de habilidades sociais educativas a ser aprimorado e percepção da violência que se expressa na escola como decorrente apenas de eventos externos à instituição. Os achados convidam ao investimento em três dimensões, a saber, pesquisa, ensino e advocacy.
Settling into routine
Authors: Green Jennifer
Published: November 2024

As more paramedics transition across various roles, Band 6 paramedic, Jennifer Green shares her journey in a new monthly column in 2024, as she makes her way from the ambulance setting into general practice
Role of nutrition in diabetes mellitus and infections
Authors: Yu Xue-Lu , Zhou Li-Yun , Huang Xiao , Li Xin-Yue , Wang Ming-Ke , Yang Ji-Shun
Published: November 2024

In this editorial, we have commented on the article that has been published in the recent issue of World Journal of Clinical Cases . The authors have described a case of unilateral thyroid cyst and have opined that the acute onset of infection may be linked to diabetes mellitus (DM). We have focused on the role of nutrition in the association between DM and infection. Patients with DM are at a high risk of infection, which could also be attributed to nutrition-related factors. Nutritional interventions for patients with diabetes are mainly based on a low-calorie diet, which can be achieved by adhering to a low-carbohydrate diet. However, dietary fiber supplementation is recommended to maintain the diversity of the gut microbiota. Furthermore, high-quality protein can prevent the increased risk of infection due to malnutrition. Supplementation of vitamins C, vitamins A, vitamins D, and folic acid improves blood sugar control and facilitates immune regulation. Mineral deficiencies augment the risk of infection, but the relationship with diabetes is mostly U-shaped and a good intake should be maintained.
A Review of the Antioxidant and Antimicrobial Activities and Photoprotective Properties of Psidium guajava L.
Authors: Dewage Dona Darshani Hansamani Dewage , Rajapakse Chandima Shashikala Kumari
Published: November 2024

Psidium guajava L. popularly known as a poor man's apple is not just a tropical plant that provides delicious fruit but also offers numerous benefits for mankind across various disciplines due to its rich pool of phytochemicals with bioactive properties. Many scientific investigations confirmed that guava leaves, fruit pulp, peel, and seeds are rich in compounds with nutritional, pharmacological, medicinal, and cosmeceutical properties. The objective of this comprehensive review is to compile the data on photoprotective properties (ultraviolet protection), antioxidants, and antimicrobial activities of Psidium guajava L. published in the last two decades and to discuss how these properties are advantageous for potential photoprotective cosmeceutical industrial applications.
CICLO MENSTRUAL E SUSTENTABILIDADE PODEM CAMINHAR JUNTOS? INTERAÇÕES EM UMA COMUNIDADE VIRTUAL DE PRODUTOS MENSTRUAIS REUTILIZÁVEIS
Authors: Daboit Sandra Beatriz Belo Guimarães , Morais Bárbara Oliveira de , Leal Lidiane Manthay , Araújo Ana Paula Sodré
Published: November 2024

Este trabalho teve como objetivo central investigar fatores associados ao consumo e à relação das pessoas com produtos menstruais reutilizáveis a partir de uma perspectiva de comunicação entre marca e público-alvo. Observamos que a oferta de produtos menstruais adaptados a diferentes tipos de corpos tem disputado espaço no mercado. Nesse contexto, comunidades virtuais, ao promoverem o compartilhamento de informações sobre menstruação, criam oportunidades de negócios para marcas que investem em produtos menstruais reutilizáveis. Por ser uma pesquisa qualitativa de natureza exploratória-descritiva, conduzimos por meio da observação online, com inspiração netnográfica, análise da comunidade virtual da Inciclo. A partir das respostas e postagens informativas da marca, bem como as interações referente às dúvidas e preocupações das usuárias, identificou-se uma oportunidade de negócio, pois a Inciclo conversa com potenciais clientes como se estivesse em “um papo entre amigas” que reforçam a confiança e a lealdade à marca.