bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of autologous emulsified stromal vascular fraction tissue injection for the treatment of complex perianal fistulas in inflammatory bowel diseases patients: a pilot study
Authors: Potenza Angelo Eugenio , Nachira Dania , Sacchetti Franco , Trivisonno Angelo , Pugliese Daniela , Boškoski Ivo , Caudullo Giuseppe , Minordi Laura Maria , Larosa Luigi , Caprino Paola , Scaldaferri Franco , Sofo Luigi , Porziella Venanzio
Published: September 2024

Complex fistulizing perianal disease is a disabling manifestation of inflammatory bowel disease (IBD), seriously compromising patients ‘quality of life’. The success rate of available treatments is quite low, and nearly half of the patients will develop chronically active fistulas or experience fistula recurrence. Mesenchymal stem cell therapy has shown interesting results, but the complexity and the cost of production limit its widespread use. This study aims to report the results of the innovative use of autologous emulsified adipose-derived stromal vascular fraction tissue for treating complex fistulizing perianal disease. From March 2021 to March 2022, 10 patients underwent a two-step procedure: (1) examination under anaesthesia, with loose seton drainage and 4 weeks later and (2) curettage of the fistulous tract, internal fistula closure and an injection of autologous emulsified adipose-derived stromal vascular fraction tissue harvested from the subcutaneous layer of the patient’s hip. Clinical and radiological (through magnetic resonance imaging) healing were assessed at 6 months. We included five patients affected by Crohn’s disease, three by ulcerative colitis and two by indeterminate colitis. All patients were on concomitant biological therapy (50% on Infliximab). One patient required a re-treatment for a relapse and two different fistulas were separately treated in another one. Out of 12 total procedures performed, clinical healing was achieved in 10 cases (83%), while radiological healing in 6 patients (50%). No adverse events were recorded. Autologous emulsified adipose-derived stromal vascular fraction tissue can represent an effective, safe and cheap add-on therapy for patients with complex perianal fistulas in IBDs.
Comparison of acoustic, optical, and heat release rate based flame transfer functions for a lean-burn injector under engine-like conditions
Authors: Alanyalıoğlu Çetin Ozan , Reinhardt Hanna , Fischer André , Lahiri Claus , Nicolai Hendrik , Hasse Christian
Published: September 2024

Determining the flame transfer function plays a crucial role during the development phase of lean-burn injectors to predict the overall stability of the combustion system. This study develops an enhanced acoustic post-processing strategy using acoustic network modeling and compressible large-eddy simulation for a lean-burn aero-engine injector in a realistic test rig. Results show that optical flame transfer functions experimentally obtained align with those derived from large-eddy simulation based on heat release rate. However, discrepancies, especially in gain, are observed when using the standard acoustic post-processing method. By employing an acoustic network model, it is shown that comparable flame transfer functions can be achieved through refined post-processing strategies. This study highlights the limitations of conventional acoustic post-processing and underscores the necessity of explicit acoustic modeling in complex setups to accurately obtain the flame response. A generalized formulation applicable to a broader range of setups, extending beyond simple configurations, is presented as an alternative to the conventional acoustic post-processing method.
Genetic landscape of homologous recombination repair and practical outcomes of PARPi therapy in ovarian cancer management
Authors: Chen Mengyu , Lei Ningjing , Guo Ruixia , Han Liping , Zhao Qinghe , Zhao Yang , Qiu Luojie , Wu Fengling , Jiang Shan , Tong Ningyao , Wang Kunmei , Li Siyu , Chang Lei
Published: September 2024

Background:

Genetic studies of ovarian cancer (OC) have historically focused on BRCA1/2 mutations, lacking other studies of homologous recombination repair (HRR). Poly (ADP-ribose) polymerase inhibitors (PARPi) exploit synthetic lethality to significantly improve OC treatment outcomes, especially in BRCA1/2 deficiency patients.

Objectives:

Our study aims to construct a mutation map of HRR genes in OC and identify factors influencing the efficacy of PARPi.

Design:

A retrospective observational analysis of HRR gene variation data from 695 OC patients from March 2019 to February 2022 was performed.

Methods:

The HRR gene variation data of 695 OC patients who underwent next-generation sequencing (NGS) in the First Affiliated Hospital of Zhengzhou University were retrospectively collected. Clinical data on the use of PARPi in these patients were also gathered to identify factors that may interfere with the efficacy of PARPi.

Results:

Out of 127 pathogenic variants in the BRCA1/2 genes, 104 (81.9%) were BRCA1 mutations, and 23 (18.1%) were BRCA2 mutations. Among the 59 variants of uncertain significance (VUS), 20 (33.9%) were BRCA1, while 39 (66.1%) were BRCA2 mutations. In addition to BRCA1/2, HRR gene results showed that 9 (69%) of 13 were HRR pathway pathogenic variants; and 16 (1.7%) of 116 VUS were Food and Drug Administration (FDA)-approved mutated HRR genes. Notably, the treatment regimen significantly influenced the effectiveness of PARPi, especially when using first-line maintenance therapy, leading to enhanced progression-free survival (PFS) compared to alternative protocols.

Conclusion:

Focusing on HRR gene mutations and supporting clinical research about PARPi in OC patients is crucial for developing precision treatment strategies and enhancing prognosis.
Electronic Health Record Alert With Heart Failure Risk and Sodium Glucose Cotransporter 2 Inhibitor Prescriptions in Diabetes: A Randomized Clinical Trial
Authors: Segar Matthew W. , Patel Kershaw V. , Keshvani Neil , Kannan Vaishnavi , Willett Duwayne , Klonoff David C. , Pandey Ambarish
Published: September 2024

Background:

Sodium glucose cotransporter 2 inhibitors (SGLT2i) prevent heart failure (HF) in patients with type 2 diabetes mellitus (T2DM) but prescription rates are low. The effect of an electronic health record (EHR) alert notifying providers of patients’ estimated risk of developing HF on SGTL2i prescriptions is unknown.

Methods:

This was a pragmatic, randomized clinical trial that compared an EHR alert and usual care among patients with T2DM and no history of HF or SGLT2i use at a single center. The EHR alert notified providers of their patient’s HF risk and recommended HF prevention strategies. Randomization was performed at the provider level across general and subspecialty internal medicine as well as family medicine outpatient clinics. The primary outcome was proportion of SGLT2i prescriptions within 30 days. Proportion of natriuretic peptide (NP) tests within 90 days was also assessed.

Results:

A total of 1524 patients (median age 75 years, 45% women, 23% Black) were enrolled between September 28, 2021, and April 29, 2022 from 189 outpatient clinics. SGLT2i were prescribed to 1.2% (9/780) of patients in the EHR alert group and 0% (0/744) of those in the usual care group ( P value = 0.009). Natriuretic peptide testing was performed within 90 days among 10.8% (84/780) of patients in the EHR alert group and 7.3% (54/744) of patients in the usual care group ( P value = 0.02).

Conclusions:

In a single-center trial with low overall SGLT2i use, an EHR alert incorporating HF risk information significantly increased SGLT2i prescriptions and NP testing although the absolute rates were low.
Antimicrobial and Molecular Docking Studies of Anthrones from the Leaf Latex of Aloe pirottae A. Berger against Some Plant Pathogenic Microbes
Authors: Ayele Shewaneh , Aragaw Misgana , Kebede Denberu , Birke Bayoush , Bisrat Daniel
Published: September 2024

Objective/Background: Aloe pirottae A. Berger has traditionally been used in Ethiopia to treat various ailments. While previous studies have examined the antimicrobial activity of different parts of A. pirottae against human pathogens, this study aimed to investigate whether its antimicrobial activity extends to plant pathogenic bacteria and fungi. Methods: Compounds were isolated from the leaf latex of A. pirottae using silica gel column chromatography, and their structures were determined using 1H-NMR, 13C-NMR, and ESI-MS spectral data. Both the leaf latex and the isolated compounds were evaluated for their antimicrobial activity against three bacterial ( Pseudomonas syringae pv. gaarcae, Ralstonia solanacearum and Xanthomonas vasicola pv. musacearum) and three fungal ( Fusarium graminarum, Fusaium oxysporum, and Fusarium solani) plant pathogens. Results: A mixture of two diastereoisomeric anthrones was isolated from the leaf latex of A. pirottae and characterized as aloin A/B using 1H-NMR, 13C-NMR, and ESI-MS. Aloin A/B showed the most potent activity against X. vasicola among the bacteria and F. oxysporum among the fungi strains tested, with minimum inhibitory concentrations (MIC) of 3.12 mg/mL and 6.25 mg/mL, respectively. Further exploration uncovered strong binding affinity of aloin A/B towards key proteins in these pathogens, specifically with topoisomerase II (−10.060 kcal/mol) and UDP-N-acetylmuramoyl-L-alanyl-D-glutamate-2, 6-diaminopimelate ligase (murE) (−8.861 kcal/mol) in F. oxysporum and X. vasicola, respectively, through molecular docking studies. Conclusion: The present findings highlight aloin A/B as promising natural antimicrobial agents and lead compounds for new plant pathogen treatments. Further research is recommended to explore their activity against a wider range of plant pathogens.
Mergers and Acquisitions, CEO Compensation, and Corporate Governance in the Hospitality and Tourism Industry
Authors: Li Yuan , Singal Manisha
Published: September 2024

Drawing on agency theory, we explore the relationship between mergers and acquisitions (M&As) and chief executive officer (CEO) compensation in the hospitality and tourism (HT) industry. Specifically, we investigate whether growth via acquisitions, a popular strategy in the HT industry, is influenced by CEO compensation. Using a sample of HT and non-HT firms for comparison from 1992 to 2019, we find that CEO compensation is significantly higher after acquisitions for both HT and non-HT firms. However, when controlling for common compensation determinants, CEO compensation is significantly higher in HT firms but not in non-HT firms. Surprisingly, in our sample, corporate governance is not significantly related to changes in CEO compensation post-acquisition. In addition, while the fraction of cash-based compensation is negatively related to M&A propensity in both HT and non-HT firms, the fraction of equity-based compensation is unrelated to M&A propensity in HT firms. Our study fills an important gap in the sparse literature on the link between M&A and CEO compensation in the HT industry, providing theoretical implications for future research and managerial implications for boards of directors to design compensation plans that align the interests of managers and shareholders.
Cavitating Osmotic Demyelination Syndrome Following Correction of Chronic Hyponatremia in Sheehan’s Syndrome: A Novel Case Report
Authors: Shaikh Alamgir , León-Ruiz Moisés , Ghosh Ritwik , Soren Manoj , Mukhopadhyay Bilwatosh , Pal Shyamal Kanti , Benito-León Julián
Published: September 2024

Introduction

Rapid correction of hyponatremia can result in osmotic demyelination syndrome (ODS). Sheehan’s syndrome, a rare pituitary disorder caused by severe postpartum hemorrhage, is a potential cause of chronic hyponatremia. This case report describes a rare progression of extrapontine myelinolysis to central pontine myelinolysis, ultimately leading to ODS, following the correction of chronic hyponatremia associated with Sheehan’s syndrome. Notably, this event occurred a decade after the initial postpartum hemorrhage due to placenta previa.

Case Report

A 40-year-old woman from rural West Bengal, India, presented in a comatose state after five years of progressively worsening symptoms, including fatigue, gastrointestinal disturbances, cold intolerance, hair loss, and severe apathy, which had been misdiagnosed as psychogenic and treated with selective serotonin reuptake inhibitors. Two days before her admission to our hospital, she was diagnosed with a lower respiratory tract infection, dehydration, and severe hyponatremia (118 mEq/L) at a local private healthcare facility. Despite treatment with 3% sodium chloride and intravenous antibiotics, her condition deteriorated, prompting her transfer. At the time of hospitalization, the patient was diagnosed with chronic hyponatremia and hypopituitarism consistent with Sheehan’s syndrome. This condition was attributed to a severe postpartum hemorrhage that occurred a decade prior, resulting from placenta previa. Initial MRI revealed extrapontine myelinolysis, and the correction of her “compensated” hyponatremia was identified as the cause of her neurological decline. Follow-up MRIs at 7 and 14 weeks confirmed the development of cavitating ODS.

Discussion

This case highlights several key points: First, even a relatively gradual correction of hyponatremia can precipitate ODS, especially in patients with chronic conditions like Sheehan’s syndrome. Second, it underscores the importance of meticulous management of chronic hyponatremia to prevent severe neurological outcomes. Third, it illustrates the diagnostic challenges of differentiating Sheehan’s syndrome from primary psychiatric disorders, particularly in low-resource settings where the syndrome remains prevalent. The case also emphasizes the need for awareness among healthcare providers about the potential for severe complications arising from even minor corrections in serum sodium levels in such patients.
Acrodermatitis enteropathica: Shedding the light on an under-recognised nutritional disorder
Authors: Loh Chee Hoou , Ee Ling Adeline Lam , Heng Yee Kiat
Published: September 2024

Acrodermatitis enteropathica is an uncommon nutritional disorder caused by zinc deficiency, characterised by the triad of periorificial dermatitis, alopecia and diarrhoea. We report an elderly man who presented with periorificial erosive dermatitis, alopecia and systemic manifestations including diarrhea and derangement of liver function.
Assessing the risk of tumor lysis syndrome associated with the use of antineoplastic agents: a real-world pharmacovigilance study based on the FDA Adverse Event Reporting System database
Authors: Li Dongxuan , Qin Chunmeng , Wang Hongli , Du Dan , Wang Yalan , Du Qian , Liu Songqing
Published: September 2024

Background:

The use of antineoplastic agents is one of the important triggers of tumor lysis syndrome (TLS), but there is still a lack of comprehensive understanding of antineoplastic agents that may trigger TLS and the TLS risk differences between different antineoplastic agents.

Objectives:

This study aims to investigate the TLS risk of different antineoplastic agents and provide reference information for clinical practice.

Design:

Real-world adverse events data in the FDA Adverse Event Reporting System (FAERS) database were used as the basis for the disproportionality analysis.

Methods:

We reviewed the TLS reports in the FAERS database from 2004 to 2022 to summarize an antineoplastic agent list that was reported to trigger TLS, based on which we conducted disproportionality analysis to assess the TLS risk of each antineoplastic agent.

Results:

In all, 164 antineoplastic agents were reported to trigger TLS. On the whole, rituximab was the most reported antineoplastic agent in TLS reports, followed by cyclophosphamide, venetoclax, doxorubicin, and etoposide, while tagraxofusp was the antineoplastic agent with the highest adverse drug reaction (ADR) signal strength in signal detection, followed by floxuridine, pentostatin, tebentafusp, and venetoclax. Integrating ADR signal detection results, 129 of 164 antineoplastic agents showed at least one positive ADR signal, and six antineoplastic agents (bevacizumab, carboplatin, cisplatin, fluorouracil, lenvatinib, and paclitaxel) have the highest total number of positive signals. Further classifying the 164 antineoplastic agents into 46 chemical subgroups to conduct ADR signal detection, nitrogen mustard analogs were the most reported antineoplastic agent subclasses, followed by clusters of differentiation 20 inhibitors, and pyrimidine analogs, while clusters of differentiation 22 inhibitors were the antineoplastic agent subclass with the highest ADR signal strength, followed by podophyllotoxin derivatives and actinomycines.

Conclusion:

Our study showed the TLS risk characteristics of 164 antineoplastic agents by detecting and integrating ADR signals, which may help to optimize clinical practice.
‘GP services are still heteronormative’: Sexual minority cisgender women’s experiences of UK menopause healthcare – Health equity implications
Authors: Westwood Sue
Published: September 2024

Objective

This article reports on UK sexual minority cisgender women’s experiences of menopause health and healthcare, based on a data subset from a study exploring lesbian, gay, bisexual, and queer (LGBTQ+) menopause.

Methods

An online survey was conducted with UK LGBTQ + individuals who went through/are going through the menopause. Quantitative data were analysed using simple descriptive statistics. Qualitative data were analysed using thematic analysis.

Results

Cisgender respondents comprised 51 lesbian, gay, bisexual, pansexual, queer, and ‘other’ women, aged between 17 and 89 years. They reported similar types and levels of menopause symptoms as heterosexual cisgender women in other studies, apart from higher levels of anxiety and depression, especially bisexual women. Dissatisfaction regarding menopause healthcare services related to access, information, and heteronormative/heterosexist provision.

Conclusions

Healthcare providers must ensure they provide inclusive menopause services to sexual minority cisgender women.
Unlocking biomedical data sharing: A structured approach with digital twins and artificial intelligence (AI) for open health sciences
Authors: Jean-Quartier Claire , Stryeck Sarah , Thien Alexander , Vrella Burim , Kleinschuster Jeremias , Spreitzer Emil , Wali Mojib , Mueller Heimo , Holzinger Andreas , Jeanquartier Fleur
Published: September 2024

Objective

Data sharing promotes the scientific progress. However, not all data can be shared freely due to privacy issues. This work is intended to foster FAIR sharing of sensitive data exemplary in the biomedical domain, via an integrated computational approach for utilizing and enriching individual datasets by scientists without coding experience.

Methods

We present an in silico pipeline for openly sharing controlled materials by generating synthetic data. Additionally, it addresses the issue of inexperience to computational methods in a non-IT-affine domain by making use of a cyberinfrastructure that runs and enables sharing of computational notebooks without the need of local software installation. The use of a digital twin based on cancer datasets serves as exemplary use case for making biomedical data openly available. Quantitative and qualitative validation of model output as well as a study on user experience are conducted.

Results

The metadata approach describes generalizable descriptors for computational models, and outlines how to profit from existing data resources for validating computational models. The use of a virtual lab book cooperatively developed using a cloud-based data management and analysis system functions as showcase enabling easy interaction between users. Qualitative testing revealed a necessity for comprehensive guidelines furthering acceptance by various users.

Conclusion

The introduced framework presents an integrated approach for data generation and interpolating incomplete data, promoting Open Science through reproducibility of results and methods. The system can be expanded from the biomedical to any other domain while future studies integrating an enhanced graphical user interface could increase interdisciplinary applicability.
How to promote telemedicine in underdeveloped cities in central China? Qualitative interviews with medical personnel in tertiary A-level hospital of Xinyang City
Authors: Qingjie Peng , Wanyu Huang , Jingying Yang , Ming Yang , Linlin Wang , Qiyue Mao , Fan Wang , Minghao Pan
Published: September 2024

Background

Telemedicine has emerged as a novel healthcare service model that plays a vital role in addressing the unequal distribution of medical resources. Telemedicine has recently gained significant traction in economically prosperous cities such as Beijing, Shanghai, and Guangzhou in China. However, Xinyang City in Henan Province is an economically less developed city, and telemedicine is still in its early stages. By exploring the views of medical staff and administrators at Xinyang City's tertiary A-level hospital on telemedicine, this study aims to determine the development status of telemedicine services in Xinyang City. The objective was to identify the challenges in the construction process and formulate corresponding strategies for advancing telemedicine in Xinyang City.

Methods

Face-to-face personal interviews were conducted with 16 medical staff and administrators from a tertiary A-level hospital in Xinyang City, Henan Province, and the data were collected and analyzed using grounded theory. In the process of data analysis, NVivo12 software was used to encode and organize the data line by line.

Results

The development of telemedicine in Xinyang City has the potential to benefit residents, hospitals, and healthcare personnel despite several challenges, including the absence of laws and regulations, inadequate policy support, limited hospital cooperation, and low resident awareness, which must be addressed to unlock the full potential of telemedicine.

Conclusion

The telemedicine system in Xinyang City is currently in a coordinated developmental phase, and several areas require further improvement. The development of standardized telemedicine in Xinyang City requires government support, better training for general practitioners, public awareness campaigns, and improved technology while ensuring reasonable work schedules and motivating medical personnel.
A feasibility study on utilizing machine learning technology to reduce the costs of gastric cancer screening in Taizhou, China
Authors: Yan Si-yan , Fu Xin-yu , Tang Shen-Ping , Qi Rong-bin , Liang Jia-wei , Mao Xin-li , Ye Li-ping , Li Shao-wei
Published: September 2024

Aim

To optimize gastric cancer screening score and reduce screening costs using machine learning models.

Methods

This study included 228,634 patients from the Taizhou Gastric Cancer Screening Program. We used three machine learning models to optimize Li's gastric cancer screening score: Gradient Boosting Machine (GBM), Distributed Random Forest (DRF), and Deep Learning (DL). The performance of the binary classification models was evaluated using the area under the curve (AUC) and area under the precision–recall curve (AUCPR).

Results

In the binary classification model used to distinguish low-risk and moderate- to high-risk patients, the AUC in the GBM, DRF, and DL full models were 0.9994, 0.9982, and 0.9974, respectively, and the AUCPR was 0.9982, 0.9949, and 0.9918, respectively. Excluding Helicobacter pylori IgG antibody, pepsinogen I, and pepsinogen II, the AUC in the GBM, DRF, and DL models were 0.9932, 0.9879, and 0.9900, respectively, and the AUCPR was 0.9835, 0.9716, and 0.9752, respectively. Remodel after removing variables IgG, PGI, PGII, and G-17, the AUC in GBM, DRF, and DL was 0.8524, 0.8482, 0.8477, and AUCPR was 0.6068, 0.6008, and 0.5890, respectively. When constructing a tri-classification model, we discovered that none of the three machine learning models could effectively distinguish between patients at intermediate and high risk for gastric cancer (F1 scores in the GBM model for the low, medium and high risk: 0.9750, 0.9193, 0.5334, respectively; F1 scores in the DRF model for low, medium, and high risks: 0.9888, 0.9479, 0.6694, respectively; F1 scores in the DL model for low, medium, and high risks: 0.9812, 0.9216, 0.6394, respectively).

Conclusion

We concluded that gastric cancer screening indicators could be optimized when distinguishing low-risk and moderate to high-risk populations, and detecting gastrin-17 alone can achieve a good discriminative effect, thus saving huge expenditures.
A method combining LDA and neural networks for antitumor drug efficacy prediction
Authors: Zhu Weiwei , Zhang Lei , Jiang Xiaodong , Zhou Peng , Xie Xinping , Wang Hongqiang
Published: September 2024

Background

Personalized medicine has gained more attention for cancer precision treatment due to patient genetic heterogeneity in recent years. However, predicting the efficacy of antitumor drugs in advance remains a significant challenge to achieve this task.

Objective

This study aims to predict the efficacy of antitumor drugs in individual cancer patients based on clinical data.

Methods

This paper proposes to predict personalized antitumor drug efficacy based on clinical data. Specifically, we encode the clinical text of cancer patients as a probability distribution vector in hidden topics space using the Latent Dirichlet Allocation (LDA) model, named LDA representation. Then, a neural network is designed, and the LDA representation is input into the neural network to predict drug response in cancer patients treated with platinum drugs. To evaluate the effectiveness of the proposed method, we gathered and organized clinical records of lung and bowel cancer patients who underwent platinum-based treatment. The prediction performance is assessed using the following metrics: Precision, Recall, F1-score, Accuracy, and Area Under the ROC Curve (AUC).

Results

The study analyzed a dataset of 958 patients with non-small cell cancer treated with antitumor drugs. The proposed method achieved a stratified 5-fold cross-validation average Precision of 0.81, Recall of 0.89, F1-score of 0.85, Accuracy of 0.77, and AUC of 0.81 for cisplatin efficacy prediction on the data, which most are better than those of previous methods. Of these, the AUC value is at least 4% higher than those of the previous. At the same time, the superior result over the previous method persisted on an independent dataset of 266 bowel cancer patients, showing the generalizability of the proposed method. These results demonstrate the potential value of precise tumor treatment in clinical practice.

Conclusions

Combining LDA and neural networks can help predict the efficacy of antitumor drugs based on clinical text. Our approach outperforms previous methods in predicting drug clinical efficacy.
Populist politicians’ representations of the people: A comparative visual content analysis of candidates’ Instagram posts in 2023 Turkish general elections
Authors: Zararsiz Ömer Faruk , Ayaşlioğlu Emrah
Published: September 2024

Social media posts play a key role in understanding how the concept of “the people,” which is a critical concept for populist politicians, is constructed and presented. This study examines how the two leading candidates, as right and left populist figures in Türkiye’s 2023 general elections, portrayed “the people” in their Instagram posts. The Instagram posts of two leaders were coded according to the categories of gender, headscarf, class, and age, and the representations of the people in these posts were analyzed using visual content analysis method. As a result, it was revealed Erdoğan, as a right-wing populist, included more headscarved women in his posts, Kılıçdaroğlu, as a left-wing populist, preferred more heterogeneous visuals in images in terms of gender, and that young individuals were more intensely preferred in the images shared by Kılıçdaroğlu in terms of the category of age.
Effect of Diffuse Idiopathic Skeletal Hyperostosis on the Occurrence of Thoracolumbar Vertebral Fragility Fractures at Different Ages
Authors: Wu Yinbo , Ye Qin , He Dong , Wei Yuguo , Pan Yaling , Wang Yajie
Published: September 2024

Study Design

Retrospective Case control Study.

Objectives

To analyze the effect of diffuse idiopathic skeletal hyperostosis (DISH) on the occurrence of new thoracolumbar vertebral fragility fractures (VFFs) at different ages.

Methods

A retrospective analysis of 564 patients, including 189 patients who presented with new-onset thoracolumbar VFFs and 375 patients without spinal fractures, was performed in 4 age groups (50-59 years, 60-69 years, 70-79 years, and 80+ years). DISH was diagnosed based on computed tomography findings, and the Mata score of each disc space level combined with the maximum number of consecutive ossified segments (MNCOS) for each patient was recorded. Data were compared between the fracture and control groups, and odds ratios (ORs) were calculated for each of the 4 age groups using logistic regression.

Results

Both the crude ORs and the adjusted ORs of DISH for VFFs decreased with age, with statistical significance shown in the 50-59 years group (crude OR = 4.373, P = 0.017; adjusted OR = 7.111, P = 0.009) and the 80+ years group (crude OR = 0.462, P = 0.018; adjusted OR = 0.495, P = 0.045). The Mata scores and the MNCOS were significant risk factors for VFFs ( P < 0.05) in the 50-59 years group, but they were protective factors in the 80+ years group, which was more significant in the T11/12–L5/S1 subsegment.

Conclusions

The effect of DISH on the occurrence of thoracolumbar VFFs is complex, and in patients above 50 years, it changes from a risk factor to a protective factor with increasing age.
The Impact of the COVID-19 Pandemic on Case Volume and Wait Times of Elective Hand Procedures: A Retrospective Chart Review Study
Authors: Uhlman Kathryn , Churchill Isabella , Dydynsky Robert , Johnston Stepfanie , Leveille Cameron , McRae Mark , McRae Matthew
Published: September 2024

Introduction: The COVID-19 pandemic has decreased the number of surgeries performed in North America. The purpose of this study was to compare the number of elective hand surgeries performed during the pandemic to a corresponding pre-pandemic time period and to quantify the impact to the surgical backlog in hand surgery. Methods: Patient health records for individuals who underwent surgical management of carpal tunnel syndrome (CTS), Dupuytren's disease (DD) or stenosing tenosynovitis (time periods: March 11, 2018 to July 1, 2019 [pre-pandemic] and March 11, 2020 to July 1, 2021 [pandemic]) were retrieved from two academic institutions. The primary outcome was number of surgeries performed in each time period. Secondary outcomes included wait times for each time period; and variables as predictors of wait times, including a) age; b) gender; c) socioeconomic status; d) geographic location; and, e) comorbidities. Results: Seven-hundred-and-fifteen cases were included (447 CTR cases, 135 fasciotomy/subtotal palmar fasciectomy cases and 133 pulley release/tendon release cases). Two-hundred-and-sixty-four elective hand procedures were performed during the COVID-19 time period, compared to 451 in the pre-pandemic time period (n = 187 surgeries, 41.5%). Mean surgical wait times decreased for CTS and DD and increased for stenosing tenosynovitis during the pandemic compared to the corresponding pre-pandemic time period. No association or variation in wait times was found in regard to the aforementioned variables. Conclusions: During the pandemic, a decreased total number of elective hand surgeries were performed when compared to the corresponding pre-pandemic period. This contributes to a backlog of elective surgical procedures.
Outcomes After Extracorporeal Shockwave Therapy for Chronic Noninsertional Achilles Tendinopathy Compared With Chronic Insertional Achilles Tendinopathy: A Retrospective Review
Authors: Butler James J. , DeClouette Brittany , Azam Mohammad T. , Walls Raymond C. , Jejelava George , Zheng Danny , Jia Nathan , Kennedy John G.
Published: September 2024

Background:

Extracorporeal shockwave therapy (ESWT) is a noninvasive treatment modality that is used in the treatment of chronic Achilles tendinopathy (AT).

Purposes:

To (1) retrospectively assess outcomes after ESWT for both noninsertional AT (NAT) and insertional AT (IAT) at >1-year follow-up and (2) identify potential predictors of outcomes.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Chart review was conducted to identify patients who underwent ESWT for AT with a minimum of 1-year follow-up. Data collected and assessed included patient demographic characteristics, pathological characteristics including the location of AT (NAT or IAT), presence of a Haglund deformity, and severity of tendon degeneration on magnetic resonance imaging (MRI), in addition to treatment characteristics including number of sessions and intensity of ESWT. The Victorian Institute of Sports Assessment–Achilles (VISA-A) and visual analog scale (VAS) pain scores were obtained before ESWT, 6 months after ESWT, and at final follow-up. Failures were also recorded, which were defined as no improvement in VISA-A or VAS scores or need for surgical intervention. Linear regression was performed to identify potential predictors of inferior subjective clinical outcomes and failures. Survival analysis was conducted using Kaplan-Meier curves.

Results:

The study included 52 patients with IAT and 34 patients with NAT. The mean follow-up in the NAT cohort was 22.3 ± 10.2 months and the mean follow-up in the IAT cohort was 26.8 ± 15.8 months. Improvements in VISA-A and VAS scores were observed in the NAT cohort at 6-month follow-up and at final follow-up ( P < .05). Improvements in VISA-A and VAS scores were recorded in the IAT cohort at 6-month follow-up, which subsequently deteriorated at final follow-up. In the NAT cohort, the failure rate at 6-month follow-up was 11.8%, which increased to 29.4% at final follow-up. In the IAT cohort, the failure rate at 6-month follow-up was 32.7%, which increased to 59.6% at final follow-up. Predictors of inferior subjective clinical outcomes and failures in the NAT cohort included pre-ESWT subjective clinical score, male sex, presence of a cardiovascular risk factor, and more severe MRI grading of tendinopathy. Predictors of inferior subjective clinical outcomes and failures in the IAT cohort included pre-ESWT subjective clinical score and more severe MRI grading of tendinopathy.

Conclusion:

Superior subjective clinical outcomes together with a lower failure rate were maintained for >1 year in the NAT cohort compared with the IAT cohort, calling into question the long-term benefit of ESWT for patients with IAT.
Smartphones Helping Memory-Impaired Individuals Overcome Inconveniences During Daily Living
Authors: Masaki Kira , Yokoi Teruo , Fukuma Takayasu , Ishiyama Takaaki
Published: September 2024

The external compensatory means recommended for rehabilitation of memory disorder must consist of a means for storing information externally and a clue for accessing the externally stored information. Writing down the information on a paper pocketbook is usually used as an external compensatory means, but smartphones are overwhelmingly more useful in terms of the functions as compared to paper pocketbooks. The author, who has a memory disorder and works as an occupational therapist, has recently devised a method for utilizing a smartphone for overcoming the inconveniences during daily living and herein describes how to use it in daily life scenarios.
The state and radicalization: Overlooked perspectives for internationalist far-right scholarship
Authors: Atterbury Sean
Published: September 2024

The purpose of this review essay is to examine four monographs that study the far-right and discuss their approaches as is relevant to the international level of analysis. This essay argues that these monographs engage with international analysis but do so in a way that has generally not been covered by the mainstream political science approaches to the far-right. This essay will first cover the mainstream political science approaches and international approaches of the far-right. Then this article will explore two overlooked approaches: (1) The statist approach to the far-right explores the transnational and domestic development of far-right ideology in specific states. (2) The radicalization approach focuses on the space and place of the far-right. This review essay will consider the international implications of these approaches and highlight key themes and methodologies that may prove useful to international far-right scholarship. This article concludes with the place of these monographs in the international far-right literature and the scope of this article.
Optimising Care for Young Adults: An Integrated Theoretical Model for Supporting Care Leavers
Authors: Sharma Girish
Published: September 2024

Individuals who leave foster and institutional care after attaining age 18, commonly referred to as care leavers, encounter numerous obstacles that impact their overall welfare. This study pesents a holistic method for comprehending individual experiences by incorporating several social, psychological and developmental perspectives. This comprehensive framework recognizes the intricate interaction among personal attributes, the societal environment and systemic elements that impact the lives of individuals transitioning out of care. This study intended to use a combination of different theoretical viewpoints to design an integrated model for more complete and effective interventions. These interventions may address the many needs of care leavers and increase their overall well-being.
Evaluating Outcomes of a Co-Produced Theatre-Based Experiential Learning Project in Psychiatry
Authors: Walker Thomas , Jones Tomos , Grant-Peterkin Hugh , Dave Rupal , Röhricht Frank
Published: September 2024

INTRODUCTION

The benefits of theatre and arts-based initiatives for enhancing the health and wellbeing of adults, regardless of mental health status, are well-documented. Theatre methodologies offer a platform for co-produced experiential learning, promoting perspective-taking and effective communication among staff and service users. This project aimed to bring together service users and mental health professionals through workshops conducted by an experiential theatre company, focusing on themes such as relationship dynamics, co-production, empowerment and perspective-taking. Notably, the sessions were conducted online due to the COVID-19 pandemic.

METHODS

The study sought to explore the experiences, learning outcomes and work-related wellbeing benefits of participating in this innovative project. Methods involved inviting East London Foundation Trust members to eight weekly online workshops, culminating in a co-created filmed performance. Interviews conducted 9 months to a year later with participants and facilitators were thematically analysed.

RESULTS

Results revealed four key themes: (1) personal and collective growth through storytelling and embodied acting experiences; (2) the importance of workshop structure for experiential learning; (3) challenging traditional role definitions through diminished hierarchy; and (4) sustained impacts on time management at work and in personal lives.

CONCLUSIONS

In conclusion, participants valued their involvement, indicating that theatre-based co-produced learning enhances communication and interpersonal skills in mental healthcare settings. These findings suggest the potential for integrating such approaches into healthcare education and training programs.
“I need them for my autism, but I don’t know why”: Exploring the friendship experiences of autistic children in UK primary schools
Authors: Fox Laura , Asbury Kathryn
Published: September 2024

Background and aims

Autistic children can experience challenges in making and maintaining friendships, and middle childhood (ages 6–12) may be particularly challenging as social networks become more complex. However, a large proportion of research into these experiences is based on adult reports or focuses on the experiences of adolescents, meaning that the voices of younger children are absent. Due to the exclusion of younger children from research, we have a limited understanding of their first-hand experiences of their friendships and the support they receive, which has implications for friendship support and wellbeing. This study aimed to amplify the voices of younger autistic children to explore their first-hand experiences of friendships and highlight areas of social support which may be most beneficial to primary-aged autistic children.

Methods

This study used novel creative methods to support interviews with 19 autistic primary school-aged children to explore their experiences of friendship. Parent-led interviews and scrapbooks supported the children in discussing the challenges and strengths of their friendships.

Results

Children discussed the challenges and strengths of their friendships including the impact of social norms on the need to have friends and their support needs in this area of life. Children also discussed gaps in their current friendships and how they would like to see these filled. It was clear that not all children required or wanted neurotypical-style friendships, with many valuing companionship and gameplay over intimacy. Analysis highlighted the heterogeneity of autistic children's friendships, especially in relation to gender and age, calling for more tailored and individualized support.

Conclusion and implications

Results from the current study show that autistic children can and do have successful friendships but that these friendships may differ from those of their non-autistic peers. The study further adds to the existing literature by showing that younger autistic children can be included in research by using differentiated, accessible and creative methods, and that they are able to voice their opinions on matters surrounding support. It also calls for a tailored approach to supporting autistic children in school and speaking with children to give them autonomy over the support they want to receive.
Children aged 5–13 years show adult-like disgust avoidance, but not proto-nausea
Authors: Alladin Sameer N.B. , Berry Dani , Anisimova Evgeniya , Judson Ruth , Whittaker Poppy , Dalmaijer Edwin S.
Published: September 2024

Disgust is a vital emotion in the avoidance of illness. Human adults across cultures show disgust towards sources of potential contamination or pathogens, and elect to avoid their ingestion or even to look at them. Stomach rhythms appear to play an important role: disgust reduces normogastric power, and the pharmacological normalisation of gastric state reduces disgust avoidance. Human children are remarkably slow to develop disgust as measured by self-report and facial expressions. Here, we investigate whether disgust-induced avoidance (measured using eye tracking) and changes in gastric rhythm (measured using electrogastrography) exist in children aged 5 to 13 years ( N = 45). We found that children in this bracket showed oculomotor avoidance of disgusting stimuli in a preferential-looking task, similar to adult samples in previous research. However, in contrast to adult samples in previous research, children did not show an attenuation in normogastric power. These findings could suggest that avoidance behaviour precedes gastric involvement during disgust. This would support the idea that children initially respond to parental modelling: parents set (and enforce) the social norm of disgust avoidance, and children initially conform and only later do they internalise disgust as an interoceptive signal. Alternatively, the employed stimuli could have been potent enough to induce oculomotor avoidance, but not a gastric response. Research is slim in this area, and future work should focus on elucidating the role of the stomach in disgust, and on longitudinal studies of disgust development from childhood to adolescence.
Book review: Radhika Iyengar, Fire on the Ganges: Life Among the Dead in Banaras
Authors: Khan Mohd. Fahad , Kaparwan Shuchi
Published: September 2024

Radhika Iyengar, Fire on the Ganges: Life Among the Dead in Banaras. HarperCollins Publishers India. 2023, 347 pp., ₹599 (Hardcover). ISBN: 978-93-5699-467-6.
Developing and reporting a healthcare-associated infection composite score for health system board review
Authors: Austin J Matthew , Gadala Avinash , Kachalia Allen , Maragakis Lisa L
Published: September 2024

Background

One strategy for supporting a hospital or health system's board of directors (Board), with their quality oversight responsibility is to review the organization's performance on quality measures. But for large systems, the number of measures needing review is quite burdensome and makes priority setting difficult. Our goal was to develop a scoring method that summarizes multiple quality measures together, while still maintaining the Board's opportunity to examine individual measures where there are specific concerns.

Methods

We calculated an overall health system-level composite performance score using six publicly reported healthcare-associated infections reported by the Centers for Medicare and Medicaid Services on their Care Compare website [central-line associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), surgical site infections (SSIs) for colon surgery and abdominal hysterectomy, hospital-onset Methicillin-resistant Staphylococcus aureus bacteremia (MRSA), and hospital-onset Clostridioides difficile ( C. diff)], where relative weights assigned to each infection type reflect the severity of patient harm. We also calculated a health-system composite performance target. For individual infection types, we calculated system-wide scores and targets and categorized individual hospital performance into three performance categories.

Results

The health system's composite score between 2015 and 2019 ranged from a high of 1.10 to a low of 0.71. The health system's composite score in 2017–2019 was better than the composite target. Of the 34 measures used to calculate the 2019 composite score, 20 were better than internal standardized infection ratio (SIR) targets, seven were between internal targets and SIR of 1.0, and seven were worse than SIR of 1.0.

Discussion

The Board communicated they find this composite score reporting approach helpful for streamlining their understanding of HAI performance, as compared to traditional approaches of reporting out individual performance measures. Approaches that streamline Board review of quality and safety performance are important as we hold Board members accountable for overseeing quality, seek greater engagement from the Board, and work to minimize measure review overload.