bluuebunny/crossref_metadata_2025 huggingface dataset:
Rebels with a cause: Introducing the Post-Rebel Electoral Parties dataset
Authors: Manning Carrie , Smith Ian O , Tuncel Ozlem
Published: December 2022

The Post-Rebel Electoral Parties (PREP) dataset offers an important new tool to study the transformation of rebel groups into political parties. It provides longitudinal data on the electoral participation and performance in national elections of political parties formed by armed opposition groups after civil war. Post-rebel electoral parties sit at the center of overlapping research agendas that address how best to build durable peace, and how to build resilient political systems and capable states after devastating conflict. A better understanding of how and why these parties participate and perform in elections over time is critical to any assessment of liberal peacebuilding. These parties – their strategic choices, organizational development, and impact on the political systems in which they participate – are also relevant to the broader study of comparative democratization, political parties, and party systems. Our dataset follows these parties forward through up to three decades of participation in postwar electoral politics. The current version of the data consists of 78 distinct parties derived from 56 conflict actors. The data cover 322 legislative election years and 216 executive elections in 39 countries over 30 years (1990–2021). This article describes the data and articulates the need for and motivation behind the dataset. We then illustrate the relevance of the data by testing the impact of rebel participation on the long-term peace.
Investigation of fiber maturity and crystallinity information in Upland seed cottons by Fourier transform infrared spectroscopy
Authors: Liu Yongliang , Delhom Christopher D.
Published: December 2022

Cotton fiber maturity has been determined by cross-sectional image analysis (IA), advanced fiber information system (AFIS), and Cottonscope methods on cotton lint. These methods have reported the results as average maturity and maturity distribution in a sample, through measuring the fibers in the ways of either individual fiber cross-section or longitude of several sub-samples. Previous studies have shown good agreement in maturity for well-prepared samples among these methods, although AFIS is observed to be less sensitive. As a different approach, attenuated total reflection Fourier transform infrared (ATR FT-IR) spectroscopy was proposed to measure fiber maturity ( MIR) at bundle fiber level. Extending fiber maturity measurement into seed cotton, the FT-IR method might be an option considering such factors as essential cotton seed and visible trash removal, measuring system availability and speed, and also sub-sampling representation in a naturally variable sample. A comparison of fiber MIR average in seed cottons with AFIS maturity ratio ( MAFIS) in ginned cotton fibers exhibited a general trend of increasing MAFIS with MIR. On the basis of MIR value, 3- MIR (low-, mid-, and high-) fiber classification analysis implied the distinctions within seed cottons having close MIR average, and among the same cultivar grown at different conditions. Additionally, cultivars with a similar maturity distribution varied in fiber crystallinity ( CIIR) distribution, and vice versa.
Red blood cells as glucose carriers to the human brain: Modulation of cerebral activity by erythrocyte exchange transfusion in Glut1 deficiency (G1D)
Authors: Wang Richard C , Lee Eunice E , De Simone Nicole , Kathote Gauri , Primeaux Sharon , Avila Adrian , Yu Dong-Min , Johnson Mark , Good Levi B , Jakkamsetti Vikram , Sarode Ravi , Holland Alice Ann , Pascual Juan M
Published: December 2022

Red blood cells circulating through the brain are briefly but closely apposed to the capillary endothelium. We hypothesized that this contact provides a nearly direct pathway for metabolic substrate transfer to neural cells that complements the better characterized plasma to endothelium transfer. While brain function is considered independent of normal fluctuations in blood glucose concentration, this is not borne out by persons with glucose transporter I (GLUT1) deficiency (G1D). In them, encephalopathy is often ameliorated by meal or carbohydrate administration, and this enabled us to test our hypothesis: Since red blood cells contain glucose, and since the red cells of G1D individuals are also deficient in GLUT1, replacing them with normal donor cells via exchange transfusion could augment erythrocyte to neural cell glucose transport via mass action in the setting of unaltered erythrocyte count or plasma glucose abundance. This motivated us to perform red blood cell exchange in 3 G1D persons. There were rapid, favorable and unprecedented changes in cognitive, electroencephalographic and quality-of-life measures. The hypothesized transfer mechanism was further substantiated by in vitro measurement of direct erythrocyte to endothelial cell glucose flux. The results also indicate that the adult intellect is capable of significant enhancement without deliberate practice.      ClinicalTrials.gov registration: NCT04137692 https://clinicaltrials.gov/ct2/show/NCT04137692
Blood-brain barrier disruption measured by albumin index correlates with inflammatory fluid biomarkers
Authors: Hillmer Laura , Erhardt Erik B , Caprihan Arvind , Adair John C , Knoefel Janice E , Prestopnik Jill , Thompson Jeffrey , Hobson Sasha , Rosenberg Gary A
Published: December 2022

Blood-brain barrier (BBB) permeability can be measured by the ratio of albumin in cerebrospinal fluid (CSF) and blood and by dynamic contrast-enhanced MRI (DCEMRI). Albumin is a large molecule measured in CSF and blood to form the albumin index (Qalb), which is a global measure of BBB permeability, while the smaller Gadolinium molecule measures regional transfer (Ktrans); few studies have directly compared them in the same patients. We used both methods as part of a study of mechanisms of white matter injury in patients with different forms of dementia. In addition, we also measured biomarkers for inflammation, including proteases, angiogenic growth factors, and cytokines, and correlated them with the BBB results. We found that there was no correlation between Qalb and Ktrans. The Qalb was associated with the matrix metalloproteinases (MMP-2, MMP-3, and MMP-10), the angiogenic factors (VEGF-C and PlGF), and the cytokines (IL-6, IL-8 and TNF-α). On the other hand, Ktrans was associated with the diffusion measures, mean free water and PSMD, which indicate white matter injury. Our results show that the Qalb and Ktrans measure different aspects of BBB permeability, with albumin being a measure of inflammatory BBB opening and Ktrans indicating white matter injury.
Assessment of Potentially Inappropriate Prescribing for People With Type 2 Diabetes Mellitus Using IMPACT2DM, a New Explicit Tool
Authors: Ayalew Mohammed B. , Dieberg Gudrun , Quirk Frances , Spark Marion J.
Published: December 2022

Background: People with type 2 diabetes mellitus (T2DM) are at greater risk of potentially inappropriate prescribing (PIP) due to multiple comorbidities and polypharmacy. IMPACT2DM (Inappropriate Medication Prescribing Assessment Criteria for Type 2 Diabetes Mellitus) is a tool designed to identify PIP for adults with T2DM. Objectives: To assess PIP for adults with T2DM in Ethiopia using the IMPACT2DM and to test the face validity and clinical validity of the tool. Methods: A cross-sectional study was undertaken using data extracted retrospectively from the medical records of adults being managed for T2DM at Debretabore Hospital. PIP was assessed using IMPACT2DM. Some items/item components of IMPACT2DM were modified to increase the tool’s applicability for the outpatient setting, to clarify content or to use the terms most common in this particular setting. Multivariant logistic regression analyses were conducted to identify factors associated with PIP. Results: More than 90% of medical records had at least 1 PIP. Prescribing omission (80.9%) was the most commonly identified type of PIP. Adults with prescribing omissions are more likely to be ≥40 years old or to be prescribed with <5 medications. Adults with dosing problems were more likely ≥50 years old, or have had a fasting blood sugar (FBS) level out of the target range (80-130 mg/dL). Conclusions: IMPACT2DM is a clinically valid PIP identification tool for application in an Ethiopian outpatient setting. Health professionals should be alert to check for potential prescribing omissions for adults ≥40 years old and dosing problems for adults with an FBS level out of the target range or >50 years.
Differences in muscle coordination between older men and women during brisk walking
Authors: Qi Liping , Li Zhi-Peng , Tian Zhi-Hao , Guan Shuo , Zhou Jian , Liu Ying
Published: December 2022

Brisk walking is a highly recommended physical activity for healthy community-dwelling older adults. The objective of this study was to examine through principal component analysis (PCA) how muscle coordination differs between older women and men during brisk walking. Thirty-five healthy older adults (65.2 ± 3.0 years old, 18 females, and 17 males) participated in the study. Eight surface electromyographic electrodes were used to record lower extremity muscle activities, and four inertial measurement unit sensors to monitor hip, knee, and ankle motion. Energy expenditure and heart rate were also measured during brisk walking. The effects of a person’s sex on muscle coordination were identified through wavelet and PCA analysis of the sEMG signals. The results of energy expenditure and heart rate confirmed that brisk walking exercise is beneficial for older adults. PCA analysis showed that muscle coordination patterns differ between older women and men: during the stance phase a greater co-contraction of tibialis anterior and soleus in the men, and a greater activation of the quadriceps muscles during the loading-response phase in the women. The wavelet and PCA analyses facilitated a quantitative appraisal of sex-specific differences in the muscle coordination patterns of older men and women during brisk walking.
Beyond stereotypes: Women and their engagement in football fandom
Authors: Kossakowski Radosław , Besta Tomasz
Published: December 2022

In common opinion, football fandom constitutes a male space as men are perceived to be more ‘authentic’ and engaged fans, more attached to the club. This article makes a contribution to the discussion on the differences between female and male fans and their modes of engagement. We aimed to answer the question of whether there are any differences between male and female supporters in: (1) self-stereotyping (agency, communion, independent self-construal, interdependent self-construal), (2) strength of the bond with the fandom and perceived personal gains from attachment to the club (identity fusion with other fans, collective action on behalf of the fan community, self-expansion) and (3) acceptance of aggressive behaviours. We applied a mixed-method approach and conducted both in-depth interviews with female football fans and quantitative analysis based on a survey among Polish football supporters. In contradiction to gender stereotypes, the results of a study conducted among 864 fans show that women saw themselves as more agentic than men did, had a stronger independent self-construal, and declared more self-development and stronger personal gains that can be achieved due to the participation in fandom culture. Moreover, gender differences in the strength of identity fusion and collective action tendency on behalf of the fandom were not significant.
Axisymmetric bending vibration analysis of bidirectional functionally graded rotating micro-disk under thermo-mechanical loading
Authors: Pal Suman , Das Debabrata
Published: December 2022

The free vibration behavior of a bidirectional functionally graded rotating micro-disk that is subjected to uniform transverse pressure and high-temperature thermal loading has been studied. The micro-disk is functionally graded along the radial and thickness directions. The problem is mathematically formulated using two distinct but interrelated steps within the framework of Kirchhoff plate theory and modified couple stress theory. The first step determines the time-invariant deformed configuration of the micro-disk under centrifugal, pressure, and thermal loading using minimum potential energy principle. The second step determines the free vibration behavior of the micro-disk in the neighborhood of the deformed configuration using Hamilton’s principle. The solutions of the governing equations for both these steps are obtained using the Ritz method. The mathematical model is successfully validated with various reduced problems. The numerical results for the first four axisymmetric bending vibration modes are presented to investigate the effects of wide range of parameters such as rotational speed, applied pressure, thermal loading, size-dependent thickness, volume fraction indices, and radius ratio. The mode shapes of vibration are illustrated through surface and contour plots.
How Do Primary Care Providers Respond to Reimbursement Cuts? Evidence From the Termination of the Primary Care Incentive Program
Authors: Brunt Christopher S.
Published: December 2022

The Primary Care Incentive Payment Program (PCIP) provided a 10% bonus payment for Evaluation and Management (E&M) visits for eligible primary care providers (PCPs) from 2011 to 2015. Using a 2012 to 2017 sample of continuously eligible PCPs (the treatment group) and ineligible specialists with historically similar provision of billed services (the control group), this study is the first to examine how PCPs responded to the program’s termination. Using inverse probability of treatment weighted difference-in-differences models that control for inter-temporal changes in provider-specific beneficiary characteristics, individual provider fixed effects, and zip code by year fixed effects, it finds that providers responded to the removal of the 10% bonus payments by increasing their billing of bonus payment eligible E&M relative value units (RVUs) by 3.7%. This response is consistent with supplier-induced demand and suggests a 46% offsetting response consistent with actuarial assumptions by the Centers for Medicare & Medicaid Services when assessing reimbursement reductions.
Recessive Dystrophic Epidermolysis Bullosa: Rare Bilateral External Auditory Canal Stenosis and Surgical Treatment
Authors: Milani Alessandro , Pace Annalisa , Iannella Giannicola , Corsi Alessandro , Cocuzza Salvatore , Maniaci Antonino , Greco Antonio , Magliulo Giuseppe
Published: December 2022

Epidermolysis bullosa (EB) is a family of rare genetic disorders affecting the skin and mucous membranes, causing blisters and lesions. Its treatment is based on the prevention of traumatic events that could favor the onset of blisters as well as careful wound care. New therapies, including gene therapy, are under investigation. In the case described here, a rare localization of EB at the level of the ear canal is described. To our knowledge, no surgical option for treatment has previously been described in the literature. The clinical features observed and the therapeutic modalities adopted are presented and discussed. A 56-year-old female patient came to our attention for bilateral progressive hearing loss. The patient was suffering from Dystrophic EB. Surgical correction of the stenosis through a retroauricular approach was planned, with the simultaneous reconstruction of the right external auditory canal using the canaloplasty technique combined with Thiersch skin grafting. The case we report here is, to our knowledge, the second describing the surgical treatment of ear canal stenosis secondary to EB. As a result of surgical correction of the stenosis, the ear regained its physiological function and there was an improvement in hearing. In the subsequent post-operative controls, there was no recurrence of the disease, from which the patient is still free 36 months after surgery. Although conservative treatment is a solid choice, our experience seems to indicate that the surgical option allows better management of the Dystrophic EB in the external auditory canal.
‘U OK hun’? Classed femininities, meme culture and locating humour in the celebrity ‘hun’
Authors: Minor Laura
Published: December 2022

This article examines ‘huns’ – specifically celebrity huns in the public spotlight – as memetic ‘figures’ who are defined by their loud, tongue-in-cheek and humorous display of British femininities coded as working class. Unlike other female figures routinely mocked and laughed at in contemporary popular culture (such as the ‘chav[ette]’ in Britain and ‘Karens’ in America), huns have been celebrated online in a seemingly more progressive and supposedly politically aware sociocultural context. However, this article argues that laughter aimed at the celebrity hun, though deemed inclusive by her fans, is ultimately ambivalent, polysemic and multifarious. Transformations online have led to the discursive creation of the hun through her ‘memeability’. Therefore, I will analyse this new classed and gendered figure via social media. Using the Instagram account ‘loveofhuns’ as a case study, I examine three memes from this page to showcase how huns are represented in complex and competing ways. Overall, this article questions whether the humour in memes uplifts huns or reinforces stereotypes of this typically derided image of (classed) femininity.
The zaniness of everyday life: Trump, Littler and Ngai
Authors: Russell Francis , Persic Rebecca
Published: December 2022

This article seeks to build on sociologist Jo Littler’s notion of the normcore plutocrat, that is, a newly emerging political actor who gains power through performances of ordinariness. We do this by expanding Littler’s work through an engagement with Sianne Ngai’s aesthetic theory. Taking up Donald Trump’s performances as a case study, we attempt to think through the relationship between what Ngai refers to as ‘zaniness’ and Littler’s normcore plutocrat. Given Trump’s abnormal and bizarre antics, this article poses the question of what it means to frame his performances as ‘ordinary’. In attempting to answer this question, we relocate Ngai’s work to an explicitly political register in the attempt to show how Trump’s use of language, abysmal business record and faux-masculinity can be understood as revealing something about ordinary neoliberalism.
School collective efficacy and gambling: A multilevel study of 11th grade students in Stockholm
Authors: Olsson Gabriella , Modin Bitte , Brolin Låftman Sara
Published: December 2022

The aim of the present study was to investigate variations between schools when it comes to gambling and risk gambling, and, in particular, to analyse the links between school collective efficacy and student gambling and risk gambling. The data consists of official register information on schools as well as survey data collected in 2016 among 1,061 teachers and 5,191 students in 46 Stockholm upper secondary schools. School collective efficacy was operationalized on the basis of teacher responses, which were aggregated to the school level. Gambling and risk gambling were based on students’ self-reports. Two-level binary logistic regression analyses were performed. The results show that there is between-school variation in gambling and in all the study’s indicators of risk gambling. Both gambling and risk gambling were more commonly reported by students attending schools with weak collective efficacy, even when adjusting for student- and school-level sociodemographic characteristics. The findings suggest that conditions at school may counteract students’ engagement in gambling and risk gambling.
Effectiveness of Unsupervised Exercise Therapy After Endovascular Treatment for an Iliac Occlusive Lesion
Authors: kobayashi Taira , Hamamoto Masaki , Okazaki Takanobu , Tomota Mayu , Fujiwara Takashi , Honma Tomoaki , Takahashi Shinya
Published: December 2022

Objective

Exercise therapy has acceptable outcomes for patients with intermittent claudication (IC), but there are few reports on the results of continuous unsupervised exercise therapy after endovascular treatment (EVT) for an iliac lesion. The aim of this study is to analyze the long-term outcomes of unsupervised exercise therapy for patients after EVT.

Material and Methods

A retrospective analysis was performed in 76 patients (93 limbs) with IC who underwent iliac EVT from 2012 to 2020 at our hospital. Maintenance of unsupervised exercise therapy was evaluated at 6 months after EVT. Long-term outcomes such as primary patency, clinically driven target lesion revascularization (CD-TLR), survival, and major adverse cardiovascular events (MACE) were compared between patients who continued (cET group) or discontinued (dET group) unsupervised exercise therapy.

Results

A total of 28 patients (37%) continued unsupervised exercise therapy until 6 months after EVT for an iliac lesion. There were no differences in patient background and procedural details between the cET and dET groups. The follow-up rate was 96% in a median follow-up period of 35 [25 – 42] months. The mean exercise time in the cET group was 52 ± 18 minutes daily, with a mean frequency of 5.8 ± 1.1 days per week. The median step count in the cET group was 5559 ± 2908 steps daily. At 3 years, the cET group had significantly higher rates for primary patency (97% vs 71%, P = .002), and freedom from CD-TLR (97% vs 79%, P = .007); and a tendency for higher survival (100% vs 94%, P = .074), and higher freedom from MACE (89% vs 73%, P = .12).

Conclusion

The findings of this study suggested superior long-term outcomes, including primary patency, freedom from CD-TLR, survival, and freedom from MACE, in patients who maintained continuous unsupervised exercise therapy after EVT.
The distal radio ulnar joint: a journey of discovery and invention of the Aptis prosthesis
Authors: Scheker Luis R. , Scheker John M.
Published: December 2022

This article describes the journey the authors took in discovering a new distal radioulnar joint prosthesis. The beginning deals with the problems we can potentially create for patients when we blindly follow the literature without any critical thinking. By challenging the established thinking on the function of the forearm, a new way of looking at the distal radioulnar joint emerged. Through trial, error and a moment of desperation, a new solution was found that allow us to relive pain and improve function for our patients with distal radioulnar joint pathologies.
Molluscicidal Activity of Compounds From the Roots of Aralia armata Against the Golden Apple Snail (Pomacea canaliculata)
Authors: Chuong Nguyen Thi Hong , Kim Lien Giang Thi , Yen Pham Hai , Ho Thanh-Tam , Thuy Van Do Thi , Van Kiem Phan , Hung Nguyen Huy , Kuo Ping-Chung , Setzer William N.
Published: December 2022

Background: Aralia armata (Araliaceae) is considered to exhibit effective molluscicidal activity, however, the relationship between the chemical components and molluscicidal activity has not been clearly elucidated. This research attempts to decipher these correlations among the 15 compounds isolated from Vietnam-grown A. armata roots against the freshwater snail, Pomacea canaliculata, a gastropod causing severe damage in agricultural production. Methods: Fifteen saponins were isolated from the methanol root extract of A. armata using chromatographic methods and were identified using spectroscopic techniques. The compounds were screened for molluscicidal activity against P. canaliculata, as well as toxicity against brine shrimp ( Artemia sp.) and phytotoxicity against rice germination and growth. Results: The saponin compounds exhibited extraordinary inhibition of P. canaliculata with LC50 values ranging from 7.90 to 17.50 µg/mL. Notably, the active compounds from A. armata exhibit safety for both nontarget aquatic animals, specifically Artemia sp. with LC50 values between 148.55 and 193.22 µg/mL, and the growth and development of Oryza sativa L. plants showed very little difference compared with the negative control . A molecular docking analysis indicated P. canaliculata acetylcholinesterase (PcAChE) and the actin-binding protein villin (PcVillin) to be potential biomolecular targets of the A. armata saponins. Conclusion: The present experimental and in silico data illustrate the potential of A. armata in agricultural applications.
How Regions React to Economic Crisis: Regional Economic Resilience in a Chinese Perspective
Authors: Li Meiyue , Wang Xiaowen
Published: December 2022

The severity of the 2007–2008 global financial crisis and the spatial heterogeneity of its impact have accelerated the study of regional economic resilience. However, few have investigated whether pre-crisis determinants impact regional economic resilience. This study explores the factors influencing regional economic resilience across 284 Chinese cities from 2003 to 2019. We use data from the National Bureau of Statistics in China and apply a multilevel logistic regression model. The results indicate the magnitude of the province effects on regional performance during the financial crisis. The results show that regional economic resilience is significantly shaped by provincial trajectories and region size. Furthermore, economic agglomeration, manufacturing, education, infrastructure, and financial development make regions less susceptible to external shocks and more resilient to financial crises. The results provide supportive evidence for governments to adopt region-based policies and thereby improve their performance.
The Association between Hearing Impairment and Postural Stability in Older Adults: A Systematic Review and Meta-analysis
Authors: Foster Jacinta I. , Williams Katrina L. , Timmer Barbra H. B. , Brauer Sandra G.
Published: December 2022

There is growing evidence linking hearing impairment to higher falls risk through alterations in postural stability, with studies showing mixed results. The primary aim of this systematic review and meta-analysis was to determine the association between hearing impairment and postural instability in older adults, including differences based on severity of hearing impairment. This review was pre-registered in PROSPERO and performed in accordance with PRISMA guidelines across six databases. Primary research on adults aged 60 years and older with hearing loss and an objective measure of postural stability or gait were eligible for inclusion. Methodological quality was assessed using the modified Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. Data were analysed using meta-analyses and a narrative synthesis. Inclusion in the meta-analyses required clearly defined audiometrically-assessed hearing impairment, and two subgroups of participants: mild (25–40 dB HL) and moderate to-severe (>40 dB HL) hearing impairment. Twenty-five eligible studies (n = 27,847) were included in the narrative synthesis, with quality ratings ranging from unsatisfactory to very good on the modified NOS. Eight studies were included in the meta-analysis which showed individuals with moderate to-severe hearing impairment were significantly slower on the 5 x sit-to-stand test (mean difference[95%CI] = 0.50 s [0.04, 0.97], p = .03), had a slower gait speed (mean difference[95%CI] = −0.11 s [−0.16, −0.05], p < .001) and had lower total Short Physical Performance Battery scores (mean difference[95%CI] = −0.79[−1.17, −0.41], p < .001) than those with normal hearing. This review provides evidence there is an inverse association between increasing severity of hearing impairment and poorer postural stability across both the meta-analysis and narrative synthesis.
An Experiential Exercise for Teaching Growth Mindset to Business Students
Authors: Moss Sherry E.
Published: December 2022

This article presents an exercise designed to instill growth mindsets in business students and to demonstrate their effects on achievement motivation. The main points of the exercise are to introduce implicit theories of intelligence (i.e., fixed and growth mindsets), demonstrate that mindsets are malleable, apply growth mindset strategies, and develop a growth orientation to continuous learning. I adapted an experiential juggling exercise to demonstrate mindset concepts. Students are given a juggling lesson and are divided into two groups. One group gets instructions designed to induce a fixed mindset while the other group gets growth mindset instruction. Results across graduate and undergraduate business students reveal a material difference in students’ expectations about the likelihood of learning to juggle. This exercise serves as the basis for training on growth mindset strategies for learning difficult business school curricula and extending this learning mindset into organizational life.
Timing and Outcomes of Endoscopy for Esophageal Food Bolus Impaction
Authors: Triadafilopoulos George , Gardner Jerry D.
Published: December 2022

Background:

The etiology, natural history, urgency, and timely management of esophageal food bolus impaction (EFBI) are not well known.

Objective:

To determine the optimal timing for endoscopic disimpaction and outcomes.

Design:

Retrospective observational cohort study.

Setting:

Urban community hospital.

Patients and Methods:

Patients with EFBI who presented to the ED were reviewed. Patient demographics, times from symptom onset to ED visit and times from ED to Endoscopy, endoscopic findings, and other data were analyzed.

Results:

Of 105 patients with EFBI, 74 required endoscopy, 31 cleared spontaneously. At endoscopy, 5 boluses (7%) had already passed into the stomach; 29 (39%) were pushed into the stomach using the endoscope; 6 (8%) were removed with rat tooth forceps; 16 (22%) were removed using the Roth net. The time from EFBI until arrival differed significantly between subjects who resolved spontaneously and those who received an EGD. Fifty percent of subjects resolved spontaneously within 3.3 hours, and 50% of subjects who received an EGD did so within 4.0 hours. The longest time from arrival until resolution was 13.1 hours for subjects who resolved spontaneously and 19 hours for those who received an EGD. There was a significant direct relationship between subjects’ age and time from EFBI and arrival but not between subjects’ age and time from arrival until resolution.

Limitations:

Retrospective, single-center, community study.

Conclusions:

Endoscopic disimpaction for EFBI is safe and effective even if it is performed within 10 hours after presentation. Overall, EFBI is not an endoscopic emergency and carries a favorable outcome.
(Ab)scent aromas: Mapping the smell texture of the COVID-19 pandemic
Authors: Allen Louisa
Published: December 2022

This paper maps the smell texture of the COVID-19 pandemic. Media and official accounts of the pandemic have been dominated by statistical rates of viral infection and death, as well as visual images of overburdened hospitals and deserted city streets. Mobilising smell as a medium for knowing the world differently, this paper documents pandemic smell markers such as ‘hand sanitizer’, ‘disinfectant’ and ‘breath and body odour’. To do this, it employs ‘smellwalk’ and ‘urban wandering’ methodologies in Bayside, a coastal town in Aotearoa-New Zealand. It argues the pandemic produces a specific smell texture, conceptualised as a momentary re-arrangement of the normal smellscape. This re-arrangement is signalled by both the presence of pandemic smell markers, and absence of normal smells which create atmospheres of ‘uncertainty’, ‘anxiety’ and ‘dis-ease’. In accordance with other emerging sensory scholarship about the pandemic, the paper considers whether this change in smellscape constitutes a ‘sensory revolution.’
Examining the impact perceptual learning artificial-intelligence-based on the incidence of paresthesia when performing the ultrasound-guided popliteal sciatic block: simulation-based randomized study
Authors: Cai Nan , Wang Geng , Xu Li , Zhou Yan , Chong Hao , Zhao Yaoping , Wang Jingxian , Yan Wenjia , Zhang Bo , Liu Nan
Published: December 2022

Objective

To explore the impact of artificial-intelligence perceptual learning when performing the ultrasound-guided popliteal sciatic block.

Methods

This simulation-based randomized study enrolled residents who underwent ultrasound-guided sciatic nerve block training at the Department of Anesthesiology of Beijing Jishuitan Hospital between January 2022 and February 2022. Residents were randomly divided into a traditional teaching group and an AI teaching group. All residents attended the same nerve block theory courses, while those in the AI teaching group participated in training course using an AI-assisted nerve identification system based on a convolutional neural network instead of traditional training.

Results

A total of 40 residents were included. The complication rates of paresthesia during puncture in the first month of clinical sciatic nerve block practice after training were significantly lower in the AI teaching group than in the traditional teaching group [11 (4.12%) vs. 36 (14.06%), P = 0.000093]. The rates of paresthesia/pain during injection were significantly lower in the AI teaching group than in the traditional teaching group [6 (2.25%) vs. 17 (6.64%), P = 0.025]. The Assessment Checklist for Ultrasound-Guided Regional Anesthesia (32 ± 3.8 vs. 29.4 ± 3.9, P = 0.001) and nerve block self-rating scores (7.53 ± 1.62 vs. 6.49 ± 1.85, P < 0.001) were significantly higher in the AI teaching group than in the traditional teaching group. There were no significant differences in the remaining indicators.

Conclusion

The inclusion of an AI-assisted nerve identification system based on convolutional neural network as part of the training program for ultrasound-guided sciatic nerve block via the popliteal approach may reduce the incidence of nerve paresthesia and this might be related to improved perceptual learning.

Clinical trial

CHiCTR2200055115, registered on 1/ January /2022.
Sex differences involved in persistent atrial fibrillation recurrence after radiofrequency ablation
Authors: Li Haiwei , Wang Zefeng , Cheng Zichao , Zhu Yingming , Yuan Zhongyu , Gao Jianwei , Zhang Xiaoping , Wu Yongquan
Published: December 2022

Background

In recent years, the difference in outcomes of radiofrequency catheter ablation (RFCA) in persistent atrial fibrillation patients has risen. In particular, biological sex seems involved in a different response to the AF ablation procedure. In our study, we analyzed the AF recurrences after RFCA assessing the other association between male/female patients with the outcomes.

Methods

We enrolled 106 patients (74.5% men) with persistent atrial fibrillation with scheduled follow-up. The baseline clinical characteristics and AF recurrence after RFCA were compared between men and women. Cox regression analyses were performed to determine the risk predictors of AF recurrence.

Results

The proportion of RFCA in women was lower than that in men. Men with persistent AF were younger than women (58.6 ± 10.4 years vs. 65.1 ± 8.7 years, respectively; p = 0.003). The left atrium (LA) diameter was higher in males (43.7 ± 4.6 mm vs. 41.3 ± 5.5 mm; p = 0.028), and the level of left heart ejection fraction (LVEF) was higher in females (59.4 ± 6.9% vs. 64.1 ± 5.5%; p = 0.001). Sex differences in AF recurrence after RFCA were significant during the median 24.4-month (interquartile range: 15.2–30.6 months) follow-up period, and the recurrence rate of AF in women was significantly higher than that in men (p = 0.005). Univariable Cox regression analysis showed that female sex was a risk factor for persistent AF recurrence after RFCA [HR: 2.099 (1.087–4.053)]. Univariate Cox regression analysis revealed that non-PV ablation not associated with AF recurrence [HR: 1.003 (0.516–1.947)].

Conclusion

In a monocentric cohort of persistent AF patients, the female biological sex was associated with a higher risk of AF recurrence after RFCA.
How do study design features and participant characteristics influence willingness to participate in clinical trials? Results from a choice experiment
Authors: Thomas Caitlin , Mulnick Sarah , Krucien Nicolas , Marsh Kevin
Published: December 2022

Background

Research about the decision to participate in a clinical study has tended to be limited to single indications and has focused on narrow sets of study and participant characteristics. This study applied stated preference methods to understand the clinical trial design attributes that most influence willingness to participate and how this varied with participant characteristics.

Methods

Adults residing in the US, China, or Poland with a self-reported diagnosis of cancer, heart disease, migraine, rheumatoid arthritis, or multiple sclerosis completed an online survey. Participants were asked whether they would participate in clinical studies defined by seventeen attributes within five categories (payment/support, administration/procedures, treatment-related, study location/time commitment, and data collection/feedback). Participants saw six different hypothetical clinical study profiles. Depending on their participation decision to an initial clinical study profile, the subsequent five questions had one design attribute (randomly selected per question) consecutively improved or deteriorated to elicit preferences. A logistic regression was used to determine which participant characteristics influenced participation decisions. A latent class logit model was used to identify how the influence of study design features varied between participants and whether groups of participants with similar preferences could be identified.

Results

The survey was completed by 487 participants (32% China, 35% Poland, 33% US; 8%–19% per indication). Willingness to participate was found to be a function of participant age, certain elements of quality of life, and previous treatment experience, in particular number of lines of treatment received and experience of adverse events. Willingness to participate was influenced by study design features such as payment, study duration, and time commitment – both the overall time and whether the time was at home or away from home, with the latter being particularly relevant to participants experiencing fatigue due to their disease.

Conclusions

This study quantifies how study designs influence willingness to participate and how this varies with participant types. These findings suggest that it is how an indication influences quality of life and treatment experience, rather than the indication alone, that impacts participation rates, opening the way for insights that are transferrable across indications, which may be particularly useful when considering rare diseases.
The use of routine data from primary care practices in Germany to analyze the impact of the outbreak of SARS-CoV-2 on the utilization of primary care services for patients with type 2 diabetes mellitus
Authors: Strumann Christoph , Blickle Paul-Georg , von Meißner Wolfgang C. G. , Steinhäuser Jost
Published: December 2022

Background

Routinely collected health data from ambulatory care providers offer a wide range of research opportunities. However, the access is often (e.g., technically) hindered, particularly in Germany. In the following, we describe the development of an infrastructure for the analysis of pseudonymized routine data extracted from primary care practices in Germany. Further, we analyze the impact of the outbreak of SARS-CoV-2 on the utilization of primary care services for patients with type 2 diabetes mellitus (DM type 2).

Methods

In this retrospective cohort study, routine data were extracted from nine private primary care practices before and since the outbreak of SARS-CoV-2 in Germany. The sample consisted of patients who were treated between 2016 and 2022 in one of the participating practices. The effects of the outbreak on the frequency of practice visits and the disease course of DM type 2 patients were analyzed by means of bivariate and multivariate analyses.

Results

The developed infrastructure offers an analysis of routine data from outpatient care within 24 h. In total, routine data of 30,734 patients could be processed for the analyses with 4182 (13.6%) patients having a diagnosed DM type 2 and 59.0% of these patients were enrolled in a disease management program (DMP). In the multivariate analysis, there was a significant negative effect of the SARS-CoV-2 outbreak on utilization of outpatient services of patients with DM type 2 disease. This decrease was less pronounced among DMP patients. The glycated haemoglobin level (HbA1c) has not changed significantly.

Conclusions

The study showed that the analysis of routine data from outpatient care in Germany is possible in a timely manner using a special developed electronic health record system and corresponding software. The significantly negative effect of the SARS-CoV-2 outbreak on utilization of outpatient services of patients with DM type 2 disease was less pronounced among DMP patients. Two years after the start of the Covid pandemic a significantly worsened course of illness cannot be observed. However, it must be taken into account that the observation period for clinically relevant outcomes is still relatively short.
Conicity-index predicts all-cause mortality in Chinese older people: a 10-year community follow-up
Authors: Zhang Anhang , Li Yingnan , Ma Shouyuan , Bao Qiligeer , Sun Jin , Cai Shuang , Li Man , Su Yongkang , Cheng Bokai , Dong Jing , Zhang Yan , Wang Shuxia , Zhu Ping
Published: December 2022

Background

Abdominal obesity (AO) has been regarded as the most dangerous type of obesity. The Conicity-index (C-index) had a high ability to discriminate underlying AO. The purpose of this study was to determine the ability of C-index to predict all-cause mortality among non-cancer Chinese older people.

Methods

The participants were residents of the Wanshou Road community in Beijing, China. Receiver operating curve (ROC) curves were used to determine the sensitivity and specificity of the best cut-off values for different anthropometric measures for predicting all-cause mortality. The area under the curve (AUC) of the ROC curves were calculated to compare the relative ability of various anthropometric measures to correctly identify older people in the community where all-cause mortality occurs. Included subjects were grouped according to C-index tertiles. The association between C-index and all-cause mortality was verified using Kaplan–Meier survival analysis and different Cox regression models.

Results

During a mean follow-up period of 9.87 years, 1821 subjects completed follow-up. The average age was 71.21 years, of which 59.4% were female. The ROC curve results showed that the AUC of the C-index in predicting all-cause mortality was 0.633. Kaplan–Meier survival curves showed a clear dose–response relationship between C-index and all-cause mortality. With the increase of C-index, the survival rate of the study population showed a significant downward trend (P < 0.05). Adjusted for age, gender, hip circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose (FBG), 2-h postprandial blood glucose (2hPG), glycosylated hemoglobin, high-density lipids protein (LDL), triglyceride, serum creatinine, serum uric acid, urine albumin-creatinine ratio (UACR), Mini-Mental State Examination (MMSE), smoking history, and drinking history, COX regression analysis showed that in the model adjusted for all covariates, the risk of all-cause mortality in tertile 3 was 1.505 times that in tertile 1, and the difference was statistically significant.

Conclusions

The C-index is an independent risk factor for all-cause mortality in the non-cancer Chinese older people.
Research trends and hotspots of recurrent pregnancy loss with thrombophilia: a bibliometric analysis
Authors: Deng Ying-jun , Liu Sheng-Jing , Zhao Ming , Zhao Feng , Guo Jun , Huang Yu-xiao
Published: December 2022

Background

Thrombophilia is a group of disorders that result in a blood hypercoagulable state and induce thrombosis, which was found widely existed in recurrent pregnancy loss (RPL). More and more research about thrombophilia has been conducted but the association between thrombophilia and RPL remains uncertain. Thus, it’s necessary to combine relevant literature to find the research hotspots and analyze the internal link between different study points, and then predict the development trend in RPL with thrombophilia.

Methods

Relevant articles between 1970 and 2022 were obtained from the Web of Science (WoS) database. Software VOSviewer and CiteSpace were used to perform the analysis and conduct visualization of scientific productivity and emerging trends.

Results

Seven hundred twenty-five articles published in recent 30 years by 3205 authors from 1139 organizations and 68 countries were analyzed. 37authors, 38 countries, and 53 organizations published papers ≥5. The United States was the most productive country and Univ Amsterdam was the most productive institution. Journal thrombosis and haemostasis had the most total citations. In keyword and clusters, factor-v-Leiden, inherited thrombophilia, activated protein-c, low-dose aspirin, molecular-weigh heparin, polymorphism had high-frequency focus on its etiology, diagnostics, and therapeutics. The strongest keyword bursts showed the research hotspots changed over time.

Conclusions

There could be differences in the clinical relevance of different type of thrombophilia, as well as single and multiple thrombophilic factors. Anticoagulation and immunotherapy are currently the main treatment options. More clinical trials and basic research are expected and we should attach more attention to the whole management of in-vitro fertilization in the future.
Acute skin toxicity of conventional fractionated versus hypofractionated radiotherapy in breast cancer patients receiving regional node irradiation: the real-life prospective multicenter HYPOBREAST cohort
Authors: Bruand Marie , Salleron Julia , Guihard Sébastien , Crety Charles Marchand , Liem Xavier , Pasquier David , Lamrani-Ghaouti Assia , Charra-Brunaud Claire , Peiffert Didier , Clavier Jean-Baptiste , Desandes Emmanuel , Faivre Jean-Christophe
Published: December 2022

Background

Large-scale trials have shown that hypofractionated adjuvant breast radiotherapy was as effective in terms of survival and local control as conventional fractionated radiotherapy, and acute toxicity was reduced with hypofractionated radiotherapy. However, there is a lack of data about the toxicity of breast with regional nodal irradiation (RNI). The aim of this study was to assess the effect of fractionation on radiation-related acute skin toxicity in patients receiving RNI in addition to whole-breast or chest wall irradiation, using real-life data.

Methods

We conducted a prospective, multicenter cohort study with systematic computerized data collection integrated into Mosaiq®. Three comprehensive cancer centers used a standardized form to prospectively collect patient characteristics, treatment characteristics and toxicity.

Results

Between November 2016 and January 2022, 1727 patients were assessed; 1419 (82.2%) and 308 (17.8%) patients respectively received conventional fractionated and hypofractionated radiation therapy. Overall, the incidence of acute grade 2 or higher dermatitis was 28.4% (490 patients). Incidence was lower with hypofractionated than with conventional fractioned radiation therapy (odds ratio (OR) 0.34 [0.29;0.41]). Two prognostic factors were found to increase the risk of acute dermatitis, namely 3D (vs IMRT) and breast irradiation (vs chest wall).

Conclusion

Using real-life data from unselected patients with regional nodal irradiation, our findings confirm the decreased risk of dermatitis previously reported with hypofractionated radiation therapy in clinical trials. Expansion of systematic data collection systems to include additional centers as well as dosimetric data is warranted to further evaluate the short- and long-term effects of fractionation in real life.