bluuebunny/crossref_metadata_2025 huggingface dataset:
Extracorporeal membrane oxygenation combined with hemoperfusion to assist in the rescue of aconitine poisoning: A case report
Authors: Zhao Zhiwen , Fang Zhicheng
Published: August 2024

Extracorporeal membrane oxygenation (ECMO) has been widely used as a clinical bridge for cardiopulmonary failure. We recently used combined veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and haemoperfusion to successfully treat a patient with acute aconitine poisoning. The patient was admitted to the Emergency Intensive Care Unit (EICU) in a state of coma and shock. Her received comprehensive treatment, including haemoperfusion and anti-shock therapy. 40 minutes after admission, the patient experienced sudden respiratory and cardiac arrest. After conventional defibrillation and cardiopulmonary resuscitation proved ineffective, veno-arterial ECMO was immediately initiated. One hour after initiation of VA-ECMO, the patient’s heart rhythm stabilised to sinus rhythm. After 33 h of supportive care, the patient was awake, haemodynamically stable and the VA-ECMO was successfully removed. The patient made full recovery 7 days after admission.
Palliative care in patients with hepatocellular carcinoma: Results from a survey among hepatologists and palliative care physicians
Authors: Iavarone Massimo , Canova Lorenzo , Alimenti Eleonora , Aghemo Alessio , Taveggia Diego , Gobber Gino , Cabibbo Giuseppe , Veronese Simone , Calvaruso Vincenza , Orsi Luciano , Caraceni Paolo , Lampertico Pietro ,   on behalf of Italian Association for the Study of the Liver (AISF) and Italian Society of Palliative Care (SICP)
Published: August 2024

Background:

Delays and limitations of palliative care in patients with liver transplantation- ineligible end-stage hepatocellular carcinoma according to Barcelona Clinic Liver Cancer staging system may be explained by different perceptions between hepatologists and palliative care physicians in the absence of shared guidelines.

Aim:

To assess physicians’ attitudes toward palliative care in end-stage hepatocellular carcinoma and to understand what the obstacles are to more effective management and co-shared between palliative care physicians and hepatologists.

Design:

Members of the Italian Association for the Study of Liver Disease and the Italian Society of Palliative Care were invited to a web-based survey to investigate practical management attitude for patients with liver transplant- ineligible end-stage hepatocellular carcinoma.

Participants:

Physician members of the of the two associations, representing several hospitals and services in the country.

Results:

Ninety-seven hepatologists and 70 palliative care physicians completed the survey: >80% regularly follow 1–19 patients; 58% of hepatologists collaborate with palliative care physicians in the management of patients, 55% of palliative care physicians take care of patients without the aid of hepatologists. Management of cirrhosis differed significantly between the two groups in terms of prescription of albumin, esophagogastroduodenoscopy, anti-viral treatment, anticoagulation, indication to paracentesis and management of encephalopathy. Full-dose acetaminophen is widely used among hepatologists, while opioids are commonly used by both categories, at full dosage, regardless of liver function.

Conclusions:

This survey highlights significant differences in the approach to patients with liver transplantation- ineligible end-stage hepatocellular carcinoma, reinforcing the need for shared guidelines and further studies on palliative care in the setting.
Race, Lived Experience, Representation, and Discrimination: Analyzing the Representative Capacities of the Racial Majority
Authors: Lofaro Ryan J. , Sapat Alka
Published: August 2024

The representative bureaucracy theory literature has often focused on the viewpoints, attitudes, and actions of minoritized groups rather than the racial majority, with studies predominately analyzing representative capacities tied to race, ethnicity, and gender. The current research employs both racial and lived experience representation lenses to analyze the viewpoints of non-Hispanic white public servants regarding the deservingness of white, Black, and unidentified clients. Using the opioid crisis as the context, results from an exploratory analysis of a nationwide survey experiment of first responders show that white law enforcement workers view white clients with opioid use disorder as more deserving than Black and unidentified clients. Both indirect and direct lived experiences with substance use disorder predict positive attitudes toward clients. Direct lived experience nullifies the negative beliefs white law enforcement workers express about Black clients, highlighting the significance of the intersection of racial and lived experience representation. Practical implications include promoting organizational practices that leverage the strength of shared lived experience to mitigate racial biases and encourage compassion for clients.
Precog visions: Predicting the future with the Minority Report sociotechnical imaginary
Authors: Glenhaber Mehitabel , Sridharan Hamsini
Published: August 2024

The 2002 film Minority Report regularly appears in tech press articles asking whether it ‘predicted the future’. When such publications invoke the film as having ‘predicted the future’ or ‘come true’, what social and political claims are being made? How has Minority Report become a discursive tool for imagining, constructing, and criticizing sociotechnical worlds? In this paper, we evaluate the worldbuilding process and real-world trajectories of three technologies ‘from’ Minority Report, as refracted through the lens of tech journalism: gestural interfaces, targeted advertising, and predictive policing. We argue that science fiction does more than represent technologies; it participates in their social construction. Some technologies imagined in Minority Report operate as ‘diegetic prototypes’, and the journalistic witnessing public takes them up in complex ways, interpreting, misinterpreting, and remixing the technologies depicted in the film. We further argue that it is not only technologies that move between film and reality in this process, but entire sociotechnical imaginaries. We find that in tech beat interpretations of Minority Report, the interfaces between bodies and technologies reflect a Silicon Valley sociotechnical imaginary of disembodied cyborg subjects and deracialized surveillance that materially and discursively shapes how technologies depicted in the film are developed and received.
Critical approaches to geoeconomics: Taiwan’s position/ing in the global chip war
Authors: Hsu Szu-Yun
Published: August 2024

This essay argues that a meshing of the genealogical analysis proposed by critical geoeconomics with the critical (geo)political economy approach is well-equipped to expound on the proliferation of geostrategic thinking and practices in the contemporary era marked by the ‘great power rivalry’ or the ‘new Cold War’. To elaborate on this proposition, I examine the rise of global strategic-technologic competition centring on semiconductor production and Taiwan’s position and positioning in such dynamics.
Perceived School Belonging Among Youth with Chronic Physical Illness
Authors: Ferro Mark A. , Abbruzzese Serafina , Leatherdale Scott T. , Patte Karen A.
Published: August 2024

In a sample of youth aged 10–16 years with chronic physical illness, this study examined psychometric properties of a modified Psychological Sense of School Membership (m-PSSM) scale; described longitudinal trends in perceptions over 24 months; and, identified factors associated with school belonging. Youth were recruited from a pediatric hospital in Canada. A total of 105 youth attended school in the past year and provided self-reports. The four-item m-PSSM had a unidimensional structure which was measurement invariant between youth in elementary (10–13 years) versus secondary school (14–16 years). Internal consistency was (ω > .80). There was no evidence that m-PSSM scores changed significantly over time (η2 = 0.05). Predictors of lower perceived school belonging were being in secondary school, having psychopathology, reporting lower quality of life in the domains of social support and school environment, experiencing peer victimization, and living in a community with higher residential instability and lower material deprivation.
“What got you here, won’t get you there”: Students as leaders of the change we need
Authors: Parker Kathryn , Binns Amanda , Dupre Cooper , Friesen Farah , Lising Dean , Sinclair Lynne , Ng Stella
Published: August 2024

Lack of access, system inequities, and inefficiencies plague our current healthcare system. With a challenge this complex, no one intervention is sufficient; all will be necessary. The primary care system needs a strong health workforce prepared in bold new ways. Students represent an important voice, given their role as future leaders of health education and healthcare. For students to lead, educators must leverage education paradigms that position current students as leaders of transformation. Yet, in current health education systems, students are often seen as passive recipients of knowledge and skill. Transformative education seeks to foster critical reflection (an ongoing process of questioning unhelpful assumptions and power relations) and informed action in students to enable them to challenge and change norms and change practices, structures, and society. This article highlights the value of transformative education in cultivating thoughtful change agents and provides one tangible example of a new education/practice model that puts this paradigm into action.
Enhancing comprehensive primary care by integrating chiropractic led musculoskeletal care into interprofessional teams through supporting education, competency attainment, and optimizing integration
Authors: Kopansky-Giles Deborah , Alleyne Julia , Mior Silvano , De Carvalho Diana , Quesnele Jairus , Hogg-Johnson Sheilah , Rahbar Pegah , Logeman Megan
Published: August 2024

Musculoskeletal (MSK) conditions are the leading cause of disability, resulting in up to 40% of visits to family physicians. Current primary care workforce shortages in Canada require other providers to maximize scopes of practice. Few MSK providers have been trained in team-based primary care settings. Study objectives included: (1) educating participating primary care teams through synchronous education, (2) educating Canadian primary care providers through asynchronous education, and (3) integrating chiropractors into primary care teams, whilst evaluating team MSK care knowledge/attitudes and integration experience. Results indicated improvements in collaborative competency, improved understanding and attitudes to chiropractic, and the importance of providing MSK care within funded primary care. Teams employed unique approaches to integrating chiropractors and indicated high demand for their services by patients and providers. Provision of MSK care without economic barrier is desirable and highly valued by teams. Chiropractors are well suited to participate in funded primary care teams in Canada.
From margins to mainstream: Incorporating internationally educated health professionals’ skills into primary care
Authors: Moser Cameron , Sadler Sue
Published: August 2024

This case study explores the collaborative integration of Internationally Educated Healthcare Professionals (IEHPs) into comprehensive primary care through partnerships between non-profit organizations and health systems actors. It addresses the critical need for such collaboration amidst challenges of limited access to primary care and underutilization of IEHPs’ skills in the Canadian healthcare workforce. Through the examination of ACCES Employment’s integration into the Team Primary Care initiative, this article demonstrates the importance of coordinated efforts in overcoming longstanding barriers faced by IEHPs. Data collection involved a review of program activities, program reports, policy documents, and interviews with key collaborators to highlight strategies, partnerships, and outcomes. Data were analyzed to identify recurring patterns in collaborative integration efforts. The initiative reveals promising outcomes in facilitating IEHPs’ transition into various healthcare roles through increasing collaboration between non-profit workforce development organizations and health systems actors.
Equity in practice: Integrating cross cultural health brokers for culturally safe primary care for immigrants and refugees in British Columbia
Authors: Wiedmeyer Mei-ling , Pedersen Jeanette S. , Wakil Zarghoona , Hedden Lindsay
Published: August 2024

Umbrella Multicultural Health Co-op is a community health centre serving cultural communities of immigrants/refugees in British Columbia. It uses Cross Cultural Health Brokers (CCHBs), multicultural workers bridging patients and the healthcare system, to better meet the primary care needs of immigrant/refugee populations. Through the Team Primary Care initiative, Umbrella Co-op: (1) added new CCHBs alongside allied health practitioners; and (2) implemented team workshops and evaluation for quality improvement. The learning health system framework guided project activities. Comprehensive, culturally responsive primary care for immigrants and refugees benefits from a team-based approach that includes the integration of CCHBs. Team development activities improved team function. Co-developing evaluation with the interprofessional team enabled meaningful participation. Health system design for equity-oriented team-based primary care for immigrants and refugees should include resources for CCHBs and team development infrastructure.
Integrating traditional practitioners within primary healthcare teams: Development of an accreditation framework
Authors: Mack Mandy
Published: August 2024

While the work of Traditional Healing and its practice is centuries old, many mainstream healthcare providers do not recognize its value. A priority for the Indigenous Primary Health Care Council (IPHCC) is to support Indigenous people, communities, and partners in the work of reclaiming safe spaces for Traditional Healing within primary healthcare settings. The primary goal of this IPHCC-led initiative was to understand barriers for organizations to integrate Traditional Healing and cultural services and from this information design an accreditation model for Traditional Healing Practitioners. This included the protection and maintenance of the experiences and knowledge of our Traditional Healing Practitioners through promoting and delivering Traditional Healing training and mentorship opportunities for the next seven generations of practitioners; and the creation of curriculum that will embed the concept of Two-Eyed Seeing as it relates to integrated Traditional Healing within mainstream practice.
The roles of Dutch skippers as partners and principals in colonial endeavours: Lessons from Amsterdam to New Netherland (1639–1664)
Authors: van den Hout Julie
Published: August 2024

While Atlantic skippers were vital to seventeenth-century Dutch imperial expansion, few histories address the roles of skippers in colonial ventures. Drawing on archival records in Amsterdam and New York, this study examines the activities of skippers along roughly 200 voyages between Amsterdam and New Netherland from 1639 to 1664. In Amsterdam, skippers in relationships with voyage outfitters functioned as trusted partners who offered continuity for operations. As principals at sea, skippers navigated hazards and managed contingencies during inherently risky transatlantic passages. In the colony, skippers collaborated with local merchants to facilitate trade, and with colonial authorities to provide maritime support. With an impact on every stage of the endeavour, skippers were key players in the colonial complex, which depended on them for its functioning. Beyond New Netherland, these findings have applications for evaluating other European colonial undertakings, and for understanding the wider mechanisms of imperial expansion into the Atlantic.
The balance of sea power in the early modern era: The Anglo-Dutch Wars (1652-1674)
Authors: Janžekovič Izidor
Published: August 2024

The balance of power is among the foundational principles in international relations. This principle, however, has been analysed mostly in relation to land powers on the European continent, while the historiography has failed to appropriately recognize its naval aspect so far. This article compares the English and Dutch sea powers or fleets during the three Anglo-Dutch Wars (1652–1674). Warships or ships of the line were the main instruments of naval warfare, and hence key to any measurements of sea power. Detailed tables of the fleets with the number of warships and guns for the major engagements show the balance of sea power at the time. Attaining and maintaining the balance of (sea) power in the early modern era was not just an abstract idea, but also an interactive process, based on numerical analysis. The author argues that there was a real or naval balance of sea power between the fleets or alliances of fleets; that the balance of sea power was acknowledged in the international alliance treaties; and that the balance of sea power became an element of early modern political discourse.
Can Anyone Learn to Code? A Qualitative Study of Place-Based Information Technology Training Programs
Authors: Bolter Kathleen , Martens Nicholas
Published: August 2024

The demand for workers with information technology skills is high, creating a challenge for today's workforce system to train enough people. In response, nonprofit organizations and workforce development agencies have developed place-based training programs for information technology jobs. The intricate nature of these jobs necessitates innovative training approaches that address both technical proficiency and cultural competence. Drawing from interviews and case studies, this analysis highlights the importance of rigorous prescreening processes, structured support for graduates transitioning to employment, and collaboration with employers in ensuring the success and sustainability of place-based information technology training programs. It is recommended that programs incorporate these elements into their design to effectively meet the demands of the labor market and foster diversity and inclusion within the technology sector.
Sensitivity analysis-based quality optimization strategy for multi-correlation parameters in spinning process
Authors: Hu Sheng , Wu Di , Zhang Xi , Wang Pinjian
Published: August 2024

To address the problem of quality optimization of multi-correlation parameters in the spinning process, this paper proposes a new method based on a sparrow search algorithm (SSA). Firstly, a generalized regression neural network (GRNN) is used to investigate the impact of the spinning process parameters on yarn quality, and quality forward modeling in the spinning process is established. And based on the coupling and correlation characteristics of spinning process parameters, sensitivity analysis is used to analyze the influence of each spinning process parameter on yarn quality, the correlation spinning process parameters for further analysis. Then a model of quality optimization with spinning process parameters is established, and SSA is used to solve the model of quality optimization with multi-correlation parameters in the spinning process. Finally, the effectiveness of the proposed method was validated through an instance. The results show that the optimal spinning process parameters combination generation of [32.159 5.2 0.8 14.8 24.540 8588.677 21.708] occurs in a configuration with a fitness value of 0.0003. The proposed sensitivity analysis-based quality optimization strategy reveals good performances in terms of both convergence speed and optimization accuracy, which will provide guidance for improving yarn quality.
Successful combination therapy of trichloroacetic acid, podophyllin, and electrocautery on giant condylomata acuminata
Authors: Yusuf Hasbiallah , Purwoko Muhammad Izazi Hari
Published: August 2024

Introduction: Giant condylomata acuminata (GCA) is a rare presentation of anogenital wart (AGW), invasive locally but does not metastasize. Combination therapy for GCA is suggested based on modalities and experiences. The combination of TCA and podophyllin has showed good efficacy, followed by electrocautery to eradicate warts. Case: A 24-year-old male had a chief complaint of large warts on the base of the penis that had started to bleed for 4 weeks. The initial lesion appeared 8 months prior as a small varucose papule. The patient is unmarried and has history of sexual contact with sex workers. Physical examination showed multiple verrucous papules, flesh-coloured, cauliflower-like shaped, 5 × 2 × 1 cm in size. The patient tested negative for HIV infection. Histopathological examination showed acanthosis, exophytic growth, parakeratosis, and koilocytosis with no signs of malignancy. This patient received a combination of TCA 90% and podophyllin 25% to initially reduce the tumor size, followed by electrocautery to eradicate the remaining lesions. The tumor showed complete clearance. Discussion: There is no definitive evidence that one therapy is superior to completely eliminating warts. Combination therapy of TCA and podophyllin leads to complete wart clearance, followed by electrocautery to destroy smaller warts.
Addressing more-than-human care through Yorùbá environmental ethics
Authors: Sunday Aanuoluwapo Fifebo
Published: August 2024

This article presents more-than-human care ethics from a Yorùbá (African) perspective with a focus on water in Yorùbá belief. The view I develop in this article to show beyond human care, how nature cares for itself is encapsulated in the notion of ‘mutual courteousness’. The article demonstrates that this mutual courteousness approach engrained in Yorùbá ontology, epistemology, and axiology possesses a sound possibility for enabling the overhauling of our understanding of conservation towards seeing it as a more-than-human process. This shared ethics is fundamental because it helps us think about conservation, action, and virtues in a reciprocal spectrum beyond human caring. The paper argues that water conservation debates surrounding non-native ownership and management in Nigeria should not only be human or economically motivated but should present a holistic and sustainable approach to environmental interactions. Employing the method of philosophical analysis, this article explores the environmental ethics rooted in the Yorùbá culture of Southwestern Nigeria.
The Sowers of Seeds: A Qualitative Analysis of the Role of Palliative Care Educators in Facilitating Goals-of-Care Conversations and Palliative Care Referrals
Authors: Zupanc Seth N. , Quintiliani Lisa M. , LeClair Amy M. , Paasche-Orlow Michael K. , Volandes Angelo , Penumarthy Akhila , Henault Lori , Itty Jennifer E. , Davis Aretha D. , Lakin Joshua R.
Published: August 2024

Background

Optimal care for seriously ill and older patients often involves advance care planning (ACP), goals-of-care (GOC) conversations, and specialty palliative care consultation, three sometimes overlapping, yet distinct practices. Insufficient staffing and investment in these areas have limited their availability.

Objectives

We explored the facilitators and barriers to successful implementation of the VIDEO-PCE trial. The intervention aimed to increase patient engagement in ACP, GOC, and by establishing Palliative Care Educators, a new clinical role integrated into existing hospital wards.

Design

This qualitative interview study employed a semi-structured interview guide tailored to the interviewee’s clinical role. The interviews elicited perceptions of the facilitators and barriers to integration of palliative care educators (PCEs) into existing workflows. We developed deductive codes a priori and inductive codes as we coded interview transcripts.

Setting/Subjects

Medical/surgical floor clinical colleagues, palliative care team members, and PCEs from both participating sites were interviewed.

Results

Twenty-four individuals were interviewed (12 clinical staff of medical and surgical wards, seven palliative care team members, and five PCEs). Four themes were identified: (1) The work completed by the PCEs provided a foundation for future palliative care involvement; (2) Constituting the new role in practice required revision and creativity; (3) Communication was important to providing continuity of care; and (4) Establishing trust catalyzed the acceptance of the role.

Conclusion

The creation and implementation of a new role within existing clinical workflows posed some challenges but were felt to relieve staff from some work burden and allow more patients to engage in ACP and GOC conversations.

Trial Registration

ClinicalTrials.gov Identifier: NCT04857060.
“I Can Feel It in My Spine”: Indigenous Women's Embodied Experiences of Violence and Healing
Authors: Doria Celina M.
Published: August 2024

This article draws on the stories told by Indigenous women in the midwestern United States to explore embodied experiences of violence and how they conceptualize healing in the aftermath of violence. Two focus groups—conducted as talking circles—were completed with 16 Indigenous women. Findings highlight four salient themes: embodied impacts of violence; normalization of violence; (im)possibilities of healing; and strategies for healing. In particular, the women highlighted embodied practices like collective storytelling as a means of healing. This study deepens our understanding of violence against women by promoting Indigenous ways of knowing and uplifting the voices of Indigenous women.
Safety and oncological effectiveness after desensitization in patients with previous hypersensitivity reactions to chemotherapy
Authors: Villarreal-González Rosalaura V. , Vidal-Gutiérrez Oscar , Martínez-Moyano Javier A. , Madrazo-Morales Marianela , Sáenz-Cantú Kathia S. , Cadenas-García Diana E. , Oyervides-Juárez Victor M. , Noriega-Iriondo María Fernanda , Rodríguez-Niño Patricia
Published: August 2024

Introduction

Taxanes and platinum are first-line treatments in gynecological tumors with high rates of hypersensitivity reactions (HSRs), leading to discontinuation of treatment. Desensitization involves induction of temporary tolerance to previously sensitized medications. The aims of this study are to describe HSRs to paclitaxel and carboplatin and evaluate the safety and effectiveness of desensitization protocols in gynecological cancer patients.

Methods

Original, retrospective, descriptive, analytical study, approved by Bioethics and Research Committee, included >18-year-old patients with gynecological tumors experiencing HSRs to first-line chemotherapy. Patients underwent 3-bag-12-step desensitization.

Results

174 desensitization (95 paclitaxel, 79 carboplatin) in 33 female patients, mean age 45.5 years (18–71y). Cancer diagnosis: breast 8 (24.2%), ovarian 14 (42.2%), endometrial 2 (6.1%) and cervix 9 (27.2%). HSR occurred in paclitaxel during cycles 1–2 and in carboplatin after 6 cycles. The most frequently seen HSR symptom was cardiovascular with paclitaxel (94.7%), and cutaneous (93.3%) with carboplatin. Three-bags 12-steps desensitization protocol (initial dilution 1:100) in 5.67hrs. All patients reached total dose desensitization: 82% with no reaction, 12% mild, 6% moderate and 0% severe reaction. Mean disease-free interval and progression-free interval in months (m): breast cancer 29 m and 14 m, ovarian 22 m and 9 m, endometrial 40 m and cervical cancer: 67.5 m and 27 m. Twenty-five patients (73.5%) are still alive.

Conclusion

HSRs to paclitaxel manifest in the first 1–2 cycles and to carboplatin after 6 cycles. Symptoms include cardiovascular, atypical neuromuscular and urticaria. Changing treatment lines impacts prognosis. Our study revealed that ovarian cancer patients undergoing desensitization protocols achieved longer progression-free intervals. All patients successfully reached total dose desensitization. This study provides evidence of the effectiveness and safety of desensitization and promising perspective for continuing first-line treatment with HSRs.
Examining clinical pharmacist interventions and identifying opioid medication-related issues in patients with cancer
Authors: Anwar Amjad , Malik Nirmal , Siddiqui Adeel , Shrestha Sunil , Bhutta Omar Akhlaq , Mazhar Saba , Khan Muhammad Rehan , Usman Hafiz Muhammad
Published: August 2024

Introduction

Opioid medications are crucial for managing pain among patients with cancer. Yet, inappropriate prescribing and medication issues can compromise patient safety and quality of care. Clinical pharmacists play a significant role in optimizing opioid therapy and addressing issues related to opioid medication use.

Objectives

This study aimed to examine clinical pharmacist interventions and identify opioid medication-related issues in patients with cancer.

Method

We conducted a retrospective observational study at Shaukat Khanum Memorial Cancer Hospital and Research Center in Lahore, Pakistan, conducting a chart review from 1st July 2021 to 31st December 2021.

Results

Out of 10,534 opioid medication orders, we documented a total of 974 interventions based on our inclusion criteria. Tramadol and morphine accounted for most of these interventions, comprising 49.27% (n = 475) and 40.04% (n = 386), respectively. Regarding clinical significance, 41.70% (n = 406) were deemed significant, while 37.36% (n = 365) were somewhat significant. The majority of interventions, i.e., 54.05% (n = 521), primarily aimed at optimizing patient outcomes, followed by a secondary aim of improvements in communication, i.e., 25.52% (n = 246).

Conclusion

This study establishes the evaluation of clinical pharmacist interventions on opioid medication use in patients with cancer, an issue particularly in oncology settings in Pakistan. The findings emphasize the crucial role of clinical pharmacists in addressing issues related to opioid issue medications, thus improving patient safety and optimizing opioid use for patient well-being.
Real-world experience of abemaciclib for adjuvant and metastatic breast cancer
Authors: Drowne Taylor , Armgardt Emily , Svoboda Alison
Published: August 2024

Objective

Hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) breast cancer is the most common subtype. Abemaciclib, an inhibitor of cyclin-dependent kinases 4 and 6, was approved to reduce risk of recurrence in high-risk, HR+, HER2-, early breast cancer based on the monarchE trial. The most common adverse events reported in monarchE were diarrhea, neutropenia, and fatigue. Real-world tolerability data and incidence of adverse events with abemaciclib in the adjuvant setting versus the metastatic setting is lacking.

Data Sources

This is a retrospective analysis of HR+, HER2- breast cancer patients on abemaciclib from March 2018 to September 2021 at Robert H. Lurie Comprehensive Cancer Center in Chicago, Illinois. Incidence, grade of adverse events, dose reductions, and discontinuations were evaluated in patients taking abemaciclib in the adjuvant setting and the metastatic setting.

Data Summary

Of the 30 patients included in this analysis, 100% experienced an adverse event of any grade. During treatment, 12.5% treated in the adjuvant setting and 35.7% in the metastatic setting experienced grade ≥3 adverse events. Adverse events leading to discontinuation of abemaciclib occurred in 18.8% of patients in the adjuvant setting and 57.1% in the metastatic setting.

Conclusions

This data suggests abemaciclib is better tolerated in high-risk, HR+, HER2-, node-positive, early breast cancer treated in the adjuvant setting compared to the metastatic setting. Management of adverse events is crucial to help patients stay on therapy to improve clinical outcomes. Real-world tolerability of abemaciclib in both the adjuvant and metastatic settings is of importance.
An overview of patents of noise reduction in buildings
Authors: Laze Kuenda
Published: August 2024

Noise is an unwanted sound in urban areas. Natural and or recycled acoustic absorbing or insulation materials are invented to reduce air and or impact sounds in buildings. Yet, they are not widely and commercially available. This review presented an overview of relevant studies on natural materials particularly on cotton and rubber using Scopus search engine and of the patents registered and granted using Espacenet and Google Patents search engines on noise reduction in buildings from the years 1996 to 2023. The 18% and 68% (out of 32 articles) relevant articles, respectively, were written on cotton and rubber and other recycled natural material e.g., consumed teabags, rubber crumb, indicating a clear vision for experimentation and modeling of natural materials e.g., to investigate their sound absorption coefficients at lower frequencies (below 250 Hz) for (recycled) cotton sound absorbing materials and for producing ultralight density with high sound absorption materials (0.56) using recycled rubber material. There were found 31 patents registered and granted, in total. Natural materials, namely, cotton, rubber, glass wool and rock wool were applied in 29% of patents registered and granted from 1996 to 2022. Yet, 93% of patents registered and granted lacked data on sound absorption index of materials they invented. LDA models estimated 29% of Espacenet and Google Patents patents registered and granted having an increased trend of patent innovations for example, in method, structure and building materials in the last decade.
Four Decades of Research Productivity and Hot Spots in Pancreas Transplantation
Authors: Rawashdeh Badi , Arpali Emre , Al Abdallat Haneen , Cooper Matthew , Dunn Ty
Published: August 2024

Background: The field of pancreas transplantation has undergone transformative phases, progressing from its promising inception in 1966 to becoming a standard treatment for patients with insulin-dependent diabetes. This bibliometric analysis explores the progression of pancreas transplantation research over a period of four decades, mapping milestones, contributors, and emerging trends. Methods: Our bibliometric analysis utilizes the comprehensive Scopus database, which includes publication titles, author information, affiliations, abstracts, keywords, and journal details. The search strategy was centered on research related to pancreas and pancreas-kidney transplantation. The analysis encompasses the time frame spanning from 1983 to 2023, with the data extraction taking place on October 7th, 2023. Results: The analysis of 4,897 articles uncovered unique trends in the field of pancreas transplantation research. The years 1989, 1996, and 2021 saw significant increases in the number of publications, which corresponded to the responses to clinical challenges and advancements. Contributions by authors from the United States of America were the most numerous, with 1,905 publications and 49,949 citations. The research topics were highlighted by keywords such as “graft survival,” “graft rejection,” and” Immunosuppressive treatment." Conclusion: The fluctuations in publication trends that have been identified indicate dynamic reactions to changing priorities and challenges. Although it has limitations, this analysis provides valuable insights for researchers, clinicians, and policymakers who are dealing with the complex field of pancreas transplantation literature. Further bibliometric research may advance our knowledge and direct future initiatives in this developing field.
Early Tissue Resection Versus Watchful Waiting After Revascularization for Chronic Limb-Threatening Ischemia: A Meta-Analysis
Authors: Xu Xu , Guo Qiang
Published: August 2024

No consensus or guideline has been established regarding the optimal timing of tissue resection after revascularization in patients with chronic limb-threatening ischemia (CLTI). This study aimed to compare early tissue resection and watchful waiting after revascularization regarding the outcomes of patients with CLTI. We searched PubMed, the Cochrane Library, and EMBASE for relevant randomized trials and observational studies published from their inception to May 1, 2024. In total, five articles were analyzed. The results showed that the early tissue resection group had a higher wound healing rate than the watchful waiting group (I2 = 26%, odds ratio [OR] = 2.80, 95% confidence interval [CI] 1.32 to 5.92, P = 0.007). However, the rate of major amputation was significantly higher in the early tissue resection group than in the watchful waiting group (I2 = 5%, OR = 1.48, 95% CI 1.18 to 1.86, P < 0.001), and wound recurrence rate in the early tissue resection group was relatively higher than that in the watchful waiting group (I2 = 0%, OR = 2.42, 95% CI: 0.99 to 5.93, P = 0.05). No statistical significance was found in the rate of postoperative mortality (I2 = 2%, OR = 0.99, 95% CI: 0.69 to 1.41, P = 0.94) and wound healing time (I2 = 97%, standardized mean difference = -105.92, 95% CI −232.96 to 21.13, P = 0.10) between the early tissue resection and watchful waiting groups. For patients without signs of infection, a watchful waiting strategy could reduce the risk of major amputation.
Acute Vascular Complications of VA-ECMO in COVID-19 Patients. Does COVID-19 Affect the Outcome?
Authors: Khedr Alhussein M. , Foula Mohammed S. , Alhewy Mohammed Alsagheer , Abdelhafez Abdelaziz Ahmed , Hanbal Ibrahim Hanbal , Ghazala Ehab Abd Elmoneim , Khamis Ahmed Atef , Gado Hassan , Abd-Elgawad Wael Abdo Abdo , El Sayed Abdullah , Ibrahim Awad , Elghoneimy Yasser , Abdelmohsen Abdelhalim A.
Published: August 2024

Background

Extracorporeal membrane oxygenation (ECMO) through the femoral artery and vein can lead to significant vascular complications. We retrospectively studied the acute vascular complications of Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) in COVID-19 patients compared to non-COVID patients during the period from January 2020 to July 2023.

Results

Seventy-eight patients underwent VA-ECMO for various indications from January 2020 to July 2023. The studied patients had a mean age of 59.6 ± 6.9 years for non-COVID patients (38 patients), and 62.2 ± 7.6 years for COVID patients (40 patients), with a P = 0.268. In non-COVID patients, The baseline characteristics were similar in both groups. The primary indications for ECMO were cardiac diseases, followed by respiratory failure (78.9% vs 10.5%). Conversely, in COVID patients, respiratory failure due to COVID-19 infection was the main indication (45% vs 40%). The overall incidence of general complications, including cerebrovascular stroke, acute kidney injury, intracardiac thrombi, and wound infection, was comparable in both groups (31.6% vs 45%). The overall incidence of vascular complications in both groups was 33.3%. Ipsilateral acute lower limb ischemia occurred in 5.3% vs 10% of non-COVID and COVID patients, respectively. Thrombosis of the distal perfusion catheter (DPC) occurred in 10.5% vs 15%, respectively.

Conclusion

During the COVID-19 pandemic, an increasing number of patients required VA-ECMO due to associated respiratory failure. Patients undergoing VA-ECMO are at high risk of developing various vascular complications. COVID-19 significantly increases the risk of acute limb ischemia and distal perfusion catheter thrombosis in both upper and lower limbs. However, other VA-ECMO-related vascular complications are comparable between COVID-19 and non-COVID patients.
Intermittency transition to azimuthal instability in a turbulent annular combustor
Authors: Singh Samarjeet , Bhavi Ramesh S. , Raghunath Midhun P. , Bhaskaran Anaswara , Mishra Pruthiraj , Chaudhuri Swetaprovo , Sujith R. I.
Published: August 2024

We experimentally study the transition from a state of combustion noise to azimuthal thermoacoustic instability in a laboratory-scale turbulent annular combustor. This combustor has sixteen swirl-stabilized burners to facilitate continuous and spatially distributed combustion along the annular region. Our approach involves simultaneous measurement of CH* chemiluminescence emission of the flame using two high-speed cameras and the acoustic pressure fluctuations using eight piezoelectric pressure transducers mounted on the backplane of combustor. We observe that the transition from combustion noise to azimuthal instability occurs through mode shifting, where the system switches from a longitudinal mode to an azimuthal mode as the equivalence ratio is decreased. Throughout this progression, the combustor exhibits various dynamical behaviors, including intermittency, dual-mode instability, standing azimuthal instability, and beating azimuthal instability. These dynamical states are determined from the acquired pressure signals by decomposing the acoustic pressure fluctuations into clockwise (CW) and counterclockwise (CCW) waves, enabling a reconstruction of the amplitude of acoustic pressure fluctuations, nature angle, (anti-)nodal line location, and spin ratio. The global heat release response is then examined during various dynamical states, contrasting their behavior at different non-dimensional time steps by phase-averaging the fluctuations of the heat release rate over the acoustic pressure cycle. Distinctive flame behaviors were observed based on the direction of pressure wave propagation, showcasing characteristic CCW spinning, standing, and CW spinning heat release patterns. Moreover, our examination of relative phase distributions during various dynamical states, computed by analyzing the phase of heat release rate fluctuations across all burners with respect to one burner, reveals the emergence of diverse patterns in the interaction of neighboring flames influenced by acoustic field.
Effect of COVID 19 pandemic on the neurology department hospitalization with analysis of the neurological complications secondary to COVID 19 and vaccination against COVID 19
Authors: Matsuzono Kosuke , Mieno Makiko , Mashiko Takafumi , Anan Yuhei , Ozawa Tadashi , Koide Reiji , Tanaka Ryota , Kimura Akio , Fujimoto Shigeru
Published: August 2024

Objective:

We investigated the effect of the pandemic on neurological hospitalizations and complications associated with severe acute respiratory syndrome coronavirus 2 infection or vaccinations.

Methods:

We retrospectively analyzed data of patients hospitalized in our neurology division from 1 April 2019 to 31 March 2022 as the opt-out study. We classified the neurological diseases into nine subgroups, evaluated changes of neurological disease characteristics, and analyzed patients hospitalized with the complications from severe acute respiratory syndrome coronavirus 2 infection or after the coronavirus disease 2019 vaccination over three eras based on the pandemic stages: (1) pre-pandemic, (2) during the pandemic but before vaccines, and (3) during the pandemic with vaccines.

Results:

Overall, 1756 patients were included in the analyses. The patient characteristics significantly changed throughout the pandemic ( p < 0.01). Although the number of autoimmune cases did not change throughout the pandemic ( p = 0.53), that of psychological cases and that of unknown cases were significantly changed ( p < 0.05, p < 0.01). There were four infectious cases and 11 cases following vaccination from 1 April 2020 to 31 March 2022. The 11 postvaccination cases involved 10 kinds of neurological diseases.

Conclusions:

The neurological characteristics significantly changed throughout the pandemic and there were diverse neurological complications following vaccinations.
Snails, time, data: On the politics of mass-digitization and the possibility of data drift
Authors: Hopman Roos
Published: August 2024

In natural history museums around the globe, museum staff are working on making collections of specimens (such as insects on pins, snail shells, dried plants, mounted birds) digitally available through online databases en masse. The mass-digitization of specimens is urgent especially now, so museum actors and biodiversity scientists stress, as natural history collections could provide the biodiversity sciences with crucial data for research into the effects of climate-change induced biodiversity loss. This paper investigates the processes and practices through which these biodiversity data are produced. It argues that the work of data production requires the negotiation of- and grappling with different temporalities, and that attending to these temporalities contributes to a further understanding of the politics of mass-digitization. Building on ethnographic fieldwork in the Museum für Naturkunde Berlin's collection of snail shells, the paper brings into view the work required to make snail specimens and their metadata digital. Following steps in a mollusk digitization workflow—meant to streamline and scale up digitization processes—it attends to the misalignment of rhythms; the importance of informal cleaning labor; the negotiation of social, biological, and colonial temporalities in practices of label transcription; and the anticipatory and expansive logics of mass-digitization. Drawing on snails’ ability to “drift,” it raises data drift as a way of engaging with natural history collections and their data.
Long COVID symptoms and demographic associations: A retrospective case series study using healthcare application data
Authors: Sunkersing David , Goodfellow Henry , Mu Yi , Ramasawmy Mel , Murali Mayur , Adams Lawrence , FitzGerald Ted J , Blandford Ann , Stevenson Fiona , Bindman Julia , Robson Chris , Banerjee Amitava
Published: August 2024

Objectives

To investigate long COVID (LC) symptoms self-reported via a digital application. Explore associations between various demographic factors and intensity of LC symptoms.

Design

A retrospective case series study. We analysed self-reported symptoms from 1008 individuals with LC between November 30, 2020, and March 23, 2022.

Setting

England and Wales.

Participants

Individuals with LC using the healthcare application in 31 post-COVID-19 clinics and self-reporting LC symptoms.

Main outcome measures

Highest reported LC symptoms, associations with demographic factors and intensity of symptoms.

Results

109 symptom categories were identified, with pain (26.5%), neuropsychological issues (18.4%), fatigue (14.3%) and dyspnoea (7.4%) the most prevalent. The intensity of reported symptoms increased by 3.3% per month since registration. Age groups 68–77 and 78–87 experienced higher symptom intensity (32.8% and 86% higher, respectively) compared to the 18–27 age group. Women reported 9.2% more intense symptoms than men, and non-white individuals with LC reported 23.5% more intense symptoms than white individuals with LC. Higher education levels (national vocational qualification (NVQ) 3 to NVQ 5) were associated with less symptom intensity (27.7%, 62.8% and 44.7% less, respectively) compared to the least educated (NVQ 1–2). People in less deprived areas had less intense symptoms than those in the most deprived area. No significant association was found between index of multiple deprivation (IMD) decile and number of symptoms.

Conclusion

Treatment plans must prioritise addressing prevalent LC symptoms; we recommend sustained support for LC clinics. Demographic factors significantly influence symptom severity, underlining the need for targeted interventions. These findings can inform healthcare policies to better manage LC.