bluuebunny/crossref_metadata_2025 huggingface dataset:
ВИКОРИСТАННЯ ПЕРІОПЕРАЦІЙНОЇ ЕПІДУРАЛЬНОЇ АНАЛГЕЗІЇ ТА РЕЗУЛЬТАТИ ХІРУРГІЧНОГО ЛІКУВАННЯ ПІСЛЯ ПАНКРЕАТОДУОДЕНЕКТОМІЇ: КЛІНІЧНЕ ДОСЛІДЖЕННЯ
Authors: УСЕНКО О. Ю. , СИМОНОВ О. М. , ГУРІН П. В.
Published: September 2024

Мета роботи: оцінка клінічної ефективності періопераційної епідуральної аналгезії та її впливу на короткострокові післяопераційні ускладнення після панкреатодуоденектомії (ПД), враховуючи при цьому інші значущі коваріанти.
Матеріали і методи. Ретроспективний огляд було проведено з використанням проспективно зібраної бази даних послідовних пацієнтів, які перенесли ПД з січня 2022 по листопад 2023 року. Група пацієнтів складалася з 234 осіб (150 чоловіків та 84 жінки) з середнім віком 68 років. Підходи до забезпечення аналгезії були різні: у 20 пацієнтів (8 %) обмежилися виключно загальною анестезією, натомість в основній частині, 215 осіб (92 %), використали комбінований метод, що включав як епідуральну, так і загальну анестезію. Передопераційне біліарне дренування було виконано у 122 пацієнтів (52 %). Післяопераційна панкреатична нориця (ПОПН) розвинулась у 44 пацієнтів (18,8 %). Для порівняння передопераційних параметрів між групами епідуральної та загальної аналгезії використовували стандартну описову статистику. Додатково був використаний кореляційний аналіз Пірсона для вивчення зв’язків між застосуванням епідуральної аналгезії та ключовими післяопераційними показниками.
Результати. Застосування комбінованої епідуральної та загальної анестезії було пов’язане з покращенням кількох післяопераційних показників, порівняно з лише загальною анестезією. Зокрема, використання епідуральної аналгезії було пов’язане зі значно нижчою частотою виникнення клінічно значущої ПОПН, з більшістю пацієнтів (88,78 %), у яких не було жодних ознак цього ускладнення. Зокрема, використання епідуральної аналгезії було пов’язане зі значно коротшим часом до відновлення функції шлунково-кишкового тракту в групі епідуральної аналгезії (3,35 дня), порівняно з групою, що отримувала лише загальну анестезію (5,5 дня, p<0,00001). Середній артеріальний тиск був значно вищим у групі з епідуральною аналгезією (71 мм рт. ст.), порівняно з групою загальної анестезії (66 мм рт. ст., p=0,0002).Кореляційний аналіз Пірсона виявив значну зворотну кореляцію між епідуральною аналгезією та ризиком розвитку ПОПН (-0,635), а також позитивний вплив епідуральної аналгезії на швидкість відновлення функції кишечника і гемодинамічну стабільність.
Результати дослідження показують, що ширше застосування комбінації епідуральної аналгезії з загальною анестезією може стати стандартом для пацієнтів, яким виконують складні абдомінальні операції. Переваги включають прискорене відновлення функції ШКТ та зменшення частоти і тяжкості ПОПН. Однак необхідно враховувати потенційні ризики та проводити ретельний вибір анестезіологічної стратегії на основі індивідуальних характеристик пацієнта. Мультидисциплінарний підхід до планування та проведення ПД є ключовим для досягнення оптимальних результатів.
ОСОБЛИВОСТІ ВИБОРУ МЕТОДУ РЕКОНСТРУКЦІЇ ДЕФЕКТІВ М’ЯКИХ ТКАНИН ПРИ ПОРАНЕННЯХ НИЖНІХ КІНЦІВОК
Authors: ШАПРИНСЬКИЙ Є. В. , МИРГОРОДСЬКИЙ Д. В.
Published: September 2024

Мета роботи: розробити підхід до вибору способу реконструкції дефектів м’яких тканин нижніх кінцівок, що виникли внаслідок їх травматичних ушкоджень.
Матеріали і методи. Були досліджені результати лікування 52 хворих, які перебували на стаціонарному лікуванні у Клінічному високоспеціалізованому хірургічному Центрі з малоінвазивними технологіями КНП “ВОКЛ імені М. І. Пирогова” з дефектами м’яких тканин нижніх кінцівок, отриманими внаслідок бойової травми кінцівок за період 2022–2024 роки. Причинами їх були вибухова травма з осколковим пораненням у 47 хворих, кульове поранення – в 5 хворих. Ізольоване поранення кінцівок спостерігалось у 18 (34,62 %) випадках, у 34 (65,38 %) – поєднані ушкодження: з органами черевної та грудної порожнин – у 28 (53,84 %), голови – в 3 (5,77 %), пошкодженнями таза та органів порожнини малого таза – в 3 (5,77 %) хворих. Залежно від розмірів, об’єму дефектів м’яких тканин, локалізації, видів ушкоджень тканин та їх глибини хворі були поділені на чотири групи.
Результати. Хворим першої групи (18 осіб) з малими та середніми неглибокими дефектами м’яких тканин нижніх кінцівок їх закриття виконували власними тканинами, використовуючи шви дерматотензії. При підготовці дефектів м’яких тканин до їх закриття проводили етапні повторні (вторинні) хірургічні обробки з використанням фізичних методів та вакуумної терапії.
Хворим другої групи (15 осіб) з великими та обширними але неглибокими дефектами м’яких тканин проводили автодермо­пластику вільним розщепленим клаптем за методикою Тірша. У трьох (5,77 %) випадках спостерігали частковий некроз автодермотрансплантата.
У третій групі хворих (14 осіб) з великими та обширними глибокими дефектами м’яких тканин нижніх кінцівок нижче рівня глибокої фасції використовували різні варіанти пластики складними клаптями після відповідної їх підготовки. У 10 хворих виконана пластика з використанням ковзаючих клаптів (V та Y-пластики), у 2 – транспозиційних (Z-пластика) та у 2 – ротаційних (пропелерна пластика). У 2 (3,85 %) випадках у післяопераційному періоді спостерігався ішемічний крайовий некроз після проведеної V-подібної пластики.
Хворим четвертої групи (5 осіб) з великими і обширними дефектами м’яких тканин нижніх кінцівок з ушкодженнями глибоко розміщених структур лікування вимагало мультидисциплінарного підходу. Після відповідної підготовки дефекту до закриття було виконано 5 реконструкцій ротаційними “пропелерними” клаптями на судинній ніжці. В післяопераційному періоді спостерігався один випадок (1,92 %) крайового некрозу внаслідок ішемії автодермотрансплантата.
Отже, запропонований підхід з поділом хворих на групи залежно від розмірів дефектів, їх глибини, видів ушкоджень тканин дозволяє оптимізувати вибір способу закриття дефектів та отримати задовільні результати лікування у 88,46 % хворих.
Perú: la derecha radical en transición hacia un orden autoritario
Authors: Goldstein Ariel Alejandro
Published: September 2024

El análisis del período comprendido entre la llegada al poder de Pedro Castillo, su caída y el desarrollo de la presidencia de Dina Boluarte, ha mostrado el paso hacia un tipo de gobierno autoritario sustentado por la derecha radical. Esta presidenta ha configurado un régimen basado en un Congreso de derecha, los militares y los policías. Estos grupos se nutren también de apoyos exteriores como el partido Vox de España. La derecha peruana, que ha sido caracterizada como un “archipiélago conservador” hasta el gobierno de Castillo por sus divisiones internas, ha logrado unirse en una cruzada “anticaviar” y “anticomunista” que tiene en la represión estatal un punto fundamental de su estrategia política para preservar el modelo económico heredado del fujimorismo.
Role of Cholesterol Metabolic Enzyme CYP46A1 and Its Metabolite 24S-Hydroxycholesterol in Ischemic Stroke
Authors: Sun Huawei , Yang Tao , Simon Roger P. , Xiong Zhi-gang , Leng Tiandong
Published: September 2024

BACKGROUND:

For several decades, it has been recognized that overactivation of the glutamate-gated N-methyl-D-aspartate receptors (NMDARs) and subsequent Ca
2+
toxicity play a critical role in ischemic brain injury. 24S-hydroxycholesterol (24S-HC) is a major cholesterol metabolite in the brain, which has been identified as a potent positive allosteric modulator of NMDAR in rat hippocampal neurons. We hypothesize that 24S-HC worsens ischemic brain injury via its potentiation of the NMDAR, and reducing the production of 24S-HC by targeting its synthetic enzyme CYP46A1 provides neuroprotection.

METHODS:

We tested this hypothesis using electrophysiological, pharmacological, and transgenic approaches and in vitro and in vivo cerebral ischemia models.

RESULTS:

Our data show that 24S-HC potentiates NMDAR activation in primary cultured mouse cortical neurons in a concentration-dependent manner. At 10 µmol/L, it dramatically increases the steady-state currents by 51% and slightly increases the peak currents by 20%. Furthermore, 24S-HC increases NMDA and oxygen-glucose deprivation–induced cortical neuronal injury. The increased neuronal injury is largely abolished by NMDAR channel blocker MK-801, suggesting an NMDAR-dependent mechanism. Pharmacological inhibition of CYP46A1 by voriconazole or gene knockout of
Cyp46a1
dramatically reduces ischemic brain injury.

CONCLUSIONS:

These results identify a new mechanism and signaling cascade that critically impacts stroke outcome: CYP46A1 → 24S-HC → NMDAR → ischemic brain injury. They offer proof of principle for further development of new strategies for stroke intervention by targeting CYP46A1 or its metabolite 24S-HC.
Time-Dependent Potentiation of the PERK Branch of UPR by GPR68 Offers Protection in Brain Ischemia
Authors: Sun Wenyan , Tiwari Virendra , Davis Grace , Zhou Guokun , Jonchhe Sarun , Zha Xiangming
Published: September 2024

BACKGROUND:

In ischemia, acidosis occurs in/around injured tissue and parallels disease progression. Therefore, targeting an acid-sensitive receptor offers unique advantages in achieving the spatial and temporal specificity required for therapeutic interventions. We previously demonstrated that increased expression of GPR68 (G protein-coupled receptor 68), a proton-sensitive G protein-coupled receptor, mitigates ischemic brain injury. Here, we investigated the mechanism underlying GPR68-dependent protection.

METHODS:

We performed biochemical and molecular analyses to examine poststroke signaling. We used in vitro brain slice cultures and in vivo mouse transient middle cerebral artery occlusion (tMCAO) models to investigate ischemia-induced injuries.

RESULTS:

GPR68 deletion reduced PERK (protein kinase R-like ER kinase) expression in mouse brain. Compared with the wild-type mice, the GPR68-/- (knockout) mice exhibited a faster decline in eIF2α (eukaryotic initiation factor-2α) phosphorylation after tMCAO. Ogerin, a positive modulator of GPR68, stimulated eIF2α phosphorylation at 3 to 6 hours after tMCAO, primarily in the ipsilateral brain tissue. Consistent with the changes in eIF2α phosphorylation, Ogerin enhanced tMCAO-induced reduction in protein synthesis in ipsilateral brain tissue. In organotypic cortical slices, Ogerin reduced pH 6 and oxygen-glucose deprivation–induced neurotoxicity. Following tMCAO, intravenous delivery of Ogerin reduced brain infarction in wild-type but not knockout mice. Coapplication of a PERK inhibitor abolished Ogerin-induced protection. Delayed Ogerin delivery at 5 hours after tMCAO remained protective, and Ogerin has a similar protective effect in females. Correlated with these findings, tMCAO induced GPR68 expression at 6 hours, and Ogerin alters post-tMCAO proinflammatory/anti-inflammatory cytokine/chemokine expression profile.

CONCLUSIONS:

These data demonstrate that GPR68 potentiation leads to neuroprotection, at least in part, through enhancing PERK-eIF2α activation in ischemic tissue but has little impact on healthy tissue.
Morphological description and DNA barcoding of Thalassomya paraskevae sp. nov. (Diptera: Chironomidae: Telmatogetoninae) from coast of the Black Sea
Authors: MAKARCHENKO EUGENYI A. , SEMENCHENKO ALEXANDER A. , PALATOV DMITRY M. , LISANOVSKAYA ELENA A.
Published: September 2024

Illustrated description of adult male, as well as DNA barcoding, of Thalassomya paraskevae sp. nov. in comparison with close related species T. frauenfeldi Schiner from coast of the Black Sea are provided. Interspecific p-distances using gene COI 5P between T. paraskevae sp. nov. and T. frauenfeldi from Madeira (Portugal) were 8.94%. Divergence between described species and T. frauenfeldi collected near the type locality (Friuli Venezia-Giulia, Italy) using COI 3P were 7.72%. Obtained values corresponds to species level.
12. Global Catastrophic Risk From Low Magnitude Volcanic Eruptions
Authors: Mani Lara , Tzachor Azaf , Cole Paul
Published: September 2024

This chapter advocates for a more systematic approach to thinking about extreme global risk and argues that most research on volcanic risk focuses on the catastrophic potential of eruptions, rather than the issues of our exposure and vulnerability to them. The authors explore seven geographical locations, or “pinch points”, where there is believed to be the highest levels of criticality for the infrastructure systems they contain, such as areas around Taiwan and the Mediterranean Sea. By considering these critical systems simultaneously with potential volcanic activity, this chapter reveals the risks of lower magnitude volcanic eruptions, allowing for new approaches to global risk management―a narrative which, this chapter argues, has been previously neglected by the volcanic risk community.
Falling Fortunes: The Contingent and Asymmetric Effect of Rankings on Organizational Outcomes
Authors: Lee Wyatt Y.
Published: September 2024

As rankings of organizations have proliferated in recent decades, much research has focused on organizational efforts to maintain a high position in rankings. A common theme in this literature is that changes in rank affect evaluations by external audiences and, consequently, organizational outcomes. Yet, accumulating evidence suggests that rankings sometimes have little effect on audience assessments and organizational outcomes, a finding that calls into question the power of rankings. Instead of asking whether rankings matter, this study adopts a contingency approach and investigates when rankings matter. I develop theory about contextual and organizational factors that shape the salience and information value of shifts in rankings: the direction of the change, the availability of information from other intermediaries, the sophistication of the audience, and the focal organization’s previous ranking position. Panel data analysis and a natural experiment focused on the Fortune 500 rankings support this theory. This article provides a framework to help scholars understand the contingent and asymmetric consequences of rankings on organizational outcomes, with implications for research on evaluation systems.
The construction of dual ethnic identity among multi-ethnic adolescents
Authors: Abutbul Selinger Guy
Published: September 2024

This article examines the relationship between intermarriage and integration in a novel context, centering on Israeli adolescents with ethnic origins from both Europe and Middle Eastern and North African countries. Current analyses explore this relationship mainly through the self-identification of multi-ethnic individuals. One line of studies shows that intermarriage enlarges social networks and lowers social differences thereby weakening ethnic identification among multi-ethnic adolescents; another line points to the continuation of ethnic boundaries within multi-ethnic families and close environments that lead adolescents to identify themselves as ethnic. In contrast to these lines of research, that examine the relationship between intermarriage and integration among different ethnic groups, this article analyses this relationship between two subgroups – Middle Eastern and North African and European Jews – from the same ethnic group: Israeli Jews. Interviews with Israeli multi-ethnic adolescents show that they develop a dual ethnic identity that comprised two opposing elements. The first is a ‘thin’ identity, which enables them to choose and switch between ethnicities, thus blurring ethnic boundaries; the other, a ‘strong’ identity, creates an inner experience of two opposing ethnicities, thereby maintaining a hierarchy between the groups. This article demonstrates that in specific structural conditions, intermarriage does not influence integration in one direction only, but facilitates and impedes this process simultaneously in both directions.
Laughing through Brexit: Family humour practices, political troubles and everyday life
Authors: Carter Adam , Davies Katherine
Published: September 2024

Humour has a well-established role in the public life of politics; however, its use within families affected by macro-level political events remains understudied. This article explores how families employed humour to navigate family troubles introduced by Brexit, the United Kingdom’s tumultuous exit from the European Union. Through an ethnographic study, we demonstrate how extraordinary political times test the positive relational potentials of humour. Families reframed situations through ‘playfulness’, exercised gentle and well-timed teasing, and digitally shared Brexit-related comedy objects to alleviate stresses and anxieties. However, the intensity of the Brexit drama rendered some family humour practices futile, and in particular circumstances, humour became an additional burden. By examining the interrelations of political events, everyday family practices and humour, this article demonstrates the integral role of humour in the reconstitution of familial relationships, the importance of craft, and the significance of relational and situational contexts to the successful deployment of humour.
Selective Access to Decision Support as a Function of Event Uncertainty
Authors: Ben Yaakov Yoav , McCarley Jason S. , Meyer Joachim
Published: September 2024

Objective

We investigate the impact of event uncertainty, decision support (DS) display format, and DS sensitivity on participants’ behavior, performance, subjective workload, and perception of DS usefulness and performance in a classification task.

Background

DS systems can positively and negatively affect decision accuracy, performance time, and workload. The ability to access DS selectively, based on informational needs, might improve DS effectiveness.

Method

Participants performed a sensory classification task in which they were allowed to request DS on a trial-by-trial basis. DS was presented in separated-binary (SB), separated-likelihood (SL), or integrated-likelihood (IL) formats. Access preferences, task performance, performance time, subjective workload, and perceived DS usefulness and performance were recorded.

Results

Participants accessed DS more often when it was highly sensitive, stimulus information was highly uncertain, or the DS cue and stimulus information were perceptually integrated. Effective sensitivity was highest with the integrated likelihood DS. Although the separated likelihood DS provided more information than the binary likelihood DS, it was accessed less often, leading to lower sensitivity.

Conclusion

Participants are most likely to access DS when raw stimulus information is highly uncertain and appear to make effective use of likelihood DS only when DS cues are integrated with raw stimulus information within a display.

Application

Results suggest that DS use will be most effective when likelihood DS cues and raw stimulus information are perceptually integrated. When DS cues and raw stimuli cannot be perceptually integrated, binary cues from the DS will be more effective than likelihood cues.
Design and simulation of artificial retinal stimulation IC with switched capacitor using Si nanowire optical properties
Authors: Han Seungju , Kim Taehwan , Kim Changhee , Lee Sangmin
Published: September 2024

This study introduces an approach for converting the current from a sensor into controllable voltage. To this end, a switched-capacitor structure was integrated to provide efficient current-to-voltage conversion. The generated voltage was further regulated by an operational amplifier current source, enhancing stability and precision. An n-type metal oxide semiconductor field-effect transistor structure under an H-bridge was integrated into the system to achieve fine-tuned control over current stimulation. This component contributed to voltage regulation and enabled bi-directional control of current flow, offering versatility in adjusting current amplitudes using working and counter electrodes. This dynamic control mechanism was pivotal for effectively controlling the intensity of current stimulation. We applied Verilog-A modeling to simulate the optical characteristics of Si nanowires. The proposed system efficiently converted sensor-derived current into voltage using a switched-capacitor structure. Simultaneously, the precision was enhanced via operational amplifier regulation and n-type metal-oxide-semiconductor field-effect transistor-based H-bridge control. The simulation showed a current stimulus amplitude ranging from 2 to 13 μA for a variable photocurrent of Si nanowires (Rex: 10 kΩ, pulse: 100 Hz, 1 ms). The ability to finely control current stimulation intensity holds promise for diverse applications requiring accurate and adjustable current manipulation. This study contributes to the growing field of sensor technology by offering a unique perspective on the integration of nanostructures and electronic components for an enhanced control and functionality.
Dynamics of Health Expectancy: An Introduction to the Multiple Multistate Method (MMM)
Authors: Shen Tianyu , Payne Collin F. , Jahromi Maria
Published: September 2024

Many studies have compared individual measures of health expectancy across older populations by time-invariant characteristics. However, very few have included time-varying variables when calculating health expectancy. Even among older adults, socioeconomic and demographic characteristics are likely to change over the life course, and these changes may have substantial implications for health outcomes. This paper proposes a multiple multistate method (MMM) that situates the multistate model within the broader family of vector autoregressive models. Our approach allows the incorporation of the coevolution of multiple life course factors and provides a flexible yet simple way to model two or more time-varying variables with the multistate model. We demonstrate the MMM in two empirical applications, showing the flexibility of the approach to explore health expectancies with complex state spaces.
Hierarchy in the Politics of Migration: Revisiting Race, Ethnicity, and Power in the Migration State
Authors: Bautista-Chavez Angie , Castañeda-Pérez Estefanía , Chan Stephanie , Mitra Ankushi
Published: September 2024

Migrants and refugees face hostile publics and organized political interests, and contend with new and evolving forms of surveillance, deportability, and political violence. Researchers show that these political dynamics are fundamentally shaped by the politics of race and ethnicity. Yet, even as this work is increasingly abundant, it has not always been taken up by mainstream accounts of migration. In this article, we revisit scholarship on the politics of international migration, bringing together a collection of — sometimes disparate — research to explore how scholars can forge new lines of inquiry regarding the relationship between migration, race, ethnicity, and power. To do so, we evaluate three types of relationships at the core of migration politics: the relationship between migration and the state, the migration-related demands of domestic publics on the state, and how migrants interact and contend with the state. Across these relationships, we examine how ethnoracial hierarchies draw on, legitimize, and reinforce uneven distributions of political power, disparate deployments of state action and violence, and projects of nation- and state-building. Combining the intellectual prowess of distinct fields and approaches, we draw on productive convergences and tensions between existing and emerging frameworks and analytic starting points across disciplines to map future research trajectories in the multidisciplinary study of immigration, citizenship, asylum, and racial and ethnic politics. We conclude with a note on the politics of knowledge production–whereby some accounts of migration have been privileged over others–and point to important epistemological and methodological interventions for advancing research on the politics of migration.
11 cases of peritoneal dialysis catheter penetrating into the intestinal cavity: case series
Authors: Xie Xiaojie , Huang Fengmei , Tong Xiaofang , Wang Manqin , Wu Ruiqi
Published: September 2024

The penetration of a peritoneal dialysis catheter into the intestinal cavity is a clinically rare complication. In the present retrospective clinical case series, 11 patients with uraemia who received continuous ambulatory peritoneal dialysis and attended hospital between 2019 and 2023 are described. The median patient age was 61.91 ± 11.33 years. All patients had previously experienced peritoneal dialysis-related peritonitis and were clinically cured by infusing sensitive antibiotics into the abdominal cavity. Colonoscopy was utilised to locate the penetrating catheter and close the perforation with a titanium clip once the catheter had been removed via an external approach. Following a 2–4-week fast, the perforations healed in all 11 patients. The present authors’ experience illustrates that directly removing the catheter and clamping the perforation opening under the guidance of colonoscopy is simple to operate with few complications compared with traditional open surgery.
Wernicke encephalopathy in a patient with medullary infarctions: a case report
Authors: Wang Lu , Song Guan-jie , Su Hong-jun
Published: September 2024

Wernicke encephalopathy (WE) is an acute life-threatening neurological condition caused by thiamine (vitamin B1) deficiency. Patients with WE often present with a triad of symptoms consisting of ophthalmoplegia, gait ataxia, and mental confusion. If WE is not treated in a timely manner, it can lead to serious complications such as confusion, coma, or death. Although alcohol abuse is the most commonly reported cause of WE, nonalcoholic causes—although rare—do exist. Herein, we present the case of a nonalcoholic woman with medullary infarctions who presented with intractable vomiting. Her clinical state subsequently progressed to include ophthalmoplegia and gait ataxia. A diagnosis of WE was suspected based on her clinical presentation; this was confirmed by brain magnetic resonance imaging (MRI) and the finding of decreased serum thiamine levels. Brain magnetic resonance imaging demonstrated the complete resolution of abnormal hyperintensities during a follow-up visit, 6 months after treatment.
The FAIRification process for data stewardship: A comprehensive discourse on the implementation of the FAIR principles for data visibility, interoperability and management
Authors: Bhat Ajra , Wani Zahid Ashraf
Published: September 2024

This article discusses the importance of good data management for knowledge discovery and innovation. It outlines the FAIR principles, which provide guidelines for publishing digital resources in a way that makes the data findable, accessible, interoperable and reusable. Using a systematic literature review, the study focuses on the implementation of these principles in research data management and their applicability in data repositories and data centres. It highlights the importance of implementing these principles systematically, allowing stakeholders to choose the minimum requirements and provide a vision for implementing them in data repositories and data centres. The article also highlights the steps in the FAIRification process, which can enhance data interoperability, discovery and reusability. The paper is unique in that it explores how implementing FAIR principles impacts data management for data hosting platforms on a global scale.
Impact of Pharmacist Intervention on Inappropriate Continuations of Antipsychotics upon ICU Discharge
Authors: Dickman Lauren T. , Bauman Kelsey , Carter Christopher K. , Buchanan Paula M.
Published: September 2024

Background: Transitions of care (TOC) are important to best practices as they are at times prone to medication errors. The intensive care unit (ICU) is an essential location needing effective TOC due to many reasons, but an important one being that certain medications are only indicated there. One example is antipsychotics used for agitation, delirium, and sedation. Objective: To design, implement, and analyze the benefit of a pharmacist intervention on inappropriate antipsychotic continuation from the ICU to another point in care at a small community hospital. Secondary outcomes include patients discharged from the hospital on antipsychotics inappropriately and accepted pharmacist interventions. Methods: This standard of care, prospective with historical control study included adult patients who were ordered a formulary antipsychotic for delirium, agitation, or sedation during their ICU-level of care admission at SSM Health: St. Clare Hospital- Fenton. Results: There were 33 patients in the historical period and 24 in the intervention period. Those in the intervention period were less likely to have a continuation of antipsychotics beyond 72 hours compared to patients in the historical period (16.7% vs 57.6%, P = 0.002). In addition, patients in the intervention period were less likely to have continuation of antipsychotics when discharged to home (12.5% vs 36.4%, P = 0.04). Conclusions: A pharmacist-driven intervention led to a significant decrease in patients continuing antipsychotics upon ICU discharge. This decrease was seen at both 72 hours from patients leaving the ICU and at hospital discharge.
A novel forward performance-driven design method for gear parameters
Authors: Zheng Jiayu , Liu Changzhao , Chen Shuxin , Chen Xianglong , Wu Nanze
Published: September 2024

Gear is one of the most crucial components of the transmission system, and the performance of gear directly affects the efficiency and reliability of the transmission system. Conventional methods for designing gear parameters involve several time-consuming and complex steps, which may not guarantee optimal performance. Therefore, we propose a new method for designing gear parameters that aims to improve efficiency and accuracy. First, the tooth surface equations of spur and helical involute gears suitable for symmetric and asymmetric teeth are deduced based on the gear-forming machining principle. Second, the performance evaluation models for load capacity, dynamic performance, efficiency, and power density of the gears are established based on the precise gear surface. The design objectives are standardized and evaluated comprehensively using a linear weighting method. Finally, a forward performance-driven design method of gear parameters is established. The proposed method is applied to a helical gear pair design case, and the results show that 90.7% of the individuals in the Pareto optimal front are asymmetric gears, with 9.3% being symmetric gears. This suggests that asymmetric gears have more opportunities to be optimal than symmetric gears. The highest-ranked gear designed using the proposed method is superior to the gear designed using conventional methods.
Assessment of Changes in Vascular Density in the Layers of the Eye in Patients With Parkinson’s Disease
Authors: Bilgin Şule , Uysal Hasan Armağan , Bilgin Sinan , Yaka Emiş Cansu , Küsbeci Özge Yılmaz , Şener Ufuk
Published: September 2024

Background

The retina is affected by Parkinson’s disease (PD).

Purpose

We aimed to assess the anatomical and vascular deterioration of the retina in PD.

Methods

Sixty-six patients with PD and 66 healthy volunteers were evaluated in this study. Choriocapillaris vessel density (CCVD), superficial vascular density (SVD), deep vascular densities (DVD), central macular thickness (CMT), retinal nerve fibre layer (RNFL), ganglionic cell layer (GCL), and choroidal thickness (CT) were assessed.

Results

RNFL, GCL, CMT, and CT were thinner than in HC, and also the differences between the groups were statistically significant ( P < .05). SVD and DVD were not statistically different between the groups ( P > .05). There was a decrease in vascular density in all quadrants of the choriocapillary layer. The decrease in vascular density was statistically significant in the nasal, inferior and central quadrants ( P < .05).

Conclusion

These results supported vascular thinning in the choroidal layer. Also showed that vascular and neural layers were affected together. It could help clinicians in the follow-up of Parkinson’s patients.
“Cameras Help, but Hurt”: The Role and Use of Prison Cameras for Accountability
Authors: Inzana Victoria , Kaur Jasmine , Garcia-Hallett Janet , Givens Ashley , Huebner Beth M. , Taylor Elizabeth , Canada Kelli E.
Published: September 2024

The context of the carceral environment is based on the logic of surveillance and relies on cameras to act as the ever-present eyes of the institution. We explore the investigative roles that cameras play in the institution from the perspective of correctional staff and residents. A qualitative study was conducted in a medium-security institution in the Midwest region of the United States as part of the Prison Research and Innovation Initiative (PRII). The findings are based on semi-structured interviews with people who are incarcerated and correctional staff (including custody and noncustody staff). Upholding accountability was a perceived benefit of reviewing footage from prison cameras during investigations, yet the harms of selective enforcement against the resident population and the perceived misuse of cameras for staff disciplinary actions thwarted the benefits of having and using cameras.
A Multi-Institutional Natural Language Processing Pipeline to Extract Performance Status From Electronic Health Records
Authors: Maghsoudi Arash , Sada Yvonne H. , Nowakowski Sara , Guffey Danielle , Zhu Huili , Yarlagadda Sudha R. , Li Ang , Razjouyan Javad
Published: September 2024

Purpose

Performance status (PS), an essential indicator of patients’ functional abilities, is often documented in clinical notes of patients with cancer. The use of natural language processing (NLP) in extracting PS from electronic medical records (EMRs) has shown promise in enhancing clinical decision-making, patient monitoring, and research studies. We designed and validated a multi-institute NLP pipeline to automatically extract performance status from free-text patient notes.

Patients and Methods

We collected data from 19,481 patients in Harris Health System (HHS) and 333,862 patients from veteran affair’s corporate data warehouse (VA-CDW) and randomly selected 400 patients from each data source to train and validate (50%) and test (50%) the proposed pipeline. We designed an NLP pipeline using an expert-derived rule-based approach in conjunction with extensive post-processing to solidify its proficiency. To demonstrate the pipeline’s application, we tested the compliance of PS documentation suggested by the American Society of Clinical Oncology (ASCO) Quality Metric and investigated the potential disparity in PS reporting for stage IV non-small cell lung cancer (NSCLC). We used a logistic regression test, considering patients in terms of race/ethnicity, conversing language, marital status, and gender.

Results

The test results on the HHS cohort showed 92% accuracy, and on VA data demonstrated 98.5% accuracy. For stage IV NSCLC patients, the proposed pipeline achieved an accuracy of 98.5%. Furthermore, our analysis revealed a documentation rate of over 85% for PS among NSCLC patients, surpassing the ASCO Quality Metrics. No disparities were observed in the documentation of PS.

Conclusion

Our proposed NLP pipeline shows promising results in extracting PS from free-text notes from various health institutions. It may be used in longitudinal cancer data registries.
Successful desensitization to etoposide in a patient after cardiac arrest
Authors: Pérez-Codesido S. , Azzi Virgini V. , Fertani S. , Jandus P.
Published: September 2024

Introduction

Etoposide phosphate is a chemotherapeutic agent used to treat various malignant neoplasms. Hypersensitivity reactions may occur with its use, and in rare cases, an anaphylactic reaction can manifest. Available options for patients experiencing hypersensitivity reactions include premedication, changing treatment, or undergoing desensitization. Various pediatric desensitization protocols have been described, ranging from six to fifteen steps, while published adult cases are rare.

Case Report

We report the case of a 61-year-old woman with small-cell lung cancer and brain metastases. In November 2019, she underwent the second cycle of cisplatin and etoposide phosphate treatment. While receiving etoposide phosphate, she experienced dyspnea and suffered a cardiorespiratory arrest, leading to cardiopulmonary resuscitation and subsequent admission to the Intensive Care Unit. Her acute tryptase levels were notably elevated at 18 µg/L (compared to a baseline tryptase level of 6,6 µg/L) during the reaction.

Case Management

We implemented a 16-step desensitization protocol (without premedication) under close monitoring in an intermediate care unit. The protocol was successfully executed over three cycles until tumor progression mandated a modification in systemic treatment.

Discussion

To our knowledge, this is the first documented case of successful desensitization to etoposide phosphate in a patient who experienced cardiac arrest during a hypersensitivity reaction. Although protocols of varying lengths have been published, we emphasize the importance of individualizing each protocol to fit the severity of the reaction and the resources and experience of each unit.
Assessment of drug-drug interactions among patients with hematologic malignancy: A clinical pharmacist-led study
Authors: Zarrabi Sogol , Hosseini Elham , Sadeghi Kourosh , Vaezi Mohammad , Shahrami Bita
Published: September 2024

Introduction

Patients with hematologic malignancies often receive multiple medications, leading to potential drug-drug interactions (DDIs). Identifying and managing these DDIs is crucial for ensuring patient safety and effective care. This study aimed to identify and describe DDIs and associated factors in hematologic malignancy patients.

Methods

This prospective interventional study was conducted at a referral center and included hospitalized patients with hematologic malignancies who were receiving at least four concurrent medications. A pharmacist initially compiled a comprehensive list of all medications through patient interviews and medication reviews, and subsequently, identified and categorized potential DDIs using the Lexi-interact® and Micromedex® databases. The clinical pharmacist then evaluated the clinical impact of the identified DDIs in every individual patient and provided appropriate interventions to resolve them.

Results

A total of 200 patients met the inclusion criteria for the study, with 1281 DDIs identified across 337 distinct types. The majority of identified DDIs exhibited major severity (52.1%) and pharmacokinetic mechanisms (50.3%), with an unspecified onset (79.4%) and fair evidence (67%). Of the identified DDIs, 81.1% were considered clinically significant, prompting 1059 pharmacotherapy interventions by the clinical pharmacist. Additionally, a significant relationship was observed between the number of drugs used during hospitalization and the occurrence of DDIs (P < 0.001, r = 0.633).

Conclusion

DDIs are highly prevalent among hospitalized patients with hematologic malignancies, with their occurrence increasing alongside the number of medications administrated. The intervention of a clinical pharmacist is crucial to evaluate the clinical impact of these DDIs and implement effective interventions for their management.
Does Smaller Government Mean Less Corruption?
Authors: Dincer Oguzhan
Published: September 2024

Government intervention, whether in the role of a regulator or a market participant, presents opportunities for corruption. A burdensome regulatory environment creates more opportunities and incentives for individuals and firms to circumvent these regulations by resorting to different forms of bribery. Glaeser and Saks find that benefits of circumventing the regulations increase as the size of the government increases. The studies collected in this special issue investigate the relationship between various forms of government interventions on corruption.
Nonlocal buckling analysis of five-layer laminated nanocomposites on kerr foundation: A refined zigzag theory approach
Authors: Akbari Birgani Yazdan , Ghorbanpour Arani Ali , Khoddami Maraghi Zahra
Published: September 2024

In this paper, the buckling analysis of a five-layer laminated nanocomposite resting on a Kerr foundation is presented. In order to describe the non-continuous behavior of composite plate through its thickness, the displacement field is determined using the Refined Zigzag Theory (RZT). Additionally, the constitutive relations of piezo electromagnetic isotropic materials, orthotropic composites, and Functionally Graded Porous Materials (FGPMs) are presented. With respect to Bi- and Uniaxial loading in the nanoplate, the Hamilton’s principle is utilized to derive the equation of motion of this nanoplate. To study the small-scale effect in nanoplates, both Nonlocal Eringen Theory and Nonlocal Strain Gradient Theory (NSGT) are employed to account for nonlocal effects. Finally, the coupled equations of motion are solved using the Differential Quadrature Method (DQM). This paper introduces the newly used Kerr foundation and its effect on the buckling analysis. It also investigates the influence of plate dimensions, piezo electromagnetic terms, boundary conditions, and loading on the dimensionless critical buckling load.
Illegal Airbnb properties and hosts’ professionalism
Authors: Boto-García David
Published: September 2024

Many destinations require Airbnb hosts to obtain permits to legally operate as accommodation providers. However, a significant portion of hosts rent their properties without legally registering their business activities (i.e., illegal suppliers). This study examines the relationship between the likelihood of operating underground and the degree of professionalism among hosts, measured by the number of properties they offer. We analyse a dataset of 3,800 Airbnb listings in Menorca by matching the provided registration numbers with official records from the city council. This allows us to identify listings without a licence and those with cancelled or duplicate licences. We find a U-shaped relationship between the number of properties a host manages and the probability of operating underground. Single-unit hosts are more likely to supply their dwellings illegally than professional hosts with more than twenty units. However, the highest probabilities of illegal activity are found among hosts with four or five listings.
Study on Pharmacodynamic Substances and Quality Control of Jiuwei Jiangtang Oral Liquid Based on Network Pharmacology, Fingerprint and In Vitro Experiment
Authors: Li Qian , Pei Jingnan , Wang Li , Li Jinsha , Qin Danjian , Mo Huining , Zhang Hongping
Published: September 2024

Objective: This study aims to explore the fingerprint and quality control index components of Jiuwei Jiangtang Oral Liquid (JWJT), known for its therapeutic effects on type 2 diabetes mellitus (T2DM). Methods: This study employed network pharmacology and molecular docking to screen the core components, core targets, and pathways of JWJT. Additionally, HPLC fingerprint was established for 12 batches of JWJT. 12 batches of JWJT were evaluated using stoichiometry and common peaks were determined following a similarity assessment. The effective substances were selected to verify the index components of JWJT through assessing their control over glucose consumption in insulin-resistant HepG2 cells and their α-glucosidase inhibitory activity. Results: Through network pharmacology and molecular docking analysis, puerarin, calycosin, ellagic acid, kaempferol-3-O-rutinoside, and kaempferol were identified as core components of JWJT for treating T2DM. Key targets such as AKT1, PIK3R1, INSR, TNF, and EGFR were implicated in regulating pathways including HIF-1, MAPK, and PI3K-Akt in T2DM treatment. The HPLC fingerprints of 12 batches of JWJT samples revealed 10 common peaks, with puerarin, calycosin, ellagic acid, and kaempferol-3-O-rutinoside specifically identified among 4 chromatographic peaks. Using chemical pattern recognition, samples were categorized into two groups, with puerarin, calycosin, and ellagic acid identified as differential markers. Verification through glucose consumption in insulin-resistant HepG2 cells and α-glucosidase inhibitory activity confirmed that puerarin, calycosin, and ellagic acid were active ingredients suitable as quality control indicators for JWJT. Conclusion: The JWJT fingerprint method established in this study is both simple and reproducible. The selected index components will serve as the basis for quality control of JWJT and introduce a novel approach for selecting and verifying quality index components of JWJT in T2DM treatment.
Irritant contact dermatitis in military healthcare personnel during COVID-19: Case report
Authors: Goh Chubin , Kok Wai Leong
Published: September 2024

Irritant contact dermatitis (ICD) is one of the most common occupational skin diseases, which is hard to differentiate from allergic contact dermatitis (ACD) clinically. Failure to identify the different forms of contact dermatitis can lead to suboptimal management of the patient, with long-term impacts on occupation and quality of life. We describe a case of ICD in a military healthcare personnel during the COVID-19 pandemic. He was exposed to butyl gloves from his protective equipment as well as frequent hand-washing during the COVID-19 period. The diagnostic approach to contact dermatitis as well as holistic management plan is further discussed in this case study.
Displaced and Diminished: How the Placemaking Value of “Being there” Influences Play-By-Play Broadcasters’ Professional Identity
Authors: Petrotta Brian A. , Bell Travis R. , Meeks Lindsey
Published: September 2024

Play-by-play (PxP) broadcasters’ routines and professions are in a state of flux. Even before COVID-19 protocols disrupted PxPs’ professional practices, broadcast networks tried to reduce on-site staff to cut costs. After COVID, some teams and networks opted to not send PxPs on the road while others experimented with artificial intelligence or alternative telecasts (e.g., the “Manningcast”). Whereas alternative broadcasts create innovative entertainment, PxPs continue to serve an important and distinct role in sports broadcasts, and often act as the link between teams, fans, and other stakeholders. Interviews with 15 professional PxPs revealed that placemaking processes are a key element of their professional identity. Displacement during the pandemic led to shortterm, yet rapid changes, and potentially long-term effects on their profession. We found that while our study’s timeframe enabled a dissection of pandemic-related obstacles, it ultimately articulated PxPs’ professional uniqueness and speaks to how placemaking influences PxPs’ professional identity. Constraints stemming from COVID-19 protocols reinforced that physical proximity is paramount to the PxP profession, and while temporary shocks can be absorbed, prolonged changes to foundational aspects could negatively alter the profession and those it serves.