bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcome of Endovascular and Open Treated Penetrating Aortic Ulcers
Authors: Kapalla Marvin , Kröger Joselyn , Choubey Rahul , Busch Albert , Hoffmann Ralf-Thorsten , Reeps Christian , Wolk Steffen
Published: March 2024

Purpose:

Penetrating aortic ulcer (PAU) is a rare etiology of acute aortic syndrome. Few studies exist regarding the perioperative outcome. The aim was to analyze clinical outcome and risk factors of mortality in this treatment population.

Methods:

Retrospective, monocentric study from 2010 to 2021. Clinical data of endovascular or open treated PAU were analyzed. In-hospital mortality was selected as the primary study endpoint. Angio-morphologies were analyzed and risk factors for mortality were identified by using univariate analysis.

Results:

Overall, 133 patients were identified. 29% (n=38) of patients presented symptomatically. In 64% (n=85), the PAU was localized in the thoracic aorta. On average, PAUs had a depth of 15.4±10.1 mm and a width of 17.9±9.6 mm. The patients had a median of 2 (95% confidence interval [CI]=2-3) high-risk features (HRF) as PAU depth >10 mm, PAU width >20 mm, aortic diameter >40 mm, symptomatic, intramural hematoma (IMH), pleural effusion. Significantly more HRF were observed in symptomatic patients (p=0.01). 53% (n=71) of patients were treated with thoracic endovascular aortic repair (TEVAR), 41% (n=54) by endovascular aortic repair (EVAR), and 6% (n=8) by open surgery. A hybrid procedure with cervical debranching was performed in 16% (n=21) and complex endovascular repair with fenestrated or branched endografts in 15% (n=20). Overall, complications greater than grade II according to the Clavien-Dindo classification occurred in 19% (n=25) and of the patients. In-hospital mortality manifested in 6% (n=8). Factors associated with increased mortality were the diameter of the aorta >40 mm (88% vs 39%, p=0.03), as well as symptomatic patients (63% vs 26%, p=0.04), coincident IMHs (38% vs 10%, p=0.05), and complex endovascular procedures (50% vs 50% p<0.01). Penetrating aortic ulcer width >20 mm tended to show higher mortality (75% vs 40%, p=0.06). Routine follow-up was available for 89% (n=117) for a median of 39 months (95% CI=25-42). One-year and 5-year survival were 83% and 60%, respectively, with 1 aortic pathology-related death.

Conclusions:

Treatment of PAU is associated with an acceptable perioperative morbidity and mortality. Risk factors associated with increased mortality are an elevated aortic diameter, the presence of IMHs, clinical symptomatology at presentation, and complex endovascular procedures.
A Systematic Review of Anti-Adhesion Agents in Hand Trauma
Authors: Forbes Kirstie E. , Cavallaro Davina , Power Dominic
Published: March 2024

Adhesions following hand surgery are common, leading to stiffness, which compromises the functional outcomes for the patient. The objective of this study was to conduct a systematic review to analyze the role of antiadhesive barriers in surgery for hand trauma. A comprehensive literature search was conducted using PubMed/MEDLINE, Embase and the Cochrane Central Register of Controlled Trials, in line with the Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines. The inclusion criteria included both randomized and non-randomized control studies in patients aged 18 or over, with the intervention of an anti-adhesive barrier compared against traditional repair without a barrier in patients with hand trauma, including nerve, fracture, and tendon injury. The primary outcome measure of interest was range of movement (ROM) after operative surgery. Secondary outcomes of interest included further surgery, reported stiffness, complications, quality of life, and time to return to work. A total of 8450 records were identified; 7 studies fulfilled the eligibility criteria and were included. Seven anti-adhesive barriers were included in the review. Three agents (amnion, MASTBiosurgery Surgiwrap antiadhesive film, and acellular dermal matrix [ADM]) demonstrated statistically significant improvements in ROM postoperatively; however, all 3 studies demonstrated a risk of bias. This review highlights the paucity of high-quality studies demonstrating any clear advantage of using anti-adhesive barriers in hand surgery; however, there is some evidence to suggest that amnion, the MAST adhesion barrier film and ADM may have favorable results as an antiadhesive barrier in hand surgery, but further high-quality research is required to quantify this effect.
A comparative analysis of CAD modeling approaches for design solution space exploration
Authors: Li Haibing , Ye Yaoliang , Zhang Zhongbo , Yu Wei , Zhu Wenbo
Published: March 2024

Design solution space (DSS) exploration is a pivotal process for comprehending design challenges and identifying diverse solution alternatives based on varying requirements. Computer-aided design (CAD) approaches, such as parametric design, knowledge-based design, and generative design, have proven successful in DSS exploration. However, a comparative study evaluating their performance is lacking in the technical literature. This paper addresses this gap by conducting a comparative analysis of these approaches regarding their performance in exploring DSS. The research begins by providing an overview of parametric design, knowledge-based design, and generative design, establishing the foundation for the study. Six evaluation criteria are identified based on the DSS exploration process. A qualitative analysis is then conducted, considering these criteria, to objectively assess the performance of each modeling approach. The results highlight the strengths and weaknesses of each approach, revealing that DSS exploration success is directly tied to the quantity of implemented knowledge. The results also emphasize the complementarity of those approaches, as their strengths and weaknesses are based on different problem-solving logics, demonstrating the synergy that can be achieved through strategic combinations of them. Additionally, the paper discusses open issues related to DSS exploration, contributing valuable insights for future developments in this field.
Examining the coach–athlete relationship for facilitators and barriers to healthy sport participation for cyclically menstruating athletes: A systematic review
Authors: Srinivasa Gopalan Sharan , Liu Sam , Mann Caitlin , Buckler E Jean
Published: March 2024

Menstrual function is an integral component of the overall health and well-being of cyclically menstruating athletes, impacted by and affecting their participation in sport and athletic training. This review used the coach–athlete relationship to examine the sport environment for factors that facilitate or hinder healthy sport participation for cyclically menstruating athletes with respect to their menstrual cycles. Four databases were searched until June 30, 2023, for studies that explored the experiences, perceptions and knowledge related to the menstrual cycle among athletes training under a coach and coaches of cyclically menstruating athletes. The search produced 2511 studies, which, following screening for relevance and eligibility, resulted in 34 studies of moderate-to-high quality. Thematic synthesis and integration of qualitative and quantitative data from 7558 athletes and coaches from elite to amateur level uncovered 4 main themes pertaining to the coach–athlete relationship and the menstrual cycle that constituted barriers (menstruation taboo, lack of knowledge and awareness, and lack of communication among stakeholders) and facilitators (presence of female coaches, positive experiences of communicating about the menstrual cycle, and trust) to healthy sport participation. A final theme summarised the needs of athletes and coaches related to the menstrual cycle. Greater education, representation of females in sporting roles, and improved collaboration among the various stakeholders emerged as the primary factors for driving a culture-shift in the sporting environment, in order to abolish the taboo against menstruation and promote healthy sport participation for cyclically menstruating athletes.
Developing a Diabetes Discharge Order Set for Patients With Diabetes on Insulin
Authors: Miles Elizabeth , McKnight Melissa , Schmitz Claire C. , McElroy Chelsea R. , Wardian Jana L. , Shostrom Valerie , Polavarapu Preethi
Published: March 2024

Background:

Insulin, a high-risk medication, is prone to prescribing errors. Patients with diabetes experience higher hospitalization rates and extended hospital stays. Prescription errors, such as missing orders, inappropriate insulin type, missing instructions, and lack of appropriate intensification of insulin regimens are common issues. This project explored the use of system-based interventions and educational tools to minimize errors and improve the quality of insulin discharge regimens.

Methods:

A needs assessment and baseline chart review were conducted before adapting a diabetes order set obtained from the University of California, San Diego. Subsequent beta testing and broader implementation were followed by repeat chart reviews to assess the impact.

Results:

Providers strongly desired an insulin discharge order set, with 98% of those surveyed expressing this preference. Those who were high utilizers of the order set showed increased rates of ordering all supplies (55%), compared with pre-intervention rates (27%). However, no change was observed in the practice of intensifying insulin regimens in patients with uncontrolled diabetes upon discharge.

Discussion:

Insulin prescribing is prone to error. A diabetes discharge order set may improve the percentage of patients who receive necessary insulin supplies at discharge and provide educational resources to encourage appropriate insulin regimens at hospital discharge.
Antibacterial Profiling of Zanthoxylum armatum Extracts: A Comprehensive Computational and Experimental Study
Authors: Mukhtar Mamuna , Khan Haris Ahmed , Naz Shumaila
Published: March 2024

Objectives

The current study was conducted to evaluate the antibacterial potential of leaf and fruit extracts of Zanthoxylum armatum against two pathogenic bacterial isolates, Staphylococcus aureus and Staphylococcus epidermidis.

Methods

Twelve commercially available antibiotics were tested S. aureus and S. epidermidis by antimicrobial susceptibility test (AST). Qualitative analysis of phytochemicals was performed to evaluate the presence of certain secondary metabolites. The activity of Z. armatum extracts against S. aureus and S. epidermidis was measured as a maximum zone of inhibition exhibited by each leaf and fruit extract. An in-silico study was conducted on flavonoids and alkaloids to show their binding affinity with the PBP2a receptor protein of S. aureus and TcaR of S. epidermidis.

Results

The AST revealed that S. aureus was resistant to Penicillin, Ampicillin, Clindamycin, Vancomycin, Rifampicin, Novobiocin, and Oxacillin, whereas S. epidermidis was resistant to Streptomycin, Oxacillin, Tetracycline, and Novobiocin. Qualitative analysis of phytochemicals resulted in the presence of Saponins, fixed oils, flavonoids, alkaloids, starch, and fatty acids in both leaf and fruit extracts. The maximum zone of inhibition against S. aureus was produced by methanolic leaf extracts of Z. armatum and chloroform fruit extracts. For S. epidermidis, the best activity was exhibited by benzene leaf extracts and methanolic fruit extracts. An in-silico study showed that flavonoids Nitidine and Nevadensin exhibited binding affinity with the PBP2a receptor protein higher than selected antibiotics, ie, Penicillin, Chloramphenicol, and Oxacillin. TcaR of S. epidermidis interacted with Tambuletin, followed by Nitidine and Kaempferol.

Conclusion

After in vitro testing, in silico analysis advised extracting and purifying the bioactive components from Z. armatum extracts that showed significant interaction with bacterial virulence proteins for use as natural antibiotics against antibiotic-resistant bacteria.
The Time Burden of Office Visits in Contemporary Pituitary Care, 2016 to 2019
Authors: Dimitroyannis Rose C. , Cyberski Thomas F. , Kondamuri Neil S. , Polster Sean P. , Das Paramita , Horowitz Peleg M. , Roxbury Christopher R.
Published: March 2024

Background

The concept of “time toxicity” has emerged to address the impact of time spent in the healthcare system; however, little work has examined the phenomenon in the field of otolaryngology.

Objective

To validate the use of Evaluation and Management (E/M) current procedural terminology codes as a method to assess time burden and to pilot this tool to characterize the time toxicity of office visits associated with a diagnosis of pituitary adenoma between 2016 and 2019.

Methods

A retrospective cohort study of outpatient office visits quantified differences between timestamps documenting visit length and their associated E/M code visit length. The IBM MarketScan database was queried to identify patients with a diagnosis of pituitary adenoma in 2016 and to analyze their new and return claims between 2016 and 2019. One-way ANOVA and two-sample t-tests were used to examine claim quantity, time in office, and yearly visit time.

Results

In the validation study, estimated visit time via E/M codes and actual visit time were statistically different ( P < 0.01), with E/M codes underestimating actual time spent in 79.0% of visits. In the MarketScan analysis, in 2016, 2099 patients received a primary diagnosis of pituitary adenoma. There were 8490 additional-related claims for this cohort from 2016 to 2019. The plurality of new office visits were with endocrinologists (n = 857; 29.3%). Total time spent in office decreased yearly, from a mean of 113 min (2016) to 69 min (2019) ( P < 0.001).

Conclusions

E/M codes underestimate the length of outpatient visits; therefore, time toxicity experienced by pituitary patients may be greater than reported. Further studies are needed to develop additional assessment tools for time toxicity and promote increased efficiency of care for patients with pituitary adenomas.
The correlation of Rotational Thromboelastometry (ROTEM) derived parameters with severe obstetric haemorrhage
Authors: Tan Hon Sen , Yek Jacklyn Jia Lin , Allen Terrence K , Sultana Rehena , Tan Chin Wen , Sng Ban Leong
Published: March 2024

Background

Prediction of severe obstetric haemorrhage may facilitate timely interventions and reduce maternal morbidity and mortality. Rotational thromboelastometry (ROTEM) provides point-of-care coagulation parameters that may identify patients at risk of severe haemorrhage.

Purpose

Our aim was to determine the correlation of ROTEM-derived parameters at early stages of postpartum haemorrhage.

Research design

Retrospective cohort study.

Study Sample

Patients who utilised ROTEM during postpartum haemorrhage from 2013 to 2021.

Data Collection and Analysis

Severe harmorrhage was defined as: (1) decrease in haemogoblin concentration >4g.dL-1 within 48 h; (2) packed red blood cell transfusion of >1000 mL; (3) haemostatic intervention such as angiographic embolisation, arterial ligration, or hysterectomy; or (4) death. ROTEM-derived parameters were collected accordingly.

Results

Data from 36 patients were analysed, of whom 29 (80.6%) developed severe haemorrhage. FIBTEM A5, A10, and A20 were highly correlated (r > +/−0.7) with severe haemorrhage. There were moderate correlations (r = +/− 0.5 to 0.7) between EXTEM A5, A10, A20, maximum clot firmness, maximum lysis, and lysis index-30 with severe haemorrhage.

Conclusions

These findings are consistent with prior studies reporting associations between fibrinogen concentration, EXTEM A10, and FIBTEM A10 with severe haemorrhage. In conjunction with these studies, our results support the use of FIBTEM A5 and A10 as early biomarkers to predict progression to severe haemorrhage and facilitate timely implementation of appropriate medical or surgical interventions.
A thermophysical investigation of the potential for the use of wastepaper for insulation building materials
Authors: Kethiri Mohamed Aymen , Chikhi Mourad , Belghar Noureddine , Chekired Fathia , Guerira Belhi
Published: March 2024

Several sectors produce more waste. Therefore, comprehensive steps are needed to ensure environmentally sustainable and economically feasible waste recovery. The main objective of the study was to investigate the potential of giving a second life to waste, which constitutes a heavy financial and environmental burden for the factories, by its valorisation in the manufacture of new materials such as insulation and energy-efficient construction materials. By a good choice of treatment and implementation methods, paper pulp waste was considered to be a raw material that can replace many synthetic products widely used in the construction field. The research aimed to characterise wastepaper for possible use as a raw material in composites for insulation in buildings. This was done with a drying treatment of the WP to eliminate the water content and analysed the chemical composition to ensure the absence of toxic elements where there might behuman contact. Analytical methods used were both physical and chemical such as granulometry, X-ray diffraction, scanning electron microscopy/EDX, Brunauer, Emmett and Teller and Fourier transform infrared. Finally, it was necessary to identify the thermal performance and microstructure for practical application.
Evaluating the risk of developing hyperuricemia in patients with type 2 diabetes mellitus using least absolute shrinkage and selection operator regression and machine learning algorithm
Authors: Chen Qingquan , Hu Haiping , He Qing , Huang Xinfeng , Shi Huanhuan , Cao Xiangyu , Zhang Xiaoyang , Xu Youqiong
Published: March 2024

Background

Hyperuricemia is a common complication of type 2 diabetes mellitus and can lead to serious consequences such as gout and kidney disease.

Methods

Patients with type 2 diabetes mellitus from six different communities in Fuzhou were recruited from June to December 2022. Questionnaires, physical examinations, and laboratory tests were conducted to collect data on various variables. Variable screening steps were performed using univariate and multivariate stepwise regression, least absolute shrinkage and selection operator (LASSO) regression, and Boruta feature selection. The dataset was divided into a training-testing set (80%) and an independent validation set (20%). Six machine learning models were built and validated.

Results

A total of 8243 patients with type 2 diabetes mellitus were included in this study. According to Occam's razor method, the LASSO regression algorithm was determined to be the optimal risk factors selection method, and nine variables were identified as parameters for the risk assessment model. The absence of diabetes medication and elevated fasting blood glucose levels exhibited a negative correlation with the risk of hyperuricemia. Conversely, seven other variables demonstrated a positive association with the risk of hyperuricemia among patients diagnosed with type 2 diabetes mellitus. Among the six machine learning models, the artificial neural network (ANN) model demonstrated the highest performance. It achieved an areas under curve of 0.736, accuracy of 68.3%, sensitivity of 65.0%, specificity of 72.2%, precision of 73.6% and F1-score of 69.0%.

Conclusions

We developed an ANN model to better evaluate the risk of hyperuricemia in the type 2 diabetes population. In the type 2 diabetes population, women should pay particular attention to their uric acid levels, and type 2 diabetics should not neglect their obesity level, blood pressure, kidney function and lipid profile during their regular medical check-ups, in order to do their best to avoid the risks associated with the combination of type 2 diabetes and hyperuricemia.
Rural patients’ experiences with anesthesia and surgical consultations in British Columbia: A survey-based comparison between virtual and in-person modalities
Authors: Kornelsen Jude , Taylor Matilda , Ebert Sean , Skinner Tom , Stoll Kathrin
Published: March 2024

Introduction

Rural patients face barriers to accessing surgical care and often need to travel long distance for pre- or post-surgical consultations. Although adaptation to the COVID-19 pandemic has demonstrated the efficacy of virtual care, there is minimal data available to evaluate patient satisfaction with this modality and consequent health service utilization if virtual services are not available.

Methods

An online survey was conducted with participants living in rural British Columbia, Canada who had undergone surgery within 12 months of data collection and had either virtual or face-to-face pre- or post-surgical consultations. It was supplemented by an in-person survey administered in two rural sites to all patients who had a virtual visit prior to undergoing procedural care. A ten-point scale was used to assess satisfaction. Quantitative and qualitative data were collected and analyzed.

Results

Findings from the province-wide survey (n = 163) revealed no significant differences in average satisfaction ratings between people with in-person and virtual surgical consultations (8.03 versus 8.38, p = 0.26). However, most participants indicated that virtual appointments saved them time traveling, energy, and money and made them less dependent on others, accruing significant social benefit. In the community-focused sample (n = 71), 38% said they would not have had the procedure without a virtual visit option and 21% said that they would have delayed the procedure. Virtual consultations saved patients an average of 9 h (range 1–90). Participants traveled an average of 427 kilometers round trip to have the procedures.

Conclusion

Findings reveal costs and time saved in accessing care due to the introduction of pre- and post-operative virtual care visits, and further investments in virtual care are warranted. This will contribute to promoting equitable access to healthcare for rural residents.
Intense prostate-specific membrane antigen receptor expression in coronary artery pypass graft scar tissue: A potential molecular imaging pitfall
Authors: Al-Ibraheem Akram , Abdlkadir Ahmed Saad , Al-Hajaj Nabeela , Khalaf Aysar , Salah Samer
Published: March 2024

68Gallium-PSMA positron emission tomography/computer tomography has been utilized recently for the diagnosis and staging of prostate cancer. PSMA is a transmembrane protein that is expressed not only in the prostate gland but also in other tissues. While some pitfalls have been addressed, there are still uncertainties. Herein, we report a 79-year-old male with prostate cancer who underwent a PSMA scan after coronary artery bypass graft surgery, revealing disease progression and PSMA-avid foci at the surgical stitch sites. This report discusses the immunohistochemical and molecular imaging mechanisms underlying PSMA expression in surgical scar tissues, providing critical insights for optimizing radiologic reporting in such situations.
Early Childhood Development and Social Mobility in China
Authors: Wu (吴晓刚) Xiaogang , Li (李欣) Xin , Miao (缪佳) Jia
Published: March 2024

Purpose

Infancy and early childhood are critical stages for the development of both cognitive and socioemotional skills, which are predictive of subsequent academic success, labor market outcomes, and socioeconomic achievement. Empirical research both in China and in other countries has revealed that nurturing quality is increasingly divergent among social classes, leading to intergenerational accumulation of advantage/disadvantage, declining social mobility, and exacerbating class inequality. The article aims to systematically examine existing theoretical and empirical research on early childhood development and social mobility and provide a holistic comparative and analytical framework for future research in the context of China.

Design/Approach/Methods

This article systematically reviews relevant theories and empirical research in the field and provides preliminary findings of early childhood education investment in China, using the data from the China Family Panel Studies (CFPS). Specifically, the article focuses on the differences in early childhood education investment and child development among families of different socioeconomic statuses and discusses the potential impact of these differences on children's future development.

Findings

The findings of this study reveal distinct patterns in early childhood education investment and child development across diverse socioeconomic strata in China. China's initiatives to enhance children's education and human capital have robust theoretical foundations and timely policy implications. However, despite the ongoing efforts, early childhood parenting and education programs lack systematic research, emphasizing the urgent need for intervention programs and comprehensive databases to inform evidence-based policymaking.

Originality/Value

The article concludes with a comprehensive analytical framework for the study of early childhood development and social mobility in China, which has implications for promoting human capital investment and facilitating social mobility.
Creating a Hospitality LGBTQ+ Health Care Clinic
Authors: Olson Eric D. , Olson Jeffrey
Published: March 2024

LGBTQ+ healthcare clinics have been created in the past several years to provide healthcare in a safe and welcoming environment for the LGBTQ+ community. This case study examines how hospitable servicescape can be used to create a LGBTQ+ health clinic for a regional healthcare organization in a post-COVID environment. Utilizing a framework for creating a LGBTQ+ health clinic, learners will discuss key issues and challenges in the intersection of hospitable service design and theoretical frameworks at the health care, hospitality, and service design for an underserved community.
Virtual Restaurants and Ghost Kitchens: A New Opportunity
Authors: Jones Samantha , Cain Lisa , Deel Gary L.
Published: March 2024

This case study examines the rise of virtual restaurants and ghost kitchens as a result of the COVID-19 pandemic. Through the lens of organizational resiliency theory, the strengths, weaknesses, opportunities, and threats surrounding these ventures and their viability is analyzed and discussed. The case study methodology was used to provide an in-depth, multi-faceted understanding of the virtual restaurant and ghost kitchen phenomenon. It was determined that minimal upfront investments coupled with data-driven support and the ability to test new concepts and increase a customer base serve as the strengths and opportunities afforded by virtual restaurants and ghost kitchens. Threats and weaknesses included a separation between the brand and the customer, an overcrowded market and a greater concentration of competition, as well as a more hands-off customer experience. This case leverages the tenets of organizational resiliency theory to explore the rise of virtual restaurants and ghost kitchens and provide educators and students with an explanation for how these concepts came to fruition, and how their existence can benefit the individual organization and impact the industry. Applications of the case in the classroom setting are also provided.
Geriatric Vertebral Compression Fracture: A Database Study Characterizing Use and Trends for Prescribed Thoracic/Lumbar Orthoses
Authors: Halperin Scott J. , Dhodapkar Meera M. , Moran Jay , Jeong Seongho , Grauer Jonathan N. , Varthi Arya
Published: March 2024

Study Design

Retrospective cohort study.

Objective

Geriatric vertebral compression fractures are the most common fracture associated with osteoporosis. Using a large national database, the current study aimed to examine and characterize bracing trends for geriatric thoracic/lumbar compression fracture management.

Methods

The current study utilized the PearlDiver database from 2015-2021. Patients who suffered thoracic/lumbar compression fractures (fifth thoracic to the fifth lumbar vertebra [T5-L5]) were identified. Exclusion criteria included patients less than 65 years old or an indication of infection or neoplasm. Patients who received a brace within 90-days after the initial diagnosis of thoracic/lumbar compression fracture were abstracted and characterized overall and by fracture level. Multivariable logistic regression was performed to assess for correlation with bracing trends.

Results

In total 290 388 patients met inclusion criteria and suffered a thoracic/lumbar compression fracture (greatest incidence at the thoracolumbar junction). Of these, bracing was only prescribed for 4263 (1.5%), with the greatest variance of 1.5% by level. Independent predictors of bracing were geographic region (relative to northeast, west WE odds ratio [OR] 1.31, Midwest OR 1.20), younger age (OR 1.27 per decade), female sex (OR 1.17), and ECI (OR 1.02 per 2-point increase) ( P < .05 for each).

Conclusion

Overall, the current study examined over a quarter of a million patients who suffered a T5-L5 compression fractures and found that only 1.5% of patients were braced. This low percentage, and that greatest predictor for bracing was non-clinical (geographic region), highlight the inconsistency of this practice and may be useful for developing treatment algorithms.
Cocaine Gut: A Rare Case of Cocaine-Induced Esophageal, Gastric, and Small Bowel Necrosis
Authors: Bathobakae Lefika , Ozgur Sacide S. , Bashir Rammy , Wilkinson Tyler , Phuu Phenyo , Yuridullah Ruhin , Melki Gabriel , Escobar Jessica , Qayyum Sohail
Published: March 2024

Cocaine is an indirect-acting sympathomimetic drug that inhibits norepinephrine and dopamine reuptake in the adrenergic presynaptic cleft. Cocaine use has been associated with strokes, angina, arrhythmias, and agitation. Data on gastrointestinal complications such as mesenteric ischemia, bowel necrosis, ulceration, and perforation are scarce. Here, we present a rare case of cocaine-induced esophageal, gastric, and small bowel necrosis that contributes to the limited literature on this subject. Diagnosis of cocaine-induced gastrointestinal complications involves a combination of imaging studies, laboratory assessments, and histopathological examinations. Timely surgical resection, supported by intravenous fluids, antibiotics, and pain management, is the mainstay of treatment. The prognosis varies but is significantly influenced by the promptness and effectiveness of the intervention, underscoring the importance of vigilant clinical care in such cases.
A Longitudinal Framework to Describe the Relation Between Age-Related Hearing Loss and Social Isolation
Authors: Motala Aysha , Johnsrude Ingrid S. , Herrmann Björn
Published: March 2024

Many older adults live with some form of hearing loss and have difficulty understanding speech in the presence of background sound. Experiences resulting from such difficulties include increased listening effort and fatigue. Social interactions may become less appealing in the context of such experiences, and age-related hearing loss is associated with an increased risk of social isolation and associated negative psychosocial health outcomes. However, the precise relationship between age-related hearing loss and social isolation is not well described. Here, we review the literature and synthesize existing work from different domains to propose a framework with three conceptual anchor stages to describe the relation between hearing loss and social isolation: within-situation disengagement from listening, social withdrawal, and social isolation. We describe the distinct characteristics of each stage and suggest potential interventions to mitigate negative impacts of hearing loss on social lives and health. We close by outlining potential implications for researchers and clinicians.
Sounding the Alarm on Public Health Education: A Need for Equity-Focused Teaching
Authors: Zamora Astrid N. , August Ella , Anderson Olivia S.
Published: March 2024

This Perspectives on Pedagogy acknowledges ongoing inequities in public health teaching and learning and describes the importance of implementing equity-focused teaching (EFT) approaches to serve present and future diverse public health student populations. Current equity-focused pedagogies being implemented within the field of public health are described, along with current limitations among public health instructors surrounding EFT training. We conclude with an example, offering recommendations to instructors on how to create transparently-designed writing assignments to support equitable learning in public health.
Symptom Burden and Quality of Life Among Patients With Heart Failure
Authors: Al-Sutari Manal Mohammed , Abdalrahim Maysoon S.
Published: March 2024

Introduction

Heart failure is a debilitating condition that is associated with several burdensome symptoms that impede patients’ quality of life. However, patients’ experience of distressing symptoms and their impacts on their quality of life is not studied in Jordan.

Objectives

To assess the severity of distressing symptoms and to assess the relationships between these symptoms and the quality of life among patients with heart failure in Jordan.

Methods

A descriptive cross-sectional design was used. A convenience sampling approach was used to recruit the participants. Heart failure patients (n  =  167) who visited the outpatient clinics in three hospitals in Amman between July and November 2021 were included. The Edmonton Symptom Assessment System and Short-Form 36 tool were used.

Results

Participants were more likely males with a mean age of 55.2 years (SD  =  13.7). The most distressing symptoms among patients with heart failure were tiredness (M  =  4.56, SD  =  3.24), worse well-being (M  =  4.34, SD  =  2.52), and drowsiness (M  =  3.5, SD  =  3.06), respectively. Symptoms burden were negatively associated with the physical and the mental components summary of the quality of life. Pain, tiredness, nausea, loss of appetite, anxiety, and poor well-being were significant predictors of the physical components. The predictors of the mental components were tiredness, nausea, loss of appetite, and anxiety.

Conclusions

This study revealed that patients with heart failure facing significant symptom burden. The patients showed inadequate quality of life in both physical and mental components that were inversely associated with symptom burden. Given the debilitating effects of symptom burden on heart failure patients’ quality of life, therefore, symptom assessment and management have to be a priority.
Dividend Payout and Firm Value Relationship: Role of Age and Size
Authors: Chettri Navin , Kharkongor Mekelle J.
Published: March 2024

This research article examines the relationship between dividend payout (DP) policy and firm value (FV), with a focus on the impact of the age and size of the firm. The study used a panel regression model to analyze the data of 657 companies for seven years with 4,599 firm-year observations, and results indicate that DP positively influences the FV of Indian firms. However, when analyzing the relationship based on age and size, it is found that there is no statistically significant relationship for younger and smaller firms. This supports the maturity hypotheses theory, suggesting that younger and smaller firms need to rely on other strategies to influence market value, while larger and older firms with more resources and experience can positively impact market value through DP. The study highlights the importance of considering age and size effects on the relationship between DP and FV.
Leadership and Innovation: A Capability-Centric View
Authors: Krishnan Rishikesha T.
Published: March 2024

Leadership is critical in building systematic, structured and well-embedded innovation capabilities in an organisation. Three core challenges are explored in the article: building an idea pipeline for innovation to happen, improving idea velocity by making sure that your ideas are not lost or stuck and finally improving the probability that your ideas get converted into good business outcomes. The article stresses that leadership helps to navigate all three challenges in achieving innovations and this can happen in eight vital steps. Steps are discussed for managers and practitioners to learn and innovate at their companies.
Chandrayaan-3 Mission: Decoding the Culture and Leadership at ISRO
Authors: Jayaraman Ravisankar
Published: March 2024

While organisation culture is crucial for innovation to foster, leadership is the key to promoting a conducive culture. In the present study, I focused on the Indian Space Research Organisation (ISRO), to understand the facets of an innovation-led organisation and the role of leadership. Based on in-depth interviews with a unique set of respondents within the age range of 66–94 years, I pulled out the facets of ISRO culture. I further explored the leadership qualities that enable the formation of such a culture.
A Systematic Review and Meta-Analysis on the Impact of Preserving the Hepatic Branch of the Vagus Nerve in Upper Gastrointestinal Surgeries
Authors: Jia Dong James Wang , Fahim Shaik Ansari Ahamed , Yong’an Matthew Tham , Yin Liu Yu , Kon Voi Tay
Published: March 2024

Background:

Upper gastrointestinal surgeries encompass procedures on the esophagus, stomach, liver, pancreas, and gallbladder. To access the surgical area, it is standard to dissect the hepatogastric ligament, transecting the hepatic branch of the vagus nerve contained within it. Yet, the hepatic branch, which innervates the liver and gallbladder, contributes to digestion, bile secretion, and glucose metabolism. Hence, recent surgical studies have explored the potential benefits of hepatic branch preservation in comparison to non-preservation. This systematic review and meta-analysis endeavors to compile and analyze the outcomes of these studies.

Methods:

PubMed, EMBASE, Scopus, and Cochrane, were searched for cohort studies and randomized control trials comparing hepatic nerve preservation and division during upper gastrointestinal surgery in adults, up to April 2023. Two independent reviewers evaluated abstracts and full-text reviews, extracted pertinent information, and conducted risk-of-bias assessments using the RoB 2 and Newcastle-Ottawa instruments.

Results:

Thirteen studies involving 3001 participants were included for meta-analysis. Hepatic branch preservation was linked to a decrease in appetite loss (OR 0.04, 95% CI 0.01-0.18), reflux symptoms (OR 0.16, 95% CI 0.06-0.43) and gallstone formation (OR 0.25, 95% CI 0.09-0.69). However, preservation was associated with an increased incidence of Clavien-Dindo Grade 2 complications (OR 1.73, 95% CI 1.01-2.96) in gastrectomies.

Conclusion:

Hepatic branch preservation is associated with favorable post-surgical metabolic outcomes, notably appetite preservation. This may be due to the hepatic branch’s role in facilitating brain-liver crosstalk, thus, influencing homeostatic processes like appetite control and glucose metabolism. Reduced gallstone incidence is likely due to preservation of gallbladder motility and function, achieved through retention of parasympathetic innervation.
Petro-states, oil shocks, and regime change: Venezuela and Ecuador, 2013–2023
Authors: Burgess Katrina , Corrales Javier
Published: March 2024

The literature on petrostates tends to blackbox the state. We argue, in contrast, that not all petro-states are configured equally. They thus respond to external crises differently. Despite sharing similar background conditions, the petro-state of Venezuela responded to the external oil shock of 2014–2015 by turning more authoritarian and predatory, whereas the petro-state of Ecuador tried to become more democratic and developmental. To explain this difference, we focus on three within-state institutional differences between these cases: the cohesion of hardliners, the reach of the coercive military and paramilitary apparatus, and the viability of the public and private sectors. In short, even petro-states operating under similar regimes (in this case, left-populist, semi-authoritarian) can exhibit different institutional make-ups, and these institutional differences help explain responses to similar external shocks.
Performance-based earthquake early warning for tall buildings
Authors: Ghahari Farid , Sargsyan Khachik , Parker Grace A , Swensen Daniel , Çelebi Mehmet , Haddadi Hamid , Taciroglu Ertugrul
Published: March 2024

The ShakeAlert Earthquake Early Warning (EEW) system aims to issue an advance warning to residents on the West Coast of the United States seconds before the ground shaking arrives, if the expected ground shaking exceeds a certain threshold. However, residents in tall buildings may experience much greater motion due to the dynamic response of the buildings. Therefore, there is an ongoing effort to extend ShakeAlert to include the contribution of building response to provide a more accurate estimation of the expected shaking intensity for tall buildings. Currently, the supposedly ideal solution of analyzing detailed finite element models of buildings under predicted ground-motion time histories is not theoretically or practically feasible. The authors have recently investigated existing simple methods to estimate peak floor acceleration (PFA) and determined these simple formulas are not practically suitable. Instead, this article explores another approach by extending the Pacific Earthquake Engineering Research Center (PEER) performance-based earthquake engineering (PBEE) to EEW, considering that every component involved in building response prediction is uncertain in the EEW scenario. While this idea is not new and has been proposed by other researchers, it has two shortcomings: (1) the simple beam model used for response prediction is prone to modeling uncertainty, which has not been quantified, and (2) the ground motions used for probabilistic demand models are not suitable for EEW applications. In this article, we address these two issues by incorporating modeling errors into the parameters of the beam model and using a new set of ground motions, respectively. We demonstrate how this approach could practically work using data from a 52-story building in downtown Los Angeles. Using the criteria and thresholds employed by previous researchers, we show that if peak ground acceleration (PGA) is accurately estimated, this approach can predict the expected level of human comfort in tall buildings.
Effect of lactoferrin treatment on symptoms and physical performance in long COVID patients: a randomised, double-blind, placebo-controlled trial
Authors: Redel Anne-Lotte , Miry Fatana , Hellemons Merel Elise , Oswald Laurien Maria Amarentia , Braunstahl Gerrit Johannes
Published: March 2024

Background

Long COVID is a heterogeneous condition with a variety of symptoms that persist at least 3 months after SARS-CoV-2 infection, often with a profound impact on quality of life. Lactoferrin is an iron-binding glycoprotein with anti-inflammatory and antiviral properties. Current hypotheses regarding long COVID aetiology include ongoing immune activation, viral persistence and auto-immune dysregulation. Therefore, we hypothesised that long COVID patients may potentially benefit from lactoferrin treatment. The aims of the present study were to investigate the effect of lactoferrin on various long COVID domains: fatigue, anxiety, depression, cognitive failure and muscle strength.

Methods

We performed a randomised, double-blind, placebo-controlled trial in long COVID patients aged 18–70 years within 12 months after proven SARS-CoV-2 infection. Patients were randomised (1:1) to 6 weeks of lactoferrin (1200 mg daily) or placebo. At three hospital visits (T0, T6 and T12 weeks), patient-reported outcome measures were collected, physical performance tests were performed and blood was drawn. The difference in fatigue at T6 was the primary outcome.

Results

72 participants were randomised to lactoferrin (n=36) or placebo (n=36). We found a significant decrease in fatigue, as measured with the Fatigue Assessment Scale, between T0 and T6 in both study arms, but without significant difference between the study arms (lactoferrin: 3.9, 95% CI 2.3–5.5, p=0.007; placebo: 4.1, 95% CI 2.3–5.9, p=0.013). No significant differences were found in any of the other outcomes in favour of the lactoferrin arm at T6 or T12.

Conclusion

Although both long COVID arms showed improved clinical outcomes at T6, the improvement did not continue until T12. Lactoferrin provided no benefit in terms of fatigue, other patient-reported outcome measures or physical functioning.
Lung cancer among outpatients with COPD: a 7-year cohort study
Authors: Bang Henriksen Margrethe , Hansen Torben Frøstrup , Jensen Lars Henrik , Brasen Claus Lohman , Borg Morten , Hilberg Ole , Løkke Anders
Published: March 2024

Introduction

Lung cancer (LC) is the most common cause of cancer-related deaths worldwide, and its prognosis upon metastasis remains poor. Patients with COPD face a significantly elevated LC risk, up to six times greater than those with normal lung function. We aimed to investigate LC prevalence and stage distribution among COPD outpatients. Furthermore, we aimed to outline the COPD-related variables associated with referral for LC examination.

Methods

We conducted a retrospective analysis encompassing the period from 1 January 2012 to 31 December 2018 on all outpatients with COPD and LC and individuals referred for LC examinations.

Results

Among all COPD outpatients, 2231 patients (18%) were referred for LC examinations and 565 (4.6%) were diagnosed with LC. LC patients with COPD were more likely to be stage I–II, in contrast to the non-COPD LC population (46%versus26%, p<0.001 for all). Patients referred for LC examinations exhibited higher use of COPD-related medications, reported more severe dyspnoea (69%versus66% with Medical Research Council dyspnoea score >2) and experienced a greater frequency of exacerbations (30%versus24% with two or more exacerbations).

Conclusion

Our study revealed a notably high LC incidence among COPD outpatients. LC patients with COPD were diagnosed at earlier stages, and outpatients with more pronounced COPD symptoms were more inclined to undergo LC diagnostics. The overrepresentation of LC cases among COPD outpatients emphasises the importance of tailoring specific screening initiatives for this demographic.
Increased bronchiectasis risk and related risk factors in inflammatory bowel disease: a 10-year Korean national cohort study
Authors: Lee Jun Su , Yang Bumhee , Shin Hye Soon , Lee Heajung , Chai Hyun Gyung , Choi Hayoung , Han Joung-Ho , Yoon Jai Hoon , Kim Eung-Gook , Lee Hyun
Published: March 2024

Background

The association between inflammatory bowel disease (IBD) and an increased risk of bronchiectasis, as well as contributing factors, remains unclear. Additionally, whether bronchiectasis increases disease burden in IBD remains unknown. Therefore, this study aimed to: 1) assess whether IBD increases the risk of incident bronchiectasis; 2) compare the risk of bronchiectasis between individuals with Crohn's disease (CD) and those with ulcerative colitis (UC); 3) identify risk factors for bronchiectasis in individuals with IBD; and 4) examine the disease burden in individuals with IBD and bronchiectasisversusthose without.

Methods

We conducted a population-based matched cohort study involving adults aged ≥20 years with IBD, using data acquired from the Korean National Health Insurance Service-National Sample Cohort database between 2002 and 2012.

Results

During the mean follow-up of 9.6 years, the incidence rate of bronchiectasis was 419.63 out of 100 000 person-years (PY) and 309.65 out of 100 000 PY in the IBD and matched cohorts (adjusted hazard ratio (aHR) 1.21, 95% CI 1.05–1.39), respectively. UC was associated with increased bronchiectasis risk (aHR 1.42, 95% CI 1.19–1.69), but CD was not. Multivariate Cox regression analyses showed that age, male sex, medical aid, underweight status, COPD and diabetes mellitus were associated with an increased risk of bronchiectasis in the IBD cohort (p<0.05). The mortality, emergency department visit and hospitalisation rates were significantly higher for individuals with IBD and bronchiectasis compared with those without bronchiectasis (p<0.05).

Conclusion

IBD is associated with increased risk of bronchiectasis, which results in a greater disease burden in individuals with IBD.