bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 9868: Novel Oral Anticoagulants versus Vitamin K Antagonists in Patients with Atrial Fibrillation and Bioprosthetic Valve Replacement: A Systematic Review and Meta-Analysis
Authors: Memon Muhammad , Amin Emaan , Siddiqui Asad Ali , Eisha Waqar , Asma Faisal , Khan Mohammad , Minhas Abdul
Published: April 2024

Background:
Vitamin K antagonists (VKAs) such as warfarin are traditionally prescribed in patients with atrial fibrillation (AF) and bioprosthetic valves (BPVs) to prevent thromboembolic events. However, various studies have proposed novel oral anticoagulants (NOACs) as an effective and safer option to use. Therefore, we conducted a systematic review and meta-analysis to compare their relative efficacy and safety profiles.

Methods:
Pubmed, Cochrane Central, and Embase were searched up until May 15, 2021 for randomized clinical trials (RCTs) and observational studies determining efficacy and safety of NOACs or VKAs in AF patients who had undergone BPV replacement. Outcomes of interest were: stroke or systemic embolism (SSE), major bleeding, all-cause mortality, and intracranial hemorrhage (ICH). Subgroup analysis by study design (RCT and observational) was performed. Summary estimates were reported as random effects risk ratios (RRs) with 95% confidence intervals (CIs).

Results:
A total of 12 studies (4 RCTs and 8 observational) with 6436 patients (mean age 72.1 years; 51.4% males) were included in the analysis. In comparison to VKAs, NOACs demonstrated a significant reduction in ICH (RR 0.41 [95% CI 0.25,0.67]; p=0.0003; I
2
= 0%) and major bleeding (RR 0.63 [95% CI 0.53,0.74]; p<0.00001; I
2
= 0%) at a mean duration follow up of 23.8 months. However, no difference was observed in risk of SSE (RR 0.77 [95% CI 0.50,1.19]; p=0.23; I
2
= 53%) and all-cause mortality (RR 0.98 [95% CI 0.78,1.22]; p=0.84; I
2
= 15%). Observational studies and RCTs did not significantly differ across all outcomes in the subgroup analysis.

Conclusions:
This meta-analysis suggests that NOACs are effective at reducing risk of ICH and major bleeding in AF patients with BPVs in contrast to VKAs. Future large-scale RCTs can aid in corroborating the legitimacy of these results.
Abstract 9890: HFpEF with Normal Natriuretic Peptides: An Earlier Stage of Disease or Fundamentally Different Phenotype?
Authors: Sorimachi Hidemi , Omote Kazunori , Obokata Masaru , Reddy Yogesh , Borlaug Barry A
Published: April 2024

Introduction:
Many patients with heart failure with preserved ejection fraction (HFpEF) display normal N-terminal-pro-B type natriuretic peptide (NTproBNP)levels. Mortality and hospitalization rates are lower in this group compared to patients with high NTproBNP, but it remains unclear whether these patients represent a fundamentally different phenotype or an earlier stage of disease.

Methods:
213 subjects with HFpEF defined by invasive hemodynamics underwent serial echocardiographic examinations >1 year apart. Clinical, cardiac structural, functional, and hemodynamic characteristics were examined.

Results:
Exam 2 was performed a median of 3.2 years (IQR 2.2-5.1) following Exam 1. From this cohort, 66 (33%) displayed normal NT-proBNP levels (≤125pg/ml, nBNP) and 147 (67%) displayed high NTproBNP (hBNP). Compared to hBNP, nBNP patients were younger (62±10 vs 71±9 years, p<0.0001) and more obese (35±8 vs 32±7 kg/m
2
, p=0.005). At Exam 1, approximately 50% of nBNP displayed left ventricular (LV) systolic dysfunction defined as LV longitudinal strain (GLS)<16% (
Figure A
) and LA dysfunction defined as left atrial (LA) reservoir strain<26% (
Figure B
), but right ventricular (RV) systolic function as relatively preserved (
Figure C
). At Exam 2, LV, LA, and RV strain decreased in both groups (Panels A-C), with no difference between nBNP and hBNP in the velocity of change (p>0.6 for all). More patients crossed the threshold definition for LV systolic and LA dysfunction in nBNP compared to hBNP (
Figure D
and
E
), but the prevalence of RV dysfunction increased more in hBNP (
Figure F
).

Conclusions:
In patients with HFpEF with normal NT-proBNP, biventricular systolic function and LA function deteriorate over time at similar pace. These data suggest that patients with HFpEF are not a fundamentally different disorder, but rather represent an earlier stage of disease that progresses from LV and LA dysfunction in early stages to RV dysfunction in advanced stages.
Abstract 9892: Proteomic Profiling of Cardiometabolic Phenotypes: A Comparison of Aptamer-Based and Antibody-Based Affinity Platforms
Authors: Katz Daniel H
Published: April 2024

Introduction:
High-throughput proteomics with novel affinity reagents for detection of specific proteins is used increasingly in cardiovascular cohort studies and clinical trials.

Hypothesis:
A detailed comparison of aptamer- vs antibody-based platforms and their associations with cardiometabolic traits (e.g. cholesterol, HbA1c, BMI, blood pressure, atherosclerotic risk) will highlight critical platform differences.

Methods:
We first compare SomaScan
®
1.3K (“Soma1.3K”, N=1301 reagents) and Olink
®
Explore (“Olink”, N=1472 reagents) platforms in 568 adults from the Jackson Heart Study. We also compare Olink to the expanded SomaScan
®
5K (“Soma5K”, N=4979 reagents) in 209 participants from the HERITAGE study.

Results:
When comparing reagents from each platform that target the same protein, 234/616 such matched reagents are highly correlated, implying accuracy. We alternatively assess accuracy by leveraging whole genome sequencing data: Olink reagents associate with variants near the coding gene (
cis
protein quantitative trait loci) for a greater proportion of their protein targets — 40% versus 28% for Soma1.3K (Figure). Principal components analysis reveals 95% of total variance is explained using fewer components on Olink, suggesting Soma1.3K covers more axes of variation. Finally, Olink demonstrates more protein associations (false discovery rate < 5%) with cardiometabolic phenotypes. When limited to matched reagents, Olink identifies more cardiometabolic associations, particularly when measurements are poorly correlated with Soma1.3K. However, on the expanded Soma5K, we identify significantly more proteins associated with cardiometabolic traits. Notably, Olink still finds more associations among poorly correlated, matched reagents.

Conclusions:
Our data show that antibody-based proteomics may provide greater accuracy and phenotypic associations while aptamers have higher precision and breadth of protein coverage.
Abstract 9935: Culprit Plaque Morphology in Young versus Elder Acute Coronary Syndrome Patients: An Optical Coherence Tomography Study
Authors: sharma prachi , Chaudhary Gaurav , Jaiswal Vikash , Gupta Basant Kumar , Singh Abhishek , Shukla Ayush , Bhandari Monika , Kumar Sharma Akhil , Vishwakarma Pravesh , Pradhan Akshyaya , Chandra Sharad , sethi rishi , Dwivedi Sudhanshu
Published: April 2024

Objective:
Culprit plaque morphology in young acute coronary syndrome (ACS) patients differs from that of elder patients. The underlying mechanisms responsible for ACS in younger compared to elder patients are yet to be explored with optical coherence tomography.

Methods:
This was a prospective, single-center, investigational study. Patients were divided into groups according to age, ≤35 (N=43) and >35 years (N=50) and further subdivided according to the underlying mechanism i.e. plaque rupture (PR) and plaque erosion (PE).

Results:
A total of 93 patients were included in this analysis. Thin-cap fibroatheroma (TCFA) was significantly higher among elder than younger patients for both PR (80.0% vs. 31.8%, p=0.002) and PE (66.7% vs. 6.3%, p<0.001) groups. Microchannels were also significantly more prevalent among elder than younger patients for both PR (65.0% vs. 18.2%, p=0.004) and PE groups (55.6% vs.12.5%, p=0.013). Macrophages were significantly higher in elder than younger patients for both PR (25.0% vs. 0%, p=0.018) and PE (44.4% vs. 0%, p=0.003) groups. In contrast, fibrous cap thickness was greater in younger than elder patients for both PR (105.71±48.02 μm vs. 58.00±15.76 μm, p<0.001) and PE (126.67±48.22 μm vs. 54.38±24.21 μm, p<0.001) groups. Intimal thickness was greater in elder than younger patients for both PR (728.00±313.92 mm
2
vs. 342.27±142.02 mm
2
, p<0.001) and PE (672.78±334.57 mm
2
vs. 295.00±99.60 mm
2
, p<0.001) groups. Plaque type, thrombus formation, and minimal luminal diameter did not differ significantly according to age.

Conclusion:
We conclude that the high resolution of OCT is able to define the detailed microstructure of the culprit lesion and allows a greater understanding of the mechanisms of coronary artery disease. The frequency of TCFA, microchannels, macrophages, and intimal thickness was significantly higher in elder ACS patients compared to younger patients. However, fibrous cap thickness was significantly greater in younger ACS patients compared to elder patients.
Abstract 9939: Admission Systolic Blood Pressure and Left Ventricular Structure/ Hemodynamics in Patients with Acute Decompensated Heart Failure with Preserved Ejection Fraction
Authors: Iwakura Katsuomi , Onishi Toshinari , Okada Masato , Tanaka Nobuaki , Koyama Yasushi , OKAMURA ATSUNORI , Fujii Kenshi , Seo Masahiro , Yano Masamichi , Hayashi Takaharu , Nakagawa Akito , Nakagawa Yusuke , Tamaki Shunsuke , Yamada Takahisa , Yasumura Yoshio , Hikoso Shungo , Sotomi Yohei , Sakata Yasushi ,   The OCVC-Heart Failure Investigators
Published: April 2024

Introduction:
The blood pressure at hospital admission is associated with prognosis in patients with acute decompensated heart failure (ADHF). It is not well elucidated how admission blood pressure is determined and how it can affect clinical outcomes in patients with heart failure with preserved ejection fraction (HFpEF).

Hypothesis:
Difference in left ventricular (LV) structure and function could be associated with admission systolic blood pressure (sBP) in patients with decompensated HFpEF.

Methods:
The PURSUIT-HFpEF (Prospective, Multicenter, Observational Study of Patients with Heart Failure with Preserved Ejection Fraction) is a multicenter registration of patients hospitalized for acute decompensated HFpEF. We divided the registered patients based on “clinical scenario (CS)” in ADHF, as CS1;sBP>140mmHg at admission, CS2; sBP 100-140mmHg, CS3; sBP <100mmHg. Echocardiography was performed during hospital stay. We followed them to observe the major adverse cardiovascular events (MACE; composite of death, heart failure hospitalization and stroke) for median of 390 days (IQR 253 to 7272 days).

Results:
Among 893 patients (age 81±9 years, male gender 45.2%) who were enrolled for the present study, only 14 patients (1.6%) were categorized as CS3. Thus, we combined patients with CS2 and CS3 into the CS2/3 group (n=383). No difference was observed in age and risk factors except gender (CS1; 49.0% vs. CS2 40.2% of male, p=0.001). Cox proportional hazard model showed admission sBP was an independent predictor of MACE (p=0.0001) along with age and presence of chronic kidney disease, and the CS2/3 had higher incidence of MACE during follow-up period than CS1 (p=0.0001 by log-rank test). While there was no differences in LV ejection fraction, the CS2/3 group showed smaller LV dimension (45±6mm vs. 46±6mm, respectively, p=0.0004) and volume (78±31 ml vs. 86±36mm, p=0.008) at end-diastole, and lower cardiac output (3.9±1.4 ml/min vs. 4.1±1.4 ml/min, p=0.0001) than the CS 1. No difference was observed in diastolic parameters such as left atrial volume index or E/e’ ratio between two groups.

Conclusions:
Smaller LV volume and lower cardiac output was associated with lower admission sBP, which led to poorer prognosis, in patients with decompensated HFpEF.
Abstract 9941: Coronary Artery Calcification Score is Associated with Left Ventricular Diastolic Function in Patients Without Coronary Artery Disease
Authors: Iwakura Katsuomi , Onishi Toshinari , Koyama Yasushi , OKAMURA ATSUNORI , IWAMOTO MUTSUMI , Watanabe Satoshi , Tanaka Koji , NAGAI Hiroyuki , Hirao Yuko , Tanaka Nobuaki , Sumiyoshi Akinori , Okada Masato , Tanaka Kota , Suzuki Satoshi , Tanaka Hirokazu , Harada Shinichi , Fujii Kenshi
Published: April 2024

Introduction:
Left ventricular (LV) diastolic dysfunction is a strong predictor of cardiovascular events, and it shares several risk factors with coronary artery disease (CAD). It is not well elucidated whether coronary atherosclerosis could affect LV diastolic function even in patients without CAD.

Hypothesis:
Coronary artery calcification (CAC) score by computer tomography (CT) might be associated with LV diastolic function even in non-ischemic patients.

Methods:
We enrolled non-ischemic patients who underwent CT coronary angiography (CTA) and echocardiography, using the following inclusion criteria; (1) age ≥65 years (2) no history of ischemic events, coronary revascularization or mitral valve operation, (3) no significant stenotic lesion on CTA, and (4) regular sinus rhythm at echocardiography study. We measured CAC score on CT and diastolic parameters including median E/e’ ratio on echocardiogram. Continuous variables were expressed as median [interquartile range] and were compared using Kruskal-Wallis rank sum test.

Results:
We enrolled consecutive 242 patients for the present study (72 [68, 77] years, male; 56.2%).

We divided them based on CAC score, as no (N: score 0, n=61), low- (L: 1-99, n=86), and high (H: ≥100, n=95) CAC group. There was difference in gender and history of diabetes among the groups, but not in age, BMI, hypertension and dyslipidemia. Significant difference was observed in E/e’ ratio among 3 groups (N: 8.1[6.9,9.9], L:8.7 [7.3,10.8], H: 9.1 [7.5,11.0], p=0.035), and the H-group had higher E/e’ than the N-group (p=0.036). There were also difference in left atrial volume (N: 35.2ml [26.8, 44.0], L:41.6 ml [30.5, 55.5], H: 42.5 [34.5 ,58.3], p=0.002) and in LV mass index (N: 82.7 g/m
2
[71.2, 93.3], L:84.1 g/m
2
[75.4, 97.7], H: 95.2 g/m
2
[80.8, 109.9], p=0.0004), and those in the H-groups were higher than those in the N-group. No difference was observed in LV ejection fraction or in E/A ratio. CAC score could detect E/e’ ratio ≥14 with 57% sensitivity and 63% specificity, using 71.0 as the cutoff value (AUC 0.64).

Conclusions:
High CAC score was associated with impaired LV diastolic function, implying the relationship between coronary artery atherosclerosis and LV diastolic dysfunction in patients without CAD.
Thalamic nuclei segmentation from T1-weighted MRI: Unifying and benchmarking state-of-the-art methods
Authors: Williams Brendan , Nguyen Dan , Vidal Julie P. , Saranathan Manojkumar
Published: April 2024

The thalamus and its constituent nuclei are critical for a broad range of cognitive, linguistic, and sensorimotor processes, and are implicated in many neurological and neurodegenerative conditions. However, the functional involvement and specificity of thalamic nuclei in human neuroimaging work is underappreciated and not well studied due, in part, to technical challenges of accurately identifying and segmenting nuclei. This challenge is further exacerbated by a lack of common nomenclature for comparing segmentation methods. Here, we use data from healthy young (Human Connectome Project, n = 100) and older healthy adults, plus those with mild cognitive impairment and Alzheimer’s disease (Alzheimer’s Disease Neuroimaging Initiative, n = 540), to benchmark four state-of-the-art thalamic segmentation methods for T1 MRI (FreeSurfer, histogram-based polynomial synthesis [HIPS]-THOMAS, synthesized contrast segmentation [SCS]-convolutional neural network [CNN], and T1-THOMAS) under a single segmentation framework. Segmentations were compared using overlap and dissimilarity metrics to the Morel stereotaxic atlas, a widely accepted thalamic atlas. We also quantified each method’s estimation of thalamic nuclear degeneration across Alzheimer’s disease progression, and how accurately early and late mild cognitive impairment, and Alzheimer’s disease could be distinguished from healthy controls. We show that the HIPS-THOMAS approach produced the most effective segmentations of individual thalamic nuclei relative to the Morel atlas, and was also most accurate in discriminating healthy controls from those with mild cognitive impairment and Alzheimer’s disease using individual nucleus volumes. This latter result was different when using whole thalamus volumes, where the SCS-CNN approach was the most accurate in classifying healthy controls. This work is the first to systematically compare the efficacy of anatomical thalamic segmentation approaches under a unified nomenclature. We also provide recommendations of which segmentation method to use for studying the functional relevance of specific thalamic nuclei, based on their overlap and dissimilarity with the Morel atlas.
Molecular phylogeny of the common wall lizard Podarcis muralis (Squamata: Lacertideae) in the southern Balkans
Authors: Keroglidou Maria , Spilani Loukia , Lymberakis Petros , Poulakakis Nikos
Published: April 2024

The lacertid wall lizards of the genus Podarcis (Wagler, 1830) originate from Western Europe and are divided into 24-25 species (Speybroeck et al., 2020). Despite the abundance of phylogenetic studies referring to the genus, the relationships among certain species, as well as the taxonomic status of some genealogical lineages, remain unclear due to great genetic diversity. The common wall lizard Podarcis muralis has a relatively wide distribution and despite the existence of various molecular studies focused on this species, its Greek populations had never been thoroughly sampled until now. To fill in this geographical gap, we sampled the species’ Greek distribution and constructed phylogenies that uncovered the presence of at least five monophyletic lineages that correspond to different geographic regions. Furthermore, species delimitation analyses assigned all lineages to a single species diversifying during the early Pleistocene (c. 1.93 mya). The strong association of the genetic lineages with specific geographical regions coupled with the Pleistocene diversification of the group imply the presence of multiple refugia within Greece and, by extension, the Balkan peninsula, supporting a refugia-within-refugia scenario. Finally, in an effort to clarify the position of these new samples within the larger phylogeny of P. muralis, a larger phylogeny was constructed which indicated that the Greek populations cluster with the central European, Italian and Turkish populations of the species.
Taxonomic revision of Asapharcha Meyrick, 1920 (Lepidoptera, Gelechiidae), with descriptions of four new species
Authors: BIDZILYA OLEKSIY V. , MEY WOLFRAM , RAJAEI HOSSEIN
Published: April 2024

The Afrotropical genus Asapharcha Meyrick, 1920 is recognized as a senior synonym of Lacistodes Meyrick, 1921, syn. nov. and Melitoxestis Meyrick, 1921, syn. nov. Nine species of Asapharcha are recognized as valid, four of which are described as new: A. angustella sp. nov. (South Africa), A. lacistoides sp. nov. (Namibia, Ethiopia, Sudan), A. ochrocapitella sp. nov. (Zimbabwe), and A. unipunctella sp. nov. (Namibia). Two new synonyms are proposed: Asapharcha crateropa Meyrick, 1930 syn. nov. of Lacistodes tauropis Meyrick, 1921, and Lacistodes brunneostola Janse, 1960, syn. nov. of Asapharcha strigifera Meyrick, 1920. Three new generic combinations are proposed: Asapharcha centrotypa (Meyrick, 1920) (Melitoxestis), comb. nov., Asapharcha fuscomaculata (Bidzilya & Mey, 2011) (Lacistodes), comb. nov., Asapharcha hirsuta (Janse, 1958) (Lasiarchis), comb. nov. The female genitalia of A. strigifera are described for the first time. Asapharcha tauropis is recorded for the first time from Kenya and Ethiopia. All species of Asapharcha are diagnosed, and an identification key to all species of the genus is provided. Wing pattern and genitalia of all species are illustrated, and an updated checklist of the genus is given.
Computing Tutors Performance Indicator in Virtual Learning Environment
Authors: Ajami Khalil
Published: April 2024

Quality assurance has become an urgent necessity in all spheres of life, including education and learning in all stages from primary school to higher education, since it constitutes the core of development in the new era of knowledge economy. The aim of this paper is to present a new methodology applied to ensure quality of learning process within virtual learning environments. Our case study focused on the model of quality control adopted by Syrian Virtual University (SVU), which is pioneer in the field of virtual learning in the Middle East and the Arab region. The methodology is based on SET methodology (Students Evaluation Test) and defined by the assessments of each of the four pillars of learning process: (1) Assessment of tutors performed by learners; (2) Assessment of tutors performed by the administration; (3) Assessment of tutors performed by their peers; (4) Self-assessment of tutors. The last two procedures have not been yet implemented within SVU, while other procedures are in continuous development in order to improve their results. The importance of this model comes from its flexibility, its appliance since 2018 in a virtual education establishment (Syrian Virtual University), its possible generalization to any similar environment with virtual academic programs.
Foreign Direct Investment and the Nigerian Economy: An Empirical Analysis
Authors: Amade Muhammed , Oyigebe Peter
Published: April 2024

The primary motive of this paper was to investigate the impact of Foreign Direct Investment on economic growth of Nigeria from 1985 to 2022. Ex – post facto research design was carefully carried out; annual time series data were extracted from Central Bank of Nigeria Statistical Bulletin of 2021 and World Development Indicator. Real Gross Domestic Product (RGDP) was used as the dependent variable proxy for economic growth. Foreign Direct Investment (FDI), Exchange Rate (EXCR), Trade Openness (TOPN) and Inflation (INF) all denoted for explanatory variables of the study. The estimated coefficients of the variables under study displayed that all the variables are integrated of the same order 1(1) exception of Foreign Direct Investment which was integrated of order 1(0). The bound test conducted showed that there is proof of the presence of a long run correlation among the variables used while the causality test clearly showed that FDI granger causes economic growth in Nigeria under review. Other diagnostic tests seen in this paper are unit root test, descriptive statistics, correlation coefficient matrix, Cointegration test and test of Normality respectively, and they long-established the validity and reliability of the model used. Based on the inferential results revealed by the research work, the paper came up with recommendation that government should improve the investment climate for both domestic and foreign investors through adequate infrastructural development, soft loans and tax holidays.
Digital Chaotic Scrambling of Voice Based on Duffing Map
Authors: Mahdi Amina , K. Jawad Ameer , S. Hreshee Saad
Published: April 2024

With the significant development in communication systems especially in the public channels through which our information travels, there are more increasing in the channels problems. The information security is the important one that should be enhanced. This paper presents a chaos-based speech scrambling system. Chaotic maps have been successfully used for large-scale data encryption such as image, audio and video data, due to their good properties such as pseudo-randomness, sensitivity to changes in initial conditions and system parameters and a periodicity. In this paper a security model based on chaotic system has been designed to be used to encrypt voice signal, chaotic duffing map used for digital Scrambling, each samples of the speech are divided into 8 bits. The simulation results show that the Cpestral Distance Measure (CD) in the proposed system is increased by (4.559) by comparing with the time domain scrambling which is about four times that gives from the analog scrambling. In addition, dlpc increased to (4.428) as comparing with time domain. The key space in this proposed is 11.8336*1064×range of parameters.
A Framework for Joint Verification and Evaluation of Seasonal Climate Services across Socioeconomic Sectors
Authors: Crochemore Louise , Materia Stefano , Delpiazzo Elisa , Bagli Stefano , Borrelli Andrea , Bosello Francesco , Contreras Eva , Dalla Valle Francesco , Gualdi Silvio , Herrero Javier , Larosa Francesca , Lopez Rafael , Luzzi Valerio , Mazzoli Paolo , Montani Andrea , Moreno Isabel , Pavan Valentina , Pechlivanidis Ilias , Tomei Fausto , Villani Giulia , Photiadou Christiana , Polo María José , Mysiak Jaroslav
Published: April 2024

Assessing the information provided by coproduced climate services is a timely challenge, given the continuously evolving scientific knowledge and its increasing translation to address societal needs. Here, we propose a joint evaluation and verification framework to assess prototype services that provide seasonal forecast information based on the experience from the Horizon 2020 (H2020) Climate forecasts enabled knowledge services (CLARA) project. The quality and value of the forecasts generated by CLARA services were first assessed for five climate services utilizing the Copernicus Climate Change Service seasonal forecasts and responding to knowledge needs from the water resources management, agriculture, and energy production sectors. This joint forecast verification and service evaluation highlights various skills and values across physical variables, services, and sectors, as well as a need to bridge the gap between verification and user-oriented evaluation. We provide lessons learned based on the service developers’ and users’ experience and recommendations to consortia that may want to deploy such verification and evaluation exercises. Last, we formalize a framework for joint verification and evaluation in service development, following a transdisciplinary (from data purveyors to service users) and interdisciplinary chain (climate, hydrology, economics, and decision analysis).
Psychiatric Diagnoses Are Associated With Postoperative Disparities in Patients Undergoing Major Colorectal Operations
Authors: Webber Alexis A. , Perati Shruthi , Su Emily M. , Ata Ashar , Beyer Todd D. , Applewhite Megan K. , Canete Jonathan J. , Lee Edward C.
Published: April 2024

Background

Over 50% of hospitalized patients have comorbid psychiatric diagnoses, resulting in increased risk of morbidity such as longer lengths of stay, worse health-related quality of life, and increased mortality. However, data regarding colorectal surgery postoperative outcomes in patients with psychiatric diagnoses (PD) are limited.

Methods

We queried a single institution’s National Surgical Quality Improvement Program from 2013-2019 for major colorectal procedures. Postsurgical outcomes for patients with and without PD were compared. Primary outcomes were prolonged length of stay (pLOS) and 30-day readmission.

Results

From a total of 1447 patients, 402 (27.8%) had PD. PD had more smokers (20.9% vs 15%) and higher mean body mass index (29.1 kg/m2 vs 28.2 kg/m2). Bivariate outcomes showed more surgical site infections (SSI) (10.2% vs 6.12%), reoperation (9.45% vs 6.35%), and pLOS (34.8% vs 29.0%) (all P values <.05) in the PD group. On multivariate analysis, PD had higher likelihood of reoperation (OR 1.53, 95% CI: [1.02-2.80]) and SSI (OR 1.82, 95% CI: [1.25-2.66]).

Discussion

Psychiatric diagnoses are a risk factor for adverse outcomes after colorectal procedures. Further studies are needed to evaluate the benefit of perioperative mental health support services for these patients.
Suicide and suicidality in Australian Defence Force veterans: A systematic scoping review
Authors: Oltvolgyi Csongor G , Meurk Carla , Heffernan Ed
Published: April 2024

Objective:

Increased suicidality and suicide deaths among veterans of the Australian Defence Force have gained recent prominence. A systematic scoping review was conducted to identify, summarise and synthesise the existing literature relating to Australian veteran suicide and suicidality, with the objective of identifying future research priorities.

Methods:

We conducted a PRISMA-compliant systematic search on PubMed/MEDLINE, Embase and CINAHL databases for all manuscripts reporting primary data on suicide and suicidality in Australian veterans. The search was supplemented by grey literature and a search of reference lists. Manuscripts of any study type, published in the English language since the Vietnam era, were eligible for inclusion.

Results:

A total of 26 articles and reports, utilising a variety of mostly quantitative approaches, were included in the review. Findings, especially in larger and more recent studies, indicate increased suicidality in the veteran population. Suicide deaths appeared to increase with transition out of the military. Mental illness was identified as an important risk factor for suicide and suicidality. Current service was identified as a protective factor against suicide. There was mixed evidence regarding the impact of operational deployment on suicide and suicidality.

Conclusions:

Gaps were identified in relation to the relative contributions to risk from transition, the various psychosocial correlates (for example, relationships, finances, employment), pre-service factors and the extent to which these are causal or mediating in nature. A better understanding of health service utilisation would also aid in targeting preventive efforts. Future research in these areas is warranted.
Koolangka Infant Life Saving: Culturally responsive infant CPR education for Aboriginal Australian parents
Authors: Stephens Nakita , Nilson Caroline , Walker Roz , Marriott Rhonda
Published: April 2024

Objectives:

Among Aboriginal children, the year between birth and 1 year of age has the highest mortality rate compared with any other age. Prompt administration of cardiopulmonary resuscitation (CPR) leads to better outcomes and a lower likelihood of ongoing sequalae. Current education on infant CPR is not provided to parents except in certain circumstances in a neonatal intensive care unit. Currently, there are no identified CPR education courses specifically available for Aboriginal or Torres Strait Islander people, meaning that current infant CPR education courses are not culturally responsive.

Design:

Partnering with an Aboriginal community from the Bindjareb region of the Western Australian Noongar nation, the researchers used a co-design approach and an Aboriginal Participatory Action Research (APAR) design to explore how to deliver culturally safe and responsive infant CPR community education. This resulted in the development of the Koolangka Infant Life Saving Education Framework (KILSEF), which can be used to guide future planning and delivery of culturally safe and responsive community level infant CPR education.

Results:

The study findings identified that members of the Aboriginal community were very interested in receiving infant CPR education, but the barriers identified from mainstream CPR course delivery need to be removed for the community to benefit from culturally responsive ways of learning. Culturally responsive community CPR education should be provided in culturally safe places and the focus of learning should be on the practical applications of CPR and less on the academic pre-reading and written requirements. Explanations should be provided in lay terms and patience is required to communicate ideas in ways that facilitate understanding, and the course may need to be delivered over several days to accommodate community participant availability.

Conclusion:

Addressing Aboriginal community concerns and barriers allowed for the implementation of culturally responsive infant resuscitation education which was highly valued by community members and led to increased community confidence and participation in CPR education.
Assessing the Compatibility of Conventional Military Doctrines With the Changing Character of War: A Case of Indo-Pak Rivalry
Authors: Khan Akbar
Published: April 2024

Military doctrines integrate and encourage armed forces to pursue their strategic objectives while acting as an instrument to forestall conflicts by retaining credible deterrence. However, the acquisition of nuclear weapons and access to sophisticated technologies have significantly changed the character of warfare, adding layers to the complexity. This strategic shift has resulted in the diversification of sub-conventional warfare in the subcontinent, blurring the line between war and peace. In the case of Indo-Pak rivalry, non-contact warfare has gained currency, yet both states continue to prioritize conventional military doctrines when engaging each other in sub-conventional domain. Furthermore, this article argues that the compatibility of conventional military doctrines with the changing character of warfare is uncertain, and this is a topic of debate that merits through investigation and analysis.
Examining the Connectorship Scale: Factor Structure and Correlations With Self-Efficacy and Extraversion
Authors: Vadher Hardi , Baerg MacDonald Kristi , Ross Sarah , Schermer Julie Aitken
Published: April 2024

The Connectorship Scale was designed to assess how leaders connect with their followers and is described to measure eight dimensions: social interactivity, dependability, positive communication, presenting oneself, storytelling ability, belief in networking, tangible introduction, and belief in the importance of online networking. This study explores the scale properties and confirmatory factor analyses (CFA) of the Connectorship Scale and examines how the scale scores correlate with self-efficacy and extraversion based on responses from 454 (52% women) adult business students. The internal consistency estimates suggested that one of the subscales, positive communication, was unreliable; we therefore excluded that subscale from further analyses. A CFA of the seven-factor model suggested good fit once two pairs of error terms were allowed to correlate. Self-efficacy and all facets of extraversion positively correlated with six of the seven connectorship subscales, the exception being the tangible introduction scale. The results raise concern about the positive communication subscale from the Connectorship Scale but do support the use of the other seven subscales for research about engaged and effective leadership.
A review of modification methods, joints and self-healing methods of adhesive for aerospace
Authors: Hu Ning , Shu Linsen , Zheng Xiangke , Deng Zhifeng , Cang Xinyu
Published: April 2024

In recent years, the adhesive technology has been widely used in the production of high-strength joins and precise positioning of various materials, such as metals, glass and composite materials. The adhesive technology has become a promising assembly process in the aerospace field due to its versatility, low creep and high damage tolerance. However, the reliability and predictability of adhesive bonding still require further development due to the complex operating conditions involved. Therefore, this article reviews and discusses the latest advances in aerospace adhesive technology, such as methods for improving bonding performance, bonding techniques (including joints structure and failure modes) and self-healing adhesive layers. Additionally, the current research results are summarised, and possible development trends and research directions in the field of adhesive bonding are prospected.
Connected Yet Cognitively Drained? A Mixed-Methods Study Examining Whether Online Vigilance and Availability Pressure Promote Mental Fatigue
Authors: Van Gaeveren Kyle , Murphy Stephen L. , de Segovia Vicente David , Vanden Abeele Mariek M. P.
Published: April 2024

This mixed-methods study investigates whether online vigilance promotes mental fatigue, and whether this effect is greater when under pressure to be available online. Additionally, it examines whether passively sensed smartphone behavior can serve as a digital proxy for online vigilance. Data were collected from 1,315 adult participants, who received 84 experience sampling questionnaires over 14 days, providing 67,762 usable datapoints on individuals’ perceptions of momentary online vigilance, mental fatigue, and availability pressure. Additionally, the smartphone use of 834 participants was passively monitored. Findings revealed both a momentary and lagged association between self-reported online vigilance and self-reported mental fatigue. Availability pressure was not a significant moderator, but did predict mental fatigue directly and indirectly, by promoting online vigilance. We found behavioral smartphone use features were weakly associated with self-reported online vigilance and mental fatigue. Overall, this study provides initial support that online vigilance may play a role in the development of mental health conditions such as burnout via its tendency to promote one of its precursors, mental fatigue.
Evolution of distal limb perfusion management in adult peripheral venoarterial extracorporeal membrane oxygenation with femoral artery cannulation
Authors: Simons Jorik , Mees Barend , MacLaren Graeme , Fraser John F , Zaaqoq Akram M , Cho Sung-Min , Patel Bhavesh M , Brodie Daniel , Bělohlávek Jan , Belliato Mirko , Jung Jae-Seung , Salazar Leonardo , Meani Paolo , Mariani Silvia , Di Mauro Michele , Yannopoulos Demetris , Broman Lars Mikael , Chen Yih-Sharng , Riera Jordi , van Mook Walther NKA , Lorusso Roberto
Published: April 2024

Limb ischaemia is a clinically relevant complication of venoarterial extracorporeal membrane oxygenation (VA ECMO) with femoral artery cannulation. No selective distal perfusion or other advanced techniques were used in the past to maintain adequate distal limb perfusion. A more recent trend is the shift from the reactive or emergency management to the pro-active or prophylactic placement of a distal perfusion cannula to avoid or reduce limb ischaemia-related complications. Multiple alternative cannulation techniques to the distal perfusion cannula have been developed to maintain distal limb perfusion, including end-to-side grafting, external or endovascular femoro-femoral bypass, retrograde limb perfusion (e.g., via the posterior tibial, dorsalis pedis or anterior tibial artery), and, more recently, use of a bidirectional cannula. Venous congestion has also been recognized as a potential contributing factor to limb ischaemia development and specific techniques have been described with facilitated venous drainage or bilateral cannulation being the most recent, to reduce or avoid venous stasis as a contributor to impaired limb perfusion. Advances in monitoring techniques, such as near-infrared spectroscopy and duplex ultrasound analysis, have been applied to improve decision-making regarding both the monitoring and management of limb ischaemia. This narrative review describes the evolution of techniques used for distal limb perfusion during peripheral VA ECMO.
Identity and Personality Pathology in Adult Forensic Psychiatric Patients and Healthy Controls
Authors: Tressová Deni , De Caluwé Elien , Bogaerts Stefan
Published: April 2024

Since the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), identity impairment has become a diagnostic criterion for all personality disorders. The current study examined the occurrence of identity dimensions, clinically relevant identity impairments and personality pathology, and associations between these constructs in 92 forensic patients and 139 healthy controls. Patients showed higher levels of almost all identity dimensions, identity impairments, personality disorders, and almost all maladaptive personality traits than controls. Various identity dimensions were associated with consolidated identity as well as identity impairments in both groups. Both patients and controls with high ruminative exploration and identity malfunctioning showed more personality pathology. Different associations between identity functioning and particularly antisocial and borderline personality disorder showed to be stronger in patients than in controls. Our results highlight the importance of identity impairment as a crucial criterion to assess and treat personality pathology in forensic patients.
Two sides to every story: Reappraising the early history of liver transplantation at Addenbrooke’s Hospital, Cambridge
Authors: Featherstone Peter J
Published: April 2024

Over the course of the past six decades, liver transplantation has evolved to become the treatment of choice for chronic end-stage liver disease and some cases of acute hepatic failure. Currently, more than 34,000 liver transplants are conducted worldwide per annum, and overall one year survival rates exceed 90%. However, the early years of human liver transplantation were beset by failure. Eyewitness reports from this period make for tragic, yet compelling reading. Volume 12 of The History of Anaesthesia Society Proceedings contains one such account, written by Dr Elizabeth Gibbs. This outlined the experience of single-handedly anaesthetising the recipient of the first liver transplant to be undertaken at Addenbrooke’s Hospital, Cambridge, UK, in June 1967. Despite the best efforts of the team, the patient died from uncontrollable haemorrhage 19 hours after the start of the procedure. While this tragic outcome might have been expected in the early days of liver transplantation, Gibbs included an unsettling postscript in her paper. This stated that all of the patient’s records had apparently been ‘lost’, and the date of the first Cambridge liver transplant was publicly reported as 2 May 1968, some 11 months after the events described. This article outlines the results of research aimed at critically appraising this postscript. In doing so a number of unexpected discoveries were made. These highlight some important lessons for medical historians and demonstrate that if you look hard enough, there really are two sides to every story.
Oculomotor Abnormalities and Aberrant Neuro-Developmental Markers: Composite Endophenotype for Bipolar I Disorder: Anomalies Oculomotrices et Marqueurs Neuro-Développementaux Aberrants : Endophénotype Composite du Trouble Bipolaire I
Authors: Ritish Daniel , Reddy Preethi V. , Sreeraj Vanteemar S. , Chhabra Harleen , Kumar Vijay , Venkatasubramanian Ganesan , Muralidharan Kesavan
Published: April 2024

Background

Neurological soft signs (NSSs), minor physical anomalies (MPAs), and oculomotor abnormalities were plausible biomarkers in bipolar disorder (BD). However, specific impairments in these markers in patients after the first episode mania (FEM), in comparison with first-degree relatives (high risk [HR]) of BD and healthy subjects (health control [HC]) are sparse.

Aim of the study

This study aimed at examining NSSs, MPAs, and oculomotor abnormalities in remitted adult subjects following FEM and HR subjects in comparison with matched healthy controls. Investigated when taken together, could serve as composite endophenotype for BD.

Methods

NSSs, MPAs, and oculomotor abnormalities were evaluated in FEM ( n = 31), HR ( n = 31), and HC ( n = 30) subjects, matched for age (years) ( p = 0.44) and sex ( p = 0.70) using neurological evaluation scale, Waldrop's physical anomaly scale and eye tracking (SPEM) and antisaccades (AS) paradigms, respectively.

Results

Significant differences were found between groups on NSSs, MPAs, and oculomotor parameters. Abnormalities are higher in FEM subjects compared to HR and HC subjects. Using linear discriminant analysis, all 3 markers combined accurately classified 72% of the original 82 subjects (79·2% BD, 56·70% HR, and 82·1% HC subjects).

Conclusions

AS and SPEM could enhance the utility of NSSs, and MPAs as markers for BD. The presence of these abnormalities in FEM suggests their role in understanding the etiopathogenesis of BD in patients who are in the early course of illness. These have the potential to be composite endophenotypes and have further utility in early identification in BD.
The “Angel-Wing” Combined Labia Minoraplasty/Majoraplasty
Authors: Goodman Michael P.
Published: April 2024

Background:

Reduction of prominent/hypertrophic/ptotic vulvar labia minora and/or labia majora is an increasingly common surgical procedure in the hands of plastic and cosmetic surgeons and female genital cosmetic and reconstructive surgeons. While several techniques for these reductions are described in the literature and are individually modified by experienced practitioners, 2 procedures for the minora (linear and wedge-type reductions), and the vertically-aligned reduction of redundant majora are the most utilized techniques. It is not unusual for a woman to present to her potential surgeon requesting “work” on both minora and majora. Historically, this has necessitated two separate incision lines (minora and majora) bilaterally, often resulting in a long case, difficult recovery, and a significant potential for visible incision lines and gaping of the vaginal introitus.

Objective:

To introduce a novel single-incision-line technique for combining labia minoraplasty and labia majoraplasty.

Methods:

A modification of a classic central V-Wedge technique is affected by “shifting” the wedge incision line across the interlabial fold to encompass a portion of the medial labum majorum, both reducing redundancy and “lifting” the lowermost portion of the majora to correct ptosis. This is accomplished in one incision line with “en-bloc” closure of both minora and majora, placing the incision line mostly within the interlabial fold.

Results:

The author has completed eight wedge-type combined labia minora-majoraplasties without complication and with 2.5-36 months of follow-up.

Discussion:

This modification in Wedge design converts two separate procedures into one, making the surgery both less time-consuming, easier to recover from, and more visually esthetic for those patients who are capable of the more rigorous recovery protocol that wedge procedures mandate.

Conclusion:

The “Angel-Wing combined labia minoraplasty + labia majoraplasty appears to be a relevant option for combined labia minor hypertrophy and labia majora deflation and redundancy.
Predicting COVID-19 Vaccination Intentions to Inform Evidence-Based Messaging for Building Vaccine Confidence Among Rural Americans
Authors: Totzkay Daniel , Fraustino Julia Daisy , Smith Brittany T. , Jarrett Traci , Dino Geri A. , Costello Lisa M. , Kristjansson Alfgeir L.
Published: April 2024

Purpose

Examine possible message topics to promote rural vaccination using psychosocial antecedents of vaccination.

Design

Cross-sectional survey administered by Research America, Inc.

Setting

West Virginia (WV).

Sample

756 WV adults via convenience sample (n = 370; ∼2% response rate from online panel of ∼20 000 WV residents), and random digit dial of landlines (n = 174; ∼1% response rate from 18 432 numbers) and cellphones (n = 212; ∼1% response rate from 20 486 numbers).

Measures

Outcome measures included self-reported vaccination intention and behavior. Predictor measures, rooted in theories of social and behavioral science that have been found to be predictive of vaccination outcomes (i.e., Reasoned Action Approach, Extended Parallel Process Model), included perceived severity and susceptibility, negative affect, instrumental and affective attitudes, social norms, self-efficacy, response efficacy, and perceived control.

Analysis

Multivariate linear regression for intention and logistic regression for behavior.

Results

Intention was positively predicted by affective attitude, β = .30, P < .05, instrumental attitude, β = .19, P < .05, response efficacy, β = .19, P < .05, negative affect, β = .16, P < .05, self-efficacy, β = .13, P < .05, and subjective norm, β = .13, P < .05, F(10, 267) = 30.12, Adj. R2 = .53. Vaccination status was predicted by instrumental attitude, exp( B) = 2.09, and subjective norm, exp( B) = 2.00, Pseudo R2 = .29, log likelihood = 125.11, χ2(10) = 38.34, P < .05. Promising message targets were instrumental attitude, M = 3.21, SD = 1.46, and subjective norms, M = 3.76, SD = 1.71.

Conclusion

COVID-19 vaccine confidence messages should address (1) positive feelings and safety perceptions, (2) vaccination’s effectiveness in preventing serious COVID-19, and (3) subjective vaccination norms.