bluuebunny/crossref_metadata_2025 huggingface dataset:
The Startup Sizzle: The HR Magic Behind Emerging Ventures
Authors: G Ashok
Published: October 2024

This article outlines how the distinctive and necessary attributes (DNA) of a startup significantly influence the HR function. The author identifies 13 traits required of human resources (HR) professionals to become successful in startups. He also highlights some of the conscious shifts required from the conventional HR mindset to work in an entrepreneurial setup. This article helps young and established professionals think through their potential fit while choosing to work in startups.
Analysis of low-velocity impact on FG-CNT reinforced cantilever sandwich beams: An FOSNDT approach
Authors: Shahbazi Masood , Feli Saeed
Published: October 2024

This study analyzes the low-velocity impact response of cantilever sandwich beams with foam cores and carbon nanotube (CNT) reinforced facesheets. Using the fifth-order shear and normal deformation theory, we explore three CNT distribution types through the thickness of the facesheets: uniformly distributed UD, functionally graded-V FG-V, and functionally graded-Λ FG-Λ. The contact force during impact is calculated according to Hertz contact law. Our findings indicate that the FG-V distribution offers the highest contact stiffness, resulting in reduced deflection compared to UD and FG-Λ distributions. Additionally, an increase in the core-to-face thickness ratio leads to decreased deflection and increased contact force, attributed to enhanced beam stiffness. The volumetric fraction of CNTs also plays a critical role, increased CNT content raises beam stiffness, decreasing deflection and enhancing contact force. Furthermore, the impactor’s initial velocity directly influences the deflection and contact force, with higher velocities leading to greater deflections due to increased kinetic energy. This comprehensive analysis underscores the significant effects of CNT distribution, volumetric fraction, and geometrical parameters on the dynamic response of sandwich beams under impact conditions.
Microbial extracellular polymeric substances (EPS) in soil: From interfacial behaviour to ecological multifunctionality
Authors: Zhang Ming , Wu Yichao , Qu Chenchen , Huang Qiaoyun , Cai Peng
Published: October 2024

Extracellular polymeric substances (EPS) are high molecular weight polymers that microorganisms secrete into their extracellular environment. EPS serves as the carrier of the structural integrity of microbial biofilms, determining the physicochemical properties and the functional complexity of biofilms. EPS creates an ideal environment for interfacial reactions and nutrient trapping around microbial cells, while also acting as a buffer zone against environmental stresses. EPS in soil can contribute to soil health through its own properties such as adhesion, hygroscopicity and complexing ability. Here, we first introduce the concept, components, properties and controlled factors of EPS in the soil environment, and outline current advances in extraction methods and characterization techniques for soil EPS. EPS form a dynamic biophysical-chemical interface between microbes and the soil matrix. We explore the role of EPS in the colonization and survival of microorganisms, aggregation and weathering of soil minerals, and cross-linking with soil organic matter. We then summarize the soil ecological functions of microbial EPS: 1) promoting aggregate formation and stabilization; 2) enhancing water retention and holding capacity; 3) mediating nutrient storage and trapping; and 4) regulating contaminant sequestration and transformation. Finally, we propose several future research interests for microbial EPS in soil, thereby calling for more attention and research on microbial EPS and its functions in soil ecosystems, and exploring their potential applications in the development of environment-friendly agriculture.
Lung function during infancy and preschool age
Authors: Carlsen K-H.
Published: October 2024

Educational aims

To analyse lung function techniques developed for preschool children and infants.

To compare lung function techniques used in adults and children.

To discuss the possibility of using equipment from childhood through to adulthood.

Measurements of pulmonary function are among the most important measurements in respiratory medicine, both in clinical and research work. Despite the rapid technological development during recent decades, we still struggle with a major obstacle in understanding the natural history of the lungs and airways; namely our inability to use one method and one piece of equipment from birth through childhood to adulthood.

Thus, various methods measuring, at best, approximations of similar mechanical or physical properties within the lungs and airways will have to be compared at different time-points to the best of our abilities. Recent studies have begun to report extensive work from many research groups addressing the acceptability and reproducibility of spirometry among preschool children.
Suppression of virulence factors of uropathogenic Escherichia coli by Trans-resveratrol and design of nanoemulgel
Authors: ElFeky Dalia Saad , Kassem Abeer Ahmed , Moustafa Mona A. , Assiri Hanan , El-Mahdy Areej M.
Published: October 2024

Background

Development of multidrug resistance in Uropathogenic Escherichia coli (UPEC) makes treatment of Urinary Tract Infections (UTIs) a major challenge. This study was conducted to investigate the effect of trans-resveratrol (t-RSV) at a subinhibitory concentration (sub-MIC-t-RSV) on phenotypic and genotypic expression of virulence factors of clinical isolates of UPEC and develop a nanoformulation of t-RSV. Fifty-five clinical UPEC strains were investigated for the presence of virulence factors by phenotypic methods and PCR detection of virulence genes. The effect of sub-MIC-t-RSV was studied on the phenotypic and genotypic expression of virulence factors. t-RSV-loaded nanoemulgel formulation was prepared and characterized.

Results

Out of the 55 tested isolates, 50.9% were biofilm producers, 23.6% showed both mannose-sensitive and mannose-resistant hemagglutination, 21.8% were serum-resistant, 18.2% were hemolysin producers, while 36.4% showed cytotoxic effect on HEp-2 cells. A total of 25.5% of the isolates harbor one or more of hly-A, cnf-1 and papC genes, while 54.5% were positive for one or more of fimH, iss and BssS genes. A concentration of 100 µg/mL of t-RSV effectively downregulates the phenotypic and genotypic expression of the virulence factors in positive isolates. A stable t-RSV-nanaoemulgel with droplet size of 180.3 nm and Zetapotential of -46.9 mV was obtained.

Conclusion

The study proves the effective role of t-RSV as an antivirulence agent against clinical UPEC isolates in vitro and develops a stable t-RSV-nanoemulgel formulation to be assessed in vivo. The promising antibacterial and antivirulence properties of t-RSV place this natural compound to be a better alternative in the treatment of persistent UTIs.
Collaborative governance of an integrated system for collecting contributions for social health insurance, pension, and taxes from the informal sector: a synthesis of stakeholder perspectives
Authors: Muntalima Nelly Claire , Silumbwe Adam , Zulu Joseph Mumba , Mweemba Chris , Hangoma Peter
Published: October 2024

Background

Many low-and middle-income countries have adopted social health insurance schemes. However, the collection of contributions from the large informal sector of these economies poses a significant challenge. Employing an integrated system of contribution collection from all relevant institutions may be cost-effective. We used the integrative framework for collaborative governance, to explore and explain factors that may shape the governance of an integrated system for collecting contributions for social health insurance, pension, and taxes from the informal sector in Zambia.

Methods

We undertook a qualitative case study involving 25 key informants drawn from government ministries and institutions, cooperating partners, non-governmental organizations, and association representatives in the informal sector. Data were analyzed thematically using Emerson’s integrative framework for collaborative governance.

Results

The main drivers of collaboration included a need for comprehensive policies and legislation to oversee the integrated system for contribution collection, prevent redundancy, reduce costs, and enhance organizational effectiveness. However, challenges such as leadership issues and coordination complexities were noted. Factors affecting principled engagement within the collaborative regime consisted of communication gaps, organizational structure disparities, and the adoption of appropriate strategies to engage the informal sector. Additionally, factors influencing shared motivation involved concerns about power dynamics, self-interests, trust issues, corruption, and a lack of common understanding of the informal sector.

Conclusion

This study sheds light on a multitude of factors that may shape collaborative governance of an integrated system for contribution collection for social health insurance, pension, and taxes from the informal sector, providing valuable insights for policymakers and implementers alike. Expanding social health insurance coverage to the large but often excluded informal sector will require leveraging factors identified in this study to enhance collaboration with pension and tax subsystems.
Resilient health care performance in the real world: fixing problems that never happened
Authors: Braithwaite Jeffrey , Churruca Kate , Ellis Louise A. , Leask Elle , Long Janet C. , Sarkies Mitchell , Zurynski Yvonne , Clay-Williams Robyn
Published: October 2024

Background

Staff in health systems everywhere have exhibited flexibility and a capacity for improvisations during, and in response to, the COVID-19 pandemic. Looking to other examples of such resilient behaviours outside of those induced by the pandemic is instructive for those involved with researching or understanding change, or making health systems improvements.

Methods

Here, we synthesise and then assess the value of eight case studies of in situ resilient performance from Canada, Sweden, Japan, Belgium, the United Kingdom, Norway, the United States and Brazil. The cases are divided into four categories: responsiveness to a crisis; adaptiveness over time; local adoption in accommodating to a top down, national policy change; and the consequential outcomes of an intervention.

Results

The cases illuminate the resourcefulness of translational and social researchers in examining such behaviours and practices. More than that, they also foreground the ingenuity and adaptive capacity of staff on-the-ground who continually anticipate, respond and adapt to make systems work and provide continuous care in the face of many challenges, including resource deficiencies, policy misalignments, and new technologies, policies and procedures that need to be integrated into local workflows. Front line clinicians make care systems work, pre-empting issues and sorting out problems before they occur or as they arise.

Conclusions

A key lesson amongst a range of findings is that, rather than focusing on shiny new tools of change (checklists, frameworks, policy mandates), it is much more insightful and satisfying to deeply apprehend care at the sharp end, where clinicians deliver care to patients, understanding how everyday work is executed. This, rather than the Health Ministry, the Boardroom, or the Management Consultant’s office, is where and how change is being enabled, and where street level actors solve problems, thwart issues in advance, and constantly avoid pitfalls.
VISIT STROKE: non-inferiority of telemedicine-based neurological consultation for post-acute stroke patients – protocol of a prospective observational controlled multi-center study
Authors: Herm Juliane , Erdur Hebun , Aigner Annette , Hengelbrock Johannes , Angermaier Anselm , Flöel Agnes , Hille Annegret , Gorski Claudia , Kinze Stephan , Schmehl Ingo , Hubert Gordian J. , Wiestler Hanni , Siepmann Timo , Arndt Martin , Gumbinger Christoph , Heyse Miriam , Weber Joachim E. , Audebert Heinrich J. ,   for the ANNOTeM-network
Published: October 2024

Background

Telemedicine provides specialized medical expertise in underserved areas where neurological expertise is frequently not available on a daily basis for hospitalized stroke patients. While tele-consultations are well established in acute stroke assessment, the value of telemedicine-based ward-rounds in the subsequent in-patient stroke management is unknown.

Methods

Four telemedicine stroke networks in Germany, implemented in eight out of 16 federal states, participate in this prospective observational multi-center study. We plan to enroll 523 patients hospitalized due to acute (suspected or confirmed) stroke or transient ischemic attack. Each recruited patient will receive both a tele-consultation and an on-site consultation at the same day within the first three days after hospital admission. We will test non-inferiority of telemedicine-based assessments in ward-rounds in terms of quality of medical assessment and recommendations for hospitalized stroke patients. The correctness of the medical assessment and recommendation is defined as positive evaluation (binary, correct vs. in-correct) of six out of six predefined quality indicators by at least two out of three blinded independent raters. The non-inferiority margin for the difference in proportions of correct assessments is set to 5%-points.

Discussion

If non-inferiority of telemedicine-based ward-rounds compared to on-site ward-rounds by a neurologist were demonstrated, telemedicine-based neurological consultation for post-acute stroke patients may contribute to deliver evidence-based high-quality stroke care more easily in underserved regions.

Trial registration

DRKS - DRKS00028671 (https://drks.de/search/de/trial/DRKS00028671; registration date 09-27-2022).
The prevalence, course, and risk factors of suicidal ideation and suicide attempts among students in vocational education
Authors: Looijmans Milou , von Spreckelsen Paula , Berkelmans Guus , Popma Arne , van Bergen Diana , Gilissen Renske , Mérelle Saskia
Published: October 2024

Background

Worldwide, suicide is one of the leading causes of death among adolescents and young adults. Given that suicide in this age group is common within vocational students, this study aims to provide insights into the prevalence, course, and risk factors of suicidal ideation (SI) and suicide attempts (SA) among students in vocational education over the past 10 years.

Methods

This study has a repeated cross-sectional design, utilizing data from 2013 to 2023 provided by the ‘Testjeleefstijl’ foundation in the Netherlands (‘Test Your Lifestyle’). In total, 101,182 students in vocational education completed a web-based standardized questionnaire. Univariate logistic regression was used to test the predictive value of risk factors separately (anxiety and depression, gender, age and school year) on SI and SA. In addition, a machine learning model (Berkelmans et al., 2023) ​was used for high-risk identification of combined risk factors (multivariate models).

Results

Within vocational students, 12-month SI and SA prevalence increased from respectively 17.7% and 2.3% in schoolyear 2013–2014 to 23% and 3.2% in 2022–2023. Although female gender significantly predicted SI and SA in the univariate analyses, the multivariate models revealed that female gender decreased the likelihood of both SI (OR 0.9) and SA (OR 0.7). A high risk for anxiety and depression was the strongest predictor in the multivariate models for SI (OR 42.8) and SA (OR 19.0).

Conclusion

Over the past decade, the prevalence of SI and SA increased in students in vocational education, with the risk of anxiety and depression being the strongest contributing factor. While females had a higher prevalence of anxiety and depression, the results suggest these conditions tend to lead to SI and SA more quickly among male students. Early intervention in suicide prevention is crucial, highlighting the need to identify and address anxiety and depression. Vocational education schools have a critical role in this, emphasizing early screening and intervention, with specific attention to gender-specific factors.
Psychometric evaluation of the Swedish version of ages and stages questionnaire social-emotional: second edition for parents of children 18 months of age
Authors: Edenius Anna , Bergström Malin , Lindberg Lene , Bergqvist Kersti , Fröjlinger Anna , Enebrink Pia , Åhlén Johan
Published: October 2024

Background

Social and emotional development are important aspects of young children’s well-being but can be difficult to assess during the first years of life. The Ages and Stages Questionnaire: Social-Emotional Second Edition (ASQ:SE-2) is a parent-rated assessment tool for child socioemotional development between 1 and 72 months of age. In this study, we examined the psychometric properties of this instrument in 18-month-old Swedish children.

Methods

Data from 586 Swedish-speaking parents of 18-month-old children were included. In addition to the ASQ:SE-2, parents also completed the Social-Emotional Assessment/Evaluation Measure (SEAM), and the child’s socioemotional development was assessed by a nurse at the Child Health Services. We used exploratory factor analysis and Rasch methodology to explore dimensionality and item properties of the ASQ:SE-2. Furthermore, we used Pearson and Spearman rank correlations to study associations with the SEAM and the nurse assessment.

Results

An exploratory factor analysis suggested a one-factor model for the ASQ:SE-2 items. However, several items showed weak factor loadings, and a final scale including 18 of the original 29 items was further explored. The Rasch analysis revealed problems with targeting, and the final scale showed acceptable reliability only in the 22% with the highest levels of socioemotional difficulties. The total score of the final version showed a strong association with the parent-rated SEAM but a weak association with the nurse observations. We labeled the reduced 18-item scale Social Interaction.

Conclusions

The results of this study highlight that the original Swedish version of the ASQ:SE-2 for 18-month-old children may not be an adequate tool for assessing social and emotional competencies in a normal population since acceptable reliability was reached only in children with the greatest difficulties (above the 78th percentile). In conclusion, the suggested 18-item version works best either as a screening instrument for problems with social interaction or as a continuous measure of such problems in children with high levels of social interaction difficulties.
The effect of attachment systems and denture cleaning methods on microbial biomass and composition in implant-supported overdentures: an experimental study
Authors: Zhao Yuwei , Yang Xin , Wen Bixin , Li Yuqing , Yu Haiyang
Published: October 2024

Objective

This research endeavors to scrutinize the influence of attachment systems and denture cleaning methodologies on microbial biomass and composition within the realm of implant-supported overdentures, a crucial consideration for patients with dentition defects necessitating such prosthetic solutions.

Subjects and methods

Employing five polymethyl methacrylate specimens designed to emulate the fitting surfaces of traditional dentures and implant-supported overdentures. Following the polishing of each specimen and the quantification of its roughness, co-cultivation with three distinct microbial strains ensued, culminating in ultrasonic cleaning in water. The bar-clip group, differentiated by the depth of attachment, underwent cleaning employing four diverse methods. Biomass quantities were meticulously recorded both pre and post cleaning interventions, with subsequent data analysis via t-testing and one-way ANOVA, maintaining a significance level of α = 0.05.

Results

The bar-clip groups demonstrated an elevated degree of microbial adhesion, with the deeper locator group exhibiting heightened biomass residue post-cleaning, indicative of increased cleaning complexity. Ultrasonic cleaning predominantly targeted biofilm and deceased bacteria, whereas chemical cleaners primarily reduced the quantity of viable bacteria. The synergistic application of ultrasonics and chemical cleaning treatments yielded the minimal biomass residue.

Conclusion

In contemplating the utilization of dentures milled by dental computer-aided design/manufacturing systems, meticulous pre-use surface polishing is imperative. The extent of biofilm adhesion correlates with the chosen attachment system. This study advocates for the incorporation of ultrasonic cleaning in conjunction with chemical cleaning solutions to optimize the removal of biofilm and live cellular entities in the context of implant-supported overdentures.
Hypermethylation of the sodium channel beta subunit gene promoter is associated with colorectal cancer
Authors: Liu Yabin , Duan Ya , Bai Tianliang , Kong Dexian
Published: October 2024

Aims

To better understand the role of sodium channel beta subunit (SCNN1B) in the initiation and progression of colorectal cancer (CRC) and to identify potential biomarkers for the early detection and prognosis of CRC.

Methods

A total of 74 pairs of CRC tissues and their adjacent normal tissues were collected between October 2016 and November 2017. The methylation levels of the SCNN1B promoter region in CRC tissues and their adjacent normal tissues were investigated by pyrosequencing. The expression of both SCNN1B mRNA and protein were detected by RT‒qPCR and immunohistochemistry, respectively.

Results

The results showed that the methylation levels of the SCNN1B promoter region were significantly higher in CRC tissues than in adjacent normal tissues. The expression levels of SCNN1B mRNA and protein were significantly lower in the CRC tissues than in their adjacent normal tissues. Moreover, Pearson’s correlation analysis showed that the methylation levels of the SCNN1B promoter were negatively correlated with the SCNN1B mRNA levels in CRC tissues. In addition, the high methylation levels and low mRNA expression of SCNN1B showed a significant association with advanced tumour stage, increased risk of lymph node metastasis and poor prognosis of CRC patients.

Conclusion

This study suggested that the decreased expression of SCNN1B due to its promoter hypermethylation may play an important role in the progression and prognosis of CRC, and the methylation levels of the SCNN1B promoter may serve as an effective molecular marker for predicting the progression and prognosis of CRC.
Development and Validation of a Clinical Prediction Model for Paclitaxel Hypersensitivity Reaction on the Basis of Real-World Data: Pac-HSR Score
Authors: Sa-nguansai Sunatee , Sukphinetkul Radasar
Published: October 2024

PURPOSE

Paclitaxel is effective chemotherapy against various cancers but can cause hypersensitivity reaction (HSR). This study aimed to identify predictors associated with paclitaxel HSR and develop a clinical prediction model to guide clinical decisions.

METHODS

Data were collected from the medical records database of Rajavithi Hospital. Patients with cancer treated with paclitaxel from 2015 to 2022 were included, and a multivariable logistic regression analysis identified predictors associated with paclitaxel HSR. The scoring system was transformed and calibrated on the basis of diagnostic parameters. Discrimination and calibration performances were assessed. Internal validation was conducted using bootstrap resampling with 1,000 replications.

RESULTS

This study involved 3,708 patients with cancer, with an incidence of paclitaxel HSR of 10.11%. An 11-predictor–based Pac-HSR scoring system was developed, involving the following factors: younger age; poor Eastern Cooperative Oncology Group performance status; previous history of paclitaxel HSR; medication allergy history; chronic obstructive airway disease; lung and cervical cancers; high actual dose of paclitaxel; no diphenhydramine premedication; low hemoglobin level; high WBC count; and high absolute lymphocyte count. The C-statistics was 0.73 (95% CI, 0.70 to 0.76), indicating acceptable discrimination. The
P
value of the Hosmer-Lemeshow goodness-of-fit test was 0.751. The ratio of observed and expected values was 1.00, indicating good calibration. At a cutoff point of 8, specificity was 75.28% and sensitivity was 57.07%. Internal validation indicated good performance with minimal bias, and decision curve analysis demonstrated improved prediction with the use of this scoring system in clinical decision making.

CONCLUSION

This study developed the 11-predictor–based Pac-HSR scoring system for predicting paclitaxel HSR in patients with cancer. High-risk patients identified by this score should be prioritized for close monitoring and early treatment prophylaxis.
Associations of AMH in Midreproductive Years with Bone Mineral Density and Turnover Markers in Midlife
Authors: Wang Siwen , Yu Elaine W , Hivert Marie-France , Rifas-Shiman Sheryl L , Shifren Jan L , Kazemi Maryam , Oken Emily , Chavarro Jorge E
Published: October 2024

Context

The concentration of circulating anti-Müllerian hormone (AMH) predicts short-term (3-5 years) bone loss around menopause. Whether AMH during midreproductive years predicts bone health over a decade later is unknown.

Objective

To study the association of AMH levels in midreproductive years with bone density and turnover biomarkers measured after ∼14 years of follow-up.

Methods

We assessed plasma AMH in 2003-2006 (mean 37.0 years, SD 5.1) among 450 parous women (71% White) in a US longitudinal cohort, and bone mineral density (BMD; spine, hip, and femoral neck, measured by dual-energy X-ray absorptiometry) in 2017-2021 (mean 51.0 years, SD 5.1). Secondary outcomes were plasma levels of procollagen type I N-propeptide (PINP) and type I collagen cross-linked C telopeptide (CTX-I).

Results

In linear regression models adjusted for demographics and lifestyle, compared with women with AMH >3.5 ng/mL, those with AMH <1.0 ng/mL had lower BMD (g/cm2) at follow-up (beta [95% CI] spine: −.06 [−0.10, −0.02]; hip: −.05 [−0.08, −0.02]; femoral neck: −.03 [−0.06, 0.00]) and higher bone turnover markers (beta [95% CI] PINP: .36 SD [0.10, 0.63]; CTX-I: .34 SD [0.07, 0.60]). The association of AMH with spine BMD was more pronounced among postmenopausal women in contrast to associations with bone turnover markers, which were more pronounced among women who had not yet reached menopause. The associations between AMH and BMD were primarily mediated by menopausal status at follow-up.

Conclusion

Lower AMH during midreproductive years is associated with lower BMD and higher bone turnover 14 years later. Ovarian reserve during midreproductive years may be a valuable predictor of long-term bone health.
Effectiveness of Dexamethasone for COVID-19 in Hospitalized Patients With Diabetes: A Retrospective Cohort Study
Authors: Bhat Salman Zahoor , Wu Jiajun , Perin Jamie , Wang Kunbo , Robinson Matthew L , Garibaldi Brian T , Mathioudakis Nestoras
Published: October 2024

Background

Patients with diabetes have higher mortality from COVID-19 compared to the general population. Dexamethasone, a potent glucocorticoid used for moderate to severe COVID-19, can worsen hyperglycemia in patients with diabetes, potentially leading to worse outcomes. The efficacy and safety of use of dexamethasone for COVID-19 in patients with diabetes needs further evaluation.

Objective

The study aimed to assess the efficacy and safety of dexamethasone in patients with diabetes hospitalized for COVID-19 infection.

Design

This retrospective study analyzed data from 5 hospitals in the Johns Hopkins Health System collected between March 3, 2020, and June 25, 2022. Propensity score matching was applied to a cohort of patients with diabetes who received dexamethasone and those who did not (controls), and outcomes were compared using Cox proportional hazards regression models.

Outcomes

The primary outcome was time to death within 28 days. The secondary outcome was time to clinical improvement. Additional outcomes included the incidence of hyperglycemic emergencies and subgroup analysis of primary outcomes by clinical severity.

Results

Out of 10,329 patients admitted for COVID-19, 3679 had diabetes, and 2361 met the inclusion criteria. After propensity score matching, 529 patients were analyzed in each group. Survival rates between the dexamethasone and control groups during the 0- to 6-day and 7- to 28-day periods and time to clinical improvement at 28 days did not differ significantly. There was no difference in the incidence of diabetic ketoacidosis or hyperosmolar hyperglycemic state between the groups.

Conclusion

Dexamethasone treatment did not significantly improve survival or time to clinical improvement in patients with diabetes and COVID-19 infection. Further prospective studies are needed to confirm these findings and determine potential mechanisms.
Perioperative Analgesic Interventions for Reduction of Persistent Postsurgical Pain After Total Hip and Knee Arthroplasty: A Systematic Review and Meta-analysis
Authors: Laigaard Jens , Karlsen Anders , Maagaard Mathias , Haxholdt Lunn Troels , Mathiesen Ole , Overgaard Søren
Published: October 2024

BACKGROUND:

High pain levels immediately after surgery have been associated with persistent postsurgical pain. Still, it is uncertain if analgesic treatment of immediate postsurgical pain prevents the development of persistent postsurgical pain.

METHODS:

We searched MEDLINE, CENTRAL, and Embase up to September 12, 2023, for randomized controlled trials investigating perioperative analgesic interventions and with reported pain levels 3 to 24 months after total hip or knee arthroplasty in patients with osteoarthritis. The primary outcome was pain score 3 to 24 months after surgery, assessed at rest and during movement separately. Two authors independently screened, extracted data, and assessed risk of bias using the Cochrane Risk of Bias 2 tool. We conducted meta-analyses and tested their robustness with trial sequential analyses and worst-best and best-worst case analyses.

RESULTS:

We included 49 trials with 68 intervention arms. All but 4 trials were at high risk of bias for the primary outcome. Moreover, the included trials were heterogeneous in terms of exclusion criteria, baseline pain severity, and which cointerventions the participants were offered. For pain at rest, no interventions demonstrated a statistically significant difference between intervention and control. For pain during movement, perioperative treatment with duloxetine (7 trials with 641 participants) reduced pain scores at 3 to 24 months after surgery (mean difference −4.9 mm [95% confidence interval {CI}, −6.5 to −3.4] on the 0–100 visual analog scale) compared to placebo. This difference was lower than our predefined threshold for clinical importance of 10 mm.

CONCLUSIONS:

We found no perioperative analgesic interventions that reduced pain 3 to 24 months after total hip or knee arthroplasty for osteoarthritis. The literature on perioperative analgesia focused little on potential long-term effects. We encourage the assessment of long-term pain outcomes.
Comparing Conservative and Early Surgical Treatments for Pyogenic Spondylodiskitis: An International Propensity Score–Matched Retrospective Outcome Analysis
Authors: Neuhoff Jonathan , Kramer Andreas , Thavarajasingam Santhosh G. , Sutherland Rebecca K. , McCaughan Hugh , Joerger Ann-Kathrin , Wostrack Maria , Lyell Barrie , Berkulian Olga , Ponniah Hariharan Subbiah , Ramsay Daniele S. C. , Meyer Bernhard , Kandziora Frank , Shiban Ehab , Davies Benjamin , Demetriades Andreas K. , Ringel Florian
Published: October 2024

BACKGROUND AND OBJECTIVES:

Pyogenic spinal infections pose therapeutic challenges, with the optimal treatment approach remaining contentious. This study aimed to compare outcomes of conservative vs early surgical treatment (SuT) modalities in primary pyogenic spondylodiskitis through an international cohort analysis.

METHODS:

A retrospective outcome analysis was conducted of 392 patients from the United Kingdom and Germany, treated between 2017 and 2022 with primary pyogenic spondylodiskitis. Patients were stratified by treatment modality. Propensity score matching, facilitated by a directed acyclic graph and principal component analysis, was used to balance risk factors between the compared patient cohorts. Primary outcome was mortality rate, while secondary outcomes included hospitalization duration, infection relapse, and neurological status at discharge.

RESULTS:

The study included 95 patients undergoing conservative treatment, primarily treated in the United Kingdom, and 297 receiving SuT, predominantly in Germany. The mortality rate was notably higher in the conservative group (P < .001), while the surgical cohort experienced a shorter hospitalization duration (P < .01). After propensity score matching, 2 comparable cohorts of 95 patients each emerged. Subsequent analysis revealed a markedly increased mortality in the conservative group (24.2% for conservative treatment vs 4.2% for SuT, P < .001). Neither relapse nor neurological status at discharge showed significant differences between the groups.

CONCLUSION:

The study indicates that early surgical intervention may be more effective than conservative management in reducing mortality and hospital stay for patients with primary pyogenic spondylodiskitis. These findings highlight the need for prospective trials and more definitive treatment guidelines.
Understanding developmental system drift
Authors: McColgan Áine , DiFrisco James
Published: October 2024

Developmental system drift (DSD) occurs when the genetic basis for homologous traits diverges over time despite conservation of the phenotype. In this Review, we examine the key ideas, evidence and open problems arising from studies of DSD. Recent work suggests that DSD may be pervasive, having been detected across a range of different organisms and developmental processes. Although developmental research remains heavily reliant on model organisms, extrapolation of findings to non-model organisms can be error-prone if the lineages have undergone DSD. We suggest how existing data and modelling approaches may be used to detect DSD and estimate its frequency. More direct study of DSD, we propose, can inform null hypotheses for how much genetic divergence to expect on the basis of phylogenetic distance, while also contributing to principles of gene regulatory evolution.
Comparison of Surgery test scores using Concept Maps and Interactive Lectures among the Undergraduate Medical Students
Authors: Masood Zubia , Jawaid Masood , Aly Moyn , Muhammad Zubair
Published: October 2024

Objective: Concept Maps (CM) aid in the acquisition of new information, and comprehend prior knowledge with better retention. Their use is not explored in undergraduate surgical education in our country, hence this study aimed to compare the surgery test scores of undergraduate medical students taught by concept maps and interactive lectures.
Methods: This quasi-experimental study was carried out at the Department of Surgery, at a Private University Hospital among 60 students of fourth year MBBS from 2017-2018. The students were divided into Group-A taught by interactive lectures and Group-B taught by CM. Post class Multiple Choice Questions test was taken and scores were compared for immediate effects on knowledge and short term knowledge retention using the Unpaired t- test. A P-value of < 0.05 was considered significant.
Results: Our study reported a mean test score of 19.5 (2.75 ± 0.49) for the Group-A, while 21.1 (3.49 ± 0.65) for Group-B with a negative t value of 2.003 with a significant p-value of 0.05. This showed that the test scores of Group-A were lower than the scores of Group-B.
Conclusions: Concept Maps is an effective and promising way to give learners better understanding of complex concepts in short amounts of time. providing valuable evidence for instituting the use of concept maps as a continuous teaching strategy for medical students.
doi: https://doi.org/10.12669/pjms.40.10.10526
How to cite this: Masood Z, Jawaid M, Aly SM, Muhammad Z. Comparison of Surgery test scores using Concept Maps and Interactive Lectures among the Undergraduate Medical Students. Pak J Med Sci. 2024;40(10):2305-2308. doi: https://doi.org/10.12669/pjms.40.10.10526
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Comparison of fresh and frozen-thawed embryo transfer cycles in patients with low oocyte retrieval
Authors: Shi Hongzhi , Song Qi , Liu Jiajia , Li Chen , Liu Rongrong
Published: October 2024

Objective: To explore the choice of embryo transfer schemes for patients with low oocyte retrieval (≤ 3 oocytes).
Methods: A retrospective analysis was conducted on patients with oocyte yields ≤ 3 undergoing in vitro fertilization and embryo transfer (IVF-ET) and frozen embryo transfer (FET) at the Maternity & Child Care Center of Qinhuangdao Reproductive Medicine Department from January 2018 to December 2022. The data included 202 fresh cycles, with 104 cycles in Group-A and 98 cycles in Group-B. Additionally, 87 cycles involved the transfer of frozen embryos from fresh cycles that could not be transplanted for various reasons, with 31 cycles in Group-C and 56 cycles in Group-D. General patient information, embryo transfer details, and clinical pregnancy outcomes in both fresh and frozen cycles were statistically analyzed.
Results: No significant differences were observed between Groups A and C in age, anti-Müllerian hormone (AMH), basal follicle-stimulating hormone (bFSH), body mass index (BMI), duration of infertility, the proportion of patients with diminished ovarian reserve (DOR), oocyte retrieval count, usable embryo count, or the number of transplanted embryos (all p> 0.05). Advanced age was a risk factor for a decreased pregnancy rate, and FET significantly increased the pregnancy rate (p< 0.05, respectively).
Conclusion: For patients under 35 years old with low oocyte retrieval, it is recommended to freeze all embryos when available and then proceed with FET. For patients aged 35 and above, without reducing the pregnancy rate, fresh embryo transfer is recommended to minimize treatment cycle frequency and economic expenses.
doi: https://doi.org/10.12669/pjms.40.10.9269
How to cite this: Shi H, Song Q, Liu J, Li C, Liu R. Comparison of fresh and frozen-thawed embryo transfer cycles in patients with low oocyte retrieval. Pak J Med Sci. 2024;40(10):2251-2255. doi: https://doi.org/10.12669/pjms.40.10.9269
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Application and clinical efficacy of comprehensive nursing intervention in pelvic floor and bladder function recovery post-cervical cancer surgery
Authors: Zhao Qiang
Published: October 2024

Objective: To evaluate the clinical efficacy of comprehensive nursing intervention in pelvic floor and bladder function recovery post-cervical cancer surgery.
Method: This was a retrospective study. A total of 120 patients with cervical cancer undergoing radical surgery at Tangshan People’s Hospital from June 2021 to June 2023 were randomly divided into two groups (n=60 cases each group). The control group received routine nursing intervention, while the study group was provided with comprehensive nursing intervention. Comparative analysis was conducted on clinical indicators, postoperative complications, bladder and pelvic floor function recovery, and patient satisfaction before and after intervention in both groups.
Result: In the study group, ambulation time, gastrointestinal function recovery, duration of postoperative drainage tube placement, oral diet resumption time, duration of postoperative vaginal bleeding, and length of hospital stay were significantly shorter than in the control group (all p< 0.05). Bladder function recovery in the study group was superior to that in the control group (p< 0.05). The study group showed lower scores for anorectal disorders, urogenital disorders, and pelvic organ prolapse than the control group (p< 0.05, respectively). Patient satisfaction was 100% in the study group and 85% in the control group, suggesting a statistically significant difference between the two groups (p< 0.05).
Conclusion: Comprehensive nursing intervention deserve to be promoted as it can accelerate postoperative clinical recovery, reduce the incidence of surgical complications, improve pelvic floor and bladder function post-cervical cancer surgery, and enhance patient satisfaction with care.
doi: https://doi.org/10.12669/pjms.40.10.9271
How to cite this: Zhao Q. Application and clinical efficacy of comprehensive nursing intervention in pelvic floor and bladder function recovery post-cervical cancer surgery. Pak J Med Sci. 2024;40(10):2287-2292. doi: https://doi.org/10.12669/pjms.40.10.9271
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Gaucher disease – a comprehensive review of clinical characteristics, diagnostic algorythms and current therapies
Authors: Kotula Alicja , Kucy Natalia , Czachor Adrianna , Kula Paula , Haber Mateusz , Grelewicz Olga , Servaas Elwira , Juśkiewicz Adam , Pilcicka Alicja
Published: October 2024

Gaucher disease (GD) is an autosomal recessive lysosomal storage disorder caused by mutations in the GBA1 gene, which encodes the enzyme glucocerebrosidase. This enzyme is crucial for breaking down glucocerebrosides, and its deficiency leads to their accumulation in the monocyte-macrophage system, forming Gaucher cells. These cells build up in the bone marrow, spleen, and liver, causing various clinical manifestations. GD is classified into three types based on clinical features and progression: GD1 (non-neuronopathic), GD2 (acute neuronopathic), and GD3 (subacute neuronopathic).
GD1, the most common form, usually presents with splenomegaly, hepatomegaly, anemia, thrombocytopenia, and skeletal symptoms and has a relatively mild course. GD2 is marked by severe neurological involvement, with a poor prognosis and a maximum survival of three years. GD3 features a mix of visceral, hematological, neurological, and skeletal symptoms, with a variable prognosis depending on the subtype.
Epidemiologically, GD is rare in the general population but more common among Ashkenazi Jews, who have a higher carrier frequency and prevalence. The genetic basis of GD is well-documented, with several mutations associated with different disease severities and outcomes. Diagnostic procedures include a comprehensive medical history, imaging studies, and biochemical and genetic tests to confirm reduced glucocerebrosidase activity and identify GBA1 mutations.
Current treatments focus on enzyme replacement therapy (ERT) and substrate reduction therapy (SRT), with supportive care for specific symptoms. ERT is the primary treatment for all children with GD1 and GD3 and for adults who meet certain criteria, while SRT is an alternative for milder forms of GD1. Despite advances in treatment, managing GD remains complex, requiring a multidisciplinary approach to address the diverse clinical manifestations and improve patient outcomes.
Fotoperiodistas en la prensa local y regional. El caso del Diario Hoy en Extremadura (España).
Authors: Trabadela-Robles Javier , García-Ramírez Lucas
Published: October 2024

Ante la necesidad de estudios sobre los fotoperiodistas de medios locales y regionales, la presente investigación trata el caso del Diario Hoy de Extremadura. Se realiza un estudio descriptivo histórico de los fotógrafos de prensa de la cabecera de referencia en Extremadura con el objetivo de poner en valor su labor y su autoría, apenas apreciada por estar siempre su obra a la sombra de la información textual. Para esto, mediante un análisis de la hemeroteca del diario, además de publicaciones previas, se estudia a los fotoperiodistas que han desarrollado o desarrollan su profesión en el área local de Badajoz y han publicado su trabajo de forma asidua, durante largos períodos de tiempo (al menos seis meses) en los más de 90 años de vida del medio. Además, se realiza una entrevista semiestructurada a los autores que ha sido posible, con el objetivo de obtener información complementaria de interés. El resultado obtenido es una cronología exhaustiva de los fotoperiodistas, así como la concienciación de la importancia de mantener vivo su legado, lo que incluye preservar sus archivos personales. Resulta destacable que, como consecuencia de la investigación, se va a poder conservar el archivo de uno de los autores de trayectoria más larga, Alfonso Rodríguez, ya retirado, quien lo ha donado a la Fundación CB, que se va a encargar de su catalogación, digitalización, conservación y puesta a disposición de la ciudadanía
Trading Flexibility for Adoption: From Dynamic to Static Walking in Ride-Sharing
Authors: Yan Julia , Martin Sébastien , Taylor Sean J.
Published: October 2024

On-demand ride-sharing aims to fulfill riders’ transportation needs whenever and wherever they want. Although this service level appeals to riders, overall system efficiency can improve substantially if riders are willing to be flexible. Here, we explore riders’ flexibility in space via walking to more accessible pickup locations. Ride-sharing platforms have traditionally implemented dynamic walking to optimize rider pickup locations and rider-driver assignment jointly. We propose an alternative that we call static walking, which presents a predetermined pickup location to the rider before optimizing rider-driver assignment. Although dynamic walking enables more efficient matching of riders and drivers, we hypothesize that riders prefer static walking because of the certainty of the pickup location before booking the ride. Using simulations on Lyft data, we show that static walking can capture up to 96% of the value of dynamic walking in congested urban networks at a fixed adoption rate. Furthermore, experimentation on Lyft’s user interface suggests that providing riders with information on pickup location before an opt-in decision can increase walking adoption—to the extent that static walking may outperform dynamic walking overall. More broadly, this study highlights the importance of carefully designing flexibility mechanisms on platforms: a little flexibility goes a long way, especially when flexibility presents a barrier to adoption.

This paper was accepted by J. George Shanthikumar, data science.

Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2022.03201 .