bluuebunny/crossref_metadata_2025 huggingface dataset:
Potential to be more effective: Reduction in lower urgency emergency department presentations during theCOVID‐19 period in New South Wales, Australia
Authors: Zhao Jiaying , Powell Ian , Chessman Julia
Published: October 2022

Objective

Diverting lower urgency ED presentations to more suitable healthcare is a key goal of several healthcare systems. During the early stages of the COVID‐19 pandemic in 2020, there was a substantial drop in ED presentations in New South Wales (NSW), potentially because of lower risk of illness and injury through social restrictions, or ED avoidance for lower urgent care. The present study aimed to better understand the impact of social restrictions during the pandemic on ED presentations, to inform potential shifts to alternative modes of care in emergency medicine.

Methods

We conducted a quasi‐experimental study of public ED presentations in NSW. We compared changes in weekly ED presentation counts by urgency, during and after the period of tightest social restrictions in contrast to the baseline period. Expected weekly counts were estimated using segmented quasi‐Poisson regression, accounting for age and seasonality.

Results

Lower urgency presentations fell more than mid‐high urgency presentations, both during and after the period of tightest social restrictions. Lower urgency presentations reduced 30.9% compared to the baseline period during tightest restrictions, in contrast to 20.9% reduction for mid‐high urgency presentations. Lower urgency presentations remained 14.4% lower after the tightest restrictions compared to the baseline period, whereas mid‐high urgency presentations returned to usual levels.

Conclusions

This finding suggests that reducing lower urgency ED presentation beyond the COVID‐19 pandemic maybe feasible, by supporting alternative, more appropriate sources of care.
Super‐selective Gelfoam embolisation in high‐flow priapism
Authors: Yap Joshua D , Power Mark A
Published: October 2022

Introduction

High‐flow priapism is a rare condition with limited data in the literature, particularly in Australia. There is therefore no clear consensus regarding treatment. We aim to present our institutional network experience in managing this condition over the last decade with super‐selective gelatin sponge (Gelfoam) embolisation of the internal pudendal artery.

Methods

We retrospectively searched for and reviewed the patient records of all cases of priapism encountered within our multicentre institutional network over the last 10 years. Of these, the cases of high‐flow priapism treated with embolisation were analysed in depth and compared with the current literature.

Results

Overall, 93 patients in our network were diagnosed with priapism from 1 January 2012 to 1 January 2022. And 89 of these patients (96%) had low‐flow priapism and four patients (4%) had high‐flow priapism. Of these four patients, two were treated within our network with super‐selective Gelfoam embolisation of the internal pudendal artery. Following embolisation, both patients achieved rapid detumescence and returned to baseline premorbid erectile function. There was no report of recurrence or erectile dysfunction on follow‐up.

Conclusion

Super‐selective embolisation of the internal pudendal artery should be considered as a treatment option for high‐flow priapism, with Gelfoam as an appropriate temporary embolic agent of choice. We show that it was a safe and effective option for the patients treated in this series, enabling quick and long‐term return to baseline erectile function. Our results support data provided by the limited number of cases in the literature.
Discovery of Early Tonian Calc‐alkaline and Shoshonitic Metamafic Rocks from the North Purulia Shear Zone, Chhotanagpur Gneissic Complex, Eastern India: Implications of Proterozoic Sub‐continental Lithospheric Mantle
Authors: GOSWAMI Bapi , DAS Susmita , BASAK Ankita , BHATTACHARYYA Chitta
Published: October 2022

Reports of shoshonitic rocks in Precambrian terrains are relatively rare. Pl‐Grt amphibolites and Hbl‐Bt mafic granulites occurring in the migmatitic gneisses of the Chhotanagpur Gneissic Complex (CGC) show calc‐alkaline and shoshonitic characteristics. Relict porphyritic, sub‐ophitic and poikilitic textures are noted in these rocks. Their parent magma was emplaced during the waning phase of the regional metamorphism. Geochemically, these metamafics are similar to the Group III potassic and ultrapotassic rocks of Foley et al. (1987). The magma was derived from the metasomatized subcontinental lithospheric mantle (SCLM). Subduction‐related sediment melts metasomatized the SCLM. Compositionally, the SCLM is a metasomatized phlogopite‐amphibole‐spinel‐bearing harzburgite. 1%–5% batch melting of the SCLM could produce the parental magma of the mafic granulites. Pressures and temperatures of metamorphic equilibration were carried out by pseudosection modeling. Peak metamorphic assemblage (M1: Grt‐Cpx‐Pl‐Qz) in garnetiferous amphibolite equilibrated at 740°C and 8.7 kbar. The Cpx‐Pl corona appeared around the garnet during decompression (M2: 655°C, 6 kbar). The Hbl‐Pl symplectites around garnet formed during isobaric cooling (M3: 580°C and 5.9 kbar). The emplacement of shoshonitic magma and subsequent decompression happened at the slab break‐off stage of continental collision (∼990 Ma).
Influence of Acid Treatment on Pore Structure and Fractal Characterization of a Tight Sandstone: A Case Study from Wudun Sag, Dunhuang Basin
Authors: GENG Weile , WANG Jiandong , ZHANG Xuecai , WANG Jun , DONG Chenqiang , ZHOU Guangqing , HUANG Gun , LI Lin
Published: October 2022

In this study, X‐ray diffraction, N2adsorption (N2A), and mercury intrusion (MI) experiments were used to investigate the influence of acid treatment on pore structure and fractal characterization of tight sandstones. The results showed that acid treatment generated a certain number of ink‐bottle pores in fine sandstone, aggravated the ink‐bottle effect in the sandy mudstone, and transformed some smaller pores into larger ones. After the acid treatment, both the pore volume in the range of 2–11 nm and 0.271–8 μm for the fine sandstone and the entire pore size range for the sandy mudstone significantly increased. The dissolution of sandstone cement causes the fine sandstone particles to fall off and fill the pores; the porosity increased at first but then decreased with acid treatment time. The fractal dimension obtained using the Frenkel‐Halsey‐Hill model was positively correlated with acid treatment time. However, the total fractal dimensions obtained by MI tests showed different changes with acid treatment time in fine sandstone and sandy mudstone. These results provide good guiding significance for reservoir acidification stimulation.
Risk factors and protective factors for alcohol‐related liver disease: A systematic review and meta‐analysis
Authors: Zhang Ru , Tang Zongzhe , Xu Wenjie , Ding Yajie , Zhang Mengting , Guan Qing , Jiang Rong , Chen Yue , Hua Yingxue , Wang Jie
Published: October 2022

Background

Although alcohol‐related liver disease (ALD) is a global health threat, there are no specific effective treatments for it. Thus, efforts at preventing ALD are important and could be enhanced by using strategies based on validated risk and protective factors for the disease.

Methods

The literature on factors influencing the risk for ALD was systematically searched from PubMed, Embase, and the Cochrane library databases from inception to June 2022. Factors suitable for quantitative analysis were submitted to meta‐analysis using fixed‐effects and random‐effects models to calculate each factor's risk ratio (RR) and 95% confidence interval (CI).

Results

Ten cohort studies (covering 1,005,339 subjects) that reported a clear causal relationship were included in the analysis, involving 11 potential risk factors (sex, race, education level, body mass index, alcohol consumption, types of alcoholic beverage, duration of drinking, drinking frequency, smoking, coffee consumption, and tea consumption). Three of these factors (sex, alcohol consumption, and smoking) were subjected to meta‐analysis, and the results showed that male sex (RR = 2.84, 95% CI = 1.86–4.36), alcohol consumption ≥280 g/week (RR = 4.96, 95% CI = 2.71–9.07), and smoking (RR = 2.39, 95% CI = 1.97–2.89) were risk factors for ALD.

Conclusions

Many factors are likely to influence the incidence of ALD, and male sex, heavy alcohol consumption, and smoking increase the risk of ALD. The relationship between other factors and ALD risk needs further evaluation.
Scanning electron microscopic and histological features of the oral cavity of the Egyptian tortoise (Testudo kleinmanni)
Authors: Abumandour Mohamed M. A. , Morsy Kareem , Abumandour Ramzy , El‐Bakary Neveen , Rashwan Ahmed , Elghoul Mahmoud
Published: October 2022

This investigation was led to depict the structural and functional adaptations of the oral cavity of herbivorous Egyptian tortoises using scanning electron and light microscopes. The SEM showed that the triangular papillary tongue possessed three conical papillary subtypes: the rectangular conical on the tip, the round conical on the rest of the dorsal lingual surface and the elongated conical on the caudal portion of the lingual wing. The presence of the serrated lips with their valves compensated for the absence of the teeth. The rostral part had a vomeronasal opening while the middle part had the choana, but the caudal part had numerous openings of the salivary glands. There are three palatine folds: a single median palatine fold, two peripheral palatine folds and the choanal fold. The current histological results show the keratinized dorsal lingual surface, in which the keratinized layer extended to cover the papillae. Two types of lingual glands, according to their position, are papillary superficial and deep lingual glands. Papillary or superficial glands open in the interpapillary spaces via narrow openings, while the deep glands are surrounded by well‐developed muscles and open via wide openings on the dorsal lingual surface. An entoglossal cartilaginous structure of hyaline cartilage was found in the mid‐ and hindtongue, with numerous chondrocytes lodged within the lacunae. Our results conclude that the oral cavity of the herbivorous Egyptian tortoise was adapted to the dietary and vigorous demands of the Egyptian fauna.
Learning from complaints to the Health and Disability Commission Office: A case study into indicators of deterioration in aged residential care organisations in New Zealand
Authors: Mowat Rebecca , Dewar Jan , Ram Felix
Published: October 2022

Objective

To identify trends in complaints received by the Health and Disability Commissioner (HDC) about aged residential care (ARC) facilities in order to learn from and implement positive changes in care.

Methods

A case study of 24 deidentified publicly available HDC cases across three large New Zealand ARC organisations was completed. Cross‐case analysis first involved analysis of each case individually and then compared all cases using inductive thematic analysis with the intention of drawing a single set of conclusions.

Results

The speed at which the events occurred was contributory to the complaint, with 58% of the cases being rapid in nature and with sepsis being the predominant contributing factor to rapid decline and death. Six main diagnoses were indicators of deterioration: nutrition/hydration was indicated in 22% of the cases, followed by sepsis 17%, wounds 17%, UTI/renal issues 15%, falls 15% and respiratory issues 15%.

Conclusions

Trends in Health and Disability complaints across multiple organisations can become a powerful tool for widespread quality improvement. This review highlights that the speed of deterioration triggered many complaints, especially in cases of sepsis which is possibly overlooked as a contributing problem. Also, that nutrition/hydration was indicated in many complaints and is an important condition‐indicator. Trends in complaints are not generalisable to all large organisations; however, they can be applied to individual facilities.
Causes and costs of delayed closure of ileostomies in rectal cancer patients in Australasian units
Authors: Barnard Jon , Milne Tony , Teo Keith , Weston Maree , Israel Lincoln , Peng Sze‐Lin
Published: October 2022

Background

Defunctioning loop ileostomies (DLIs) are a frequent adjunct to rectal cancer surgery. Delayed closure of DLIs is common and associated with increased morbidity. The reasons for delayed DLI closure are often unknown. The economic burden of delayed DLI closure is not quantified. The present study aimed to determine the reasons for, and economic burden of, delayed DLI closure.

Methods

Clinical and economic data were audited from a prospective database of patients in two Australasian colorectal cancer centres. Patients treated at each unit with low/ultra‐low anterior resection for rectal cancer with formation of DLI between January 2014 and December 2019 were included. Post‐operative complication rate, stoma‐related complication rate and costs of hospital admissions and stoma care were recorded and analysed. Multivariate linear regression analysis was used to investigate risk factors for delay to closure.

Results

146 patients underwent low/ultra‐low anterior resection with DLI; 135 patients (92.5%) underwent reversal. The median duration to reversal was 7 months (IQR 4.5–9.5). Sixty‐six percent of patients underwent reversal >6 months after their index surgery. Neoadjuvant and adjuvant chemotherapy were associated with delayed reversal (P < 0.001). Non‐English speakers waited longer for DLI closure (P = 0.028). The costs of outpatient stoma care (P < 0.001), post‐operative care (P = 0.004), and total cost of treatment (P = 0.014) were significantly higher in the delayed closure group, with a total cost of treatment difference of $3854 NZD per patient.

Conclusions

Causes of delay include systemic factors and demographic factors that can be addressed directly, addressing such causes may alleviate a significant economic burden.
Evaluation of complications, conversion rate, malignancy rate, and, surgeon's experience in laparoscopic assisted supracervical hysterectomy (LASH) of 1274 large uteri: A retrospective study
Authors: Tchartchian Garri , Bojahr Bernd , Krentel Harald , De Wilde Rudy L.
Published: October 2022

Introduction

Hysterectomy now belongs to standard gynecological procedures. Moreover, a shift towards laparoscopic techniques is ever more apparent as they provide many advantages such as less traumatization and shorter convalescence. Large uteri are still mentioned as contraindications for laparoscopic hysterectomy even though those patients might benefit from the lower morbidity associated with minimal invasive techniques. In this study, the largest reported so far, we analyzed intraoperative and postoperative complications as well as the surgeon's experience of laparoscopic assisted supracervical hysterectomy (LASH) in patients with a uterus weight over 500 g.

Material and Methods

The present retrospective study, between June 27, 1998 and August 31, 2019, evaluates 1274 patients with a uterus weight over 500 g who were treated with LASH for benign uterine diseases at the Clinic for Minimal Invasive Surgery (Berlin, Germany). All surgeries were performed by one of four in‐house surgeons with experience in LASH: they had performed at least 500 LASH procedures before the study. Patients receiving surgical treatment for malignant tumors were not included in the study. Major and minor intraoperative and postoperative complications were recorded and evaluated. Additionally, medical files were evaluated for demographic data, American Society of Anesthesiologists score (I–IV), name of the surgeon, duration and indication for surgery, history of previous gynecological procedures and concomitant surgical interventions, weight of removed uterine tissue, duration of postoperative hospitalization in patients with complications, intraoperative conversion from laparoscopy to laparotomy, and malignancy rate.

Results

The mean age was 47.0 ± 7.3 years and mean body mass index was 25.6 ± 7.1 kg/m2. Average parity was 1.04 ± 1.57. Average uterus weight was 761.8 ± 317.9 g (500–4065 g). The mean duration of surgery was 96.9 ± 49.5 min; 54% of all patients were treated without concomitant intervention, conversion rate was 2.12%. The malignancy rate was 0.4% and the complication rate was 6.81% with 1.36% intraoperative complications and 5.45% postoperative complications.

Conclusions

The overall low complication and malignancy rates observed in this study allow us to present LASH as a safe and efficient alternative laparoscopic approach to remove uteri of any size in the hands of experienced surgeons.
Longitudinal reflections on the slow and fast crisis of domestic violence during COVID‐19
Authors: Cuomo Dana
Published: October 2022

This paper draws on a four‐year qualitative study that examines changes to legal processes related to the response to domestic violence in Seattle that began before and continued through the COVID‐19 pandemic, to examine a series of crisis temporalities that were exacerbated by the pandemic and associated lockdowns. In reflecting on the crisis temporalities that mark this research project, I underscore how such crises can also create conditions that lead to long overdue social change. In this case, the modernisation of a court system that for too‐long served as an obstacle to survivors' legal protection and facilitated abusers' ability to engage in slow violence during Domestic Violence Protection Order (DVPO) hearings. This paper thus highlights the ‘temporal affordances’ of longitudinal research that enable analysis to better understand the factors that motivate transition over time, particularly those in traditional institutions like the legal system.
Big data and innovative organizational performance: Evidence from a moderated‐mediated model
Authors: Demir Mahmut , Demir Şirvan Şen , Yaşar Emre
Published: October 2022

Big data in hotels is crucial in new business models, processes and methods for improving innovative organizational performance. This study investigates how big data and its sharing directly impact innovative organizational performance through big data analytics capabilities. Research data collected from 438 participants at 36 five‐star hotels were analysed using structural equation models. The analysis found that using and sharing big data in hotels directly affects big data analytics capabilities and innovative organizational performance. Furthermore, analytical capacities mediate between using and sharing big data and creative organizational performance. These results have some theoretical and practical implications.
Trajectories of self‐management and independence in youth with spina bifida: Demographic predictors of growth
Authors: Ridosh Monique M. , Adams William , Magaña Fabiola , Sawin Kathleen J. , Holmbeck Grayson N.
Published: October 2022

Aim

The purpose of this study was to examine the trajectories of condition and independent living self‐management in youth with spina bifida (SB).

Methods

A diverse sample of adolescents and young adults (AYAs) with SB completed the Adolescent/Young Adult Self‐Management and Independence Scale (AMIS‐II) across four time points. Parents reported on demographic characteristics including age, sex, race/ethnicity, and family income. Growth in self‐management and its subscales (condition and independent living) were estimated using linear mixed‐effect models as a function of respondents' demographics.

Results

This study included 99 respondents age 18 to 27 years old. About half were female (52.5%) and White (52.5%); 15.2% were Black, and about a third were Hispanic/Latino (32.3%). Eighty‐seven AYAs (87.9%) had myelomeningocele. The lesion level was 31.3% sacral, 48.5% lumbar and 18.2% thoracic. A third of the families earned less than 50K. Overall, self‐management growth was dependent on age, sex, and race/ethnicity, but not income. Growth in condition self‐management depended on sex; only males demonstrated increasing growth (
 = 0.11, p < 0.001). Black participants endorsed higher increasing total and condition self‐management when compared with White (
diff = 0.17 and 0.17, respectively, both p < 0.05) and Hispanic/Latino (
diff = 0.18 and 0.21, respectively, both p = 0.02) respondents.

Conclusion

This study provides evidence of differences in growth of self‐management by demographic/social determinants of health. Possible reasons for differences are discussed. Predictors of changes in self‐management behaviours over time in young adults with SB can identify subgroups in need of further study.
Harmonic Shape Interpolation on Multiply‐connected Planar Domains
Authors: Dongbo Shi , Renjie Chen
Published: October 2022

Shape interpolation is a fundamental problem in computer graphics. Recently, there have been some interpolation methods developed which guarantee that the results are of bounded amount of geometric distortion, hence ensure high quality interpolation. However, none of these methods is applicable to shapes within the multiply‐connected domains. In this work, we develop an interpolation scheme for harmonic mappings, that specifically addresses this limitation. We opt to interpolate the pullback metric of the input harmonic maps as proposed by Chen et al. [CWKBC13]. However, the interpolated metric does not correspond to any planar mapping, which is the main challenge in the interpolation problem for multiply‐connected domains. We propose to solve this by projecting the interpolated metric into the planar harmonic mapping space. Specifically, we develop a Newton iteration to minimize the isometric distortion of the intermediate mapping, with respect to the interpolated metric. For more efficient Newton iteration, we further derived a simple analytic formula for the positive semidefinite (PSD) projection of the Hessian matrix of our distortion energy. Through extensive experiments and comparisons with the state‐of‐the‐art, we demonstrate the efficacy and robustness of our method for various inputs.
Localized Shape Modelling with Global Coherence: An Inverse Spectral Approach
Authors: Pegoraro M. , Melzi S. , Castellani U. , Marin R. , Rodolà E.
Published: October 2022

Many natural shapes have most of their characterizing features concentrated over a few regions in space. For example, humans and animals have distinctive head shapes, while inorganic objects like chairs and airplanes are made of well‐localized functional parts with specific geometric features. Often, these features are strongly correlated – a modification of facial traits in a quadruped should induce changes to the body structure. However, in shape modelling applications, these types of edits are among the hardest ones; they require high precision, but also a global awareness of the entire shape. Even in the deep learning era, obtaining manipulable representations that satisfy such requirements is an open problem posing significant constraints. In this work, we address this problem by defining a data‐driven model upon a family of linear operators (variants of the mesh Laplacian), whose spectra capture global and local geometric properties of the shape at hand. Modifications to these spectra are translated to semantically valid deformations of the corresponding surface. By explicitly decoupling the global from the local surface features, our pipeline allows to perform local edits while simultaneously maintaining a global stylistic coherence. We empirically demonstrate how our learning‐based model generalizes to shape representations not seen at training time, and we systematically analyze different choices of local operators over diverse shape categories.
Smooth Interpolating Curves with Local Control and Monotone Alternating Curvature
Authors: Binninger Alexandre , Sorkine‐Hornung Olga
Published: October 2022

We propose a method for the construction of a planar curve based on piecewise clothoids and straight lines that intuitively interpolates a given sequence of control points. Our method has several desirable properties that are not simultaneously fulfilled by previous approaches: Our interpolating curves are C2 continuous, their computation does not rely on global optimization and has local support, enabling fast evaluation for interactive modeling. Further, the sign of the curvature at control points is consistent with the control polygon; the curvature attains its extrema at control points and is monotone between consecutive control points of opposite curvature signs. In addition, we can ensure that the curve has self‐intersections only when the control polygon also self‐intersects between the same control points. For more fine‐grained control, the user can specify the desired curvature and tangent values at certain control points, though it is not required by our method. Our local optimization can lead to discontinuity w.r.t. the locations of control points, although the problem is limited by its locality. We demonstrate the utility of our approach in generating various curves and provide a comparison with the state of the art.
Topological Simplification of Nested Shapes
Authors: Zeng D. , Chambers E. , Letscher D. , Ju T.
Published: October 2022

We present a method for removing unwanted topological features (e.g., islands, handles, cavities) from a sequence of shapes where each shape is nested in the next. Such sequences can be found in nature, such as a multi‐layered material or a growing plant root. Existing topology simplification methods are designed for single shapes, and applying them independently to shapes in a sequence may lose the nesting property. We formulate the nesting‐constrained simplification task as an optimal labelling problem on a set of candidate shape deletions (“cuts”) and additions (“fills”). We explored several optimization strategies, including a greedy heuristic that sequentially propagates labels, a state‐space search algorithm that is provably optimal, and a beam‐search variant with controllable complexity. Evaluation on synthetic and real‐world data shows that our method is as effective as single‐shape simplification methods in reducing topological complexity and minimizing geometric changes, and it additionally ensures nesting. Also, the beam‐search strategy is found to strike the best balance between optimality and efficiency.
Pioglitazone reduces epicardial fat and improves diastolic function in patients with type 2 diabetes
Authors: Moody Alexander J. , Molina‐Wilkins Marjorie , Clarke Geoffrey D. , Merovci Aurora , Solis‐Herrera Carolina , Cersosimo Eugenio , Chilton Robert J. , Iozzo Patricia , Gastaldelli Amalia , Abdul‐Ghani Muhammad , DeFronzo Ralph A.
Published: October 2022

Aims

To examine the effect of pioglitazone on epicardial (EAT) and paracardial adipose tissue (PAT) and measures of diastolic function and insulin sensitivity in patients with type 2 diabetes mellitus (T2DM).

Methods

Twelve patients with T2DM without clinically manifest cardiovascular disease and 12 subjects with normal glucose tolerance (NGT) underwent cardiac magnetic resonance imaging to quantitate EAT and PAT and diastolic function before and after pioglitazone treatment for 24 weeks. Whole‐body insulin sensitivity was measured with a euglycaemic insulin clamp and the Matsuda Index (oral glucose tolerance test).

Results

Pioglitazone reduced glycated haemoglobin by 0.9% (P < 0.05), increased HDL cholesterol by 7% (P < 0.05), reduced triacylglycerol by 42% (P < 0.01) and increased whole‐body insulin‐stimulated glucose uptake by 71% (P < 0.01) and Matsuda Index by 100% (P < 0.01). In patients with T2DM, EAT (P < 0.01) and PAT (P < 0.01) areas were greater compared with subjects with NGT, and decreased by 9% (P = 0.03) and 9% (P = 0.09), respectively, after pioglitazone treatment. Transmitral E/A flow rate and peak left ventricular flow rate (PLVFR) were reduced in T2DM versus NGT (P < 0.01) and increased following pioglitazone treatment (P < 0.01‐0.05). At baseline normalized PLVFR inversely correlated with EAT (r = −0.45, P = 0.03) but not PAT (r = −0.29, P = 0.16). E/A was significantly and inversely correlated with EAT (r = −0.55, P = 0.006) and PAT (r = −0.40, P = 0.05). EAT and PAT were inversely correlated with whole‐body insulin‐stimulated glucose uptake (r = −0.68, P < 0.001) and with Matsuda Index (r = 0.99, P < 0.002).

Conclusion

Pioglitazone reduced EAT and PAT areas and improved left ventricular (LV) diastolic function in T2DM. EAT and PAT are inversely correlated (PAT less strongly) with LV diastolic function and both EAT and PAT are inversely correlated with measures of insulin sensitivity.
Age‐specific associations between the number of co‐morbidities, all‐cause mortality and public direct medical costs in patients with type 2 diabetes: A retrospective cohort study
Authors: Hong Sabrina Nan , Mak Ivy Lynn , Chin Weng Yee , Yu Esther Yee Tak , Tse Emily Tsui Yee , Chen Julie Yun , Wong Carlos King Ho , Chao David Vai Kiong , Tsui Wendy Wing Sze , Lam Cindy Lo Kuen , Wan Eric Yuk Fai
Published: October 2022

Aim

To evaluate the association between the number of co‐morbidities, all‐cause mortality and public health system expenditure in patients with type 2 diabetes (T2D) across different age groups.

Materials and Methods

A retrospective observational study of T2D patients using electronic health records in Hong Kong was conducted. Patients were stratified by age (< 50, 50‐64, 65‐79, ≥ 80 years) and the number of co‐morbidities (0, 1, 2, 3, ≥ 4), defined using the Charlson Comorbidity Index and prevalent chronic diseases identified in local surveys. The association between the number of co‐morbidities, all‐cause mortality and direct medical costs was examined using Cox proportional hazard regression and the gamma generalized linear model with log link function.

Results

A total of 262 212 T2D patients with a median follow‐up of 10 years were included. Hypertension and dyslipidaemia were the most common co‐morbidities in all age groups. After age stratification, cardiovascular diseases dominated the top pair of co‐morbidities in the older age groups (65‐79 and ≥ 80 years), while inflammatory and liver disease were predominant among younger individuals. Compared with co‐morbidity–free T2D patients, the hazard ratios (95% CI) of death for patients aged younger than 50 and 80 years or older with two co‐morbidities were 1.31 (1.08‐1.59) and 1.25 (1.15‐1.36), respectively, and increased to 3.08 (2.25‐4.21) and 1.98 (1.82‐2.16), respectively, as the number of co‐morbidities increased to four or more. Similar trends were observed for medical costs.

Conclusions

Age‐specific co‐morbidity patterns were observed for patients with T2D. A greater number of co‐morbidities was associated with increased mortality and healthcare costs, with stronger relationships observed among younger patients.
An Evaluation of Automatic Item Generation: A Case Study of Weak Theory Approach
Authors: Fu Yanyan , Choe Edison M. , Lim Hwanggyu , Choi Jaehwa
Published: October 2022

This case study applied the weak theory of Automatic Item Generation (AIG) to generate isomorphic item instances (i.e., unique but psychometrically equivalent items) for a large‐scale assessment. Three representative instances were selected from each item template (i.e., model) and pilot‐tested. In addition, a new analytical framework, differential child item functioning (DCIF) analysis, based on the existing differential item functioning statistics, was applied to evaluate the psychometric equivalency of item instances within each template. The results showed that, out of 23 templates, nine successfully generated isomorphic instances, five required minor revisions to make them isomorphic, and the remaining templates required major modifications. The results and insights obtained from the AIG template development procedure may help item writers and psychometricians effectively develop and manage the templates that generate isomorphic instances.
Improving distress perception and mutuality in migraine caregivers after 6 months of galcanezumab treatment
Authors: Fofi Luisa , Altamura Claudia , Fiorentini Giulia , Brunelli Nicoletta , Marcosano Marilena , Barbanti Piero , Vernieri Fabrizio
Published: October 2022

Objective

This prospective cohort, real‐life study aimed to evaluate whether galcanezumab, a monoclonal antibody anti‐calcitonin gene‐related peptide (CGRP) ligand, can reduce caregivers' distress and improve their mutuality with patients.

Background

Migraine is a highly disabling chronic disease that negatively impacts patients' and often their relatives' lives, occurring during an active phase of life with direct consequences on leisure‐ and work‐related activities. The figure of caregiver is crucial in several neurological conditions but poorly accounted for in migraine care so far. Studies on monoclonal antibodies against the CGRP pathway, recently introduced as migraine‐preventive treatments, demonstrated that they significantly reduce migraine frequency and disability in the first weeks of treatment.

Methods

Consecutive patient‐caregiver dyads were evaluated at baseline and after 6 months of treatment with galcanezumab (V6) at our headache center from September 2020 to September 2021. Enrolled patients were requested to report their monthly migraine days, monthly intake of acute medications, attack pain intensity (on the Numeric Rating Scale), concomitant preventives, and disability questionnaires (Headache Impact Test, Migraine Disability Assessment). Each dyad filled in the Mutuality Scale to check their reciprocity; moreover, the Relatives' Stress Scale was used to detect caregivers' distress.

Results

We enrolled 27 patient‐caregiver dyads. At 6 months, migraine burden significantly improved with reductions in monthly migraine days (falling from 14.8 [SD = 4.8] days by 10.3 [SD = 4.8] days; 95% CI: 8.4, 12.2; p < 0.001) and Migraine Disability Assessment scores (lowering from 83.6 [SD = 46.7] by 71.5 points [SD = 49.3]; 95% CI: 51.2, 91.9; p < 0.001). From baseline to month 6, the caregiver Relatives' Stress Scale score significantly decreased (falling from 20.7 [SD = 13.7] by 6.5 [SD = 14.1] points; 95% CI: 0.8, 12.2; p = 0.027), while the Mutuality Scale's caregiver total score increased (from 3.04 [SD = 0.61] by 0.29 [SD = 0.49] points; 95% CI: −0.508, −0.064; p = 0.014).

Conclusions

Our findings preliminarily demonstrated that patients' migraine improvement after 6 months of galcanezumab treatment could be favorably perceived by caregivers, significantly reducing their distress with better reciprocity within the dyad.
Triacylglycerol characterisation of Moringa oleifera seed oil by LC‐Q‐TOF and ESI
Authors: Jayanti Latifun , Yuliyanti Dewi , Zhan Zhaoqi , Hou Peiling , Mulyono Karyanto E. , Wassell Paul
Published: October 2022

Currently, in the analysis of triacylglycerol (TAG) composition of the Moringa oleifera seed oil (MOSO), there are still approximately 13.9% of TAG still unknown. Reverse‐phase high‐performance liquid chromatography (HPLC) coupled to a refractive index detector (RID) has previously been applied for the identification of TAG in MOSO. A new approach focuses on the properties of the fatty acid assay and the full characterisation of TAGs. Identification and determination of TAG compositions in MOSO were done by LC‐Q‐TOF (LCMS‐9030) with ESI interface and HCOONH4 (ammonium formate) additive in the mobile aqueous phase. Triolein (OOO) was 39.3% and is the dominant TAG in MOSO. This new method was able to fully characterise a total of 33 TAG compositions using accurate mass MS data and MS/MS spectra.
Multifunctional ultralight, recoverable, piezoresistive, and super thermal insulating SiC nanowire sponges
Authors: Chen Yu , Han Lei , Ola Oluwafunmilola , Liu Guangsheng , Wang Nannan , Saadi Zakaria , Neves Ana I. S. , Tabari Rana Sabouni , Thummavichai Kunyapat , Khalil Ahmed M. E. , Xia Yongde , Sun Shibin , Zhu Yanqiu
Published: October 2022

Ultralight three‐dimensional (3D) architectured silicon carbide (SiC) nanowire sponges with integrated properties of recoverable compressibility, outstanding high‐temperature thermal and chemical stability, and fire‐retardance have been actively pursued in recent years. However, efficient construction of SiC nanowire sponges with well‐controlled overall shapes and distribution of SiC nanowires remains challenging. Herein, by coupling the electrospinning technique and carbothermal reduction process, we have developed a new fabrication process for highly porous and free‐standing 3D SiC nanowire (SiCNW) sponges with closely attached nanowires through thermal treatment of stacked electrospun PAN/SiO2 nanofiber membranes. The resulting SiCNW sponges possess ultralow density (∼29 mg cm−3), excellent compressive recoverability from large compressive deformation (up to 40% strain), and fatigue resistance, which endow them with excellent piezoresistive sensing capability under a variety of complex conditions. Furthermore, the sponges display superb thermal insulation (thermal conductivity of 24 mW m−1K−1) and fire‐retardance. We believe that the present process provides technical clues for the development of other multifunctional ceramic sponges, and that further development of these ultralight multifunctional ceramic sponges offers potential for the design of advanced components for application in harsh engineering environments.
Effect of anthocyanin indicator addition on cellulose nanocrystals/gellan gum‐based intelligent packaging films
Authors: Yue Chongze , Huang Yinggang , Kong Boyang , Wang Guiying
Published: October 2022

Food spoilage often causes a change in pH inside the package. As a type of intelligent packaging, pH freshness indication packaging, with its simplicity, sensitivity, and efficiency, can monitor food quality and inform consumers promptly. In this study, Clitoria ternatea anthocyanin (CT) was added to gellan gum (GG), glycerol and cellulose nanocrystal (CNC) matrix to prepare a pH‐sensitive indicator film. The addition of CT disrupted the network structure, forming a new hydrogen bond and a smooth and continuous cross‐section of the film, giving the film excellent mechanical properties. The addition of CNC locked the CT firmly into the indicator film while improving the film's water resistance. Anthocyanin improved the light‐blocking ability of the film and gave an excellent pH response to the indicator film. The pH response tests showed a significant color change in the film at pH in the range of 3–12 when anthocyanin was added at 20% and 30%, suggesting the potential application of the developed intelligent indicator film in monitoring food freshness.

Novelty impact statement

Excellent mechanical properties (Tensile strength: 33.47 MPa; Elongation at break: 27.12%), even with the addition of anthocyanins.

High water contact angle (88.4°) provided excellent moisture resistance to the film.

Excellent pH responsiveness and new ideas for real‐time material monitoring of food packaging.
A or I‐A? Unifying the computational structures of process‐ and IO‐based LCA for clarity and consistency
Authors: Heijungs Reinout , Yang Yi , Park Hung‐Suck
Published: October 2022

Why are both and used in life cycle assessment (LCA) matrix computations? This is a question that, in our experience of teaching LCA, students often wonder about and struggle with. A brief survey of the literature suggests that the question can also confuse experienced LCA practitioners. Here, we seek to unify the computational structures of the two LCA approaches to achieve greater clarity and consistency, especially to make them easier to teach. We first show how small but crucial differences in the set‐up of the two approaches lead to the use of versus . Then, we discuss the options to unify the presentations in a coherent way. We do not prescribe one way or the other. A larger point we hope to stress is the importance of unification, which may have both pedagogical and methodological benefits.
Sustainability assessment of product systems in dire straits due to ISO 14040–14044 standards: Five key issues and solutions
Authors: Schaubroeck Thomas
Published: October 2022

Quintessential for a more sustainable society is adequate sustainability assessment to guide us. In the case of environmental impact assessment of product systems, life cycle assessment (LCA) is the main method, with associated variants covering other sustainability pillars. At the core of LCA practice are the standards set up by the International Organization for Standardization (ISO), namely ISO 14040–14044. However, I point out five key issues with these standards: (1) the presence of inconsistencies on crucial matters as pointed out in the literature; (2) a lack in major update since two decades; (3) mismanagement of notified issues; (4) lacking representativeness; and (5) a low or unclear relevance. I provide solutions for these but overall plea for a societal intervention to put this method back on track.
Assessment of Brassica oleraceae L. (Brassicaceae) extract loaded ethosomal gel as a versatile vesicular carrier system for dermocosmetic application: A noninvasive split‐faced study
Authors: Khan Palwasha , Akhtar Naveed , Khan Haji Muhammad Shoaib , Tasneem Rabia , Zaka Hafiz Saqib , Akhtar Naheed , Sharif Arfa
Published: October 2022

Background

Plant extracts with rich ascorbic acid contents have greater antioxidant capability; extensively employed in skin beautifying products and protect skin from detrimental photodamaging environmental effects. Brassica oleraceae is having a substantial prospective toward cosmeceuticals owed by its profound activity against oxidation.

Aim

To develop an effective topical ethosomal gel loaded with Brassica oleraceae leaves extract with significant antioxidant activity.

Methodology

Valuation of antioxidant capability of plant leaves extract by 2,2‐diphenyl‐1‐picrylhydrazyl (DPPH), and quantification of ascorbic acid was done through high performance liquid chromatography (HPLC). Ethosomes were prepared by cold method. Optimized suspension containing extract was incorporated in 2% Carbopol gel (test) along with extract solution (control). Noninvasive in vivo studies were performed for final product to assess its effects on skin by measuring melanin and erythema, sebum level, elasticity, moistness level, facial pores count and their area, skin wrinkling, and smoothness.

Results

Brassica oleraceae (red cabbage) leaves extract exhibited significant antioxidant potential (85.64 ± 1.28%) with 14.22 μg/g of ascorbic acid; expressed prominent cosmetic effects in terms of skin melanin, erythema, sebum, elasticity, hydration, facial pores, wrinkles, and smoothness when incorporated in ethosomes. ANOVA test also exhibited positive significant (p ≤ 0.05) effects on skin.

Conclusion

Brassica oleraceae extract is a strong antioxidant with remarkable dermocosmetic benefits for skin.
Effects of varying pandemic restrictions on the health‐related behaviours of Australian children
Authors: Robinson Lauren , Measey Mary‐Anne , Efron Daryl , Mundy Lisa , Hoq Monsurul , Rhodes Anthea
Published: October 2022

Aim

To explore the effects of COVID‐19 pandemic restrictions varying in severity and duration on health‐related behaviours in children aged 5–17 years.

Methods

We used data from the Royal Children's Hospital National Child Health Poll, an online cross‐sectional survey of Australian caregivers. The survey assessed 1222 caregivers' perceived changes in health‐related behaviours (physical activity, sleep, screen‐time, diet, outdoor activity, family and peer connectedness) of 2011 children aged 5–17 years in a typical week from June to September 2020 (when jurisdictions experienced varying restriction severity and duration) compared to retrospective reports of behaviour before March 2020 (pre‐pandemic). To compare the effects of varying restriction severity in Victoria, New South Wales (NSW) and other states and territories on health‐related behaviours binary logistic regression was used, adjusting for caregiver demographics and weighted to reflect Australia's parent population.

Results

Compared to pre‐pandemic, Victoria's restrictions had a greater impact on child health‐related behaviours compared to NSW restrictions and an even stronger impact compared to other states and territories which experienced few or no restrictions. A greater proportion of Victorian children reported more recreational screen time (71.3%) than NSW (53.9%) and other states and territories (34.5%) and less physical activity (57.2%) than NSW (30.3%) and other states and territories (26.5%). Victorian children reported less outdoor activity (62.6%) than NSW (32.0%) and other states and territories (25.2%), and less social connectedness (68.0%) than NSW (35.4%) and other states and territories (27.3%).

Conclusions

More severe and longer COVID‐19 pandemic restrictions are associated with greater impacts and predominantly more negative impacts to children's health‐related behaviours. These should be mitigated through policies and programs to encourage healthier life‐styles.
Physiological consequences of space flight, including abnormal bone metabolism, space radiation injury, and circadian clock dysregulation: Implications of melatonin use and regulation as a countermeasure
Authors: Hirayama Jun , Hattori Atsuhiko , Takahashi Akihisa , Furusawa Yukihiro , Tabuchi Yoshiaki , Shibata Masahiro , Nagamatsu Aiko , Yano Sachiko , Maruyama Yusuke , Matsubara Hajime , Sekiguchi Toshio , Suzuki Nobuo
Published: October 2022

Exposure to the space environment induces a number of pathophysiological outcomes in astronauts, including bone demineralization, sleep disorders, circadian clock dysregulation, cardiovascular and metabolic dysfunction, and reduced immune system function. A recent report describing experiments aboard the Space Shuttle mission, STS‐132, showed that the level of melatonin, a hormone that provides the biochemical signal of darkness, was decreased during microgravity in an in vitro culture model. Additionally, abnormal lighting conditions in outer space, such as low light intensity in orbital spacecraft and the altered 24‐h light–dark cycles, may result in the dysregulation of melatonin rhythms and the misalignment of the circadian clock from sleep and work schedules in astronauts. Studies on Earth have demonstrated that melatonin regulates various physiological functions including bone metabolism. These data suggest that the abnormal regulation of melatonin in outer space may contribute to pathophysiological conditions of astronauts. In addition, experiments with high‐linear energy transfer radiation, a ground‐based model of space radiation, showed that melatonin may serve as a protectant against space radiation. Gene expression profiling using an in vitro culture model exposed to space flight during the STS‐132 mission, showed that space radiation alters the expression of DNA repair and oxidative stress response genes, indicating that melatonin counteracts the expression of these genes responsive to space radiation to promote cell survival. These findings implicate the use of exogenous melatonin and the regulation of endogenous melatonin as countermeasures for the physiological consequences of space flight.