bluuebunny/crossref_metadata_2025 huggingface dataset:
Thermotherapy for knee osteoarthritis
Authors: Shen Cimin , Li Na , Chen Bin , Wu Jinzuan , Wu Zhining , Hua Dangyun , Wang Lu , Chen Dangdang , Shao Zhuoyi , Ren Changjie , Xu Jinsen
Published: May 2021

Background:

Osteoarthritis of the knee is one of the leading causes of pain and disability among adults. Thermotherapy has been widely used to treat knee osteoarthritis. But its efficiency has not been scientifically and methodically evaluated. The aim of this study is to assess the benefits of thermotherapy for people with osteoarthritis of the knee, in terms of pain, stiffness, and physical dysfunction.

Methods:

Eight databases will be searched from their inception to September 2020. They are as follows: PubMed, Embase, Cochrane Library, ClinicalTrials.gov, China Knowledge Resource Integrated Database (CNKI), Weipu Database for Chinese Technical Periodicals (VIP), Chinese Biomedical Literature Database (CBM), and Wanfang Database. Two researchers will independently select studies, collect data, and assess the methodology quality by the Cochrane risk of bias tool.

Results:

The systematic review will provide high-quality evidence to assess the benefits and harms of thermotherapy for people with osteoarthritis of the knee, in terms of pain, stiffness, and dysfunction of knee joint, and quality of life, as well as adverse events.

Conclusion:

The systematic review will provide evidence to assess the effectiveness and safety of thermotherapy for knee osteoarthritis patients.

INPLASY registration number:

INPLASY202140038.
The influence of RS738409 I148M polymorphism of patatin-like phospholipase domain containing 3 gene on the susceptibility of non-alcoholic fatty liver disease
Authors: Akkiz Hikmet , Taskin Emre , Karaogullarindan Umit , Delik Anil , Kuran Sedef , Kutlu Ozlem
Published: May 2021

We aimed to elucidate the frequency of polymorphic genotypes and alleles of patatin-like phospholipase domain containing 3 rs738409 polymorphism and its possible associations with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis in a cohort from Turkey.

We enrolled 200 patients diagnosed with NAFLD and genotyped for rs738409 I148M polymorphism by real-time polymerase chain reaction, particularly by melting curve analysis. SPSS analysis software was used for statistical significance. Continuous variable values were expressed as mean ± standard deviation. Significant statistical level was chosen as p 
= 0.05.

Our results demonstrate in a cohort from Turkey that rs738409 C > G polymorphism (I148M) of patatin-like phospholipase domain containing 3 gene is significantly able to affect individuals to have NAFLD in unadjusted regression model.

Consistent with the previous studies in other populations, our study group showed a significantly higher risk of having NAFLD in unadjusted regression model but not in the adjusted model indicating that non-genetic factors such as age and sex may be responsible for the association. However, independent studies need to validate our findings with a larger group of NAFLD patients, as well as in different ethnic cohorts.
Prognostic factors for conversion to generalization in ocular myasthenia gravis
Authors: Witthayaweerasak Juthamat , Rattanalert Narisa , Aui-aree Nipat
Published: May 2021

Patients with ocular myasthenia gravis (OMG) are frequently treated to prevent the development of generalized myasthenia gravis (GMG). This retrospective cohort study aimed to assess prognostic factors associated with conversion to GMG.

We analyzed the time from the onset of OMG symptoms to GMG in relation to demographic variables, clinical findings, initial investigation results, and treatment regimens using Kaplan–Meier survival curves and multivariate Cox proportional regression analysis.

Of 115 patients diagnosed with OMG (median follow-up time, 2.9 years), 28 (30.4%) developed GMG. The 2-year probability of GMG conversion was 23.7%. Patients with thymic abnormalities and a positive response to repetitive facial nerve stimulation had a significantly higher risk than those with negative results (hazard ratios [HR] 4.28, P < .001 and HR 3.84, P = .04, respectively). Treatment with immunosuppressants was found to be a preventive factor for secondary generalization (HR 0.36, P = .02).

Patients with OMG had a low risk of developing GMG. Immunosuppressive treatments may mitigate disease progression. Chest imaging and repetitive nerve stimulation should be routinely performed to assess the risk of generalization.
Using decision trees to determine participation in bundled payments in sepsis cases
Authors: Matzner William , Freund Deborah
Published: May 2021

Rationale:

The purpose of this research is to determine and develop a valid analytical method that can be easily implemented by providers to evaluate whether they should join the bundled payments for care improvement (BPCI) advanced bundled payment program, and analyze the projected impacts of BPCI advanced payment on their margins.

Methods:

We have developed a decision tree model that incorporates the types of sepsis encountered and the resultant typical complications and associated costs.

Results:

The initial cost of a sepsis episode was $30,386. Since Medicare requires that there is a 3% cost reduction under BPCI, we applied the model with a 3% cost reduction across the board. Since the model considers probabilities of the complications and readmission, there was actually a 3.36% reduction in costs when the 3% reduction was added to the model. We applied 2-way sensitivity analysis to the intensive care unit (ICU) long and short costs. We used the unbundled cost at the high end, and a 10% reduction at the low end. Per patient episode cost varied between $28,117 and $29,658. This is a 5.2% difference between low and high end. Next, we looked at varying the hospital bed (non-ICU) costs. Here the resultant cost varied between $28,708 and $29,099. This is only a 1.34% difference between low and high ends. Finally, we applied a sensitivity analysis varying the attending physician and the intensivist reimbursement fees. The result was a cost that varied between $29,191 and $29,366 which is a difference of only 0.595%.

Conclusion:

This is the precise environment where decision tree analysis modeling is essential. This analysis can guide the hospital in just how to allocate resources in light of the new BPCI advanced payment model.
Endoscopic coblation treatment for congenital pyriform sinus fistula in children
Authors: Chen Wei , Chen Jiarui , Chen Fang , Wu Jiali , Zhao Limin , Xu Hongming , Li Xiaoyan
Published: May 2021

Congenital pyriform sinus fistula (CPSF) is a very rare branchial apparatus malformation. Traditional open surgery for fistulectomy might fail to excise the lesion completely, leading to continual recurrence. Herein, we report our experience of endoscopic coblation technique for treatment of CPSF in children.

To observe the clinical efficacy of endoscopic coblation treatment of CPSF in children, especially for those in acute infection stage.

Retrospective case series with 54 patients (including 20 cases in acute infection stage and 34 cases in non infection stage) who were diagnosed with CPSF between October 2017 to November 2019, all patients were treated with endoscopic coblation to close the piriform fossa fistula, neck abscess incision and drainage performed simultaneously for acute infection stage cases. Data collected including age of diagnosis, presenting symptoms, diagnostic methods, prior and subsequent treatments, length of hospitalization, and recurrence were analyzed.

Of the 20 cases in acute infection stage, there were 3 children with transient vocal cord paresis all of which resolved with 1 month. Four children of the 34 cases in non infection stage appeared reddish swelling of the neck on the 4th, 5th, 6th, and 7th days after coblation and then underwent abscess incision and drainage. All cases experienced no recurrence, vocal cord paralysis, pharyngeal fistula and massive hemorrhage after their first endoscopic coblation of the sinus tract in the follow up of 3 to 28 months.

Endoscopic coblation is an effective and safe approach for children with CPSF, neck abscess incision and drainage could be performed simultaneously in acute infection stage. We advocate using this minimally invasive technique as first line of treatment for CPSF.
Determinants of first-line biological treatment in patients with rheumatoid arthritis
Authors: Angelici Laura , Addis Antonio , Agabiti Nera , Kirchmayer Ursula , Davoli Marina , Belleudi Valeria
Published: May 2021

Guidelines for the treatment of rheumatoid arthritis (RA) recommend the use of conventional synthetic disease modifying anti-rheumatic drugs (cs-DMARDs) at the onset of the disease and only in the case of therapeutic failure, the addition of a biological drug (b-DMARD) is suggested.

The study aimed to evaluate determinants for first-line biological treatment in patients with RA in clinical practice.

A cohort of patients with RA, resident in Lazio, a central Italian Region, where Rome is located, and with at least one disease modifying anti-rheumatic drugs (DMARD) prescription between 2010 and 2016 was selected using health information systems linkable with each other by an individual unique anonymous identifier. In particular RA cohort was defined retrieving all patients with at least a RA disease code in regional data claims (hospital discharge, exemption code, emergency department access, or therapeutic plan). Only new users were included and the first-line treatment was identified: cs-DMARD or b-DMARD.

Descriptive analysis according to type of DMARD treatment was performed. Through multivariate logistic regression models (odds ratio [OR]; confidence interval [CI95%]) determinants of therapy such as age, comorbidity, and comedication were investigated.

Finally, switching during the first year of treatment from cs-DAMARDs to b-DMARDs was analyzed.

DMARD-new users with RA were 5641; 7.1% of them with b-DMARD as first-line treatment. Considering the year of dispensing, this percentage ranged from 4.9% (2011) to 8.2% (2015). Among cs-DMARD the most prescribed active agent was methotrexate (59.3%), while among b-DMARD it was etarnecept (37.0%), followed by adalimumab (21.2%). The average age of the cohort was 54 years with 77% of women. Determinants of first-line b-DMARD use were: age (OR<30vs>65 = 3.7; 2.6–5.2, OR[30–45)vs>65 = 1.7; 1.2–2.4, OR[45–55)vs>65 = 1.6; 1.1–2.4, OR[55–65)vs>65 = 1.2; 0.8–1.7), cancers (OR = 2.3; 1.3–4.2), cardio-cerebrovascular disease (OR = 1.4; 1.0–1.9), use of non-steroidal anti-inflammatory drugs (NSAIDs) (OR = 0.6; 0.4–0.7) and corticosteroids (OR = 0.6; 0.5–0.7) in the 6 months preceding diagnosis.

In the first year of treatment, we observed a percentage of switch from cs-DMARDs to b-DMARDs of 7.9%.

In clinical practice, about 7% of patients with RA are prescribed with a b-DMARD as first-line treatment. This therapeutic option, even if not supported by guide lines, is mostly link to younger age and clinical profile of the patients.
Analysis of psychological status and effect of psychological intervention in quarantined population during the epidemic of SARS-CoV-2
Authors: Wu Chen , Zhou Tian , Wu Li-Ping , Zhao Yu-Xi , Shang Hai-Ming , Gao Yang-Yang , Rao Ping , Jiao Yang , Xi Jia-Ning
Published: May 2021

During outbreaks of the coronavirus disease 2019 (COVID-19), many countries adopted quarantine to slow the spread of the virus of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Quarantine will cause isolation from families, friends, and the public, which consequently leads to serious psychological pressure with potentially long-lasting effects on the quarantined population. Experience of specific practices to improve the psychological status of the mandatory quarantined population was limited. The aim of this study was to investigate the psychological impact of mandatory quarantine, and evaluate the effect of psychological intervention on the quarantined population.

We conducted a prospective cohort study to assess and manage the psychological status of a mandatory quarantined population in Beijing, China. A total of 638 individuals completed 2 questionnaires and were enrolled in this study, of which 372 participants accepted designed psychological intervention while other 266 participants refused it. The SCL-90 questionnaire was used to evaluate the psychological status and its change before and after the intervention. The differences of SCL-90 factor scores between participants and the national norm group were assessed by 2 samples t test. While the SCL-90 factor scores before and after intervention were compared with 2 paired samples t test.

Compared with the Chinese norms of SCL-90, the participants had higher SCL-90 factor scores in most items of the SCL-90 inventory. The SCL-90 factor scores of participants with psychological intervention significantly decreased in somatization, obsessive-compulsive, depression, anxiety, phobic anxiety, paranoid ideation, and psychoticism. In contrast, most factor scores of the SCL-90 inventory changed little without statistical significance in participants without psychological intervention.

Psychological problems should be emphasized in the quarantined individuals and professional psychological intervention was a feasible approach to improve the psychological status of the mandatory quarantined population in the epidemic of SARS-CoV-2.
Successful diagnosis and treatment of pulmonary aspergillosis-related malignant catatonia using propofol and quetiapine
Authors: Nomura Kazuhito , Sakawaki Sonoko , Sakawaki Eiji , Yamaoka Ayumu , Aisaka Wakiko , Okamoto Hiroyuki , Takeyama Yoshihiro , Uemura Shuji , Narimatsu Eichi
Published: May 2021

Introduction:

Malignant catatonia (MC) is a movement disorder syndrome characterized by immobility, rigidity, and consciousness disorders that develops in association with mental and physical diseases. It is often fatal due to hyperthermia, rhabdomyolysis, and acute kidney injury. Its clinical symptoms are similar to those of another disorder, neuroleptic malignant syndrome (NMS), and it is often difficult to distinguish between the 2 disorders.

Patient concerns:

An Asian woman in her 60s with history of schizophrenia. She was admitted to our hospital because of symptoms such as fever, unconsciousness, and muscle rigidity. Blood tests showed kidney injury and high creatinine kinase levels.

Diagnoses:

At the time of admission, she had been diagnosed with NMS complicated by pulmonary aspergillosis and was undergoing treatment although there was no improvement.

Interventions:

Subsequently, the administration of propofol, a gamma-aminobutyric acid A agonist, markedly improved the symptoms, and the diagnosis was corrected to MC. At the beginning of her hospitalization, she received dantrolene, bromocriptine, amantadine, and L-3,4-dihydroxyphenylalanine as treatment for NMS, but her symptoms did not improve. With propofol, which is used for sedation, her catatonic symptoms improved markedly. Quetiapine administration further improved the symptoms, and it eventually resolved completely.

Outcomes:

The patient's MC was in remission. Prolonged intensive care management resulted in a decline in activities of daily living, and she required rehabilitation at another hospital.

Conclusion:

This is the first report of MC with suspected involvement of pulmonary aspergillosis. MC differs from NMS, in that it is treated more effectively with gamma-aminobutyric acid A agonists. Although benzodiazepines are the first choice for the diagnosis and treatment of MC, they are ineffective for majority of patients with schizophrenia. However, even in such cases, propofol and quetiapine are effective, and they facilitate diagnosis and treatment.
The effect of acupoint herbal patching on the quality of life of patients recovering from COVID-19
Authors: Wang Heran , Jiang Hailin , Zhao Jinying , Zhao Xuewei , Han Yiran , Meng Meng , Pan Ting , Li Tie , Wang Fuchun
Published: May 2021

Background:

There is a worldwide outbreak of COVID-19, and as the number of patients increases, an increasing number of patients are recovering. However, no relevant systematic review or meta-analysis has been designed to evaluate the effects of acupoint herbal patching on the life of patients recovering from COVID-19.

Methods:

The following electronic databases will be searched from the respective dates of database inception to April 20, 2021: The Cochrane Library, Web of Science, EMBASE, MEDLINE, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Wanfang database, the Chinese Scientific Journal Database (VIP), and other sources. All published randomized controlled trials in English or Chinese related to acupoint herbal patching for COVID-19 will be included. The primary outcome was the timing of the influence of acupoint herbal patching on the quality of life of convalescent patients. Secondary outcomes were accompanying symptoms (such as myalgia, expectoration, stuffiness, runny nose, pharyngalgia, anhelation, chest distress, dyspnea, crackles, headache, nausea, vomiting, anorexia, diarrhea) disappearance rate, negative COVID-19 results rate on two consecutive occasions (not on the same day), average hospitalization time, clinical curative effect, and improved quality of life.

Results:

The main purpose of this systematic review protocol was to assess the effectiveness and safety of acupoint herbal patching therapy for treating patients recovering from COVID-19.

Conclusion:

The conclusion of our study will provide evidence to judge whether acupoint herbal patching is an effective intervention for the quality of life in patients recovering.

PROSPERO registration number:

CRD42021246550
Splicing regulation in hematopoiesis
Authors: Chen Sisi , Abdel-Wahab Omar
Published: May 2021

Purpose of review

Splicing mutations are among the most recurrent genetic perturbations in hematological malignancies, highlighting an important impact of splicing regulation in hematopoietic development. However, compared to our understanding of splicing factor mutations in hematological malignancies, studies of splicing components and alternative splicing in normal hematopoiesis have been less well investigated. Here, we outline the most recent findings on splicing regulation in normal hematopoiesis and discuss the important questions in the field.

Recent findings

Recent studies have highlighted the critical role of splicing regulation in hematopoiesis, including characterization of splicing components in normal hematopoiesis, investigation of transcriptional alterations on splicing, and identification of stage-specific alternative splicing events during hematopoietic development.

These interesting findings provide insights on hematopoietic regulation at a co-transcriptional level. More high-throughput RNA ribonucleic acid (RNA) sequencing and functional genomic screens are needed to advance our knowledge of critical alternative splicing patterns in shaping hematopoiesis.
Effects of Botulinum Toxin A on an Incisional Hernia Reconstruction in a Rat Model
Authors: Kwon Jin Geun , Kim Eun Key
Published: May 2021

Background:

Although the effects of botulinum toxin A on hernia reconstruction have been consistently reported, few studies provide objective evidence. The authors aimed to compare the effects of chemical component separation with those of mechanical component separation, and with a combination of chemical and mechanical component separation, in a rat hernia model.

Methods:

Rats were divided into four groups: 1, control; 2, chemical component separation; 3, mechanical component separation; and 4, chemical and mechanical component separation. Four weeks after hernia induction, botulinum toxin A was injected into groups 2 and 4. Hernia repair was performed 2 weeks after chemical component separation when mechanical component separation was performed in groups 3 and 4. Pretreatment and posttreatment defect sizes, traction forces, intraabdominal pressure, and hernia recurrences were analyzed.

Results:

The defect size was significantly decreased in groups 2 and 4 after chemical component separation. The traction force was significantly smaller in groups 2 and 3 compared with the control group, and the effects of chemical and mechanical component separation were additive. The mean intraabdominal pressure was 16.83 mmHg in group 1, 10.67 mmHg in group 2, 10.17 mmHg in group 3, and 9.67 mmHg in group 4, thus showing significant reductions following chemical and mechanical component separation. Recurrence was observed in all six animals (100 percent) in groups 1 and 3, but in only one of six (17 percent) in groups 2 and 4.

Conclusions:

Preoperative botulinum toxin A significantly reduces hernia size (by 30 percent) and the traction force required to medialize the rectus abdominis. After hernia repair, chemical component separation decreases the intraabdominal pressure to a similar degree as mechanical component separation, but only chemical component separation appears to reduce hernia recurrence.
The Unilateral Cleft Lip Nasal Deformity: Revisions within 20 Years after Primary Correction
Authors: Yao Caroline A. , Mulliken John B.
Published: May 2021

Background:

As patients grow older, the unilateral cleft lip nasal deformity becomes more noticeable than the repaired lip. The authors assessed nasal revisions over 20 years of the senior author’s management of unilateral complete cleft lip.

Methods:

One hundred patients who underwent primary two-stage nasolabial correction of unilateral complete cleft lip between 1991 and 2001 were reviewed.

Results:

The median patient age was 21 years at the time of analysis. Only 13 percent of patients did not require nasal revision after primary nasolabial repair. One to two nasal revisions were undertaken in 65 percent of patients. The extent of nasal maneuvers during primary labial repair was associated with the number of revisions. Recently treated patients had fewer revisions. Female patients were more likely to undergo several revisions. Of patients who had semiopen suspension sutures at primary repair, 61 percent had this maneuver repeated two or more times. In contrast, patients who had closed suspension sutures at primary repair underwent more nasal revisions and later required more nasal maneuvers. Nasal revision before skeletal maturity was significantly associated with another nasal revision after completion of skeletal growth. Twenty-seven percent of patients eventually required an aesthetic or functional rhinoplasty in adulthood.

Conclusions:

Patients with a severe initial nasal deformity require multiple revisions. Semiopen suspension sutures are associated with fewer revisions. Revision of the nasal cartilages or alar base can often be performed in the intermediate phase, in combination with other operations.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
“To Pre or Not to Pre”: Introduction of a Prepectoral Breast Reconstruction Assessment Score to Help Surgeons Solving the Decision-Making Dilemma. Retrospective Results of a Multicenter Experience
Authors: Casella Donato , Kaciulyte Juste , Lo Torto Federico , Mori Francesco L. R. , Barellini Leonardo , Fausto Alfonso , Fanelli Benedetta , Greco Manfredi , Ribuffo Diego , Marcasciano Marco
Published: May 2021

Background:

Implant-based reconstruction is the most performed breast reconstruction, and both subpectoral and prepectoral approaches can lead to excellent results. Choosing the best procedure requires a thorough understanding of every single technique, and proper patient selection is critical to achieve surgical success, in particular when dealing with prepectoral breast reconstruction.

Methods:

Between January of 2014 and December of 2018, patients undergoing mastectomy and eligible for immediate prepectoral breast reconstruction with tissue expander or definitive implant, were selected. The Prepectoral Breast Reconstruction Assessment score was applied to evaluate patient-related preoperative and intraoperative risk factors that could influence the success of prepectoral breast reconstruction. All patients were scored retrospectively, and the results obtained through this assessment tool were compared to the records of the surgical procedures actually performed.

Results:

Three hundred fifty-two patients were included; 112 of them underwent direct-to-implant immediate reconstruction, and 240 underwent the two-stage procedure with temporary tissue expander. According to the Prepectoral Breast Reconstruction Assessment score, direct-to-implant reconstruction should have been performed 6.2 percent times less, leading to an increase of 1.4 percent in two-stage reconstruction and 4.8 percent in submuscular implant placement.

Conclusions:

To date, there is no validated system to guide surgeons in identifying the ideal patient for subcutaneous or retropectoral breast reconstruction and eventually whether she is a good candidate for direct-to-implant or two-stage reconstruction. The authors processed a simple risk-assessment score to objectively evaluate the patient’s risk factors, to standardize the decision-making process, and to identify the safest and most reliable breast reconstructive procedure.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Virologic efficacy of tenofovir, lamivudine and dolutegravir as second-line antiretroviral therapy in adults failing a tenofovir-based first-line regimen
Authors: Keene Claire M. , Griesel Rulan , Zhao Ying , Gcwabe Zimasa , Sayed Kaneez , Hill Andrew , Cassidy Tali , Ngwenya Olina , Jackson Amanda , van Zyl Gert , Schutz Charlotte , Goliath Rene , Flowers Tracy , Goemaere Eric , Wiesner Lubbe , Simmons Bryony , Maartens Gary , Meintjes Graeme
Published: May 2021

Objective:

Recycling tenofovir and lamivudine/emtricitabine (XTC) with dolutegravir would provide a more tolerable, affordable, and scalable second-line regimen than dolutegravir with an optimized nucleoside reverse transcriptase inhibitor (NRTI) backbone. We evaluated efficacy of tenofovir/lamivudine/dolutegravir (TLD) in patients failing first-line tenofovir/XTC/efavirenz or nevirapine.

Design:

Single arm, prospective, interventional study.

Setting:

Two primary care clinics in Khayelitsha, South Africa.

Participants:

Sixty adult patients with two viral loads greater than 1000 copies/ml.

Intervention:

Participants were switched to TLD with additional dolutegravir (50 mg) for 2 weeks to overcome efavirenz induction.

Primary outcome:

Proportion achieving viral load less than 50 copies/ml at week 24 using the FDA snapshot algorithm.

Results:

Baseline median CD4+ cell count was 248 cells/μl, viral load 10 580 copies/ml and 48 of 54 (89%) had resistance (Stanford score ≥15) to one or both of tenofovir and XTC. No participants were lost to follow-up. At week 24, 51 of 60 [85%, 95% confidence interval (CI) 73–93%] were virologically suppressed, six had viral load 50–100 copies/ml, one had viral load 100–1000 copies/ml, one no viral load in window, and one switched because of tenofovir-related adverse event. No integrase mutations were detected in the one participant meeting criteria for resistance testing. Virological suppression was achieved by 29 of 35 (83%, 95% CI 66–93%) with resistance to tenofovir and XTC, 11 of 13 (85%, 95% CI 55–98%) with resistance to XTC, and six of six (100%, 95% CI 54–100%) with resistance to neither.

Conclusion:

A high proportion of adults switching to second-line TLD achieved virologic suppression despite substantial baseline NRTI resistance and most not suppressed had low-level viraemia (≤100 copies/ml). This suggests recycling tenofovir and XTC with dolutegravir could provide an effective second-line option.
Gastrojejunostomy in Roux-En-Y Gastric Bypass for Morbid Obesity: Linear Stapler Length Does Not Affect Mid-term Outcomes
Authors: Tankel James , Ahmed Ahmed R.
Published: May 2021

Background:

The purpose of this study was to compare whether different linear stapler lengths used to form the gastrojejunostomy during laparoscopic Roux-En-Y gastric bypass affects mid-term weight loss outcomes.

Materials and Methods:

A retrospective single center analysis was performed. Surgical technique was identical other than either a 35 or 45 mm linear stapler being used to form the gastrojejunostomy. Multivariate regression was used to assess the relationship between the different stapler lengths and weight loss outcomes 2 years following surgery.

Results:

Of the 97 patients identified, 67 (69.1%) were included in the study. There were 30 patients in the 35 mm group and 37 in the 45 mm group. The groups were comparable in terms of basic demographic data and preoperative weight characteristics. There was no significant difference in weight loss outcomes 2 years following surgery when comparing between the different linear stapler lengths.

Conclusion:

Thirty-five versus 45 mm linear stapler lengths does not affect mid-term weight loss outcomes.
Systematic Review and Meta-analysis of Laparoscopic Common Bile Duct Exploration in Patients With Previous Failed Endoscopic Retrograde Cholangiopancreatography
Authors: Zhu Jisheng , Zhang Yang , Du Peng , Hu Wang , Xiao Weidong , Li Yong
Published: May 2021

Background:

The aim was to compare the outcomes of laparoscopic common bile duct exploration (LCBDE) after failed endoscopic retrograde cholangiopancreatography (group A) versus primary LCBDE (group B) for the management of gallbladder and common bile duct stones.

Materials and Methods:

A comprehensive and systematic literature search was performed in several databases, including PubMed, Ovid, and Cochrane Library. Meta-analysis of operative outcomes, postoperative outcomes, and gallstone clearance rates was conducted using random-effect models.

Results:

Six studies including 642 patients (239 in group A and 403 in group B) were included. The operative time was longer in group A (P=0.02). The overall complication, bile leakage, conversion, postoperative hospital stay, and reoperation were comparable in group A and group B. Similarly, no significant difference was present concerning the incidence of stone clearance, residual stone, and recurrent stone (P>0.05).

Conclusion:

LCBDE is an alternative acceptable procedure when removal of common bile duct stones by endoscopic therapy fails.
Glial Cell Responses to constant low Light exposure in Rat Retina
Authors: Bruera Manuel Gastón , Benedetto María Mercedes , Guido Mario E , Degano Alicia Laura , Contin María A.
Published: May 2021

Retinal damage promoted by constant illumination of low intensity resulted in a diminution in classical photoreceptors cells. Glial cells exert profound effects on neurons, vasculature and other glial cells. Macroglia and microglia with specific morphological, physiological, and antigenic characteristics may play an essential role in both the maintenance and control of retinal homeostasis, or to exert mechanisms that promote cell death. The role of glial cells and immune function in the pathogenesis promoted by low light is poorly understood. We performed glial cells characterization along the time-course of retinal degeneration induced by chronic exposure to low intensity of light in Wistar rats. We exposed the animals at constant light from 2 to 8 days and assessed the retinal glia. After 6 days of light exposure, retinas presented increased levels of GFAP, a macroglia marker and microglia markers Iba1 and CD68 displayed increased mRNA levels after 6 days. The number of Iba1 positive cells increased in the outer nuclear layer, showing ameboid morphology with thicker processes characteristic of microglial activated cells. The expression levels of immune mediators TNF-□ and IL-6 were also significantly increased after 6 days. Finally, chemokines analysis showed that CX3CR1 and CCL2 expression levels were significantly elevated after 6 days. Hence, all the events of glial activation occurred after 5-6 days of constant light exposure, when the number of cells of the outer nuclear layer has already decreased significantly. Herein we demonstrated that glial and immune activation are secondary to neurodegeneration; in this scenario, our results suggest that photoreceptor death is an early event that may be induced by phototransduction-dependent mechanisms.
The terminal heme synthetic enzyme, Coproheme Decarboxylase, coordinates heme synthesis and uptake in response to iron in Mycobacteria
Authors: Donegan Rebecca K. , Copeland Jacqueline , Edgha Stanzin , Brown Gabriel , Hale Owen F. , Mitra Avishek , Yang Hui , Dailey Harry A. , Niederweis Michael , Jain Paras , Reddi Amit R
Published: May 2021

Heme is both an essential cofactor and an abundant source of nutritional iron for the human pathogen Mycobacterium tuberculosis (Mtb). While heme is required for Mtb survival and virulence, it is also potentially cytotoxic. Since Mtb has the ability to both make and uptake heme, the de novo synthesis of heme and its acquisition from the host must be balanced in order to mitigate heme toxicity. However, the mechanisms employed by Mtb to regulate heme uptake, synthesis, and bioavailability are poorly understood. By integrating ratiometric heme sensors with mycobacterial genetics, cell biology, and biochemistry, we determined that the terminal heme biosynthetic enzyme, coproheme decarboxylase (ChdC), plays a role in regulating both heme bioavailability and uptake in Mtb. Moreover, we found that Mtb has a preference for scavenging reduced ferrous heme and exhibits a cell surface heme reductase activity that is regulated by ChdC. In Mtb, ChdC expression is down-regulated when iron is limiting, which in-turn increases both heme import and bioavailability. Such a mechanism may serve to protect cells from heme toxicity while trying to meet the nutritional demand for iron. Our results demonstrate that heme synthesis and uptake are tightly integrated in mycobacteria and represent the first example of a heme synthetic enzyme playing a role in controlling heme uptake.
Factors affecting Vietnamese farmers' intention toward organic agricultural production
Authors: Nguyen Thi Phuong Linh , Doan Xuan Hau , Nguyen Thu Thuy , Nguyen Thi Mai
Published: May 2021

Purpose

The purpose of this paper is to investigate factors affecting Vietnamese farmer's intention toward organic agricultural production based on research model integrating theories: theory of planned behavior (TPB) and norm activation model (NAM).

Design/methodology/approach

After in-depth interviews with 5 agricultural researchers and 5 farmers, the authors determined the official research model and built a complete survey. Data were collected from 318 farmers in the Hanoi, Vietnam by directly survey. Statistical methods, such as Cronbach's alpha analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and structural equation modeling (SEM), were used to analyze the data.

Findings

This paper shows that attitude, subjective norms, perceived behavioral control and personal norm were significantly related to intention of the farmers; awareness of consequences was positively related to ascription of responsibility, personal norm, attitude and subjective norms; ascription of responsibility has a positive relationship with personal norm. The TPB-NAM integration model is proven to be superior to the original TPB model when studying factors affecting Vietnamese farmer's intention toward organic agricultural production.

Research limitations/implications

The main limitation of this paper is that the sampling method is not representative for the whole country and just stops at researching the intentions of farmers without understanding the practices of organic agricultural production.

Practical implications

The findings indicate that state management agencies in Vietnam need to pay attention to raise awareness among farmers about the role of organic farming, communicate to farmers through different channels about the benefits of organic farming compared to conventional agriculture and form information spillover groups between farmers who have produced organic agriculture and have not yet produced organic agriculture.

Originality/value

This paper contributes to the existing literature by focusing on integrating TPB and NAM when understanding farmers' intention toward organic agricultural production in Vietnam. This integrated model has proven the suitability of combining two approaches, a rational approach and an ethical approach, when studying farmer intentions.
Testing the link between psychological contract, innovative behavior and multidimensional well-being during the COVID-19 pandemic
Authors: Karani Anushree , Deshpande Revati , Mall Sunita , Jayswal Mitesh
Published: May 2021

Purpose

The study investigates the impact of psychological contract breach on employees' innovative behavior and well-being (happiness, work engagement and mental well-being) who are working from home during this COVID-19 pandemic situation. Drawing on social information processing (SIP) and job-demand resource (JD-R) theory, job stress was proposed as a mediator explaining this relationship.

Design/methodology/approach

Data were collected via a structured questionnaire through Google Docs from 258 respondents working at different capacity in Indian organizations. The study includes those respondents who are working from home during COVID-19 pandemic situation. The hypotheses were tested using structural equation modeling (SEM).

Findings

Psychological contract breach was negatively impacting innovative behavior and well-being. Job stress mediated the relationship between psychological contract breach and innovative behavior as well as well-being during the COVID-19 pandemic situation and especially for those who are working from home only.

Research limitations/implications

The data for the study were collected from the employees working from home during this COVID-19 pandemic situation was cross-sectional. The study implied or spoke about the unmet expectations leading to reduced innovative behavior harming the organization's effectiveness and it also reduces well-being which harms the individual in the era of social and financial uncertainty.

Originality/value

The novel contribution of the study is integrating SIP and JD-R theory during the pandemic situation. The results highlighted meticulous empirical evidence which answers the question that how the unmet expectations cause a detrimental effect on the employees as well as the organizations in this COVID-19 pandemic situation.
Blockchain informative infrastructure: a conceptual reflection on public administrative procedures and a citizen-centred view
Authors: Rainero Christian , Modarelli Giuseppe
Published: May 2021

Purpose

This work highlights the potential of blockchain from a public management (PM) angle. Given the limited presence of blockchain's broad-spectrum, empirical-applicative evidence in the public sector, as well as theoretical systematisations that can exemplify its potential within this scope, the authors have concentrated their efforts on structuring a referring model.

Design/methodology/approach

After identifying a gap and conducting a preliminary literature review related to public administration (PA), the authors propose a paradigm focused on a conceptual synthesis methodology, starting from a longitudinal analysis and a coding activity that are able to structure a clear framework of theoretical parallelism regarding blockchain's main functionalities, as well as future perspectives in the public sector.

Findings

The main results yielded a specific longitudinal literature review and constitute a referring model of blockchain's systematised functionalities through a conceptualised matrix. The outcome of the conceptualisation process frames and systematises a rapidly growing controversial phenomenon, furnishing a specific referring paradigm for the issue as it relates to policymakers.

Originality/value

The study's originality resides in the two views the authors created, both from the literature review and from the conceptual synthesis for public sector operative practice via an anthropocentric lens, conveyed by a three-year range of analysis.
Fueling leadership in yourself: a leadership development program for all types of health-care workers
Authors: Houchens Nathan , L. Sivils Stacy , Koester Elizabeth , Ratz David , Ridenour Jennifer , Saint Sanjay
Published: May 2021

Purpose

Leadership development may be a key strategy to enhance job satisfaction, reduce burnout and improve patient safety in health-care systems. This study aims to assess feasibility of a leadership development series in an effort to invigorate a collaborative culture, create peer networks and elevate autonomy in daily work.

Design/methodology/approach

The authors implemented a collectivistic leadership development series titled Fueling Leadership in Yourself. The series was designed for all types of health-care workers in the medicine service at a tertiary referral center for veterans. Two series of leadership development sessions with varied experiential learning methods were facilitated by content experts. Subjects focused on leadership approaches and attributes applicable to all roles within a health-care system. The authors collected participant perceptions using pre- and post-series surveys. Primary outcomes were understanding and applicability of leadership concepts, employee engagement in leadership, satisfaction with training and work environment and qualitative reflections.

Findings

A total of 26 respondents (of 38 participants) from 8 departments and several role types increased their knowledge of leadership techniques, were highly satisfied with and would recommend the series and found leadership principles applicable to their daily work. Participants continued to use skills years after the series.

Practical implications

Short, intermittent, collectivistic leadership development sessions appear effective in expanding knowledge, satisfaction and skills used in daily practice for a diverse group of health-care workers.

Originality/value

Novel programmatic aspects included inviting all types of health-care workers, practicing universally applicable content and using a variety of active, experiential learning methods.
Towards 2014/95/EU directive compliance: the case of Poland
Authors: Matuszak Łukasz , Różańska Ewa
Published: May 2021

Purpose

This study aims to investigate the differences in the extent of non-financial disclosure (NFD) across companies listed on the Warsaw Stock Exchange over the period surrounding the implementation of the Directive 2014/95/EU.

Design/methodology/approach

The sample comprising 134 selected companies. Content analysis and a disclosure index were used to measure the level of NFD. Non-financial reporting practices in the two years before (2015) and one year after (2017) the implementation of the Directive were compared.

Findings

The results highlight that there is already a high level of compliance with the European Union’s regulation. The extent of the NFD across different thematic aspects in reporting media increased significantly between 2015 and 2017 in particular in human rights and anti-corruption. The Directive had the largest impact on those firms with previously low levels of NFD and led to more homogeneity of NFD across different industries.

Originality/value

The study contributes to the understanding of the impact of the Directive on the NFD practices by European Union companies. The research has important implications for policymakers because it revealed that mandatory regulations form a crucial instrument in improving the harmonization of NFD. The research suggests that, due to the Directive, stakeholders should be provided with more comprehensive information that they need in their decision-making process.
Bridging the global digital divide through digital inclusion: the role of ICT access and ICT use
Authors: Adam Ibrahim Osman , Dzang Alhassan Muftawu
Published: May 2021

Purpose

In an increasingly digitalised society, digital participation is reliant on information communication technology (ICT) access and the ability to use technologies for everyday tasks. To this end, people risk being digitally excluded if they cannot access and use ICTs. The purpose of this paper is to examine globally the effects of ICT access and ICT use on digital inclusion on one hand and the mediating role of ICT usage on the linkage between ICT access and digital inclusion on the other.

Design/methodology/approach

The study used a hypothesized model based on structuration theory and secondary data drawn from multiple archival sources in 121 countries. The authors test the model using partial least squares structural equation modelling.

Findings

The results from the PLS analysis shows that while ICT usage significantly influences digital inclusion at the global level, ICT access does not. Furthermore, the mediating role of ICT usage was not supported.

Originality/value

This study to the best of the authors’ knowledge is one of the very few studies to examine the effects of ICT access and ICT use on digital inclusion at the global level. The study contributes to the discourse on digital inclusion in ICT4D research.
Quantifying the effects of intraspecific variation on predator feeding rates through nonlinear averaging
Authors: Coblentz Kyle E. , Merhoff Stephanie , Novak Mark
Published: May 2021

Theory suggests that intraspecific trait variation will alter species interaction strengths through nonlinear averaging when interaction strengths are nonlinear functions of individuals' traits. This effect is expected to be widespread, yet what factors mediate its magnitude in nature and hence its potential effects on ecosystems and communities are unclear.

We sought to quantify how nonlinear predator functional responses, variation in prey densities and counteracting variation in attack rates and handling times among predator individuals of similar body size alter their population‐level feeding rates through nonlinear averaging in a natural system, and to determine the processes influencing the net magnitude of this effect.

We used a field caging experiment in the rocky intertidal of Oregon, USA to quantify attack‐rate variation and feeding rates of the whelk Nucella ostrina on its barnacle and mussel prey. We also used empirically parameterized simulations to examine the effects of handling‐time variation among individuals on population‐level feeding rates.

Within cages, individual attack‐rate variation reduced population‐level whelk feeding rates. However, the magnitude of this reduction differed among prey species and cages depending on cage‐specific magnitudes of attack‐rate variation and functional‐response nonlinearity. The inferred effects of handling‐time variation among individuals were of smaller magnitude than those of attack‐rate variation, yet counteracted them to cause a net weakening of the effect of individual attack‐rate variation on population‐level feeding rates. Across cages, attack‐rate and prey‐density variation had non‐additive effects that produced greater feeding‐rate reductions at the experiment scale relative to the cage scale.

Our results indicate that the effects of trait variation via nonlinear averaging depend critically on the features of systems that determine the magnitudes of nonlinearities and trait variation. Because of counteracting trait variation, nonlinear‐averaging effects may be quite complex, involving both the variances and covariances of all traits and environmental variables influencing the ecological process of interest.

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