bluuebunny/crossref_metadata_2025 huggingface dataset:
Short- and long-term evaluation of disease-specific symptoms and quality of life following uterine artery embolization of fibroids
Authors: Psilopatis Iason , Fleckenstein Florian Nima , Collettini Federico , Can Elif , Frisch Anne , Gebauer Bernhard , Fehrenbach Uli , Torsello Giovanni Federico , Schnapauff Dirk , David Matthias , Wieners Gero
Published: June 2022

Background

The purpose of this study is to evaluate uterine artery embolization (UAE) for the management of symptomatic uterine leiomyomas regarding changes in quality of life after treatment in a large patient collective. This study retrospectively analyzed prospectively acquired standardized questionnaires of patients treated with UAE. Clinical success was evaluated before and after embolization. Patients were stratified into short- (≤ 7 months) and long-term (> 7 months) follow-up groups depending on the time of completion of the post-interventional questionnaire. Uterine leiomyomas were furthermore divided into small (< 10 cm) and large (≥ 10 cm) tumors based on the diameter of the dominant fibroid.

Results

A total of 245 patients were included into the final data analysis. The Kaplan–Meier analysis showed a cumulative clinical success rate of 75.8% after 70 months until the end of follow-up (9.9 years). All questionnaire subscales showed a highly significant clinical improvement from baseline to short- and long-term follow-up (p < 0.001). Patients with small fibroids showed a significantly better response to UAE in multiple subcategories of the questionnaire than patients with fibroids ≥ 10 cm who had a twofold higher probability of re-intervention in the Cox-regression model.

Conclusions

UAE is an effective treatment method for symptomatic fibroids that leads to quick relief of fibroid-related symptoms with marked improvement of quality of life and is associated with a low risk for re-interventions. Patients with small fibroids tend to show a better response to UAE compared to patients with large fibroids.

Trial registration Charité institutional review board, EA4/167/20. Registered 27 November 2020—Retrospectively registered. https://ethikkommission.charite.de/
FG-4592 protects the intestine from irradiation-induced injury by targeting the TLR4 signaling pathway
Authors: Feng Zhenlan , Xu Qinshu , He Xiang , Wang Yuedong , Fang Lan , Zhao Jianpeng , Cheng Ying , Liu Cong , Du Jicong , Cai Jianming
Published: June 2022

Background

Severe ionizing radiation (IR)-induced intestinal injury associates with high mortality, which is a worldwide problem requiring urgent attention. In recent years, studies have found that the PHD-HIF signaling pathway may play key roles in IR-induced intestinal injury, and we found that FG-4592, the PHD inhibitor, has significant radioprotective effects on IR-induced intestinal injury.

Methods

In the presence or absence of FG-4592 treatment, the survival time, pathology, cell viability, cell apoptosis, and organoids of mice after irradiation were compared, and the mechanism was verified after transcriptome sequencing. The data were analyzed using SPSS ver. 19 software.

Results

Our results show that FG-4592 had significant radioprotective effects on the intestine. FG-4592 improved the survival of irradiated mice, inhibited the radiation damage of intestinal tissue, promoted the regeneration of intestinal crypts after IR and reduced the apoptosis of intestinal crypt cells. Through organoid experiments, it is found that FG-4592 promoted the proliferation and differentiation of intestinal stem cells (ISCs). Moreover, the results of RNA sequencing and Western blot showed that FG-4592 significantly upregulated the TLR4 signaling pathway, and FG-4592 had no radioprotection on TLR4 KO mice, suggesting that FG-4592 may play protective role against IR by targeting TLR4.

Conclusion

Our work proves that FG-4592 may promote the proliferation and regeneration of ISCs through the targeted regulation of the TLR4 signaling pathway and ultimately play radioprotective roles in IR-induced injury. These results enrich the molecular mechanism of FG-4592 in protecting cells from IR-induced injury and provide new methods for the radioprotection of intestine.
Xeno-free protocol for GMP-compliant manufacturing of human fetal pancreas-derived mesenchymal stem cells
Authors: Jabbarpour Zahra , Aghayan Sajjad , Arjmand Babak , Fallahzadeh Khadijeh , Alavi-Moghadam Sepideh , Larijani Bagher , Aghayan Hamid Reza
Published: June 2022

Background

Mesenchymal stem cells (MSCs) have been suggested as an appropriate source for diabetes cell-based therapies. The high proliferation and differentiation capacity of fetal MSCs and the role of fetal pancreatic-derived MSCs (FPMSCs) in islet generation make them good candidates for diabetes treatment. To manufacture clinical-grade MSCs, animal-free culture protocols are preferred. The current study aimed to establish a xeno-free/GMP-compliant protocol for FPMSCs manufacturing. The focus was on the effects of fetal bovine serum (FBS) replacement with pooled human serum (HS).

Material and methods

FPMSCs were isolated and expanded from the pancreas of legally aborted fetuses with few modifications in our previously established protocol. The cells were expanded in two different culture media, including DMEM supplemented with 10% FBS or 10% pooled HS. A side-by-side comparison was made to evaluate the effect of each serum on proliferation rate, cell cycle, senescence, multi-lineage differentiation capacity, immunophenotype, and tumorigenesis of FPMSCs.

Results

Flow cytometry analysis and three-lineage differentiation ability demonstrated that fibroblast-like cells obtained from primary culture had MSCs’ characteristics. The FPMSCs displayed similar morphology and CD markers expression in both sera. HS had a higher proliferative effect on FPMSCs than FBS. In FBS, the cells reached senescence earlier. In addition to normal karyotypes and anchorage-dependent growth, in vivo tumor formation was not seen.

Conclusion

Our results demonstrated that HS was a better serum alternative than FBS for in vitro expansion of FPMSCs. Compared with FBS, HS increased FPMSCs’ proliferation rate and decreased their senescence. In conclusion, HS can effectively replace FBS for clinical-grade FPMSCs manufacturing.

Graphical abstract
Are there employment and income gains of a national breast cancer screening program?
Authors: Kambourova Zornitza , Kalwij Adriaan
Published: June 2022

Background

The Dutch national breast cancer screening program invites women aged 50–75 for screening. By detecting the disease in an early phase, the program aims to achieve lower breast cancer mortality and improve breast cancer survivors’ health. Arguably, the latter also improves the employability of diagnosed women.

Objective

This study investigates the effects of the Dutch national breast cancer screening program on diagnosed women’s employment and income.

Methods

The empirical analysis uses data of 229,357 women aged 40–59, of whom 10,515 were diagnosed with breast cancer at an age in the range 47–53. A regression-based difference-in-differences estimator is used to identify program effects by comparing outcomes for women diagnosed at ages 47–49 with the outcomes for those diagnosed at ages 50–53. The empirical models account for individual fixed effects, and for age and year fixed effects by using a control group of women who were not diagnosed with breast cancer.

Results

Women’s employment rates declined in the six-year period after a breast cancer diagnosis with, on average, about 3 percentage points and their incomes declined with, on average, about 5% over this period. The empirical evidence, based on a comparison of outcomes for women diagnosed at ages 47–49 with the outcomes for those diagnosed at ages 50–53 when covered by the breast cancer screening program, does not support that these declines in employment and income were affected by the program. The evidence also does not support short or medium-term survival gains of the program.

Conclusions

The findings of this study suggest that the Dutch national breast cancer screening program yields no discernible short or medium-term employment and income gains for women diagnosed with breast cancer.
Incidence of acute myocardial injury and its association with left and right ventricular systolic dysfunction in critically ill COVID-19 patients
Authors: Jansson Saga , Blixt Patrik Johansson , Didriksson Helen , Jonsson Carina , Andersson Henrik , Hedström Cassandra , Engvall Jan , Aneq Meriam Åstrom , Chew Michelle S.
Published: June 2022

Background

Previous studies have found an increase in cardiac troponins (cTns) and echocardiographic abnormalities in patients with COVID-19 and reported their association with poor clinical outcomes. Whether acute injury occurs during the course of critical care and if it is associated with cardiac function is unknown.

The purpose of this study was to document the incidence of acute myocardial injury (AMInj) and echocardiographically defined left ventricular (LV) and right ventricular (RV) systolic dysfunction in consecutive patients admitted to an intensive care unit (ICU) for COVID-19. The relationship between AMInj and echocardiographic abnormalities during the first 14 days of ICU admission was studied. Finally, the association between echocardiographic findings, AMInj and clinical outcome was evaluated.

Methods

Seventy-four consecutive patients (≥18 years) admitted to the ICU at Linköping University Hospital between 19 Mar 2020 and 31 Dec 2020 for COVID-19 were included. High-sensitivity troponin-T (hsTnT) was measured daily for up to 14 days. Transthoracic echocardiography was conducted within 72 h of ICU admission. Acute myocardial injury was defined as an increased hsTnT > 14ng/l and a > 20% absolute change with or without ischaemic symptoms. LV and RV systolic dysfunction was defined as at least 2 abnormal indicators of systolic function specified by consensus guidelines.

Results

Increased hsTnT was observed in 59% of patients at ICU admission, and 82% developed AMInj with peak levels at 8 (3–13) days after ICU admission. AMInj was not statistically significantly associated with 30-day mortality but was associated with an increased duration of invasive mechanical ventilation (10 (3–13) vs. 5 days (0–9),p=0.001) as well as ICU length of stay (LOS) (19.5 (11–28) vs. 7 days (5–13),p=0.015). After adjustment for SAPS-3 and admission SOFA score, the effect of AMInj was significant only for the duration of mechanical ventilation (p=0.030).

The incidence of LV and RV dysfunction was 28% and 22%, respectively. Only indices of LV and RV longitudinal contractility (mitral and tricuspid annular plane systolic excursion) were associated with AMInj. Echocardiographic parameters were not associated with clinical outcome.

Conclusions

Myocardial injury is common in critically ill patients with COVID-19, with AMInj developing in more than 80% after ICU admission. In contrast, LV and RV dysfunction occurred in approximately one-quarter of patients. AMInj was associated with an increased need for mechanical ventilation and ICU LOS but neither AMInj nor ventricular dysfunction was significantly associated with mortality.
Stress and strain among veterinarians: a scoping review
Authors: Pohl Robert , Botscharow Julia , Böckelmann Irina , Thielmann Beatrice
Published: June 2022

The aim of this review is to systematically review studies on work-related stress that may affect the mental health of veterinarians. Studies have indicated a high prevalence of various risk factors for mental disorders among practicing veterinarians. In addition to a high risk of suicide, there is increasing evidence of burnout and depression. A scoping review was conducted using the PubMed, MEDLINE, Scopus, Cochrane Library, Web of Science, PubPsych and PSYNDEX databases. Twenty-one studies (plus seven studies with nonstandardized questionnaires) published between 2000 and 2021 were found that presented data on the effect of workload on the mental wellbeing of veterinarians. All of the included studies indicate a high prevalence of psychological stressors in veterinary practice. The risks of burnout, anxiety and depressive disorders are higher in this occupational group than in the general population and other occupational groups. Subjectively, female veterinarians perceive their psychological workload to be higher than that of their male counterparts. Working hours and ethical dilemmas stand out as major sources of stress. There is a need to improve overall psychological wellbeing of veterinarians. Organizational support services and developing personal strategies for coping with work-related stress can prove helpful.
Low-complexity signal detection networks based on Gauss-Seidel iterative method for massive MIMO systems
Authors: Yao Haifeng , Li Ting , Song Yunchao , Ji Wei , Liang Yan , Li Fei
Published: June 2022

In massive multiple-input multiple-output (MIMO) systems with single- antenna user equipment (SAUE) or multiple-antenna user equipment (MAUE), with the increase of the number of received antennas at base station, the complexity of traditional detectors is also increasing. In order to reduce the high complexity of parallel running of the traditional Gauss-Seidel iterative method, this paper proposes a model-driven deep learning detector network, namely Block Gauss-Seidel Network (BGS-Net), which is based on the Gauss-Seidel iterative method. We reduce complexity by converting a large matrix inversion to small matrix inversions. In order to improve the symbol error ratio (SER) of BGS-Net under MAUE system, we propose Improved BGS-Net. The simulation results show that, compared with the existing model-driven algorithms, BGS-Net has lower complexity and similar the detection performance; good robustness, and its performance is less affected by changes in the number of antennas; Improved BGS-Net can improve the detection performance of BGS-Net.
Blockchain-based multi-skill mobile crowdsourcing services
Authors: Xu Weize , Duan Hongyue , Chen Xiao , Huang Jie , Liu Deyong , Chen Yichao
Published: June 2022

With the boom in 5G technology, mobile spatial crowdsourcing has shown great dynamism in industrial mobile communications and edge computing node management. But the traditional crowdsourcing system is not advanced enough to adapt to the new environment. Typically, traditional crowdsourcing workflow is hosted by a centralized crowdsourcing platform. However, the centralized crowdsourcing platform faces the following problems: (1) single point of failure, (2) user privacy leakage, (3) subjective arbitration, (4) additional service fee, and (5) non-transparent task assignment process. To improve those problems, we replaced the centralized crowdsourcing platform with a decentralized blockchain infrastructure. And we analyzed the challenge problems of multi-skilled spatial crowdsourcing tasks in the blockchain crowdsourcing system. In addition, a crowdsourcing task allocation algorithm has been proposed, which implements a transparent task distribution process and can adapt to the computing-constrained environment on the blockchain. Compared with the TSWCrowd blockchain-based crowdsourcing model, our system has a higher task allocation rate under the same conditions. And the experimental result shows our work has good economic feasibility, which decentralizes the crowdsourcing process and significantly reduces the additional consumption of the crowdsourcing process.
Cloud accounting adoption in Thai SMEs amid the COVID-19 pandemic: an explanatory case study
Authors: Sastararuji Dalinee , Hoonsopon Danupol , Pitchayadol Pongsakorn , Chiwamit Pimsiri
Published: June 2022

The COVID-19 pandemic has altered the way small and medium-sized businesses (SMEs) function. To maintain business efficiency and reduce operating costs in the context of the constraints imposed by the pandemic, SMEs have been forced to embrace new digital technologies. Cloud accounting is becoming an increasingly important business operating tool for SMEs. By adopting cloud-based accounting, SMEs can become more efficient, financially organized, and flexible. This study aims to investigate the factors that have a pervasive influence on cloud accounting adoption among SMEs in Thailand, following the pandemic's effects. This study integrates three technology adoption theories—the Technology–Organization–Environment framework, Diffusion of Innovation theory, and Institutional Theory—and studies them alongside SMEs' unique characteristics. The research employs a qualitative case study method and triangulated sources of evidence. The findings provide important implications for the research community, policymakers, cloud accounting vendors, and SME owners aiming to formulate better approaches to cloud accounting adoption after the pandemic. The results suggest that vendors should focus on SMEs' particular characteristics and needs. By contrast, SMEs should determine the organizational fit of the cloud accounting platform and integrate cloud accounting with other aspects of their operations.
Relational capital and strategic orientations as antecedents of innovation: evidence from Mexican SMEs
Authors: Ramírez-Solis Edgar R. , Llonch-Andreu Joan , Malpica-Romero Alberto D.
Published: June 2022

Questions "Where does innovation initiate in a company?" and "How can a small and medium-sized enterprise (SME) leverage its different resources to enhance its innovation capabilities to outperform its competitors?" remain unanswered to date. Accordingly, this study examined the relationship between the firm's relational capital and fundamental strategic orientations that a firm can adopt and how these different orientations affect innovation and organizational performance. The target sample included 360 Mexican SMEs who completed a pen-and-pencil questionnaire conducted at the four main cities of this country. Structural equation modeling was performed, and results revealed a strong positive effect of relational capital over all four strategic orientations considered in this study. However, mixed findings of strategic orientations and innovation were obtained. Although market and entrepreneurial orientation positively influenced innovation, a negative relationship was found between learning orientation and innovation and a nonsignificant relationship between technology orientation and innovation. As expected, innovation positively influenced the performance of SMEs. This study offers essential academic contributions and interesting managerial insights to improve performance using relational capital through innovation and strategic orientations. Therefore, we propose relational capital as an underexploited resource and a source of innovation for SMEs.
Target capture sequencing reveals a monoclonal outbreak of respiratory syncytial virus B infections among adult hematologic patients
Authors: Baier Claas , Huang Jiabin , Reumann Kerstin , Indenbirken Daniela , Thol Felicitas , Koenecke Christian , Ebadi Ella , Heim Albert , Bange Franz-Christoph , Haid Sibylle , Pietschmann Thomas , Fischer Nicole
Published: June 2022

Background

Respiratory syncytial virus (RSV) causes community-acquired respiratory tract infections during winter. However, outbreaks in hospitals also occur repeatedly. In particular, patients with hematologic malignancies are at an increased risk for a severe and potentially fatal course of RSV infection. Here we present the investigation of an RSV outbreak in a hematology ward for adults following the ORION statement.

Methods

An epidemiologic and molecular outbreak analysis was performed. We developed and employed a minimal oligonucleotide probe set in target capture probe sequencing that allows cost-effective RSV-A or -B capturing to reconstruct RSV genomes from clinical samples.

Results

Four adult patients were involved in the outbreak caused by RSV-B in March 2019. The enforcement of the pre-existing infection control measures by effective training of hospital staff contributed to a successful containment. PCR-based RSV screening on the ward enabled early detection of new cases and rapid isolation measures. The molecular analysis demonstrated that the outbreak sequences were highly related and distinct to other RSV-B strains circulating at the same time.

Conclusions

A multimodal infection control concept is essential for the timely detection and control of RSV outbreaks in patients with hematological disease. Among other measures, preventive screening for respiratory viruses is recommended. Furthermore, the integration of conventional and molecular epidemiology, such as whole-genome sequencing and variant calling, significantly contributes to the understanding of transmission pathways. Based on this, appropriate conclusions can be drawn for targeted prevention measures that have prepared us for the COVID-19 pandemic beyond the RSV approach described here.
Say NOPE to social disorganization criminology: the importance of creators in neighborhood social control
Authors: Linning Shannon J. , Olaghere Ajima , Eck John E.
Published: June 2022

Despite decades of research into social disorganization theory, criminologists have made little progress developing community programs that reduce crime. The lack of progress is due in part to faulty assumptions in the theory: that neighborhoods are important; that residents are the primary source of control; and that informal social controls are emergent. In this paper we propose an alternative: the neighborhoods out of places explanation (NOPE). NOPE starts with property parcels (i.e., proprietary places), rather than neighborhoods. It focuses on the power and legal authority of people and institutions that own property, rather than on residents. It posits that control is intentional and goal driven, rather than emergent. We refer to those who own and control as creators. This small group of elites shape city areas and residents must adapt to the environments that suppress or facilitate crime. We discuss how shifting our focus to creators provides important new implications for theory, research, and policy in criminology.
Geometry aware physics informed neural network surrogate for solving Navier–Stokes equation (GAPINN)
Authors: Oldenburg Jan , Borowski Finja , Öner Alper , Schmitz Klaus-Peter , Stiehm Michael
Published: June 2022

Many real world problems involve fluid flow phenomena, typically be described by the Navier–Stokes equations. The Navier–Stokes equations are partial differential equations (PDEs) with highly nonlinear properties. Currently mostly used methods solve this differential equation by discretizing geometries. In the field of fluid mechanics the finite volume method (FVM) is widely used for numerical flow simulation, so-called computational fluid dynamics (CFD). Due to high computational costs and cumbersome generation of the discretization they are not widely used in real time applications. Our presented work focuses on advancing PDE-constrained deep learning frameworks for more real-world applications with irregular geometries without parameterization. We present a Deep Neural Network framework that generate surrogates for non-geometric boundaries by data free solely physics driven training, by minimizing the residuals of the governing PDEs (i.e., conservation laws) so that no computationally expensive CFD simulation data is needed. We named this method geometry aware physics informed neural network—GAPINN. The framework involves three network types. The first network reduces the dimensions of the irregular geometries to a latent representation. In this work we used a Variational-Auto-Encoder (VAE) for this task. We proposed the concept of using this latent representation in combination with spatial coordinates as input for PINNs. Using PINNs we showed that it is possible to train a surrogate model purely driven on the reduction of the residuals of the underlying PDE for irregular non-parametric geometries. Furthermore, we showed the way of designing a boundary constraining network (BCN) to hardly enforce boundary conditions during training of the PINN. We evaluated this concept on test cases in the fields of biofluidmechanics. The experiments comprise laminar flow (Re = 500) in irregular shaped vessels. The main highlight of the presented GAPINN is the use of PINNs on irregular non-parameterized geometries. Despite that we showed the usage of this framework for Navier Stokes equations, it should be feasible to adapt this framework for other problems described by PDEs.
Decision-making and the trajectories of young Europeans in the London region: the planners, the dreamers, and the accidental migrants
Authors: Koikkalainen Saara , Lulle Aija , King Russell , Leon-Himmelstine Carmen , Szkudlarek Aleksandra
Published: June 2022

This paper focuses on the intra-EU movement of young adults from Finland, Poland, and Spain who have settled, short- or long-term, in London and its wider region. In our comparative analysis, we find that the 46 interviewees differ in the way in which they took the original decision to move to the UK. Study, work, career, life goals, and lifestyle are the main variables shaping, in various combinations, migration decisions and plans. We categorize the decision-making and subsequent trajectories into three groups based on migrants’ life-stories. The first group, the planners, had a long-term plan to move abroad with well-defined objectives of what they hoped to achieve. The second group, the dreamers, had the idea to move abroad someday, but then decided to activate the idea rather suddenly. The third group, the accidental migrants, moved abroad almost by accident, having had no prior plans, but responded to the opportunity when it arose out of a chance event, and had no specific plans as to what they would do abroad. The boundaries between these groups are somewhat blurred and the mobile individual’s attitudes and motivation towards migration may change over time. Examining the decision-making process of current migrants helps to estimate how inbound mobility to the UK from the EU might change in the new post-Brexit migration scenario.
Awake intubation for thoracic aortic aneurysm causing esophageal stenosis with food residues and compression of the pulmonary artery and left bronchi: a case report
Authors: Suda Yasuhiro , Sugawara Ami , Kanao-Kanda Megumi , Shirasaka Tomonori , Kamiya Hiroyuki , Kanda Hirotsugu
Published: June 2022

Background

Anesthetic management of thoracic aortic aneurysms (TAAs) is sometimes difficult due to fatal complications, including hypovolemic shock secondary to aneurysm rupture. We report the successful management of an impending rupture of a TAA with associated esophageal stenosis and compression of the pulmonary artery and left bronchi.

Case presentation

An 83-year-old woman, diagnosed with an impending rupture of the ascending TAA, was scheduled to undergo emergency total aortic arch replacement. Computed tomography showed esophageal stenosis with significant amounts of food residues in the thoracic esophagus and compression of the pulmonary artery and bronchi. We performed awake intubation and superior laryngeal nerve block with light sedation to prevent aspiration and aneurysmal rupture, respectively. General anesthesia was induced immediately after the intubation. No intraoperative complications occurred.

Conclusions

Performing awake intubation with a superior laryngeal nerve block and sedation may prevent aspiration of food residues and hemodynamic changes that may lead to rupture.
Postoperative respiratory depression in patients on sublingual buprenorphine: a retrospective cohort study for comparison between postoperative continuation and discontinuation of buprenorphine
Authors: Komatsu Ryu , Singleton Michael D. , Peperzak Katherin A. , Wu Jiang , Dinges Emily M. , Bollag Laurent A.
Published: June 2022

Background

We tested the hypothesis that patients who continued buprenorphine postoperatively experience postoperative respiratory depression less frequently than those who discontinued buprenorphine.

Methods

This is a retrospective cohort study of patients who were on buprenorphine preoperatively. The primary outcome was postoperative respiratory depression as defined by respiratory rate < 10/minute, oxygen saturation (SpO2) < 90%, or requirement of naloxone for 48 h postoperatively. The secondary outcome was the composite of postoperative respiratory complications. The associations between postoperative buprenorphine continuation and respiratory depression and respiratory complications were estimated using separate multivariable logistic regression models, including demographic, intraoperative characteristics, and preoperative buprenorphine dose as covariates.

Results

Postoperative buprenorphine continuation was not associated with postoperative respiratory depression (adjusted odds ratio (OR), 1.11, 95% confidence interval (CI), 0.61 to 1.99, P=0.72). In subanalysis stratified by the preoperative buprenorphine dose, buprenorphine continuation was not associated with postoperative respiratory depression either when preoperative buprenorphine dose was high (≥16 mg daily) or low (<16 mg daily). Postoperative buprenorphine continuation was associated with lower incidence of postoperative respiratory complications (adjusted OR, 0.43, 95% CI, 0.21 to 0.86, P=0.02).

Conclusions

Continuing buprenorphine was not associated with respiratory depression, but it was associated with a lower incidence of respiratory complications.
What matters in the annuitization decision?
Authors: Abou Daya Mohamad Hassan , Bernard Carole
Published: June 2022

We perform a simultaneous test for several rational and behavioral factors known to affect the uptake of life annuities in a sample of Americans. We also investigate whether analysts’ short-term stock market expectations affect the decision to annuitize retirement wealth. We find that facing such expectations without trusting them lowers the purchase of annuities. Moreover, we find that individuals who trusted financial analysts’ expectations were less likely to purchase annuities. We attribute these findings to the availability heuristic and present bias, respectively. Finally, we discuss the mediating role of annuity antipathy. Our results provide guidance for policy-makers and annuity providers and offer venues for future research.
The burden of polypharmacy and potentially inappropriate medication in Nigeria: a clarion call for deprescribing practice
Authors: Borodo Safiya Bala , Jatau Abubakar Ibrahim , Mohammed Mustapha , Aminu Nafiu , Shitu Zayyanu , Sha’aban Abubakar
Published: June 2022

Background

Polypharmacy and potentially inappropriate medications (PIMs) could cause adverse drug events leading to poor health outcomes. This burden is addressed through deprescribing practice. However, data on deprescribing practices are lacking in Nigeria, where the healthcare systems are fragile.

Aim

This review aimed to summarise the literature on the burden of polypharmacy and PIMs and identify the need for deprescribing practice in Nigeria.

Method

A systematic search of the literature was conducted on MEDLINE through PubMed (Public Medline), Google Scholar, and a manual search of included articles to identify information on deprescribing, polypharmacy, and PIMs in Nigeria from the inception of the database to date. Relevant information from the articles was summarised and presented as subsections in the manuscript.

Results

In this review, we reported the burden of polypharmacy, PIMs, and the need for deprescribing practice in Nigeria. The estimated prevalence of polypharmacy was up to 23.8% among older patients with chronic disorders. Polypharmacy and PIMs have been reported to be a significant cause of medication non-adherence, drug addiction, drug interactions, adverse drug reactions, hospitalisation, morbidity, and mortality. Thus, there is the need to consider deprescription practice in the country.

Conclusion

This review revealed that polypharmacy and PIMs are common in Nigeria. Therefore, there is a need for deprescribing practice to improve drug safety in the country. This could be achieved through patient education, increasing awareness of deprescribing practice among the healthcare professionals, and ensuring adherence to the core prescribing indicators of the World Health Organization (WHO) and National Standard Treatment Guidelines.
Role of transperineal ultrasound in evaluation of patients with perianal inflammatory disorders
Authors: Roman Boles Mary Salah , Awadallah Maryse Youssef , Shawali Haney Ahmed Sami , Farag Ahmed , El-Sayed Rania Farouk
Published: June 2022

Background

The aim of this study was to study the degree of accuracy of transperineal ultrasound (TPUS) in pre-operative evaluation and follow-up of cases with perianal inflammatory disorders in relation to MRI findings. Thirty patients with symptoms and signs of perianal inflammatory disorders underwent TPUS and pelvic MRI examinations. The radiologist who performed the TPUS was blinded to MR findings and was asked to comment on the site of the internal opening and extension of the tract, any related side branches or collections.

Results

The overall accuracy of TPUS in detection of the site of internal opening of perianal tracts was 83.33%, with sensitivity of 91.30%. TPUS showed sensitivity, specificity and accuracy of 100% in detection of horseshoe collections. The overall accuracy of TPUS in detection of perianal abscesses was 93.33% with specificity of 100%. TPUS showed sensitivity of 50.00%, specificity of 92.31% and accuracy of 86.67% in visualization of side branches. TPUS showed sensitivity of 33.33%, specificity of 88.89% and overall accuracy of 83.33% in detection of supralevator extension of perianal tracts. TPUS correctly classified (23/30) perianal tracts with accuracy of 76.7%.

Conclusions

TPUS can be used as a first diagnostic tool in patients with perianal inflammatory disorders and related pathologies, particularly horseshoe collections which can change the operative decision made by the surgeon. TPUS can be used in repeated follow-up during the course of management of perianal inflammatory disorders or when other imaging modalities are unavailable or contra-indicated.
Implementation strategies to promote measurement-based care in schools: evidence from mental health experts across the USA
Authors: Connors Elizabeth H. , Lyon Aaron R. , Garcia Kaylyn , Sichel Corianna E. , Hoover Sharon , Weist Mark D. , Tebes Jacob K.
Published: June 2022

Background

Despite an established taxonomy of implementation strategies, minimal guidance exists for how to select and tailor strategies to specific practices and contexts. We employed a replicable method to obtain stakeholder perceptions of the most feasible and important implementation strategies to increase mental health providers’ use of measurement-based care (MBC) in schools. MBC is the routine use of patient-reported progress measures throughout treatment to inform patient-centered, data-driven treatment adjustments.

Methods

A national sample of 52 school mental health providers and researchers completed two rounds of modified Delphi surveys to rate the relevance, importance, and feasibility of 33 implementation strategies identified for school settings. Strategies were reduced and definitions refined using a multimethod approach. Final importance and feasibility ratings were plotted on “go-zone” graphs and compared across providers and researchers to identify top-rated strategies.

Results

The initial 33 strategies were rated as “relevant” or “relevant with changes” to MBC in schools. Importance and feasibility ratings were high overall for both survey rounds; on a scale of 1 to 5, importance ratings (3.61–4.48) were higher than feasibility ratings (2.55–4.06) on average. Survey 1 responses resulted in a reduced, refined set of 21 strategies, and six were rated most important and feasible on Survey 2: (1) assess for readiness and identify barriers and facilitators; (2) identify and prepare champions; (3) develop a usable implementation plan; (4) offer a provider-informed menu of free, brief measures; (5) develop and provide access to training materials; and (6) make implementation easier by removing burdensome documentation tasks. Provider and researcher ratings were not significantly different, with a few exceptions: providers reported higher feasibility and importance of removing burdensome paperwork than researchers, providers reported higher feasibility of train-the trainer approaches than researchers, and researchers reported higher importance of monitoring fidelity than providers.

Conclusions

The education sector is the most common setting for child and adolescent mental health service delivery in the USA. Effective MBC implementation in schools has the potential to elevate the quality of care received by many children, adolescents, and their families. This empirically derived, targeted list of six implementation strategies offers potential efficiencies for future testing of MBC implementation in schools.
The impact of macroeconomic factors on food price inflation: an evidence from India
Authors: Samal Asharani , Ummalla Mallesh , Goyari Phanindra
Published: June 2022

The present study investigates the impact of macroeconomic factors on food price inflation in India utilizing the monthly time series during January 2006–March 2019. The long-run relationship is confirmed among the variables using the ARDL bounds testing approach to cointegration. The coefficients of long-run estimates show that per capita income, money supply, global food prices, and agricultural wages are positively and significantly impacted food price inflation in both the short and long-run. While food grain availability has a negative and significant impact on food price inflation in both the short-run and long run. Further, the short-run estimates revealed that real exchange rate positively impacts food price inflation. However, the coefficient is insignificant in the short-run. The Granger causality estimates show that a short-run bidirectional causality is confirmed among per capita income, the exchange rate, per capita net availability of food grain and food price inflation. Further, there is evidence of unidirectional causality running from global food prices to food price inflation. However, there is no causal relationship running from money supply and agricultural wages to food price inflation in the short-run.
Clinicopathological Features and Mortality in Patients With Kaposi Sarcoma and HIV: A Retrospective Analysis of a Thirty-Year Study From a Peruvian Oncologic Center
Authors: Cuellar Luis E. , Meza Kelly , Holguín Alexis Manuel , Velarde Juan , Portillo-Alvarez Diana , Castro Victor , Sulca-Huamani Oliver , Intimayta-Escalante Claudio , Gaby-Pérez Rushmely , Patel Arpan
Published: June 2022

PURPOSE

Kaposi's sarcoma (KS) is a multifocal angioproliferative disease. In Peru, the implementation of the highly active antiretroviral treatment (HAART) program was in 2005, the model for treating patients with HIV-positive KS shifted to a potential cure. In this study, we aim to compare clinicopathological characteristics and prognostic factors associated with outcomes in patients with HIV-positive KS.

METHODS

We developed a retrospective cohort study that includes patients with HIV/AIDS and KS seen in the Instituto Nacional de Enfermedades Neoplasicas between 1987 and 2017. Patients were divided into two groups according to the implementation of HAART in our country: the non-HAART group and those treated with HAART after 2005. Multivariate analysis for overall survival (OS) was performed with the Cox proportional hazard regression model.

RESULTS

There was a greater visceral compromise and more extensive oral cavity involvement in the non-HAART group (60% 31.7%, P < .01). Regarding the immune status, there was a significant difference from the CD4 count at 1-year follow-up (73 v 335, P = .01). The CD4/CD8 rate were significant different before QT (0.23 v 0.13, P = .01) and at 1-year follow-up (0.12 v 0.32, P = .03.). The estimated 5-year OS rate was significantly lower ( P = .0001) for the non-HAART group (41.7%; 95% CI, 25.9 to 56.9) compared with the HAART group (79.3%; 95% CI, 66.8 to 87.5). In the multivariate model for OS, full-HAART regimen and previous diagnosis of HIV/AIDS ( P < .01) were significantly associated with longer survival.

CONCLUSION

Clinical and demographic characteristics of our patients are compatible with the literature, but we report a higher rate of gastrointestinal involvement. Furthermore, our findings provide evidence for the importance of HAART and its ability to reduce KS-related mortality.
Density-induced BCS-Bose evolution in gated two-dimensional superconductors: The role of the interaction range in the Berezinskii-Kosterlitz-Thouless transition
Authors: Shi Tingting , Zhang Wei , Sá de Melo C. A. R.
Published: June 2022

We discuss the evolution from Bardeen-Cooper-Schrieffer (BCS) to Bose superconductivity vs. carrier density n in two-dimensional (2D) gated superconductors and address the fundamental role that the interaction range plays in the Berezinskii-Kosterlitz-Thouless transition. We investigate the density dependence of the critical temperature (T

c
), superfluid density, order parameter modulus, chemical potential and pair size. Our most important finding is that it is absolutely essential to include classical and quantum phase fluctuations, as well as finite-ranged interactions to explain the non-monotonic behavior of T

c

vs. n and to guarantee that the upper bound on T

c
is not exceeded in 2D superconductors, as experimentally observed in

(Nakagawa Y. et al., Science, 372 (2021) 190), a lithium-intercalated layered nitride, and in magic-angle twisted trilayer graphene (Park J. M. et al., Nature, 590 (2021) 249). Furthermore, we show that we can extract, from measurements of T

c
and the order parameter modulus, the effective mass of charge carriers and their interaction strength and range.
Cost Comparison of Microsurgery vs Endovascular Treatment for Ruptured Intracranial Aneurysms: A Propensity-Adjusted Analysis
Authors: Labib Mohamed A. , Rumalla Kavelin , Karahalios Katherine , Srinivasan Visish M. , Nguyen Candice L. , Rahmani Redi , Catapano Joshua S. , Zabramski Joseph M. , Lawton Michael T.
Published: June 2022

BACKGROUND:

In specialized neurosurgical centers, open microsurgery is routinely performed for aneurysmal subarachnoid hemorrhage (aSAH).

OBJECTIVE:

To compare the cost of endovascular vs microsurgical treatment for aSAH at a single quaternary center.

METHODS:

All patients undergoing aSAH treatment from July 1, 2014, to July 31, 2019, were retrospectively reviewed. Patients were grouped based on primary treatment (microsurgery vs endovascular treatment). The primary outcome was the difference in total cost (including hospital, discharge facility, and all follow-up) using a propensity-adjusted analysis.

RESULTS:

Of 384 patients treated for an aSAH, 234 (61%) were microsurgically treated and 150 (39%) were endovascularly treated. The mean cost of index hospitalization for these patients was marginally higher ($9504) for endovascularly treated patients ($103 980) than for microsurgically treated patients ($94 476) (P = .047). For the subset of patients with follow-up data available, the mean total cost was $45 040 higher for endovascularly treated patients ($159 406, n = 59) than that for microsurgically treated patients ($114 366, n = 105) (P < .001). After propensity scoring (adjusted for age, sex, comorbidities, Glasgow Coma Scale score, Hunt and Hess grade, Fisher grade, aneurysms, and type/size/location), linear regression analysis of patients with follow-up data available revealed that microsurgery was independently associated with healthcare costs that were $37 244 less than endovascular treatment costs (P < .001). An itemized cost analysis suggested that this discrepancy was due to differences in the rates of aneurysm retreatment and long-term surveillance.

CONCLUSION:

Microsurgical treatment for aSAH is associated with lower total healthcare costs than endovascular therapy. Aneurysm surveillance after endovascular treatments, retreatment, and device costs warrants attention in future studies.
Making Meaningful Use of Price Transparency Data: Describing Price Variation of Spine Surgery and Imaging in a Single System
Authors: Olufawo Michael O. , Evans Sophia S. , Stecher Priscilla T. , Youkilis Samuel L. , Dibble Christopher F. , Greenberg Jacob K. , Ray Wilson Z. , Hamilton Barton H. , Leuthardt Eric C.
Published: June 2022

Price transparency is an increasingly popular solution for high healthcare expenditures in the United States, but little is known about its potential to facilitate patient price shopping. Our objective was to analyze interhospital and interpayer price variability in spine surgery and spine imaging using newly public payer-specific negotiated charges (PNCs). We selected a subset of billing codes for spine surgery and spine imaging at 12 hospitals within a Saint Louis metropolitan area healthcare system. We then compared PNCs for these procedures and tested for significant differences in interhospital and interinsurer IQR using the Mann–Whitney U Test. We found significantly greater IQRs of PNCs as a factor of the insurance plan than as a factor of the hospital for cervical spinal fusions (interinsurer IQR $8256; interhospital IQR $533; P < .0001), noncervical spinal fusions (interinsurer IQR $28 423; interhospital IQR $5512; P < .001), computed tomographies of the lower spine (interinsurer IQR $595; interhospital IQR $113; P < .0001), and MRIs lower spinal canal (interinsurer IQR $1010; interhospital IQR $158; P < .0001). There was no significant difference between the interinsurer IQR and the interhospital IQR for lower spine x-rays (interinsurer IQR $107; interhospital IQR $67; P = .0543). Despite some between-hospital heterogeneity, we show significantly higher price variability between insurers than between hospitals. Our single system analysis limits our ability to generalize, but our results suggest that savings depend more on hospital and provider negotiations than patient price shopping, given the difficulty of switching insurers.
Lumbar Giant Disk Herniations Treated With a Unilateral Approach for Bilateral Decompression
Authors: Sommer Fabian , McGrath Lynn , Kirnaz Sertac , Goldberg Jacob , Medary Branden , Schmidt Franziska A. , Shtayer Lior , Gadjradj Pravesh S. , Härtl Roger
Published: June 2022

BACKGROUND:

Disk herniations that obstruct the spinal canal by more than 50% are named “giant disk herniations” (GDHs). GDHs are challenging to treat from a surgical perspective because of their size and the risk of iatrogenic manipulation during resection resulting in additional neurological compromise. As a result, the appropriateness of minimally invasive tubular approaches for the treatment of lumbar GDHs remains controversial.

OBJECTIVE:

To report our experience in treating lumbar GDHs using tubular minimally invasive surgery.

METHODS:

A total number of 228 disk herniations were evaluated for the criteria of GDH. In addition, the presence of neurological deficits such as cauda equina syndrome, pain as measured by a visual analog scale, operating time, complications, estimated intraoperative blood loss, and number of surgical revisions were assessed. The standard tubular diskectomy technique was modified to include unilateral laminectomy for bilateral decompression before the diskectomy to create a sufficient working space for removal of the disk fragments.

RESULTS:

Twenty-three (10%) patients met the criteria for GDH. Clinically significant motor weakness was present in 21 patients (91.3%) before surgery, and 3 patients (13%) presented with cauda equina syndrome. The average mean visual analog scale (±SD) for the preoperative pain score was 8.3 and decreased to 2.4 at follow-up after surgery. All cases of cauda equina syndrome resolved postoperatively.

CONCLUSION:

Unilateral tubular minimally invasive surgery diskectomy seems to be a safe and effective treatment alternative for lumbar GDHs, combined with the “over-the-top” decompression, which provides bilateral decompression and working space.