bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of early versus delayed umbilical cord clamping on term neonates' haemoglobin levels: a randomized controlled trial
Authors: Enyinna Kelechi P. , Eleje George U. , Odugu Boniface U. , Nevo Calistus O. , Ofor Ifeanyichukwu J. , Mbachu Ikechukwu I. , Eze Chukwuka C. , Okoh Darlington S. , Ikwuka David C. , Awkadigwe Fredrick I. , Okafor Chidinma C. , Malachy Divinefavour E. , Ortuanya Kelvin E. , Eze Hyacinth T. , Okoro Chukwuemeka C. , Okafor Chigozie G.
Published: June 2024

Objective

To compare the effects of early and delayed cord clamping on the haemoglobin levels of neonates delivered at term.

Methods

This randomized controlled trial enrolled pregnant women during the second stage of labour. They were randomized into either the early cord clamping (ECC) group or the delayed cord clamping (DCC) group in the ratio of 1:1. Following delivery of the baby, the umbilical cords of participants in the ECC group were clamped within 30 s of delivery of the neonate while those of participants in the DCC group were clamped after 2 min from the delivery of the neonate. The primary outcome measure was the effect of ECC and DCC on the haemoglobin levels of neonates delivered at term.

Results

A total of 270 pregnant women were enrolled in the study. Their baseline sociodemographic and clinical characteristics were similar in both groups. There was no significant difference in the mean haemoglobin level between ECC and DCC groups at birth. The mean haemoglobin level of the neonates at 48 h postpartum was significantly higher in the DCC group than the ECC group.

Conclusion

DCC at birth was associated with a significant increase in neonatal haemoglobin levels at 48 h postpartum when compared with ECC. Trial Registration: The trial was registered at Pan African Clinical Trial Registry with approval number PACTR202206735622089.
Middle Eocene molluscan fossils from the Siju Formation of the Garo Hills, Meghalaya, India
Authors: Singh Y. Raghumani , Singh Sh. Priyokumar , Devi K. Bigyapati , Singh W. Ajoykumar , Singh Ningthoujam Surdas
Published: June 2024

Bivalves and Gastropoda are collected from the Siju Formation of South Garo Hills, Meghalaya, India. Eighteen molluscan taxa are recorded, that is, nine taxa of bivalves and nine taxa of gastropods. These are comprising Ostrea ( Ostrea) adbasaensis, Lucina rakhiensis, Lucina ( Lucina) yawensis, Trachycardium minbuense, Mactra ( Mactra) protoreevesii, Pitar ( Calpitaria) carteri, Paphia ( Callistotapes) pseudoliratus, Tellina ( Peronaea) planta, Corbula ( Bicorbula) praexarata, Natica coxi, Seila stracheyi, Euspira soriensis, Semicassis mekranica, Oliva ( Strephona) australis var. indica, Conus ( Lithoconus) kyudawonensis. Dolium ( Eudolium) arabicum, Gistortia ( Vicetia) depressa and Planorbis sp. The detailed systematic description of the present molluscan fossils is studied. One zone is established, that is, Lucina yawensis– E. soriensis zone, for correlation purpose and dating. Overall, the zone is based on the total range of molluscan species and name accordingly. The present zone has been assigned to Middle Eocene in age.
Musculoskeletal disorders and visual problems among surgical versus medical physicians: A cross-sectional study
Authors: Khorshed Enjy Ahmad Esmat , El-Shafei Dalia A , Zaitoun Mona Fathy , ElHewala Tarek , Awad Ahmed Mohamed Bahgat , Elshamy Raghda Ali
Published: June 2024

The healthcare industry is one of the main industries with a high prevalence of musculoskeletal disorders (MSDs). Surgical practice mostly involves repetitive tasks with fine motor control, precise motions, high levels of mental concentration, and close visual focus. This cross-sectional study aimed to define the prevalence and risk factors of MSDs and visual problems among physicians. One hundred surgical physicians and one hundred medical physicians were involved in the study. Both groups underwent assessment of socio-demographic and occupational history, alongside evaluation for musculoskeletal and visual problems. The study revealed a significantly higher prevalence of MSDs, particularly neck and back pain, as well as blurred near vision and eye dryness, among surgical physicians compared to medical physicians. Risk factors for these conditions included long working hours (≥30 h/week) in clinics or operating rooms, as well as using endoscopes and microscopes/loupes during surgery. In conclusion, MSDs and visual problems were prevalent among physicians, particularly surgical physicians. Integrating ergonomic principles across all domains of healthcare and promoting healthcare worker awareness through training and intervention programs are crucial steps in addressing these issues.
Contestations of Liberal Globalism and the Rise of the Retrograde Party
Authors: Kemmerzell Jörg , Selk Veith
Published: June 2024

The crisis of the liberal order opened up space for ideas that only some years ago had appeared out of time. During globalization’s heyday, parties that called for a rollback of liberal globalism were either stuck in a marginal position or unable to implement fundamental reforms. This has changed as the main political approaches toward liberal globalism are now being publicly and electorally contested. We argue that this has triggered the rise of a phenomenon we refer to as retrogradism. This article applies the concept of retrogradism to the case of the German right-wing party Alternative für Deutschland (AfD). It argues that we may be witnessing the rise of a new type of political party that pursues a retrograde agenda. We suggest that the current debate on the AfD fails to take into account that its defining features may be its politics of time and its retrograde opposition to liberal globalism.
The War in Ukraine: Challenges to Just War Doctrines in Eastern Orthodoxy
Authors: Stoyanov Yuri
Published: June 2024

The sequence and escalation of Russian–Ukrainian political and military conflicts since 2014, culminating in Russia's invasion of Ukraine in February 2022, have reopened interest in and debates on just war theory and practice in general and specifically in historic and modern Eastern Orthodox cultures and Orthodox-majority states. These debates have significant repercussions in areas like church–state and church–military relations in these cultures; ecclesial involvement in these conflicts has varied from war-justification rhetoric (in the case of the Russian Orthodox Church) to reiterations of the inherited traditions of ecclesial pacifism/condemnation of all violence (the Ecumenical Patriarchate of Constantinople, a number of Orthodox Churches, clerical and theological networks, etc.). The Russian ecclesial involvements in the justification of war/military necessity and formulation of just war narratives have triggered divisions and antagonisms in the Eastern Orthodoxy. The development and course of the ecclesial conflicts involving Russian and Ukrainian Orthodox churches and parishes (and other Orthodox ecclesiastic bodies) will show whether Orthodox religious actors may begin to play a more significant role in the articulation and application of newly emerging trends in areas like the theology of just peace, just peace-making and Christian realism, Orthodox social ethics and the dynamic praxis of just peace-making.
The space of permanent and state-level exceptional security measures: Formative years of Israel and Turkey
Authors: Türkoğlu Burcu , Elitsoy Z Asli
Published: June 2024

Studies examining the spatial patterns of exceptional security measures focus on constructed spaces or national territories exposed to international military intervention. Contemporary literature defines these spaces as zones of lawlessness where the exception prevails. By examining the security policies in the historical homelands of the Palestinians in Israel and the Kurds in Turkey, this article shows how exceptional security and the law co-constitute each other. Through a comparative historical analysis of the formative years of the Israeli and Turkish states, we argue that permanent exceptional security measures in territories inhabited by minority citizens are relevant to the political context in which the constituent power frames the political characteristics of the nation. In the process, exceptional security measures coexisting with the law become instrumental in maintaining and reproducing the distinction between the ‘legitimate members’ of the nation and the ‘enemies’ of the nation/state. The coexistence of exceptional security measures with the legal system challenges the conventional understanding of the exception and its dichotomous relationship with the norm, as outlined by Schmitt and Agamben. Instead, the conceptual framework of ‘legal violence,’ as articulated by Benjamin, offers a more comprehensive perspective for understanding the early years of the Israeli and Turkish states.
Do You Love Me, or Do You Hate Me? Bad Communication’s Effect on Low-Cost Airline Brand
Authors: Rodrigues Paula , Sousa Ana , Borges Ana Pinto
Published: June 2024

This study examined the influence of brand personality on consumer–brand relationships, specifically brand love (BL) and brand hate (BH), and their subsequent impact on purchase intention, drawing from the balance theory of attitude change. It also investigated whether negative communication associated with a low-cost airline brand moderates these relationships, potentially increasing or decreasing purchase intention. Structural equation modelling and Hayes’s PROCESS macro were employed for analysis based on data from a survey of 200 Portuguese consumers. Results indicate that the selected dimensions of brand personality positively influence BL and negatively influence BH, while both BL and BH impact purchase intention. Additionally, ‘Bad’ communication was found to moderate the relationship between BL/BH and purchase intention. This research contributes to the branding literature by exploring these relationships within the airline service sector and underscores the significance of considering the impact of negative brand information on emotional consumer–brand relationships in this context.
Maritime Diplomacy and Regional Cooperation Mechanisms: Insights from the Black Sea and Bay of Bengal
Authors: Islam Md Syful
Published: June 2024

This article conducts a comparative analysis of maritime diplomacy in the Black Sea and Bay of Bengal, focusing on the challenges and strategies of regional cooperation mechanisms like the Black Sea Economic Cooperation Organization (BSEC) and the Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation (BIMSTEC). It explores the unique geopolitical contexts of these maritime regions, addressing issues such as territorial disputes, resource competition, piracy and environmental concerns. The study examines the influence of external powers, including Russia, the EU, China and the USA, and their impact on regional dynamics. Utilizing a comparative analysis approach, the study examines the geopolitical dynamics, roles and effectiveness of BSEC and BIMSTEC in promoting economic integration, security collaboration and crisis response, along with the influence of external powers on these dynamics. The findings reveal the pivotal roles of both organizations in addressing maritime challenges, despite facing issues like economic disparity among members and geopolitical tensions. Key initiatives like joint naval exercises and security agreements have been effective in enhancing regional maritime security and stability. The study concludes by highlighting the need for strengthening organizational frameworks, enhancing transparency and integrating environmental considerations into maritime diplomacy, considering emerging trends like cybersecurity and the increasing role of non-traditional actors.
Assessment of Neonatal Mortality and Associated Hospital-Related Factors in Healthcare Facilities Within Sunyani and Sunyani West Municipal Assemblies in Bono Region, Ghana
Authors: Tawiah Kassim , Asosega Killian Asampana , Iddi Samuel , Opoku Alex Akwasi , Abdul Iddrisu Wahab , Ansah Richard Kwame , Bukari Francis Kwame , Okyere Eric , Adebanji Atinuke Olusola
Published: June 2024

Objectives:

Ghana’s quest to reduce neonatal mortality, in hospital facilities and communities, continues to be a nightmare. The pursuit of achieving healthy lives and well-being for neonates as enshrined in Sustainable Development Goal three lingered in challenging hospital facilities and communities. Notwithstanding that, there have been increasing efforts in that direction. This study examines the contributing factors that hinder the fight against neonatal mortality in all hospital facilities in the Sunyani and Sunyani West Municipal Assemblies in Bono Region, Ghana.

Methods:

The study utilized neonatal mortality data consisting of neonatal deaths, structural facility related variables, medical human resources, types of hospital facilities and natal care. The data was collected longitudinally from 2014 to 2019. These variables were analysed using the negative binomial hurdle regression (NBH) model to determine factors that contribute to this menace at the facility level. Cause-specific deaths were obtained to determine the leading causes of neonatal deaths within health facilities in the two municipal assemblies.

Results:

The study established that the leading causes of neonatal mortality in these districts are birth asphyxia (46%), premature birth (33%), neonatal sepsis (11%) and neonatal jaundice (7%). The NBH showed that neonatal mortality in hospital facilities depend on the number of incubators, monitoring equipment, hand washing facilities, CPAPb machines, radiant warmers, physiotherapy machines, midwives, paediatric doctors and paediatric nurses in the hospital facility.

Conclusions:

Early management of neonatal sepsis, birth asphyxia, premature birth and neonatal infections is required to reduce neonatal deaths. The government and all stakeholders in the health sector should provide all hospital facilities with the essential equipment and the medical human resources necessary to eradicate the menace. This will make the realization of Sustainable Development Goal three, which calls for healthy lives and well-being for all, a reality.
The Effect of National Origin and Skin Color on Playing Time in the WNBA
Authors: Agha Nola , Berri David J. , Bhat Akash , Van Gilder Jennifer
Published: June 2024

This article uses data from the 1997–2022 seasons to investigate the role of bias in the distribution of playing time in the WNBA. We evaluate national origin, a fixed and objective measure, and improve upon past uses of subjective, perception-based measures of race by using a more objective measure of skin tone. More specifically, via a fixed-effect estimation of 2,949 WNBA player-year combinations we find no evidence that the national origin of either players or coaches is related to the provision of playing time. Similarly, skin tone of players or coaches ( n = 893), either alone or in combination with national origin, shows no robust significance. Evidence of national origin bias has previously been reported in professional men's basketball leagues in the U.S., Spain, and China. The WNBA may be demographically similar to the National Basketball Association, but it is culturally different and we find no evidence of employer discrimination.
Linking Local Insights to Global IR: Locating Malaysian Contours and Contributions
Authors: Kuik Cheng-Chwee , Benny Guido
Published: June 2024

This article traces the trajectories, theoretical propensities, and thematic insights underlying Malaysian scholarly thinking and writings about international relations (IR). It argues that while their contributions to the Global IR research program have been indirect and implicit, they are not insignificant. The contributions are not claims of exceptionalism but expressions of diverse experiences, perspectives, and narratives that are reflective of the contesting, yet recurring logics significant for understanding and explaining small- and medium-sized states’ behavior in an anarchical world. Three themes are particularly pertinent: (1) external policy choices are extensions of internal attributes; (2) small-state outlook on regionalism and multilateralism; and (3) middle-state alignment behavior. Local insights contribute to Global IR by enriching, expanding, and exporting national narratives and regional mindsets into thematic thrusts pertinent for making sense of similar cases elsewhere, thereby pluralizing the universality and inclusivity of IR concepts and theories.
What Makes Consumers Purchase Social Media Influencers Endorsed Organic Food Products
Authors: Kim Minji , Kim Hyelin (lina) , Ma Zihui , Lee Sooyeon
Published: June 2024

Given the growing interest in healthy and sustainable consumption, organic food has gained much attention from restaurants and markets aiming to achieve a competitive advantage. As a new form of word of mouth, influencers’ endorsements help organic food marketers reach and attract potential consumers. However, little is known about the persuasiveness of influencer marketing in organic food settings. Drawing on source credibility theory, this study proposes influencer credibility as the key to influencer marketing and examines its impact on consumer responses. Using data from an online survey, structural equation modeling revealed a significant and positive relationship between all credibility dimensions (expertise, trustworthiness, attractiveness, and interactivity) and perceived information quality leading to behavioral intention. Moreover, a significant moderation of herd behavior on the credibility information quality relationship was found. These findings will provide useful insights for organic food marketers in developing effective influencer marketing strategies.
Lymphoepithelial carcinoma of the parotid gland
Authors: Kallel Souha , Ayadi Sirine , Salem Noura , Zghal Mouna , Mariem Ben Ayed , Ayedi Lobna , Mnejja Malek , Boudawara Tahya , Charfeddine Ilhem
Published: June 2024

Primary lymphoepithelial carcinoma of the salivary glands is an exceptional oncological condition that predominantly emerges within the parotid gland. A significant prevalence of lymphoepithelial carcinoma has been reported in the Inuit population, along with an associated positive serology for Epstein-Barr virus in these endemic regions. In this paper, we present a case of primary lymphoepithelial carcinoma of the parotid gland in a 68-year-old female patient with a history of diabetes and hypertension residing in a non-endemic area. Histology plays a critical role in the definitive diagnosis, and confirming the primary origin of lymphoepithelial carcinoma after ruling out metastasis from undifferentiated nasopharyngeal carcinoma. The mainstay of treatment is a combination of surgical resection and adjuvant radiotherapy. Inoperable forms are typically managed with chemoradiotherapy.
General Equilibrium Model for Monetary Policy Responses to Macroeconomic Instabilities in Developing Economy: A Ghanaian Perspective
Authors: Akosah Nana Kwame , Alagidede Imhotep Paul , Schaling Eric
Published: June 2024

The study develops a standard New Keynesian model to examine how monetary authority reacts to both domestic and external shocks as well as how its policy decision impacts the general macroeconomy in developing African economy. Using Bayesian estimation techniques and a Ghanaian dataset, the article also seeks to determine the best-suited monetary policy rule for Ghana and countries with similar characteristics. The basic finding is that a forward-looking Taylor rule—where authority reacts to one-period-ahead inflation deviation from target alongside the current output gap—is the most appropriate monetary policy rule for Ghana. Another salient finding is that variations in output are mainly driven by price markup, labour supply, monetary policy and productivity shocks across the forecast horizons. In addition, the dominant determinants of inflation are exchange rate risk premium and price markup shocks. Collectively, the article also unveils that monetary policy responses to macroeconomic shocks are broadly in line with conventional economic theory. There is also conspicuous evidence that the general equilibrium model with representative consumers is practically suitable for monetary policy analysis in Ghana, as contractionary monetary policy impulse is able to contemporaneously induce disinflation and output contraction. Given the strong evidence of a large segment of the unbanked population in Ghana, the findings in this study could be verified based on a model that allows for the co-existence of optimizing and non-optimizing consumers.

JEL Classification: B41, C5, C11, D11, D21, D41, D42, E2, E12, E43, E52, E58, F31, F41
A Study on the Role of the ODOP (One District, One Product) Scheme on Strengthening the Metal Craft Industry in Moradabad Region, Uttar Pradesh
Authors: Sharma Anant Kumar , Kumar Pavnesh
Published: June 2024

The foundation of Uttar Pradesh’s industrial operations and economic development is its traditional occupation, geographic culture and unique products. Products that are unique to a given area play a vital role in the growth of any nation, state or region. The One District, One Product (ODOP) programme, which is being used in Uttar Pradesh, has given the state’s small businesses a new name. In the Moradabad region of Uttar Pradesh, a metal craft enterprise has been chosen under this model to enhance the production capacity, business opportunities and start-up optimisation. This particular product is essential to the state economy’s continued survival. By sponsoring investor exhibits, district fairs and mega craft clusters, which directly affect production, the state government promotes the productivity of metal crafts, creating a new vision for metal products and new opportunities for local and regional companies to gain worldwide prominence through this programme. The researchers of this study conducted a pilot study and primary survey based on the demographic profile of the Moradabad region of Uttar Pradesh to examine the increase in production capacity and its component under the ODOP scheme.

The findings of this study indicate that all efforts to strengthen the local metal craft clusters and units through state government initiatives such as investor summits, exhibitions and district fairs under the ODOP scheme prove to be right for the success of productivity.

The uniqueness of this research article serves as a living example for other states or countries to successfully implement the ODOP programme, which is a transformative step towards realising the true potential of the metal craft industry. The state government’s strategy like the ODOP scheme can serve as a bridge to strengthen and improve the local specified products like metal crafts by solving the barriers of productivity disparities and geographical product identity imbalances.
Migration, Borderland Subjectivity and the Novel Form: Reading Temporary People
Authors: Karinkurayil Mohamed Shafeeq
Published: June 2024

The novel form has been traced as contemporaneous with the nation-state form and is associated with a homogenous speaking community. This article concerns itself with the role of affect in sustaining a community in a condition in which the distinction between the agent of capital and that of community is not unconditionally or ahistorically available. Drawing its theoretical apparatus from the conceptualisation of post colony by Achille Mbembe, and on studies of rumour, and contextualising itself in the contractual labour practice known as kafala and the exclusionary practices of citizenship in the countries of the Arab Gulf, this article argues that the reproduction of the exploitative capital/state along the axes of community produces both the capital/state and the community along affective lines, and away from the bureaucratic coldness or democratic openness that is supposed to characterise them. Taking Deepak Unnikrishnan’s Temporary People, as an instance of a novel produced from such a milieu, the article pays attention to the figure of the reader because traditionally scholarship has put the onus of the effects of the novel such as nationalism as the affordance of the figure of the reader. The article illustrates reconfigurations in the form of the novel and suggests that it is through fallibility rather than efficiency that power operates both as oppressive and resistant.
Multivocality and Its Implications for the Representation of Heritage: A Case Study of the Slavery Heritage in Mikindani, Tanzania
Authors: Lwoga Noel Biseko , Chami Maximillian , Kafumu Balele , Kisusi Rachel , Ndahani Paul
Published: June 2024

This article, by using evidence from the old town of Mikindani in Tanzania, explores multivocality in the memorialization of the slavery heritage in Mikindani. It also looks at how multivocality perpetuates dissonance and shapes cultural negotiations and the people’s strategies for coping with violent memories. It employed the notion of heritage dissonance and integrated heritage discourse and a qualitative case-study design. Thirty-three respondents were interviewed and three focus group discussion sessions were held. The findings support the argument that multivocality is an inherent part of heritage that shapes the dissonance regarding what should be conserved and heritage meaning-making processes. Multivocality and the resultant dissonance are further shaped by a complex mix of demographic dynamics, socio-cultural contexts, including religious values, identity struggles, the community’s articulation of the theoretical apparatus, political contexts, including power relations, the local or state political standing, the cultural heritage management (CHM) approach in place, and economic contexts, including the forward-looking nature of the younger people based on the tourist potential of the heritage. Although the resultant dissonance may be passive, it is embedded with the inert social tensions that may not necessarily be harmful to the heritage, but which provide potential spaces for conducting cultural negotiations that strive to defuse the boundaries of identities and the moral superiority–inferiority dogma. This article notes that multivocality should neither be ignored nor evaded, as it could be embraced as a medium for unlocking the sedimentation of a single discourse, understanding and addressing different experiences and expressions and resolving conflicts. The article also provides practical suggestions to the CHM authorities in Mikindani and related sites, as well as suggestions for further research.
A Prospective Evaluation for a Possible Safe Skin Bridge in Elective Foot Surgery
Authors: Moore Graeme , Saragas Nikiforos P. , Ferrao Paulo N. F.
Published: June 2024

Background:

In foot and ankle surgery, adequate surgical exposure often requires multiple incisions to be used near one another, thus creating a skin bridge. As the skin bridge becomes narrower, the wound edge vitality is potentially compromised and therefore the wound’s ability to heal. The impact of local, host, and surgical factors on wound healing are well documented in the literature; however, little is known about the role of the skin bridge. The aim of this study is to determine if there is a recommendable safe skin bridge in elective foot and ankle surgery.

Methods:

A prospective study was performed on 56 patients with 60 feet who had elective foot surgery. The length of each incision and distance between the incisions were recorded. The wounds were assessed for complications at 2, 4, and 6 weeks after surgery. Patient demographics and host risk factors were documented.

Results:

The average incision length was 5.5 (range: 3-8.5) cm. The average skin bridge was 3.9 (range: 2-6.8) cm. Five (8.3%) of the 60 feet developed a wound complication. Four (80%) of these patients had a known comorbidity. Two patients had diabetes and 2 were smokers. The incidence of relevant comorbidities was 5.5% (n = 3) for patients without a wound complication ( P < .001). Age did not differ significantly between patients with and without a wound complication. Patients with a wound complication had significantly longer incision lengths ( P = .047). There was no significant independent association between skin bridge width and risk of wound complications ( P > .05) with skin bridge widths of 2 cm or larger.

Conclusion:

In this relatively small cohort of 60 elective operative foot surgeries, we did not find increased wound complications in skin bridges 2 cm or larger, when meticulous surgical technique is practiced and host risk factors are optimized.

Level of Evidence:

Level III, prospective case control study.
Nephrectomy for emphysematous pyelonephritis in a nonfunctional renal allograft due to rejection after kidney transplantation
Authors: Kikkawa Kazuro , Wakamiya Takahito , Kojima Fumiyoshi , Kohjimoto Yasuo , Hara Isao
Published: June 2024

Background

Emphysematous pyelonephritis represents an acute and necrotizing infection characterized by the accumulation of gas within the kidney. This condition poses a swift progression toward sepsis, leading to a poor prognosis. We experienced a rare case of emphysematous pyelonephritis in a nonfunctioning renal allograft attributed to antibody‐mediated rejection after kidney transplantation.

Case presentation

A 71-year-old man with diabetes had undergone living-donor renal transplantation from his wife. Unfortunately, the transplanted kidney’s function declined due to antibody-mediated rejection, necessitating the introduction of hemodialysis 12 months post-transplantation. Subsequently, 4 months after initiating hemodialysis, the patient presented with pain and swelling in the right lower abdomen. A computed tomography scan revealed the enlargement of the transplanted kidney and gas formation. This constellation of symptoms led to the diagnosis of emphysematous pyelonephritis, resulting in his hospitalization. Further contrast-enhanced computed tomography scans demonstrated an absence of arterial flow and ischemia within the renal allograft. Despite antibiotic treatment and percutaneous drainage, both the gas and fluid in the renal parenchyma and surrounding tissue displayed minimal reduction. Given these compelling findings, an allograft nephrectomy was performed 20 days into his hospital stay. Pathological examination confirmed complete allograft necrosis, revealing nonviable renal parenchyma. The patient’s postoperative recovery progressed favorably.

Conclusions

Instances of emphysematous pyelonephritis within transplanted kidneys are infrequently documented. Among these cases, emphysematous pyelonephritis in a nonfunctioning renal allograft is very rare and may be associated with graft ischemia and the presence of injured tissue. The determination of an immediate diagnosis and surgery is important.
Measuring the performance and maturity of the plastic recycling value chain system: implications and prospects
Authors: Olatayo Kunle Ibukun , Mativenga Paul T. , Marnewick Annlizé L.
Published: June 2024

The sustainability of plastic materials and products requires the continuous improvement of the circular pathways for the material. A key strategy in the circularity of plastic is plastic recycling. Improving the circular pathways requires an understanding of the maturity level of the plastic recycling system. This study evaluated the maturity of the plastic recycling system in South Africa across the plastic value chain. Both secondary and primary data were collected, analysed and cross-validated. The results put the maturity of the country’s system at “Visionary” (Level 3) for the value chain stages of primary plastic production, product manufacturing and recycling, whereas waste generation, collection and handling, sorting and recyclate market were rated as “Structured” (Level 2). Furthermore, a set of initiatives to advance the maturity of the system to the desired level of “Connected and Dynamic” (Level 5) were identified. The paper provides a benchmark of performance and determines the stages of the system requiring additional attention. This is aimed at providing insight into policymaking to advance plastic recycling and circularity.
Radiomics of pericoronary adipose tissue on computed tomography angiography predicts coronary heart disease in patients with type 2 diabetes mellitus
Authors: Miao Shumei , Yu Feihong , Sheng Rongrong , Zhang Xiaoliang , Li Yong , Qi Yaolei , Lu Shan , Ji Pei , Fan Jiyue , Zhang Xin , Xu Tingyu , Wang Zhongmin , Liu Yun , Yang Guanyu
Published: June 2024

Background

Diabetes is a common chronic metabolic disease. The progression of the disease promotes vascular inflammation and the formation of atherosclerosis, leading to cardiovascular disease. The coronary artery perivascular adipose tissue attenuation index based on CCTA is a new noninvasive imaging biomarker that reflects the spatial changes in perivascular adipose tissue attenuation in CCTA images and the inflammation around the coronary arteries. In this study, a radiomics approach is proposed to extract a large number of image features from CCTA in a high-throughput manner and combined with clinical diagnostic data to explore the predictive ability of vascular perivascular adipose imaging data based on CCTA for coronary heart disease in diabetic patients.

Methods

R language was used for statistical analysis to screen the variables with significant differences. A presegmentation model was used for CCTA vessel segmentation, and the pericoronary adipose region was screened out. PyRadiomics was used to calculate the radiomics features of pericoronary adipose tissue, and SVM, DT and RF were used to model and analyze the clinical data and radiomics data. Model performance was evaluated using indicators such as PPV, FPR, AAC, and ROC.

Results

The results indicate that there are significant differences in age, blood pressure, and some biochemical indicators between diabetes patients with and without coronary heart disease. Among 1037 calculated radiomic parameters, 18.3% showed significant differences in imaging omics features. Three modeling methods were used to analyze different combinations of clinical information, internal vascular radiomics information and pericoronary vascular fat radiomics information. The results showed that the dataset of full data had the highest ACC values under different machine learning models. The support vector machine method showed the best specificity, sensitivity, and accuracy for this dataset.

Conclusions

In this study, the clinical data and pericoronary radiomics data of CCTA were fused to predict the occurrence of coronary heart disease in diabetic patients. This provides information for the early detection of coronary heart disease in patients with diabetes and allows for timely intervention and treatment.
Automated detection of steps in videos of strabismus surgery using deep learning
Authors: Zheng Ce , Li Wen , Wang Siying , Ye Haiyun , Xu Kai , Fang Wangyi , Dong Yanli , Wang Zilei , Qiao Tong
Published: June 2024

Background

Learning to perform strabismus surgery is an essential aspect of ophthalmologists’ surgical training. Automated classification strategy for surgical steps can improve the effectiveness of training curricula and the efficient evaluation of residents’ performance. To this end, we aimed to develop and validate a deep learning (DL) model for automated detecting strabismus surgery steps in the videos.

Methods

In this study, we gathered 479 strabismus surgery videos from Shanghai Children’s Hospital, affiliated to Shanghai Jiao Tong University School of Medicine, spanning July 2017 to October 2021. The videos were manually cut into 3345 clips of the eight strabismus surgical steps based on the International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubrics (ICO-OSCAR: strabismus). The videos dataset was randomly split by eye-level into a training (60%), validation (20%) and testing dataset (20%). We evaluated two hybrid DL algorithms: a Recurrent Neural Network (RNN) based and a Transformer-based model. The evaluation metrics included: accuracy, area under the receiver operating characteristic curve, precision, recall and F1-score.

Results

DL models identified the steps in video clips of strabismus surgery achieved macro-average AUC of 1.00 (95% CI 1.00–1.00) with Transformer-based model and 0.98 (95% CI 0.97-1.00) with RNN-based model, respectively. The Transformer-based model yielded a higher accuracy compared with RNN-based models (0.96 vs. 0.83, p < 0.001). In detecting different steps of strabismus surgery, the predictive ability of the Transformer-based model was better than that of the RNN. Precision ranged between 0.90 and 1 for the Transformer-based model and 0.75 to 0.94 for the RNN-based model. The f1-score ranged between 0.93 and 1 for the Transformer-based model and 0.78 to 0.92 for the RNN-based model.

Conclusion

The DL models can automate identify video steps of strabismus surgery with high accuracy and Transformer-based algorithms show excellent performance when modeling spatiotemporal features of video frames.
Geriatric assessment with management for older patients with cancer receiving radiotherapy: a cluster-randomised controlled pilot study
Authors: Slaaen Marit , Røyset Inga Marie , Saltvedt Ingvild , Grønberg Bjørn Henning , Halsteinli Vidar , Døhl Øystein , Vossius Corinna , Kirkevold Øyvind , Bergh Sverre , Rostoft Siri , Oldervoll Line , Bye Asta , Melby Line , Røsstad Tove , Eriksen Guro Falk , Sollid May Ingvild Volungholen , Rolfson Darryl , Šaltytė Benth Jūratė
Published: June 2024

Background

Geriatric assessment and management (GAM) improve outcomes in older patients with cancer treated with surgery or chemotherapy. It is unclear whether GAM may provide better function and quality of life (QoL), or be cost-effective, in a radiotherapy (RT) setting.

Methods

In this Norwegian cluster-randomised controlled pilot study, we assessed the impact of a GAM intervention involving specialist and primary health services. It was initiated in-hospital at the start of RT by assessing somatic and mental health, function, and social situation, followed by individually adapted management plans and systematic follow-up in the municipalities until 8 weeks after the end of RT, managed by municipal nurses as patients’ care coordinators. Thirty-two municipal/city districts were 1:1 randomised to intervention or conventional care. Patients with cancer ≥ 65 years, referred for RT, were enrolled irrespective of cancer type, treatment intent, and frailty status, and followed the allocation of their residential district. The primary outcome was physical function measured by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (QLQ-C30). Secondary outcomes were overall quality of life (QoL), physical performance, use and costs of health services. Analyses followed the intention-to-treat principle. Study registration at ClinicalTrials.gov ID NCT03881137.

Results

We included 178 patients, 89 in each group with comparable age (mean 74.1), sex (female 38.2%), and Edmonton Frail Scale scores (mean 3.4 [scale 0–17], scores 0–3 [fit] in 57%). More intervention patients received curative RT (76.4 vs 61.8%), had higher irradiation doses (mean 54.1 vs 45.5 Gy), and longer lasting RT (mean 4.4 vs 3.6 weeks). The primary outcome was completed by 91% (intervention) vs 88% (control) of patients. No significant differences between groups on predefined outcomes were observed. GAM costs represented 3% of health service costs for the intervention group during the study period.

Conclusions

In this heterogeneous cohort of older patients receiving RT, the majority was fit. We found no impact of the intervention on patient-centred outcomes or the cost of health services. Targeting a more homogeneous group of only pre-frail and frail patients is strongly recommended in future studies needed to clarify the role and organisation of GAM in RT settings.
Plasma copeptin and markers of arterial disorder in patients with type 2 diabetes, a cross-sectional study
Authors: Davidson Lee Ti , Engvall Jan , Chisalita Simona I. , Östgren Carl Johan , Nyström Fredrik H.
Published: June 2024

Objectives

There is currently limited understanding of the relationship between copeptin, the midregional portion of proadrenomedullin (MRproADM) and the midregional fragment of the N-terminal of proatrial natriuretic peptide (MRproANP), and arterial disorders. Toe brachial index (TBI) and aortic pulse wave velocity (aPWV) are established parameters for detecting arterial disorders. This study evaluated whether copeptin, MRproADM, and MRproANP were associated with TBI and aPWV in patients with type 2 diabetes with no history of cardiovascular disease (CVD).

Methods

In the CARDIPP study, a cross-sectional analysis of 519 patients with type 2 diabetes aged 55–65 years with no history of CVD at baseline, had complete data on copeptin, MRproADM, MRproANP, TBI, and aPWV was performed. Linear regression analysis was used to investigate the associations between conventional CVD risk factors, copeptin, MRproADM, MRproANP, TBI, and aPWV.

Results

Copeptin was associated with TBI (β–0.0020, CI–0.0035– (–0.0005), p = 0.010) and aPWV (β 0.023, CI 0.002–0.044, p = 0.035). These associations were independent of age, sex, diabetes duration, mean 24-hour ambulatory systolic blood pressure, glycated hemoglobin A1c, total cholesterol, estimated glomerular filtration rate, body mass index, and active smoking.

Conclusions

Plasma copeptin may be a helpful surrogate for identifying individuals at higher risk for arterial disorders.

Trial Registration:

 ClinicalTrials.gov identifier NCT010497377.
Effect of preoperative frailty on postoperative infectious complications and prognosis in patients with colorectal cancer: a propensity score matching study
Authors: Zhang Huipin , Zhang Hailin , Wang Wei , Ye Yun
Published: June 2024

Background

Few studies have explored the impact of preoperative frailty on infectious complications in patients with a diagnosis of colorectal cancer (CRC). Therefore, this study aimed to investigate the effect of preoperative frailty on postoperative infectious complications and prognosis in patients with CRC using propensity score matching (PSM).

Methods

This prospective single-centre observational cohort study included 245 patients who underwent CRC surgery at the Department of Gastrointestinal Surgery, The Affiliated Lianyungang Hospital of Xuzhou Medical University between August 2021 to May 2023. Patients were categorised into two groups: frail and non-frail. They were matched for confounders and 1:1 closest matching was performed using PSM. Rates of infectious complications, intensive care unit (ICU) admission, 30-day mortality, and 90-day mortality, as well as postoperative length of hospital stay, total length of hospital stay, and hospital costs, were compared between the two groups. Binary logistic regression using data following PSM to explore independent factors for relevant outcome measures.

Results

After PSM, each confounding factor was evenly distributed between groups, and 75 pairs of patients were successfully matched. The incidence of intra-abdominal infectious complications was significantly higher in the frail group than in the non-frail group (10.7% vs. 1.3%, P < 0.05). There were no significant differences in ICU admission rate, postoperative length of hospital stay, total length of hospital stay, hospital costs, 30-day mortality rate, or 90-day mortality rate between the two groups (P > 0.05). Our logistic regression analysis result showed that preoperative frailty (OR = 12.014; 95% CI: 1.334–108.197; P = 0.027) was an independent factor for intra-abdominal infection.

Conclusions

The presence of preoperative frailty elevated the risk of postoperative intra-abdominal infectious complications in patients undergoing CRC surgery. Therefore, medical staff should assess preoperative frailty in patients with CRC early and provide targeted prehabilitation interventions.
Reflections on co-producing an obesity-prevention toolkit for Islamic Religious Settings: a qualitative process evaluation
Authors: Hall Jennifer , Rashid Rukhsana , Rafiq Abida , Fatima Kiran , Barber Sally E. , Dogra Sufyan Abid
Published: June 2024

Background

Islamic leaders, staff, and Muslim parents in the UK are supportive of healthy lifestyle intervention delivery through Islamic Religious Settings. Such interventions are necessary given high obesity rates in British South Asian (40%) compared to White British (32%) children of equivalent age. Co-production can facilitate the development of culturally appropriate health interventions, however it can be theoretically and practically challenging, and evaluation of co-production within an Islamic Religious Setting context is lacking. The aim of this study was to examine the feasibility and acceptability of taking a co-production approach to develop an obesity-prevention toolkit for Islamic Religious Settings.

Methods

An obesity-prevention toolkit for use in Islamic Religious Settings, incorporating physical activity, healthy diet, and organisational change, has been co-produced to be evidence-informed and contextually relevant. A qualitative process evaluation was employed to examine experiences of co-production. Semi-structured interviews (n = 15) and a focus group (n = 5) were conducted with toolkit co-production stakeholders, e.g., subject experts, an Islamic scholar, and Islamic Religious Setting staff. Transcripts were analysed inductively using reflexive thematic analysis.

Results

The analysis revealed four major themes regarding stakeholders' experiences of co-producing a childhood obesity-prevention toolkit for Islamic Religious Settings. These themes are: (1) attitudes towards obesity-prevention through Islamic Religious Settings, (2) benefits of co-production including capacity building and ownership (3) negotiating involvement, power, and perspectives within the co-production process, and (4) the complexities of effective communication in co-production.

Conclusion

This study adds to the evidence-base in support of delivering health promotion through faith settings. Taking a co-production approach to develop an obesity-prevention toolkit for Islamic Religious Settings provided benefit to the toolkit product and local stakeholders. The toolkit is currently being implemented across Bradford, UK and there is potential to adapt the toolkit to other geographical contexts, and for evaluating effectiveness for preventing obesity in British Muslim families.
Calcium signaling from sarcoplasmic reticulum and mitochondria contact sites in acute myocardial infarction
Authors: Agyapong Esther Densu , Pedriali Gaia , Ramaccini Daniela , Bouhamida Esmaa , Tremoli Elena , Giorgi Carlotta , Pinton Paolo , Morciano Giampaolo
Published: June 2024

Acute myocardial infarction (AMI) is a serious condition that occurs when part of the heart is subjected to ischemia episodes, following partial or complete occlusion of the epicardial coronary arteries. The resulting damage to heart muscle cells have a significant impact on patient’s health and quality of life. About that, recent research focused on the role of the sarcoplasmic reticulum (SR) and mitochondria in the physiopathology of AMI. Moreover, SR and mitochondria get in touch each other through multiple membrane contact sites giving rise to the subcellular region called mitochondria-associated membranes (MAMs). MAMs are essential for, but not limited to, bioenergetics and cell fate. Disruption of the architecture of these regions occurs during AMI although it is still unclear the cause-consequence connection and a complete overview of the pathological changes; for sure this concurs to further damage to heart muscle. The calcium ion (Ca2+) plays a pivotal role in the pathophysiology of AMI and its dynamic signaling between the SR and mitochondria holds significant importance. In this review, we tried to summarize and update the knowledge about the roles of these organelles in AMI from a Ca2+ signaling point of view. Accordingly, we also reported some possible cardioprotective targets which are directly or indirectly related at limiting the dysfunctions caused by the deregulation of the Ca2+ signaling.