bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Mortality and Postoperative Complications Between Open and Laparoscopic Repair of Perforated Peptic Ulcer
Authors: Eghbali Foolad , Banijamali Mahdi , Jahanshahi Fatemeh , Tizmaghz Adnan , Rezvani Hamid , Ghadimi Parmida , Madankan Ahmad , Alipour Homan , Vaseghi Hamed , Haghmoradi Meisam , Bahardoust Mansour , Mosavari Hesam
Published: November 2024

Background: Perforated peptic ulcer (PPU) is one of the common complications of peptic ulcers. Open repair (OR) is the traditional surgical treatment for this condition, but with advances in laparoscopic and minimally invasive surgery, laparoscopic repair (LR) has gained popularity. Many studies have compared the effectiveness of OR vs. LR for PPU. However, the superiority of one method over the other remains a topic of debate. We conducted this review to investigate the advantages and disadvantages of LR over OR.

Methods: PubMed, Scopus, Google Scholar, and Web of Science were searched from 2000 to 2022 for systematic reviews and meta‐analyses comparing OR and LR for PPU. Previous studies included seven postoperative outcomes, including mortality, reoperation, postoperative ileus, intra‐abdominal abscess, leakage, pneumonia, and wound infection. Two researchers independently extracted data and assessed the quality of the eligible studies using the AMSTAR 2 tool.

Results: Five systematic reviews and meta‐analyses were included, involving 36 studies. The pooled estimate showed that the risks for mortality, postoperative ileus, and wound infection were significantly lower with LR. In comparison, the risks for reoperation and leakage were less with OR. Based on the pooled estimate, no significant relationship was noted between the surgical method and intraabdominal abscess or postoperative pneumonia.

Conclusion: Evidence suggests that in stable patients with PPU, LR is better than OR in terms of mortality. However, more high‐quality evidence is needed to determine which is more appropriate for different circumstances (e.g., unstable or high‐risk patients).
Electrocatalytic Barrier Comprising Polar SnO2 Quantum Dots Anchored Within Porous Carbon Microspheres Prepared by Spray Drying Process for Li–S Batteries
Authors: Baek Kun Woo , Oh Geon Hui , Saroha Rakesh , Kang Dong-Won , Park Gi Dae , Cho Jung Sang
Published: November 2024

Hypothesis: Porous carbon microspheres (PCMs) with embedded tin di‐oxide (SnO2) quantum dots (QDs) (P‐SnO2@PCMs) are synthesized and employed as polysulfide barriers to enrich the electrochemical properties.

Experiments: This composite structure is prepared by spray drying procedure and followed by heat‐treatment, resulting in well‐arranged macropores with a diameter of 59 nm generated by the polystyrene (PS) nanobeads (ϕ = 150 nm) decomposition. P‐SnO2@PCMs is functioned as an electrocatalytic interlayer and offer advantages such as reduced diffusion length for charged particles that guarantees immediate transfer, improved electrode wetting due to efficient electrolyte infiltration, and accommodation of large volume fluctuations during the redox reactions. Furthermore, the incorporation of polar SnO2 QDs within the microspheres allows for efficient chemical confinement and alteration of trapped polysulfide species due to catalytic activity, leading to an extensive use of the active material.

Findings: Advancing from the nanostructural eminence, lithium–sulfur (Li–S) cells paired with P‐SnO2@PCMs‐coated separator and conventional sulfur electrode showed outstanding rate performance (321 mA h g−1 at 2.0 C) and prolonged cyclic steadiness at 0.1 C. This innovative synthesis strategy provides valuable insights for developing novel nanostructures applicable to various rechargeable devices.
Deep Structure Usage of Electronic Patient Records: Enhancing the Influence of Nurses’ Professional Commitment to Decrease Turnover Intention
Authors: Chang Hao-Yuan , Huang Guan-Ling , Lotus Shyu Yea-Ing , May-Kuen Wong Alice , Tai Shih-I , Cheng T. C. E. , Teng Ching-I
Published: November 2024

Background: Organizational turnover exacerbates the shortage of nurses in the global workforce. However, no study has yet explored how deep structure usage—nurses’ integration of electronic patient records into nursing practice delivery—reduces their turnover intention and moderates the impact of affective, continuance, and normative professional commitment on their turnover intention.

Aims: To ascertain (1) the linkage between the deep structure usage of electronic patient records and nurses’ organizational turnover intention and (2) the moderating role of deep structure usage on the associations between elements of commitment (affective, continuance, and normative) and turnover intention.

Methods: Using a cross‐sectional survey and proportionate random sampling by ward unit, we collected data from 417 full‐time nurses via a self‐administered questionnaire. We performed hierarchical regression analyses to test the study hypotheses.

Results: Deep structure usage was not directly related to organizational turnover intention (β = −0.07, p = 0.06). However, the results suggested that deep structure usage may enhance the effect of high affective commitment on nurses’ organizational turnover intention (β = −0.09, p = 0.04), while potentially mitigating the effect of low continuance commitment on organizational turnover intention (β = 0.10, p = 0.01).

Conclusions: Deep structure usage of electronic patient records helps to ease nurses’ workload and facilitates their retention, which is particularly due to their affective commitment (attachment) but not their continuance commitment (switching costs).

Implications for Nursing Management: Nursing management may advise hospital management that medical records systems need to be improved and fully embedded for nursing care delivery, as a more in‐depth use of these systems can help to retain nurses.
A Route Diversity–Based Approach for Estimating Vulnerability of Stations in a Multimodal Public Transport Network
Authors: Jia Jianlin , Huang Yuwen , Zhang Wanting , Chen Yanyan , Liu Zhuo
Published: November 2024

Multimodal public transport network (MPTN) plays an important role in relieving road traffic pressure for metropolitan area. Nevertheless, the impact of an accident happened in an individual station may not only disrupt the station itself or the single lines that go through the station but also spread over the whole network. Therefore, identifying the vulnerable stations is essential for improving the MPTN management against the systematic risk caused by accidents. In this paper, we proposed a route diversity‐based approach to measure the vulnerability of stations in MPTN based on the complex network theory. The route constraint parameters were established to reflect the travel time restriction in constructing the set of passengers’ acceptable routes. In addition, an algorithm was formulated to rapidly calculate the route diversity index and meanwhile avoid the “overlapping routes” problem. A simple virtual network was used as a numerical example to compare the proposed approach with the vulnerability evaluation approaches based on degree centrality and betweenness centrality. Finally, the proposed approach was applied to the MPTN of Beijing to explain its effectiveness and potential applications. The results show that the proposed method can efficaciously estimate vulnerable nodes compared with degree centrality and betweenness centrality. Meanwhile, the acceptable routes between any OD pairs in the MPTN are 1–10 according to the constrained parameter. In addition, the average number of acceptable routes between OD pairs of Beijing MPTN is 3.649. By ranking the stations according to their vulnerability, it can be found that the top 5 vulnerable stations are all external traffic hubs or the stations around famous commercial areas. The results suggest that these stations are significant for external transport as well as crucial for internal urban transportation systems. The research output could contribute to the MPTN management in accident prevention and emergency handling.
Visceral Adiposity as an Independent Risk Factor for Diabetic Peripheral Neuropathy in Type 2 Diabetes Mellitus: A Retrospective Study
Authors: Wu Rui-Ling , Chen Niyao , Chen Yanni , Wu Xiaohong , Ko Chih-Yuan , Chen Xiao-Yu
Published: November 2024

Background: Diabetic peripheral neuropathy (DPN) impacts approximately 50% of individuals with Type 2 diabetes mellitus (T2DM), leading to severe complications such as foot ulcers and amputations. Notably, visceral adiposity is increasingly recognized as a pivotal factor in augmenting the risk of DPN. We aim to evaluate the correlation between obesity‐related body composition, particularly visceral fat, and DPN to facilitate early identification of high‐risk patients with T2DM.

Methods: This cross‐sectional analysis encompassed 113 T2DM patients from the Department of Endocrinology and Metabolism at the Second Affiliated Hospital of Fujian Medical University, conducted between September 2020 and January 2021. Patients were categorized into two cohorts: those with DPN (DPN group) and those without (NDPN group). We utilized bioelectrical impedance analysis (BIA) to determine body measurements, such as weight and visceral fat area, in addition to collecting clinical and biochemical data. Logistic regression was employed to analyze the data.

Results: The study uncovered a statistically significant difference in the visceral fat area between the DPN and NDPN groups (p = 0.048). Through multivariate logistic regression analysis, the visceral fat area was identified as an independent risk factor for DPN among T2DM patients (OR 1.027; 95% CI 1.004–1.051, p = 0.022). Other significant risk factors included the duration of diabetes and the presence of diabetic retinopathy.

Conclusion: The visceral fat area serves as an independent risk factor for DPN in individuals with T2DM. Implementing measures to assess and manage visceral obesity could be vital in the prevention and management of DPN. This underscores the value of technologies such as BIA in clinical and community settings for early intervention.
Survivin Promotes Stem Cell Competence for Skin Cancer Initiation
Authors: Canato Sara , Sarate Rahul , Carvalho-Marques Sofia , Maia Soares Raquel , Song Yura , Monteiro-Ferreira Sara , Vieugué Pauline , Liagre Mélanie , Grossi Giancarlo , Cardoso Erik , Dubois Christine , Conway Edward M. , Schenone Silvia , Sánchez-Danés Adriana , Blanpain Cédric
Published: November 2024

Stem cells (SC) and not progenitors (P) act as cells of origin of basal cell carcinoma (BCC). The mechanisms promoting BCC formation in SCs or restricting tumor development in Ps are currently unknown. In this study, we transcriptionally profiled SCs and Ps and found that Survivin, a pleiotropic factor that promotes cell division and inhibits apoptosis, was preferentially expressed in SCs. Using genetic gain- and loss-of-function mouse models, we showed that Survivin deletion in oncogene-expressing SCs prevents BCC formation. Survivin overexpression renders Ps competent to BCC formation by promoting cell survival and division while preventing apoptosis and differentiation. We identified Serum glucocorticoid–regulated kinase 1 (Sgk1) as a key downstream factor of Survivin and that its inhibition prevents BCC formation. This study uncovers the role and mechanisms by which Survivin regulates the competence of SCs to initiate BCC formation, promoting the survival of oncogene-expressing SCs and self-renewing division while restricting differentiation and apoptosis.

Significance:

This study identifies Survivin as a key regulator of the different ability of SCs and Ps to initiate skin cancer. Survivin expression in oncogene-targeted SCs is essential for their survival and self-renewal and to prevent their differentiation and apoptosis, allowing SCs and not Ps to initiate skin cancer.
The Effect of Different Adaptation Formulas on Mid-Latency Auditory Evoked Potentials in Adults with Hearing Aids
Authors: Kaya Nedim Ugur , Aydin Emine , Akin Ocal F. Ceyda , Satar Bulent
Published: November 2024

Introduction: We were conducting this study to evaluate the effects of different hearing aid adaptation formulas on middle latency responses (MLR) in adult hearing aid users.
Methods: The study included 72 participants: those with moderate hearing loss using hearing aids with two different formulas for the last year, those with moderate hearing loss not using hearing aids, and those without hearing loss. Sixteen participants using NAL-NL1 and NAL-RP formulas were Group 1; twenty using NAL-NL2 and DSL formulas were Group 2; fifteen with hearing loss not using devices were Group 3; and twenty-one without hearing loss were Group 4. We obtained and compared MLR responses, including Na latency, Pa latency, and Na-Pa amplitude.
Results: Group 1 mean Na-Pa amplitude value was found to be higher than Group 2 (p = 0.001). No significant difference was observed between Group 1 and Group 2 in terms of Na latency and Pa latency values (p = 0.001; p = 0.035). It was observed that the mean Na-Pa amplitude values in Group 1 and Group 2 were higher than Group 3 (p = 0.001), but this elevation reached the level of statistical significance only in Group 1. No difference was observed between Group 1, Group 2, and Group 3 in terms of Na latency and Pa latency values (p = 0.001; p = 0.035). Compared with those without hearing loss (Group 4), participants with hearing loss (Group 1, Group 2, and Group 3) had longer Na latency and Pa latency values (p = 0.001; p = 0.035), and Na-Pa amplitudes were lower (p = 0.001). The effect of current (tested) hearing aid usage time on Na latency, Pa latency, and Na-Pa amplitude values of Group 1 and Group 2 was not observed. In all groups, there was a positive correlation between audiometric airway/bone conduction pure tone averages and speech acquisition threshold values, Na latency and Pa latency values, and a negative correlation between Na-Pa amplitude values. In all groups, there was a negative correlation between speech discrimination scores and Na and Pa latency values, as well as a positive correlation between Na and Pa amplitude values. There was a positive correlation between age and Pa latency values in all groups, as well as a negative correlation between Na and Pa amplitude values.
Conclusion: Middle latency responses are affected by the presence of hearing loss, the use of hearing aids, and different hearing aid adaptation formulas. MLR measurements with a hearing aid can be used as an objective test to evaluate the benefit of hearing aid use.
The Effects of Memantine on Cisplatin-Induced Ototoxicity
Authors: Güven Selis Gülseven , Erdoğan Hilal , Arslan Murat , Ersoy Onur , Bulut Erdoğan , Çilingir Kaya Özlem Tuğçe , Şirvancı Serap , Uzun Cem
Published: November 2024

Introduction: We aimed to investigate electrophysiologically and histopathologically, the protective effects of intratympanic memantine, an N-methyl-D-aspartate receptor antagonist, on ototoxicity caused by cisplatin, an anti-neoplastic agent used in many types of cancer. Methods: Thirty-seven guinea pigs with a normal auditory function were randomly allocated to group 1 (cisplatin; n = 8), group 2 (memantine; n = 8), group 3 (cisplatin + memantine; n = 8), group 4 (cisplatin + physiological serum [PS]; n = 8), and group 5 (control; n = 5). Auditory assessments were conducted using distortion product otoacoustic emissions (DPOAE) within a frequency range of 1–32 kHz and auditory brainstem responses (ABRs) within 8–32 kHz. A single dose of cisplatin (12 mg/kg) was administered intraperitoneally, followed by intratympanic administration of 0.2 mL of either memantine or PS to both ears at least half an hour before cisplatin administration. Subsequent auditory evaluations were conducted 72 h after cisplatin administration. Histopathological analyses were performed using light microscopy of the right ear and scanning electron microscopy (SEM) of the left ear. Results: Auditory evaluations conducted before and after treatment revealed significant findings. Specifically, within groups 3 and 4, ABR thresholds were elevated at all frequencies (p = 0.00), whereas the DPOAE signal-to-noise ratios were reduced at frequencies of 8, 12, 16, and 24 kHz (p = 0.001, p = 0.01, p = 0.01, and p = 0.00, respectively). Histopathologically, both light microscopy and SEM revealed that the cisplatin + memantine group exhibited fewer hair cells and nuclear degeneration in the spiral ganglion than the cisplatin and cisplatin + PS groups. Additionally, the stria vascularis thickness was greater in the cisplatin + memantine group than in cisplatin and cisplatin + PS groups. Conclusion: Despite the negative electrophysiological findings, the histopathological outcomes suggest that intratympanic memantine may have a potential protective effect against cisplatin-induced ototoxicity. However, further investigations are warranted to corroborate these findings and elucidate the underlying mechanisms of action of memantine.
БІОБЕЗПЕКА, БІОЗАХИСТ І «ХВОРОБА Х»: ДЕФІНІЦІЇ, ГЛОБАЛЬНІ ТА НАЦІОНАЛЬНІ ПРОБЛЕМИ, ШЛЯХИ ВИРІШЕННЯ
Authors: Задорожна В. І. , Шагінян В. Р. , Винник Н. П.
Published: November 2024

Обговорюються питання сучасних біологічних загроз, зокрема «хвороби Х», наслідків штучних катастроф, які можуть бути різними за масштабом і непередбачуваними за наслідками щодо біоризиків тощо, підходів до визначення понять біологічної безпеки та біологічного захисту, а також шляхів удосконалення системи біологічної безпеки в Україні. Зважаючи на різноманіття сучасних біозагроз і біоризиків, термін «біобезпека» повинен бути широким поняттям та охоплювати всі їх елементи. У зв’язку з неоднозначністю тлумачення цього терміну в різних літературних джерелах, ми пропонуємо своє його бачення, а саме: «Біобезпека – це збереження стану рівноваги між людською популяцією, тваринним, рослинним світом з одного боку та їх патогенами – з другого боку, що характеризується відсутністю або контрольованістю несприятливих подій, які могли б спричинити поширення особливо небезпечних патогенів і викликати надзвичайну ситуацію у сфері охорони здоров’я, тваринництва чи сільського господарства». Забезпечення біобезпеки можливе за рахунок функціонування належної сталої системи біобезпеки та біозахисту на регіональних і національному рівнях, яка здатна належним чином протидіяти як емерджентним, так і рутинним біозагрозам. Хоча в Україні вже багато зроблено на шляху до побудови системи біобезпеки, вона потребує подальшого розвитку. Це повинна бути комплексна система, у структурі якої будуть задіяні всі причетні органи центральної влади, відомства та організації на всіх адміністративних рівнях. Щодо суто медичної складової цієї системи, то головне місце в ній належить системі епідеміологічного нагляду, функціями якого залишаються нагляд, виявлення, аналіз, прогноз, ухвалення та реалізація управлінських рішень, спрямованих на запобігання біоризикам та протидію їм.
ТВОРИ УКРАЇНСЬКОЇ ЛІТЕРАТУРИ ПРО ІНФЕКЦІЙНІ ХВОРОБИ
Authors: Андрейчин М. А. , Юкало В. Я.
Published: November 2024

Розглянуто твори української літератури, в яких відображено інфекційні хвороби. Здійснено опис і аналіз фактів фіксації інфекційних хвороб, епідемій в основних жанрах давньої літератури, в поезії і прозі ХІХ-ХХІ ст. Охарактеризовано художню рецепцію інфекційних хвороб і їх лікування в літературних творах. Обґрунтовано важливість осмислення хвороби через сприйняття художнього образу для формування професійної компетентності лікаря. Наведено рекомендації щодо використання творів української літератури про інфекційні хвороби у вивченні фахових і загальних дисциплін у медичному закладі вищої освіти.
ВИЗНАЧЕННЯ ДИФЕРЕНЦІЙНОГО ПІДХОДУ ДО ВИБОРУ МЕТОДИКИ ЕФЕКТИВНОЇ ХІРУРГІЧНОЇ КОРЕКЦІЇ МІТРАЛЬНОГО КЛАПАНА У ПАЦІЄНТІВ З ІШЕМІЧНОЮ РЕГУРГІТАЦІЄЮ ТА ІШЕМІЧНОЮ ХВОРОБОЮ СЕРЦЯ
Authors: МОРОЗ В. С. , ЛАЗОРИШИНЕЦЬ В. В.
Published: November 2024

Мета – створити алгоритм диференційного підходу до вибору методики ефективної хірургічної корекції мітрального клапана у пацієнтів з ішемічною мітральною регургітацією та ІХС.
Матеріали і методи. У дослідження увійшли пацієнти з ішемічною мітральною регургітацією та ішемічною хворобою серця (n=140), як чоловічої (n=99), так і жіночої статі (n=41), середній вік учасників дослідження становив (65,9±4,0) років. Усім пацієнтам вибірки проведені операції з приводу реваскуляризації міокарда та пластики / протезування мітрального клапана. Матеріалом для аналізу стали дані з первинної облікової медичної документації: історія хвороби, дані фізикального, клініко-лабораторного та інструментального обстеження.
Результати. В ході дослідження були встановлені особливості клінічного перебігу та даних клініко-інструментального обстеження пацієнтів з ішемічною мітральною регургітацією та ІХС, які дозволили в майбутньому реалізувати нашу спробу на створення алгоритму з диференційного підходу до вибору методики ефективної хірургічної корекції мітрального клапана. А саме були установлені достовірно значимі наступні показники: стаж артеріальної гіпертензії понад 25 років (р=0,05, χ2=3,84); дебют артеріальної гіпертензії до 40 років; особливості в показниках ехокардіографії; середній ступінь вираження гіпертрофії лівого шлуночка (р=0,04, χ2=3,92), тяжкий ступінь вираження гіпертрофії лівого шлуночка (р=0,06, χ2=3,52); мітральна недостатність вираженого ступеня (р=0,03, χ2=4,69); наявність акінезу міокарда (р=0,04, χ2=4,21); наявність гіпокінезу міокарда: за локалізацією акінез задньо-нижньо-бічних відділів міокарда (р=0,001, χ2=19,76); за ступенем вираження: помірний гіпокінез (р=0,008, χ2=46,417,03); значний гіпокінез (р=0,03, χ2=4,32) тощо. В результаті це дало змогу сформувати алгоритм з диференційного підходу до вибору методики ефективної хірургічної корекції мітрального клапана, суть якого полягає у тому, що певний фенотип хворого з ішемічною мітральною регургітацією та ІХС формується під комплексним впливом первинних етіологічних та вторинних модифікуючих факторів.
Висновки. Створено алгоритм диференційного підходу до вибору методики ефективної хірургічної корекції мітрального клапана у пацієнтів з ішемічною мітральною регургітацією та ІХС, завдяки якому можливо формувати групи диспансерного спостереження при проведенні періодичних медичних оглядів або під час госпіталізації до кардіохірургічного стаціонару.
ХОЛЕСТЕРИН ЯК КЛІНІКО-ЛАБОРАТОРНИЙ МАРКЕР МЕТАБОЛІЧНИХ ПОРУШЕНЬ У ПАЦІЄНТІВ З ІШЕМІЧНОЮ ХВОРОБОЮ СЕРЦЯ РІЗНИХ ВІКОВИХ ГРУП
Authors: ЖУРБА О. О.
Published: November 2024

Мета роботи: вивчити частоту гіперхолестеринемії та застосування статинів у пацієнтів з ІХС різних вікових груп з урахуванням гендерних особливостей.
Матеріали і методи. У дослідження увійшли пацієнти з ІХС, яким проведено коронарне шунтування на серці, що працює (n=3674), як чоловічої (n=3061), так і жіночої статі (n=613), середній вік учасників дослідження становив (60,6±0,8) років. Матеріалом для аналізу стали дані клініко-лабораторного дослідження крові. Дизайн дослідження побудований в залежності від вікової групи пацієнта відповідно до вікової класифікації ВООЗ та гендерної ознаки пацієнта.
Результати. Встановлено, що найвищі рівні холестерину були у віковій групі “середній вік”, як у чоловіків – 3,54 ммоль/л, так і у жінок – 3,89 ммоль/л. З’ясовано, що частота гіперхолестеринемії була достовірно вищою у пацієнток-жінок, порівняно з відповідною частотою у чоловіків, р=0,0001, χ2=14,48. Найвища частота гіперхолестеринемії спостерігалася у пацієнтів вікової групи “середній вік”, причому у пацієнтів чоловічої статі її частота була достовірно нижчою, ніж у пацієнток тієї ж вікової групи, р=0,0001, χ2=18,08. Установлено, що зі збільшенням віку та з урахуванням статі пацієнтів відбувалося достовірне фізіологічне зниження частоти гіперхолестеринемії. Визначено, що статини достовірно частіше застосовували пацієнти-жінки – 49,4 %, порівняно з пацієнтами-чоловіками – 32,2 %, р=0,0001, χ2=73,89. Також установлено, що жінки з ІХС достовірно частіше, ніж чоловіки, застосовували статини в усіх вікових групах.
Висновки. В результаті дослідження з’ясовано, що рівні холестерину залишаються достовірним клініко-лабораторним маркером для виявлення метаболічних порушень у пацієнтів з ІХС. Визначено, що найвищі рівні холестерину зафіксовані у пацієнтів середнього віку обох статей. Гіперхолестеринемія також достовірно частіше трапляється у віковій групі “середній вік”, причому з урахуванням статі достовірно частіше у пацієнток з ІХС. Визначено, що з віком відбувається достовірне зниження рівня холестерину, незалежно від прийому статинів.
Desmoplakin Cardiomyopathy in Pediatric Patients: A Distinct, Underrecognized Cohort of Arrhythmogenic Cardiomyopathy
Authors: Choi Nak Hyun , Cherny Sara , Berul Charles I. , Goodyer William R. , Howard Taylor S. , Joong Anna , Liberman Leonardo , Silver Eric S. , Villa Chet R. , Lee Teresa M. , Zuckerman Warren A.
Published: November 2024

BACKGROUND:

DSP
cardiomyopathy is a distinct subset of arrhythmogenic cardiomyopathy, reported primarily in adults, that has predominantly left ventricular involvement and features of myocarditis. Clinical characteristics, risk stratification, and management of pediatric patients with
DSP
variants are not well known. We sought to identify phenotypic features and prognosis of pediatric patients with
DSP
pathogenic or likely pathogenic variants.

METHODS:

Multicenter, retrospective study of patients <21 years of age with
DSP
variants from 6 tertiary pediatric hospitals.

RESULTS:

Thirty-four patients, including 10 probands with clinical disease and 24 genotype-positive phenotype-negative patients, were included in the study. The majority of probands were initially diagnosed with myocarditis (50%) and had biventricular (60%) or left ventricular predominant (40%) disease. Chest pain was the most common symptom at presentation (30%), and all had troponin elevation. Probands with homozygous or compound heterozygous
DSP
variants were likely to present at an early age (<13 years) with symptoms of heart failure, severe biventricular involvement, and dermatologic abnormalities. Low-voltage QRS was the most prominent ECG abnormality. Of those who underwent implantable cardioverter defibrillator implantation, 50% received appropriate implantable cardioverter defibrillator therapy and were found to have significant biventricular involvement in addition to severe left ventricular dysfunction with an ejection fraction <35%.

CONCLUSIONS:

DSP
cardiomyopathy in children and adolescents has varied phenotypic manifestations based on age and genotype and often can be diagnosed as myocarditis. Severe left ventricular dysfunction and biventricular involvement may be associated with a higher likelihood of malignant ventricular tachyarrhythmia.
Contemporary Clinical Characteristics, Imaging, Management, and Surgical and Nonsurgical Outcomes of Adult Patients With Subaortic Stenosis
Authors: Agrawal Ankit , Arockiam Aro Daniela , Majid Muhammad , Saraswati Ushasi , El Dahdah Joseph , Chandna Sanya , Kassab Joseph , Chedid El Helou Michel , Khurana Rishabh , Dong Tiffany , Atar Mustafa , Haroun Elio , Zakhour Samer , Rodriguez Leonardo , Popovic Zoran B. , Smedira Nicholas , Griffin Brian P. , Wang Tom Kai Ming
Published: November 2024

Background

Subaortic stenosis (SAS) is characterized by a fibromuscular membrane located just below the aortic valve, causing fixed outflow tract obstruction. There is a paucity of studies evaluating this condition. This cohort study reviewed the contemporary characteristics and outcomes of SAS in adult patients in a single large referral center.

Methods and Results

We retrospectively studied adult patients with SAS evaluated at our center during 2011 to 2022. The primary outcome was all‐cause mortality and heart failure hospitalizations during follow‐up, with secondary end points including recurrence of SAS and repeat surgery after initial SAS surgery. Among 484 patients with SAS, key characteristics included mean age 55±18 years, 67.5% female, left ventricular outflow tract peak velocity 352±140 cm/s and gradient 57±40 mm Hg, left ventricular ejection fraction 60%±14%, 54.8% had prior SAS surgery, and 45.1% had surgery during follow‐up. Over a median follow‐up of 5.5 (1.5–12.3) years, 11.5% (n=56) died, 6.8% (n=33) had heart failure hospitalizations, 8.0% (n=39) experienced SAS recurrence, and 14 (5.9%) underwent repeat SAS surgery. Multivariable analyses identified older age per 10‐years (hazard ratio [HR], 1.37 [95% CI, 1.12–1.68]) and baseline New York Heart Association class (HR, 2.48 [95% CI, 1.54–3.99]) to be statistically significantly associated with the primary end point; higher body mass index, New York Heart Association class, and peak left ventricular outflow tract gradient were also statistically significantly associated with SAS recurrence and redo surgery.

Conclusions

Almost half of patients with SAS had surgery in the past or during follow‐up, and a significant minority had mortality or morbidity events during follow‐up. Identified prognosticators warrant further research to guide management.
Person‐Centered Approach to Understanding Psychosocial Stressor Subgroups and Cardiovascular Disease: New Perspectives From the Multi‐Ethnic Study of Atherosclerosis Study
Authors: Ajibewa Tiwaloluwa A. , Colangelo Laura A. , Chirinos Diana A. , Kershaw Kiarri N. , Carnethon Mercedes R. , Allen Norrina B.
Published: November 2024

Background

This study examined the longitudinal associations of psychosocial stress subgroups with cardiovascular disease (CVD) events and whether social support, neighborhood cohesion, and physical activity modified these associations in MESA (Multi‐Ethnic Study of Atherosclerosis).

Methods and Results

Data from 6349 adults (aged: 62.2 ± 10.2 years; 52.9% women) from the MESA study with no prior CVD in 2000 to 2002 (baseline) were used in this analysis. Latent class analysis was used to specify distinct psychosocial stress subgroups based on self‐reported stressors stemming from respondents' neighborhood and social environment. Adjudicated CVD events (fatal and nonfatal events) were ascertained annually through the year 2019. Cox proportional hazards models were used to examine the associations between subgroup membership and CVD events. Five distinct psychosocial stress subgroups were identified via latent class analysis and were labeled “moderate neighborhood noise” (12.1%), “excessive neighborhood noise” (6.4%), “multiple high stressors” (6.3%), “high discrimination” (21.4%), and “optimal” (53.8%). By 2019, 1121 participants had experienced a CVD event. Membership in the high discrimination (hazard ratio [HR], 1.29 [95% CI, 1.10–1.51]) subgroup was associated with higher risk of a CVD event when adjusted for sociodemographic characteristics and cardiovascular health metrics. Neither social support, neighborhood cohesion, nor physical activity modified this association (
P
>0.05).

Conclusions

Distinct subgroups of individuals with high self‐reported psychological distress—particularly related to discrimination and chronic stress are associated with high incident cardiovascular events.
A Cold Shower for the Hot Hand Fallacy: Robust Evidence from Controlled Settings
Authors: Miller Joshua B. , Sanjurjo Adam
Published: November 2024

The canonical hot hand fallacy result was recently reversed, based largely on a single statistic, and a data set that was underpowered for individual-level testing. Here we perform a more robust analysis, testing whether hot hand performance exists across (i) data sets: four different controlled shooting experiments, (ii) time: multiple sessions per individual spread across a six month gap, and (iii) various (improved) approaches to statistical testing. We find strong evidence of hot hand performance, both across data sets and within individuals across time. Moreover, in a study of beliefs, we find that expert observers can successfully predict which shooters get the hottest.
Assessing Motivational Factors in Young Serbian Athletes: A Validation Study of the Sport Motivation Scale-II
Authors: Jakšić Damjan , Trbojević Jocić Jovana , Manojlović Marko
Published: November 2024

Background. Motivation is considered crucial in sports participation and performance, influencing athletes’ psychological well-being, investment in training, and interpersonal relationships. Self-determination theory (SDT) is a prominent framework used to understand motivation in sports, highlighting the importance of autonomous motivation for optimal performance and well-being. A large number of questionnaires for examining processes in sports were created by relying on the constructs of SDT. Objective. This study explores the psychometric characteristics (construct validity) of the Sport Motivation Scale II (SMS-2), as well as gender and age differences in motivation among young Serbian athletes. This questionnaire has proven to be important for understanding the motivation of adult athletes, but so far, its psychometric characteristics have not been sufficiently examined on a sample of young athletes in Serbia. Given the high dropout rate from sports in adolescence, valid questionnaires to assess the motivation of young athletes can help to identify athletes who are at risk of leaving a sport. Design. The sample consisted of 365 young athletes (51% girls, aged 12–16) from Serbia participating in team sports (at an organized level, not a recreational level), including volleyball, basketball, and handball. They completed the SMS-2 using paper and pen, in the presence of a psychologist and with parental consent obtained by the clubs. The questionnaire has been translated into Serbian. Young athletes from team sports were selected due to the large number of adolescents in Serbia who are engaged in organized team sports. There is a small number of adolescents who are involved in organized individual sports. Results. Factor analysis of the SMS-2 revealed six factors, in line with the original structure of the Scale: identified motivation, intrinsic motivation, amotivation, external motivation, integrated motivation, and introjected motivation. The questionnaire demonstrates satisfactory psychometric properties, with Cronbach’s alpha coefficients indicating good internal consistency. Gender differences were obtained only in external motivation, where boys scored higher than girls. No significant differences emerge in motivation across age groups or among athletes participating in different sports. It is possible that differences were not found in relation to the type of sport because there are similarities in the process of working with young athletes in team sports. Conclusion. The Sport Motivation Scale II (SMS-2) showed satisfactory psychometric characteristics in a Serbian sample of young athletes. The original structure was replicated, with six factors representing six types of motivation, in line with SDT. These findings suggest the SMS-2’s validity across gender, age, and sport types, offering a valuable tool for assessing motivation in young athletes engaged in organized team sports.
The Association Between Social Desirability and Competitive Anxiety in Young Football Players with Different Qualifications
Authors: Sultanov Murad B.
Published: November 2024

Background. Sports performance anxiety is understood as a tendency to respond with cognitive or physical anxiety in competitive situations where the athlete's performance can be assessed. Objective. To investigate the role of social desirability and competitive anxiety in male football players with varying levels of skill. The study had two main objectives: first, to assess the levels of social desirability and competitive anxiety in two different groups, and second, to compare the levels of social desirability and competitive anxiety between highly skilled and less skilled players and explore their relationship. Design. Participants were divided into highly skilled (n = 39) and less skilled (n = 39) football players. The Eysenck Personality Questionnaire was used to assess the participants’ social desirability bias. The Sport Competition Anxiety Test assessed the level of competitive anxiety. The t-test for independent samples was used to compare social desirability and competitive anxiety between the groups. A linear regression model was used to determine if social desirability could predict anxiety levels among the players. Results. The t-test showed that highly skilled players have a lower level of competitive anxiety than less skilled participants. However, social desirability did not show a statistically significant difference between the highly skilled and less skilled football players. The regression analysis showed a statistically significant association between social desirability and competitive anxiety (inverse relation) in both groups. Conclusion. Highly skilled football players demonstrated less competitive anxiety than less skilled ones. Lower levels of competitive anxiety are associated with higher social desirability among football players in both groups.
The Distinction between Refugees and Immigrants
Authors: Gerhards Jürgen , Antoine Lukas , Ollroge Rasmus
Published: November 2024

International law obliges states to admit refugees while allowing discretion in accepting voluntary immigrants. This study, based on a 26-country survey, examines citizen attitudes towards these groups. With reference to the debate in political philosophy, the authors distinguish between different attitudinal groups: Nationalists, who advocate for border control; Cosmopolitans, who support unrestricted immigration rights; Legalists, who align with international law by supporting state discretion for voluntary immigrants but mandating refugee acceptance; and Inconsistents, who believe the state should have the right to reject refugees but not voluntary immigrants. The findings reveal that most citizens do not differentiate between refugees and voluntary immigrants, challenging the legal distinction in international law. Nationalists make up 44% of respondents, Cosmopolitans 31%, Legalists 15%, and Inconsistents 9%. Nationalists and Cosmopolitans have clear social profiles based on structural and cultural characteristics, while Legalists and Inconsistents do not.
Explaining the US Health Paradox
Authors: Kettl Julian , Baeza Marcos , Carrasco Natalia
Published: November 2024

Despite its high health spending, the US shows below-average life expectancy when compared to other OECD-countries. To find explanatory factors for this paradox, this article employs a Nested Analysis combining Large N Analysis (LNA) and Small N Analysis (SNA). First, it examines how far US life expectancy deviates from OLS model predictions which include a comprehensive set of health determinants. The results show that the established determinants clearly fail to explain the US underperformance. Second, a comparative analysis between the US and Canada identifies three idiosyncratic factors that explain the US deviation: its health care system particularities (1), the opioid crisis and drug-related deaths (2), and the particularly severe impact of the COVID-19 pandemic (3).
The Passing-On of F.W. de Klerk: a Trigger for a Renewed Theological Discourse on the Truth and Reconciliation Commission
Authors: Thinane Jonas Sello
Published: November 2024

After his death on 11 November 2021, social media in South Africa was immediately inundated with reactions to the mixed legacy of Frederik Willem de Klerk, the last President of South Africa during apartheid (1989–1994) and the former Vice President of Nelson Mandela (1994–1996) under the democratic dispensation. In most transitional justice processes, truth is often required in exchange for reconciliatory or peace accords. With the benefits of the literature review, this article problematises the deficiency of truth-telling or its absence thereof, by beneficiaries of apartheid, with particular stress on statements made by F.W. de Klerk during and after the TRC public hearings. It focuses on truth-telling as a neglected aspect in previous studies examining the work of the TRC. It uses the biblical understanding of the concept of truth as a foundational component of reconciliation to test the authenticity of the acclaimed reconciliation after the TRC hearings.
Diachronic Diversity in Classical Biblical Hebrew
Authors: Hornkohl Aaron D.
Published: November 2024

According to the standard periodisation of ancient Hebrew, the division of Biblical Hebrew as reflected in the Masoretic tradition is basically dichotomous: pre-exilic Classical Biblical Hebrew (CBH) versus post-Restoration Late Biblical Hebrew (LBH). Within this paradigm, the chronolectal unity of CBH is rarely questioned—this despite the reasonable expectation that the language of a corpus encompassing traditions of various ages and comprising works composed, edited, and transmitted over the course of centuries would show signs of diachronic development. From the perspective of historical evolution, CBH is remarkably homogenous. Within this apparent uniformity, however, there are indeed signs of historical development, sets of alternant features whose respective concentrations seem to divide CBH into two sub-chronolects. The most conspicuous typological division that emerges is between the CBH of the Pentateuch and that of the relevant Prophets and Writings. The present volume investigates a series of features that distinguish the two ostensible CBH sub-chronolects, weighs alternative explanations for distribution patterns that appear to have chronological significance, and considers broader implications for Hebrew diachrony and periodisation and for the composition of the Torah.
Finding a Home during the Affordable Housing Crisis: How Social Ties Shape Renters’ Housing-Search Outcomes
Authors: Schmidt Steven
Published: November 2024

Housing searches play a central role in the reproduction of racial inequality in U.S. cities. Past research finds that movers’ social ties influence residential segregation, as renters receive information about homes located near friends and family. Fewer studies examine how renters’ social ties also provide instrumental assistance during moves, or how this aid unequally shapes moving outcomes. In the present study, I show how 69 low-income, Latina/o and non-Hispanic white renters rely on their friends, family, and acquaintances to navigate moves in Los Angeles, a highly unaffordable rental market. Both groups mobilize their ties for instrumental assistance, but the resources available through renters’ ties contribute to diverging search outcomes. Low-income Latina/o renters’ ties, who also struggled to make ends meet, provided what I call constrained support—referrals to open units, loans to cover moving costs, and informal rental opportunities. This assistance channeled movers to specific apartments and left them negotiating informal, doubled-up homes and new debt. In contrast, low-income white renters leveraged comparatively affluent ties to cosign leases, provide financial gifts, and strengthen applications across buildings—what I refer to as flexible assistance. This aid helped low-income white movers secure housing advantages, while avoiding short-term reciprocal obligations to friends and family. These findings advance research on residential mobility and social support, and they show how network resource inequalities contribute to racial stratification in rental markets.
Abortion and Women’s Future Socioeconomic Attainment
Authors: Everett Bethany G. , Taylor Catherine J.
Published: November 2024

Abortion is a safe and common medical procedure. Roughly one in four women in the United States will have an abortion before the end of her reproductive years. Because of how common this experience is and how rapidly abortion policy is shifting, understanding the relationship between abortion and women’s socioeconomic futures is well worth exploring. Extant research has demonstrated that the transition to parenthood is a critical inflection point in women’s socioeconomic trajectories, often leading to poorer outcomes. In this article, we connect previous sociological work elucidating mechanisms of socioeconomic stratification and gender by considering the relationship between abortion use and access and future socioeconomic outcomes such as education, income, and financial stability—as measured by several measures, including evictions, debt, ability to pay bills, and a separate index of economic instability. We use national longitudinal survey data to assess socioeconomic outcomes associated with abortion using two statistical approaches. We find that women who lived in a location with fewer abortion restrictions in adolescence, and women who had an abortion, compared to a live birth, in adolescence, are more likely to have graduated from college, have higher incomes, and have greater financial stability at two time-points over an almost 25-year period. Our results provide evidence that policy environments allowing access to abortion, and teenagers having the option to use abortion to avoid early parenthood, are important axes along which women’s economic lives are shaped. Our research implies that the widespread abortion bans and restrictions in the United States are likely to lead to lower educational attainment and adult economic stability among women living under such restrictions, as compared to women in locations with better access to abortion.
Can’t Buy Me Love? The Use of Gifts in the Residency Application Process
Authors: Anderson Brigitte , Ducich Nicole , Campbell Brady , Cahn Matthew , Kavic Stephen M.
Published: November 2024

Introduction

To set themselves apart, some programs use gifts or promotional items to highlight the residency program or unique local culture. The distinction between advertisement and persuasion may be blurry in this case. We sought to quantify the prevalence of gifts to applicants and how frequently the US federal threshold for “nominal gifts” was exceeded.

Methods

We reviewed a publicly accessible, Internet resource called the “ERAS Megathread.” This is a Google spreadsheet found on Reddit where applicants participating in The Match can anonymously contribute information about their experience. The incidence of “gifts” was quantified for surgical residency programs, along with the nominal value if indicated. The spreadsheets were reviewed for 2021, 2022, and 2023.

Results

Over the past 3 application cycles, 15.1% [11.1%-18.2%] of general surgery residency programs provided a gift to applicants. Of these programs, the majority (70.2%) are university-based programs. In 2023, 57.9% of these gifts exceeded US$20. Given the anonymous nature of the data set, and the lack of transparency in the match process, it was not possible to correlate gift giving with its effect on recruitment.

Discussion/Conclusion

Students are courted by residency programs, and a significant minority of programs provide a gift to applicants. The impact of a substantial gift on a financially vulnerable student is difficult to quantify. It behooves us as a specialty to determine what should be a universal standard and to consider outlining explicit guidelines for The Match.
Improving Trauma Surgeons Prospective Estimation of the Injury Severity Score
Authors: Mlaver Eli , Dente Christopher J. , Solomon Gina , Krause Morgan , Vassy William Matthew , Todd S. Rob , Ayoung-Chee Patricia
Published: November 2024

Injury Severity Score (ISS) as a prospective predictive variable is limited, as it is scored post-discharge by registrars. We followed a phase 1 pilot investigation of the feasibility of prospective ISS estimation (eISS) by trauma surgeons within 1 day of admission with an investigation of the impact of a simple educational aid on the accuracy of these estimations. Eleven surgeons evaluated 178 patients in phase 2. With the educational aid, ISS concordance improved from 74.6% to 85.1% for non-severe (abstracted ISS, aISS <16) injuries and from 78.8% to 83.1% for severe (aISS ≥16) injuries; weighted k improved from 0.53 to 0.72. Abbreviated Injury Scale (AIS) concordance similarly improved in five of seven body regions. The ability to prospectively document ISS has important clinical and research implications. There remains opportunity to refine educational aides and harness the EHR to further improve prediction accuracy and facilitate adoption in standard clinical workflows.