bluuebunny/crossref_metadata_2025 huggingface dataset:
Odontoid fractures in the pediatric population: a systematic review and management algorithm
Authors: Prabhat Anjali M , Liu David S , Cohen Lara , Gabriel Daniel , Hines Kristen E , Hogue Grant D
Published: September 2024

Purpose:

The management of odontoid fractures in adult patients has been widely described. However, there is sparse literature about this injury in the pediatric population. This study aimed to review published literature regarding the management and outcomes of pediatric odontoid fractures to develop a stepwise treatment algorithm.

Methods:

A literature review was conducted using PRISMA guidelines on PubMed to identify studies between 1960 and 2023 that reported on the management and outcomes of odontoid fracture in pediatric patients. Studies were included if they were published in English and if their sample included at least four patients aged 0–18, minimum follow-up of 6 weeks, and outcomes for each patient clearly differentiated.

Results:

In total, 15 studies including 125 pediatric patients with odontoid fractures were included. Treatment options varied from non-operative management with immobilization in rigid collars, halo vests, cervicothoracic orthosis, or soft collars to surgical management with fixation and/or arthrodesis. There were 73 patients initially treated nonoperatively, 47 initially treated surgically, 2 who healed with observation alone, and 3 who died acutely of concomitant injuries. The nonunion rate for nonoperative management was 5.5%. Surgery was successful, demonstrating bony union at final follow-up, in 94.6% of cases treated via a posterior approach and 85.7% of cases treated with an anterior approach.

Conclusions:

Odontoid fractures must be considered in pediatric patients with cervical spine trauma. This is the largest literature review of pediatric odontoid fractures. Various management strategies exist and can be considered. The proposed algorithm offers an evidence-based framework for the management of pediatric odontoid fractures.
Novel MEN1-associated retroperitoneal pleomorphic liposarcoma
Authors: McNicoll Christopher F , Belmonte Jessica , Nir Itzhak , Ferguson Benjamin D
Published: September 2024

Soft tissue sarcomas are rarely associated with mutations of the MEN1 gene. We report a patient with a large retroperitoneal pleomorphic liposarcoma harboring a rare mutation of the MEN1 gene not previously reported to be associated with soft tissue sarcomas. This report expands the known spectrum of MEN1-associated cancers.
Assessing potential risk factors for metamizole-induced leukopenia
Authors: Brüne Birgit , Sonderer Sarah , Bösing Maria , Hübner Simona , Dongre Kanchan , Späni Selina , Holboro Andreas , Leuppi Jörg D. , Leuppi-Taegtmeyer Anne B.
Published: September 2024

Background:

Metamizole is a non-opioid analgesic agent that can rarely cause agranulocytosis, a severe form of leukopenia.

Objectives:

The aim of this study was to assess previously identified potential risk factors for the development of metamizole-induced leukopenia.

Design:

A retrospective, observational, matched case-control study was performed in a single-center setting.

Methods:

Patients who developed leukopenia in the setting of metamizole therapy were included as cases and matched 1:3 on the basis of age and sex to control patients who did not develop leukopenia when treated with metamizole. The data were obtained from the medical records of patients hospitalized at Cantonal Hospital Baselland between 2015 and 2020. Univariate and multivariate analyses were performed.

Results:

Eighty-six cases and 258 matched controls aged between 18 and 102 years were included. Fifty-seven percent were female. Previous leukopenic episodes (odds ratio (OR): 4.02, 95% CI: 1.95–8.28, p < 0.001) and a history of penicillin allergy (OR: 2.49, 95% CI: 1.03–6.03, p = 0.044) were found to be independent risk factors for metamizole-induced leukopenia.

Conclusion:

A history of previous leukopenic episodes and a history of penicillin allergy were confirmed as risk factors for metamizole-induced leukopenia. In our opinion, metamizole should be avoided in patients with these risk factors.
Biplane 3D overlay guidance for congenital heart disease to assist cardiac catheterization interventions—A pilot study
Authors: Vegulla Ravi V , Greil Gerald , Reddy Surendranath V. , Zabala Luis , Dimas Vivian , Arar Yousef , Pontiki Antonia , Rhode Kawal , Hussain Tarique
Published: September 2024

Cardiac catheterization for congenital heart disease (CHD) performed under fluoroscopic guidance still lacks definition and requires exposure to ionizing radiation and contrast agents, with most patients needing multiple procedures through their lifetime, leading to cumulative radiation risks. While fusion overlay techniques have been employed in the past to aid, these have been limited to a single plane, while interventions are traditionally performed under biplane fluoroscopy. We describe our initial experience performing cardiac catheterizations guided by an enhanced biplane GuideCCI system© (Siemens Healthcare, Germany) augmented by 3D magnetic resonance imaging and computed tomography modeling. Twenty-one children and young adults with CHD undergoing catheterization procedures between October 2019 and May 2021 were chosen based on their degree of complexity of cardiac anatomy. 3D stereolithography models were generated, overlayed, and displayed in real time, alongside angiographs in both planes on the screen during these procedures. We report successful implementation of this novel technology for performance of 26 interventions including stent placements, balloon dilations, vessel occlusion and percutaneous valve and transvenous pacemaker implantation all in patients with various complex cardiac anatomies. A statistically significant reduction in radiation and contrast use was noted for coarctation of the aorta stent angioplasty and transcatheter pulmonary valve replacement when compared with national benchmarks and local institutional metrics (with and without single plane overlay). No complications were encountered with the use of this technology. Use of a tracheal registration technique provided very good correlation in most cases. Operators preferred using biplane augmented catheterization over traditional fluoroscopy in patients with complex cardiac anatomy undergoing interventions.
Marketing and food consumption: Nurturing new possibilities
Authors: O.C. Werle Carolina , Sirieix Lucie , Pantin-Sohier Gaelle
Published: September 2024

This article introduces the RAM 2024 Special Issue on Marketing and Food, designed to report on and stimulate new scientific advancements in the field. It discusses the conflicting concerns related to food consumption and the emerging practices of consumers and industry players. The Special Issue explores how consumers react to new technologies used in post-purchase situations through the representation of experiences via social media (David et al., 2024). Food is at the heart of today’s sustainability issues, and this Special Issue shows that the environmental impact of food consumption is influenced by the provisioning systems geographically available for consumers (Mourre et al., 2024) and by the perceived and objective accessibility of local food at the moment of choice (in supermarkets or restaurants; Garcia et al., 2024). Consumers’ reactions to retailers’ sustainable initiatives to manage and prevent food waste are shown to be ambivalent (Hanan et al., 2024), revealing a complex relationship. Finally, the Special Issue explores consumers’ reconnection with food consumption through mindful eating, allowing a greater focus on internal sensations and fostering awareness of both personal motivations and the environmental impact of consumption (Dupont Le Priol and Schmitt, 2024). Avenues for future research and implications for practice and policy are discussed.
Bibliometric Analysis of Smartphone Addiction Literature
Authors: Wong Boon Yew , Yeo Kee Jiar , Lee Shih-Hui
Published: September 2024

Smartphone addiction has been widely recognized as a notable global public health issue. Researchers have already conducted numerous researches to look into various aspects of smartphone addiction such as risk/protective factors, negative consequences, prevalence, and intervention strategies. Despite the existence of these researches, they remain fragmented in the existing literature, which make it challenging for researchers to have an integrative view of smartphone addiction literature. Addressing this research gap, this study conducts bibliometric analysis on the 924 publications extracted from Scopus. More specifically, through the use of various performance indicators (e.g., total number of citations/publications and citation per publication), this study has identified the publication trend, most influential/productive journals, authors, and publications. Furthermore, through co-word analysis conducted on the title and abstract of publications, this study has also identified and briefly elaborated on the research themes in the existing literature of smartphone addiction (i.e., protective/risk factors, neurobiological mechanisms, and intervention; prevalence and negative consequences; scale development and psychometric properties). Taken together, this study provides researchers especially those new to the field of smartphone addiction a one-stop platform to gain an aggregative view of smartphone addiction literature.
The Power of Social Commerce: Understanding the Role of Social Word-of-Mouth Behaviors and Flow Experience on Social Media Users’ Purchase Intention
Authors: Álvarez Santamaría Coloma , Riaño Gil Consuelo , Ruiz Vega Agustín V.
Published: September 2024

Social commerce has emerged as a phenomenon that supports social interaction and user-generated content, allowing individuals to make informed purchasing decisions. This study aims to identify the antecedents of the sWOM behaviors present in social network sites (SNSs). Specifically, tie strength, homophily, trust, informational, and normative influence were included as sWOM antecedents. This study provides a deeper understanding of sWOM behavior in SNSs by identifying and analyzing separately three interrelated behaviors with distinct antecedents: opinion-giving, opinion-seeking, and opinion-passing. Additionally, flow experience is proposed as a less studied antecedent that interacts with all sWOM behaviors, and simultaneously, purchase intention. Our results suggest that flow experience, followed by opinion-seeking and opinion-passing, exerts the greatest influence on purchase intention. Additionally, our findings reveal that informative and normative influence are the analyzed antecedents that have the greatest impact on purchase intention.

JEL Classification: M31.
To Continue or Quit Business? Mediating Roles of Resilience and Quality of Life in Forming a Sustainable Entrepreneurial Intention
Authors: Hamzah Muhammad Iskandar , Othman Abdul Kadir , Fern Yeo Sook
Published: September 2024

The dynamics and volatility of market conditions require entrepreneurs to exercise their utmost perseverance and fortitude to progress forward. Despite the emerging evidence that associates their motivation with business continuity, little is known about whether quality of life and resilience bear any mediating effects on this connection. Guided by the self-determination theory, this study examines the indirect effects of resilience and quality of life on sustainable entrepreneurial intention. Structural equation modeling via SmartPLS was utilized to examine the cross-sectional survey data involving 102 Malaysian small business entrepreneurs and test the hypotheses. The results suggested that goal attainment motivation has a direct positive effect on sustainable entrepreneurial intention. Additionally, goal attainment motivation via resilience indirectly predicts quality of life, and quality of life mediates the relationship between resilience and sustainable entrepreneurial intention. The main theoretical implication of the findings suggests that the relationship between goal attainment motivation, resilience, quality of life, and sustainable entrepreneurial intention is more nuanced and mediated than previously assumed. Practically, stakeholders and policymakers should develop multifaceted support systems that address psychological resilience and quality of life factors alongside goal-oriented strategies to cultivate a conducive environment for sustainable entrepreneurship.
Analysis of Patients Who Undergo Index Arthroscopy With Biopsy but Not Implantation for Staged Chondrocyte Cell Transplantation
Authors: Kemler Bryson R. , Johnson Emma E. , Evert Brad M. , Dees Azra N. , Giakas Alec M. , Hanna Adeeb Jacob , D’Amore Taylor , Freedman Kevin B. , Hammoud Sommer
Published: September 2024

Background:

Autologous chondrocyte implantation (ACI) and matrix-induced autologous chondrocyte implantation (MACI) are 2-stage procedures requiring an index full-thickness cartilage biopsy. Only a portion of patients ultimately undergo second-stage ACI/MACI.

Purpose:

To identify patients with articular cartilage defects who underwent arthroscopic debridement with biopsy for ACI/MACI and compare those who did with those who did not proceed with implantation within 2 years after biopsy. Additionally, the authors sought to identify why patients did not proceed with implantation.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

Patients who underwent arthroscopy and autologous chondrocyte biopsy from January 1, 2015, to December 31, 2019, and who had minimum 2-year follow-up data were grouped into those who proceeded with second-stage ACI/MACI (implant group; n = 97) and those who did not (biopsy group; n = 63). Demographic factors, cartilage defect characteristics, and preoperative International Knee Documentation Committee (IKDC) scores were analyzed. Patients in both groups were evaluated postoperatively using the IKDC, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Single Assessment Numeric Evaluation (SANE), and visual analog scale (VAS) for pain, and patients who did not undergo implantation were asked for their reasoning.

Results:

Body mass index (BMI) ( P < .001) and Outerbridge grades at index arthroscopy ( P = .047) were significantly higher for the implant group than the biopsy group. Both groups had significantly improved IKDC scores from their initial presentation to final follow-up (implant group: 46.4 ± 16.2 preoperative vs 69.6 ± 20.6 postoperative [ P < .001]; biopsy group: 47.2 ± 15.9 preoperative vs 70.7 ± 19.1 postoperative [ P < .001]); however, the level of improvement did not differ significantly between groups. Postoperative WOMAC, SANE, and VAS pain scores were also similar between groups. In the biopsy group, 23 patients (37%) cited symptom resolution or activity level improvement after initial arthroscopy as the reason for not proceeding with implantation.

Conclusion:

Patients who proceeded to the second stage of chondrocyte implantation via either ACI or MACI had higher-grade articular defects and higher BMI compared with those who underwent biopsy with concomitant debridement chondroplasty alone. Postoperative outcomes were similar between the groups.
China’s Arms Transfer to Iran: More Noise, Less Substance
Authors: Kumar Atul
Published: September 2024

China sees Iran as a crucial power with significant influence over the security landscape of the Middle East. Despite being sensitive to regional and global dynamics surrounding Iran, China cannot ignore Tehran’s strategic significance. Yet, their bilateral relations are significantly influenced by the regional security environment. China has consistently prioritized its ties with the United States over Iran and has generally adhered to UN regulations concerning Iran. China’s sensitivity to Arab and regional interests in the Middle East significantly impacts the China–Iran arms relationship. These concerns significantly restricted the flow of Chinese arms to Iran since 2005, with UN sanctions ultimately sealing the cessation of arms flow.
Environmental Sustainability Analysis of Rotary-Screen Printing and Digital Textile Printing
Authors: Azizul Hoque Sharif Mohammad , Chapman Lisa Parrillo , Moore Marguerite , Lavelle Jerome , Saloni Daniel , Woodbridge Janie , Maguire King Kerry
Published: September 2024

Worldwide concern regarding the need for more sustainable textile supply chain prompted emphasis on innovation in the coloration process, often considered the most problematic segment of the supply chain. Digital textile printing, an emerging coloration technology, has the potential to improve sustainability significantly. This study undertakes an environmental sustainability analysis that compares the impacts of rotary-screen printing, the traditional, more established printing method, and digital textile printing. Researchers partnered with Creditex S.A.A., a vertically integrated textile company from Peru, to perform the research in a realistic factory setting. Creditex printed a 16-color design for an order of 1000m cotton fabric with reactive dye occupying both rotary-screen printing and digital textile printing and collected environmental impact data throughout the production process, including consumption, usage, and wastage. The findings suggest that digital textile printing is favorable to rotary-screen printing in terms of environmental sustainability impacts within the research context.
Anatomic and Visual Outcomes of Scleral Buckle in Primary Rhegmatogenous Retinal Detachment in the Era of Pars Plana Vitrectomy
Authors: Kannan Naresh Babu , Sayyad Kulsum J. , Vallinayagam Muthu Krishnan , Mishra Chitaranjan , Chakrabarti Keya , Chakpram Priyalaxmi , Ramasamy Kim
Published: September 2024

Introduction: To determine the presenting clinical characteristics of patients with rhegmatogenous retinal detachment (RRD) who underwent scleral buckling and the impact on final visual outcomes and to determine the postoperative primary attachment rate, complications, and subsequent management. Methods: This retrospective observational study comprised patients with RRD who had scleral buckling surgery from January 2016 to December 2021 with a minimum follow-up of 6 months. Results: The study comprised 307 eyes of 290 patients; 97% of eyes were phakic. Primary anatomic attachment was achieved in 93% of eyes. Macula-on detachment had a significant relationship with visual gain, while age, refractive status, number of breaks, configuration of the detachment, traumatic etiology, and lens status did not. Eyes with recurrent detachment did not have a significant visual gain after subsequent pars plana vitrectomy (PPV). Conclusions: Most eyes that underwent scleral buckling were phakic. Macular status played a significant role in the visual prognosis. The primary anatomic attachment rate after scleral buckling surgery is comparable to that after PPV. Thus, scleral buckling is far from being a procedure of the past. Multiple breaks, inferior detachments, and traumatic etiology do not appear to adversely affect the visual outcomes. Multiple vitreoretinal surgeries may not result in a visual gain in cases of recurrent detachment.
Transitions of Care From Hospital to Home: Can Continuous Glucose Monitoring Improve Outcomes for Patients With Diabetes?
Authors: Jenkins Marjorie , Simpson Jenny , Ursuy Tyler , Hanks Judy , Burroughs Thomas Edward
Published: September 2024

Purpose

The purpose of this study was to examine the impact of continuous blood glucose monitoring (CGM) on transitions of care as patients with diabetes are discharged from the hospital on insulin.

Methods

This is a descriptive study with 2 cohorts of patients (transition to home with CGM and transition to home without CGM) who were assessed prior to discharge (baseline) and 30 days post discharge (follow-up). The key outcome measures were satisfaction with diabetes management, diabetes-related quality of life, frequency of blood glucose monitoring, and 30-day readmission rates.

Results

Patients in the CGM group reported significantly higher levels of satisfaction with diabetes self-care management and higher levels of diabetes-related quality of life compared to those patients discharged without CGM.

Conclusion

The results of this study suggest that CGM enables a smoother transition from hospital to home for patients with diabetes placed on insulin at discharge. CGM was associated with higher satisfaction and diabetes-related quality of life, perhaps as a result of timely, ongoing information about glucose levels without the burden and pain of finger sticks. CGM may provide greater confidence in self-care decisions regarding insulin dosing, food intake, and exercise. Further research is needed to confirm our results and explore the additional factors associated with greater quality of life and satisfaction.
Subpectoral Biceps Tenodesis Using an All-Suture Anchor
Authors: Raji Yazdan , Bugarinovic George , Helenius Kevin N. , Freehill Michael T.
Published: September 2024

Background:

The long head of the biceps tendon (LHBT) has long been considered an intra-articular pain generator in the shoulder. While nonoperative treatment modalities can be acceptable for less severe presentations of LHBT pathology, surgical treatment options such as tenotomy and tenodesis remain controversial for recalcitrant cases. Open subpectoral biceps tenodesis allows for removal of all pathologic tissue from the bicipital groove, and all-suture anchor fixation utilizes a small caliber unicortical drill hole, which can potentially reduce the risk of a stress riser and iatrogenic fracture.

Indications:

In this study, we present a male patient with a history of left anterolateral shoulder pain worse overhead activities who has failed extensive physical therapy and other conservative measures. After extensive discussion regarding the treatment options, surgery in the form of shoulder arthroscopy, extensive debridement, rotator cuff repair, and open subpectoral biceps tenodesis was recommended and the patient had opted to proceed. For the purposes of this video, we focus on the open subpectoral biceps tenodesis portion of the procedure.

Results:

Open subpectoral biceps tenodesis can reduce pain with low complication and high satisfaction rates.

Discussion:

In this surgical technique study, we underline the importance position of the skin incision in axillary crease as well as skin tensioning when making the incision and retracting the conjoint tendon. We also highlight a locking lasso loop and double luggage tag fixation technique using a double-loaded all-suture anchor for the biceps tenodesis. We also provide technique commentary for appropriate restin tension of the LHBT. Finally, we review outcomes, postoperative management, rehabilitation protocol, and technique pearls and pitfalls.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Neurodiversity and third-level education: A lacuna between the strength-based paradigm shift and the lived experience
Authors: Quigley Etain , O’Hanlon Molly , Brandes Martha , Kennedy Rowan , Gavin Blánaid
Published: September 2024

There has been a notable change in how third-level institutions perceive and interact with students who do not meet historically typical expectations regarding education. This is evidenced by an increased emphasis on equality, diversity, and inclusion in terms of access and retention across the sector. The extent to which this includes a neurodiversity focus varies significantly across jurisdictions. However, research suggests a gap between rhetoric and reality concerning neurodiversity at the third level, with many students’ lived experiences being reported as challenging, and at times compounding stigma, masking, and feelings of inadequacy. Moreover, it is unclear whether third-level institutions understand the nuance of neurodiversity and the significance of the neurodiversity movement. This project utilised the Global Café methodology to explore the above phenomenon from a participatory lived experience perspective. The project found that, despite the increase in focus by third-level institutions in the area of neurodiversity, this cohort is still disadvantaged when compared to their neurotypical peers and indeed may be experiencing greater exclusion as a result of the overemphasis upon what is perceived to be a singular and neurotypical understanding of the strength-based model within the third-level sector.

Lay abstract

This study looks at how colleges and universities treat students who learn differently. Even though colleges and universities talk a lot about being fair and inclusive, the research shows that many students who think and learn differently still face a lot of difficulties. This study explored this using a method called the Global Café. The Global Café method gathers information with students about their own experiences, allowing the students to direct the research. The findings reveal that, despite colleges and universities saying they support students who learn differently, many students still face challenges compared to those who learn in more traditional ways. The study highlighted that terms used in the area of neurodiversity were open to question/debate with different terms being preferred by different people in different contexts. It also found that many supports and initiatives are steeped in neurotypical (typical learning approaches) assumptions and therefore do not always apply to the needs of students who think and learn differently. Finally, the study found that more needs to be done to make sure students with different learning styles have the same opportunities in higher education, not just when they are entering it.
Occurrence rate and species and subtypes of Cryptosporidium spp. in pet dogs in Yunnan Province, China
Authors: Jian Jinhua , Liu Aiqin , Yang Yaming , Peng Xiaoxue , Yao Lan , Li Benfu , Zi Jinrong , Cao Jianping , Shen Yujuan
Published: September 2024

Background

Cryptosporidiumspp. is a ubiquitous, globally distributed intestinal protozoan infecting humans and at least 260 animal hosts. Due to close human contact with pet dogs and identification of zoonoticCryptosporidiumspecies and subtypes in these animals, dog health is not only a veterinarian issue but also a public health issue. This study aimed to understand occurrence and genetic characterization at both genotype and subtype levels in pet dogs in Yunnan Province, China.

Results

A total of 589 fresh fecal specimens were collected from adult pet dogs in the rural areas of eight cities/autonomous prefectures of Yunnan Province, China. 16 fecal specimens were positive forCryptosporidiumspp. by polymerase chain reaction (PCR) amplification and sequence analysis of the small subunit ribosomal RNA (SSU rRNA) gene, with an average occurrence rate of 2.7% (16/589) being observed. Three zoonoticCryptosporidiumspecies were identified:C. parvum(n = 7),C. suis(n = 5) andC. canis(n = 4). At the 60-kDa glycoprotein (gp60) locus, only threeC. parvumand twoC. canisspecimens were successfully amplified and sequenced, with subtype IIaA17G2R1 (n = 3) and subtypes XXa4 (n = 1) and XXa5 (n = 1) being identified, respectively.

Conclusions

The present finding of three zoonoticCryptosporidiumspecies in dogs implied that dogs infected withCryptosporidiumspp. may pose a threat to human health.C. suiswas identified in dogs in this study for the first time, expanding the host range of this species. Identification ofC. parvumsubtype IIaA17G2R1 andC. canissubtypes XXa4 and XXa5 will be helpful to explore the source attribution of infection/contamination and assess the transmission dynamics ofC. parvumandC. canisin the investigated areas in the future.
A theoretical framework for linking hospitals longitudinally: demonstrated using German Hospital Quality Reports 2016–2020
Authors: Ji Limei , Geraedts Max , de Cruppé Werner
Published: September 2024

Background

In longitudinal health services research, hospital identification using an ID code, often supplemented with several additional variables, lacks clarity regarding representativeness and variable influence. This study presents an operational method for hospital identity delimitation and a novel longitudinal identification approach, demonstrated using a case study.

Methods

The conceptualisation considers hospitals as evolving entities, identifying “similar enough” pairs across two time points using an automated similarity matrix. This method comprises key variable selection, similarity scoring, and tolerance threshold definition, tailored to data source characteristics and clinical relevance. This linking method is tested by applying the identification of minimum caseload requirements-related German hospitals, utilizing German Hospital Quality Reports (GHQR) 2016–2020.

Results

The method achieved a success rate (min: 97.9% - max: 100%, mean: 99.9%) surpassing traditional hospital ID-code linkage (min: 91.5% - max: 98.8%, mean: 96.6%), with a remarkable 99% reduction in manual work through automation.

Conclusions

This method, rooted in a comprehensive understanding of hospital identities, offers an operational, automated, and customisable process serving diverse clinical topics. This approach has the advantage of simultaneously considering multiple variables and systematically observing temporal changes in hospitals. It also enhances the precision and efficiency of longitudinal hospital identification in health services research.
Baltimore community resident and collaborator perspectives on the influence of guaranteed income on health: a formative qualitative study
Authors: Nishimura Holly M. , Snguon Sevly , Dean Lorraine T. , Moen Marik
Published: September 2024

Background

Given increased interest and investment in guaranteed income initiatives across North America, it is critical to understand the impact of guaranteed income on health, an understudied outcome. As part of Baltimore, Maryland’s guaranteed income pilot, we conducted formative research to understand the influence of increased income on health and develop concrete recommendations for implementation and evaluation of the pilot.

Methods

We conducted semi-structured in-depth interviews with Baltimore community residents (n = 8) and community collaborators (n = 8), probing on familiarity with guaranteed income; effect of guaranteed income on overall health and specific health outcomes (e.g., mental health, nutrition); and recommendations for program structure (e.g., eligibility, target population). Data were analyzed thematically using a framework analysis approach.

Results

Respondents agreed that guaranteed income could have beneficial effects on health though some were unsure of specific mechanisms. Respondents emphasized pathways through which guaranteed income could improve health: (1) reduced financial-related stress; (2) improved nutrition through purchase of healthier foods; (3) improved family well-being including child health and parent-child relationships; (4) increased utilization of health services; (5) improved community health through increased community cohesion and decreased violence. Respondents described decreased feelings of time scarcity as a social determinant of health. Most respondents reported that Baltimore’s guaranteed income program should prioritize young, low-income families with $1,000/month or more for at least one year.

Conclusions

This formative research on the potential health impacts of guaranteed income in Baltimore highlights important health outcomes and pathways, such as social cohesion and decreased feelings of time scarcity, to prioritize for evaluation.
Spatiotemporal variability of the association between greenspace exposure and depression in older adults in South Korea
Authors: Yoo Eun-Hye , Min Jin-Young , Choi Baek-Yong , Ryoo Seung-Woo , Min Kyoung-Bok , Roberts John E.
Published: September 2024

Background

A number of studies based on young to middle aged adult and child samples have found that exposure to greenspace and bluespace can have a positive impact on mental health and well-being. However, there is limited research among older adults and the extant studies have provided mixed results. The present study was designed to examine how the association between these forms of exposure and depressive symptoms among older adults varies as a function of different spatially and temporally resolved exposure metrics.

Methods

The sample consisted of 617 individuals (46.19% female) aged ≥ 60 years of age. Depressive symptoms were measured using the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Individuals’ greenspace exposure was quantified using spatially and temporally resolved metrics, including monthly and annual averaged satellite-derived normalized difference vegetation index (NDVI) across multiple buffer distances (250 m to 2,000 m) centered at participants’ home address. We also quantified exposure to blue-greenspace from a highly detailed land use and land cover dataset. A multivariable logistic regression model assessed the association between greenspace and blue-greenspace exposure and depressive symptoms, adjusting for age, sex, income, education, marital status, current smoking, alcohol status, medical conditions, temperature, crime rate, population density, and per capita park area.

Results

We found a significant association between exposures to greenspace and blue-greenspace and depressive symptoms (CES-D cutoff ≥ 4) among older adults. After adjusting for confounding variables, the odds of depressive symptoms were significantly decreased by an IQR increment in residential exposure to greenspace [odds ratio (OR) = 0.67; 95% confidence interval (95% CI), 0.49 ~ 0.91] and blue-greenspace (OR = 0.59; 95% CI, 0.41 ~ 0.84) measured nearby their home address (i.e., as close as 250 m). When stratified by household income level, the association was only significant among low-income individuals. We also found temporal variation in the association between depressive symptoms and monthly NDVI-based greenspace exposure, in which the odds of depressive symptoms were the lowest for greenspace in cold months (i.e., January, February, and March).

Conclusions

Our findings suggest that neighborhood greenspace may serve as a protective factor against depression among older adults, but the benefits may depend on the spatial and temporal context. More investigation is needed to replicate our findings on the spatial and temporal variations of greenspace exposure metrics and their effects on depressive symptoms.
Short-term safety and effectiveness of conversion from sleeve gastrectomy to Ring augmented Roux-en-Y gastric bypass
Authors: van Dam Kayleigh Ann Martina , de Witte Evelien , Broos Pieter Petrus Henricus Luciën , Greve Jan Willem M. , Boerma Evert-Jan Gijsbert
Published: September 2024

Background

Weight recurrence, suboptimal clinical response and functional disorder (such as reflux) after a Sleeve Gastrectomy (SG) are problems that may require conversional surgery. For reflux, conversion to Roux-en-Y Gastric Bypass (RYGB) is considered effective. Regarding treatment for suboptimal clinical response, the technique of choice remains a subject of debate. This study aims to evaluate the safety and effectiveness of conversion from SG to Ring-augmented RYGB ( RaRYGB).

Methods

All laparoscopic SG to RaRYGB conversions performed between January 2016 and January 2022 were included. Primary outcome was percentage total weight loss (%TWL) after 1-year follow-up. Secondary outcomes consisted of cumulative %TWL, complications (with a focus on ring-related complications), and resolution of medical-associated problems.

Results

We included 50 patients of whom 44 were female. Mean pre-conversion BMI was 37.6 kg/m2. All patients have reached the 1-year follow-up point, however 10 were lost to follow-up. After 1-year mean TWL was 17.8% while mean cumulative TWL, calculated from primary SG, was 32%. A total of 10 complications occurred in 8 patients within 30 days, 6 of which were ≤ CD3a and 4 ≥ CD3b. One MiniMizer was removed for complaints of severe dysphagia. Of the 35 medical-associated problems present at screening 5 remained unchanged(14.2%), 15 improved(42.9%) and 15 achieved remission(42.9%).

Conclusion

Our series of 50 patients undergoing conversion from SG to RaRYGB is adequate and successful regarding additional weight loss 1 year after conversion, cumulative weight loss, complication rate and achievement of improvement or remission of medical-associated problems.
Observations from the first 100 cases of intraoperative MRI – experiences, trends and short-term outcomes
Authors: Barchéus Hanna , Peischl Christoffer , Björkman-Burtscher Isabella M. , Pettersson Christina , Smits Anja , Nilsson Daniel , Farahmand Dan , Eriksson Johanna , Skoglund Thomas , Corell Alba
Published: September 2024

Background

We sought to analyze, in well-defined clinical setting, the first 100 patients treated at the intraoperative MRI (iMRI) hybrid surgical theatre at our facility in a population-based setting to evaluate which pathologies are best approached with iMRI assisted surgeries, as this is not yet clearly defined.

Methods

Patients undergoing surgery in the 3T iMRI hybrid surgical theatre at our neurosurgical department between December 2017 to May 2021 were included after informed consent. Demographic, clinical, surgical, histological, radiological and outcome parameters, as well as variables related to iMRI, were retrospectively collected and analyzed. Patients were subdivided into adult and pediatric cohorts.

Results

Various neurosurgical procedures were performed; resection of tumors and epileptic foci, endoscopic skull base procedures including pituitary lesions, deep brain stimulation (DBS) and laser interstitial thermal therapy (LITT). In total, 41 patients were pediatric. An iMRI scan was carried out in 96% of cases and led to continuation of surgery in 50% of cases, mainly due to visualized remaining pathological tissue (95.2%). Median time to iMRI from intubation was 280 min and median total duration of surgery was 445 min. The majority of patients experienced no postoperative complications (70%), 13 patients suffered permanent postoperative deficits, predominantly visual.

Conclusion

Herein, we demonstrate the first 100 patients undergoing neurosurgery aided by iMRI at our facility since introduction. Indications for surgery differed between pediatric and adult patients. The iMRI was utilized for tumor surgeries, particularly adult low-grade gliomas and pediatric tumors, as well as for epilepsy surgery and DBS. In this heterogenous population, iMRI led to continuation of surgery in 50%. To establish the benefit in maximizing the extent of resection in these brain pathologies future studies are recommended.

Clinical trial number

Not applicable.
A summer course in cancer for high school students-an update on lessons taught and lessons learned
Authors: Solone Xzaviar K. , Chitre Siddhi , Font Laura Falceto , Pereira Kimberly N. Espinoza , Stofer Kathryn , Siemann Dietmar W.
Published: September 2024

Background

Previous graduate students and postdoctoral associates from the University of Florida Health Cancer Center, in partnership with the University of Florida Student Science Training Program, implemented a cooperative learning curriculum, providing high school students with a broad overview of cancer topics over six weeks over the summer. To address discussions necessitated by the COVID-19 pandemic on student autonomy, we report lessons learned and outcomes of a cancer biology and therapeutic curriculum modified for a collaborative learning environment.

Methods

This pre-post longitudinal observational study conducted in 2023 on a cancer biology and therapeutics course evaluated students’ knowledge retention and general awareness and opinions in cancer research. A structured survey was employed for data collection, using learning assessment surveys and the Likert scale ranging from 1 to 10, with 10 being highly likely.

Results

Student performance tracked over a 7-year period indicated consistency in performance between years. Post-assessment analysis revealed significant improvements in student benchmark understanding, notably in their ability to define cancer in one sentence (p = 0.0407), identify cancer therapies (p = 0.0040), and recognize cancer hallmarks (p < 0.0001). An increased trend in median response to the likelihood of pursuing cancer research (p = 0.8793) and the possibility of pursuing cancer research (p = 0.4874) were also observed, although not statistically significant. Moreover, feedback from participating students indicated that “the educational activities at the end of class (e.g., escape room, case studies)” and “learning about cancer and getting to work in groups…” the curriculum fostered a positive educational learning environment.

Conclusion

Students generally retained the course material presented and upheld a positive perception of the course. Incorporating opportunities for peer-to-peer learning, especially when introducing or discussing complex issues like cancer, may benefit student autotomy.
Toward a roadmap for sustainable lean adoption in hospitals: a Delphi study
Authors: Van Zyl-Cillié Maria M. , van Dun Desirée H. , Meijer Hanneke
Published: September 2024

Background

The benefits of lean adoption in healthcare include improved process efficiency and quality of patient care. However, research indicates that lean implementation in healthcare, and specifically hospitals, is often not sustained. Furthermore, there is a need for maturity models that guide lean implementation, specifically in hospitals. This study develops a prescriptive maturity model named the Sustaining of Lean Adoption in Hospitals Roadmap (SOLAR) that acts as a practical guideline for the sustainable adoption of lean in hospitals.

Methods

The SOLAR has three theoretical foundations, namely lean implementation success factors in hospitals, implementation science, and change management theory. A systematic literature review was conducted to determine the lean implementation success factors in hospitals as the first building block. Secondly, practices from implementation science were used to create the action items in the SOLAR. Ten change steps were elicited from change management theory as the third theoretical building block of the roadmap. We refined the roadmap through three Delphi rounds that verified its useability in hospitals.

Results

The final SOLAR consists of four maturity phases (prepare, plan, experiment and learn, and sustain) and includes action items for each phase related to the hospital’s strategy, resources, engaging of people, and culture. The action items and change management steps shown in the SOLAR are not intended as an exhaustive list but provide guidelines on aspects hospitals must consider when they aim to adopt lean sustainably.

Conclusions

The strong theoretical base of the SOLAR enables hospitals to safely experiment and learn which implementation methods are best suited to their unique environment. The SOLAR is, therefore, an actionable guideline that informs both academics and practitioners involved in lean adoption in hospitals. This roadmap can guide future retrospective longitudinal or action research.
Bone turnover: the role of lipoproteins in a population-based study
Authors: Winckel Todd , Friedrich Nele , Zylla Stephanie , Fenzlaff Marc , Schöpfel Juliane , Gauß Karen Friederike , Petersmann Astrid , Nauck Matthias , Völzke Henry , Hannemann Anke
Published: September 2024

Background

Dyslipidemia has been associated with reduced bone mineral density and osteoporotic fractures, but the relation between lipid and bone metabolism remains poorly understood. Analysing the effects of lipoprotein subclasses on bone turnover may provide valuable insights into this association. We therefore examined whether lipoprotein subclasses, measured by proton nuclear magnetic resonance (1H-NMR) spectroscopy, are associated with bone turnover markers (BTMs) and with the ultrasound-based bone stiffness index.

Methods

Data from 1.349 men and 1.123 women, who participated in the population-based Study of Health in Pomerania-TREND were analysed. Serum intact amino-terminal propeptide of type I procollagen (P1NP, bone formation) and carboxy-terminal telopeptide of type I collagen (CTX, bone resorption) concentrations were measured. Associations between the lipoprotein data and the BTMs or the stiffness index were investigated using linear regression models.

Results

The triglyceride or cholesterol content in very-low-density lipoprotein and intermediate-density lipoprotein particles was inversely associated with both BTMs, with effect estimates being slightly higher for CTX than for P1NP. The triglyceride content in low-density lipoprotein and high-density lipoprotein particles and the Apo-A2 content in high-density lipoprotein particles was further inversely associated with the BTMs. Associations with the ultrasound-based bone stiffness index were absent.

Conclusions

Consistent inverse associations of triglycerides with bone turnover were observed, which argue for a protective effect on bone health, at least in the normal range. Yet, the presented associations did not translate into effects on the ultrasound-based bone stiffness. Further, there was no relevant gain of information by assessing the lipoprotein subclasses. Nevertheless, our study highlights the close relations between lipid and bone metabolism in the general population.
Opioid-specific harm reduction in the emergency department: how staff provide harm reduction and contextual factors that impact their capacity to engage in harm reduction practice
Authors: Jiao Sunny , Bungay Vicky , Jenkins Emily , Gagnon Marilou
Published: September 2024

Background

Emergency Departments (ED) staff, including nurses and physicians, are most directly involved in the care of people who use unregulated substances, and are ideally positioned to provide harm reduction interventions. Conceptualizing the ED as a complex adaptive system, this paper examines how ED staff experience opioid-specific harm reduction provision and engage in harm reduction practice, including potential facilitators and barriers to engagement.

Methods

Using a mixed methods approach, ED nurses and physicians completed a self-administered staff survey (n = 99) and one-on-one semi-structured interviews (n = 15). Five additional interviews were completed with clinical leaders. Survey data were analyzed to generate descriptive statistics and to compute scale scores. De-identified interview data were analyzed using a reflexive thematic analysis approach, which was informed by the theory of complex adaptive systems, as well as understandings of harm reduction as both a technical solution and a contextualized social practice. The final analysis involved mixed analysis through integrating both quantitative and qualitative data to generate overarching analytical themes.

Results

Study findings illustrated that, within the context of the ED as a complex adaptive system, three interrelated contextual factors shape the capacity of staff to engage in harm reduction practice, and to implement the full range of opioid-specific harm reduction interventions available. These factors include opportunities to leverage benefits afforded by working collaboratively with colleagues, adequate preparation through receiving the necessary education and training, and support in helping patients establish connections for ongoing care.

Conclusions

There is a need for harm reduction provision across all health and social care settings where people who use unregulated opioids access public sector services. In the context of the ED, attention to contextual factors including teamwork, preparedness, and connections is warranted to support that ED staff engage in harm reduction practice.