bluuebunny/crossref_metadata_2025 huggingface dataset:
Altered Corticospinal and Intracortical Excitability After Stroke: A Systematic Review With Meta-Analysis
Authors: Washabaugh Edward P. , Foley Sierra A. , Czopek Emily G. , Krishnan Chandramouli
Published: September 2024

Background

Intracortical inhibitory/faciliatory measures are affected after stroke; however, the evidence is conflicting.

Objective

This meta-analysis aimed to investigate the changes in motor threshold (MT), motor evoked potential (MEP), short-interval intracortical inhibition (SICI), and intracortical facilitation (ICF), and identify sources of study variability using a machine learning approach.

Methods

We identified studies that objectively evaluated corticospinal excitability and intracortical inhibition/facilitation after stroke using transcranial magnetic stimulation. Pooled within- (ie, affected hemisphere [ AH] vs unaffected hemisphere [ UH]) and between-subjects (ie, AH and UH vs Control) standardized mean differences were computed. Decision trees determined which factors accurately predicted studies that showed alterations in corticospinal excitability and intracortical inhibition/facilitation.

Results

A total of 35 studies (625 stroke patients and 328 healthy controls) were included. MT was significantly increased and MEP was significantly decreased (ie, reduced excitability) in the AH when compared with the UH and Control ( P < .01). SICI was increased (ie, reduced inhibition) for the AH when compared with the UH, and for the AH and UH when compared with Control ( P < .001). ICF was significantly increased (ie, increased facilitation) in the AH when compared with UH ( P = .016) and decreased in UH when compared with Control ( P < 0.001). Decision trees indicated that demographic and methodological factors accurately predicted (73%-86%) studies that showed alterations in corticospinal and intracortical excitability measures.

Conclusions

The findings indicate that stroke alters corticospinal and intracortical excitability measures. Alterations in SICI and ICF may reflect disinhibition of the motor cortex after stroke, which is contrary to the notion that stroke increases inhibition of the affected side.
Comparative Analysis of LORETA Z Score Neurofeedback and Cognitive Rehabilitation on Quality of Life and Response Inhibition in Individuals with Opioid Addiction
Authors: Faridi Alireza , Taremian Farhad , Thatcher Robert W.
Published: September 2024

Background. Previous studies has shown that conventional neurofeedback and cognitive rehabilitation can improve psychological outcomes in people with opioid use disorders. However, the effectiveness of LORETA Z-score neurofeedback (LZNFB) and attention bias modification training on quality of life and inhibitory control of these people has not been investigated yet. LZNFB targets deeper brain structures with higher precision, compared to conventional neurofeedback that typically focuses on surface EEG activity. The present study aims to compare the effect of these two methods on quality of life and response inhibition in men with opioid use disorders under methadone maintenance therapy (MMT). Methods. In this randomized controlled clinical trial with a pre-test, post-test, follow-up design, 30 men with opioid use disorders under MMT were randomly assigned into three groups of LZNFB, attention bias modification training, and control (MMT alone). The LZNFB and Cognitive Rehabilitation groups received 20 and 15 sessions of treatment, respectively. The Persian versions WHO Quality of Life-BREEF questionnaire and the Go/No-Go test were completed by the participants before, immediately after, and one month after interventions. The collected data were analyzed in SPSS v.22 software. Results. Both intervention groups showed a significant improvement in quality-of-life score and a significant reduction in response time at the post-test phase ( P < .05), where LZNFB group showed more improvement in quality of life and more reduction in response inhibition. After one month, the increase in quality of life continued in both groups, while the decrease in response time continued only in the LZNFB group. Conclusion. Both LZNFB and attention bias modification training are effective in improving quality of life and response inhibition of men with OUD under MMT, however, LZNFB is more effective.
Robot-Assisted Minimally Invasive Coronary Artery Bypass Grafting: Total Arterial Revascularization Using the Double-Docking Technique
Authors: Yusuf Meeranghani Mohammed , Bansal Varun , Venkatesh Ashwin , Chandrasekharan Ganapathy Arumugam , Vora Minal , Mahesh Kumar Aishwarya
Published: September 2024

Objective:

The right internal mammary artery is considered to be the second choice for arterial conduits for coronary artery bypass grafting (CABG). However, the widespread use of bilateral internal mammary artery (BIMA) grafting is limited owing to increased technical demands, lengthy procedure, and high incidence of sternal wound complications. We compared the early clinical outcomes of a novel robot-assisted double-docking technique (DDT) with an open sternotomy technique for total arterial revascularization using BIMA.

Methods:

Between June 2019 and June 2023, 445 patients with multivessel coronary artery disease underwent open sternotomy CABG using BIMA grafting and 145 patients underwent robot-assisted BIMA grafting using DDT. Comparative analysis of 104 pairs of matched patients obtained using propensity score matching was performed. Procedural characteristics, postoperative 30-day mortality, and composite outcome (major adverse cardiac and cerebrovascular events) at a median follow-up of 1.5 years were evaluated.

Results:

Preprocedural characteristics were well balanced between the groups after propensity matching. The number of distal anastomoses performed in the conventional group was statistically higher than that performed using DDT ( P < 0.001). The durations of postsurgical ventilation, intensive care unit stay, and in-hospital stay were significantly lower with the DDT than with conventional CABG ( P < 0.001). There was no significant difference in all-cause mortality or major adverse cardiac events between the DDT and conventional CABG groups at a median follow-up of 1.5 years.

Conclusions:

The DDT is feasible and efficacious for revascularization of multiple coronary targets in select individuals. It is equivalent to open sternotomy in terms of early clinical outcomes and superior to open sternotomy with regard to rates of sternal infection and intensive care unit and in-hospital stay.
Cost Analysis of Robot-Assisted Versus On-Pump and Off-Pump Coronary Artery Bypass Grafting: A Single-Center Surgical and 30-Day Outcomes Comparison
Authors: Gianoli Monica , de Jong Anne R. , van der Harst Pim , van der Kaaij Niels P. , Jacob Kirolos A. , Suyker Willem J. L.
Published: September 2024

Objective:

Throughout Europe, the interest in implementing robot-assisted minimally invasive direct coronary artery bypass (RA-MIDCAB) has been growing. However, concerns about additional costs have emerged concurrently. In this analysis, we aim to provide a comparison of the cumulative perioperative costs of RA-MIDCAB, on-pump coronary artery bypass grafting (CABG), and off-pump CABG (OPCAB).

Methods:

We conducted a propensity score–matched analysis comparing patients undergoing RA-MIDCAB with those undergoing CABG or OPCAB at our institution from January 2016 to December 2021. After matching, we analyzed the combined intraoperative surgical costs and 30-day postoperative costs. We first compared RA-MIDCAB costs to CABG and then to OPCAB separately. Violin plots illustrated the cost distribution among individual patients. Total cost uncertainty was estimated using 1,000 bootstrapping iterations.

Results:

Seventy-nine RA-MIDCAB patients were matched to 158 CABG patients, and 80 RA-MIDCAB patients were matched to 149 OPCAB patients. Considering both surgical and clinical outcomes, RA-MIDCAB yielded an average cost of €17,121 per patient (€16,781 to €33,294), CABG was €16,571 per patient (€16,664 to €41,860), and OPCAB was €15,463 per patient (€10,895 to €57,867). After bootstrap iterations, RA-MIDCAB was found to be €472 (2.8%) and €1,599 (10.3%) more expensive per patient than CABG and OPCAB, respectively.

Conclusions:

In The Netherlands, the adoption of RA-MIDCAB did not show a significant economic impact on hospital resources. The additional robotic costs for the surgery were almost entirely offset by the cost savings during the postoperative hospital stay. However, these comparisons may differ when considering hybrid coronary revascularization with its additional percutaneous coronary intervention costs.
Lower Recurrence Rate After Surgical Treatment for Primary Spontaneous Pneumothorax Using a Digital Chest Drainage System
Authors: Yu Peter Sze-Yuen , Chan Kin Wai , Lim Kevin , Siu Ivan Chi Hin , Wong Randolph Hung Leung , Wan Innes Yuk Pui
Published: September 2024

Objective:

This study assessed the impact of digital chest drainage systems for patients undergoing video-assisted thoracoscopic surgery (VATS) pleurodesis for primary spontaneous pneumothorax (PSP) as compared with conventional chest drainage.

Methods:

A retrospective analysis of patients who underwent VATS pleurodesis for PSP was conducted. The primary outcome was pneumothorax recurrence, while secondary outcomes included time to mobilization, degree of lung expansion, drainage duration, and length of hospital stay. These measures were expressed as average treatment effect and subsequently compared after propensity score adjustment.

Results:

In total, 125 consecutive patients over a 64-month period were analyzed, with 55 patients in the digital drainage system group and 70 patients in the conventional drainage system group. After propensity score adjustment, the use of a digital drainage system was significantly associated with earlier mobilization (−2.22 days, P < 0.001) and lower rate of recurrence (−11.2%, P = 0.049).

Conclusions:

The digital drainage system facilitated earlier postoperative free mobilization and resulted in lower pneumothorax recurrence rates.
Electromechanical properties of knitted structures for potential socks sensing systems
Authors: Ullah Sultan , Akhter Zeenat , Hamdani Syed Talha Ali , Janusas Giedrius
Published: September 2024

The use of knitted structure pressure sensors in wearable applications and health monitoring systems has attracted a great deal of attention. This study aims to assess the single jersey and double jersey knitted structures as well as the electromechanical characteristics of electrically conductive yarns (ECY). The knitted structures were made with two different types of electrically conductive yarn, including the (i) fully drawn yarn (FDY) and the (ii) drawn textured yarn (DTY). FDY had higher tensile strength than DTY in reference to their drawing and twisting processes. Based on the results in terms of tensile strength, conductive yarns of 280D-FDY and SPFX25070-FX were chosen from seven available conductive yarns for the further production of knitted structures. Additionally, the knittability of the conductive yarn was also considered. Due to the knit-tuck stitch assembly, which increases the thickness of the structure, it was found that the double Lacoste, popcorn, and milano ribs had the necessary compression resistance. The compression properties of the knitted structures were tested using the kawabata evaluation system (KES FB-03). It was found that the recommended knitted structure sensing technology can be easily expanded into a scalable and affordable solution for the production of smart socks and related applications.
The effect of intravenous thrombolysis in stroke patients with unsuccessful thrombectomy
Authors: Elawady Sameh Samir , Kasem Rahim Abo , Matsukawa Hidetoshi , Cunningham Conor , Sowlat Mohamed Mahdi , Nawabi Noah Lee , Orscelik Atakan , Venegas Joshua M , Isidor Julio , Loulida Hasna , Maier Ilko , Jabbour Pascal , Kim Joon-Tae , Wolfe Stacey Quintero , Rai Ansaar , Starke Robert M , Psychogios Marios-Nikos , Samaniego Edgar A , Goyal Nitin , Yoshimura Shinichi , Cuellar Hugo , Howard Brian , Alawieh Ali , Alaraj Ali , Ezzeldin Mohamad , Romano Daniele G , Tanweer Omar , Mascitelli Justin , Fragata Isabel , Polifka Adam , Siddiqui Fazeel , Osbun Joshua , Grandhi Ramesh , Crosa Roberto , Matouk Charles , Park Min S , Levitt Michael R , Brinjikji Waleed , Moss Mark , Daglioglu Ergun , Williamson Richard , Navia Pedro , Kan Peter , De Leacy Reade , Chowdhry Shakeel , Altschul David J , Spiotta Alejandro M , Al Kasab Sami
Published: September 2024

Background

The benefit of intravenous thrombolysis (IVT) is well established. We aim to study the benefits of IVT in acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) who underwent unsuccessful mechanical thrombectomy (MT).

Methods

We included AIS patients who underwent MT for anterior circulation LVO with failed recanalization (modified treatment in cerebral ischemia [mTICI] score ≤ 2A). Patients who received IVT prior to MT were compared to those who received MT alone. Propensity score matching using demographic, clinical, radiographic and procedural variables was used to match patients with and without IVT. The primary outcome was favorable 90-day good functional outcome (defined as modified Rankin scale of 0–2), and secondary outcomes included intracranial hemorrhage (ICH), symptomatic ICH (sICH), and 90-day mortality.

Results

Totally, 610 AIS patients with unsuccessful MT were included. After propensity matching, 219 patients were identified in each group. Median age was 70 years and 73 years in the IVT + MT and MT alone groups, respectively. In the IVT + MT group, final mTICI scores of 0, 1, and 2A were achieved in 92 (42.0%), 33 (15.1%), and 94 (42.9%) patients, respectively, versus 76 (34.7%), 29 (13.2%), and 114 (52.1%) in the MT alone group. The IVT + MT group had greater odds of 90-day good functional outcome (adjusted odds ratio 2.54, 95% confidence interval 1.53–4.32). There were no significant differences in secondary outcomes.

Conclusions

IVT is associated with improved functional outcomes in AIS patients with LVO despite unsuccessful MT.
Perfecting the pour: A novel co-axial technique with sequential injections for optimising cement delivery during sacroplasty
Authors: Nasralla Mehran , Alfalahi Afra , Hendriks Eef J , Murphy Kieran , Smith Roger
Published: September 2024

Background

Percutaneous sacroplasty is an effective treatment for painful sacral fractures and tumours, however there is no accepted optimal technique for performing this procedure. This study investigated a novel approach to sacroplasty combining co-axial sacral access, sequential cement injections and hypothermic cement manipulation to improve cement delivery.

Methods

This retrospective study analysed 11 patients who underwent co-axial sacroplasty between April 2023 and March 2024 for treatment of painful insufficiency fractures ( n = 5) or malignant sacral tumours ( n = 6). All cases were performed using biplane fluoroscopy with conebeam CT navigation for planning and monitoring percutaneous access. Procedural details, technical outcomes, and clinical outcomes including Numerical Rating Scale (NRS) pain and analgesic utilisation on a six-point scale were analysed pre-procedure and at follow-up.

Results

Technical success of was achieved in all cases using this technique. The mean injected cement volume was 20.5 ± 6.4 ml. Median pre-procedural NRS pain scores of 8 (IQR 7.25–8) significantly decreased to 0 (IQR, 0–0.25) at follow-up ( p <.01). The median preprocedural analgesic utilisation score reduced from 3 (IQR, 2–3) to 0 (IQR, 0–2.5) at follow-up ( p <.01). Cement leakage occurred during two cases without associated adverse clinical sequelae. There were no major adverse events.

Conclusion

Co-axial sequential injection sacroplasty is a safe and effective technique which allows facilitates controlled delivery of cement. Improved control of cement delivery, including around high-risk structures for cement leakage, offers a potential safety advantage over conventional sacroplasty techniques. Further research comparing technical and clinical outcomes to conventional techniques is warranted.
Efficacy and safety of flow diverters in retreatment of recurrent intracranial aneurysms—A systematic review and meta-analysis
Authors: Zarrintan Armin , Ghozy Sherief , Maroufi Seyed Farzad , Reda Abdullah , Brinjikji Waleed , Kadirvel Ramanathan , Kallmes David F
Published: September 2024

Background and purpose

Treatment of recurrent intracranial aneurysms after their initial therapy has been a significant challenge in the field of neurointervention. Recently flow diverters stents are widely used for treating intracranial aneurysms. In this systematic review and meta-analysis, we assessed the safety and efficacy of flow diverter in treating recurrent or recanalized intracranial aneurysms.

Methods

This meta-analysis is reported following the PRISMA 2020 guidelines. We conducted a systematic review of literature in the PubMed, Embase, Web of Sciences, and Scopus databases. Pooled prevalence and the corresponding 95% are calculated from extracted data using a random-effect model.

Results

The systematic literature search included 21 studies involving 411 patients, with 135 (32.8%) being male and 276 (67.2%) being females with a total number of 447 aneurysms. The overall rate of adequate occlusion was 90.67% (95% CI: 84.23%–94.65%), and the rates were comparable between the surgery (93.48%), coiling (91.78%), and stenting (85.77%) groups. The overall pooled rate of complete occlusion was 81.80 (95% CI: 71.14%–89.13%). On doing a subgroup analysis, the complete occlusion rates were 89.68%, 84.39%, and 73.47% for the surgery, coiling, and stenting groups, respectively. The overall mortality rate and achieving modified Rankin scale score of 0-2 was 1.28% (95% CI: 0.45%–3.64%) and (95% CI: 89.92%–97.84%), respectively. No significant heterogeneity is noted in the included studies.

Conclusion

Flow diverter stents are an effective and safe method for retreating recurrent or residual intracranial aneurysms with a high rate of complete and adequate occlusion. The rate of mortality, intracerebral hemorrhage, and overall and procedural complications following using flow diverters for intracranial aneurysms is low.
Radically Re-Reading Youth Feedback With Anticolonial Black Feminist Critique
Authors: Carter Cee
Published: September 2024

Many scholars have drawn on youth voice as a way of learning about educational inequity from the perspective of those closest to it. Yet, methodological engagements with youth voice tend to elide considerations of how coloniality and raciality operate in the very interpretive strategies leveraged to represent youth voice in academic knowledge produced about inequity. Following anticolonial black feminist critique and method-making, the inquirer turns to a radical reading practice for engaging youth feedback at a summer achievement program dedicated to promoting racial and educational justice and reversing summer learning loss. Key to this radical reading practice are methodological and analytical moves that: (a) pivot from earlier interpretations of youth feedback; (b) trace raciality in educational text to demonstrate how the text relies on modern signifying strategies that hide Man, his descriptive statements for existence, and the attendant power structures that facilitate global capital; and (c) consider how youth feedback illustrates coloniality and raciality at work within the out-of-school program. In all, the paper demonstrates how a black inquiry approach complicates educational equity’s federally mandated, state-monitored, and locally enacted pursuit at an out-of-school program to collectively consider alternatives to our current ethical-political education demands, and how we might engage the task of posing those alternatives.
Systematic review of clinical guidelines and consensus statements concerning heparin and protamine dosing and monitoring of anticoagulation levels for non-cardiac arterial procedures
Authors: Roosendaal Liliane C , Doganer Orkun , Wiersema Arno M , Blankensteijn Jan D , Jongkind Vincent
Published: September 2024

Objectives

This systematic review was performed to examine all published practice Guidelines and Consensus Statements (together: GCS) on heparin dosing and monitoring during non-cardiac arterial procedures (NCAP). The objective was to scrutinize the recommendations and advice outlined within these GCS documents and to evaluate the supporting evidence for these recommendations. Additionally, the use of the activated clotting time (ACT) and target ACT values were explored.

Methods

This systematic review was performed in accordance with the PRISMA Guidelines. Medline and Embase databases were searched to identify all GCSs in the English language on NCAP. The final literature search was performed in January 2023. This search was supplemented by searching websites of relevant professional vascular surgical organizations for GCSs. Titles and abstracts were assessed by two independent reviewers.

Results

Of 9716 titles identified, 27 GCSs met the predefined inclusion criteria: six GCSs regarding carotid intervention, seven regarding procedures for aneurysmal disease of the abdominal aorta and iliac arteries, 12 regarding interventions for acute and chronic peripheral arterial occlusive disease and two regarding open and endovascular interventions of thoraco-abdominal aortic aneurysms. Administration of heparin is advised for al NCAP. There was high variability concerning heparin dose: both standard dose as weight based dosing (30-150 IU/kg) was advised. Recommendations on repeated doses, ACT monitoring and heparin reversal using protamine also varied widely. In none of the GCSs, the type of the ACT measuring device or used cartridges were specified.

Conclusions

Large variability was found between the included GCSs with regard to the recommendations on heparin dose and target ACT values during NCAP. Advice and recommendations in GCSs were based on low-quality studies or without providing any reference at all. The described variability in recommendations emphasizes the need for large prospective (randomized) studies or the incorporation of data on heparin and the use of ACT monitoring into verified vascular surgery registries, to develop evidence-based, practical and uniform applicable recommendations.
Approaching principalship in Sweden: Novice principals’ recollections of their career trajectories
Authors: Jerdborg Stina
Published: September 2024

Novice principals can easily recall how and why they became principals. Although transitioning from teacher to school principal is often experienced as daunting, few studies have examined the career trajectories of principals, either before or after becoming a principal. This qualitative empirical interview study investigates the life-span career trajectories of 14 novice principals in Sweden by investigating their pre-entry and entry stages to principalship. Their career trajectories are influenced by structural factors and aspects of their agency. The results show that their concerns pass several stages and that they either have applied to become a principal because they see value in being a principal per se, or they apply ‘away from being a teacher’, that is, to become a principal because teaching has become too stressful. Two paths were revealed, the first path approaches principalship as a practice and the second path approaches principalship as a project.
Teachers’ professional learning: Do instructional leadership and teacher leadership make a difference in Turkiye?
Authors: Dasci Sonmez Elif , Cemaloglu Necati , Kahraman Gulsah
Published: September 2024

Numerous studies have explored teachers’ professional learning, yet ongoing efforts persist to understand the influence of leadership factors on this concept. This study aims to analyse the relationship between school principals’ instructional leadership behaviours, teacher leadership and teachers’ professional learning. A structural model was created and tested using data from 346 Turkish teachers. Results confirmed that teacher leadership behaviours mediate the relationship between principals’ instructional leadership behaviours and teachers’ professional learning. In contexts where principals demonstrate instructional leadership, teachers tend to exhibit more teacher leadership behaviours, fostering positive attitudes towards professional learning. Teachers engaged in teacher leadership behaviours prioritise activities enhancing their professional learning. This study concludes that the impact of instructional leadership on teacher leadership and professional learning hinges on principals’ implementation of instructional leadership and teachers’ integration of professional learning into their practices, contributing to leadership literature.
Is there a cost when predictions are not met? A VWP study investigating L1 and L2 speakers
Authors: Fernandez Leigh B , Hadley Lauren V , Koç Aybora , Gamboa John CB , Allen Shanley EM
Published: September 2024

Research has found that both first language (L1) and second language (L2) speakers make predictions about upcoming linguistic information, with predictive behaviour being impacted by individual differences and methodological factors. However, it is not clear whether a cost is incurred when a prediction is made, but not met. L2 speakers have less experience with their L2 and parsing can be cognitively demanding, which together may lead L2 speakers to incur prediction costs differently relative to L1 speakers. In this study using the visual world paradigm, we test whether L1 and L2 speakers predict in the same way, within the same time frame, and incur the same costs if predictions are not met. We also explore the role of proficiency and speech rate. We found that both groups predict in a similar way and within a similar time frame. In addition, neither group incurred a prediction cost when the target was the most likely alternative, though L2 speakers take longer to shift their attention to the target object when predictions are not met. We argue that this reflects a slowing of lexical access rather than a specific cost of prediction. We only found prediction differences when speech rate was included in the analysis, highlighting the importance of attending to speech rate in studies using the visual world paradigm. Overall, this study supports research showing that both L1 and L2 speakers may make multiple partial predictions about upcoming information rather than predicting one specific lexical candidate while inhibiting less likely lexical candidates.
The drop in worry about crime and its gender gap: Trends in England and Wales from 1998 to 2019/2020
Authors: Pohl Sophie , Buil-Gil David
Published: September 2024

Using data from the Crime Survey for England and Wales, this research explores trends in worry about crime and its gender gap between 1998 and 2019/20. Worry about different types of crime follows a downwards trajectory, with worries about car-related crimes showing the strongest decline. Although both men’s and women’s worries decline over time, the gender gap in worry about crime reveals a narrowing trend for crimes that involve physical interaction with the offender (e.g. assault or rape) due to women’s worries decreasing more rapidly than men’s. Potential reasons for the general downwards trend include the steady decline in crime rates, the rise in security standards and a shift in worry from traditional to newer forms of crime (e.g. cybercrime). Rising gender equality and women’s empowerment over the last few decades may explain the narrowing trend in the gender gap in worry about personal crime.
Re-heating the “First” Thanksgiving: the Thanksgiving episode as settler colonial narrative
Authors: Stowell Olivia
Published: September 2024

Thanksgiving-themed episodes of cooking television open up questions about the interrelations of food, history, power, and culture. This study addresses such questions through textual and thematic analysis of 46 Thanksgiving-themed episodes of reality cooking competition programmes on US cable TV, exploring how the Thanksgiving episode operates as a site for the deployment of the culinary as a category by which the past is re/created. I argue that the Thanksgiving episode represents history through two frames: “tradition” and “reenactment.” Reading the Thanksgiving episode as a site of history's reconstruction illuminates popular media's involvement in the socio-historical-political machinery of contemporary life.
WHO Surgical Safety Checklist compliance rate at a large tertiary hospital in Vietnam
Authors: Thanh Nguyen Duc , Thanh Tran Chi , Nguyet Ha Thi Minh , Nhiem Nguyen Thi Thanh , Hung Phung Thanh
Published: September 2024

The WHO Surgical Safety Checklist has been instrumental in reducing surgical deaths by 47% globally since its inception in 2009. A study was conducted to assess the compliance of hospital staff with the Surgical Safety Checklist and identify potential barriers to its implementation at a large tertiary public hospital in Vietnam. The study analysed 135 surgical cases between February and September 2021 using the Pareto principle with eight error categories, including (1) patient identification, (2) equipment, (3) risk management, (4) blood loss, (5) allergy, (6) items left inside the patient, (7) surgical specimens and (8) patient safety and recovery management. Compliance with the Surgical Safety Checklist was between 77% and 93%, with five categories accounting for more than 80% of errors. Periodic monitoring and staff training can improve compliance and help reduce errors for better patient safety. Long-term solutions addressing infrastructure challenges are also crucial.
The (ever)changing face of news, with broadcast interviews in focus
Authors: Facchinetti Roberta
Published: September 2024

In this paper I intend to shed light on broadcast news interviews with a focus on the increasing role of video-mediated platforms. To do so, I first overview the rules of conduct journalists are required to follow, pondering on whether the shift to video-platforms has made substantial changes to what recommended in manuals and posited in scholarly studies. Then, I illustrate a corpus-based case study of news interviews carried out by professional journalists with Chinese and Russian diplomats. Similarities and differences between face-to-face and video-mediated interviews as well as between Chinese and Russian interviewees have been identified, with special reference to (a) the format of the questions posed by the journalists, (b) their degree of compliance to the traditional ground rules of conduct in the Q&A interface, (c) the role of the interviewees’ lingua-cultural background and (d) reference to the audience.
Head in the clouds: A Deleuzoguattarian analysis of the environmental impacts of digital memory
Authors: Loots Olivia
Published: September 2024

Digital memory in the twenty-first century is a complex combination of human and nonhuman elements that interact in various combinations. In an era where environmental devastation is inundating the planet, it is vital to address the digital’s role in this degradation. This article explores various facets of the environmental implications of the digital storage of memory objects using Deleuze and Guattari’s assemblage theory. I identify the ways in which the digital realm is constructed, or ‘territorialised’ in Deleuzoguattarian terms. Beyond identifying the most common myths related to digital memory’s environmental impact, I expand on the work of information theorists such as Clements, Floridi, and Ess by forwarding three ways in which digital memory practices can be deterritorialised. These approaches include (1) knowledge acquisition, (2) taking response-ability, and (3) anti-redundancy movements. I argue that it is vital for cloud storage users, especially those who self-identify as environmentally conscious, to align their online memory practices with accurate understandings of the environmental impacts of the digital.
Syringomyelia-induced wrist Charcot neuroarthropathy
Authors: Lunga Zamalunga , McGuire Duncan , Solomons Michael
Published: September 2024

We present a rare case of wrist Charcot neuroarthropathy secondary to post-tuberculosis syringomyelia.

Level of evidence: V
Surgical correction of radially deviated Wassel type III thumb polydactyly: a prospective case series
Authors: Guo Yongqiang , Li Tao , Tian Xiaofei , Xiao Jun , Li Tianwu , Qiu Lin
Published: September 2024

We report our experience with correction of radially deviated Wassel type III thumb polydactyly. After comprehensive assessments from preoperative radiographs, physical examinations and intraoperative reports, we corrected the metacarpophalangeal joint in 34 cases of radially deviated Wassel type III thumb polydactyly. Opening-wedge osteotomies combining bone graft and soft tissue reconstruction were used in 28 cases and soft tissue reconstruction only in six cases. Absorbable sutures were used instead of traditional Kirschner (K)-wires to fix the bone grafts. Patients were followed up for 12–78 months (mean 47 months). According to the Tada scoring system, 25 patients achieved good results, seven fair results and two poor results. Our modified technique for correcting radially deviated Wassel type III thumb polydactyly yielded satisfactory results. Continued follow-up and further studies will contribute to a better understanding of the long-term efficacy and potential refinements of this technique.

Level of evidence: IV
Titanium patient-specific scaphoid replacement for unreconstructable nonunions: a case series study
Authors: Geuskens Willem , Verstreken Andreas , Stroobants Eline , Verstreken Frederik
Published: September 2024

Although reconstruction is the preferred treatment option for symptomatic scaphoid nonunions, this may not be an option due to inadequate bone quality or degenerative changes. Existing salvage procedures tend to compromise function. This study introduces an alternative approach through the utilisation of a 3-D-printed titanium patient-specific scaphoid implant. In this retrospective case series, the outcomes of 12 patients treated for an unreconstructable scaphoid nonunion with a 3-D-printed prosthesis were evaluated. Patient-reported outcomes, range of motion, grip strength and plain radiographs were assessed pre- and postoperatively. The mean follow-up was 2 years and 8 months. Range of movement and patient-reported outcome scores improved postoperatively, although improvement in movement was not significant. Except for one, all implants showed satisfactory alignment on radiographs without any further degenerative changes. 3-D-printed titanium scaphoid replacement may be an alternative to salvage procedures for unreconstructable scaphoid nonunion.

Level of evidence: IV
Indocyanine green near infrared fluorescent imaging and its potential role in peripheral nerve repair
Authors: Friedman Rebecca , Kubajak Chistopher , Agrawal Nikhil A. , Bass Jonathan L.
Published: September 2024

This case series describes the successful use of indocyanine green dye and near infrared fluorescence imaging in primary peripheral nerve repair.
Clarithromycin sustained-release tablet may be an improper therapy for the eradication of Helicobacter pylori
Authors: Zuo Xingsheng , Shen Qingli , Luo Jing , Wang Yaqin , Zhao Chenglong
Published: September 2024

Background:

Clarithromycin plays an important role in eradicating Helicobacter pylori ( H. pylori) through quadruple therapy. However, there is limited research on whether different forms of clarithromycin dosage have similar efficacies against H. pylori.

Objective:

We aimed to evaluate the efficacy of different forms of clarithromycin dosage in bismuth-containing quadruple therapy for eradicating H. pylori.

Design:

A single-center retrospective analysis comparing the efficacy of different forms of clarithromycin dosage in eradicating H. pylori.

Methods:

An analysis was conducted on patients diagnosed with H. pylori infection through the 13C-urea breath test (13C-UBT) at Henan Provincial People’s Hospital, China from 2020 to 2022 who were treated with either a dispersible or sustained-release clarithromycin tablet (500 mg each), alongside amoxicillin (1000 mg), a standard dose of proton pump inhibitors (PPIs), and bismuth citrate (220 mg), administered twice daily as part of bismuth-containing quadruple therapy. Treatment efficacy was assessed using 13C-UBT at least 4 weeks after treatment completion. The H. pylori eradication rate was the primary outcome of this study, and factors influencing it were analyzed.

Results:

Among 2094 screened patients, 307 with H. pylori infection (mean age, 41.8 ± 0.7 years; 43% men) received bismuth-containing quadruple therapy. Univariate analysis of the dispersible and sustained-release tablet groups revealed a lower eradication rate with the sustained-release tablet compared with the dispersible clarithromycin tablet regimen (75.26% (73/97) vs 95.26% (200/210), respectively; p < 0.05). Other factors, such as smoking, age, and PPI type, were not significantly associated with the cure rate. Multivariate analysis identified the form of clarithromycin dosage (dispersible vs sustained-release) to be an independent risk factor for eradication failure using the bismuth-containing quadruple therapy (odds ratio = 0.145, 95% confidence interval: (0.065–0.323); p < 0.05).

Conclusion:

The clarithromycin dispersible tablet demonstrated a higher H. pylori eradication rate, and the sustained-release clarithromycin tablet may be inappropriate for H. pylori eradication.
Efficacy and safety of patisiran for ATTRv-PN: a systematic review and meta-analysis
Authors: Huang Xinyue , Sun Chong , Chen Haofeng , Zhao Chongbo , Lin Jie
Published: September 2024

Background:

Hereditary transthyretin amyloidosis (ATTRv; v for variant) with polyneuropathy is a rare, progressive, and fatal autosomal dominant disorder. Therapies such as liver transplantation and TTR stabilizations have limitations. Patisiran is a small interfering RNA (siRNA), offering potential as a genetic-level therapy for hereditary transthyretin amyloidosis with polyneuropathy (ATTRv-PN). However, evidence on patisiran’s efficacy and safety for ATTRv-PN remains limited.

Objectives:

This study aimed to further clarify patisiran’s efficacy and safety for ATTRv-PN by meta-analysis.

Design:

Systematic review and meta-analysis.

Methods:

After literature searches in PubMed, Ovid MEDLINE, Embase, JBI EBP, Cochrane, and ClinicalTrials.gov databases on 7 June 2024, 11 studies with 503 patients were included and clinical data were extracted.

Results:

Results showed an 88% (95% confidence interval (CI): 81%–94%) pooled responsiveness rate. The standardized mean difference of modified Neuropathy Impairment Score plus 7 nerve tests (mNIS + 7) scores was −0.18 (95% CI: −0.32 to −0.03, p-value 0.018) and Norfolk Quality of Life–Diabetic Neuropathy was −0.21 (95% CI: −0.35 to −0.08, p-value 0.002). In total, 413 adverse events (AEs) (84.8%), 158 serious AEs (32.4%), and 37 deaths (7.6%) were recorded. Most of AEs were mild to moderate. No deaths were attributed to patisiran. However, there is no statistically significant improvement in Neuropathy Impairment Scores.

Conclusion:

In conclusion, patisiran was effective and safe for patients with ATTRv-PN. More large-scale clinical trials and long-term studies are necessary to further validate patisiran’s efficacy and safety.

Trial registration:

PROSPERO registration ID: CRD42023428838.
Effect of surgical, medical, and behavioral weight loss on hormonal and sexual function in men: a contemporary narrative review
Authors: Santamaria Alvaro , Amighi Arash , Thomas Melbin , Goradia Rajvi , Choy Jeremy , Hehemann Marah C.
Published: September 2024

This review explores the mechanisms and ramifications of weight loss achieved through lifestyle modifications, medical treatments, and bariatric surgery on testosterone levels and sexual health. Obesity significantly affects the hypothalamic–pituitary–gonadal axis in men, leading to diminished libido and erectile dysfunction. Here, we delve into the physiological disruptions caused by this imbalance and the intricate interplay of hormonal factors contributing to the dysregulation associated with obesity to comprehensively grasp the consequences of weight loss via diverse mechanisms. Lifestyle modifications involving dietary adjustments and regular exercise represent a widely employed and efficacious means of weight loss. While adherence demands discipline, our review scrutinizes various studies specifically investigating the impact of weight loss, attained through lifestyle modifications, on serum hormone levels and sexual function. Notably, several randomized controlled trials within the existing body of literature corroborate the enhancement of testosterone levels and sexual function consequent to weight loss through lifestyle modifications. The realm of medical management in addressing obesity is growing, notably propelled by the popularity of pharmacotherapy. Despite its prevalence, the current literature exploring the effects of weight loss medications on men remains insufficient. Nonetheless, we examine available studies on the medical management of obesity and its implications for sexual health, emphasizing pivotal avenues requiring further investigation. Bariatric surgery stands as an effective approach for individuals seeking substantial weight loss. Our review assesses existing literature that evaluates the impact of various surgical techniques on serum hormone levels, sexual function, and semen parameters. Despite certain limitations, the available body of evidence suggests enhancements in hormone levels and sexual function post-surgery, with semen parameters generally exhibiting minimal changes. This review critically evaluates the landscape of weight loss and its correlation with sexual function, while highlighting crucial areas necessitating future research endeavors.
Targeting mTOR signaling for the treatment of intrahepatic cholangiocarcinoma with TSC1/ARID1A mutations: a case report with an unexpected response
Authors: Daugan Clémentine , Boidot Romain , Ghiringhelli François , Borg Christophe , Vienot Angélique
Published: September 2024

Biliary tract cancer incidence is increasing and the prognostic remains dismal. The development of personalized medicine is a pivotal issue in proposing therapeutic options for biliary tract cancer patients. Whole exome sequencing identifies approximately 15% of IDH1 mutations and 15% of FGFR2 fusions in intrahepatic cholangiocarcinoma. Other patients are not currently eligible for targeted therapy. Here, we present a patient treated for a metastatic cholangiocarcinoma with an unexpected response to a mammalian target of rapamycin (mTOR) targeting agent. Whole exome sequencing enabled the identification of TSC1 and ARID1A mutations. Reintroduction of mTOR inhibitors with similar results sustains the main role of these targeted agents in the control of the disease. These results suggest the existence of an mTOR oncogenic addiction in biliary tract cancer. Our results support the interest in performing exome sequencing in liver cancers and the potential to identify actionable mutations with important therapeutic issues.
The Brazilian Extreme-Right and China
Authors: Bessimo Thiago P. B. , Amorim Neto Octavio
Published: September 2024

This study examines Brazil's foreign policy towards China, focusing on the extreme-right presidency of Jair Bolsonaro (2019–2022). Based on original and systematic quantitative data, we investigate the drivers behind policy variation and their implications for Brazil–China relations. Using measures of voting and speech convergence at the United Nations, legal agreements with China, and trade and investment, our data covers the period from 1995 to 2022. We then explore the concept of asymmetry and consider the asymmetric relationship between Brazil and China using CINC scores. Our empirical analysis indicates that Brazil's foreign policy stance towards China did change under Bolsonaro. However, this shift did not disrupt the broader relationship due to the pre-existing partnership and widening asymmetry between the two countries. Our findings contribute to a deeper understanding of Brazil–China relations and of Beijing's relations with other middle powers.
To Explore the Rule and Mechanism of Traditional Chinese Medicine in the Treatment of Postmenopausal Osteoporosis Based on Data Mining, Network Pharmacology and Molecular Docking Technology
Authors: Zeng Hao , Huang Keqi , Chai Yuan , Liu Hua , Li Yongjin , Li Zhengpeng , Zhang Xiaoyun
Published: September 2024

Postmenopausal osteoporosis (PMOP) is an important part of primary osteoporosis, and the current clinical treatment program for PMOP is easily limited by side effects and adverse reactions, so it is particularly important to seek more efficient, safe, and economical drug treatment for PMOP. In recent years, with the change of disease treatment mode and the gradual deepening of Traditional Chinese medicine (TCM) research on PMOP, a review of the literature reveals that there is a huge number of studies on the use of TCM in the treatment of PMOP, but there are no relevant systematic studies on the rules of its formulas and the specific mechanisms by which the core drugs exert their therapeutic effects. Therefore, in this study, we collected a total of 141 formulas used by TCM clinicians to treat PMOP, statistically analyzed their high-frequency medications, Four Qi, Five Flavors, meridians, and efficacies, and analyzed the core medications based on the association rules, which were Rehmanniae Radix Praeparata, Epimedium, Eucommia ulmoides, Rhizoma Drynariae, Angelica sinensis, Achyranthes, Astragalus propinquus, Psoralen, Cornus officinalis and licorice. A total of 87 drug pairs were obtained from the correlation analysis, and a total of 8 groups of potential core combination drugs and 4 potential new prescriptions were derived based on the cluster analysis. Subsequently, a network pharmacological analysis of the core drugs was conducted to obtain 173 active ingredients in the core drugs, including kaempferol, β-sitosterol, quercetin, etc. 298 targets of action, including MAPK3, STAT1, HSP90AA1, etc. 170 signaling pathways including AGE-RAGE, PI3 K/Akt, TNF, HIF-1 and others. The molecular docking results showed that 11 key active ingredients in the core drugs had stable binding to the target targets. This study showed that TCM treatment of PMOP is mainly based on “reinforcing liver and kidney, warmly invigorating spleen and stomach, activating blood and resolving stasis.” Core drugs therapy for PMOP is a comprehensive intervention through multi-component, multi-target, and multi-pathway approaches. The minimum binding energies between the 11 key active ingredients and the 11 key targets were calculated in a comprehensive analysis, which shows that the core drugs have good binding activities to their therapeutic targets, proving that the predictions of this study are reliable. In the future, it will provide certain medication basis and data support for TCM treatment of PMOP.