bluuebunny/crossref_metadata_2025 huggingface dataset:
437. LAPAROSCOPIC RESECTION OF AN ESOPHAGEAL LEIOMYOMA WITH DOR FUNDOPLICATION
Authors: Katsoulis Iraklis , Tasis Nikos , Dafnis Andreas , Sarafi Aikaterini , Mpalampou Eleni , Kavalieratos George , Mitsaka Dimitra
Published: August 2023

Background

Leiomyomas are the most common benign esophageal tumors originating from the muscular layer. They are rare lesions that constitute less than 1% of esophageal neoplasms. In one-third of the patients leiomyomas occur at the level of the gastroesophageal junction. Minimally invasive surgery is considered today the treatment of choice with the laparoscopic approach used for distal tumors.

Methods

We present the case of a 79-year-old woman with an esophageal stromal tumor located above the gastroesophageal junction. The patient underwent a successful laparoscopic excision (enucleation) of the tumor. Subsequently a Dor fundoplication was performed in order to cover the muscular esophageal defect.

Results

The recovery from surgery was uneventful. The patient resumed liquid diet within 24 hours and was discharged from hospital on the 3d postoperative day. In one year follow-up, the patient is free of symptoms without stricture or evidence of esophagitis on endoscopy. Histology of the tumor was consistent with leiomyoma.

Conclusion

Distal esophageal leiomyomas can be safely and effectively treated with the laparoscopic approach.
444. SHOULD T2 ESOPHAGEAL SQUAMOUS CELL CARCINOMA BE SUBCLASSIFIED WITH RESPECT TO LYMPH NODE INVOLVEMENT AND SURVIVAL?
Authors: Gu Yi-Min , Chen Long-Qi
Published: August 2023

Background

Whether T2 esophageal squamous cell carcinoma should be subclassified into circular muscle (T2a) and longitudinal muscle (T2b) remains controversial. We aimed to investigate the effect of the depth of muscularis propria invasion on the incidence of lymph node involvement and patient survival outcomes in T2 esophageal squamous cell carcinoma.

Methods

We identified patients with pT2 esophageal squamous cell carcinoma who underwent primary surgery from January 2009 to June 2017. The pathological information of the depth of muscularis propria invasion was reassessed, and patients were grouped into the T2a group and T2b group. Binary logistic regression was used to determine risk factors for lymph node metastases. The impact of the depth of muscularis propria invasion on survival was investigated using Kaplan–Meier analysis and a Cox proportional hazard regression model.

Results

This study included a total of 750 patients from three institutes. The depth of muscularis propria invasion (OR: 3.95, 95% CI: 2.46–6.35; P < 0.001) was correlated with lymph node metastases using logistic regression. T substage (OR: 1.37, 95% CI: 1.05–1.79; P < 0.001) and N status (OR: 1.51, 95% CI: 1.05–2.17; P < 0.001) were independent risk factors in multivariate Cox regression analysis. The T2a group had better overall survival (OR: 1.52, 95% CI: 1.19–1.94; P = 0.001) than the T2b group, specifically in T2N0 patients (OR: 1.38, 95% CI: 1.08–1.94; P = 0.035).

Conclusions

The depth of muscularis propria invasion should be subclassified to T2a and T2b with respect to lymph node involvement and survival outcomes in T2 esophageal squamous cell carcinoma.
448. PREDICTORS OF RECURRENT LARYNGEAL NERVE PALSY RECOVERY FOLLOWING ESOPHAGECTOMY
Authors: Li Ricardo , Wong Ian , Zhang Riki , Wong Claudia , Chan K K , Law Betty , Chan S Y , Law Simon
Published: August 2023

Background

Recurrent laryngeal nerve (RLN) palsy is a serious complication of esophagectomy that significantly impacts patients’ quality of life. This condition can be permanent or temporary, and identifying the factors associated with recovery can guide treatment options and manage patient expectations. We aimed to investigate the predictors associated with recovery from RLN palsy after esophagectomy.

Methods

We selected patients who underwent esophagectomy between 2003 and 2022, had a minimum survival and follow-up of 6 months, and experienced right, left, or bilateral RLN palsy from a prospectively managed database. Recovery was defined as restoration of vocal fold mobility within 6 months, irrespective of dysphonia symptoms while permanent injury was defined as persistent vocal cord palsy after six months. Univariate and multivariable logistic regression analyses were used to identify associations between variables and the likelihood of recovery.

Results

The overall RLN palsy rate was 14.5%. Ninety-five esophagectomy patients with RLN palsy were included. The mean age at operation was 64.4 years. Fifty-two patients (54.7%) recovered from vocal cord palsy. Sixty-four patients (67.4%) underwent minimally-invasive or video-assisted thoracoscopic esophagectomy. On multivariable analysis, patients who underwent neoadjuvant therapy (OR = 0.250, P = 0.012), vocal fold augmentation (OR = 0.283, P = 0.009), or reconstruction via the retrosternal route (OR = 0.326, P = 0.036) or right chest (OR = 0.088, P = 0.046) with reference to the orthotopic route, were less likely to recover from RLN palsy.

Conclusion

Neoadjuvant therapy, vocal fold augmentation and the route of esophageal reconstruction were significant predictors of recovery from RLN palsy after esophagectomy.
457. WHEN LAPAROSCOPIC MYOTOMY FAILS, COMPLEMENTARY PNEUMATIC DILATIONS REPRESENT AN EFFECTIVE AND SAFE OPTION
Authors: Costantini Andrea , Salvador Renato , Provenzano Luca , Capovilla Giovanni , Nicoletti Loredana , Forattini Francesca , Vittori Arianna , Nezi Giulia , Valmasoni Michele , Costantini Mario
Published: August 2023

Background

In the last 3 decades, laparoscopic Heller myotomy (LHM) has represented the treatment of choice for esophageal achalasia (EA), solving symptoms in most patients. Little is known about the fate of patients who relapsed after LHM, or about their most appropriate treatment. In this study we aimed at evaluating the results of complementary pneumatic dilations (CPD) after ineffective LHM.

Methods

We evaluated the patients with EA who underwent LHM plus Dor fundoplication (LHD) from 1992 to 2021 and were submitted to CPD for persistent or recurrent symptoms. The patients were followed clinically and with manometry, barium swallow and endoscopy when necessary. An Eckardt score (ES) > 3 was used as threshold for failure both after LHD and after LHD + CPD.

Results

Out of 1420 patients undergoing LHD in the study period, 115 (8.1%) were considered failures and were offered CPD. Ten patients refused further treatment, in 5 CPD was not indicated for severe reflux esophagitis, 1 patient had surgery for a misshaped fundoplication and 1 last patient developed a cancer 2 years after LHD; that leaves 103 patients who underwent a median 2 CPD (IQR:1–3), at a median of 16 (IQR:8–36) months after surgery, with 3.0 to 4.0 cm Rigiflex dilator. No perforations were recorded. Only 6 patients were lost to follow up. The remaining 97 were followed for a median of 37 months (IQR:6–112) after the last CPD: 70 saw their symptoms healed, whereas 27 still complained of symptoms (ES > 3). The only differences between the 2 groups were the ES before CPD, that was 3 (IQR:3–4) in the former and 4 (IQR:4–5) in the latter (p < 0.05), and the number of required CPD, that was 2 (IQR:1–2) and 3 (IQR:1–3), respectively (p < 0.05). All other parameters were similar between the 2 groups. Of the un-responding patients, 17 still require repeated CPD, 7 underwent re-myotomy, 1 POEM and 1 esophagectomy for end-stage disease.

Conclusion

CPD represent an effective and safe option to treat patients after a failed LHD: when the post-surgery ES consistently remains high, and the number of CPD exceeds 3, this may suggest the need for further invasive treatments.
473. PARACONDUIT HIATUS HERNIA AFTER OESOPHAGECTOMY: INCIDENCE, RISK FACTORS AND MANAGEMENT
Authors: Ahmed Rakesh , Elliott Jessie , Donohoe Claire L , Ravi Narayanasamy , Reynolds John V
Published: August 2023

Background

Hiatus hernia after oesophagectomy is an uncommon but serious complication of oesophageal cancer surgery. With improving long-term oncologic outcomes, post oesophagectomy hiatus hernia is an increasingly recognised entity in oesophageal cancer survivorship. The aim of this study was to assess the incidence of and risk factors for paraconduit hiatus hernia (PHH), and to describe management approaches in a tertiary referral centre.

Methods

All patients undergoing oesophagectomy for cancer from 2008 to 2022 were included. Early PHH was defined as occurring within 3 months of index surgery, with all other PHH defined as late PHH. Surveillance computed tomography scans were undertaken among all disease-free patients to 5-years postoperatively. Kaplan Meier and Cox proportional hazards regression models were used to determine independent risk factors for PHH.

Results

897 patients were studied. Early PHH occurred in 1.2%, and late PHH in 5.7% of patients. There was no late recurrence after early PHH. PHH was an asymptomatic radiologic finding in 45.5% of early and 84.3% of late cases. Median time to PHH was 15.7 months postoperatively. Nausea, abdominal pain and vomiting were the most common symptoms associated with PHH. Surgical intervention was required in 25.8% of cases, more commonly following early PHH (63.6%) as compared with late PHH (17.6%, P < 0.01). Operative approach (P < 0.001), extended resection of crura or diaphragm (P < 0.001) and male sex (P = 0.037) were associated with increased risk of hiatus hernia.

Conclusion

Paraconduit hiatus hernia is an uncommon complication after oncologic oesophagectomy. Surgical intervention is often required for patients with PHH presenting in the first three months after surgery, but a majority of patients with asymptomatic late PHH may be managed expectantly.
487. CAMRELIZUMAB COMBINED WITH CHEMOTHERAPY OR APATINIB AS NEOADJUVANT THERAPY FOR LOCALLY ADVANCED ESOPHAGEAL SQUAMOUS CELL CARCINOMA: A PHASE 2 TRIAL
Authors: Meng Xiangrui , Qi Yu , Shan Zhengzheng , Yang Yang , Fan Qingxia , Wang Feng
Published: August 2023

Background

Increasing evidences prove the encouraging efficacy of neoadjuvant immunochemotherapy for esophageal squamous cell carcinoma (ESCC). However, the safety of chemotherapy is still unsatisfactory. Previous studies have confirmed the good efficacy and tolerance of camrelizumab (PD-1 inhibitor) combined with apatinib (angiogenesis inhibitor) in advanced ESCC. This trial is to assess the effectiveness and safety of camrelizumab plus chemotherapy or apatinib as neoadjuvant therapy for locally advanced ESCC. Here, we reported the results of cohort 2.

Methods

This is an open-label, non-randomized phase 2 trial of patients with stage cT2-4aN0–3 M0 ESCC. Eligible patients were 18–75 years old, had ECOG PS score of 0–1. Cohort 2 planned to enroll patients with 4 cycles of camrelizumab (200 mg Q2W) and apatinib (250 mg QD). Surgery was performed within 4–6 weeks after neoadjuvant therapy. The primary endpoint was major pathological response (MPR) rate. Secondary endpoints included pathological complete response (pCR) rate, R0 resection rate, disease-free survival, overall survival, and safety.

Results

Between Feb 2022 and May 2023, 21 patients were enrolled in cohort 2. 14 patients completed neoadjuvant therapy, the ORR was 50% and the DCR was 100%. 14 patients completed surgery and all patients (100%) reached R0 resection, 4 patients (4/14, 28.6%) reached MPR, 2 patients (2/14, 14.3%) reaching pCR, and 9 patients (9/14, 64.3%) had TNM downstaging. Any grade and grade ≥ 3 adverse events occurred in 84.2% and 9.5% of 21 patients, respectively. The most common AEs were thrombocytopenia (6/21, 28.6%) and increased alanine aminotransferase (6/21, 28.6%). No new safety signals or treatment-related deaths were observed.

Conclusions

Neoadjuvant camrelizumab in combination with apatinib in patients with locally advanced ESCC showed promising pathological response and downstaging effect with acceptable security. The study enrollment is ongoing, and further survival and safety data will be reported in the future.
488. LEFT BRONCHIAL ARTERY IN ESOPHAGEAL SURGERY
Authors: Thammineedi Subramanyeshwar Rao
Published: August 2023

Commonest cause of morbidity after esophagectomy is pulmonary. Tracheobronchial devascularization during surgery contributes to this morbidity and can potentially lead to mortality. This video shows that left bronchial arteries can be preserved like the right ones in an attempt to aid rapid recovery of patients.

This is the link to the video.

https://drive.google.com/file/d/11iWQ5KUTSoc9qCmViCUlGPF61iCvCnJk/view?usp=share_link.
Essential Cases: EU Law
Authors: O'Meara Noreen
Published: August 2023

Essential Cases: EU Law provides a bridge between course textbooks and key case judgments. Essential Cases provides you with succinct summaries of some of the landmark and most influential cases in EU law. Each summary begins with a review of the main case facts and decision. The summary is then concluded with expert commentary on the case from the author, Noreen O'Meara., including her assessment of the wider questions raised by the decision.
Essential Cases: Public Law
Authors: Webb Thomas E.
Published: August 2023

Essential Cases: Public Law provides a bridge between course textbooks and key case judgments. Essential Cases provides you with succinct summaries of some of the most influential, landmark cases in public law. Each summary begins with a review of the main case facts and decision. The summary is then concluded with expert commentary on the case from the author, Thomas Webb, including the wider questions raised by the decision for you to consider.
4. Article 101 TFEU: The Elements
Authors: Jones Alison , Sufrin Brenda , Dunne Niamh
Published: August 2023

This chapter discusses the text and scheme of Article 101 which prohibits agreements, decisions, and concerted practices which restrict competition and affect trade between Member States. It explains the terms employed in Article 101(1) and how they are interpreted and applied. In particular, it discusses: the meaning of ‘undertaking’ and ‘association of undertakings’, including the concepts of ‘economic activities’ and of a ‘single economic entity’; the meaning of ‘agreement’ including the coverage of both horizontal and vertical agreements; the meaning of ‘concerted practice’; the meaning of ‘decisions by associations of undertakings’; the application of Article 101(1) to complex arrangements and single continuous infringements; and the meaning of an appreciable effect on trade between Member States.
9. Horizontal Agreements—Cartels and Collusion
Authors: Jones Alison , Sufrin Brenda , Dunne Niamh
Published: August 2023

This chapter examines how EU competition law applies both to undertakings operating cartels and to undertakings that tacitly coordinate their behaviour on a market. It starts by looking at the difference between ‘explicit’ and ‘tacit’ collusion. The chapter then deals with cartels and other agreements akin to cartels, or which may facilitate explicit or tacit collusion on a market. Next, it considers the problem of tacit collusion and whether, in particular, Articles 101 and 102 operate as effective mechanisms for dealing with the oligopoly problem. The chapter also considers other options that EU competition law might offer to deal with tacit collusion, either ex ante or ex post, such as the use of the concept of collective dominance and sector inquiries under Regulation 1/2003, Article 17.
10. Horizontal Cooperation Agreements
Authors: Jones Alison , Sufrin Brenda , Dunne Niamh
Published: August 2023

This chapter discusses EU competition policy towards horizontal cooperation agreements. It covers joint ventures; the contents of the 2022 Draft Guidelines; the general approach to horizontal cooperation agreements in the Guidelines; research and development agreements, including the 2022 draft block exemption on research and development; production agreements, including the 2022 draft block exemption on specialisation agreements; purchasing agreements; commercialisation agreements; standardisation agreements; and sustainability agreements.
14. Private Enforcement of Articles 101 and 102
Authors: Jones Alison , Sufrin Brenda , Dunne Niamh
Published: August 2023

This chapter focuses on the private civil enforcement of EU antitrust rules through claims made by private litigants in the national courts and tribunals of the individual Member States. The discussion covers the principle of direct effect and national procedural autonomy, mechanisms for cooperation between the Commission and national courts, the obligations of national courts when dealing with cases that raise the issue of whether a contract in violation of Article 101 or Article 102 is enforceable and whether, and if so when, damages and injunctions should be available to remedy such violations. It also considers why historically there was relatively little antitrust litigation in the EU; the relationship between public and private enforcement; and the Commission’s policy towards private enforcement, the package of measures the Commission has taken to encourage private litigation, especially the 2014 Damages Directive and its impact.
Contemporary Intellectual Property
Authors: Brown Abbe , Kheria Smita , Cornwell Jane , Iljadica Marta
Published: August 2023

Contemporary Intellectual Property: Law and Policy, sixth edition, offers a unique perspective on intellectual property (IP) law, unrivalled amongst IP textbooks. An accessible introduction to IP law, it provides not only a comprehensive account of the substantive law, but also discusses the overarching policies directing the legal decision-making, as well as areas for further debate. Intellectual property law is an increasingly global subject, and the book introduces the relevant European and international dimensions—along with the implications of Brexit—to present a realistic view of the law as it actually operates. It explores IP law as an organic discipline, evaluating the success with which it has responded to new challenges. Images and diagrams, with analysis of key cases and key extracts, are all incorporated alongside the author commentary to clearly illustrate the core principles in IP law. Exercise, questions, and discussion points are provided to help the reader to engage with the material, and additional material is provided in the Online Resources. Beyond providing an up-to-date account of IP law, the text examines the complex policies that inform modern IP law at the UK, European, and international levels, giving the reader a true insight into the discipline and the shape of things to come. The focus is on contemporary challenges to IP law and policy, and the reader is encouraged to engage critically with the text and the subject matter. The book has been carefully developed to ensure that the complexities of the subject are addressed in a clear and approachable way.
European Union Law
Authors: Peers Steve , Barnard Catherine
Published: August 2023

European Union Law draws together a range of perspectives to provide an introduction to this important subject. The volume offers a broad range of approaches to provide students with a solid foundation to the institutional and substantive law of the EU. Topics covered include the development of the EU, its political institutions, and constitutionalism in the EU. International law and the EU is examined, as well as the effects of EU law on national legal systems. There is a specific chapter on the effect of Brexit on both the EU and the UK. The volume also considers the free movement of goods, and free movement of natural persons, legal persons, and capital in the EU. Labour and equality law, EU health law, environmental law, consumer law, and criminal law are also considered in detail, as are immigration and asylum law.
International Law
Authors: Henriksen Anders
Published: August 2023

International Law provides comprehensive and concise coverage of the central issues in public international law. The text takes a critical perspective on various aspects of international law, introducing the controversies and areas of debate without assuming prior knowledge of the topics discussed. Supporting learning features, including central issues boxes, chapter summaries, recommended reading and discussion questions, highlight the essential points. Topics covered include the history of international law, legal sources, the law of treaties, legal personality, jurisdiction and state immunity. The text also looks at the international law of the sea, human rights law, international environmental law, international economic law, the peaceful settlement of disputes, the use of force, the laws of armed conflict and international criminal law.
EU Law Directions
Authors: Foster Nigel
Published: August 2023

EU Law Directions explains the key topics and developments in this fast-paced and increasingly important subject area. Based on 35 years’ experience teaching and examining European Union (EU) law, this book provides a student-friendly text which is readable without compromising on academic quality. The text is easy to follow, with useful features throughout such as case summaries, key definitions, and diagrams. Cross-references and end-of-chapter summaries demonstrate how topics link together and enable students to quickly build up a comprehensive understanding of EU law. The text is clearly broken down into logical sections, guiding students through institutional, procedural, and substantive law from a European perspective. It also takes into account the fast-moving events in the UK generated by the result of the Brexit referendum and the consequent exit of the UK from the EU and entry into the transition period which ended 31 December 2020. A clear and uncomplicated writing style ensures students new to EU law quickly grasp the central elements of the subject. This book has been fully revised in this new edition to take account of new legislative and case law developments, in particular relating to the free movement of persons and equality law. This new edition includes a full consideration of the UK’s relationship with the EU, the 2016 referendum, and the process of negotiating withdrawal concluding with the UK withdrawal on 31 January 2020.
Juke Stick: A Case of Pediatric Atraumatic Compartment Syndrome
Authors: Oswald Brandon , DeFeo Devin R , Jude Joseph W , Brillhart Dan , Borden Nathan
Published: August 2023

Compartment syndrome is usually due to trauma but can also have atraumatic causes. It is defined as a compromise of neurovascular and muscle function that presents symptomatically with the six P’s: pain, pallor, paresthesia, paralysis, poikilothermia, and pulselessness. Diagnosis is confirmed by a delta pressure of <30 mmHg (diastolic blood pressure minus the compartment pressure). This case details a 15-year-old male football player with atraumatic compartment syndrome in the lateral compartment of the right lower leg. Symptoms of swelling and pain began 2 weeks before presentation after the patient was “juked.” The patient’s symptoms improved after a week of rest but worsened when he returned to practice. In the emergency department, the patient was able to ambulate with pain and declined pain medication. Examination revealed severe tenderness, mildly decreased strength, decreased sensation, and edema in the lateral compartment via bedside ultrasound. Because of the concern for compartment syndrome, pressure was checked with a disposable manometer (Compass CT disposable pressure transducer) revealing a delta pressure of 26 mmHg. The patient consequently underwent fasciotomy, eventually returning to baseline function without deficits. Awareness of this atypical presentation of compartment syndrome will assist providers in making a critical diagnosis and preventing severe complications and disability. This case also demonstrates the potential of disposable pressure transducers for cost-effective and accurate diagnostic confirmation of compartment syndrome in the emergency department.
A prospective intervention study to identify drug-related emergency department visits comparing a standard care group and a pharmaceutical care group
Authors: Hellinger Benjamin J. , Gries André , Schiek Susanne , Remane Yvonne , Bertsche Thilo
Published: August 2023

Background and importance

Adverse drug reactions impose a major burden. Those adverse drug reactions might lead to hospitalization but are often not correctly identified in the emergency department (ED). Clinical pharmacists, although not routinely implemented, can help identify adverse drug reactions.

Objective

The primary objective was to examine the drug association of ED visits in a pharmaceutical group with a clinical pharmacist integrated in the ED team compared with a standard group without additional support.

Design/setting/participants

This prospective intervention study was performed in the ED of a tertiary care university hospital in Leipzig, Germany. Patients who were ≥50 years old were included. From 1 March 2020 to May 31, 2020 patients were enrolled in the standard group. From 1 March 2021 to 31 May 2021, the pharmaceutical group was enrolled. The clinical pharmacist supported the ED team with patient´s detailed medication history and medication analysis. In both groups, patients were evaluated whether their ED visit was drug-related.

Outcome measures and analysis

The number of identified drug-related ED presentations were compared between the two groups. Interventions performed on adverse drug reaction management, causative drugs and patient characteristics were evaluated.

Main results

A total of 798 patients were enrolled in the standard group and 827 patients in the pharmaceutical group. Patients whose ED visit was drug-related had a median age of 77 years [(Q25–Q75) 63.5–83.5] and took 7 [(Q25–Q75) 5–8] drugs in standard group. In the pharmaceutical group median age was 78 years [(Q25–Q75) 66–83] and number of drugs taken was 9 [(Q25–Q75) 5.25–11]. 31 (3.9%) drug-related ED visits were identified in the standard group compared to 104 (12.6%) in the pharmaceutical group (OR 3.56; 95% CI 2.35–5.38). An intervention on the patient’s pharmacotherapy was performed in 16 drug-related ED visits in standard group compared to 77 in the pharmaceutical group.

Conclusion

In this study the implementation of a clinical pharmacist was associated with improved identification of drug-related ED visits. Discontinuations of causal medications and dose reductions were significantly higher in the pharmaceutical group compared to the standard care group.
Impact of Internet-based media on food supply chain among Ukrainian farmers following Russia’s invasion
Authors: Asogwa Chika Euphemia , Oyesomi Kehinde , Olijo Igwebuike Innocent , Igboke Ambrose , Onah Ogochukwu Gabriella , Gever Verlumun Celestine
Published: August 2023

Purpose

This study evaluated the use of Internet-mediated platforms for food supply chain among Ukrainian farmers due to the war.

Design/methodology/approach

The study was an online survey involving 325 Ukrainian farmers. The instrument for data collection was a structured questionnaire.

Findings

The result of the study revealed the main effect of Internet-powered media such as social media, mobile applications and dedicated websites on food supply, F(1,308) 5.745, p = 0.004, p2 = 0.036. The result also revealed the interacting effect of supply intention (p = 0.001) and destination of supply (p = 0.001). Further analysis revealed that farmers with profit and charity intentions are likely to use dedicated websites, while those with trade-by-batter intentions are likely to use mobile applications. Also, the supply destination significantly interacted with the use of Internet-powered technologies (p = 0.001). A breakdown of the result showed that supply destinations in Ukraine are likely to be coordinated through dedicated websites, while those for neighbouring countries are likely to be coordinated through social media. Finally, variables from the unified theory of technology acceptance and use of technology, such as effort expectancy (ß = 0.412), performance expectancy (ß = 0.655) and social influence (ß = 0.182), collectively and individually predict the use of Internet-powered communication technologies for food supply among Ukrainian farmers, F(3,308)16.801, p = 0.001, R2 = 0.142.

Research limitations/implications

This study explains how Internet-based media have contributed to the sustenance of agribusiness and food supply chain in challenging times like war.

Originality/value

Information from this study could be useful in understanding the contributing role of digital media in agribusiness and food supply during uncertainties.
Digitally reflective employees as facilitators of digital work
Authors: Juyumaya Jesus
Published: August 2023

Purpose

This paper aims to identify digitally reflective employees as facilitators of digital work characteristics.

Design/methodology/approach

This conceptual paper focuses on developing a general micro-theoretical framework that clarifies digital reflection (DR). It integrates theoretical and empirical accounts from different management viewpoints on DR into one general micro-theoretical framework.

Findings

This research defines DR as an individual’s tendency to consider how digital work characteristics affect them and their organization.

Practical implications

The results indicate that firms wishing to introduce or maintain new digital work characteristics that positively impact human resources may profit from involving and promoting DR in the work design and human resources management processes.

Originality/value

This paper describes a DR framework that can help scholars and managers understand the mediating role of DR in the relationship between digital work characteristics and individual results.
The effect of intraoperative positive end expiratory pressure and tidal volume on postoperative acute kidney injury after orthopedic surgery
Authors: Almonacid‐Cardenas Federico , Saab Remie , Nemirovsky Eitan Scher , Rivas Eva , Araujo‐Duran Jorge , Mao Guangmei , Esa Wael Ali Sakr , Ruetzler Kurt , Argalious Maged , Turan Alparslan
Published: August 2023

Background

To test whether higher intraoperative PEEP levels and/or higher TV levels are associated with higher incidence of postoperative AKI within the first postoperative week, in adult patients having orthopedic surgeries under general anesthesia.

Methods

We conducted a sub analysis of a non‐randomized alternating intervention cross over study performed in patients undergoing orthopedic surgery under general anesthesia at Cleveland Clinic, Cleveland, OH. We included four different combinations of PEEP (5 or 8 cm H2O) and TV (6 or 10 mL/kg of PBW) that alternated each week in the six orthopedic operating rooms. Our primary outcome was postoperative AKI defined by the KDIGO criteria with baseline creatinine as the closest preoperative value to the time of surgery obtained within 30 days and postoperative value as the highest creatinine value within 7 days after surgery. Secondary outcome was the maximum postoperative in‐hospital creatinine level within seven postoperative days.

Main Results

A total of 1933 patients were included in the analysis. The incidence of AKI was 6.8% in the study population and similar in high TV versus low TV group and high PEEP versus low PEEP group. Neither TV nor PEEP significantly impacted AKI incidence. The estimated odds ratio of AKI comparing TV = 6 mL/kg to TV = 10 mL/kg was 0.96 (97.5% CI: 0.63, 1.46; p = .811); while the estimated odds ratio of AKI comparing PEEP = 5cm H2O to PEEP = 8cm H2O was 0.92 (97.5% CI: 0.60, 1.39; p = .623). No interaction was found between TV and PEEP on AKI. Additionally, neither TV nor PEEP had a significant effect on the seven postoperative day creatinine levels.

Conclusion

Higher levels of PEEP or TV during mechanical ventilation in adult patients undergoing orthopedic surgeries under general anesthesia do not increase the odds of developing postoperative AKI within the narrow limits studied.
How do landscape and life history traits contribute to the threat context of Brazilian primates?
Authors: Matte A. L. L. , Buss G. , Fialho M. , Becker F. G. , Jerusalinsky L. , de Lacerda J. C. , Santos P. J. P. , Bezerra B.
Published: August 2023

Brazilian primates differ regarding landscape characteristics within their ranges (e.g. habitat availability) and life‐history traits (e.g. body size). These landscape and life history attributes may be related to extinction risk. Here, we verified how such attributes correlate with primate threat categories. We considered 124 Brazilian primates based on the 2014 Brazilian list of threatened (Critically Endangered, Endangered and Vulnerable) and non‐threatened (Least Concern and Near Threatened) species. We then characterized their landscape (i.e. habitat availability, habitat loss and fragmentation, indigenous lands, roads, urban areas, deforestation arch) and life‐history attributes (i.e. body weight, gestation length and generation time), which together make up the threat context for each threat category. We compared threat categories to identify differences in such attributes, considering biome (Atlantic Forest, Amazon, Caatinga and Cerrado) as a factor and testing for phylogenetic effect. We investigated the attributes responsible for group characterization for specific threats and binary threatened/non‐threatened categories. We show that life history and landscape attributes differ in the biomes. However, only landscape features varied across biomes. In the Amazon, the threatened categories reached the highest level of habitat loss in the last 30 years, while in the Atlantic Forest, the landscape of threatened species had the highest proportions of roads and urban areas. Most threatened species landscapes in the Caatinga and Cerrado were highly fragmented. We found a positive link between human impacts and extinction risk in the Amazon. In the other biomes, anthropogenic landscape characteristics were associated with threatened and non‐threatened species. Threatened species tended to have large bodies and a slow life history, regardless of the biome. The more closely related the species, the more similar the traits. We suggest considering biomes and threat categories together with specific landscape and life history attributes to distinguish primate threat context for species conservation priority‐setting.
Temporal relationships between Staphylococcus aureus colonization, filaggrin expression, and pediatric atopic dermatitis
Authors: Dahal Arya , Chang Wan Chi , Almasri Cassandra , Johansson Elisabet , Hurd Makenna , Velasquez Veronica , Grashel Brittany , Spagna Daniel , Jenkins Seth , Morgan David , Satish Latha , Martin Lisa J. , Biagini Jocelyn M. , Khurana Hershey Gurjit K.
Published: August 2023

Background

Atopic dermatitis (AD) is characterized by Staphylococcus aureus (S. aureus) colonization. Longitudinal early life data delineating relationships of S. aureus colonization, barrier function, and AD outcomes are lacking. We define longitudinal S. aureus endotypes and AD pathogenesis in early life.

Methods

We defined longitudinal S. aureus skin colonization phenotypes across two annual visits (non‐colonized: V1−V2−, early transient: V1+V2−, late‐onset: V1−V2+, persistent: V1+V2+) in the Mechanisms of Progression of Atopic Dermatitis to Asthma in Children cohort. We analyzed AD severity, sensitization, and skin barrier function across phenotypes, and performed mediation analyses between colonization and FLG expression.

Results

Persistent S. aureus colonization was associated with increased SCORAD at V1 (33.5 vs. 19.0, p = .004) and V2 (40.1 vs.16.9, p < .001), and lower non‐lesional (NL) FLG at V2 (1.77 vs. 4.09, p = .029) compared to the non‐colonized phenotype, with early transient and late‐onset colonization as intermediate phenotypes. Children colonized at V2 demonstrated a decrease in NL‐FLG expression from V1 to V2 compared to those non‐colonized at V2 (p = .0012), who maintained expression. This effect remained significant even after adjusting for V1 colonization and SCORAD (p = .011).

Conclusions

Our findings are the first to present longitudinal quantitative FLG expression and S. aureus skin colonization in early life and suggest that a decrease in NL‐FLG drives later colonization. Hence, therapies to maintain NL‐FLG expression may prevent S. aureus colonization. Further, a longitudinal AD endotype of persistent colonization is characterized by increased AD severity, sensitization, and decreasing NL‐FLG.
Drug–drug interactions between propofol and ART drugs: Inhibiting neuronal activity by affecting glucose metabolism
Authors: Li Sijun , Zheng Yanqing , Long Qian , Nong Jianhong , Shao Honghua , Liang Gang , Wu Fengyao
Published: August 2023

Background

The use of two or more drugs carries the potential risk of drug–drug interactions (DDIs), which may result in adverse reactions. Some human immunodeficiency virus (HIV)‐infected patients who receive antiretroviral therapy (ART) may require general anesthesia with propofol (PRL) before undergoing surgical treatment. Both PRL and ART drugs may lead to neuronal dysfunction, which can be accompanied by energy metabolism disorders. Neurons take in glucose mainly through glucose transporter 3 (Glut3) which is specifically expressed on the cell membranes of neurons. However, to date, no study has examined whether the DDIs of PRL and ART drugs interfere with glucose metabolism and Glut3 expression in neurons.

Methods

An in vitro model was constructed using the primary cultures of neurons. PRL and ART drugs (EFV, AZT, and 3TC), were added at different concentrations (low, medium, and high). The neurons were exposed to the drugs for 1, 4, 8, and 12 h. The optimal drug concentration and exposure time were selected. The cellular survival rate, glucose concentration, electrophysiology, and the expression of Glut3 were detected.

Results

There were no significant changes in the cellular survival rates of the neurons that were exposed to both PRL and ART drugs at low concentrations for 1 h. However, the survival rates of the neurons decreased significantly as the drug concentrations and durations increased. The glucose concentration of the neurons that were exposed to both PRL and the ART drugs was significantly decreased. The glucose concentration of the neurons was not affected by any individual drug. The amplitude of the action potential and the expression of Glut3 were decreased in the neurons that were exposed to both PRL and ART drugs.

Conclusions

The main adverse reactions induced by the DDIs between PRL and the ART drugs were decreased glucose metabolism and neuronal damage, which were caused by inhibiting the expression of Glut3. More importantly, we found that decreases in glucose metabolism predated neuronal damage.
Should foreign aid consider inter‐Pacific Islands migration in the context of climate change? Evidence from Fiji
Authors: Goundar Sargam
Published: August 2023

Motivation

This research brings a Pacific Islands‐centred perspective into the discussion of foreign aid and climate mobility. Climate‐related migration is a crucial issue in Oceania as climate change is increasingly affecting Pacific Islanders. In this context, the Pacific Islands are typically seen as migrant‐sending countries to places outside the region. Inter‐Pacific Islands migration (IPIM) is barely recognized.

Purpose

Should foreign aid consider climate‐related IPIM? This article focuses on Fiji to: (1) assess current knowledge on migration between the Pacific Island Countries and Territories (PICTs) and Fiji's role therein; (2) maps aid‐funded climate mobility initiatives in the Pacific Islands; and (3) explores Fiji's national polices and local Fijian perspectives on regional climate‐related immigration to Fiji.

Methods and approach

This study draws on a combination of statistical analysis, policy document analysis, expert interviews, and semi‐structured interviews and an in‐depth online survey involving local Fijians. Additionally, it incorporates the author's personal work experience as a Pacific Islander and a Fijian traversing climate mobility aid and policy spaces relating to Oceania.

Findings

Current aid policies and initiatives addressing climate mobility have insufficiently considered IPIM. Migration from other PICTs to Fiji is significant, both in terms of numbers and in its current and potential impacts on local Fijians. Neither research, nor Fiji's national policies, nor donors have sufficiently considered this issue to date.

Policy implications

Aid policies and initiatives targeting climate‐related migration in PICTs need to be refocused to give more attention to IPIM. Donors must expand their support to migrant‐receiving communities in PICTs such as Fiji. By recognizing and investing in IPIM, donors can foster mutual benefits for Fiji, other PICTs, and donor countries.
Clinical evidence in ischemic stroke: Where we have gone so far and hopes for the future
Authors: Li Tianhua , Song Chengyu , Liebeskind David S. , Dmytriw Adam A. , Xu Ran , Wang Xue , Wang Jie , Zhao Hengxiao , Cao Wenbo , Gong Haozhi , Zhang Chao , Bai Xuesong , Jiao Liqun
Published: August 2023

Objective

Ischemic stroke is a significant cause of disability and death worldwide. Randomized clinical trials (RCTs) are important in changing guidelines and treatment strategies. This study aimed to analyze the progress of RCTs in ischemic stroke and to guide future research directions.

Methods

Ischemic stroke‐related RCT articles were identified in six high‐impact medical journals using the Web of Science Core Collection database. Google Scholar was used to check whether relevant articles were included in the guidelines. The characteristics of these articles were analyzed and future research hotspots were predicted.

Results

389 relevant articles were included in the analysis. The number of articles increased rapidly from 1972 to 2022, from 5 (1.3%; 1972–1982) to 208 (53.5%; 2013–2022) articles. 338 (86.9%) articles were included in relevant guidelines. According to corresponding author location, Europe was the source of the highest number of publications (183; 47.0%), followed by the Americas (152; 39.1%) and the Western Pacific (54; 13.9%). The number of publications steadily increased over time in the USA, England, Canada, Australia, Germany, and France, and surged in China and Spain, especially in the last 5 years. In recent years, endovascular therapy has accounted for the majority of ischemic stroke‐related RCT articles.

Conclusions

Numerous RCTs related to ischemic stroke have been conducted in recent decades, and both the number of articles and their contribution to guideline updates are increasing. Also, a shift in research topics was observed. However, great regional imbalances in this research exist, calling for more research to be conducted in specific regions to promote the generalizability of trial conclusions.
Clinical implications of imprecise sampling time for 10‐ and 30‐min thyrotropin‐releasing hormone stimulation tests in horses
Authors: Vorster Dante M. , Wang Wenqing , Kemp Kate L. , Bamford Nicholas J. , Bertin François‐René
Published: August 2023

Background

The thyrotropin‐releasing hormone (TRH) stimulation test is used to diagnose pituitary pars intermedia dysfunction (PPID) using 10‐ or 30‐min protocols. Imprecise sampling time for the 10‐min protocol can lead to misdiagnoses.

Objectives

To determine the effect of imprecise sampling time for the 30‐min protocol of the TRH stimulation test.

Study design

In vivo experiment.

Methods

Plasma immunoreactive adrenocorticotropin (ACTH) concentrations were measured 9, 10, 11, 29, 30 and 31 min after intravenous administration of 1 mg of TRH in 15 control and 12 PPID horses. Differences in ACTH concentrations between sampling times, variability in ACTH concentrations between protocols, and diagnostic classification of PPID were assessed using Friedman's test, Bland–Altman plots, and Fisher's exact test, respectively, with 95% confidence intervals reported and significance set at p < 0.05.

Results

Imprecise sampling time resulted in variable ACTH concentrations, but significant differences in absolute ACTH concentrations were not detected for imprecise sampling within each protocol or between protocols. Imprecise sampling changed PPID diagnostic classification for 3/27 (11 [4–28] %) horses for both protocols. Using the 30‐min protocol as a reference, 1/12 (8 [1–35] %) horses returned a negative test result and 5/12 (42 [19–68] %) horses returned equivocal test results that would be considered positive in practice due to the presence of supportive clinical signs.

Main limitations

Limited sample size and inter‐horse variability reduced the ability to detect small but potentially relevant differences.

Conclusions

Overall, the impact of imprecise sampling was not significantly different between the 10‐ and 30‐min TRH stimulation test protocols. However, diagnostic classification for PPID would have varied between the 10‐ and 30‐min protocols in this population, if clinical signs had been ignored. Precise timing during TRH stimulation tests and contextual interpretation of ACTH concentrations remain fundamental for the diagnosis of PPID.
Leptin receptor expression in blood mononuclear cells of lactating women is associated with infant body weight: Potential role as a molecular biomarker
Authors: Malpeli Agustina , Fasano María Victoria , Sala Marisa , Obregón Pablo , Casado Carla , Mendez Ignacio , Fotia Lucrecia , Castrogiovanni Daniel , Varea Ana , Disalvo Liliana , Tournier Andrea , Mazziota Lucía , Rocha Daniela , Kruger Ana Luz , Orellano Laura , Andreoli María F.
Published: August 2023

Background

Molecular biomarkers of maternal leptin resistance associated with infant weight are needed.

Objectives

To evaluate gene expression of leptin receptor (LEPR), suppressor of cytokine signalling 3 (SOCS3) and insulin receptor in peripheral blood mononuclear cells (PBMCs) of lactating women and their relationship with infant body weight and adiposity.

Methods

At day 10 postpartum, maternal gene expression in PBMCs as well as leptin and insulin concentrations in plasma and milk were assessed (n = 68). Infant weight and BMI z‐scores, skinfolds and arm circumference were obtained at 10 days and/or at 3 months old.

Results

In mothers with pre‐pregnancy overweight or obesity (OW/OB), LEPR expression was reduced (p = 0.013) whereas plasma and milk leptin and milk insulin concentrations were elevated. LEPR expression was positively related with infant weight z‐score (Beta (95% CI): 0.40 (0.17, 0.63), p = 0.001) but not with leptin concentrations. SOCS3 expression was positively related with infant weight z‐score (Beta (95% CI): 0.28 (0.04, 0.51), p = 0.024) and arm circumference (Beta (95% CI): 0.57 (0.32, 0.82), p < 0.001). Relationships remained significant after adjusting for maternal and infant confounders.

Conclusions

LEPR and SOCS3 gene expression in PBMCs are novel maternal molecular biomarkers that reflect leptin resistance and are associated with infant body weight and adiposity.
Ageism Hinders Mental Attribution Toward Older Adults: Translation and Validation of the Japanese Version of the Mind Attribution Scale1
Authors: Saito Toshiki , Hugenberg Kurt , Motoki Kosuke , Nouchi Rui
Published: August 2023

The influence of ageism on mind attribution in older adults remains unclear. For this study, the Mind Attribution Scale—a measure of intentional, cognitive, and emotional mental attribution—was translated into Japanese. The Need to Belong Scale was used to confirm construct validity. Therefore, the effect of ageism (measured using the Fraboni Scale of Ageism) on mind attribution was investigated through 892 participants (age range: 20–83 years) recruited through crowdsourcing. Participants were asked to rate the degree of their mental capacity after reading the vignettes. The findings showed that the three components of the Mind Attribution Scale were valid measures with high internal consistency and criterion validity. Participants tended to ascribe more emotional components, but not intentional or cognitive components, to older adults. Those with stronger ageist attitudes were less likely to attribute their mental capacity to older adults. The results suggest that when considering older individuals rather than a group, people tend to have more positive attitudes and mentalize older adults, while negative ageism may contribute to dementalization.