bluuebunny/crossref_metadata_2025 huggingface dataset:
Simultaneous approach in tandem occlusion: a safe, effective, and faster way to achieve recanalization
Authors: Kiwan Ruba , Alvarado-Bolanos Alonso , Maree Mosab , Bres-Bullrich Maria , Mascarenhas Annika , Hatipoglu Majernik Gökce , Jukes Alistair , Xuan Lisa , Yang Victor , Mayich Michael , Sharma Manas , Boulton Melfort , Pandey Sachin K
Published: November 2024

Background

Endovascular thrombectomy (EVT) is the standard of care for patients with acute ischemic stroke (AIS) and intracranial vessel occlusion. Tandem occlusions (TO) comprise 20% of all anterior circulation AIS and are related to a poorer prognosis. The optimal EVT treatment strategy remains controversial. Our main objective was to determine if simultaneous endovascular treatment of intracranial and extracranial occlusions in patients with TO results in faster recanalization times, with similar efficacy and safety, compared with the sequential approach.

Methods

Single center, retrospective analysis of patients with TO undergoing EVT using the simultaneous or sequential technical approach. The primary outcome was puncture-to-final recanalization time. Secondary outcomes included modified Rankin scale (mRS) score at 3 months, 30 day mortality, and hemorrhagic transformation.

Results

We included 111 patients with TO (35 treated with the simultaneous approach and 76 treated with the sequential approach). Successful recanalization was achieved in 91.9% of cases, and the first pass effect was 50.5%, with no differences between groups. The simultaneous technique resulted in shorter puncture-to-final recanalization time (33.0 min (IQR 25.0–55.0) vs 52.0 (30.0–73.0), P=0.018), adjusting for number of passes, first pass effect, thrombolysis, age, and previous stroke (adjusted β −0.21 (95% CI −29.47 to −2.79); P=0.018). No significant differences were found in 30 day functional outcome, mortality, or rate of hemorrhagic transformation when comparing simultaneous and sequential techniques.

Conclusion

The simultaneous approach was effective, safe, and faster than the classic sequential approach in patients with TO. This result may obviate the debate over which occlusion should be addressed first during EVT.
One in six patients exhibit changes in reperfusion on 10-minute repeat cerebral angiography during mechanical thrombectomy for stroke
Authors: Midtlien Jackson P , Ashraf Omar , Hui Ferdinand K , Tsappidi Sam , Zhang Yi Jonathan , Forster Aren A , Chang Emily , Wiater Angelina H , Starke Robert M , Abdelsalam Ahmed , Rai Ansaar T , Tarabishy Abdul R , Boo SoHyun , Vu Phong , Ehrig Molly R , Kittel Carol , Brown Patrick A , Wolfe Stacey Q , Fargen Kyle M
Published: November 2024

Background

Post-recanalization target vessel re-occlusion (TVR) following endovascular thrombectomy (EVT) is a known complication of the procedure, and it is associated with worse long-term functional outcomes. The incidence and factors that contribute to TVR are not well understood, particularly within the immediate timeframe following EVT.

Methods

A prospective, multicenter study was performed across four comprehensive stroke centers on adult patients undergoing EVT for acute large vessel occlusion. Modified Thrombolysis in Cerebral Infarction (TICI) score was recorded at the end of the standard procedure, and another TICI score was recorded 10 min later to evaluate for TVR.

Results

167 patients underwent EVT for a large vessel occlusion, 93.4% of which were in the anterior circulation. Twenty-seven patients (16.2%) had a change in their TICI score 10 min after EVT, with 19 of these patients (70%) having a worsening in their score. Of the total sample, 13% had their post-procedure care altered by any intervention, and 8% underwent further endovascular interventions due to the change in reperfusion over the 10 min time period. Functional independence (modified Rankin Scale score 0–2) at 90 days was observed in 31% of the entire cohort and in 21% of patients with a worse TICI score at 10 min.

Conclusions

This is the first study to prospectively assess for TVR in the immediate timeframe following EVT. One in six patients had a change in their TICI score, and one in 11 patients had additional intervention. Accordingly, neurointerventionalists should consider integrating angiographic evaluation at 10 min following EVT.
Integrated Analysis of College Student Information Management Based on Embedded Neural Network Algorithm
Authors: He Liu
Published: November 2024

In today’s constantly advancing educational technology, this study focuses on how to effectively combine embedded neural network algorithms with college student information management, aiming to significantly improve the intelligence level of educational management. Unlike traditional high-speed electronic data processing methods, this study delves into the potential of embedded neural networks in complex educational information management, particularly their outstanding data processing and pattern recognition capabilities. To overcome the limitations of traditional information management platforms in initial clustering center selection and sensitivity to data distribution, this study innovatively proposes a method based on data partition density characteristics to dynamically adjust global variables and select optimal clustering parameters. This method not only reduces the dependence on initial clustering conditions, but also significantly improves the accuracy and robustness of clustering analysis. In addition, by embedding neural networks to achieve intelligent selection of clustering centers, the accuracy and efficiency of sample classification have been further enhanced, bringing unprecedented intelligent upgrades to the information management platform for college students. This study developed a comprehensive analysis platform for college student information management based on embedded neural networks, which integrates centralized data storage, intelligent analysis, and real-time sharing functions. Through detailed methodological explanation and experimental verification, we demonstrate how the platform can be effectively applied to the management and analysis of diverse educational data such as student personal information, course grades, teacher lesson plans, and teaching progress. At the same time, we provide detailed data analysis results to demonstrate the effectiveness and superiority of the proposed method in practical applications.
The onset of Jeffreys fluid porous convection with throughflow in the presence of a heat source and electric field
Authors: Gangadharaih Y. H. , Manjunatha N. , Nagarathnamma H.
Published: November 2024

The investigation delves into the examination of Jeffreys fluid flow within a porous medium, incorporating a temperature-dependent heat source and throughflow, while also taking into account the presence of an external electric field. The eigenfunction, also known as the critical Rayleigh number, is obtained to determine the initiation of convection by employing Galerkin processes during the linear stability analysis. Subsequently, the findings are scrutinized by means of graphical illustrations to explore the impacts of various factors, including the Jeffreys parameter, heat source, throughflow, and electric field. Upon careful examination of the outcomes, it becomes evident that specific parameters, such as the Jeffreys parameter, heat source, and throughflow parameters, exert an influence in stabilizing the system under consideration. The investigation evidently points toward an observation that an augmentation in the electric field parameter results in an accelerated onset of convection. This observation implies that the external electric field assumes a role as a destabilizing element within the system, thereby intensifying the convective tendencies exhibited within the medium. The results demonstrated that elevated throughflow characteristics played a significant role in the postponement of convection onset, while a rise in the heat source parameter dependent on temperature was found to enhance the overall stability of the system. Additionally, it was observed that the downward throughflow exhibited a greater stabilizing influence when juxtaposed with the upward throughflow, particularly in scenarios involving the Jeffreys term and electric fields. The implications of these findings suggest a complex interplay between throughflow parameters, temperature-dependent heat sources, and external forces, highlighting the intricate dynamics governing convection initiation and system stability in the studied environment.
Level-One Modules of Quantum N-Toroidal Algebras in Type B
Authors: Jing Naihuan , Xu Zhucheng , Zhang Honglian
Published: November 2024

Quantum [Formula: see text]-toroidal algebras are generalization of the quantum toroidal algebras. In this paper, we construct two types of level-one vertex representations of the quantum [Formula: see text]-toroidal algebras in type [Formula: see text], which also realize the quantum toroidal algebras of type [Formula: see text] as special cases.
Suppression of Dad1 induces cardiomyocyte death by weakening cell adhesion
Authors: Mori Shota , Kimura Rumi , Morihara Hirofumi , Tomimatsu Masashi , Fuchigami Shota , Matsumoto Kotaro , Tanaka Shota , Okada Yoshiaki , Maeda Makiko , Obana Masanori , Fujio Yasushi
Published: November 2024

This study found for the first time that the knockdown of Dad1 induced cardiomyocyte death, accompanied by impairment of myofibrillogenesis and cell spreading. Dad1 regulates the N-glycosylation of integrins in cooperation with Stt3A and preserves cell adhesion activity, promoting cardiomyocyte survival. This is the first demonstration that Dad1 contributes to the maintenance of cardiac homeostasis through the posttranslational modification of integrins, providing a novel insight into the biological significance of OST complex in cardiomyocytes.
Study of Anisotropic Compact Star Model in Modified Gravity Using Finch–Skea Geometry
Authors: Shahzad M. R. , Amjad M. , Essa Y. M. Abo , El-Rashidy K. , Rasheed Faisal , Hakami Khalil Hadi , Emadifar Homan
Published: November 2024

In this work, we construct a new model of compact stars in the presence of anisotropic matter in the Rastall theory of gravity. For this, we considered the anisotropic matter content when formulating the Rastall field equations. Secondly, the Tolman–Oppenheimer–Volkoff (TOV) equation in the context of Rastall theory is formulated. We apply the Finch–Skea ansatz in the static and spherically symmetric geometry to obtain the analytic solution of the derived field equations in the Rastall theory of gravity. We match the internal solution to the corresponding external Schwarzschild space‐time in order to determine the values of the unknown constants involved in the Rastall field equations due to the Finch–Skea ansatz. The resulting model is applied to a few prominent compact stars in order to verify its physical viability. Energy conditions, the TOV equation, stability analysis via sound speeds (radial and transverse in this case), equation of state parameters, mass function, compactness, and surface redshift are some of the analytical expressions that are examined in this inquiry. In order to verify the physical acceptance of the obtained results, we provided a graphical analysis of some necessary analytical expressions. Also, the numerical values of some physical parameters are calculated and are presented in the tabular form to observe the Buchdahl limit and some other important criterion. We note that our model is well consistent with the physical requirements.
Antibiotic Susceptibility Profile of Mycobacterium intracellulare Clinical Strains Isolated From Southwestern Gyeongnam Province in South Korea Using the Resazurin‐Based Microtiter Assay
Authors: Choi Jeong-Gyu , Shin Jeong-Ih , Kim Kyu-Min , Park Seo-Rin , Anh Won Jun , Trinh Min Phuong , Kang Kyung-Min , Byun Jung-Hyun , Park Jin-Sik , Jung Myunghwan , Kang Hyung-Lyun , Lee Kon-Ho , Baik Seung-Chul , Lee Woo-Kon , Yoo Jung-Wan , Park Hyun-Eui , Shin Min-Kyoung
Published: November 2024

Mycobacterium avium complex (MAC) infection is a growing public health concern worldwide, particularly affecting the elderly and immunocompromised population. The treatment of MAC lung disease relies on a combination of antibiotics in a three‐drug regimen that includes macrolides, rifamycins, and ethambutol. Therefore, the investigation of antimicrobial susceptibility is crucial for successful treatment. This study aimed to assess the antibiotic susceptibility of the most prevalent MAC species causing MAC lung disease, Mycobacterium intracellulare, in the Southwestern Gyeongsang province of South Korea using a resazurin‐based microtiter assay. A total of 97 strains of M. intracellulare were isolated and tested for antimicrobial susceptibility. The results demonstrated high susceptibility rates for two aminoglycosides (amikacin and streptomycin, 94.9% and 99%), rifampicin (90.9%), clarithromycin (98%), linezolid (100%), and moxifloxacin (94.9%) against M. intracellulare. However, notably high resistance rates were observed for ethambutol (97%) and clofazimine (98%) against M. intracellulare. In conclusion, our findings indicate relatively high susceptibility rates for these six antibiotics and significantly elevated resistance rates for clofazimine and ethambutol compared to other regions in South Korea and foreign countries. The investigated MIC data can offer valuable insights for developing an effective treatment regimen for MAC lung infection in this area.
Association of MicroRNA-146a-5p Polymorphism with Cognitive Impairment in Adolescents with Depressive Disorder
Authors: Xie Chunping , Hu Qingting , Zhang Chunhu , Deng Kuancai
Published: November 2024

Introduction: The incidence of depression in adolescents is increasing and is associated with severe cognitive impairment. This paper aimed to investigate the relationship between polymorphisms in microRNA-146a-5p (miR-146a-5p) and cognitive impairment in adolescent depression patients. Methods: Quantitative real-time polymerase chain reaction was used to quantify miR-146a-5p in serum. Detection of miR-146a-5p gene polymorphism was performed by TaqMan SNP Genotyping Assay. Odds ratios and 95% confidence intervals (CIs) were calculated by chi-square test (χ2) and logistic regression analysis. Results: Genotyping of miR-146a rs2910164 showed that CC (OR = 0.443, 95% CI, 0.264–0.741, p = 0.002) and GC (OR = 0.445, 95% CI, 0.279–0.712, p = 0.001) genotype reduced the risk of cognitive impairment in adolescent depression. The C allele (OR = 0.794, 95% CI, 0.694–0.741, p = 0.001) was a protective factor for cognitive impairment in adolescent depression compared to the rs2910164 G allele. Rs2910164 (OR = 0.425, 95% CI = 0.273–0.662, p = 0.000) showed a negative correlation with adolescents with cognitive impairment in depression by logistic regression analysis. The level of miR-146a-5p was decreased in carriers of the CC and CG genotypes. Conclusion: Rs2910164 C allele carriers have a low risk of cognitive impairment in adolescent depression and could reduce miR-146a-5p level.
C.655C>T Variant of Sepiapterin Reductase Deficiency: Genetic and Bioinformatic Analysis
Authors: Eslamiyeh Hosein , Sefid Fatemeh , Iravani Farzaneh
Published: November 2024

Background: Sepiapterin reductase deficiency (SRD) is a very rare psychomotor disorder related to enzyme defects in synthesizing tetrahydrobiopterin (BH4) with a spectrum of symptoms. The most common of which are developmental delay and hypotonia. To elucidate the genetic cause of SRD, the patient was analyzed by whole-exome sequencing (WES) followed by mutation analysis. Methods: A complete clinical examination was performed by a pediatric neurologist. Brain imaging and a thorough neuro-metabolic investigation were applied along with biochemical tests including high-performance liquid chromatography (HPLC) to quantify the concentrations of cerebrospinal fluid (CSF) pterins. Genomic DNA was extracted and evaluated through WES. This was followed by bioinformatic analysis of mutated sepiapterin reductase (SPR) protein structure and identification of the functional protein amino acids. Results: Biochemical analysis of biogenic amines of CSF with HPLC showed very low levels of homovanillic acid and 5-hydroxyindolacetic acid in favor of neurotransmitter metabolism disorder. WES analysis displayed a homozygous nonsynonymous variant in exon 3 of the SPR gene (C.655C>T, p.Arg219Ter). The molecular graphic of SPR protein structure with 4HWK PDB code was generated by MOE software in comparison with P.Arg219* mutated protein which is predicted by a Swiss model homology modeling server determining the ligand-binding site residues using COFACTOR software and indicated that the (R219*) mutation destroyed the ligand-binding site from the position of 219. Another important codon including 254 and 256 positions is omitted. Conclusion: Whole exome sequencing and bioinformatic analysis could overcome lengthy, expensive, and emotional diagnostic adventures of challenging neurodevelopmental cases leading to improved management and prevention of irreversible side effects.
Osteopontin as a Novel Biomarker in Distinguishing Chronic Rhinosinusitis with Nasal Polyp Endotypes and Predicting Disease Severity
Authors: Liu Peiqiang , Liu Meng , Sun Yibin , Yu Mengcheng , Lei Weiwei , Xu Yu
Published: November 2024

Introduction: The objective of this study was to ascertain the predictive value of osteopontin (OPN), a cytokine with pro-inflammatory properties implicated in inflammatory and allergic conditions, in nasal secretions for the identification of chronic rhinosinusitis with nasal polyp (CRSwNP) endotypes and the assessment of disease severity. Methods: A cohort comprising 81 individuals diagnosed with CRSwNP was enrolled, which included 37 subjects with the non-eosinophilic CRSwNP and 44 subjects with the eosinophilic CRSwNP (eCRSwNP), alongside 32 healthy controls (HCs). Nasal secretions and tissue samples were collected from all participants. The quantification of OPN in these samples was conducted using ELISA and immunohistochemistry. Nasal fractional exhaled nitric oxide levels were determined with the Nano Coulomb Breath Analyzer. The diagnostic efficacy of OPN levels in distinguishing eCRSwNP was assessed using the receiver operating characteristic (ROC) curve, while Pearson correlation analysis was employed to evaluate the correlation between OPN levels and disease severity indicators. Results: Concentrations of OPN in nasal secretions were found to be elevated in CRSwNP patients compared to the HC group and significantly higher in patients with eCRSwNP. A positive correlation was identified between OPN levels in nasal secretions and peripheral blood eosinophil counts and percentages, and tissue eosinophil counts, as well as the Visual Analog Scale (VAS) score, Lund-Mackay score, and Lund-Kennedy score. The ROC analysis demonstrated that the OPN level in nasal secretions possesses a robust discriminatory capacity for eCRSwNP, with a cutoff value of 121.05 ng/mL. Furthermore, the OPN concentration was determined to be a more precise predictor of the VAS score, Lund-Mackay score, and Lund-Kennedy score than the CRSwNP endotypes. Conclusion: The findings of this study indicate that OPN is differentially expressed in the nasal secretions of eCRSwNP patients and correlates with eosinophilic inflammation. The presence of OPN in nasal secretions emerges as a novel and potentially valuable biomarker for the differentiation of CRSwNP endotypes and the prognostication of disease severity.
Exploring Recovery Priorities in Inpatient Addiction Treatment: A Q-Methodological Study
Authors: Pars Esther , VanDerNagel Joanneke E.L. , Dijkstra Boukje A.G. , Schellekens Arnt F.A.
Published: November 2024

Introduction: Recovery from substance use disorder (SUD) is increasingly recognized as a personal journey, necessitating an approach that considers individual goals and priorities. Research on recovery priorities in inpatient settings is limited. Our study employs Q-methodology to explore recovery priorities among clients with multimorbid SUD, aiming to guide targeted, recovery-oriented care. Methods: This cross-sectional study employed Q-methodology to explore recovery priorities among 129 individuals entering inpatient addiction treatment. A collaboratively developed Q-set of 42 statements covered clinical, functional, and personal recovery goals. Participants ranked statements by importance, and rotated factor analysis was used to identify clusters of recovery priorities. Qualitative interview data were then analyzed for further interpretation. Results: We found 12 consensus statements and two distinct factors. Factor 1 (n = 60) emphasized personal growth and coping, while factor 2 (n = 51) highlighted practical aspects such as securing income and housing. Qualitative data supported these findings. Conclusions: Despite the individual nature of recovery and the diversity within the addiction treatment population, our study identified shared goals and two distinct factors. This insight can inform tailored interventions, with factor 1 individuals potentially favoring psychological approaches and factor 2 individuals focusing on practical goals.
Sarkome: Neue Kombinationstherapie mit günstigerem Nebenwirkungsprofil
Authors: Zygmunt Anne-Christine , Bösch Florian , Szuszies Christoph J.
Published: November 2024

Purpose: While cytotoxic chemotherapy is the standard first-line treatment for patients with metastatic soft-tissue sarcoma (STS), clinical outcomes remain suboptimal. Our prior study showed lurbinectedin plus doxorubicin is well tolerated with promising clinical activity in STS. We designed this phase 1b trial to optimize dosing as the basis for a randomized trial in leiomyosarcoma and to further explore the safety profile and efficacy signal. Patients and methods: Patients had advanced/metastatic STS and no prior anthracycline/lurbinectedin/trabectedin. Escalation followed a 3 + 3 design with 3-week cycles: lurbinectedin (3.2 mg/m2 day 1) and two doxorubicin levels (DL1, 25 mg/m2 day 1; DL2, 25 mg/m2 days 1 and 8). The primary objectives were to identify the maximum tolerated dose and recommended dose for subsequent randomized trials. Results: Ten patients were enrolled in a 6-month period. The most common treatment-emergent adverse events were grade (G) 2 fatigue and nausea, and G2 cytopenias with no febrile neutropenia events. There were two dose-limiting toxicities (DLTs) at DL2 [day 8 (G2 alanine aminotransferase [ALT]/aspartate aminotransferase increase, G3 neutropenia)], and one DLT in DL1 (G3 ALT increase). These were reversible and all patients continued the study. DL1 was chosen for further study. At the time of data cutoff, the estimated median progression-free survival is 16.5 months [95% confidence interval (CI), 6.0-ND]. The objective response rate was 60% (6/10 confirmed partial responses).
A model for predicting severe intra-abdominal adhesions following prior cesarean sections
Authors: Ram Shai , Shalev-Ram Hila , Alon Shira , Shapira Ziv , Berkovitz-Shperling Roza , Johansson-Lipinski Margaret , Yogev Yariv , Many Ariel
Published: November 2024

Objective: The increasing rate of cesarean sections (CS) raises concerns over severe intra-abdominal adhesions, which are associated with numerous complications. We aimed to identify risk factors and predictive tools for severe adhesions.
Methods: In a prospective study at a tertiary medical center from January-July 2021, women with at least one prior CS were evaluated. Surgeons assessed adhesions at four anatomical sites, scoring them from 0 (none) to 2 (dense), with a total possible score of 0-8. Severe adhesions were defined as a score of ≥5. Risk factors were analyzed using logistic regression to create a prediction model.
Results: Overall, 341 women were included in the study. Significant predictors included the number of previous CS, maternal BMI, maternal morbidity at the time of the previous CS, and operation time. The model predicted severe adhesions with 79.1% accuracy, a positive predictive value of 68.4%, and a negative predictive value of 79.5%.
Conclusion: The severity of most cases of post-CS adhesions can be predicted by a model which considers common risk factors
The application value of 3D model in partial nephrectomy of varying complexity
Authors: Li Yajie , Zhou Qifei , Li Weihao , Cao Jiahui , An Kangjie , Liu Shuhui , Ma Yanping , Tao Bo , Wang Ning , Jia Yaodong , Nie Lihong , Zhao Ruining
Published: November 2024

Introduction: To explore the application value of three-dimensional (3D) model in partial nephrectomy across varying RENAL scores.
Methods: A total of 126 patients were enrolled, divided into three groups: 25 cases in the 3D-partial nephrectomy (3D-PN), 86 cases in the 2D-partial nephrectomy (2D-PN), and 15 cases in the 3D-robot-assisted PN (3D-RAPN). Preoperative basic data were collected, including age, gender, neutrophil ratio, platelet count, blood glucose, GFR of the kidney, tumor diameter, tumor staging, RENAL score, Mayo adhesive probability (MAP) score, surgical time, warm ischemia time, intraoperative bleeding, postoperative drainage volume, postoperative hospital stay, change in creatinine level at 3 months postoperatively, and pathological results. Perioperative data between 3D-PN and 2D-PN, between the RENAL score 4-6 subgroup of 3D-PN and 2D-PN, between the RENAL score ≥7 subgroup of 3D-PN and 2D-PN, and between the 3D-PN and 3D-RAPN were compared. Statistical analysis was performed using SPSS version 26.0.
Results: The 3D-PN showed statistically significant differences compared to the 2D-PN in warm ischemia time, intraoperative bleeding volume, postoperative drainage volume, and postoperative hospital stay (P<0.05). In the RENAL score 4-6 subgroup, the 3D-PN showed statistically significant differences in intraoperative bleeding volume compared to the 2D-PN (P<0.05). In the RENAL score ≥7 subgroup, the 3D-PN showed statistically significant differences compared to the 2D-PN in surgical time, warm ischemia time, postoperative drainage volume, and postoperative hospital stay (P<0.05). There were statistically significant differences between the 3D-PN and the 3D-RAPN in warm ischemia time, intraoperative bleeding volume, and postoperative hospital stay (P<0.05).
Conclusion: Patients with RENAL score ≥7 benefit more from preoperative evaluation with 3D model. The combination of 3D model and RARP can further enhance the advantages and expand the convenience of surgery.
Associations of small-airway disease with exercise intolerance and long-term outcomes in patients with heart failure and reduced or preserved ejection fraction
Authors: Nagumo Daina , Hamazaki Nobuaki , Kamiya Kentaro , Miki Takashi , Kobayashi Shuken , Nozaki Kohei , Ichikawa Takafumi , Yamashita Masashi , Uchida Shota , Noda Takumi , Ueno Kensuke , Ogura Ken , Maekawa Emi , Yamaoka-Tojo Minako , Matsunaga Atsuhiko , Ako Junya
Published: November 2024

Introduction: Small airway is reportedly more susceptible than central airways in heart failure (HF), which may cause poor outcomes. We investigated clinical significance of small-airway disease (SAD) on exercise intolerance and clinical events in patients with HF and reduced or preserved left ventricular ejection fraction (LVEF).
Methods: We studied consecutive patients with HF admitted for medical treatment and measured maximum mid-expiratory flow (MMEF) on spirometry and six-min walking distance (6MWD) at hospital discharge. SAD and exercise intolerance were defined by MMEF relative to <60% of the predicted value and 6MWD <300 m, respectively. Endpoint was composite clinical events of all-cause death and/or HF readmission.
Results: Among 1016 studied patients, 478 (47.0%) had SAD, the prevalence of which was higher in patients with LVEF ≥40% than LVEF <40%. SAD correlated to 6MWD <300 m (adjusted odds ratio: 4.23, 95% confidence interval [CI]: 2.49–7.19). This correlation was consistently observed in both LVEF <40% (aOR: 3.99, 95% CI: 1.59–9.98) and LVEF ≥40% (aOR: 4.50, 95% CI:2.22–9.13). SAD also showed significant associations with high incidences of clinical events in all patients (adjusted hazard ratio [aHR]: 1.35, 95% CI: 1.05–1.72) and in LVEF <40% (aHR: 1.76, 95% CI: 1.21–2.54), but not in LVEF ≥40% (aHR: 1.10, 95% CI: 0.78–1.53).
Conclusion: The prevalence of SAD is high in patients with HF, which is associated with exercise intolerance regardless of LVEF. Additionally, SAD may have a predictive significance for clinical events in these patients, especially in LVEF <40%.
Screening for cognitive impairment in the emergency department: agreement between older adult patient- and informant-completed Ascertain Dementia 8 tool
Authors: Galske James , Sather Anna , Chera Tonya , Hwang Ula , Carpenter Christopher R. , Babcock Matthew , Gettel Cameron J.
Published: November 2024

Introduction
Emergency department (ED) screening for cognitive impairment (CI) is crucial for early intervention, yet guidance on dementia screening protocols remains limited. Our objective was to assess the concordance between the Ascertain Dementia 8 (AD8), a brief screening tool for CI, administered to ED patients and their informants.

Methods
We conducted a prospective observational study of dyads, including patients ≥65 years without a diagnosis of dementia seeking care in the ED and their informants (e.g. family, friend with close contact). Trained research assistants used the 4AT to exclude patients with concern for delirium. The AD8 was then administered to blinded patients (pAD8) and informants (iAD8), with scores ranging from 0-8 and scores of ≥2 indicating CI. We used the Intraclass Correlation Coefficient (ICC) to calculate the level of agreement between AD8 scores.

Results
Our analytic sample included 538 dyads, of which 63.3% of patients were female with a mean age of 73.5 years. A total of 131 (24.3%) patients without a diagnosis of dementia self-identified as having CI using the pAD8, in comparison to 110 (20.4%) informants using the iAD8. The ICC of 0.519 (95% CI 0.454-0.578) indicated moderate agreement between pAD8 and iAD8 scores.

Conclusions
When seeking emergency care, one in four older adults without a diagnosis of dementia and approximately 20% of informants indicated that patients were cognitively impaired. Our finding of moderate agreement between the pAD8 and iAD8 has important implications for clinicians providing care to patients with suspected CI and investigators conducting dementia-related studies.
Prognostic Significance of HER2 Positivity in Endometrium Cancer
Authors: Sekmek Serhat , Bayram Dogan , Karahan Irfan , Seven Ismet , Perkin Perihan , Muftuoglu Kamil Hakan , Bal Oznur , Yalcin Bulent , Uncu Dogan , Algin Efnan
Published: November 2024

Introduction: Endometrium cancer is the most common gynaecological malignancy in developed countries. In this study, we aimed to investigate the effect of HER2 positivity on prognosis in endometrial cancer.
Methods: In our study, patients admitted to our clinic with a diagnosis of endometrial cancer between September 2019 and December 2023 were retrospectively evaluated. Human epidermal growth factor receptor 2 (HER2) immunohistochemistry was performed in 121 patients. HER2-low group (HER2 score: 0 and 1) and HER2-high group (HER2 score: 2 and 3) were defined according to the HER2 immunohistochemistry score in the pathology and patients were compared accordingly.
Results: We observed that 97 (80.2%) of the patients were in the HER2-low group, while 24 (19.8%) were in the HER2-high group. In the OS analysis, age (p = 0.381), menopausal status (p = 0.511), ECOG performance status (p = 0.087), histological type of tumour (p = 0.727), pathological grade (p = 0.206), serum LDH (p = 0.091) and albumin (p = 0.315) levels did not affect the prognosis. Patients with lower FIGO stage (p = 0.003) and HER2-high patients (p = 0.040) had better survival outcomes. Multivariable analysis showed that FIGO stage (p = 0.004) and HER-2 status (p = 0.040) were independent risk factors affecting survival in endometrial cancer.
Conclusion: As a result of our study, it was observed that FIGO stage and HER2 status were independent risk factors affecting OS in endometrial cancer patients. HER2-high group had a better prognosis than HER2-low group.
Kolektif Çalışma Yönelimi Ölçeği Türkçe Formu: Geçerlik ve Güvenirlik Çalışması
Authors: Kosova Jülide Ece , Başbay Pınar
Published: November 2024

Takım üyelerinin bireysel tutum ve davranışları takım performansını etkiler. Araştırmalar, takım üyelerinin kolektif çalışma yöneliminin takım çalışmasını olumlu etkilediğine işaret etmektedir. Bu çalışmada, Kolektif Çalışma Yönelimi Ölçeğinin geçerlik ve güvenirliğinin incelenmesi amaçlanmıştır. Çalışmaya yaşları 18 ile 26 arasında değişen 359 üniversite öğrencisi katılmıştır. Yapı geçerliği sınaması için doğrulayıcı faktör analizi uygulanmıştır. Ayrıca, ölçeğin yakınsak ve ıraksak geçerliği sınanmıştır. Bununla beraber, ölçeğin INDCOL (yatay bireycilik boyutu), İş birliği, Tek Başına Olmayı Tercih Etme ve Grup Çalışmasına Yönelik Tutum (ürün ve sürecin kalitesi boyutu) ölçekleriyle ilişkisi korelasyon analizi ile incelenmiştir. Ayrıca, ölçeğin düzeltilmiş madde toplam puan korelasyonları incelenerek madde analizi yapılmıştır. Ölçeğin güvenirliği Cronbach alfa iç tutarlılık katsayısı hesaplanarak sınanmıştır. Sonuçlar, Kolektif Çalışma Yönelimi ölçeğinin geçerli ve güvenilir bir ölçme aracı olduğuna dair çeşitli kanıtlar ortaya koymaktadır.
FinTek Gelişmelerinin Merkez Bankacılığı ve Para Politikasına Yansımaları Üzerine Tarihsel Bir Değerlendirme
Authors: Kömürcüoğlu Ömer Faruk , Akyazı Haydar
Published: November 2024

Finansal teknolojilerde (FinTek) yaşanan gelişmeler finansal hizmetlerin ucuz, hızlı ve erişilebilir hale gelmesini kolaylaştırmaktadır. Tarihsel süreç içerisinde bu gelişmeler transatlantik kablosu, kredi kartı, ATM, bilgisayar ve internet gibi teknolojik yeniliklerle; günümüzde ise yapay zekâ, makine öğrenme, bulut bilişim ve yazılım ile şekillenmektedir. Söz konusu gelişmelerin hızlı yapısı merkez bankalarını ve yürüttükleri para politikasını etkilemektedir. Çalışma, bu etkileşimin temellerini FinTek dönemleri çerçevesinde tarihsel olarak incelemeyi amaç edinmektedir. Finansal sistemin istikrarından sorumlu olan merkez bankalarının, düzenleyici ve denetleyici rolü gereği, FinTek gelişmelerinin hızına ayak uydurmasının finansal kriz risklerinin en aza indirilmesindeki kilit rolü vurgulanmaktadır.
Gastronomi ve Mutfak Sanatlari Bölüm Müfredatlarinda Yer Alan Sanat İçerikli Derslerin Değerlendirilmesi
Authors: Demir Özkan , Seyhan Melek
Published: November 2024

Gastronomi kavramı tarih boyunca ve birçok tanımla sanat kavramıyla ilişkilendirilmiştir. Bu araştırmada Türkiye’de bulunan güzel sanatlar fakülteleri ve sanat tasarım ile ilişkili diğer fakültelerdeki gastronomi ve mutfak sanatları ders müfredatlarında yer alan sanat içerikli derslerinin analiz edilerek gastronomi ve sanat ilişkisinin ortaya konması amaçlanmaktadır. Yöntem olarak doküman analizi tekniğinin kullanıldığı araştırmada 4’ü devlet üniversitesi, 22’si vakıf üniversitesi olmak üzere toplam 26 fakültede bulunan gastronomi ve mutfak sanatları ders programları internet sitelerinden incelenmiştir. İnceleme sonucunda 26 fakültenin gastronomi ve mutfak sanatları bölüm müfredatlarında toplam 2.802 dersin olduğu, 195 dersin ise sanat içerikli ders olduğu belirlenmiştir. Araştırmada bölüm müfredatlarında zorunlu sanat dersleri olduğu gibi aynı zamanda bölüm seçmeli sanat dersleri ve üniversite seçmeli sanat derlerinin olduğu da belirlenmiştir. Araştırmada zorunlu sanat derslerinin genel olarak birinci ve ikinci yarıyıla, seçmeli sanatla içerikli derslerin ise her yarıyıla yayıldığı belirlenmiştir. Araştırma bulguları ile gastronomi ve sanat kavramlarının birbiriyle olan ilişkisi düşünüldüğünde sanat içerikli zorunlu ve seçmeli derslerin arttırılması önerilmektedir.
Bilgi Paylaşımı, Dönüşümcü Liderlik, Tutumlu İnovasyon ve Firma Performansı Arasındaki İlişki
Authors: İmamoğlu Sena Esin , Türkcan Hülya , İnce Hüseyin , İmamoğlu Salih Zeki
Published: November 2024

Kısıtlı kaynak kullanımı ile temel işlevlerde kaliteden ödün vermeden çözümler sunmayı mümkün kılan tutumlu inovasyon kavramına ilişkin literatür henüz gelişme aşamasındadır. Bu kapsamda bu çalışmanın amacı, dönüşümcü liderlik, bilgi paylaşımı, tutumlu inovasyon ve firma performansı arasındaki ilişkileri incelemektir. Ayrıca tutumlu inovasyon ile firma performansı arasındaki ilişkide pazar belirsizliğinin düzenleyici rolünün ortaya konması da hedeflenmektedir. Bu sebeple Gebze’deki imalat sanayi yöneticilerinden anket yöntemiyle 253 veri toplanmıştır. Yapılan analizler sonucunda, dönüşümcü liderlik ile tutumlu inovasyon arasında ve bilgi paylaşımı ile tutumlu inovasyon arasında pozitif ilişki olduğu tespit edilmiştir. Bununla birlikte, tutumlu inovasyon ve firma performansının da pozitif ilişkili olduğu, pazar belirsizliğinin ise bu ilişkide düzenleyici etkisinin bulunmadığı saptanmıştır.
Almanya’nın 2023 Tarihli Nitelikli İş Gücü Göçü Yasası Üzerinden Nitelikli Göç Politikaları ve İş Gücü Piyasası İlişkisine Dair Bir Analiz
Authors: Filiz Anlam
Published: November 2024

Almanya’nın son yıllarda en çok tartışılan toplumsal sorunlarından biri yaşlanan nüfus ve bu demografik değişime bağlı olarak ortaya çıkan iş gücü açığıdır. Bu açığı kapatmak için geliştirilen çözümlerden biri 2023 yılında çıkartılan Nitelikli İş Gücü Göçü Yasası’dır. Makale, bu yasa örneği üzerinden iş gücü piyasasının nitelikli göç politikalarını nasıl etkilediğini incelemektedir. Bu ilişkiyi hem göç çalışmalarının ve çalışma sosyolojisinin merkezi kavramlarından olan hem de yasanın özgün dilindeki isminde yer alan uzmanlık ve nitelik kavramlarının bu yasayla birlikte dönüşümüne odaklanarak araştırmaktadır. Makale vaka analizi yöntemini kullanmaktadır ve bu dönüşümü ülkelerin nitelikli göçmen çekmek için girdikleri küresel yarışta geliştirdikleri göç politikaları konusunda açıklayıcı bir örnek olarak ele almaktadır. Bu kavramların Almanya’nın göç politikalarındaki tanımı, iş piyasalarının gereksinimleri doğrultusunda esnetilmiştir. Bu dönüşüm, nitelikli göç politikalarının göçmen karşıtı söylemle tezat oluşturur şekilde biçimlenebildiğini göstermektedir.
Olağanüstü Dönemlerde Uygulanan Vergilerin Eşitlik İlkesi Açısından Değerlendirilmesi: Varlık Vergisi Uygulaması
Authors: Şahin Serdar , Özhan Emine Nur
Published: November 2024

Varlık vergisi 1942 yılında II. Dünya Savaşının ortaya çıkardığı finansman ihtiyacının karşılanması ve dönemin şartlarından faydalanarak sebepsiz zenginleşen kesimlerle diğer kesimler arasında bozulan gelir dağılımında adaletin sağlanması amacıyla uygulamaya konulan bir vergidir. Varlık vergisi siyasi açıdan yoğun eleştirilere uğrarken esasen varlık vergisine yöneltilen eleştiriler vergi ilkelerinden eşitlik ilkesi ile bağlantılıdır. Ancak dönemin karmaşık yapısından kaynaklı veri eksikliği nedeniyle konu eşitlik ilkesi açısından yeterince incelenmemiştir. Bu çalışmanın amacı vergide eşitlik ilkesi açısından varlık vergisini değerlendirerek literatüre katkıda bulunmaktır. Bu kapsamda çalışmada; sosyal, siyasi, etnik ya da ideolojik tartışmalardan bağımsız bir şekilde varlık vergisi vergilemede eşitlik ilkesi açısından incelenmiştir. Sonuçta her ne kadar vergi uygulanmasında muhtelif sorunlar baş göstermiş olsa da verginin konusunun teorik olarak vergilemede eşitlik ilkesinin sağlanmasına yönelik olarak düzenlendiği, vergi uygulamasının yatay ve dikey eşitliğe uygun olduğu kanaatine ulaşılmıştır.
Toplumsal Cinsiyet Eğitiminin Toplumsal Cinsiyet Algısı ve Flört Şiddeti Tutumlarına Etkisi
Authors: Öztürk Miroğlu Fatma Sena , Aydın Yeral Şule
Published: November 2024

Bu araştırmanın amacı Toplumsal Cinsiyet eğitiminin öğrenciler üzerindeki etkilerini anlamaktır. Toplumsal Cinsiyet Algısı ve Flört Şiddeti Tutum ölçekleri kullanılmıştır. Deney grubu 41, kontrol grubu 39 kişi olmak üzere toplam 80 kişinin katılımı sağlanmıştır. Bağımsız Örneklem T Testi ve Pearson Korelasyon Testi uygulanmıştır. Toplumsal cinsiyet algısı ile flört şiddeti tutumlarının arasındaki ilişkinin pozitif yönde, orta düzeyli ve anlamlı olduğu tespit edilmiştir. Deney ve kontrol grupları benzer başlangıç noktasında olduklarını gösteren öntest puanlarını almışlardır. Öntest ve sontest arasındaki farkların ortalamaları incelendiğinde deney grubunun toplumsal cinsiyet algısı üzerinde kontrol grubuna göre daha olumlu bir etkiye sahip olduğu, ancak flört şiddetine yönelik tutumlara yönelik anlamlılık ifade eden bir farkın olmadığı belirlenmiştir. Sonuçlar toplumsal cinsiyet eğitiminin hedeflediği gibi toplumsal cinsiyete yönelik algıyı değiştirdiğini fakat doğrudan flört şiddetine yönelik tutumları değiştirmediğini göstermektedir.
Yönetim Biliminin Erken Dönem Öncü İsimlerinden Olan Robert Owen Üzerine Bir İnceleme
Authors: Bilmez Nurettin
Published: November 2024

Yönetim olgusunun bilimsel açıdan ele alınışı çeşitli bilim adamlarının çalışmalarıyla başlatılmaktadır. Bu çalışmaların yoğun ve sistematik biçimde ortaya çıktığı döneme bakılırsa 19. yüzyılın sonlarına ve 20. yüzyılın başlarına denk gelmektedir. Bu çalışmanın amacı, Sanayi Devrimi ile hızlanan fabrikalaşma sürecinde ortaya çıkan yönetimsel sorunlar üzerine çalışma yapan önemli kişilerden birisi olan Robert Owen’ı yönetim bilimine katkıları açısından ele almaktır. Görüşleri ve çalışmaları incelendiğinde yönetim bilimi açısından önemli tespitler ve çözüm önerileri geliştiren Owen’ın, bu yönüyle akademik çalışmalara çok fazla konu edinmediği de anlaşılmıştır. Çalışmanın iddiası, Owen’ın yönetim biliminin erken dönem öncü isimlerinden birisi olduğu ve alana önemli katkılar sağladığıdır. Sonuç olarak, yönetim biliminin erken dönemlerinde yaşayan ve yaşadığı dönem içinde yönetimsel sorunlara çözümler üreten, bu konuda çeşitli akademik çalışmalar yapan ve görev aldığı organizasyonları daha verimli hale getirmeyi amaçlayan Owen’ın önemli bir akademik miras bıraktığı düşünülmektedir.
Biomechanical evaluation of percutaneous compression plate and femoral neck system in Pauwels type III femoral neck fractures
Authors: Xie Xiaoping , Bi Songqi , Song Qingxu , Zhang Qiong , Yan Zhixing , Zhou Xiaoyang , Yu Tiecheng
Published: November 2024

Background

The optimal treatment for Pauwels type III femoral neck fractures remains contentious. We aim to compare the biomechanical properties of three inverted cannulated compression screw (ICCS), femoral neck system (FNS), and percutaneous compression plate (PCCP) to determine which offers superior stability for unstable femoral neck fractures.

Materials and methods

Finite element analysis and artificial bone models were used to establish Pauwels III femoral neck fracture models. They were divided into ICCS, FNS, and PCCP groups based on respective internal fixation assemblies. The models were subjected to vertical axial loads (2100 N) and torsional forces (10 N × mm) along the femoral neck axis in the finite element analysis. The primary outcomes such as the Z axis fragmentary displacements, as well as displacements and the von Mises stress (VMS) distributions of internal fixations, were analyzed. Additionally, the artificial bones were subjected to progressively increasing vertical axial pressures and torsional moments at angles of 2°, 4°, and 6°, respectively. The vertical displacements of femoral heads and the required torque values were recorded.

Results

Finite element analysis revealed that under single-leg stance loading, the maximum Z-axis fragmentary displacements were 5.060 mm for ICCS, 4.028 mm for FNS, and 2.796 mm for PCCP. The maximum displacements of internal fixations were 4.545 mm for ICCS, 3.047 mm for FNS, and 2.559 mm for PCCP. Peak VMS values were 512.21 MPa for ICCS, 242.86 MPa for FNS, and 413.85 MPa for PCCP. Under increasing vertical loads applied to the artificial bones, the average vertical axial stiffness for the ICCS, FNS, and PCCP groups were 244.86 ± 2.84 N/mm, 415.03 ± 27.10 N/mm, and 529.98 ± 23.08 N/mm. For the torsional moment tests, the PCCP group demonstrated significantly higher torque values at 2°, 4°, and 6° compared with FNS and ICCS, with no significant difference between FNS and ICCS (P > 0.05).

Conclusions

Finite element analysis and artificial bone models indicated that PCCP offers the best compressive and rotational stability for fixing Pauwels type III femoral neck fractures, followed by FNS and then ICCS. No significant difference in rotational resistance was observed between FNS and ICCS in synthetic bones.

Level of Evidence Level 5.
Hydraulic strategy defines contrasting responses to an abrupt precipitation during a successive lethal drought
Authors: Lin Xiaoying , Wu Caixiao , Zhang Kaikai , Dong Haoran , Xiao Ling , Li Fan , Huang Yao , Li Qiang
Published: November 2024

Background

As precipitation patterns are predicted to become more erratic, it’s vital to understand how abrupt climate events will affect woody seedlings that develop different hydraulic strategies. We cultivated anisohydric Robinia pseudoacacia L. and isohydric Quercus acutissima Carr. in a greenhouse, and subjected an abrupt precipitation event during a successive drought. Patterns of leaf and root gas exchange, leaf and stem hydraulics, seedlings growth, and non-structural carbohydrate (NSC) patterns were determined.

Results

We found that as an anisohydric species, R. pseudoacacia seedlings adopted a strategy of sacrificing leaves in response to stress, resulting in the lowered photosynthesis and ultimately leading to a decrease in NSC accumulation. In contrast, isohydric Q. acutissima maintained the integrity of leaves by reducing respiratory consumption in response to drought stress, thereby ensured the stability of NSC pool.

Conclusion

R. pseudoacacia exhibited an extravagant strategy with efficient water transport, photosynthetic assimilation, and growth capabilities, but its resistance to embolism was relatively weak, while Q. acutissima adopted a resource-saving strategy with higher hydraulic safety. We also found that Q. acutissima seedlings were prone to allocate carbohydrates to maintain growth, while R. pseudoacacia preferred to sacrifice growth and aboveground NSC limitation only happened when precipitation was subjected after total stomatal closure. We thus believe that hydraulic strategy could define seedlings responses to drought and recovery, and further may adversely affect their re-sprouting capacity after drought stress relief.
Novel retrieving device for coronary stent dislodgement
Authors: Han Zhan-Ying , Zhu Yong-Jian , Lu Wen-Jie , Wang Zhi-Fang , Yang Jian-Feng , Zhang Wen-Cai , Qiu Chun-Guang , Dong Jian-Zeng
Published: November 2024

Background

Stent dislodgement is a rare but particularly challenging complication. However, current treatment strategies are suboptimal.

Objective

This study sought to preliminarily assess the feasibility of a novel self-expanding basket (SEB) catheter to successfully retrieve dislodged stent during percutaneous coronary intervention (PCI).

Method

The novel SEB catheter is designed as a self-expanding basket tip made of superelastic shape nitinol memory alloy, which could automatically expand to tightly wrap and flatten the deformed struts regardless of whether the stent come off the guidewire. Consecutive patients with coronary artery disease who experienced stent dislodgement during PCI were included. The primary outcome was procedure success defined as completely removing the stent without surgical incision of blood vessels, or hemostatic forceps, or injury of access vessels.

Results

From May 2020 to May 2023, a total of 6 patients encountering stent dislodgment were enrolled. Five presented as stent dislodgment with the guidewire in situ and the rest one as total stent and guidewire loss. Successful retrieving of dislodged stent with SEB catheter was achieved in 100% (6 of 6) subjects. After retracting lost stent, 5 of 6 patients received new stent implantation, and one only underwent balloon angioplasty with acceptable imaging results. No safety events were observed.

Conclusions

This preliminary report of the novel stent retrieving device presents favorable efficacy and safety profile. Further multicenter study is required to confirm these findings.

Clinical trial number

Not applicable.