bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and validation of a model to predict mortality risk among extremely preterm infants during the early postnatal period: a multicentre prospective cohort study
Authors: Zhang Wen-wen , Wang Shaofeng , Li Yuxin , Dong Xiaoyu , Zhao Lili , Li Zhongliang , Liu Qiang , Liu Min , Zhang Fengjuan , Yao Guo , Zhang Jie , Liu Xiaohui , Liu Guohua , Zhang Xiaohui , Reddy Simmy , Yu Yong-hui
Published: December 2023

Background

Recently, with the rapid development of the perinatal medical system and related life-saving techniques, both the short-term and long-term prognoses of extremely preterm infants (EPIs) have improved significantly. In rapidly industrialising countries like China, the survival rates of EPIs have notably increased due to the swift socioeconomic development. However, there is still a reasonably lower positive response towards the treatment of EPIs than we expected, and the current situation of withdrawing care is an urgent task for perinatal medical practitioners.

Objective

To develop and validate a model that is practicable for EPIs as soon as possible after birth by regression analysis, to assess the risk of mortality and chance of survival.

Methods

This multicentre prospective cohort study used datasets from the Sino-Northern Neonatal Network, including 46 neonatal intensive care units (NICUs). Risk factors including maternal and neonatal variables were collected within 1 hour post-childbirth. The training set consisted of data from 41 NICUs located within the Shandong Province of China, while the validation set included data from 5 NICUs outside Shandong Province. A total of 1363 neonates were included in the study.

Results

Gestational age, birth weight, pH and lactic acid in blood gas analysis within the first hour of birth, moderate-to-severe hypothermia on admission and adequate antenatal corticosteroids were influencing factors for EPIs’ mortality with important predictive ability. The area under the curve values for internal validation of our prediction model and Clinical Risk Index for Babies-II scores were 0.81 and 0.76, and for external validation, 0.80 and 0.51, respectively. Moreover, the Hosmer-Lemeshow test showed that our model has a constant degree of calibration.

Conclusions

There was good predictive accuracy for mortality of EPIs based on influencing factors prenatally and within 1 hour after delivery. Predicting the risk of mortality of EPIs as soon as possible after birth can effectively guide parents to be proactive in treating more EPIs with life-saving value.

Trial registration number

ChiCTR1900025234.
Feasibility of a pregnancy intervention mimicking viral transmission mitigation measures on the incidence of preterm birth in high-risk pregnant women enrolled in antenatal clinics in Melbourne, Australia: protocol for a pilot, randomised trial
Authors: Sridhar Shivadharshini , Mol Ben W , Hodges Ryan , Palmer Kirsten R , Sundram Suresh , de Carvalho Pacagnella Rodolfo , Souza Renato T , Barbosa-Junior Francisco , Mackin David , Said Joanne , Rolnik Daniel L , Malhotra Atul
Published: December 2023

Introduction

Preterm birth is a leading cause of perinatal morbidity and mortality. During the COVID-19 pandemic, reduction in rates of preterm birth in women exposed to viral mitigation measures was reported by multiple studies. In addition, others and we observed a more pronounced reduction of preterm birth in women who had previously experienced a preterm birth. The aim of this pilot study is to establish the feasibility of a lifestyle intervention based on viral mitigation measures in high-risk pregnancies, with the ultimate aim to reduce the incidence of preterm birth.

Methods and analysis

One hundred pregnant women, enrolled in antenatal clinics at two tertiary maternity centres in Melbourne, Australia, who have had a previous preterm birth between 22 and 34 weeks gestation will be recruited. This is a two-arm, parallel group, open-label randomised controlled feasibility trial: 50 women will be randomised to the intervention group, where they will be requested to comply with a set of lifestyle changes (similar to the viral mitigation measures observed during the pandemic). Another 50 women will be randomised to the control group, where they will undergo standard pregnancy care. The primary outcome of this trial is feasibility, which will be assessed by measuring patient eligibility rate, recruitment rate, compliance rate and data completion rate. Secondary outcomes include incidence of preterm birth, maternal satisfaction, maternal quality of life and other pregnancy outcomes. Standard methods in statistical analysis for randomised controlled trials on an intention to treat basis will be followed.

Ethics and dissemination

This trial has been approved by the Monash Human Research Ethics Committee; approval reference number RES-22-0000-122A. Study findings will be reported and submitted to peer-reviewed journals for publication, and presentation at conferences.

Trial registration number

ACTRN12622000753752; Pre-results.
Adverse drug events associated with nortriptyline compared with paroxetine and alternative medications in an older adult population: a retrospective cohort study in Southern California
Authors: George Monique Margaret , Deamer Robert Louis , Do Duy
Published: December 2023

Objective

Investigate risk for falls, fractures and syncope in older adult patients treated with nortriptyline compared with paroxetine and alternative medications.

Design

Retrospective cohort study.

Setting

The electronic medical record and prescription drug database of a large integrated healthcare system in Southern California.

Participants

Ambulatory patients, age ≥65 years diagnosed with depression, anxiety disorder or peripheral neuropathy, dispensed one or more of ten study medications between 1 January 2008 and 31 December 2018.

Main outcome measures

HR for falls, fractures and syncope with exposure to study medications adjusted for patient demographic variables and comorbidities.

Results

Among 195 207 subjects, 19 305 falls, 15 088 fractures and 11 313 episodes of syncope were observed during the study period. Compared with the reference medication, nortriptyline, the adjusted HRs (aHRs) for falls were statistically significantly greater for: paroxetine (aHR 1.48, 95% CI 1.39 to 1.57), amitriptyline (1.20, 95% CI 1.08 to 1.33), venlafaxine (1.44, 95% CI 1.34 to 1.56), duloxetine (1.25, 95% CI 1.12 to 1.40), fluoxetine (1.51, 95% CI 1.44 to 1.59), sertraline (1.53, 95% CI 1.44 to 1.62), citalopram (1.61, 95% CI 1.52 to 1.71) and escitalopram (1.37, 95% CI 1.21 to 1.54), but not gabapentin (0.95, 95% CI 0.89 to 1.02). For fractures, compared with nortriptyline, aHRs were significantly greater for: paroxetine, venlafaxine, duloxetine, fluoxetine, sertraline, citalopram, escitalopram and gabapentin, with aHRs ranging from 1.30 for gabapentin to 1.82 for escitalopram; risk was statistically similar for amitriptyline. For syncope, the aHRs were significantly greater for: paroxetine, venlafaxine, fluoxetine, sertraline and citalopram, with aHRs ranging from 1.19 for fluoxetine and paroxetine up to 1.30 for citalopram and sertraline; risk was similar for amitriptyline, duloxetine, escitalopram and gabapentin.

Conclusions

Compared with therapeutic alternatives, nortriptyline was found to represent a lower risk for falls, fractures and syncope, versus comparator medications, except for a few instances that had equivalent risk. The risk for these adverse events from paroxetine was comparable to the alternative medications.
Financial burden of postoperative complications following oesophagectomy: a scoping review protocol
Authors: Buchholz Vered , Berman Jordan , Liu David , Le Peter , Weinberg Laurence
Published: December 2023

Introduction

The rapid rise in the incidence of oesophageal adenocarcinoma has resulted in an increasing number of patients undergoing oesophagectomy. Although novel surgical techniques are enhancing surgical outcomes, postoperative complications remain pervasive. Despite this, there are limited reviews mapping the cost of postoperative complications following oesophagectomy, and none has compared cost differences between patient groups. Such information would be invaluable in appreciating the financial burden on the healthcare system and serving to guide hospital financing decisions. This scoping review protocol outlines an approach to reviewing the literature to precipitate and inform discussions surrounding financing oesophagectomy procedures as well as funding requirements for upper gastrointestinal surgical units.

Methods and analysis

Adhering to the pertinent components of the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Review Protocols guidelines, a systematic exploration will be conducted across electronic databases, including MEDLINE, EMBASE, the Cochrane Library and Econolit, with further reference tracking of eligible studies. This review will encompass studies related to the costs associated with complications following oesophagectomy. All studies published prior to 31 October 2023 are eligible for inclusion. The process of screening and extracting data will be undertaken by two independent reviewers. Subsequently, the amassed data will be pooled and subjected to comprehensive analysis and presented descriptively, using both a mixed methods and a narrative approach.

Ethics and dissemination

Ethics approval was not required. The results will be communicated through established professional networks, conference presentations and publication in peer-reviewed journals.
Tubular deficiency of ABCA1 augments cholesterol- and Na+-dependent effects on systemic blood pressure in male mice
Authors: Carneiro de Oliveira Karin , Wei Yuan , Repetti Robert L. , Meth Jennifer , Majumder Nomrota , Sapkota Ananda , Gusella G. Luca , Rohatgi Rajeev
Published: December 2023

Cholesterol has been linked to greater Na+ channel activity in kidney cells, which may predispose to systemic hypertension. We showed that when ABCA1, a protein that removes cholesterol from tissues, is ablated from mouse kidneys, systemic blood pressure is greater than normal mice. Dietary cholesterol further increases blood pressure in transgenic mice, whereas low dietary salt intake reduced blood pressure to that of normal mice. Thus, we speculate that diseases and pharmaceuticals that reduce renal ABCA1 expression, like diabetes and calcineurin inhibitors, respectively, contribute to the prominence of hypertension in their clinical presentation.
Acute aerobic exercise enhances cerebrovascular shear-mediated dilation in young adults: the role of cerebral shear
Authors: Sakamoto Rintaro , Kamoda Tatsuki , Sato Kohei , Ogoh Shigehiko , Katayose Masaki , Neki Toru , Iwamoto Erika
Published: December 2023

We found that 30-min cycling (target intensity was 80% of the ventilatory threshold) with increasing shear of the internal carotid artery (ICA) enhanced transient hypercapnia-induced shear-mediated dilation of the ICA, reflecting improved cerebrovascular endothelial function. This enhancement of ICA dilation was diminished by suppressing the exercise-induced increase in ICA shear via hyperventilation. Our results indicate that increases in cerebral shear may be a key stimulus for improving cerebrovascular endothelial function after exercise in young adults.
TÜRKİYE'S INTERNATIONAL COMPETITIVENESS AND EXPORT PERFORMANCE IN THE TEXTILE SECTOR: COMPARATIVE ANALYSIS WITH THE WORLD'S TOP TEXTILE EXPORTER COUNTRIES
Authors: Özözen Serdar , Polat Mehmet Ali
Published: December 2023

The textile industry plays a pioneering role in the development of developing countries. Türkiye in Eurasia, Germany and Italy in Europe, the United States in North America, China, India, Pakistan, Twain ve South Korea in Asia are among prominent countries in the textile sector. The textile industry maintains its importance in developed countries as well as developing countries. The aim of this study is to examine the competitiveness of the textile sector, which is one of the locomotive sectors in Türkiye and its export performance over rival countries which are the prominent countries in the textile export in the world market. Revealed Comparative Advantage (RCA) Index and Comparative Export Performance (CEP) Index were used in this study. RCA and CEP indices were calculated using data obtained from Uncomtrade database for the period 2001-2020. According to the calculated Revealed Comparative Advantage (RCA) Index results, It was determined that Türkiye had a competitive advantage in two-digit textile product group SITC 65 and in 7 of the 9 three-digit sub-product groups SITC (652, 653, 655, 656, 657,658, 659) had a competitive advantage, while the competitiveness in the SITC 651 sub-product group remained at the marginal limit. According to result of Comparative Export Performance Index, It was seen that Turkey has an advantage in export against all analyzed countries except Pakistan in SITC two-digit textile product group
THE EFFECT OF THE USE OF GAMIFICATION STRATEGY IN MOBILE HEALTH APPLICATIONS ON CUSTOMER LOYALTY
Authors: Toprak Cansu , Özgüner Kılıç Hicran
Published: December 2023

The introduction of mobile technologies’s included users in the mobile world with new features. The progress of mobile marketing has affected the development of the mobile application market. Mobile applications, which developed in parallel with the development of mobile marketing, helped the development of new applications in the health sector. Developing mobile technologies’re becoming widespread in the health sector. With the mobile health applications developed, different opportunities can be offered to patients or users who want a healthier lifestyle, and the applications can have the power to increase the quality of life of people. One of the rising values in mobile health applications’s gamification. With gamification, health services can be offered to the user in a mobile environment. It aims to monitor their health by rewarding its users because it’s motivational on the basis of gamification. The gaming experience leads to the formation of loyalty towards the mobile application with the value created by the user by connecting to the mobile application. In this research, the effect of game experiences on customer loyalty as a result of gamified content in mobile health applications was investigated. As a result of the research, it’s been shown that the game experience dimensions in mobile health applications’ve a positive effect on customer loyalty and suggested that healthcare companies or application developers can apply gamification strategies in their mobile applications to increase the loyalty of their customers.
WAREHOUSE LOCATION SELECTION WITH FUZZY C-MEANS METHOD
Authors: Ulu Mesut
Published: December 2023

Choosing the right warehouse location reduces costs while increasing efficiency and customer satisfaction in logistics processes. However, the choice of warehouse location usually involves a large number of uncertain factors. This study examines the fuzzy c-means method in the warehouse location selection process. Using the principles of fuzzy logic, it offers a methodology that allows the warehouse location to be evaluated with uncertainty and imprecise data. The flexibility, uncertainty, and successful applicability of fuzzy logic to real-world problems are important in decision-making processes such as warehouse location. The fuzzy C-means method is a clustering algorithm used to identify groups (clusters) in the data set. This approach makes decisions regarding warehouse location selection more accurate and supported by information. The results of the study show that the fuzzy C-means method can be used effectively in warehouse location selection and that this approach adds value to the decision processes in logistics management. This methodology can be used in decision-making processes on logistics planning and strategic selection of warehouse locations, while helping businesses increase their competitive advantage.
THE HUMAN DIMENSION OF SUSTAINABLE DEVELOPMENT IN THE PERSPECTIVE OF OCCUPATIONAL SAFETY AND HEALTH
Authors: Candır Şimşek Hanife , Candır Şimşek Hanife
Published: December 2023

The aim of this study is to examine the "Decent Work and Economic Growth" section of the United Nations' (2015) "Agenda 2030: UN Sustainable Development Goals" from the perspective of occupational safety and health. Decent work consists of various dimensions, but this study specifically focuses on the aspect of occupational safety and health. While there are studies in the literature that evaluate sustainable development from the standpoint of occupational safety and health, it is crucial to investigate the topic from a human perspective, taking into account the International Labor Organization's goal of decent work. This is because the core element of working life is the human being, and sustainable development cannot be achieved without a focus on humanity. Therefore, research in this direction underscores the significance of the study. In the analysis of this study, data obtained by the International Labor Organization from various countries on the fundamental indicators of occupational safety and health have been categorized, tabulated, and evaluated, considering the World Bank's country classifications by income groups. In conclusion, there are challenges in accessing accurate data, especially in the field of occupational safety and health worldwide. Furthermore, there is a long way to go in terms of the human dimension of sustainable development resulting from occupational accidents and diseases.
THE IMPACT OF FINANCIAL STABILITY AND ECONOMIC FREEDOMS ON ECONOMIC GROWTH: EVIDENCE FROM DEVELOPING COUNTRIES WITH NEW QUANTITATIVE MODELS
Authors: Tekman Nazlı
Published: December 2023

This study examines the effect of financial stability and economic freedom levels of developing countries on economic growth. A financial stability index was calculated in this study to represent the financial stability of developing countries, whereby the Heritage Foundation "Economic Freedom Index" was used to represent their economic freedom. Econometric analyzes were conducted within the framework of the 2000-2020 period in 16 developing countries of the upper-middle income bracket. As a result of the models estimated utilizing the Moment Quantile Regression Method (MM-QR), it was observed that the effect of economic freedom and financial stability on economic growth is positive and statistically significant for the country group. These research findings hold significant implications for policy makers, economists and researchers.
Gender-Specific Differences in Preoperative Concerns in Patients Undergoing Endoscopic Sinus Surgery for Chronic Rhinosinusitis
Authors: Tam Benjamin , Le Jessica , Tang Dennis M. , Wu Arthur W. , Hopp Martin L. , Borrelli Michela , Rice Dale H. , Wrobel Bozena B. , Hur Kevin
Published: December 2023

Objectives:

Among patients with chronic rhinosinusitis (CRS), gender differences in epidemiology as well as quality of life have been reported. However, whether gender differences in endoscopic sinus surgery (ESS) preoperative concerns exist is unclear.

Methods:

CRS patients undergoing ESS at 3 tertiary care centers in Los Angeles completed the validated Western Surgical Concern Inventory - ESS assessing ESS preoperative concerns.

Results:

Of the 75 patients included, female patients expressed greater concern than male patients in regard to nasal packing, undergoing anesthesia, impact of surgery on daily activities, and pain and discomfort following surgery.

Conclusion:

This study suggests there are gender differences in ESS preoperative concerns and otolaryngologists should be aware of these possible concerns during preoperative discussions.
Clinical Predictors of Steroid Resistance in Childhood Nephrotic Syndrome
Authors: Cicek Neslihan , Yıldız Nurdan , Guven Sercin , Kaya Mehtap , Gokce Ibrahim , Alpay Harika
Published: December 2023

We aimed to evaluate the clinical parameters, histopathological findings of nephrotic syndrome (NS) patients, and independent factors predicting steroid resistance in a single tertiary center. One hundred and sixty-two children (57 girls and 105 boys) with NS who were followed between 1998 and 2018 were analyzed in this retrospective cohort. The median (interquartile range; range) age and follow-up time were 4.9 (5.7; 0.1-16.8) and 5.5 (5.4; 0.1-20.3) years. A total of 82.7% of the patients were steroid-sensitive nephrotic syndrome (SSNS) and 17.3% were steroid-resistant nephrotic syndrome (SRNS). The median age at first presentation was lower in the SSNS group ( P = .002). The most common histopathological findings were focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD). Hypertension and macroscopic and microscopic hematuria were higher in the SRNS group ( P < .001). The age and microscopic hematuria were independent risk factors for steroid resistance ( P = .019 and P = .002, respectively). Complement 3 (C3) was evaluated in 148 patients and found low in 7 patients who were subsequently diagnosed as membranoproliferative glomerulonephritis. There is still no better clinical predictor for steroid response than late age of onset and microscopic hematuria. Hypertension may also give a hint for potential steroid resistance.
A 10-Year Retrospective Review of Playground-Associated Craniofacial Injuries in the Pediatric Patient Population
Authors: Kolbow Madison , Quick Joseph D. , Powell Lauren E. , Wang Qi , Nguyen Minh-Doan T. , Barta Ruth J.
Published: December 2023

This retrospective study utilized the National Electronic Injury Surveillance System (NEISS) database to identify pediatric emergency department (ED) patients with playground-associated craniofacial injuries between January 2012 and December 2021. A total of 25 414 patients were identified. The majority of injuries occurred in preschool and elementary school–age children (90.3%) and patients were more commonly boys (59.3%). Injuries most often involved the head/scalp (52.4%), face (30.4%), and mouth (11.9%). Infant (32.7%) and teen (40.0%) injuries most commonly involved swings, whereas preschool (23.1%) and elementary school (28.1%) injuries were mostly associated with slides and climbers, respectively. Most patients were treated in the ED and discharged to home (96.5%), a small portion required hospitalization (1.6%), and one death was reported. Although the majority of the injuries were relatively minor and resulted in same-day discharges, these injuries can result in serious physical harm, emotional stress, and unexpected financial burdens. Proper education and supervision regarding safe play is important to prevent these injuries.
PICU Admission of Children for Status Epilepticus: Is There a Different Approach Between Referral and Second-Level Hospitals in an Italian Region?
Authors: Bonardi Claudia Maria , Nosadini Margherita , Lorenzoni Giulia , Tessari Anna , Santoro Lorenza , Pettenazzo Andrea , Gregori Dario , Sartori Stefano , Amigoni Angela
Published: December 2023

Appropriate status epilepticus (SE) management is key to minimize admission to the pediatric intensive care unit (PICU). We retrospectively describe 115 children admitted to the PICU of the tertiary-care referral hospital of Padova for seizures, SE, and SE-related complications (59% from second-level hospitals, 41% from the referral hospital) and compare SE management among hospitals. Compared with the referral center, in second-level hospitals, anesthetics were more often administered as first/second drug ( P < .001), and intubation was more frequent ( P < .001). Intubation was significantly associated with SE onset at home ( P = .045) and benzodiazepine-associated respiratory depression ( P = .044). There was no association between intubation and SE duration, etiology, PICU length of stay, and morbidity at discharge. In conclusion, adherence to treatment protocols on SE management after the first-line drug differs between referral center and second-level hospitals. Lack of association with SE characteristics and patient’s outcome suggests PICU admission could be due to inappropriate invasive management.
The implementation of tunnel handling in a mouse breeding facility revealed strain-specific behavioural responses
Authors: Hohlbaum Katharina , Merle Roswitha , Warnke Ramona , Nagel-Riedasch Stefan , Thöne-Reineke Christa , Ullmann Kristina
Published: December 2023

As a step towards implementing non-aversive handling techniques at a big mouse breeding facility in Germany, tunnel handling was introduced in a breeding unit comprising three inbred mouse strains. To assess whether tunnel handling would be feasible for the animal technicians in their everyday work and beneficial for the mice when being handled during weekly cage change only, the behaviour of tunnel- and tail-handled animals of both sexes was examined before, during and after the handling events over a period of nine weeks. Moreover, the time expenditure was compared between both handling techniques. It was possible to use the tunnel in all three mouse strains. However, the impact of the handling techniques on the behavioural parameters investigated in the present study were strain-specific. All behavioural parameters suggested that NZW mice benefited the most from tunnel handling. The results obtained from Hello Kitty and WNK mice were ambiguous, which may suggest that a brief handling session during the cage clean may have not been sufficient to habituate them to the process of handling. It took the animal technicians approximately 3 seconds longer per mouse when using a tunnel. The strain-specific results should encourage researchers to share their experiences with non-aversive handling techniques in different mouse strains, for example, along with their research articles.
Opioid Prescriptions Prior to Emergency Department Dental Visits: A Comparison of Dental Health Professional Shortage Areas (DPSAs) and Non-DPSAs Using Electronic Health Records
Authors: Dreyer Mallory , Shukla Anubhuti , Sabadee Juyee , Bibireddy Meghana , Börner Katy , Thyvalikakath Thankam , Simon Kosali
Published: December 2023

Although prior research has linked dental conditions and opioid prescribing in the U.S., it is not yet known whether the receipt of opioid prescriptions prior to seeking emergency care for dental conditions differs in geographical areas that are underserved by health care professionals (Dental Professional Shortage Areas, DPSAs) compared to other areas. Using Indiana’s state-wide electronic health records from January 1, 2016 to October 31, 2020, we examine if patients from DPSAs presenting at the emergency department (ED) for dental conditions are more likely to have received opioid prescriptions in the 30 days prior to their visit, compared to patients from other areas. A higher rate of opioid receipt among DPSA individuals may indicate an association between lower availability of dental professionals and the use of opioids as a coping strategy. We note that our study design has several limitations (such as a lack of data on prescription use after the ED visit) and does not prove causation. We find that individuals experiencing dental condition ED visits in DPSAs are 16% more likely (than those in non-DPSAs) to have filled an opioid prescription in the 30 days prior to the ED visit, after controlling for age, gender, and race/ethnicity. This result is statistically significant at the 1% level. The baseline rate of opioid filling in the 30 days prior to the ED visit is 12% in DPSAs. These correlational results suggest that unmet dental needs might be substantially connected to opioid prescriptions, although further research is needed to establish whether this relationship is causal.
The Ruins of a Steel Mill: Planetary Urbanization in the Brazilian Amazon
Authors: Lerner Patrón Adrián
Published: December 2023

This article studies the socio-environmental history of a steel mill in Manaus, Brazil, the largest city in Amazonia. The Companhia Siderúrgica da Amazônia Sociedade Anônima, SIDERAMA, an integrated steel mill created in 1961 and liquidated in 1997 after a convoluted history of mismanagement, was part of private and public efforts to colonize the Brazilian Amazon through industrial urbanization. Exploring its impacts at a diversity of scales, the article presents it as a historical case study of planetary urbanization. The steel mill polluted the city of Manaus, and resource extraction to feed it with materials and energy disrupted environments and societies deep into the Amazon rainforest. This process underscores the global reach of urbanization during the second half of the twentieth century and the need to rethink the role of Amazonia during the Anthropocene.
Methodological challenges and potential solutions for economic evaluations of palliative and end-of-life care: A systematic review
Authors: Fischer Claudia , Bednarz Damian , Simon Judit
Published: December 2023

Background:

Given the increasing demand for palliative and end-of-life care, along with the introduction of costly new treatments, there is a pressing need for robust evidence on value. However, comprehensive guidance is missing on methods for conducting economic evaluations in this field.

Aim:

To identify and summarise existing information on methodological challenges and potential solutions/recommendations for economic evaluations of palliative and end-of-life care.

Design:

We conducted a systematic review of publications on methodological considerations for economic evaluations of adult palliative and end-of-life care as per our PROSPERO protocol CRD42020148160. Following initial searches, we conducted a two-stage screening process and quality appraisal. Information was thematically synthesised, coded, categorised into common themes and aligned with the items specified in the Consolidated Health Economic Evaluation Reporting Standards statement.

Data sources:

The databases Medline, Embase, HTADatabase, NHSEED and grey literature were searched between 1 January 1999 and 5 June 2023.

Results:

Out of the initial 6502 studies, 81 were deemed eligible. Identified challenges could be grouped into nine themes: ambiguous and inaccurate patient identification, restricted generalisability due to poor geographic transferability of evidence, narrow costing perspective applied, difficulties defining comparators, consequences of applied time horizon, ambiguity in the selection of outcomes, challenged outcome measurement, non-standardised measurement and valuation of costs as well as challenges regarding a reliable preference-based outcome valuation.

Conclusion:

Our review offers a comprehensive context-specific overview of methodological considerations for economic evaluations of palliative and end-of-life care. It also identifies the main knowledge gaps to help prioritise future methodological research specifically for this field.
Reduction in potentially inappropriate end-of-life hospital care for cancer patients during the COVID-19 pandemic: A retrospective population-based study
Authors: Slotman Ellis , Fransen Heidi P , van Laarhoven Hanneke WM , van den Beuken-van Everdingen Marieke HJ , Tjan-Heijnen Vivianne CG , Huijben Auke MT , Jager Agnes , van Zuylen Lia , Kuip Evelien JM , van der Linden Yvette M , Raijmakers Natasja JH , Siesling Sabine
Published: December 2023

Background:

The COVID-19 pandemic impacted cancer diagnosis and treatment. However, little is known about end-of-life cancer care during the pandemic.

Aim:

To investigate potentially inappropriate end-of-life hospital care for cancer patients before and during the COVID-19 pandemic.

Design:

Retrospective population-based cohort study using data from the Netherlands Cancer Registry and the Dutch National Hospital Care Registration. Potentially inappropriate care in the last month of life (chemotherapy administration, >1 emergency room contact, >1 hospitalization, hospitalization >14 days, intensive care unit admission or hospital death) was compared between four COVID-19 periods and corresponding periods in 2018/2019.

Participants:

A total of 112,919 cancer patients (⩾18 years) who died between January 2018 and May 2021 were included.

Results:

Fewer patients received potentially inappropriate end-of-life care during the COVID-19 pandemic compared to previous years, especially during the first COVID-19 peak (22.4% vs 26.0%). Regression analysis showed lower odds of potentially inappropriate end-of-life care during all COVID-19 periods (between OR 0.81; 95% CI 0.74–0.88 and OR 0.92; 95% CI 0.87–0.97) after adjustment for age, sex and cancer type. For the individual indicators, fewer patients experienced multiple or long hospitalizations, intensive care unit admission or hospital death during the pandemic.

Conclusions:

Cancer patients received less potentially inappropriate end-of-life care during the COVID-19 pandemic. Because several factors may have contributed, it is unclear whether this reflects better quality care. However, these findings raise important questions about what pandemic-induced changes in care practices can help provide appropriate end-of-life care for future patients in the context of increasing patient numbers and limited resources.
Platelet-rich plasma for pilonidal disease: a systematic review
Authors: Zhuang Yu , Feng Wen-zhe
Published: December 2023

Objective

To examine the use of platelet-rich plasma (PRP) for treatment of pilonidal disease (PD) and thus provide a reference for clinical application.

Methods

A systematic review of PubMed and the Cochrane Library was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We considered all studies that reported the use of PRP for treatment of PD. Extracted data included the first author’s name, year of publication, study type, number of included patients, inclusion and exclusion criteria, interventions, anesthesia, application of PRP (source, preparation, dose, and operation), antibiotics, follow-up time, therapeutic outcomes, and adverse events.

Results

In total, eight randomized controlled trials and one prospective cohort study involving 809 patients were included. PRP reduced pain, accelerated healing, and reduced adverse events. The application of combined minimally invasive surgery achieved better results. However, overfilling of the wound with PRP in minimally invasive surgeries was shown to potentially increase the risk of adverse events.

Conclusion

PRP can be used as an adjuvant treatment in PD surgery to improve the therapeutic effect and reduce adverse events. The optimal combination of PRP and various factors is an important direction of future research. INPLASY registration number: INPLASY2023100070.
Evaluation of psychosocial status of CKD patients on renal replacement therapy and post renal transplant patients: An observational study
Authors: Sarkar Debansu , Tripathi Chandranshu , Pal Dilip Kumar
Published: December 2023

Introduction:

Recent studies have shown a high prevalence of depression and anxiety in patients with end-stage renal disease (ERSD) and renal transplant recipients.

Aim:

The aim of this observational study is to asses prevalence of depression and anxiety symptoms in CKD patients and post renal transplant patients.

Methods:

In this study 100 patients divided in 50–50 each group. Group 1 with CKD patients on dialysis and group 2 with post renal transplant patients. Each group evaluated for depression and anxiety symptoms using BDI (Beck’s Depression Inventory) and STAI (State-Trait Anxiety Inventory) score which is divided into STAI-X1 and STAI-X2, respectively.

Results:

Our study revealed in group 1 48% patient versus group 2 34% patients present with depressive symptoms whereas in case of anxiety symptoms STAI-X1 and STAI-X2. Group 1 24% and 18% whereas group 2 34% and 28% patients, respectively.

Conclusion:

It is observed that depressive symptoms are more common in CKD patients on dialysis whereas anxiety symptoms observed more in patients after renal transplant. The obtained results indicate that screening tests and monitoring of the emotional state of patients with CKD are necessary, regardless of the disease stage and treatment; this includes patients after kidney transplantation.
Counting the Numbers: Nationalism and the Question of Surplus Women
Authors: Pan Anandita
Published: December 2023

The ‘evils’ of sati and widowhood constituted two of the major elements of social reformation and women’s progress in India in the nineteenth and early twentieth centuries. These ‘evils’ were rooted in casteist and sexist ideologies and practices, aspects that remained largely unrecognised by the dominant reformist agendas. The narrative of social progress of women focused only on the upper-class and upper-caste women whose lives were prescribed by brahmanical and patriarchal ideals of chastity, purity, and devotion to husbands. Consequently, ‘patriarchy’ was interpreted as a traditional system oppressing the upper-class upper-caste women. The social reformations such as companionate marriage, widowhood, sati, were practices predominant only in upper-caste communities. It is also significant to note that social reformation was intended to revive the ‘great’ Hindu tradition and rid it of its bad elements exhibited through the practice of sati. This article, through a comparative reading of the discourses on sati and widowhood by Raja Rammohan Roy and the idea of endogamy by B. R. Ambedkar, examines the roots of brahmanical patriarchy to delineate the gendering of caste in imposing a false homogeneity of nationalism.
Child Abuse: Perspectives from a Gendered Trauma-informed Lens
Authors: Ray Sukanya
Published: December 2023

Child abuse that involves maltreatment of children by parents and/or trusted adults, including child sexual abuse can be conceptualized with the trauma-informed lens for both the survivor and the perpetrator. The trauma-informed lens is a significant departure from the prevailing DSM view of trauma and rests on the understanding of trauma being pervasive, undetected and disabling. Conventional clinical practices can be damaging to this already vulnerable group of service users. A paradigmatic shift is necessary in clinical services for child abuse survivors. The trauma-informed clinician takes a nuanced clinical perspective of the past that has survived into the present with an appreciation of survival mechanisms and constructs such as dissociation, attachment, relational trauma and development of the self. There is more importance on preventing retraumatizing and causing harm to the client, and avoiding mis-steps in the clinical interview. Resourcing, empowerment and a humane approach to the clinical rendezvous is recommended for the trauma-informed clinician engaged in working with survivors of child abuse. A gendered perspective that appreciates gender as a social construct and patriarchy as the mechanism that traumatized both the male and the female ideal enables clinicians to work with the survivor without othering the perpetrator. The article also addresses important considerations for working with survivors of child abuse, including betrayal trauma and the relational field in therapy.
Impact of Abuse on Mental Health and Happiness Among Students: Mediating Role of Family Environment
Authors: Kumar Aneesh , Deb Sibnath , Bhagyalakshmi KC
Published: December 2023

Background:

Child abuse and neglect is an issue of concern for public health professionals. The impact of abuse may lead to poor physical and mental health conditions. Family environment may impact coping and recovery among victims of abuse. The association between child abuse, mental health, happiness, and family environment is complex. The study examines the association and pathways between child abuse exposure, mental health and happiness, while exploring the potentially mediating effect of the family environment.

Methods:

Data were collected from 571 high school students from Kerala, India, by using various tools, including a semi-structured questionnaire, Depression and Anxiety Youth Scale, and happiness scale. A mediation analysis using structural equation modeling (SEM) was carried out to test the objectives of the study.

Results:

The analysis shows that mental health, happiness, and family environment are correlated with abuse experience. The mediation analysis further shows that the indirect effect of abuse on mental health via the family environment was significant (β = 0.013, 95% CI [0.002, 0.033]). The indirect effect of abuse on happiness via the family environment was significant (β = –0.019, 95% CI [–0.044, –0.003]). Furthermore, the total effect of abuse on mental health (β = 0.266, 95% CI [0.164, 0.354]) and abuse on happiness (β = –0.152, 95% CI [–0.259, –0.050]) was significant.

Conclusion:

The study reveals that abuse experiences impact happiness and mental health outcomes among students. The family environment mediates the relationship between child abuse and mental health, and between child abuse and happiness.
Parental Understanding of Cultural Difference: A Study of Transracially Adopting Couples
Authors: Straughan Hope Haslam , Hoyt-Oliver Jane , Anderson Chelsea
Published: December 2023

White parents who adopt transracially raise their children within a context of racial disparity, a history of generational inequity, racial bias, and discrimination. The purpose of this research study was to learn more about the experiences of white parents of transracial children, who had adopted within the United States. The research questions focused on how the parents understood and dealt with parenting a child of another race. This mixed-methods study identified five key themes that these white parents experienced as significant in raising children of color. The themes include motivation for transracial adoption; parental racial identity development; coexisting issues of race, trauma, and mental health; recognition and the impact of parent’s white privilege; and seeking and not seeking exposure to diversity for the entire family.
Antimicrobial effect of chamomile-containing over-the-counter ear and eye drops
Authors: Farsi Soroush , Chaudhry Shahrukh , Khan Ahmed , Gardner Joshua , Ogwo Morgan , Ofori Brendon , Hosseini Mehrdad , Cervantes Jorge
Published: December 2023

Chamomile ( Matricaria chamomilla) is a plant with known antimicrobial, anti-inflammatory, and analgesic properties. Homeopathic drops containing chamomile extract are often used for ear pain and chronic ear infections. We aimed to evaluate the antimicrobial effect of over-the-counter eardrops containing chamomile against organisms causing bacterial conjunctivitis and otitis externa. Liquid cultures of Streptococcus aureus and Pseudomonas aeruginosa were exposed to increasing concentrations of eardrops containing chamomile extract. Liquid cultures of S. aureus and Streptococcus pneumoniae were exposed to increasing concentrations of chamomile eye drops for 5, 10, 15, and 45 min. Colony forming units (CFUs) were assessed after 18 h. Viability assays for these organisms were performed using the resazurin microdilution assay. We observed a reduction in the number of P. aeruginosa CFUs when the bacteria were exposed to any of the three concentrations of the chamomile drops as early as 5 min, with maximal reduction upon exposure to the 30% concentration at 45 min. Reduction in S. aureus CFUs, on the other hand, was observed for all three concentrations as maximal in the 5 min of exposure. We observed a marked reduction in the number of S. aureus CFUs upon exposure to any of the three preparations of chamomile-containing eye drops, which was almost immediate at 10% concentration. Streptococcus pneumoniae reduction happened at 5 min and continued through the 45-min observation period for all three concentrations. Our findings suggest that over-the-counter ear drops containing chamomile extract could potentially be used as a non-prescription treatment for mild cases of otitis externa and bacterial conjunctivitis.
Removal of stuck tunnelled dialysis line requiring cardiopulmonary bypass and venous repair
Authors: Bakr Lubna , Ali Jason
Published: December 2023

Tunnelled central venous dialysis catheters can usually be removed easily. However, their removal can become rarely complicated requiring more invasive techniques. We report a case in which cardiopulmonary bypass and repair of great veins was required for safe removal. A 38-year-old female with end-stage renal failure and a 3-year-old Hickman line inserted into her right internal jugular vein was referred to our cardiac surgical unit following failed attempts of line removal by local vascular surgical team using open vascular surgical techniques. As a result, an MDT decision was made that it was safer to proceed to a cardiothoracic surgical approach rather than other techniques. Investigations showed significant calcification surrounding the line which was adherent to the venous wall. Removal of the retained catheter required median sternotomy and the use of cardiopulmonary bypass as the great veins had to be opened to free the line and allow complete removal. The line was successfully removed with its encircling calcified sheath, and the veins were closed primarily without needing a patch repair. The integrity of the great veins was maintained to meet the on-going need this young patient has for central venous access. The patient made an uneventful recovery. When other measures fail, sternotomy and cardiopulmonary bypass provide a safe option for complete removal of stuck central venous catheters with low risk to the patient.
Effect of flow reduction surgery in a patient with high flow arteriovenous fistula with aortic dissection using 4D flow magnetic resonance imaging: A case report
Authors: Oh Yeongrok , Heo Chang Min , Gwoo Sangeon , Huh Hyungkyu , Park Sungho , Heo Woon
Published: December 2023

This study aimed to investigate cardiovascular function in a patient with high-flow arteriovenous fistula (AVF) who underwent aortic dissection (AD) using four-dimensional (4D) flow magnetic resonance imaging (MRI) as well as analyze the effect of flow reduction surgery on AD. On March 12, 2017, a 60-year-old woman underwent emergency surgery for AD. After that, she experienced acute kidney injury, and hemodialysis was initiated. On April 24, 2017, a left brachiocephalic arteriovenous fistula (AVF) was created to facilitate her dialysis. However, after 5 years, the patient presented with a high-flow AVF, and a flow reduction surgery was performed on March 11, 2022. To evaluate the procedure’s effectiveness, we measured the changes in left ventricular (LV) function and blood flow in the aorta and vascular access before and after surgery using 4D flow MRI. Notable changes were observed in LV function, blood flow in the aorta before and after the surgery, and maximum velocity and flow volume after surgery. During the 6-month follow-up after the surgery, the maximum velocity and flow volume in the aorta and vascular access were reduced; also, indicators such as LV volume, cardiac output, cardiac index, and LV mass were improved. In patients with high-flow AVF, flow reduction surgery should be considered as it may improve LV function and reduce the risk of AD recurrence by lowering the flow volume of the aorta.