bluuebunny/crossref_metadata_2025 huggingface dataset:
Formulation, Development, Evaluation and Solubility Enhancement of Lercanidipine Hydrochloride by Solid Dispersion Techniques
Authors: Mankar S. D. , Rachh Punit R.
Published: December 2021

Background: Solid dispersions (SDs) are the dispersion of hydrophobic drugs in an inert hydrophilic carrier. SDs are prepared to improve the dissolution properties and bioavailability of slightly water-soluble drug molecules by dispersing them into an inert hydrophilic carrier.

Aims and Objective: Evaluate the dissolution and solubility of Solid Dispersion of Lercanidipine Hydrochloride (LER).

Materials and Methods: To study the effect of polymer, dissolution and solubility studies were carried out. Solid state characterizations of prepared solid dispersions were performed by differential scanning calorimetry (DSC).Drug- carrier interactions were studied by FT-IR spectroscopy, whereas X-ray diffraction of powder was done to demonstrate the crystal structure of the dispersions.

Results: The prepared solid dispersion exhibited 94% drug release at 30 minutes which is higher than both LER pure and LER MKT. Better dissolution characteristic of solid dispersion was confirmed by 9.86 min MDT and 63.12% DE30 which is higher than that of LER MKT (13.64 MDT, 46.92 % DE30) Solid state characterization revealed that enhancement of dissolution is the result of conversion of crystalline form of LER to less crystalline and/or amorphous form.

Conclusion: Solid dispersion of LER can successfully be prepared with the PEG6000 in the ratio of 1:6 using solvent evaporation technique. It is a successful and easy approach for the increase in onset of action of drug after administration and facilitates treatment of cardiovascular diseases.
Assessment of Knowledge and Practices on Effective Hand Hygiene among Rural and Urban Population of South India: A Web Based Cross Sectional Survey
Authors: Ishrar S. M. G. , Nagavalli C. , Reddy V. Vikas , Navya G.
Published: December 2021

Aims: The study aims to assess the level of awareness regarding Hand hygiene among the population in urban and rural areas of South India.

Study Design: A web based cross sectional survey.

Place and Duration of Study: An online study was conducted among public of South India for a period of 6 months.

Methodology: The data was collected through online mode by providing google link to fill questionnaire form through various social media platforms. The questionnaire consists of demographic details, knowledge and practice related questions. SPSS was used to interpret data and chi-square test, independent T test, backward multiple regression analysis was done.

Results: From the collected data a total of 1178 responses were collected (urban:726, rural:452). From independent T test the knowledge mean score of HH was: 10.07±2.136 for urban population and 9.79±2.138 for rural population. By this urban population has more knowledge than rural population. From backward multiple regression analysis of Knowledge score, the findings shown that the urban male residents with 2 members household residing in Tamilnadu have preferably more knowledge than others when compared with demographic details. From the independent T test the HH practice mean score was 11.25±1.991 for urban residents and 10.77±2.280 for rural residents. From the Backward multiple regression analysis of Practice score, the findings shown that most parsimonious combination of region (rural, urban), age group (10-30 years, 30-60 years and >60 years), gender(female, male), state and UT (Andhra Pradesh, Karnataka, Tamilnadu, Kerala, Telangana, Andaman and nicobar, Puducherry, Lakshadweep), household (2, 3, 4, >4 members), education level (10 and below 10, intermediate, UG, PG, Ph. D) in predicting the practice score.

Conclusion: The study results concluded that urban residents have preferably more knowledge than rural residents. Creative campaigns and awareness programs should be conducted to attain persistent improvement in HH practices.
Development of Scientifically-based Approaches to the Design of Food Products for Herodietic Purposes
Authors: Varivoda A. A. , Kenijz N. V. , Dadueva M. V. , Davidyan D. K. , Pshikhopova M. Z. , Kirichenko I. S. , Basova N. Y.
Published: December 2021

The study conducted a detailed analysis and provides data on the demographic situation in the world, as well as in the Russian Federation, concluded that the trend of rapid aging. Nutrition refers to the most important factors of the influence of the external environment on the state of health, working capacity and life expectancy of a person. For this reason, every person needs high-quality and specialized nutrition that will fill all the needs of the body in nutrients, namely proteins, lipids, carbohydrates, vitamins and mineral elements. This scientific article analyzes and systematizes approaches to ensuring the nutritional needs of people of older age groups and recommends ratios in the composition of diets according to gender and age characteristics. The standards of energy and nutritional requirements for various groups of the population are analyzed. The problems associated with the development of the production of products for the elderly are investigated and promising directions of their production are established. It is determined that the most social problem for the elderly is providing the body with biologically and physiologically valuable substances, in particular macro - and microelements, vitamins, essential amino acids, the presence and ratio of which has a significant impact on the processes of metabolism and assimilation by the body.
Computational Analysis for Physicochemical Properties of Compounds in Senna auriculata Leaves Methanolic Extract to have Antidiabetic Potentials and their Molecular Interaction with α-amylase
Authors: Dukhyil Abdulaziz Bin
Published: December 2021

Aims: Diabetes mellitus (DM) is chronic disorder well known for increased glucose level in blood. This disease can be controlled by inhibiting the enzyme (e.g., α-amylase) involve in carbohydrate hydrolysis. Senna auriculata leaves methanolic extract (SALME) have potential antidiabetic properties and it was also found to be safe in preclinical studies. In this study the aim was to explore the molecular interactions of α-amylase and bioactive compounds in SALME and their physicochemical properties.

Methodology: Computational approach such as molecular docking and physicochemical analysis prediction was applied to understand the antidiabetic potential of natural compounds present in SALME.

Results: The results showed from physicochemical analysis that out of 11 only 7 compounds are having drug like properties which are orally and intestinally better bioavailable. Furthermore, molecular docking analysis explained that three compounds (C3, C4, and C7) have lower binding energy, ΔG (-8, -9.1, -9.5 kcal/mol) and better binding affinity, Ki (7.31 x 105, 4.68 x 106, and 9.2 x 106 M-1, respectively) than the acarbose ΔG (-7.8 kcal/mol) and Ki (6.18 x 105 M-1), a well-known FDA approved medication for DM. The study also explained the binding pattern that the catalytic residue such as Asp197, Glu233 and Asp300 are involved in stabilizing the natural compounds with in the catalytic active site of target enzyme.

Conclusions: From the results it has been concluded that these three compounds found in SALME have better inhibitory potential for α-amylase in comparison with acarbose. Further validation of the findings is required through molecular dynamics simulation, ADME-T study, and in-vitro enzyme inhibition by the purified compounds.
Effectiveness of Water, Sanitation and Hygiene (WASH) Intervention for School going Children on Hygiene Practices, Absenteeism, Diarrhea, and Respiratory Infection: An Interventional Study Protocol
Authors: Dakhode Sarika , Gaidhane Abhay
Published: December 2021

Introduction: Safe drinking water, sanitation and hygiene beyond the household, and particularly in the school setting, are crucial to the health and education of children. Ashram schools where children from tribal community are taking education in India are mostly ignored. Thus, inclusion of water, sanitation and hygiene (WASH) in schools as part of the SDG, necessitates assessing the coverage and utilization in all types of schools; Government, private, funded including Ashram (residential) schools. Hence, we plan this research to study the effectiveness of proposed WASH in Ashram school with regards to hygiene practices, diarrheal diseases, respiratory infection and school absenteeism.

Methods: Interventional study will be conducted in all eight Ashram schools of Wardha district. Baseline data regarding WASH practices and absenteeism, diarrhea, and respiratory infection will be collected. Intervention model for adopting safe WASH practices will be developed implemented in randomly selected four ashram schools. Survey and interview questionnaire will be adopted from UNICEF monitoring package modules. Children of forth, fifth and sixth classes (460), teachers, and Principles(8) will be interviewed; and school environment will be reviewed. After collection of post intervention data in ODK tool, descriptive statistics, two-sample t-tests and unadjusted mean percentages for all outcome variables were calculated by aggregating individual-level data to the school level.

Conclusion: The intervention package is based on community mobilization and participation; life skill education, capacity building of school staff related to WASH. This will contribute to bring long term changes and improvement in health status and academic performance of school children.
Metastasis Relapse in Synovial Sarcoma of Parotid Gland Followed by Neuropathies and Tissue Damage: A Case Report
Authors: Babar Quratulain , Obeagu Emmanuel Ifeanyi , Udenze Chikwendu Lawrence , Ifionu Bart I. , Vincent C. C. N. , Okafor Chukwuma J. , Nwobodo Emmanuel Ikechukwu , Ibe C. O. C.
Published: December 2021

Synovial sarcomas are a heterogeneous group of tumors, accounting for 1-2% of adult cancers worldwide. Formation of synovial sarcoma after tissue and nerve injury, radiations induced neuropathies and latent metastasis is those events which are still controversial and need more research. In this report, we present the case of an 18-year-old female patient who developed synovial sarcoma followed by a punch to the face. MRI showed lobulated lesion of 4x3cm appreciated in left parotid space. In spite of Parotidectomy, radiotherapy and radiosurgery followed by MRI and CT-scan latent metastasis was raised in lungs which leads to demise of patient. There are numerous potential etiologic and neurological factors for the development of latent metastasis in synovial sarcoma. Here we will summarize all factors and its complications according to the current literature.
Role of IL-33 and IL-1α in Ovarian Cancer Metastasis
Authors: Parveen Gulshan , Qadir Aaisha , Sarfraz Abubakar , Butt Ahmad Farooq , Aftab Rubab , Laghari Qurrat-Ul-Ain , Hadi Faheem , Sumreen Laila , Ali Qurban , Altaf Awais , Sattar Huma , Naz Anam , Arooj Mahwish , Malik Arif
Published: December 2021

Aim: The current study conducted with aims to evaluate the levels of various inflammatory cytokines in women affected by ovarian cancer.

Methods: Case-control study was conducted from 1st January 2018 to 4th March 2018 among women affected by ovarian cancer in Institute of Molecular Biology and Biotechnology, The University of Lahore, Pakistan. Ovarian cancer patients (n=50) and control individuals (n=50) were included in present study. Serum was separated from patients and control individuals from which levels of various interleukins (IL-6, IL-33, IL-8, IL-10, IL-1α) and TNF-α were measured by ELISA kit method.

Results: The results of present study explain that increased levels of IL-10, IL-6, IL-8 and TNF-α were recorded in women affected by ovarian cancer in contrary with control individuals. Elevated trend of IL-33 and IL-1α were recorded in ovarian cancer patients (9.02±2.55 pg/ml and 8.44±2.55 pg/ml) in contrary with healthy group (3.88±1.02 pg/ml and 3.56±1.32 pg/ml) with statistical significant p-value=0.000.

Conclusion: Study has concluded that inflammatory cytokines particularly IL-1α and IL-33 are major source of inflammatory pathway in the development of ovarian cancer invasion, proliferation and metastasis.
Awareness of Diabetic Foot and its Risk Factors in the General Population of Arar, Northern Saudi Arabia
Authors: Abukanna Abdelrahman Mohamed Ahmed , Alshamlani Ghaida Abdullah R. , Sultan F. Alenezi,Ahlam , Alanazi Reham Arif A. , Alanazi Shahad Fahis A.
Published: December 2021

Background: Foot ulcers may be complicated to toe amputation or limb amputation which can be prevented by patient education on self-management and appropriate foot care procedures.

Study Objectives: The objective of this study is to determine the awareness of diabetic foot and its risk factors among the general population of Arar city, Northern Saudi Arabia.

Methods: An analytical cross-sectional study was carried out in primary health care centers in Arar, Northern Saudi Arabia, during the period from 1st September to 10th October 2021. Data was collected by personal interview with the attendees of the primary health care center, using a predesigned questionnaire.

Results: Almost 60% of participants have knowledge about diabetic foot. The Source of information about diabetic foot was doctors and nurses in 13% and 11.9% social media in our study population. 62.7% know that diabetic foot risk may be reduced by controlling blood sugar level, 13% by checking the feet every day and several times a day, and 9.2% reported wearing shoes and socks on a daily basis. 65.6%, 66.7%, 48.4%, 82.6% and 62.1% knew that skin infections, foot abscess, bone infections, gangrene, and foot deformity are complications of diabetic foot respectively. Good knowledge of diabetic foot was significantly associated with age and educational level but not with marital status.

Conclusion: The level of knowledge of diabetic foot and its related complications is relatively average. Due to the high incidence of diabetes mellitus (DM) in Saudi Arabia, it is vital that the population has appropriate information and awareness about this illness to enable continued promotion of public health measures to limit its prevalence. It is also crucial for DM patients to understand the medication and lifestyle modifications that may enable them to better regulate their blood glucose and prevent the complications.
Sacubitril/ Valsartan in Advanced Heart Failure: Is it Just a Matter of Contractility or are there Effects on the Pulmonary Circulation? A Real Life Monocentric Experience
Authors: Serra Walter , Bonura Rosario , Alabrese Renato , Ferretti Marco
Published: December 2021

Background: Sacubitril/valsartan (S/V), an angiotensin receptor neprilysin inhibitor (ARNI), is the first drug to demonstrate a mortality benefit in patients with chronic heart failure and reduced ejection fraction. S/v had a 20% reduction in the primary composite endpoint of cardiovascular death or heart failure hospitalization, compared with subjects receiving enalapril.  However, the mechanisms are not clear.  The aim of this prospective, non-randomized study was to assess the clinical and instrumental effects of this agent in patients with HFrEF and pulmonary hypertension.

Methods: To investigate the effects of S/V in HFrEF, we selected 40 consecutive patients (31 males, 9 females, mean age 64±19 years) in the NYHA class II-III, because they had left ventricular ejection fraction ≤35% at echocardiography. Etiology: 22 CHD, 3 Myocarditis, 15 IDCM.

Results: 2 patients took the maximum dose of 97/103 mg, 2 stopped the therapy due to a creatinine increase, all the others took the dose of 49/52 mg. During a mean ± SD follow-up of 24±6 months, no patients died. PASP decreased from 42.71 to 36 mm/Hg (p <0.0001); 6MWT improved from 402 m to 453 m (p <0.0001). Mean LVEF increased from 28.9% to 31.5% p <0.005); NYHA mean class improved from 1.95 to 1.70.  An AICD was implanted in 20 patients.

Conclusion: These preliminary data suggest that in patients with severe heart failure, S/V is able to improve 6MWT and PASP, even in the absence of a significant improvement of ventricular contractility. S/v may reduce the fluid retention and pulmonary vasoconstriction that contribute to heart failure symptoms.
Formulation Consideration and Skin Retention-Permeation Study of Insitu Nanogel Containing Dimethylfumarate for Treatment of Psoriasis
Authors: Patel Deepa , Patel Sneha
Published: December 2021

Aims and Objective: to develop and evaluate an insitu nanogel formulation containing dimethylfumarate for targeted topical delivery therapy of psoriasis.

Study Design: 32 full factorial design

Place and Duration of Study: Department of Pharmaceutics, Parul Institute of Pharmacy and Research, Parul University, Vadodara, between 2016 to 2019.

Methodology: Nanogel were formulated by chemical cross linked gel method using Polyvinyl alcohol and Hyaluronic acid (1:5) ratio using Glutaraldehyde (GA) (25 %w/v) and Hydrochloric acid (HCl) (6%v/v) as a crosslinking agent and catalyst. Dimethylfumarate loaded nanogel were clear and showed physicochemical parameters desired for topical delivery and stability.

Results: The Permeation profile of dimethylfumarate through rat skin from selected nanogel formulation exhibited highest skin uptake. The Micoscopic observations indicated that the optimized nanogel had n significant effect on the microscopic structure of the sin and epithelial cells appered mostly unchanged. The surface epithelium lining and the granular cellular structure of the skin were totally intact. The developed Nanogel may be a potential drug delivery vehicle for targeted topical delivery of dimethylfumarate in the treatment of psoriasis.

Conclusion: As per drug retention study the highest amount of drug retained on the skin and lowest amount of drug permeate to the skin. Hence it was observed that there was no signiﬁcant correlation between skin retention and skin permeation study.
Evaluation of the Diagnostic Utility of Geohelminths from Environmental and Stool Samples in Nnewi Metropolis
Authors: Obi Chioma Maureen , Akunna Anikpe Chinwoke , Oshim Ifeanyi Onyema , Unaeze Bright , Ugochukwu Okeke Monique
Published: December 2021

Background: Geohelminths are groups of four intestinal soil transmitted parasites.They are of public health concern due to their serious morbidity they cause in children which are the major groups affected.

Aim/Objective: The aim of this study is to evaluate the diagnostic performance of wet mount and concentration techniques of stool and soil samples for identification of geohelminths.

Methodology: Eighty stool samples were collected from four primary schools, while forty soil samples were collected from the important sites (playground, and classroom areas) in each of the school accessed. The stool samples were examined with the wet preparation and formol-ether concentration technique, while the soil samples were examined with the formol-ether concentration technique. Ethical approval was sought from the Faculty of Health Sciences and Technology. Results: The results of geohelminths showed an overall prevalence of 6.25% (5/80) from the stool samples, and 27.5% (11/40) obtained from the soil. Recovery rates from the stool showed the presence of only two geohelminth;Hookworm (5%) and Strongyloides stercoralis (1.25%). Out of the four schools examined only three showed positive results with geohelminth infections, while the remaining school showed positive results with only Giardia.lamblia. The recovery rates from the soil also showed the same pattern of distribution as with the stool but with a higher prevalence of Hookworm (20.7%) and Strongyloides stercoralis (7.5%) with the toilet areas showing the highest prevalence (50%). The dominant specie of geohelminth observed in both stool and soil was Hookworm. The results also showed that both male (6%) and female (6.7%) are susceptible to the infection with no significant difference between their prevalances (p>0.05).

Conclusion: The prevalence of Hook worm was poorly reported by wet mount technique.The diagnostic performance of concentration methods for the diagnosis of Hook worms in the samples was notably high as compared to wet mount techniques.
Value Chain Analysis of Namgang Chilli: The Produce of Pakshikha, Chukha, Bhutan
Authors: Gautam Khem Prasad , Ratna Rajnish , Dhakal Keshar Nath , Dhakal Hita Nath
Published: December 2021

Chilli is the most ubiquitous spice used in Bhutanese cuisine. Almost all dishes in Bhutan contain chillies in various forms. Bhutan produces many variants of chilli, one of which is Namgang chilli. Commonly known for being one of the hottest and tastiest variants in Bhutan, it is cultivated in Pakshikha, Bongo Gewog, Chukha. This study is aimed at identifying value chain actors of Namgang chilli, their roles, margins, and mapping out its overall value chain. The quantitative and qualitative data for this study were obtained from 29 of the 49 Namgang chilli-cultivating households in Pakshikha. Other published sources were also referred for gathering secondary data required for this study. The data were analysed using descriptive statistics, and chain mapping was performed to identify actors and their supply linkages. Margin analysis was conducted to assess the value gained by each player in the value chain. The identified actors of the value chain were input suppliers, farmers, transporters, retailers, and consumers. Farmers, retailers, and transporters share 53.6, 28.7, and 5 percentage of the margin respectively. Some of the critical constraints and challenges faced by farmers are rising pest infestation; lack of awareness about modern tools and techniques; lack of agency support; lack of motivation and encouragement for mass commercial farming; no initiative for organizing farmers’ cooperative/group; and ack of crop protection mechanism. The findings suggest that the overall value chain of Namgang chilli is underdeveloped. Therefore, relevant agencies should intervene and encourage farmers to form groups/cooperatives for Namgang chilli cultivation. The chilli farmers could be provided with technical supports in the form of knowledge and training to improve efficiency in the production and marketing of the commodity.
Resource Based Conflict and Climate Change in the Niger Delta Region, Nigeria
Authors: Ogele Eziho Promise
Published: December 2021

The study examined the effects of climate change on the local economy occasioned by resource-based conflict in the Niger Delta region, Nigeria. The alteration in weather conditions in the Niger Delta region is associated with anthropogenic activities of the transnational oil companies for over five decades in the Niger Delta region, Nigeria. Despite the degree of oil exploration and exploitation, the Niger Delta region remained underdeveloped in social amenities. The inhabitants were deprived and alienated from the Petrodollar benefits. The launching of artisanal refining by the locals as a way of getting from Petro Dollar business became inevitable. These activities have increased greenhouse gas emission leading to the alteration in weather conditions in the Region Sadly, the Joint Military Task Force deployed to monitor and arrest culprit bombard and burn down the artisanal refining equipment unprofessionally, thereby increasing greenhouse gas emission into the atmosphere. Given the above, the Niger Delta inhabitants are experiencing alteration in weather condition leading to poor agricultural harvest.  The study adopted Frustration/Aggression theoretical as its framework. The study relied on primary through questionnaires and interview, while secondary sources data was through journals, books, newspapers, among others. The study unraveled that resource-based conflict occasioned deprivation and frustration increased greenhouse gas emission. The study recommends amongst others convening a climate change summit that will involve all the stakeholders in the oil activities in the Region.
A degradação enquanto face da modernização, que avança sobre os territórios pesqueiros
Authors: De Paula Cristiano Quaresma
Published: December 2021

O artigo busca compreender como a face da degradação se evidencia nos territórios e territorialidades da pesca artesanal brasileira. A análise das faces da modernização se estabelece metodologicamente a partir do diálogo entre propostas e abordagens da Geografia, e relatos ou denúncias dos movimentos sociais da pesca. A face da degradação resulta de impactos ambientais, disputas no território e conflitos por território, tem o conceito de ambiente como preponderante e recai principalmente em territórios pesqueiros. Portanto, é necessário compreender como o processo de transfiguração da natureza se evidencia em diferentes contextos do Brasil, de forma correlacionada aos processos de territorialização e desterritorialização da pesca. A análise de contextos geradores como industrialização, urbanização, atividades relacionadas ao agronegócio e mineração, expõe táticas de ofensivas em territórios tradicionais.
Enter the Physicianeers—How They Will Transform Health Care
Authors: Pettigrew Roderic Ivan
Published: January 2025

This Viewpoint discusses the potential for the integration of medicine and engineering to solve major problems in health care and the programs that are training these new physicianeers.
Cost-Effectiveness of Breast Cancer Screening Using Digital Mammography in Canada
Authors: Wilkinson Anna N. , Mainprize James G. , Yaffe Martin J. , Robinson Jessica , Cordeiro Erin , Look Hong Nicole J. , Williams Phillip , Moideen Nikitha , Renaud Julie , Seely Jean M. , Rushton Moira
Published: January 2025

Importance

Evolving breast cancer treatments have led to improved outcomes but carry a substantial financial burden. The association of treatment costs with the cost-effectiveness of screening mammography is unknown.

Objective

To determine the cost-effectiveness of population-based breast cancer screening in the context of current treatment standards.

Design, Setting, and Participants

In this economic evaluation, the Canadian Partnership Against Cancer/Statistics Canada OncoSim-Breast microsimulation model was used to estimate the impact of various screening schedules in terms of clinical outcomes and treatment costs. Breast cancer treatment costs were derived from activity-based costing published in 2023 specific to a publicly funded health system in Ontario, Canada. A single birth cohort of individuals assigned female at birth in 1975 was modeled until death or age 99 years (whichever came first).

Exposures

Five screening scenarios were modeled: no screening, biennial (ages 50-74 years and 40-74 years), hybrid (biennial ages 40-49 years and annual ages 50-74 years), and annual screening (ages 40-74 years).

Main Outcomes and Measures

Incremental cost-effectiveness ratios for deaths averted, life-years (LYs) gained, and incremental cost-utility ratios for quality-adjusted life-years (QALYs) gained were determined for screening scenarios. Sensitivity analyses were conducted by varying screening participation rates and reducing recall rates to 5% and the estimated mortality benefits of screening.

Results

Earlier initiation of breast cancer screening at age 40 years (vs age 50 years) was associated with improved clinical outcomes (deaths averted, LYs saved, and QALYs gained) and reduced health care spending on breast cancer treatment. From a health system perspective, incremental cost-effectiveness ratios for biennial screening at ages 40 to 74 years compared with biennial screening at ages 50 to 74 years were cost saving, with CAD$49 759 saved per death averted, $1558 per LY saved, and $2007 saved per QALY gained. Annual screening at ages 40 to 74 years was cost-effective while achieving the best breast cancer outcomes, with costs of $25 501 per death averted, $1100 per LY saved, and $1447 per QALY gained compared with the current Canadian standard of biennial screening at ages 50 to 74 years.

Conclusions and Relevance

In this economic analysis, although screening costs increased according to the number of lifetime screens, they were completely or largely offset by reduced breast cancer therapy costs. Digital mammography was a highly cost-effective tool to reduce breast cancer mortality. These results have important policy implications for all single-payer health systems and call for greater investment in screening programs.
Esophagectomy Trends and Postoperative Outcomes at Private Equity–Acquired Health Centers
Authors: Williams Jonathan E. , Schaefer Sara L. , Jacobs Ryan C. , Ibrahim Andrew M. , Odell David D.
Published: January 2025

Importance

Growing trends in private equity acquisition of acute care hospitals in the US have motivated investigations into quality of care delivered at these health centers. While some studies have explored comparative outcomes for high-acuity medical conditions, care trends and outcomes of complex surgical procedures, such as esophagectomy, at private equity–acquired hospitals is unknown.

Objective

To compare structural characteristics and postoperative outcomes following esophagectomy between private equity–acquired and nonacquired health centers.

Design, Setting, and Participants

This retrospective cohort study included Medicare beneficiaries aged 65 to 99 years who underwent elective esophagectomy at US health centers between January 1, 2016, and December 31, 2020. Health centers were designated as private equity acquired using the Agency for Healthcare Research and Quality Compendium of US Health Systems. Data were analyzed between October 15, 2023, and March 30, 2024.

Exposure

Patient cohorts were created based on whether they received care at private equity–acquired or nonacquired health centers.

Main Outcomes and Measures

The main outcome was 30-day postoperative complications, mortality, failure to rescue, and readmission using summary statistics and multivariable logistic regression.

Results

A total of 9462 patients (mean [SD] age, 72.9 [5.6] years; 6970 male [73.7%]) underwent esophagectomy during the study period, with 517 (5.5%) receiving care at private equity–acquired institutions. Annual procedure volume was lower at private equity–acquired hospitals vs nonacquired hospitals (median, 2 [IQR, 1-4] vs 7 [IQR, 3-15] procedures per year). Compared with patients treated at nonacquired hospitals, patients treated at private equity–acquired hospitals had significantly higher 30-day mortality (8.1% [95% CI, 5.8%-10.3%] vs 4.9% [95% CI, 4.5%-5.3%]; odds ratio [OR], 1.82 [95% CI, 1.25-2.64]; P = .002), any complications (36.6% [95% CI, 32.9%-40.3%] vs 30.1% [95% CI, 29.2%-30.9%]; OR, 1.46 [95% CI, 1.18-1.80]), serious complications (17.5% [95% CI, 14.5%-20.6%] vs 14.3% [95% CI, 13.7%-15.0%]; OR, 1.34 [95% CI, 1.03-1.77]; P = .03), and failure to rescue (5.9% [95% CI, 3.9%-7.9%] vs 3.4% [95% CI, 3.1%-3.8%]; OR, 1.86 [95% CI, 1.22-2.84]; P = .004).

Conclusions and Relevance

These findings suggest that patients who undergo esophagectomy at private equity–acquired hospitals may be at risk for worse outcomes. Further understanding of the drivers of these outcomes is needed to improve performance and inform policy pertaining to care allocation for select surgical conditions.
Dynamic Redox Induced Localized Charge Accumulation Accelerating Proton Exchange Membrane Electrolysis
Authors: Chang Bin , Ren Yuanfu , Mu Nan , Zuo Shouwei , Zou Chen , Zhou Wei , Wen Linrui , Tao Huabing , Zhou Weijia , Lai Zhiping , Kobayashi Yoji , Zhang Huabin
Published: January 2025

The sluggish anodic oxygen evolution reaction (OER) in proton exchange membrane (PEM) electrolysis necessitates applied bias to facilitate electron transfer as well as bond cleavage and formation. Traditional electrocatalysis focuses on analyzing the effects of electron transfer, while the role of charge accumulation induced by the applied overpotential has not been thoroughly investigated. To explore the influence mechanism of bias‐driven charge accumulation, capacitive Mn is incorporated into IrO2 to regulate the local electronic structure and the adsorption behavior. The applied bias triggers dynamic redox reactions at the active sites, which introduce local charge accumulation on the surface of electrocatalyst. Under bias, Mn oxidation induced a noticeable pseudocapacitance in the pre‐OER region, promoting the OER kinetics of iridium sites. Meanwhile, the increased oxygen vacancy formation energy further prevents the lattice oxygen activation. The PEM electrolyzer, equipped with optimal materials as an anode, operates at a low driving voltage of 1.637 V under 2.0 A cm−2, maintaining stable performance for over 800 h with a low degradation rate (19.4 µV h−1). This work provides insights into the performance of metal oxide catalysts in acidic environments and offers forward‐looking strategies for enhancing the catalytic performance through dynamic redox induced capacitive behavior.
High‐Entropy Metal Interstitials Activate TiO2 for Robust Catalytic Oxidation
Authors: Liu Xiao‐Cheng , Wu Geng , Han Xiao , Wang Yang , Wu Bei , Wang Gongming , Mu Yang , Hong Xun
Published: January 2025

Substitution metal doping strategies are crucial for developing catalysts capable of activating O2, but the leaching of metal dopants has greatly hindered their potential for extensive oxidation reactions under mild conditions. Here, the study develops an entropy‐increase strategy to synthesize high‐entropy metal (Mg, Ca, Mn, Fe, and Co) interstitial functionalized anatase TiO2 (HE‐TiO2) nanosheets, demonstrating remarkable degradation efficiency across a wide pH range and exceptional stability in a flow‐by electro‐catalytic reactor. Relative to that of pristine TiO2, the intense lattice distortion on the (001) plane, an average lattice expansion of 2% on the (100) plane, and decrease of second shell peak of X‐ray absorption spectra serve as compelling evidence for the formation of metal interstitials in HE‐TiO2. Theoretical analysis and in situ synchrotron radiation Fourier transform infrared studies reveal that the electron of metal interstitials can populate the subgap states within the host TiO2, enabling a moderate adsorption band for robust and efficient O2 activation. This study introduces a universal strategy for synthesizing a novel class of high‐entropy materials with integrated metal interstitials in metal oxides, promising to enhance the stability and efficiency of O2 activation catalysts and broaden their potential applications.
Topological Insulator Heterojunction with Electric Dipole Domain to Boost Polysulfide Conversion in Lithium‐Sulfur Batteries
Authors: Chen Hedong , Qiu Yecheng , Cai Zhiyuan , Liang Wenhao , Liu Lin , Li Manman , Hou Xianhua , Chen Fuming , Zhou Xunzhu , Cheng Tengfei , He Liqing , Wang Jiazhao , Zhang Xiao , Dou Shixue , Li Lin
Published: January 2025

The heterojunction materials are considered as promising electrocatalyst candidates that empower advanced lithium‐sulfur (Li−S) batteries. However, the detailed functional mechanism of heterojunction materials to boost the sulfur redox reaction kinetics remains unclear. Herein, we construct a multifunctional potential well‐type Bi2Te3/TiO2 topological insulator (TI) heterojunction with electric dipole domain to elucidate the synergistic mechanism, which facilitates rapid mass transport, strengthens polysulfide capture ability and accelerates polysulfide conversion. Therefore, the Li−S battery with Bi2Te3/TiO2 TI heterojunction modified separator achieves high utilization of sulfur cathode, delivering a high reversible specific capacity of 1375 mAh g−1 at 0.2 C and long cycling capability with a negligible capacity decay of 0.022 % per cycle over 1000 cycles at 1 C. Even with the high sulfur loading of 13.2 mg cm−2 and low E/S ratio of 3.8 μL mg−1, a high area capacity of 11.2 mAh cm−2 and acceptable cycling stability can be obtained. This work provides guidance for designing high‐efficiency TI heterojunctions to promote the practical application of Li−S batteries.
Initiator‐Free Thiol‐Aldehyde Photo Polycondensation
Authors: Tian Wangmao , Wang Jie , Jin Yu , Cheng Yaming , Yan Kangle , Hu Chengcheng , Chen Cheng , Wang Baoxia , Wang Zhongkai , Yuan Liang
Published: January 2025

Traditional photopolymerizations generally require an initiator for initiating the polymerization while few cases have created degradable chemical bonds. Moreover, the migration instability and cytotoxicity of photo initiators are posing issues to human health and the environment. In this work, we discovered an initiator‐free photo polycondensation system (IFPPC) between polymercaptans and aldehyde monomers, producing elastic and high strength plastic materials with exchangeable and degradable dithioacetal groups. IFPPC proceeds through a radical mechanism and is applicable in producing linear polymers and crosslinked networks. Nano‐composites can also be obtained via an organic solvent‐free Pickering emulsion polymerization using cellulose nanofibers as the stabilizer. The dithioacetal groups afford excellent stability under hydrolytic conditions and repeated thermal processing of cross‐linked polymers, while their cleavage in aqueous solution of salts (silver nitrate, zinc iodide, copper bromide, etc.) results in fast degradation for recovering the aldehyde monomer. This is a successful demonstration of producing recyclable and degradable plastics through photo irradiation while avoiding the problematic issues of photo initiators.
New Route to Cycloplatinated N‐Heterocyclic Carbene Complexes via Iodide Assisted C‐H Activation and Proton Transfer
Authors: Jia Wei‐Guo , Xie Xiao‐Die , Wang Kun , Yin Di , Zhong Rui , Lee Richmond
Published: January 2025

A convenient strategy to access cyclometalated platinum (II) N‐heterocyclic carbene (NHC) complexes is reported herein, synthesized by treating a Pt (NHC)I2Py precursor with Schiff‐base (N^O) ligands in the presence of K2CO3 base under mild reaction conditions. These cyclometalated Pt(II) NHC complexes were fully characterized by 1H and 13C NMR, mass spectrometry, and infrared spectroscopies, and the solid‐state molecular structures of complexes 1, 2b, and 3b were unambiguously determined by single‐crystal X‐ray diffraction methods. To form these complexes, C‐H bond activation and C‐N cleavage and cycloplatination had to occur. In a bid to understand this transformation, density functional theory was carried out to rationalize the cycloplatination mechanism unveiling an intriguing anion assisted C‐H activation and proton transfer process.
N‐Alkyl Chain Induced Molecular Aggregation in Mononuclear Gold(I)‐N‐Heterocyclic Carbene Complexes for Blue Light Emitting Applications
Authors: Muduli Gopendra , Vaddamanu Moulali , Sathyanarayana Arruri , Siddhant Kumar , Rawat Arushi , Hisano Kyohei , Tsutsumi Osamu , Prabusankar Ganesan
Published: January 2025

The gold(I) N‐heterocyclic carbene (NHC) molecule exhibits outstanding luminescent properties along with high thermal stability due to its strong carbene gold bond. Gold(I)‐NHC complexes are known to emit green to yellow color, while blue emission is limited. Herewith, we report the photoluminescence and thermal stability correlation between blue emitting mononuclear gold(I)‐NHC chloride complexes, N‐(9‐anthracenyl)‐N’(n‐alkyl)imidazol‐2‐ylidene gold(I) chloride (alkyl=n‐butyl (1), n‐pentyl (2), n‐hexyl (3)). These complexes were synthesized by transmetallation route and characterized by FT‐IR, NMR, TGA, and single crystal X‐ray diffraction analysis. The solid‐state study reveals a unique molecular packing due to hydrogen bonding, aurophilic interaction, and CH⋅⋅⋅π interactions in all 1–3. In addition, the π⋅⋅⋅π stacking has been found in 1. All these complexes show good thermal stability due to the strong metal‐ligand bond strength along with crystal packing. In addition, 1–3 emits a blue colour in both solution and crystalline state. The quantum yield in the crystalline state was found to be higher for 1 (22.44 %) compared to 2 (9.90 %), and 3 (14.98 %). A similar high quantum yield for blue‐emitting gold(I)‐NHC chloride complex is rare. This promising quantum yield for 1 can be ascribed to the crystal packing effect. The theoretical calculations were carried out to understand the electronic and structural properties of 1–3. Computational studies revealed the origin of the luminescence behaviour of complexes. The blue light emitting thin film and LED are demonstrated using 1 exhibited the emission peak at the blue region with Commission Internationale de L'Eclairage (CIE) coordinates near the National Television Standards Committee (NTSC) value.
Unravelling the Role of Sterically Encumbered Ligands in Tuning the Magnetic Properties of Lanthanide‐Based D5h Single‐Ion Magnets
Authors: Ghatak Aheli , Bhatt Gargi , Rana Rajanikanta , Gupta Sandeep K. , Meyer Franc , Rajaraman Gopalan , Murugavel Ramaswamy
Published: January 2025

Isostructural Dy(III) and Er(III) complexes [L12Ln(H2O)5][I]3 ⋅ L12 ⋅ (CH2Cl2) (Ln=Dy (1), Er (3)) and [L22Ln(H2O)5][I]3 ⋅ L22 ⋅ (CH2Cl2)2 (Ln=Dy (2), Er (4)), with distorted pentagonal bipyramidal geometry (D5h) around the central metal were synthesized by utilizing two bulky phosphonamide ligands, adamantyl phosphonamide, (Ad)P(O)(NHiPr)2 (L1) and carbazolyl phosphoramide (Cz)P(O)(NHiPr)2 (L2). The resultant complexes were investigated for their magnetic properties in order to elucidate the impact of modification of the coordinating P−O bond environment either by increasing steric bulk and/or introduction of a third P−N bond at the central phosphorus atom. Magnetic studies revealed substantial energy barriers (Ueff) of 640 K and 491 K for Dy compounds 1 and 2, respectively, rendering them as some of the best‐performing air‐stable SIMs amongst the class of SIMs with D5h symmetry. Compounds 1 and 2 exhibit magnetization blocking (TB) at 6.5 K and 6 K, respectively, at a sweep rate of 20 Oe/s. Compound 1 benefits from increased lattice intermetallic distances due to bulky adamantyl substituent, but exhibits a significant deviation from linear axial (P)O−Dy−O(P) geometry (173.7(1)°). In addition to the deviation from linearity, the incorporation of a bulky adamantane (or carbazole) ligand in complex 1 (or 2) was found to result in relatively strong Dy…H−C agostic interactions, with distances of 3.698 Å (3.376 Å). These interactions are expected to induce transverse anisotropy. Ab initio CASSCF/RASSI‐SO/SINGLE_ANISO calculations offer valuable insights into the dynamics of magnetic relaxation and the impact of axial bulkiness on the anisotropy of D5h systems. Beyond highlighting the crucial role of crystal field and symmetry in achieving high‐temperature SIMs, this study also explores how the secondary coordination sphere can be engineered to create novel SIMs.
Prostate Cancer Patients' Perceptions Regarding the Relevance of a Digital Rectal Examination During Their Follow‐Up After Radiation Therapy
Authors: Klein Clément , Bosc Ninon , Marty Sylvie , Calen Laura , Debard Candice , Robert Grégoire , Haaser Thibaud
Published: January 2025

Background

Prostate cancer is an example of the undervaluation of clinical examinations in care of patients. After external radiotherapy, cancer recurrence is primarily determined biologically by measuring prostate‐specific antigen concentration. Consequently, there is no systematic requirement for the digital rectal examination (DRE). Nevertheless, research has shown that patients attach both practical and symbolic significance to being examined by their physicians. This study aimed to assess how patients perceive DRE omission after prostate cancer radiation therapy.

Materials and Methods

We conducted a survey of 107 men in remission after radiotherapy for prostate cancer in the Radiotherapy Oncology Department of Bordeaux University Hospital, France. The aim of the survey was to assess the significance that patients place on undergoing a DRE as part of their follow‐up care, both from a practical perspective (medical relevance) and a symbolic perspective (influence on the perception of the treating radiation oncologist).

Results

Despite receiving information on the lack of relevance of DRE during follow‐up, 40 of the 100 respondents still perceived a practical benefit of undergoing DRE (pragmatic dimension). On a symbolic level, many patients associated the performance of DRE by their radiotherapy oncologist with impressions of competence, concern for their health and concern for them personally (61%, 63% and 64%, respectively). Although the correlations between the pragmatic and symbolic dimensions were significant, more than one‐third of patients who understood the lack of clinical relevance of DRE still attributed symbolic value to it.

Conclusions

A positive perception of DRE persists among patients, mainly at the symbolic level, including a proportion of patients who understand the low clinical utility of DRE. Importantly, the persistence of these perceptions regarding DRE should not be misconstrued as justification for performing pelvic examinations without clear clinical reasons.
Tandem Versus Single Autologous Stem Cell Transplantation for High‐Risk Multiple Myeloma in the Era of Novel Agents: A Real‐World Study of China
Authors: Dou Xuelin , Ren Juan , Li Jiangtao , Liu Xiaodan , Bao Li , Chen Yuan , Zhao Peng , Zhong Yuping , Peng Nan , Wen Lei , Cao Leqing , Liu Yang , Deng Daoxing , Wang Fengrong , Wang Liru , Liu Hui , Huang Xiaojun , Mo Xiaodong , Lu Jin
Published: January 2025

Background

This study compares the efficacy and safety of single autologous stem cell transplantation (ASCT) versus tandem ASCT for multiple myeloma (MM) patients in the era of novel agents.

Methods

A total of 112 high‐risk MM patients were included (single ASCT, (n = 57) or tandem ASCT(n = 55) in this retrospective multicenter study. Responses and outcomes were evaluated.

Results

At 100 days after ASCT1 and ASCT2, 36 (63.2%) versus 45 (81.8%) patients achieved sCR/CR, 16 (28.1%) versus 7 (12.7%) patients achieved VGPR, and 5 (8.8%) versus 1 (1.8%) patient achieved PR, respectively, in the single and tandem ASCT cohorts. The 3‐year cumulative incidence of non‐relapse mortality and disease progression was 0% versus 7.3% (p = 0.083), and 45.8% versus 25.8% (p = 0.039), respectively, for the single and tandem ASCT cohort. The tandem ASCT cohort showed a trend of better 3‐year probability of PFS (58.1% vs. 64.7%, p = 0.064) compared with the single ASCT cohort. In multivariate analysis, ultra high‐risk and achieving<VGPR response after ASCT1 were associated with an inferior PFS. Ultra high‐risk was also associated with an inferior OS.

Conclusions

Tandem ASCT demonstrated improved outcomes compared to single ASCT in high‐risk MM patients receiving triplet or quadruplet induction and maintenance therapy. However, patients with ultra high‐risk cytogenetics may require innovative therapeutic approaches, as tendem ASCT does not overcome their adverse prognosis.