bluuebunny/crossref_metadata_2025 huggingface dataset:
Unexpected intensive care unit admission after surgery: impact on clinical outcome
Authors: Cammarota Gianmaria , De Robertis Edoardo , Simonte Rachele
Published: February 2024

Purpose of review

This review is focused on providing insights into unplanned admission to the intensive care unit (ICU) after surgery, including its causes, effects on clinical outcome, and potential strategies to mitigate the strain on healthcare systems.

Recent findings

Postoperative unplanned ICU admission results from a combination of several factors including patient's clinical status, the type of surgical procedure, the level of supportive care and clinical monitoring outside the ICU, and the unexpected occurrence of major perioperative and postoperative complications. The actual impact of unplanned admission to ICU after surgery on clinical outcome remains uncertain, given the conflicting results from several observational studies and recent randomized clinical trials. Nonetheless, unplanned ICU admission after surgery results a significant strain on hospital resources. Consequently, this issue should be addressed in hospital policy with the aim of implementing preoperative risk assessment and patient evaluation, effective communication, vigilant supervision, and the promotion of cooperative healthcare.

Unplanned ICU admission after surgery is a multifactorial phenomenon that imposes a significant burden on healthcare systems without a clear impact on clinical outcome. Thus, the early identification of patient necessitating ICU interventions is imperative.
Perioperative management of patients on glucagon-like peptide-1 receptor agonists
Authors: Mizubuti Glenio B. , Ho Anthony M.-H. , Silva Leopoldo Muniz da , Phelan Rachel
Published: February 2024

Purpose of review

To summarize the mechanism of action, clinical outcomes, and perioperative implications of glucagon-like peptide-1 receptor agonists (GLP-1-RAs). Specifically, this review focuses on the available literature surrounding complications (primarily, bronchoaspiration) and current recommendations, as well as knowledge gaps and future research directions on the perioperative management of GLP-1-RAs.

Recent findings

GLP-1-RAs are known to delay gastric emptying. Accordingly, recent case reports and retrospective observational studies, while anecdotal, suggest that the perioperative use of GLP-1-RAs may increase the risk of bronchoaspiration despite fasting intervals that comply with (and often exceed) current guidelines. As a result, guidelines and safety bulletins have been published by several Anesthesiology Societies.

While rapidly emerging evidence suggests that perioperative GLP-1-RAs use is associated with delayed gastric emptying and increased risk of bronchoaspiration (particularly in patients undergoing general anesthesia and/or deep sedation), high-quality studies are needed to provide definitive answers with respect to the safety and duration of preoperative drug cessation, and optimal fasting intervals according to the specific GLP-1-RA agent, the dose/duration of administration, and patient-specific factors. Meanwhile, clinicians must be aware of the potential risks associated with the perioperative use of GLP-1-RAs and follow the recommendations put forth by their respective Anesthesiology Societies.
Stress hyperglycaemia following trauma – a survival benefit or an outcome detriment?
Authors: Rugg Christopher , Schmid Stefan , Zipperle Johannes , Kreutziger Janett
Published: February 2024

Purpose of review

Stress hyperglycaemia occur often in critically injured patients. To gain new consideration about it, this review compile current as well as known immunological and biochemical findings about causes and emergence.

Recent findings

Glucose is the preferred energy substrate for fending immune cells, reparative tissue and the cardiovascular system following trauma. To fulfil these energy needs, the liver is metabolically reprogrammed to rebuild glucose from lactate and glucogenic amino acids (hepatic insulin resistance) at the expenses of muscles mass and – to a less extent – fat tissue (proteolysis, lipolysis, peripheral insulin resistance). This inevitably leads to stress hyperglycaemia, which is evolutionary preserved and seems to be an essential and beneficial survival response. It is initiated by damage-associated molecular patterns (DAMPs) and pathogen-associated molecular patterns (PAMPs), intensified by immune cells itself and mainly ruled by tumour necrosis factor (TNF)α and catecholamines with lactate and hypoxia inducible factor (HIF)-1α as intracellular signals and lactate as an energy shuttle. Important biochemical mechanisms involved in this response are the Warburg effect as an efficient metabolic shortcut and the extended Cori cycle.

Stress hyperglycaemia is beneficial in an acute life-threatening situation, but further research is necessary, to prevent trauma patients from the detrimental effects of persisting hyperglycaemia.
Improving morbidity and mortality in hip fragility fractures
Authors: Kelly Tara , Moore Brenden , George Renuka
Published: February 2024

Purpose of review

Hip fragility fractures (HFF) carry high morbidity and mortality for patients and will increase in frequency and in proportion to the average patient age. Provision of effective, timely care for these patients can decrease their morbidity and mortality and reduce the large burden they place on the healthcare system.

Recent findings

There are associative relationships between prefracture frailty, postoperative delirium and increased morbidity and mortality. The use of a multidisciplinary approach to HFF care has shown improved outcomes in care with focus on modifiable factors including admission to specialty care floor, use of peripheral nerve blocks preoperatively and Anesthesia and Physical Therapy involvement in the care team. Peripheral nerve blocks including pericapsular nerve group (PENG) blocks have shown benefit in lowering morbidity and mortality.

HFF are associated with >40% chance of continued pain and inability to return to prefracture functional status at 1 year as well as >30% mortality at 2 years. In this opinion piece, we will discuss how a multidisciplinary approach that includes Anesthesia as well as utilization of peripheral nerve blocks can help to lessen postoperative issues and improve recovery.
Can the Lower Extremity Functional Scale Be Used in Children and Adolescents? A Validation Study
Authors: Chua Yi Ling , Sheri Sonia , Yeo Beatrice Shu Qing , Lee Nicole Kim Luan , Ng Shin Huey , Lim Kevin Boon Leong
Published: February 2024

Background:

The lower extremity functional scale (LEFS) is a patient-reported outcome measure for assessment of lower extremity function. It has been validated in adults but not in children or adolescents.

Methods:

Patients 8 to 18 years of age who were treated for a lower limb fracture, injury, or other conditions were invited to join the study. LEFS and Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL) were administered. Reliability and validity of the LEFS were determined for the entire cohort and for 2 age groups (children: 8 to 12 years; adolescents 13 to 18 years) using PedsQL as comparison.

Results:

A total of 178 patients were recruited into this study. In the entire cohort, internal consistency of LEFS was excellent (0. 972) with acceptable floor (0%) and ceiling (12%) effects. Correlation between LEFS and PedsQL physical functioning component was high (r=0.859). Construct validity was acceptable, with all 8 hypotheses demonstrating statistical significance. Factor analysis showed that item 15 (sitting for 1 hour) may contribute to measurement error in the pediatric population. Results remained similar when comparing the 2 age groups.

Conclusions:

The LEFS is overall an acceptable patient-reported outcome assessment of children and adolescents with various lower limbs disorders.

Level of Evidence:

Level II.
Cardiac rehabilitation for heart failure: progress and gaps in evidence and policy
Authors: Ngo-Hamilton Alfred , Agakishiev Dzhalal , Maharaj Valmiki
Published: February 2024

Purpose of review

This review synthesizes recent research on the efficacy, optimal design, and delivery methods of cardiac rehabilitation tailored to heart failure patients. Despite established benefits, cardiac rehabilitation referral and access disparities persist, necessitating elucidation of limitations and solutions.

Recent findings

Exercise-based cardiac rehabilitation improves long-term mortality and hospitalization rates but not short-term mortality. cardiac rehabilitation further enhances quality of life and medical therapy adherence. However, cardiac rehabilitation relies on in-person delivery, presenting access barriers exacerbated during COVID-19. Significant geographic disparities exist, with analyses indicating current capacity only serves 45% of eligible US adults even if fully utilized. Referral rates also lag, disproportionately affecting women and minority groups. Research increasingly focuses on home-based and digital therapeutics modalities to expand reach, with evidence demonstrating comparable improvements across settings. Protocols and research center on heart failure with reduced ejection fraction (HFrEF), despite growing heart failure with preserved ejection fraction (HFpEF) prevalence.

Increasing referrals through standardized procedures and addressing multifactorial geographic, economic, and capacity limitations are imperative to ensure equitable cardiac rehabilitation access. Broadening HFpEF rehabilitation research and care standards also constitutes a critical practice gap requiring alignment with projected epidemiologic shifts. Advancing patient-centered, evidence-based solutions can promote rehabilitation as essential secondary prevention for wider cardiac populations.

Video abstract:

http://links.lww.com/HCO/A97
Performance of ChatGPT in Diagnosis of Corneal Eye Diseases
Authors: Delsoz Mohammad , Madadi Yeganeh , Raja Hina , Munir Wuqaas M. , Tamm Brendan , Mehravaran Shiva , Soleimani Mohammad , Djalilian Ali , Yousefi Siamak
Published: February 2024

Purpose:

The aim of this study was to assess the capabilities of ChatGPT-4.0 and ChatGPT-3.5 for diagnosing corneal eye diseases based on case reports and compare with human experts.

Methods:

We randomly selected 20 cases of corneal diseases including corneal infections, dystrophies, and degenerations from a publicly accessible online database from the University of Iowa. We then input the text of each case description into ChatGPT-4.0 and ChatGPT-3.5 and asked for a provisional diagnosis. We finally evaluated the responses based on the correct diagnoses, compared them with the diagnoses made by 3 corneal specialists (human experts), and evaluated interobserver agreements.

Results:

The provisional diagnosis accuracy based on ChatGPT-4.0 was 85% (17 correct of 20 cases), whereas the accuracy of ChatGPT-3.5 was 60% (12 correct cases of 20). The accuracy of 3 corneal specialists compared with ChatGPT-4.0 and ChatGPT-3.5 was 100% (20 cases, P = 0.23, P = 0.0033), 90% (18 cases, P = 0.99, P = 0.6), and 90% (18 cases, P = 0.99, P = 0.6), respectively. The interobserver agreement between ChatGPT-4.0 and ChatGPT-3.5 was 65% (13 cases), whereas the interobserver agreement between ChatGPT-4.0 and 3 corneal specialists was 85% (17 cases), 80% (16 cases), and 75% (15 cases), respectively. However, the interobserver agreement between ChatGPT-3.5 and each of 3 corneal specialists was 60% (12 cases).

Conclusions:

The accuracy of ChatGPT-4.0 in diagnosing patients with various corneal conditions was markedly improved than ChatGPT-3.5 and promising for potential clinical integration. A balanced approach that combines artificial intelligence–generated insights with clinical expertise holds a key role for unveiling its full potential in eye care.
Long-Term Outcomes of Keratoprosthesis With Biological Haptic: A Review of 25 Years of Single-Center Surgeries
Authors: Angerer Maximilian P. M. , Weller Julia M. , Kruse Friedrich E. , Hille Konrad
Published: February 2024

Purpose:

To study the outcome of eyes that underwent surgery for keratoprosthesis with a biological haptic, osteo-odonto-keratoprosthesis (OOKP) or tibia keratoprosthesis, by a single surgeon over a time span of more than 25 years.

Methods:

One hundred thirty eyes that had received a keratoprosthesis with a biological haptic between 1994 and 2022 by a single surgeon were included in this retrospective analysis. Main outcome parameters were postoperative best corrected visual acuity, postoperative refractive error, postoperative complications, anatomical and functional survival of the prosthesis as well as comparison of subgroups of the 2 different types (OOKP n = 78; tibia keratoprosthesis n = 52) of keratoprostheses, and subgroup analysis of different indications for surgery. Patients were examined every 6 months.

Results:

The longest follow-up was 25.8 years. Reasons for implantation were graft-vs-host disease (6.9%), vascularized corneas and dry eye (22.9%), physical or chemical burns (29.8%), Stevens–Johnson syndrome (9.9%), and ocular cicatricial pemphigoid (30.5%). The functional success rate with postoperative visual acuity of better than 0.7 log MAR was achieved by 56.9%. The OOKP subgroup showed a better mean visual outcome. 14 keratoprostheses (10.7%) had to be explanted over the whole time span. In the time leading to explantation, refraction showed a statistically significant myopic shift when compared with the non-explanted prosthesis. Anatomical survival rates were better for the OOKP in the first 12 years after implantation.

Conclusions:

The study shows that keratoprosthesis with a biological haptic has favorable long-term outcomes. The retention rate stayed very high with excellent functional outcomes.
Effect of dysnatremia and dysglycemia on outcomes among surgical intensive care unit patients
Authors: Abu Abeeleh Mahmoud , Hamouri Hanan , Bani Hani Amjad , Ahmad Fatima M. , Abu Halaweh Sami , Al-Warafi Wedad A. , Al Sahile Leen B. , Abu Amrieh Zain M. , Abu Abeeleh Farah , Battah Abdelkader H. , Bani Ismail Zuhair , Al Nassarwin Saif , Al Jaafreh Tala , Ribie Mohammad , Salameh Mohammad , Abu-Humaidan Anas H.A.
Published: February 2024

Objectives:

The objectives of this study were to evaluate the relationships between serum sodium and glucose concentrations and outcomes among patients admitted to the surgical intensive care unit (SICU).

Materials and methods:

Patient records admitted to the SICU between July 2020 and December 2020 were used in the study. Data included in the analysis were patient age, sex, comorbidities, surgical intervention, diagnosis of sepsis, sequential organ system failure scores, serum sodium concentrations, serum glucose concentrations, and SICU outcomes (discharged vs. deceased). A univariate logistic regression analysis was used to determine significant risk factors for mortality during a SICU stay.

Results:

A total of 194 patients with a mean age of 60±16 years were admitted to the SICU during the study period. Twenty-three percent of the patients were found to have sepsis with 18% mortality. Serum sodium and glucose concentrations were significantly higher (P-value ≤0.05) at all-time points in deceased patients compared to those who were discharged from the SICU.

Conclusion:

The results of the study indicate that serum sodium and glucose concentrations could be used as independent predictors of mortality in SICU patients with sepsis. However, further clinical trials are warranted before this application could be recommended in SICU.
Impact of the starch-based anti-adhesive agent 4DryField PH on anastomotic healing after rectal surgery
Authors: Stoerzer Simon , Winny Markus , Beetz Oliver , Jacobi Severin , Klempnauer Juergen , Poehnert Daniel
Published: February 2024

Aim:

Postoperative adhesions cause medical and socio-economic problems. 4DryField PH (4DF) is a starch-based medical product/agent with approved anti-adhesive and haemostatic effects. However, the influence on anastomotic healing has not yet been evaluated. The purpose of this study was, therefore, to characterize the effects of intraoperatively applied 4DF on the incidence of anastomotic leakage (AL) after rectal surgery.

Methods:

In this retrospective, monocentric cohort study, 157 patients after rectal surgery and primary anastomosis were divided into two groups. One group received 4DF (n=57), the other was treated without 4DF application (n=100). The groups were followed up for confirmed ALs.

Results:

The rate of ALs (P=0.850) proved to be comparable. Other additional outcome parameters like postoperative hospital stay (P=0.801), wound infection rate (P=0.627), re-admission rate (P=1.000), re-operation rate (P=0.533) and the 30-day mortality (P=0.463) also showed no statistically significant differences. A multivariable regression model for the complete cohort could not identify 4DF application as prognostically relevant for the development of AL, whereas rectal cancer (OR=2.660 [1.184–5.974]; P=0.018), smoking (OR=3.555 [1.326–9.533]; P=0.012), an ASA (American Society of Anaesthesiologists) score ≥3 (OR=2.894 [1.300–6.442]; P=0.009) and male sex (OR=2.411 [1.040–5.591]; P=0.040) were determined as independent risk factors.

Conclusion:

The application of 4DF in proximity to the anastomotic region after rectal surgery did not increase the risk of AL and showed no impact on other investigated outcome parameters.
Is 3 weeks a proper time point for the diagnosis of grade B POPF after pancreaticoduodenectomy?
Authors: Shen Yuhang , Gao Yuan , Wu Siyuan , Ma Le , Zhu Chunfu
Published: February 2024

Background:

In 2016, the International Study Group of Pancreatic Fistula (ISGPF) improved the definition of postoperative pancreatic fistula, which defines one of diagnostic criteria for progression of biochemical leak (BL) to grade B fistula as drain for more than 3 weeks. However, the authors found patients with BL after pancreaticoduodenectomy (PD) or laparoscopic pancreatoduodenectomy (LPD) in our medical center usually progressed to grade B fistula within 3 weeks, which is inconsistent with diagnostic criteria (more than 3 weeks) described in the guidelines. The objective of this study was to investigate the time point at which patients with BL progressed to grade B fistula after PD or LPD.

Methods:

The authors selected patients from June 2013 to October 2022 as the research subjects. The authors used a receiver operating characteristic curve to calculate the cutoff value of the time point when BL progressed to grade B fistula.

Results:

The cutoff value of the time point at which BL progresses to grade B fistula was postoperative day (POD) 9.5. The sensitivity and specificity were 63.6 and 81.4%, respectively.

Conclusion:

The cutoff value of time point of BL progression to grade B fistula was 9.5, which indicated that we do not need to define grade B fistula as drain for more than 3 weeks. The authors considered that a too-late time point might delay the timely diagnosis and treatment of grade B fistula and further optimization of the definition of grade B fistula was necessary.
The emerging role of cell-free DNA as a molecular marker for duodenal adenocarcinoma
Authors: Lai Hon-Fan , Wang Shin-E , Chen Shih-Chin , Shyr Bor-Shiuan , Shyr Yi-Ming , Shyr Bor-Uei
Published: February 2024

Background:

Duodenal adenocarcinoma is rare and its prognostic factors remain controversial. In our study, the role of cell-free deoxyribonucleic acid (cfDNA) as prognostic factor in duodenal adenocarcinoma was evaluated.

Methods:

From June 2003 to July 2021, plasma samples were collected from 41 patients with duodenal adenocarcinoma. Plasma cfDNA was assessed in combination with clinicopathological and biochemical characteristics. Univariate and multivariate analyses were conducted to identify independent prognostic factors for overall survival with a Cox proportional hazards regression model.

Results:

The 1- and 5-year survival rates of the patients with high plasma cfDNA level (>9288 copies/mL) group were 58.7% and 17.6%, respectively, which were much lower than patients with low cfDNA level (≤9288 copies/mL), with 95.2% and 64.6%. In univariate analysis, high cfDNA level, lymph node involvement, lymphovascular invasion, and tumor stage were associated with decreased survival. When subjected to multivariate analysis, only high cfDNA level showed significance in influencing the overall survival of duodenal cancer.

Conclusion:

cfDNA analysis is simple and noninvasive. High cfDNA level is a strong independent prognostic factor for decreased overall survival and it should be integrated into clinical care.
Sugammadex shortens operation time and improves operation turnover efficacy in video-assisted thoracoscopic surgery
Authors: Lin Yu-Tsen , Ting Chien-Kun , Hsu Han-Shui
Published: February 2024

Background:

This study compared sugammadex and neostigmine as agents for routine neuromuscular blockade reversal in video-assisted thoracoscopic surgery (VATS) to determine the optimal choice that achieves a shorter operation time and improved turnover efficiency while enhancing postoperative outcomes and ensuring patient safety during thoracic surgery.

Methods:

This prospective study, conducted from July 2022 to March 2023, compared the effect of sugammadex and neostigmine on operation time and turnover efficiency in VATS, involving 60 participants randomly assigned to either group, with the primary objective of identifying the optimal anesthesia reversal choice for improved outcomes and patient safety during thoracic surgery.

Results:

In the study, the sugammadex group showed a significantly shorter total operation room occupancy time (130 ± 7 vs 157 ± 7 minutes; p = 0.009) than the neostigmine group. Patients in the neostigmine group had higher mean pulse rates when leaving the operation room (85 ± 3 vs 73 ± 3 beats/min; p = 0.002) and 120 minutes later in the postanesthesia care unit (76 ± 2 vs 68 ± 2; p = 0.016).

Conclusion:

This study’s findings suggest that sugammadex may enhance total operating room occupancy time, operation turnover efficacy, and respiratory recovery outcomes in VATS, potentially improving patient care and anesthesia management.
Effects of internet-based exercise intervention on depression and anxiety: A systematic review and meta-analysis
Authors: Chen Zuo , Huang Hui , Liu Ruidong , Tang Zhengyan
Published: February 2024

Background:

While exercise is acknowledged for its positive effects on depression and anxiety symptoms, the benefits of internet-based exercise on mental health have not been extensively examined. This study seeks to systematically review and quantify the outcomes of high-quality randomized controlled trials (RCTs) that investigate the impact of internet-based exercise on depression and anxiety symptoms.

Methods:

Following the PRISMA 2020 guidelines, we conducted a comprehensive meta-analysis of RCTs. Databases, including Web of Science Core Collection, PubMed, PsycINFO, Medline, BIOSIS Previews, SPORTDiscus, and Education Source, were scoured through in September 2023. After quality assessment and data extraction, the analysis was performed using R. Using random effects models, effect sizes were determined and subsequently represented as standardized mean differences (SMD).

Results:

Our analysis incorporated data from 11 RCTs, involving a cohort of 1009 participants. We observed a modest yet significant reduction in depression and anxiety symptoms, with an SMD of −0.44 [95% confidence interval (CI) (−0.63, −0.26), I^2 = 79.3%, P < .01]. Interestingly, the effects were more pronounced in individuals diagnosed with depression, as indicated by an SMD of −0.96 [95% CI (−1.55, −0.37), I^2 = 82%, P < .01]. Furthermore, participants utilizing smartphone applications as part of their intervention reported a meaningful reduction in their symptoms, evidenced by an SMD of −0.52 [95% CI (−0.90, −0.14), I^2 = 87%, P < .01]. Additionally, short-term interventions, specifically those lasting <12 weeks, indicated a notable alleviation in depression symptoms, with an SMD of −0.76 [95% CI (−1.38, −0.14), I^2 = 86%, P < .01].

Conclusion:

Internet-based exercise interventions yield significant amelioration in depression and anxiety symptoms, with heightened efficacy observed among individuals with depression. Notably, short-term interventions, specifically those under 12 weeks, demonstrate enhanced benefits for depression relief.
Managing massive palatial defect secondary to palatoplasty failures: an in-depth analysis
Authors: Boot Madison , Winters Ryan
Published: February 2024

Purpose of review

Massive palatal defects resulting from palatoplasty failures arising from cleft palate repair complications present ongoing challenges in clinical practice. The purpose of this review is to provide up-to-date insights into aetiology, risk factors, surgical techniques, and adjunctive therapies, aiming to enhance the understanding of such complex cases, and optimize patient outcomes.

Recent findings

Primary palatoplasty has fistula recurrence rates ranging from 2.4% to 55%. Factors such as cleft width, surgical repair method, and patient characteristics, influence the likelihood of failure. Classifications such as the Pakistan Comprehensive Classification and Richardson's criteria aid in assessing defects. Surgical options range from local flaps and revision palatoplasty to regional flaps (e.g., buccinator myomucosal, facial artery-based flaps, tongue flaps, nasal septal flaps) to free microvascular flaps. Alternative approaches include obturator prostheses, and acellular dermal matrix has been used as an adjuvant to multiple repair techniques. Hyperbaric oxygen therapy has emerged as an adjunctive therapy to enhance tissue healing.

This comprehensive review underscores the intricate challenges associated with massive palatal defects resulting from palatoplasty failures. The diverse range of surgical and nonsurgical options emphasizes the importance of patient-centric, individualized approaches. Practitioners, armed with evidence-based insights, can navigate these complexities, offering tailored interventions for improved patient outcomes.
Risk Factors for Pneumocystis jirovecii Pneumonia in Children With Systemic Lupus Erythematosus Exposed to Prolonged High-Dose Glucocorticoids
Authors: Qian Yifang , Zhang Yuanzhen , Huang Jun , Liu Jingjing , Chen Guangming , Xia Guizhi , Wang Chengfeng , Feng Ai , Chen Yi , Chen Junyan , Zeng Yugui , Nie Xiaojing
Published: February 2024

Background

Pneumocystis jirovecii pneumonia (PJP) is a life-threatening opportunistic infection in immunocompromised children with systemic lupus erythematosus (SLE). Prophylaxis against PJP in high-risk children is crucial, but the risk factors for PJP in children with SLE are not adequately characterized. This study sought to identify the risk factors for PJP in long-term glucocorticoid-treated pediatric SLE patients.

Methods

This study encompassed 71 treatment episodes involving 64 children with prolonged (≥4 weeks) high-dose (≥20 mg/d prednisone) steroid regimens. Fourteen treatment episodes involved the PJP, whereas others did not. Risk factors for PJP were assessed through Cox regression. The predictive value of these factors was evaluated using receiver operating characteristic curves. The incidence of PJP in different risk groups was compared using the Kaplan-Meier method.

Results

The creatinine (hazard ratio, 1.009; 95% confidence interval [CI], 1.001–1.017; p = 0.021) and the lowest lymphocyte count (hazard ratio, 0.007; 95% CI, 0.000–0.373; p = 0.014) were independent risk factors for PJP in children with SLE. The receiver operating characteristic curve showed that using creatinine greater than 72.5 μmol/L and the lowest lymphocyte count less than 0.6 × 109/L as risk predictors for PJP resulted in an area under the curve value of 0.934 (95% CI, 0.870–0.997; p < 0.001). The study revealed a significant increase in PJP prevalence (p < 0.001) in children with elevated creatinine levels and low lymphocyte count.

Conclusions

Elevated levels of creatinine and decreased lymphocyte count are identified as distinct risk factors for PJP in children with SLE who receive prolonged high-dose steroid therapy.
Unusual 131I Uptake Caused by Paronychia in a Patient With Papillary Thyroid Cancer
Authors: Yang Jun , Pan Zhengzhou , Su Xinhui
Published: February 2024

A 33-year-old woman was referred for radioiodine 6 months after total thyroidectomy and neck dissection for papillary thyroid cancer. Posttherapy whole-body 131I scintigraphy showed not only the known activity in the neck but also accumulated activity in both feet. SPECT/CT revealed focal uptake in bilateral great toenails. On further clinical evaluation and follow-up, the patient was diagnosed as paronychia of the great toenails.
Medium- and Long-Term Outcomes of Autologous Fat Grafting to Hands and Feet for Patients With Raynaud Phenomenon
Authors: Haravu Pranav N. , Bond Stephanie , Hendren-Santiago Bryce , Prescher Hannes , Bank Jonathan , Zachary Lawrence S.
Published: February 2024

Background

Autologous fat grafting (AFG) has emerged as a promising treatment option for Raynaud phenomenon. However, existing studies are limited by short follow-up, and there is little evidence regarding predictive factors for successful outcomes.

Methods

A retrospective chart review and standardized phone interviews were performed for all patients (n = 17, 65% response rate) treated with AFG to the hands or feet at our institution for primary or secondary Raynaud from 2010 to 2021. Each occurrence of AFG was defined as a separate surgery (n = 23), with an average follow-up of 3.7 years.

Results

At follow-up, patients reported a 31% reduction in cold attack frequency, a 45% reduction in the intensity of individual attacks, a 29% reduction in the duration of attacks, and a 40% improvement in overall Raynaud Condition Score (P < 0.01). Although initial AFG to an extremity significantly improved symptoms, subsequent attempts were not shown to statistically improve outcomes. Digital ulcers were present in 65% of cases, and AFG resulted in ulcer healing in 87% of those cases. Median duration of maximum symptom relief was 1 year postoperatively, with 74% of patients reporting diminishing symptom relief by 4 years postoperatively. Those with a BMI ≥25, with primary Raynaud phenomenon or without preoperative ulcers experienced significantly longer symptom relief (P < 0.05). Average patient satisfaction was 7.7 of 10, and 91% would recommend the procedure to others.

Conclusions

Autologous fat grafting is an effective, albeit sometimes temporary, treatment for Raynaud and digital ulcers. Certain patients may be more likely to experience lasting symptom relief beyond 1 year.
Scalp Closure in Midline Cutis Aplasia—An Absolute Indication for Preoperative Imaging
Authors: Chim Harvey , Arcelona Christian , Gosain Arun K.
Published: February 2024

The ideal evaluation and treatment of aplasia cutis congenita remains disputed. We present a case of midline scalp cutis aplasia that healed by secondary intention, leaving an area of residual alopecia. There were no clinical indicators of an underlying calvarial defect. Tissue expansion of the scalp was done in preparation for scalp closure. However, on the removal of the expanders and scalp advancement, an unrecognized midline calvarial defect in which a scar tract of herniated dura was found. This resulted in a dural tear, repaired with minimal hemorrhage. However, manipulation of the sagittal sinus resulted in a right subdural hemorrhage followed by cerebral ischemia and a stroke. On the basis of this clinical scenario, we recommend that all cases of midline scalp cutis aplasia undergo preoperative imaging with thin slices of the calvaria before performing scalp advancement—even if the only clinical indication for surgery is scalp alopecia without a palpable skull defect.
Machine-learning parameter tracking with partial state observation
Authors: Zhai Zheng-Meng , Moradi Mohammadamin , Glaz Bryan , Haile Mulugeta , Lai Ying-Cheng
Published: February 2024

Complex and nonlinear dynamical systems often involve parameters that change with time, accurate tracking of which is essential to tasks such as state estimation, prediction, and control. Existing machine-learning methods require full state observation of the underlying system and tacitly assume adiabatic changes in the parameter. Formulating an inverse problem and exploiting reservoir computing, we develop a model-free and fully data-driven framework to accurately track time-varying parameters from partial state observation in real time. In particular, with training data from a subset of the dynamical variables of the system for a small number of known parameter values, the framework is able to accurately predict the parameter variations in time. Low- and high-dimensional, Markovian and non-Markovian, and spatiotemporal nonlinear dynamical systems are used to demonstrate the power of the machine-learning based parameter-tracking framework. Pertinent issues affecting the tracking performance are addressed.

Published by the American Physical Society
2024
Turbulent spot formation in stably stratified three-dimensional Yukawa liquids
Authors: Kalita Suruj , Ganesh Rajaraman
Published: February 2024

A plane-Couette flow (PCF) is considered in a stably stratified three-dimensional (3D) Yukawa liquid, perturbed initially with a finite amplitude 3D perturbation. Stable stratification in density is achieved by subjecting the medium to external gravity. We demonstrate turbulent spot formation in a stably stratified PCF. The dynamics of the system is shown to depend upon the value of κ, which is associated with the range of interaction. We have performed “first principles” classical 3D molecular dynamics (MD) simulations for “hypergravity” (1.3g0, g0 is Earth's gravitational force for unit mass in our normalized unit) and “milligravity” (9×10−3g0) cases for κ, 1.0 and 4.0, respectively. We extract relevant fluid quantities from MD data. For the hypergravity case, when the system is evolved in time under stable stratification, the kinetic energy is observed to deposit in the lower wave vectors (Kx, Kz), leading to “inverse cascade” in the plane perpendicular to the direction of stratification. As a result, we observe large-scale structure formation in velocity and streamwise vorticity fields. Nucleation of velocity streak is observed for the first time in the stably stratified case in our simulation. The coherent structures in the velocity and streamwise vorticity fields are found to sustain for longer period of time for the stably stratified cases as compared to the unstratified case. For the milligravity case, the large-scale dynamics is observed to enhance. Unlike unstratified PCF, a background flow in Y-averaged streamwise fluid velocity field is observed for the stably stratified case. We believe that our results using “first principles” classical MD simulations on subcritical turbulence in stably stratified Yukawa liquid, may have ramifications to wider class turbulence problems.

Published by the American Physical Society
2024
Gender vs gender identity: which influences word-of-mouth communication more, and its implications for self-brand connection? In the case of Airbnb
Authors: Sun Bongran Lucia
Published: February 2024

Purpose

This study aims to explore the relationships between gender, gender identity and Word of Mouth (WOM). There are three objectives of this study. The first was to observe the impact of gender identity on WOM. The second was to examine the mediation role of self-brand connection (SBC) bridging the relationship between gender identity and WOM. The final one was to test the moderating role of gender.

Design/methodology/approach

The conceptual model was tested by analyzing data collected via Mturk from Americans participants who use Airbnb. Confirmatory factor analysis was conducted to evaluate the psychometric property. To test hypotheses, the structural equation model was assessed. Further, Hayes’ PROCESS was adopted to examine the mediation role of SBC. The moderation role of gender was examined by the chi-square difference test.

Findings

The research outcomes elucidated that feminine gender identity exerted a noteworthy influence on WOM communication, whereas masculine gender identity appeared to bear no significant impact on WOM. It was determined that SBC operates as a potent mediator bridging the relationship between gender identity and WOM. Gender did not demonstrate a significant moderating effect on any part of the WOM communication pathway in the context of this study.

Practical implications

The conclusions drawn from this research underscore that practitioners in the field of brand management should not overlook the crucial role of consumers' gender identity. It is imperative to cultivate robust, positive relationships with consumers as a strategic measure to engender favorable WOM communication.

Originality/value

This investigation distinguishes itself as one of the relatively scarce studies interrogating the relationship between gender identity, gender and WOM, specifically through the mediating lens of SBC. Consequently, the discoveries made herein have the potential to furnish unprecedented insights into comprehending consumer behavior in the hospitality industry with respect to WOM communication, particularly as it pertains to the dimension of gender identity.
The contribution of public-private partnership (PPP) to sustainability: governance and managerial implications from a literature review
Authors: De Matteis Fabio , Borgonovi Elio , Notaristefano Giovanni , Striani Fabrizio
Published: February 2024

Purpose

Based on the theoretical background of stakeholder capitalism, the purpose of this paper is to contribute to the scientific debate on the topic of public–private partnerships (PPPs), considering in particular how this governance structure relates to the pursuit of sustainable development. Specifically, this objective will be pursued with a focus on stakeholder relations and governance aspects, to highlight enablers and barriers in change for sustainability.

Design/methodology/approach

The systematic literature review is applied starting with the use of keywords in Web of Science, which leads to the extrapolation of 629 articles on the topic of “PPP and sustainability”. Subsequently, through various skimming steps, 75 papers are sampled. A mixed (quantitative-qualitative) approach is then followed: a co-word semantic network to identify the pattern of discourse and a more in-depth and explanatory analysis of the papers. These quantitative and qualitative tools synergistically work together to evidence the main aspects related to the aim of the paper.

Findings

With reference to the governance structure and stakeholders of PPPs, the analyses highlight the shift towards a triadic type of relational governance that considers stakeholders (especially the community) in addition to public–private partners. This can improve the partnership's performance (particularly in sustainable development) and social legitimacy. With reference to the role of PPPs in the implementation of sustainable development, they have positive potential in terms of implementing sustainability and raising stakeholder awareness of it. Nevertheless, PPPs may entail risks to the implementation of sustainability. The findings lead to some concluding remarks on future research opportunities.

Research limitations/implications

The research leads to some managerial implications, such as the need to follow a competitive collaboration approach among stakeholders, to develop relational governance skills and related managerial tools and to incorporate sustainability aspects starting from the design of PPPs.

Originality/value

The originality aspect of this research is the consideration of a PPP by relating it to the pursuit of sustainability. Such an inter-organizational structure could be suitable to deal with the complexity inherent in the implementation of sustainability and is peculiar in terms of governance and stakeholder relations, considering that it is characterised by the presence of several partners of different nature (public and private).
Sustainability-driven market impacts of climate change and firms’ renewable energy innovation: a conceptual analysis
Authors: Rastegar Hiva , Eweje Gabriel , Sajjad Aymen
Published: February 2024

Purpose

This paper aims to unravel the relationship between market-driven impacts of climate change and firms’ deployment of renewable energy (RE) innovation. The purpose is to understand how market-related forces, influenced by uncertainty, shape firms’ behaviour in response to climate change challenges.

Design/methodology/approach

Drawing on the behavioural theory of the firm (BTOF), the paper develops a conceptual model to decode the relationship between each category of market-driven impacts and the resulting RE innovation within firms. The model takes into account the role of uncertainty and differentiates between multinational enterprises (MNEs) and domestic firms.

Findings

The analysis reveals five key sources of market-driven impacts: investor sentiment, media coverage, competitors’ adoption of ISO 14001, customer satisfaction and shareholder activism. These forces influence the adoption of RE innovation differently across firms, depending on the level of uncertainty and the discrepancy between environmental performance and aspiration level.

Originality/value

This paper contributes to the literature in four ways. Firstly, it emphasises the importance of uncertainty associated with market-driven impacts, which stimulates different responses from firms. Secondly, it fills a research gap by focusing on the proactivity of firms in adopting RE innovation, rather than just operational strategies to curb emissions. Thirdly, the paper extends the BTOF by incorporating the concept of uncertainty in explaining firm behaviour. Finally, it provides insights into the green strategies of MNEs in the face of climate change, offering a comprehensive model that differentiates MNEs from domestic firms.
The influence of neurodiversity management on affective commitment and turnover intention: the role of neurodiversity awareness
Authors: Ali Muhammad , Grabarski Mirit K. , Baker Marzena
Published: February 2024

Purpose

In the wake of labor shortages in the retail industry, there is value in highlighting a business case for employing neurodivergent individuals. Drawing on signaling theory, this study explores whether perceived neurodiversity management (neurodiversity policies and adjustments) helps enhance neurodiversity awareness and affective commitment and whether affective commitment leads to lower turnover intention.

Design/methodology/approach

A cursory content analysis of publicly available documents of randomly selected four retail organizations was undertaken, which was followed by an online survey of the Australian retail workforce, leading to 502 responses from supervisors and employees.

Findings

The content analysis shows that retail organizations barely acknowledge neurodiversity. The findings of the main study indicate that neurodiversity policies are positively associated with both neurodiversity awareness and affective commitment, while adjustments were positively linked to affective commitment. Moreover, affective commitment was negatively associated with turnover intention. Affective commitment also mediated the negative effects of neurodiversity policies and adjustments on turnover intention.

Originality/value

This study supports, extends and refines signaling theory and social exchange theory. It addresses knowledge gaps about the perceptions of co-workers and supervisors in regard to neurodiversity management. It provides unprecedented evidence for a business case for the positive attitudinal outcomes of neurodiversity policies and adjustments. The findings can help managers manage neurodiversity for positive attitudinal outcomes.
Impact of security on wallet adoption: multiple and serial mediating roles of trust and attitude and gender as a moderator
Authors: Joshi Himanshu , Chawla Deepak
Published: February 2024

Purpose

The study investigates the influence of perceived security (PS) on behavioral intention (BI) via the trust attitude process and explores the moderating effects of gender. PS in mobile wallets enhances user trust (TR), attitude (ATT) and intention (INT). Using a multiple and serial mediation model, both TR and ATT were found to mediate the relationship between PS and BI.

Design/methodology/approach

Drawing on the stimulus-organism-response (S-O-R) theory, the proposed conceptual model comprises PS, TR, ATT and BI. An online survey was conducted with a cross-sectional sample of 744 mobile wallet users in India. Partial least squares structural equation modeling (PLS-SEM) was used to analyze the hypothesized relationships and test the mediation effects.

Findings

Results show that the stimulus, PS, has a positive and significant influence on TR and ATT, which eventually has a positive influence on BI. The research model explains 64.4 percent of the variance in BI. Further, both TR and ATT independently and parallelly mediate the relationship PS and BI. Lastly, gender is found to moderate the relationship between TR and BI and ATT and BI.

Practical implications

The research showed the importance of PS, TR and ATT towards mobile wallet adoption INTs. Further, the findings support the idea that developing TR and ATT is essential for shaping INTs. This suggests that mobile wallet service providers should invest in methods that not just enhance user TR but also reinforce a positive ATT towards the platform. To demonstrate TR, mobile wallet providers must ensure the confidentiality and privacy of user data, keep customer interests in mind and fulfill commitments. Lastly, for strengthening customer TR, excellent customer support is extremely important.

Originality/value

While prior researchers have majorly used technology acceptance model (TAM) and unified theory of acceptance and use of technology (UTAUT) models to explain adoption INTs, this study examines the relationship between PS, TR, ATT and BI through the lens of the SOR framework.