bluuebunny/crossref_metadata_2025 huggingface dataset:
3D full-time anisotropic TEM modelling using a mixed BDF2/SAI method
Authors: Huang Kui , Lu Kailiang , Zhou Jianmei , Li Xiu , Meng Lifei
Published: December 2021

Transient electromagnetic (TEM) data are affected by resistivity anisotropy, which should be considered in 3D modelling. The influence of anisotropy on full-time response is the main focus of this research. For spatial discretisation of an anisotropic model, the mimetic finite volume approach was applied. The accuracy of the shift-and-invert (SAI) Krylov subspace approach and the two-step backward differentiation formula (BDF2) for modelling 3D full-time electromagnetic data has been demonstrated. However, both algorithms require time-consuming calculations. The SAI technique requires a number of projection subspace constructions, whereas the BDF2 algorithm necessitates numerous coefficient matrix decompositions. We proposed a novel mixed BDF2/SAI algorithm in this paper, which combines the advantages of the two algorithms. The on-time response is computed using BDF2, while the off-time response is computed using the SAI-Krylov subspace method. The forward results of a 1D model with a half-sine waveform demonstrated that the new algorithm is accurate and faster than both the BDF2 algorithm and the SAI algorithm. During the full-time period, the forward results of a 3D anisotropic model with half-sine waveform show that abnormal responses can be induced. It was shown that the relative abnormal of ${{{\bf b}}_{\boldsymbol{z}}}$ is higher during the on-time period, while the relative abnormal of $\partial {{{\bf b}}_{\boldsymbol{z}}}/\partial t$ is higher during the off-time period. Furthermore, the change in relative anomaly is more obvious as the anisotropic block rotates around the x-axis. And the larger the rotation angle, the larger the relative anomaly.
Multisource stress data constraints on Cretaceous—present regional tectonic stress field evolution in the southern Jinzhou area, North China Craton
Authors: Yang Chengwei , Wang Chenghu , Jiao Mingruo , Li Yujiang , Wang Pu
Published: December 2021

Regional tectonic stress fields are key crustal stress elements that drive tectonic movements and are associated with regional tectonics and geological resources. Regional tectonic stress field evolution of the Jinzhou area, located in the eastern block of the North China Craton (NCC), may provide a deeper understanding of tectonics of western Liaoning and the NCC. This work conducted borehole television, hydraulic fracturing and focal mechanism solutions to invert the paleo and present regional tectonic stress fields. Four groups of tensile fracture in the southern Jinzhou area were identified via borehole television, and their azimuths were NNW–SSE, NWW–SEE, nearly W–E and NE–SW in temporal order representing four stages of extensional tectonic events. Hydraulic fracturing and focal mechanism solutions showed that the stress status was normal fault and strike-slip, revealing that the southern Jinzhou area is undergoing NEE–SWW-oriented compression and nearly N–S-oriented extension in accordance with the strike-slip mechanism. From the Early Cretaceous to the present, the direction of the regional extensional stress in the southern Jinzhou area has evolved counterclockwise and sequentially from NNW–SSE to NWW–SEE, W–E, NE–SW and nearly N–S, and the regional tectonic mechanism has transited from extension to extension-strike-slip to strike-slip, leading to the current tectonic framework.
Laparoscopic treatment of an unruptured cystic artery pseudo-aneurysm in the presence of calculous emphysematous cholecystitis
Authors: Kelly Sarah , Shah Krisha , Motizada Jasneet , Soggiu Fiametta , Sheth Hemant
Published: December 2021

Cystic artery pseudoaneurysm is a rare complication of invasive biliary procedures or of acute or chronic cholecystitis and pancreatitis. Emphysematous cholecystitis is an acute inflammatory process of the gallbladder due to gas forming organisms such as Escherichia coli and Clostridium perfringens. We report the case of a 34-year-old gentleman admitted with a 3-day history of generalized abdominal pain, vomiting and markedly raised inflammatory markers. A computed tomography scan demonstrated acute calculus cholecystitis and an incidental CAP. This was successfully treated with an emergency laparoscopic cholecystectomy. CAPs are reported in the literature as rare and are usually diagnosed after rupture with severe haemorrhage. In this report, we highlight that a non-ruptured CAP identified preoperatively can be safely managed simultaneously with a laparoscopic approach, thus avoiding the need for invasive angiographic procedures or open surgery.
A case of malignant glomus tumor (glomangiosarcoma) of the nasal cavity
Authors: Alhroub Omar A , Mahameed Shimaa A , Abdelhafez Mohammad O , Alhroub Asil , Hour Hani , Hasasna Nabil , Kamal Nazmi
Published: December 2021

Glomus tumors are rare and usually benign. The malignant form (glomangiosarcoma) comprises <1% of all glomus tumors. There are limited reports that describe glomus tumors in the nasal cavity. However, to the best of our knowledge, glomangiosarcoma of the nasal cavity was never reported in humans. We report on the first case of nasal cavity glomangiosarcoma in a 59-year-old male who presented with a bleeding mass in his right nostril. We completely excised the lesion with a 0.7-mm free margin, and the histopathologic examination was consistent with glomangiosarcoma. A 6-month follow-up illustrated no evidence of recurrence or distant metastasis. Although it is rare, glomus tumors should be in the differential diagnosis of nasal cavity tumors. Histopathologic examination is essential for glomangiosarcoma diagnosis. Treatment requires complete excision with free margin, alongside careful clinical and radiological follow-up.
Challenges With Engaging Military Stakeholders for Clinical Research at the Point of Care in the U.S. Military Health System
Authors: Rhon Daniel I , Oh Robert C , Teyhen Deydre S
Published: December 2021

The DoD has a specific mission that creates unique challenges for the conduct of clinical research. These unique challenges include (1) the fact that medical readiness is the number one priority, (2) understanding the role of military culture, and (3) understanding the highly transient flow of operations. Appropriate engagement with key stakeholders at the point of care, where research activities are executed, can mean the difference between success and failure. These key stakeholders include the beneficiaries of the study intervention (patients), clinicians delivering the care, and the military and clinic leadership of both. Challenges to recruitment into research studies include military training, temporary duty, and deployments that can disrupt availability for participation. Seeking medical care is still stigmatized in some military settings. Uniformed personnel, including clinicians, patients, and leaders, are constantly changing, often relocating every 2-4 years, limiting their ability to support clinical trials in this setting which often take 5-7 years to plan and execute. When relevant stakeholders are constantly changing, keeping them engaged becomes an enduring priority. Military leaders are driven by the ability to meet the demands of the assigned mission (readiness). Command endorsement and support are critical for service members to participate in stakeholder engagement panels or clinical trials offering novel treatments. To translate science into relevant practice within the Military Health System, early engagement with key stakeholders at the point of care and addressing mission-relevant factors is critical for success.
Special-Science Counterfactuals
Authors: List Christian
Published: December 2021

On the standard analysis, a counterfactual conditional such as “If P had been the case, then Q would have been the case” is true in the actual world if, in all nearest possible worlds in which its antecedent (P) is true, its consequent (Q) is also true. Despite its elegance, this analysis faces a difficulty if the laws of nature are deterministic. Then the antecedent could not have been true, given prior conditions. So, it is unclear what the relevant “nearest possible worlds” are. David Lewis suggested that they are ones in which a local breach of the laws occurred: a “small miracle.” Others have suggested that they are ones in which the initial conditions were different (“backtracking”). I propose another response. It builds on the idea that the special sciences, where counterfactual reasoning is most common, operate at a higher level of description from fundamental physics, and that the world may behave indeterministically at higher levels even if it behaves deterministically at the fundamental physical one. The challenge from determinism can then be bypassed for many special-science counterfactuals.
Dual IGF1R/IR inhibitors in combination with GD2-CAR T-cells display a potent anti-tumor activity in diffuse midline glioma H3K27M-mutant
Authors: de Billy Emmanuel , Pellegrino Marsha , Orlando Domenico , Pericoli Giulia , Ferretti Roberta , Businaro Pietro , Ajmone-Cat Maria Antonietta , Rossi Sabrina , Petrilli Lucia Lisa , Maestro Nicola , Diomedi-Camassei Francesca , Pezzullo Marco , De Stefanis Cristiano , Bencivenga Paola , Palma Alessia , Rota Rossella , Del Bufalo Francesca , Massimi Luca , Weber Gerrit , Jones Chris , Carai Andrea , Caruso Simona , De Angelis Biagio , Caruana Ignazio , Quintarelli Concetta , Mastronuzzi Angela , Locatelli Franco , Vinci Maria
Published: December 2021

Background

Diffuse midline gliomas (DMG) H3K27M-mutant, including diffuse intrinsic pontine glioma (DIPG), are pediatric brain tumors associated with grim prognosis. Although GD2-CAR T-cells demonstrated significant anti-tumor activity against DMG H3K27M-mutant in vivo, a multimodal approach may be needed to more effectively treat patients. We investigated GD2 expression in DMG/DIPG and other pediatric high-grade gliomas (pHGG) and sought to identify chemical compounds that would enhance GD2-CAR T-cell anti-tumor efficacy.

Methods

Immunohistochemistry in tumor tissue samples and immunofluorescence in primary patient-derived cell lines were performed to study GD2 expression. We developed a high-throughput cell-based assay to screen 42 kinase inhibitors in combination with GD2-CAR T-cells. Cell viability, western blots, flow-cytometry, real time PCR experiments, DIPG 3D culture models, and orthotopic xenograft model were applied to investigate the effect of selected compounds on DIPG cell death and CAR T-cell function.

Results

GD2 was heterogeneously, but widely, expressed in the tissue tested, while its expression was homogeneous and restricted to DMG/DIPG H3K27M-mutant cell lines. We identified dual IGF1R/IR antagonists, BMS-754807 and linsitinib, able to inhibit tumor cell viability at concentrations that do not affect CAR T-cells. Linsitinib, but not BMS-754807, decreases activation/exhaustion of GD2-CAR T-cells and increases their central memory profile. The enhanced anti-tumor activity of linsitinib/GD2-CAR T-cell combination was confirmed in DIPG models in vitro, ex vivo, and in vivo.

Conclusion

Our study supports the development of IGF1R/IR inhibitors to be used in combination with GD2-CAR T-cells for treating patients affected by DMG/DIPG and, potentially, by pHGG.
Bilateral renal infarction with COVID-19 pneumonia: a case report
Authors: Jana Kundan , Janga Kalyana C , Greenberg Sheldon , Kumar Kamlesh
Published: December 2021

Acute renal infarction is a rare and often underdiagnosed condition with estimated incidence of 0.5–1.5%. Coronavirus disease 2019 (COVID-19) has been shown to cause a hypercoagulable state in patients leading to arterial and venous thromboembolism. Renal infarction as a consequence of COVID-associated coagulopathy has been reported, sometimes resulting in acute kidney injury. Most of the patients so far reported had other existing comorbidities and risk factors that compounded the risk of precipitating an infarction. Here, we present a 37-year-old, the youngest patient reported so far, with no pre-existing comorbidities or risk factors, who developed bilateral renal infarction with COVID-19 pneumonia. The patient was treated with anticoagulation for renal infarction and discharged on apixaban. Anticoagulation is an important part of current treatment strategies for COVID-19 pneumonia and should extend beyond the acute phase of the disease to prevent long-term sequelae, especially in young patients.
Bureaucracy and the Imaginal Realm: Max Weber, Rationality and the Substantive Basis of Public Administration
Authors: Langer Julie
Published: December 2021

Max Weber is an important figure in Public Administration. Nearly all foundational texts in the field include his theory of bureaucracy. Yet, although the field teaches the core tenets of an efficient bureaucracy, namely, formalization, division of labor, impersonality, and hierarchy, his view of the formally rational thought systems undergirding it and the role of values in shaping bureaucratic action are largely overlooked. An attempt here is made to reexamine Weber’s conceptualization of bureaucracy and review his propositions regarding both the promise and peril it holds for social progress. In order to evaluate the degree to which Weber’s darker propositions have come to fruition and the forces at play acting as bulwarks against them, the relationship between formal and substantive rationality is considered against the backdrop of changing administrative models in the United States. Based on this analysis, a substantive path for the future of Public Administration in the United States is laid out.
Average stride length and stride rate of Thoroughbreds and Quarter Horses during racing
Authors: Vergara-Hernandez Fernando B , Nielsen Brian D , Robison Cara I , Fabus Taylor A , Kompare Jasmin L , LeCompte Lazić Rebecca Ashley , Colbath Aimee C
Published: December 2021

The main factors influencing speed in athletes are stride length (SL) and stride rate (SR). However, conflict remains whether SL or SR is the key determinant of higher speeds. Quarter Horses (QH) generally reach higher speeds in their races than do Thoroughbreds (TB). However, the influence of SL and SR on this greater speed is unclear. Therefore, the main objective of this study was to compare SL and SR in QH and TB raced in short (sprint) and long (classic) distances. We hypothesized that QH have a higher SR in comparison to TB, and SR decreases as distance increases. Two race distances were analyzed for each breed: QH races of 100.6 and 402.3 m, and TB races of 1,207.0 and 2,011.7 m. Data from 20 horses were obtained, consisting of five horses from each race distance (10 QH and 10 TB). Five individuals watched recordings of each race three times counting the number of strides taken by each winning horse. The SR was calculated using the average number of strides over a given race duration, and SL was determined by calculating the total number of strides over the distance covered. Speed was calculated by dividing the distance by the time of the winning horse. The PROC Mixed Procedure was used to identify statistical differences between breeds, and between distances within the same breed. Results showed that although the SL of the TB was longer in comparison with the QH (P < 0.001), the average SR in QH was higher than in TB (2.88 vs. 2.34 + 0.03 strides/s; P < 0.001). Furthermore, QH classic distance demonstrated a faster speed than TB at either distance (P < 0.001). In conclusion, QH achieve a higher SR in comparison to TB (between 14% and 20% more than TB), confirming the importance of SR in achieving high racing speeds.
Impacts of Row Spacing and Fungicide Timing on Foliar Disease, Greenstem, and Yield in Double-Cropped Soybeans Grown in the Chesapeake Bay Region of the United States
Authors: Kleczewski Nathan , Kness Andrew , Koehler Alyssa
Published: December 2021

Double-cropped soybean crops are planted on approximately one-third of crop acres in the Chesapeake Bay region of the United States. Producers have asked whether foliar fungicides are required to optimize yields in this region. We assessed the impacts of foliar fungicide application timing and row spacing on foliar disease, greenstem, and yield from 11 site-years spanning 2017 to 2019. Foliar diseases only developed at rateable levels in one location. Fungicide application, regardless of timing, increased percent greenstem over nontreated controls. Fungicide application did not affect soybean yield. Yield was greater in 38.1-cm rows when compared with 19-cm rows. Our data do not support the use of foliar fungicides in double-cropped soybean production in this region.
A Rare Case of Cytomegalovirus and Herpes Simplex Virus Coinfection Gastritis and Colitis in a Person Living With HIV/AIDS
Authors: Huang Jingwen , Qamar Zahra , Gancher Elizabeth
Published: December 2021

Herpes simplex virus (HSV) colitis and gastritis is a very rare gastrointestinal manifestation in immunocompromised patients. We report the case of a 46-year-old man with a medical history of poorly controlled HIV/AIDS who presented with 2 months of progressively worsening nonbloody diarrhea. Esophagogastroduodenoscopy showed gastritis and sigmoidoscopy revealed severe colitis. Biopsy immunostaining revealed cytomegalovirus and HSV viral inclusions in the stomach, appendix, and rectum. The patient's symptoms largely improved with ganciclovir. To our knowledge, this is the first case demonstrating cytomegalovirus and HSV coinfection gastritis and colitis in a patient with HIV/AIDS.
Long-Acting Lipoglycopeptide Antibiotics (Dalbavancin and Oritavancin) for the Treatment of Endotipsitis in a Patient With Cirrhosis
Authors: Winbush Angelina , Alpizar-Rivas Rodolfo , Gupta Purba , Zanoria Catherine , Chuang Sally , Prasad Paritosh , Louie Ted
Published: December 2021

Endovascular Staphylococcal infections involving prosthetic material typically require long courses of intravenous antibiotics, which are often completed at home or in a rehabilitation facility with outpatient parenteral antibiotic therapy. An alternative to outpatient parenteral antibiotic therapy is the use of long-acting lipoglycopeptides (LaLGPs). Dalbavancin and oritavancin are LaLGPs that have been used for the treatment of catheter-related blood-stream infections and endocarditis. However, their use in patients with liver dysfunction is not well documented in the literature. Herein, we describe a case of LaLGPs used to successfully treat endotipsitis, an infection of the transjugular intrahepatic portosystemic shunt system, in a patient with cirrhosis.
Disparities of Access, Use, and Barriers to Seeking Health Care Services in Arizona
Authors: Gallaway Michael Shayne , Aseret-Manygoats Teresa , Tormala Wayne
Published: December 2021

Background:

Access to health care (HC) services is important for promoting and maintaining health, preventing and managing disease, reducing unnecessary disability and premature death, and achieving health equity for all persons.

Objectives:

We assess social indicators among people living in Arizona that are associated with access, use, and barriers to seeking HC services.

Research Design:

We analyzed data (n=8073) from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) to describe demographic and health characteristics among persons by HC access and use, and for whom costs were a barrier to seeking care.

Results:

Among Arizona adults, 13.5% reported lacking HC coverage, 28.7% reported lacking a personal doctor, and medical costs were a barrier to seeking care for 14.1%. Arizonans aged 18–34 years or with a high school education or less more often reported lacking HC coverage, a personal doctor, or not visiting a doctor because of costs. Past year medical and dental checkups were less common among less educated (≤high school) and never married persons. Hispanic persons more often reported lacking HC coverage or not visiting a doctor because of costs, and less often reported past year dental checkups.

Conclusions:

BRFSS can be analyzed to identify and quantify unique HC disparities, and the findings can serve as the basis for improving HC in communities. Expansion of HC services and providers may be achieved, in part, through incentives for providers to work in designated health professional shortage areas and/or leveraging telehealth/telemedicine in rural and urban underserved communities.
Differential Effects by Mental Health Status of Filling the Medicare Part D Coverage Gap
Authors: Liu Judith , Zhang Yuting , Kaplan Cameron M.
Published: December 2021

Objective:

The objective of this study was to study how changes in insurance benefit design affect medication use of older adults with mental disorders.

Data Sources:

US Medicare claims data from 2007 to 2018.

Study Design:

Exploiting the gradual elimination of the Medicare prescription drug coverage gap beginning in 2011, we examine the effects on medication use and out-of-pocket spending by drug type with a difference-in-differences approach. We identify subpopulations by mental disorder and compare the estimates across mental health groups and to the general Medicare population.

Principal Findings:

Closing the gap substantially reduced individuals’ out-of-pocket spending, and the reduction was larger for those with more severe mental disorders. The policy led to a statistically significant increase in branded drugs used for the Medicare population (0.91; P<0.01; 12.12% increase), beneficiaries with severe mental disorders (2.71; P<0.01; 11.13% increase), and common mental disorders (2.63; P<0.01; 11.62% increase), whereas such effect for beneficiaries with Alzheimer disease and dementia (AD) is substantially smaller (0.44; P<0.01; 1.83% increase). In contrast, the policy decreased generic drugs used by about 3%–5% for all groups. Overall, beneficiaries without mental health illness have a statistically significant increase in total medication use (2.05%) following the coverage gap closure, while all 3 mental health groups have either no statistically significant changes or a small reduction in total mediation use (AD, −1.26%).

Conclusions:

Patients’ responses to price changes vary across mental disorders and by drug type. The impact on branded drug utilization among those with AD is particularly small. Our findings suggest that lowering medication costs has differential impacts across diseases and may not be sufficient to improve adherence for all conditions, in particular those with severe mental health disorders such as AD.
Monitoring Preventable Adverse Events and Near Misses: Number and Type Identified Differ Depending on Method Used
Authors: Isaksson Stina , Schwarz Anneli , Rusner Marie , Nordström Sophia , Källman Ulrika
Published: December 2021

Objectives

This study aimed to investigate how many preventable adverse events (PAEs) and near misses are identified through the methods structured record review, Web-based incident reporting (IR), and daily safety briefings, and to distinguish the type of events identified by each method.

Methods

One year of retrospective data from 2017 were collected from one patient cohort in a 422-bed acute care hospital. Preventable adverse events and near misses were collected from the hospital’s existing resources and presented descriptively as number per 1000 patient-days.

Results

The structured record review identified 19.9 PAEs; the IR system, 3.4 PAEs; and daily safety briefings, 5.4 PAEs per 1000 patient-days. The most common PAEs identified by the record review method were drug-related PAEs, pressure ulcers, and hospital-acquired infections. The most common PAEs identified by the IR system and daily safety briefings were fall injury and pressure ulcers, followed by skin/superficial vessel injuries for the IR system and hospital-acquired infections for the daily safety briefings. Incident reporting and daily safety briefings identified 7.8 and 31.9 near misses per 1000 patient-days, respectively. The most common near misses were related to how care is organized.

Conclusions

The different methods identified different amounts and types of PAEs and near misses. The study supports that health care organizations should adopt multiple methods to get a comprehensive review of the number and type of events occurring in their setting. Daily safety briefings seem to be a particularly suitable method for assessing an organization’s inherent security and may foster a nonpunitive culture.
Frequency and Nature of Communication and Handoff Failures in Medical Malpractice Claims
Authors: Humphrey Kate E. , Sundberg Melissa , Milliren Carly E. , Graham Dionne A. , Landrigan Christopher P.
Published: December 2021

Background

The Joint Commission has identified miscommunication as a leading cause of sentinel events, the most serious adverse events, but it is unclear what role miscommunications play in malpractice claims. We sought to determine the proportion of medical malpractice claims involving communication failure and describe their nature, including providers involved, locations, miscommunications types, costs, and the potential for handoff tools to avert risk and associated costs.

Methods

We retrospectively reviewed a random sample of malpractice claims from 2001 to 2011, collected in CRICO Strategies’ Comparative Benchmarking System, a national claims database. Two researchers reviewed cases to determine if a claim involved communication failure, its type, and potential preventability using a communication tool. Interrater reliability was assessed by dual review of 50 cases (81% agreement, κ = 0.62 for evidence of miscommunication). Claimant demographics, case characteristics, and financial data were analyzed.

Results

Communication failures were identified in 49% of claims. Claims with communication failures were significantly less likely to be dropped, denied, or dismissed than claims without (54% versus 67%, P = 0.015). Fifty-three percent of claims with communication failures involved provider-patient miscommunication, and 47% involved provider-provider miscommunication. The information types most frequently miscommunicated were contingency plans, diagnosis, and illness severity. Forty percent of communication failures involved a failed handoff; the majority could potentially have been averted by using a handoff tool (77%). Mean total costs for cases involving communication failures were higher ($237,600 versus $154,100, P = 0.005).

Conclusions

Communication failures are a significant contributing cause of malpractice claims and impose a substantial financial burden on the healthcare system. Interventions to improve transmission of critical patient information have the potential to substantially reduce malpractice expenditures.
Capturing Parents’ Perspectives of Child Wellness to Support Identification of Acutely Unwell Children in the Emergency Department
Authors: Albutt Abigail , Roland Damian , Lawton Rebecca , Conner Mark , O’Hara Jane
Published: December 2021

Objective

Early signs of serious illness can be difficult to recognize in children and a delayed response can result in poor outcomes. Drawing on the unique knowledge of parents and carers may improve identification of the deteriorating child. However, there is a lack of evidence exploring parental perspectives as part of track and trigger systems. This study examines the utility of capturing parent-reported child wellness, using the Patient Wellness Questionnaire for Pediatrics, to support identification of acutely unwell children presenting to the Emergency Department.

Methods

Parent-reported child wellness was recorded alongside the Pediatric Observation Priority Score (POPS), a multidimensional scoring system akin to a Pediatric Early Warning Score, used as part of routine care. Multiple linear regression assessed the independent effects of 3 variables (parent-reported child wellness, nurse concern, and child age) on POPS and hospital admission.

Results

Data were collected for 407 children. All 3 variables explained a statistically significant proportion of variance in POPS (F(3, 403) = 7.525, P < 0.001, R
2 = 0.053), with parent-reported child wellness (B = 0.223, SE = 0.054, β = 0.202, P < 0.001) having the strongest effect. Approximately 10% of the children with no physiological derangement were rated as “very poorly” by their parents.

Conclusions

The findings suggest that parents have insight in to the wellness of their children that is reflected in the physiological assessment. Some parents’ perceptions about their child’s wellness were not consistent with the score captured in the same assessment. More work is needed to understand how to use and address parental perspectives and concerns to support clinical decision making and the management of acute illness.
Safety Attitude of Operating Room Personnel Associated With Accurate Completion of a Surgical Checklist: A Cross-sectional Observational Study
Authors: Sens Florence , Viprey Marie , Piriou Vincent , Peix Jean-Louis , Herquelot Eléonore , Occelli Pauline , Bourdy Stéphanie , Gawande Atul A. , Carty MJ Matthew J. , Michel Philippe , Lifante Jean-Christophe , Colin Cyrille , Duclos Antoine
Published: December 2021

Objective

How the checklist is executed in routine practice may reflect the teamwork and safety climate in the operating room (OR). This cross-sectional study aimed to identify whether the presence of a fully completed checklist in medical records was associated with teams’ safety attitudes.

Methods

Data from 29 French hospitals, including 5677 operated patients and 834 OR professionals, were prospectively collected. The degree of checklist compliance was categorized for each patient in 1 of 4 ways: full, incomplete, inaccurate, and no checklist completed. The members of OR teams were invited to complete a questionnaire including teamwork climate measurement (Safety Attitudes Questionnaire) and their opinion regarding checklist use, checklist audibly reading, and communication change with checklist. Multilevel modeling was performed to investigate the effect of variables related to hospitals and professionals on checklist compliance, after adjustment for patient characteristics.

Results

A checklist was present for 83% of patients, but only 35% demonstrated full completion. Compared with no checklist, full completion was associated with higher safety attitude (high teamwork climate [adjusted odds ratio for full completion, 4.14; 95% confidence interval, 1.75–9.76]; communication change [1.31, 1.04–1.66]; checklist aloud reading [1.16, 1.02–1.32]) and was reinforced by the designation of a checklist coordinator (2.43, 1.06–5.55). Incomplete completion was also associated with enhanced safety attitude contrary to inaccurate completion.

Conclusions

Compliance with checklists is associated with safer OR team practice and can be considered as an indicator of the extent of safety in OR practice.
Gender Related Differences in Surgeon Compensation
Authors: Lopez Nicole E. , Nguyen Nghia H. , Hull Tracy L. , Peters Walter R. , Singh Siddharth , Ramamoorthy Sonia L.
Published: December 2021

Objective:

We sought to understand the effect of sex on compensation among colorectal surgeons and to determine which factors contribute to gender-based differences in compensation.

Summary of Background Data:

The sex-based wage gap in the medical profession is among the most pronounced wage gaps in the U.S. Data regarding the wage gap among colorectal surgeons and the underlying reasons for this disparity remain unclear.

Methods:

The Healthcare Economics Committee of the American Society of Colon and Rectal Surgeons conducted a survey to evaluate surgeon demographics, compensation, and practice characteristics. To evaluate the effect of sex on compensation, we performed multivariable linear regression with backward selection. We used a two-sided P-value with a significance threshold <0.05.

Results:

The mean difference in normalized total compensation between men and women was $46,250, and when salary was adjusted for FTEs, the difference was $57,000. Women were more likely to perform anorectal surgery, less likely to perform general surgery and less likely to hold positions in leadership. After adjustments, women reported significantly lower compensation (aOR, 0.88; 95% CI, 0.80-0.97). Time spent doing abdominal surgery (aOR, 1.13; 95% CI 1.03-1.23), professor status (aOR, 1.17; 95% CI, 1.03–1.32) and instructor status (aOR, 1.49; 95% 1.28–1.73) were independently associated with compensation.

Conclusions:

We found a 12% adjusted sex wage gap among colorectal surgeons. Gender-based differences in leadership positions and allocation of effort may contribute. Further research will be necessary to clarify sources of wage inequalities. Still, our results should prompt expedient actions to support closing the gap.
Reassuring Intraoperative Parameters Do Not Obviate the Need for Infrainguinal Bypass Completion Angiograms
Authors: Png C.Y. Maximilian , Kim Young , Jessula Samuel , DeCarlo Charles S. , Waller H. Davis , Feldman Zachary M. , Sumpio Brandon J. , Lee Sujin , Dua Anahita , Srivastava Sunita D. , Conrad Mark F.
Published: December 2021

Objective:

To determine if routine completion angiography for lower extremity bypasses using vein conduit results in lower rates of postoperative bypass occlusion.

Summary of Background Data:

With the increasing availability of on-table angiography and significant advancements in endovascular techniques, some operators routinely perform completion angiograms. The effect of this surgical paradigm has yet to be rigorously compared to the more widespread selective use of completion imaging in the modern era.

Methods:

This retrospective cohort study included infrainguinal arterial bypass procedures utilizing vein conduit completed at a single hospital system from 2001 to 2018 and compared postoperative outcomes between bypasses that underwent routine completion angiography versus selective completion angiography. Notably, any bypasses that underwent completion angiography due to intraoperative concerns were excluded from this analysis.

Results:

666 bypasses that were performed in 589 patients met inclusion criteria. 126 (18.9%) bypasses were classified into the routine completion angiogram group compared to 540 (81.0%) into the selective completion angiogram group. Patients who underwent routine completion angiograms had a rate of intraoperative reintervention of 22.2%. The routine angiogram group had lower rates of reintervention (3.9% vs 10.0%, P = 0.03) and graft occlusion (2.3% vs 9.2%, P = 0.01) at 1-month postoperatively.

Conclusion:

Lower extremity bypasses using vein conduit that undergo routine completion angiography are associated with lower rates of graft occlusion at 30-days postoperatively. Completion angiography should thus be routinely performed in infrainguinal bypasses that utilize venous conduit.
Spatial organization of chromosomes leads to heterogeneous chromatin motion and drives the liquid- or gel-like dynamical behavior of chromatin
Authors: Salari Hossein , Di Stefano Marco , Jost Daniel
Published: December 2021

Chromosome organization and dynamics are involved in regulating many fundamental processes such as gene transcription and DNA repair. Experiments unveiled that chromatin motion is highly heterogeneous inside cell nuclei, ranging from a liquid-like, mobile state to a gel-like, rigid regime. Using polymer modeling, we investigate how these different physical states and dynamical heterogeneities may emerge from the same structural mechanisms. We found that the formation of topologically associating domains (TADs) is a key driver of chromatin motion heterogeneity. In particular, we showed that the local degree of compaction of the TAD regulates the transition from a weakly compact, fluid state of chromatin to a more compact, gel state exhibiting anomalous diffusion and coherent motion. Our work provides a comprehensive study of chromosome dynamics and a unified view of chromatin motion enabling interpretation of the wide variety of dynamical behaviors observed experimentally across different biological conditions, suggesting that the “liquid” or “solid” state of chromatin are in fact two sides of the same coin.
Meta-analysis of human and mouse ALS astrocytes reveals multi-omic signatures of inflammatory reactive states
Authors: Ziff Oliver J. , Clarke Benjamin E. , Taha Doaa M. , Crerar Hamish , Luscombe Nicholas M. , Patani Rickie
Published: December 2021

Astrocytes contribute to motor neuron death in amyotrophic lateral sclerosis (ALS), but whether they adopt deleterious features consistent with inflammatory reactive states remains incompletely resolved. To identify inflammatory reactive features in ALS human induced pluripotent stem cell (hiPSC)–derived astrocytes, we examined transcriptomics, proteomics, and glutamate uptake in VCP-mutant astrocytes. We complemented this by examining other ALS mutations and models using a systematic meta-analysis of all publicly-available ALS astrocyte sequencing data, which included hiPSC-derived astrocytes carrying SOD1, C9orf72, and FUS gene mutations as well as mouse ALS astrocyte models with SOD1G93A mutation, Tardbp deletion, and Tmem259 (also known as membralin) deletion. ALS astrocytes were characterized by up-regulation of genes involved in the extracellular matrix, endoplasmic reticulum stress, and the immune response and down-regulation of synaptic integrity, glutamate uptake, and other neuronal support processes. We identify activation of the TGFB, Wnt, and hypoxia signaling pathways in both hiPSC and mouse ALS astrocytes. ALS changes positively correlate with TNF, IL1A, and complement pathway component C1q-treated inflammatory reactive astrocytes, with significant overlap of differentially expressed genes. By contrasting ALS changes with models of protective reactive astrocytes, including middle cerebral artery occlusion and spinal cord injury, we uncover a cluster of genes changing in opposing directions, which may represent down-regulated homeostatic genes and up-regulated deleterious genes in ALS astrocytes. These observations indicate that ALS astrocytes augment inflammatory processes while concomitantly suppressing neuronal supporting mechanisms, thus resembling inflammatory reactive states and offering potential therapeutic targets.
Addiction recovery stories: Jerome Carson in conversation with Lisa Ogilvie
Authors: Carson Jerome , Ogilvie Lisa
Published: December 2021

Purpose

The purpose of this paper is to explore the accomplishments of those who realise addiction recovery. To the best of the authors’ knowledge, this is the first in a series of recovery stories, where candid accounts of addiction and recovery are examined. In doing so, shared components of recovery are considered, along with the change and growth necessary to facilitate it.

Design/methodology/approach

The CHIME (Connectedness, Hope, Identity, Meaning and Empowerment) framework comprises five elements important to recovery. It provides a standard to qualitatively study mental health recovery, having also been applied to addiction recovery. In this paper, an additional element for Growth has been introduced to the model (G-CHIME), to consider both recovery and sustained recovery. A first-hand account of addiction recovery is presented, followed by a semi-structured e-interview with the author of the account. This is structured on the G-CHIME model.

Findings

This paper shows that successful and sustained recovery from alcohol addiction can be effectively explained using the G-CHIME model. Each element was well represented in the described process of reaching recovery.

Originality/value

Each account of recovery in this series is unique, and as yet, untold.
Assessing design buildability through virtual reality from the perspective of construction students
Authors: Samarasinghe Don Amila Sajeevan , Piri Imelda Saran
Published: December 2021

Purpose

The purpose of this paper is to evaluate the impact of visual models on the ability of construction students to assess design buildability.

Design/methodology/approach

The study engaged 45 construction students from one selected tertiary education institute in New Zealand. The data collection process involved meeting the students face-to-face and demonstrating the VR model to them, after which the students completed an online questionnaire and assessed design buildability using both 2D drawing and virtual reality (VR) models. To make this assessment, the participants considered a residential earth building modelled to promote sustainable building features. The assessment process required the participants to evaluate the design buildability of the same building design using a 2D drawing and a 3D VR model.

Findings

The study found that VR models have significant advantages for assessing design buildability. Students measured 16.80% higher average buildability with the 3D VR model compared to the 2D drawing. The participants in the evaluation felt that the visual model significantly improved the comprehensibility of complex designs, which helped identify and manage design buildability (overall, 83% of participants strongly supported this).

Originality/value

The paper showed construction digitisation such as VR, augmented reality and building information modelling is highly cooperative as it can easily be made available for online learning. Thus, the findings support construction educators use online-based VR learning to promote efficient teaching of design buildability to students.
Enhancing rating prediction for recommendation by metric learning with gray relational analysis
Authors: Chen Jiangmei , Zhang Wende , Zhang Qishan
Published: December 2021

Purpose

The purpose of the paper is to improve the rating prediction accuracy in recommender systems (RSs) by metric learning (ML) method. The similarity metric of user and item is calculated with gray relational analysis.

Design/methodology/approach

First, the potential features of users and items are captured by exploiting ML, such that the rating prediction can be performed. In metric space, the user and item positions can be learned by training their embedding vectors. Second, instead of the traditional distance measurements, the gray relational analysis is employed in the evaluation of the position similarity between user and item, because the latter can reduce the impact of data sparsity and further explore the rating data correlation. On the basis of the above improvements, a new rating prediction algorithm is proposed. Experiments are implemented to validate the effectiveness of the algorithm.

Findings

The novel algorithm is evaluated by the extensive experiments on two real-world datasets. Experimental results demonstrate that the proposed model achieves remarkable performance on the rating prediction task.

Practical implications

The rating prediction algorithm is adopted to predict the users' preference, and then, it provides personalized recommendations for users. In fact, this method can expand to the field of classification and provide potentials for this domain.

Originality/value

The algorithm can uncover the finer grained preference by ML. Furthermore, the similarity can be measured using gray relational analysis, which can mitigate the limitation of data sparsity.
Analysing developing countries approaches of supply chain resilience to COVID-19
Authors: Aman Sadaf , Seuring Stefan
Published: December 2021

Purpose

The Covid-19 pandemic has made it essential to explore the resilience factors specific to developing regions, not only because they pose threats of extreme poverty and offer a novel context but also because they play an important role in globalisation.

Design/methodology/approach

A mixed-method approach was undertaken to address this novel pandemic situation. First, an open-ended structured questionnaire was developed, and data were collected from three neighbouring emerging economies: Pakistan, India and Iran. Experts' perspectives on vulnerabilities, response measures, resilience and restoration of supply chain activities, and the role of social capital were collected. Second, building upon the findings from phase one of the studies, a quantitative structured questionnaire using the supply chain operational reference (SCOR) model was used to collect data in a structured manner. This quantitative data were further analysed using frequency and contingency analysis.

Findings

The findings from the first phase of the study inductively derive 36 resilience categories. Later, the contingency findings show that supply chain (SC) disruption is a major vulnerability for emerging economies, whereas solutions offered to combat it lay in the reconfiguration of resources, such as financial, technological, human, information and material. Additionally, supply network structure and social capital play an integral part in making SCs resilient against disruption.

Research limitations/implications

The respondents comprise the academics/SC researchers, which make the findings interesting though they lack the industrial experts' perspectives, directly. Nevertheless, the propositions can be tested in industrial settings to see whether the results are limited to a specific industrial setting or are rather generalised.

Practical implications

Similarly, practitioners and policy makers can incorporate the SCOR metrics/factors outlined in this study into their performance measurement systems and ensure continuous monitoring for firm's resilience.

Originality/value

The study offers a holistic understanding of the developing regions' approaches to Covid-19. The paper also takes a social capital perspective to explain firms' resilience in these emerging economies.
Participation in farmer organizations and adoption of farming technologies among rice farmers in Ghana
Authors: Addai Kwabena Nyarko , Temoso Omphile , Ng'ombe John N.
Published: December 2021

Purpose

The authors examine the factors influencing membership in farmer organizations (FO) and their effects on the decision to adopt farm technologies by rice farmers in Ghana.

Design/methodology/approach

This study uses a farm survey of 900 households from Northern Ghana and a recursive bivariate probit (RBP) model that accounts for selection bias and endogeneity.

Findings

The results indicate that the household head’s decision to adopt machinery and row planting increases by 38.4 and 25.3%, respectively, upon joining a farmer organization. Membership in farmer organization is positively influenced by off-farm income, asset value, farmer organization location and farmer location in Upper West region but negatively by males, age and total livestock units owned. Machinery adoption is positively influenced by membership in farmer organizations and respondent being male but negatively influenced by the years of schooling, farm size, farm distance and location of a farmer in Ghana's Upper East and West regions. Similarly, row planting adoption is positively influenced by membership in farmers' organization but adversely by farm size, farm distance and a farmer's location in Upper East region of Ghana.

Research limitations/implications

It can be concluded that membership in farmers' organizations significantly impacts farm household head’s decision to adopt machinery and row planting in rice production, which potentially enhance crop productivity.

Practical implications

These results show the importance of agricultural stakeholders in encouraging the formation and strengthening of farmer organizations to support the adoption of modern farming technologies.

Originality/value

Developing literature has demonstrated that farmer organizations promote the adoption of agricultural innovations. However, most of these studies have concentrated on conventional agricultural innovations and have used methods that fail to account for potential selection bias. This paper fills this important gap.