bluuebunny/crossref_metadata_2025 huggingface dataset:
Concluding Thoughts
Authors: O’Shea Sarah , May Josephine , Stone Cathy , Delahunty Janine
Published: September 2023

The final chapter draws together the threads of a compelling argument that exhorts educators and policymakers to perceive of First-in-Family students in terms of strengths rather than in deficit terms. By using the lens of family and community, the focus is on what students bring to the university environment rather than the ways in which the institution acts upon the individual learner. The chapter outlines the key arguments contained within the book and provides recommendations for teachers, key stakeholders and university administrators for how this important student population can be best supported in their academic pursuits.
Disrupting the Deficit: Beyond Notions of Lack for First-in-Family Students
Authors: O’Shea Sarah , May Josephine , Stone Cathy , Delahunty Janine
Published: September 2023

This chapter draws upon a strengths perspective that seeks to frame first in family students not as ‘lacking’ or as ‘deficit’ but rather as a cohort replete with cultural wealths. Building on Bourdieuian theories and referring explicitly to the work of Yosso and Sen, the capabilities and cultural strengths of this older FiF cohort are revealed. The chapter provides a relational understanding of this student experience that considers the wider dynamics of learners’ lived realities. In exploring these unique contexts, three richly descriptive vignettes are featured and these are discussed collectively. This discussion reflects both upon the constraints that are expressed by the older learners as well as the personal strengths each story reveals about the narrator.
Introduction
Authors: Dev S. Mahendra , Ganesh-Kumar A. , Pandey Vijay Laxmi
Published: September 2023

Despite a significant increase in the per capita food production in India, hunger and malnutrition are still quite high. The COVID-19 pandemic is likely to have further worsened the situation of hunger and malnutrition, placing India at a high risk of missing the target of achieving the SDG 2.1 target of zero hunger by 2030. The need to achieve food security by providing balanced and adequate nutrition to all requires coordination and concerted efforts from a host of stakeholders. This book in its twelve chapters takes an integrated approach by examining diverse aspects of food and nutrition security through a multidisciplinary lens of Agricultural Economics, Nutrition, Crop Sciences, Anthropology, and Law, while being rooted in economics. The chapters reflect this diversity in disciplines in terms of the questions posed, the data sets used, and the methodologies followed. Starting from the evolution of policy response for hunger and nutrition security, the book covers aspects such as gender budgeting, dietary diversity, women’s empowerment, calorie intake norms, socio-legal aspects of the right to health, subjective wellbeing, bio-fortification, crop insurance, and food security linkages, the interdependence of public distribution system (for food security) and employment guarantee schemes, especially during COVID-19 pandemic, effects of dairy dietary supplements, and so on. The book arrives at a rich set of findings and policy recommendations for India towards achieving the SDG 2.1 target of zero hunger by 2030.
Revisiting Women’s Empowerment as an Agriculture–Nutrition Pathway Using the Framework of Intersectionality
Authors: Mukhopadhyay Simantini
Published: September 2023

The second goal of Sustainable Development Agenda set in 2015 by the United Nations General Assembly seeks to end hunger and all forms of malnutrition, and double agricultural productivity by 2030. It has been laid down that sustainable access to nutritious food would require sustainable agricultural production and practices. The pathways through which agriculture affects nutritional outcomes have been well-documented; the linkages operate through improving access to food, affecting agricultural incomes and prices, and ‘feminising’ the agricultural workforce.
Socio-legal Analysis of the Impact of Food Insecurity and Hunger on the Right to Health of Urban Poor Living in the State of Gujarat
Authors: Shanthakumar S. , Dhanya S.
Published: September 2023

Despite the socio-economic development, food insecurity and malnutrition are two evils found unexpectedly high around the globe hampering one of the most important human rights, the right to health. The conditions of health of people living in poverty are disproportionately worse than others. India’s obligation to ensure food security and health for all has its roots in International Law. Similarly, the country is also bound to provide these rights under the Constitution of India and the other national legal frameworks. However, India’s position in the recent Food Security Index, as well as Health Index, highlights the inadequacies in the nation’s obligation to guarantee the availability and accessibility of quality food to ensure physical well-being to all. This socio-legal research analysed the status of food insecurity in the State of Gujarat and its impact on urban poor living in the state. The study also has analysed the journey of ‘right to food’ as a fundamental human right under the Indian Legal system and the efficacy and success ratio of the Government initiatives with reference to Sustainable Development Goals. The study found that there is a huge gap in the system as the government schemes lack accessibility and as a result, the majority of the surveyed population are out of ration and also are not utilizing other government schemes for their benefits, hence leading a miserable life.
Mapping the Food Security Situation in Rural Bihar and Jharkhand: Insights from Two Food Security Atlases
Authors: Sharma Alakh N. , Mishra Sunil K. , Kundu Tanushree , Dutta Swati , Arya Prashant Kumar
Published: September 2023

The paper draws from the district-level food security atlases of rural Bihar and Jharkhand prepared by the Institute for Human Development (IHD). The atlases explore the dimensions and approach to measuring food security as well as the linkages with the component indicators. Food availability, access to food, and utilization of food are the three dimensions that have been delved into in detail. It identifies the ‘priority indicators’ and ‘priority districts’ which are the most food-insecure regions in both the states. The government programmes relevant to food insecurity have been briefly analysed and policy interventions have been suggested to improve the food security situation, especially in the food insecure regions of the two states. Female literacy rate, dependency ratio, disease and health behaviour, access to toilet facilities, availability of non-agricultural employment opportunities, and extent of irrigation have emerged as crucial policy variables for overall food security in Bihar. On the other hand, in Jharkhand, the value of agricultural output, availability of health institutions, and dependency ratio have emerged as priority indicators related to food security. Special welfare programmes targeted at vulnerable communities and food-insecure regions are suggested in both states to tackle food insecurity. There is also an imperative need to increase the availability and accessibility of health institutions in both states. At the same time, an increase in agricultural productivity by enhancing irrigation coverage is a crucial aspect, common for both states. An increase in dietary diversity through community and individual kitchen gardens is also suggested for improving the status of malnourishment in rural areas of Bihar and Jharkhand.
Exploring the Prevalence of Undernutrition and Consumers’ Knowledge, Preferences, and Willingness to Pay for Biofortified Food
Authors: Singh Alka , Palanisamy Venkatesh , Raman Renjini Valiyaveettil , Velayudhan Praveen Koovalamkadu , Singh Ashok Kumar
Published: September 2023

In this chapter, the prevalence of child and adult malnutrition in India is assessed using the latest National Family Health Survey-5 (2019–21) data. Though the country has made a moderate improvement in reducing the incidence of stunting, wasting, and underweight in children and the incidence of thin adults, the issue of obesity and anaemia has emerged as significant concerns. We identified the northern and southern regions of the country to be better nourished in general than the eastern and western regions and pointed out the malnutrition hotspots using district-level maps. The determinants of malnutrition incidences are identified using multivariate regression analysis. Among different methods to combat the issue of malnutrition, biofortification is a promising one. We estimated the potential of biofortified crops to improve the nutritional outcomes in children and women using a systematic review and meta-analysis. Further, an ex ante health benefits assessment of biofortification was done using rice biofortification with zinc and iron. Finally, since awareness and perception are crucial in improving the adoption of biofortified crops, we extracted the consumer perception of biofortification and their willingness to pay through a cross-sectional survey.
Does Crop Insurance Promote Nutrition and Good Health Among Women and Children in the Agrarian Households of India?
Authors: Sengupta Reshmi , Rooj Debasis
Published: September 2023

Improving maternal and child health is one of the top objectives of Sustainable Development Goals (SDG). The use of maternal services can help improve both maternal and child health. However, the factors influencing such utilizations are complex and can be determined by several factors. This paper aims to examine the role of crop insurance on health-seeking behaviour among women of reproductive age. We also examine the nutritional outcome of children below 5 years. We use two nationally representative data sets and combine them using district as the common identification level. To capture the health-seeking behaviour, we use several measures of antenatal care use, safe delivery, and postnatal care as outcome variables. We use multilevel regression to find that women in districts with higher crop insurance adoption seek more antenatal care than their counterparts with lower crop insurance adoption. Further, we observe that these groups of women are more likely to opt for institutional delivery and receive postnatal care in a private facility. Apart from secondary data analysis, we also conduct a pilot survey in the two districts of Bihar. Using a sample size of 400 households, we find that households who are beneficiaries of the Government of India’s recently launched income support programme (PM-Kisan Samman Niddhi Yojna) report a greater level of food security. Women from these households seek higher early antenatal care. Finally, children from the benefited households received higher immediate postnatal care. Therefore our finding suggests that crop insurance and income support programmes for the farmers not only provide a hedge against crop loss by ensuring some degree of certainty and ensuring income smoothing but also positively impact food security for the households, improve healthcare-seeking practices by women in their reproductive age and improves child nutritional outcomes.
Perils of towers in the swamp: dark dimensions and the robustness of EFTs
Authors: Burgess C. P. , Quevedo F.
Published: September 2023

Abstract

Recently there has been an interesting revival of the idea to use large extra dimensions to address the dark energy problem, exploiting the (true) observation that towers of states with masses split, by $$ {M}_N^2 $$

M
N
2

= f(N)m2, with f an unbounded function of the integer N, sometimes contribute to the vacuum energy only an amount of order mD in D dimensions. It has been argued that this fact is a consequence of swampland conjectures and may require a departure from Effective Field Theory (EFT) reasoning. We test this claim with calculations for Casimir energies in extra dimensions. We show why the domain of validity for EFTs ensures that the tower spacing scale m is always an upper bound on the UV scale for the lower-energy effective theory; use of an EFT with a cutoff part way up a tower is not a controlled approximation. We highlight the role played by the sometimes-suppressed contributions from towers in extra-dimensional approaches to the cosmological constant problem, old and new, and point out difficulties encountered in exploiting it. We compare recent swampland realizations of these arguments with earlier approaches using standard EFT examples, discussing successes and limitations of both.
Setting the distal and posterior condyle of the femoral component to restore the medial pre‐arthritic femoral articular surface results in better outcomes after total knee arthroplasty
Authors: Rak Dominik , Rügamer Thorsten , Klann Lukas , Nedopil Alexander J. , Rudert Maximilian
Published: September 2023

Purpose

The present study of total knee arthroplasty (TKA) describes an intra‐operative method that determines the direction and quantifies the magnitude of deviation of the distal and the posterior medial and lateral (DM, PM, DL, and PL) condyle of the femoral component relative to the pre‐arthritic femoral articular surface. For each femoral condyle, the deviations were categorized, and an analysis determined which had better or worse Forgotten Joint Score (FJS), Oxford Knee Score (OKS), and WOMAC scores at 1‐year follow‐up.

Methods

Four academic arthroplasty surgeons supervised a cemented primary CR TKA (Triathlon, Stryker) on 120 consecutive patients. 103 that completed patient‐reported outcome measures (PROMs) were analyzed. The surgeon determined the direction and the magnitude of deviation of the condyle of the femoral component by intraoperatively measuring the thickness of the femoral resection, adding compensations of 1 mm for the saw kerf and 2 mm for worn cartilage, and then subtracting the thickness of the femoral component’s condyle. For each femoral condyle, a Kruskal–Wallis test determined the categories of deviation with clinically important and significantly different 1‐year PROMs.

Results

A 1 to 2.5 mm and 3 mm or more proximal deviation of the DM condyle of the femoral component worsened the median FJS by 35 and 40 points, OKS by 9 and 14 points, and WOMAC score by 9 and 17 points, respectively, relative to those with a –0.5 to 0.5 mm deviation (p < 0.01). A 1 to 2.5 mm and 3 mm or more anterior deviation of the PM condyle of the femoral component worsened the FJS by 34 and 48 points, OKS by 7 and 13 points, and WOMAC scores by 8 and 16 points, respectively (p < 0.01). Deviations of the DL and PL condyle of the femoral component did not affect PROMs (p ≥ 0.13).

Conclusions

Although many factors can affect PROM, such as patient expectations, the surgeon should understand that setting the DM and the PM condyles of the femoral component within 1 mm of the patient’s pre‐arthritic femoral articular surface can potentially result in better FJS, OKS, and WOMAC scores at 1 year.

Level of evidence

II, Prospective cohort study
Tankyrase inhibition interferes with junction remodeling, induces leakiness, and disturbs YAP1/TAZ signaling in the endothelium
Authors: Ma Nan , Wibowo Yohanes Cakrapradipta , Wirtz Phillip , Baltus Doris , Wieland Thomas , Jansen Sepp
Published: September 2023

Tankyrase inhibitors are increasingly considered for therapeutic use in malignancies that are characterized by high intrinsic β-catenin activity. However, how tankyrase inhibition affects the endothelium after systemic application remains poorly understood. In this study, we aimed to investigate how the tankyrase inhibitor XAV939 affects endothelial cell function and the underlying mechanism involved. Endothelial cell function was analyzed using sprouting angiogenesis, endothelial cell migration, junctional dynamics, and permeability using human umbilical vein endothelial cells (HUVEC) and explanted mouse retina. Underlying signaling was studied using western blot, immunofluorescence, and qPCR in HUVEC in addition to luciferase reporter gene assays in human embryonic kidney cells. XAV939 treatment leads to altered junctional dynamics and permeability as well as impaired endothelial migration. Mechanistically, XAV939 increased stability of the angiomotin-like proteins 1 and 2, which impedes the nuclear translocation of YAP1/TAZ and consequently suppresses TEAD-mediated transcription. Intriguingly, XAV939 disrupts adherens junctions by inducing RhoA-Rho dependent kinase (ROCK)-mediated F-actin bundling, whereas disruption of F-actin bundling through the ROCK inhibitor H1152 restores endothelial cell function. Unexpectedly, this was accompanied by an increase in nuclear TAZ and TEAD-mediated transcription, suggesting differential regulation of YAP1 and TAZ by the actin cytoskeleton in endothelial cells. In conclusion, our findings elucidate the complex relationship between the actin cytoskeleton, YAP1/TAZ signaling, and endothelial cell function and how tankyrase inhibition disturbs this well-balanced signaling.
In vitro and in silico evaluation of the serrapeptase effect on biofilm and amyloids of Pseudomonas aeruginosa
Authors: Katsipis Georgios , Avgoulas Dimitrios I. , Geromichalos George D. , Petala Maria , Pantazaki Anastasia A.
Published: September 2023

Pseudomonas aeruginosa is an emerging threat for hospitalized and cystic fibrosis patients. Biofilm, a microbial community embedded in extracellular polymeric substance, fortifies bacteria against the immune system. In biofilms, the expression of functional amyloids is linked with highly aggregative, multi-resistant strains, and chronic infections. Serrapeptase (SPT), a protease possessing similar or superior anti-microbial properties with many antibiotics, presents anti-amyloid potential. However, studies on the employment of SPT against Pseudomonas biofilms and Fap amyloid, or the possible mechanisms of action are scarce. Here, SPT inhibited biofilm formation of P. aeruginosa ATCC 27853 on both plastic and glass surfaces, with an IC50 of 11.26 µg/mL and 0.27 µg/mL, respectively. The inhibitory effect of SPT on biofilm was also verified with optical microscopy of crystal violet-stained biofilms and with confocal microscopy. Additionally, SPT caused a dose-dependent decrease of bacterial viability (IC50 of 3.07 µg/mL) as demonstrated by MTT assay. Reduction of bacterial functional amyloids was also demonstrated, employing both fluorescence microscopy with thioflavin T and photometrical determination of Congo-red-positive compounds. Both viability and functional amyloids correlated significantly with biofilm inhibition. Finally, in silico molecular docking studies provided a mechanistic insight into the interaction of SPT with FapC or FapD, proving that both peptides are possible targets of SPT. These results offer new insights into the biofilm formation of P. aeruginosa and potentiate the involvement of SPT in the prevention and eradication of Pseudomonas biofilms.

Graphical abstract

Key points

• Serrapeptase inhibits biofilm formation of P. aeruginosa on plastic and glass.

• Biofilm inhibition correlated with reduced viability and functional amyloid levels.

• In silico studies indicated that serrapeptase may target FapC and FapD peptides.
High-cell-density cultivation of Vibrio natriegens in a low-chloride chemically defined medium
Authors: Biener Richard , Horn Thomas , Komitakis Alexander , Schendel Ines , König Leon , Hauenstein Anna , Ludl Alina , Speidel Andrea , Schmid Svenja , Weißer Julian , Broßmann Max , Kern Sofia , Kronmüller Max , Vierkorn Sonja , Suckow Lennart , Braun Arthur
Published: September 2023

Vibrio natriegens is a halophilic bacterium with the fastest generation time of non-pathogenic bacteria reported so far. It therefore has high potential as a production strain for biotechnological production processes or other applications in biotechnology. Culture media for V. natriegens typically contain high sodium chloride concentrations. The corresponding high chloride concentrations can lead to corrosion processes on metal surfaces in bioreactors. Here we report the development of a low-chloride chemically defined medium for V. natriegens. Sodium chloride was completely replaced by the sodium salts disodium hydrogen phosphate, disodium sulfate, and sodium citrate, while keeping the total concentration of sodium ions constant. The use of citrate prevents the occurrence of precipitates, especially of ammonium magnesium phosphate. With this defined medium, high-cell-density fed-batch cultivations in laboratory-scale bioreactors using exponential feeding yielded biomass concentrations of more than 60 g L−1.

Key points

A defined medium for V. natriegens that only contains traces of chloride was developed

Corrosion processes on metal surfaces in industrial bioreactors can thus be prevented

High yields of biomass can be achieved in fed-batch cultivation with this medium
Co-Producing Narratives and Indicators as Catalysts for Adaptive Governance of a Common-Pool Resource within a Protected Area
Authors: Roux Dirk J. , Taplin Megan , Smit Izak P. J. , Novellie Peter , Russell Ian , Nel Jeanne L. , Freitag Stefanie , Rosenberg Eureta
Published: September 2023

The theory and practice of adaptive management and adaptive governance have been widely studied in the complex social contexts that mediate how humans interact with ecosystems. Adaptive governance is thought to enable adaptive management in such contexts. In this study, we examine four often-used principles of adaptive governance (polycentric institutions, collaboration, social learning and complexity thinking) to develop a framework for reflecting on adaptive governance of a social-ecological system—the Knysna Estuary in South Africa. This estuary is a priority for biodiversity conservation, as well as a common-pool resource central to livelihoods. We used the framework to structure dialogue on the extent to which the four principles of adaptive governance were being applied in the management of the Knysna Estuary. The dialogue included diverse stakeholders, from those who have the power to influence adaptive management to those most dependent on the resource for their livelihoods. Based on a combination of theory and current reality we then identified eight indicators that could be used to guide a transition towards improved adaptive governance of the estuary. These indicators were assessed and supported by most stakeholders. The main contributions of our research are (a) a process for combining theory and stakeholder dialogue to reflect on adaptive governance of a social-ecological system; (b) a set of indicators or conditions that emerged from our participatory process that can be used for reflexive monitoring and adaptation of adaptive governance of Knysna Estuary; and (c) a real-world example of seeking complementary links between adaptive governance and adaptive management to promote effective management of complex social-ecological systems.
Modified Enhanced Recovery After Surgery (ERAS) Protocol Versus Non‐ERAS Protocol in Patients Undergoing Emergency Laparotomy for Acute Intestinal Obstruction: A Randomized Controlled Trial
Authors: Aggarwal Ankit , Irrinki Santosh , Kurdia Kailash C. , Khare Siddhant , Naik Naveen , Tandup Cherring , Savlania Ajay , Dahiya Divya , Kaman Lileswar , Sakaray Yashwant
Published: September 2023

Background

Enhanced Recovery After Surgery (ERAS) is a multimodal approach with promising results in improving patient outcome. Only recently, is evidence emerging highlighting how similar principles of care can be applied to patients undergoing emergency abdominal surgery.

Methods

A randomized controlled trial was conducted from November 2021 to April 2022 at PGIMER Chandigarh, which is a leading tertiary care hospital in northern India. 60 patients with acute intestinal obstruction requiring emergency laparotomy were randomized and assigned to ERAS or Non‐ERAS group. ERAS protocol with some modifications was applied. Primary endpoints were post‐operative hospital stay. Secondary end points were morbidity, 30‐day readmission and mortality rate. Data analysis was done using SPSS 22.0. Independent t test or Mann–Whitney test and Chi‐square or Fisher‐exact test were used for analysis.

Results

A significant 3‐day reduction in hospital stay was observed in ERAS compared to non‐ERAS group (median (interquartile range) 5.50 (4.75–8.25) vs 8.0 (6.0–11.0) p = 0.003) with no difference in 30‐day readmission rate, mortality rate and complication rate (according to Clavien–Dindo classification). ERAS group was associated with early recovery of gastrointestinal functions including time to first passage of flatus (p < 0.001), stools (p = 0.014), early ambulation (p < 0.001), time to first fluid diet (p < 0.001), solid diet (p = 0.001) and reduced nasogastric tube reinsertion rates (p = 0.01) despite its early removal.

Conclusion

ERAS with some modifications can be applied in patients with intestinal obstruction. Thus, we can expedite post‐operative recovery and early regain of gastrointestinal function with decreased hospital stay, comparable morbidity and mortality. Further studies are needed to assess ERAS role in emergency gastrointestinal surgeries.

Trial registration Ctri.gov Identifier: CTRI/2022/04/042156.
Impact of preoperative statin medication on long-term outcomes after pancreatoduodenectomy for ductal adenocarcinoma: an international multicentric cross-sectional study
Authors: Joliat Gaëtan-Romain , Gaspar-Figueiredo Sérgio , Labgaa Ismail , Vrochides Dionisios , Perinel Julie , Adham Mustapha , Demartines Nicolas , Schäfer Markus
Published: September 2023

Purpose

Statin treatment has been shown in certain population studies and meta-analyses to improve survival of patients with pancreatic ductal adenocarcinoma (PDAC). This study assessed if patients with statin treatment had better overall survival (OS) and disease-free survival (DFS) after upfront pancreatoduodenectomy for PDAC.

Methods

Consecutive PDAC patients were retrospectively collected from three centers in Europe and USA (study period: 2000–2017). Adult patients who underwent upfront pancreatoduodenectomy and survived the first 90 postoperative days were included. Patients with metastasis at diagnosis or with macroscopic incomplete resection were excluded. Patients were considered under statin if started at least one month before pancreatoduodenectomy. Survival rates were calculated using Kaplan–Meier method and compared with log-rank test.

Results

A total of 496 patients were included. Median age was 67 years (IQR 59–75), 48% (n = 236) were women, and 141 patients (28%) received statin treatment already preoperatively. Patients with and without statin treatment were comparable in terms of demographics and pre-/intraoperative characteristics, except for age and pre-existing diabetes. Median OS and DFS were similar in patients with and without statin treatment (OS: 29, 95% CI 22–36 vs. 27 months, 95% CI 22–32, p = 0.370, DFS: 18, 95% CI 14–22 vs. 16 months, 95% CI 14–18, p = 0.430). On multivariable Cox regression, lymph node involvement (HR 1.9, 95% CI 1.6–2.2, p < 0.001), tumor differentiation (HR 1.3, 95% CI 1.1–1.6, p = 0.003), and postoperative chemotherapy (HR 0.5, 95% CI 0.4–0.7, p < 0.001) were predictors of OS, whereas statin treatment was not a prognostic factor (HR 0.9, 95% CI 0.7–1.2, p = 0.376).

Conclusion

In this international cohort of PDAC patients, statin treatment did not influence survival after upfront pancreatoduodenectomy. Nodal involvement, tumor differentiation, and postoperative chemotherapy were independent predictors of OS.
Statistical inference on quantiles of two independent populations under uncertainty
Authors: Hesamian Gholamreza , Chukhrova Nataliya , Johannssen Arne
Published: September 2023

Statistical inference is the process of drawing conclusions about underlying population(s) using sample data to either confirm or falsify hypotheses. However, the complexity of real-life problems often makes the underlying statistical models inadequate, as information is often imprecise in many respects. To address this common problem, some papers have been published on modifications and extensions of test concepts by employing tools of fuzzy statistics. In this paper, we present a non-parametric test for the difference between quantiles of two independent populations based on fuzzy random variables. For this purpose, we consider the fuzzy quantile function and its estimation based on $$\alpha $$
α
-values of fuzzy random variables. We then provide a fuzzy test based on the fuzzy empirical distribution function for the difference of fuzzy order statistics from these independent populations. We also suggest a specific degree-based criterion to compare the fuzzy test statistics at a specific significance level to decide whether the underlying fuzzy null hypothesis can be rejected or not. The effectiveness of the proposed two-sample test on quantiles is investigated via numerical examples.
The efficacy and safety of opioid-free anesthesia combined with ultrasound-guided intermediate cervical plexus block vs. opioid-based anesthesia in thyroid surgery—a randomized controlled trial
Authors: Liu Zhi , Bi Congjie , Li Xingguo , Song Ruonan
Published: September 2023

Purpose

In the context of the current comfort medicine and enhanced recovery after surgery, there is a demand for a new anesthesia method to reduce adverse reactions and accelerate recovery after surgery. This randomized controlled trial aimed to compare the efficacy and safety between opioid-free anesthesia (OFA) combined with ultrasound-guided intermediate cervical plexus block (ICPB) and opioid-based anesthesia in patients after thyroid surgery.

Methods

In this study, 75 patients scheduled for thyroid surgery under general anesthesia were randomly allocated into two groups. The primary outcome included the incidence of nausea within 24 h after surgery. The main secondary outcomes included the incidence of vomiting and the visual analog score (VAS) scores within 24 h after surgery as well as the quality of recovery 40 questionnaires (QoR-40) scores 24 h after surgery.

Results

In the OFA group, the incidence of postoperative nausea was 6.1%, compared to 39.4% in the control group (p = 0.001). No patient presented with postoperative vomiting in the OFA group, while 15.2% of patients suffered from postoperative vomiting in the control group (p = 0.063). The VAS scores of patients in the postanesthetic care unit (PACU) and 2 h, 4 h, and 6 h after surgery were lower in the OFA group, and the difference is statistically significant. Besides, the VAS scores of patients at rest (p = 1.000) and during swallowing (p = 1.000) 24 h after surgery were comparable.

Conclusion

Compared with opioid-based anesthesia, the OFA combined with the ultrasound-guided ICPB can better improve patients' postoperative recovery, reduce nausea, and decrease pain scores.

Trial registration

Chinese Clinical Trial Regisrty, ChiCTR2200056344, https://www.chictr.org.cn
The correlation between osteoporotic vertebrae fracture risk and bone mineral density measured by quantitative computed tomography and dual energy X-ray absorptiometry: a systematic review and meta-analysis
Authors: Chen Lin , Wu Xin-yi , Jin Qi , Chen Guang-yao , Ma Xiao
Published: September 2023

This paper presents a comparison of quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA) in osteoporosis with vertebral fracture and osteoporosis without fracture. It has been proved that the volumetric bone mineral density (vBMD) measured by QCT exhibits a stronger correlation with fracture risk than areal bone mineral density (aBMD) measured by DXA.

Purpose

This study aims to systematically evaluate the ability of QCT and DXA to distinguish between osteoporosis with vertebral fracture and osteoporosis without fracture according to vBMD and aBMD.

Methods

We conducted a primary literature search of the online databases up to 3 July, 2022, in both English and Chinese publications, combining synonyms for “QCT”, “DXA” and “osteoporosis”. The Newcastle–Ottawa scale (NOS) was employed to evaluate the quality of the selected articles. vBMD obtained through QCT and aBMD obtained through DXA were extracted, and were analyzed by Review Manager 5.4 and RStudio.

Results

Six studies with 610 individuals aged 45 to 90, of which 179 had vertebral fractures, were included in the final analysis. The weighted mean difference (WMD) between osteoporosis with vertebral fracture and osteoporosis without fracture for vBMD was − 27.08 (95% CI  − 31.24 to  − 22.92), while for aBMD was − 0.05 (95% CI − 0.08 to − 0.03).

Conclusions

Both vBMD detected by QCT and aBMD detected by DXA could discriminate fracture status in the spine, and vBMD performed a stronger correlation with fracture risk.

Trial registration: PROSPERO 2022 CRD42022349185.
Cohort study of postural sway and low back pain: the Copenhagen City Heart Study
Authors: Madsen Anja Lykke , Gyntelberg Finn , Marott Jacob Louis , Schnohr Peter , Astrup Jens
Published: September 2023

Purpose

Low back pain is a significant health problem with a high prevalence. Studies of smaller cohorts of low back pain patients have indicated increased body sway. The present paper tests the hypothesis of an association between low back pain and postural sway in a large randomly selected population.

Methods

The current study used the fifth examination (2011–2015) of The Copenhagen City Heart Study where 4543 participated. The participants answered a self-administered questionnaire regarding pain, physical activity, smoking, alcohol consumption, education, and other lifestyle factors. Measurement of postural body sway was performed using the CATSYS system.

Results

Totally 1134 participants (25%) reported to have low back pain. Subjects with low back pain had higher sway area and sway velocity than subjects without.

Conclusion

When using multivariate statistical analysis, confounding factors such as male gender, higher age, larger body height, low education level, smoking, and low activity level explained the association between low back pain and postural sway.
Clinical evaluation of sodium hypochlorite/amino acids and cross-linked hyaluronic acid adjunctive to non-surgical periodontal treatment: a randomized controlled clinical trial
Authors: Ramanauskaite Egle , Machiulskiene Vita , Shirakata Yoshinori , Dvyliene Urte Marija , Nedzelskiene Irena , Sculean Anton
Published: September 2023

Objectives

To compare the clinical outcomes obtained with either mechanical subgingival debridement in conjunction with a sodium hypochlorite and amino acids containing gel followed by subsequent application of a cross-linked hyaluronic acid gel (xHyA) gel, or with mechanical debridement alone.

Materials and Methods

Fourty-eight patients diagnosed with stages II-III (Grades A/B) generalised periodontitis were randomly treated with either scaling and root planing (SRP) (control) or SRP plus adjunctive sodium hypochlorite/amino acid and xHyA gels (test). The primary outcome variable was reduction of probing depth (PD), while changes in clinical attachment level (CAL), bleeding on probing (BOP) and plaque index (PI) were secondary outcomes. The outcomes were assessed at baseline, at 3 and 6 months following therapy.

Results

All patients completed the 6 months evaluation. At 6 months, the test group showed statistically significantly better results in terms of mean PD reduction (2.9 ± 0.4 vs 1.8 ± 0.6 mm, p < 0.001). Similarly, mean CAL gain was statistically higher in the test group compared to the control one (test: 2.6 ± 0.5 vs control: 1.6 ± 0.6 mm, p < 0.001). Mean BOP decreased from 81.8 ± 16.2% to 48.9 ± 14.5% in control (p < 0.001) and from 83.2 ± 15.5% to 17.6 ± 11.5% in test (p < 0.001) groups with a statistically significant difference favouring the test group (p < 0.001). Mean PI scores were reduced statistically significantly in both groups (from 38.8 ± 26% to 26.5 ± 20.5% in control (p = 0.039) and from 60.6 ± 10.9% to 12.7 ± 8.9% in test group (p < 0.001)), with a statistically significant difference between the groups (p < 0.001). The number of moderate pockets (4–6 mm) were reduced from 1518 (41.2%) to 803 (22.6%) in the control and from 1803 (48.6%) to 234 (7.7%) in the test group with a statistically significant difference between the groups (p < 0.001), while the number of deep pockets (≥ 7 mm) changed from 277 (7.6%) to 35 (1.0%) in the control and from 298 (8.7%) to 4 (0.1%) in test group (p = 0.003).

Conclusion

Within their limits the present data indicate that: a) both treatments resulted in statistically significant improvements in all evaluated clinical parameters, and b) the adjunctive subgingival application of sodium hypochlorite/amino acid and xHyA to SRP yielded statistically significantly higher improvements compared to SRP alone.

Clinical relevance

The combination of sodium hypochlorite/amino acid and xHyA gels to subgingival mechanical debridement appears to represent a valuable approach to additionally improve the outcomes of non-surgical periodontal treatment.

Clinical Trial Registration Number NCT04662216 (ClinicalTrials.gov).
Integrating shallow head measurements and InSAR data to quantify groundwater-storage change in San Joaquin Valley, California (USA)
Authors: Lees M. , Knight R.
Published: September 2023

Monitoring groundwater storage is essential for sustainable groundwater management. Storage can be quantified by considering the two main components through which storage change is expressed: saturation changes and deformation of aquifer materials. Here, these components were quantified using a selected area in California’s San Joaquin Valley (USA). First, this involved following existing observational approaches: quantifying the component expressed through saturation changes by identifying head measurements from shallow wells and scaling by specific yield. In the San Joaquin Valley, existing approaches to estimate the deformation component are to ignore it or approximate it with a simple linear relation to measured head. However, head and deformation measurements made at extensometers revealed that assuming a linear relationship between deformation and head might provide a poor estimate, particularly during periods in which measured head is rising. Instead, InSAR-derived surface deformation measurements were used to quantify the deformation component of storage changes. This showed that the two components—saturation and deformation—accounted for storage declines of equal magnitude over 2015–2021, suggesting that the deformation component should not be neglected when estimating storage changes in regions with subsidence. Summing the two calculated components gave a new estimate of the total storage change that captured the major trends seen in independent estimates, while better accounting for the deformation component. An additional benefit is that this method accounts for the deformation component in the unconfined aquifer. This method to quantify total storage change can be a practical and effective tool to support groundwater management.
Disparities in computed tomography utilization for pediatric blunt trauma: a systematic review and meta-analysis comparing pediatric and non-pediatric trauma centers
Authors: Hassankhani Amir , Valizadeh Parya , Amoukhteh Melika , Jannatdoust Payam , Saeedi Nikoo , Sabeghi Paniz , Ghadimi Delaram J. , Johnston Jennifer H. , Gholamrezanezhad Ali
Published: September 2023

Pediatric blunt trauma is a major cause of morbidity and mortality, and computed tomography (CT) imaging is vital for accurate evaluation and management. Pediatric trauma centers (PTCs) have selective CT practices, while non-PTCs may differ, resulting in potential variations in CT utilization. The objective of this study is to delineate disparities in CT utilization for pediatric blunt trauma patients between PTCs and non-PTCs. A systematic review and meta-analysis were conducted following established guidelines, searching PubMed, Scopus, and Web of Science up to March 3, 2023. All studies examining CT utilization in the management of pediatric (aged < 21 years) blunt trauma and specifying the type of trauma center(s) were included, and data were extracted and analyzed using STATA software version 17.0. An analysis of 30 studies revealed significant variations in CT scan utilization among pediatric blunt trauma patients across different types of trauma centers. PTCs exhibited lower pooled rates of abdominopelvic CT scans (35.4% vs. 44.9%, p < 0.01), cranial CT scans (36.9% vs. 42.9%, p < 0.01), chest CT scans (14.5% vs. 25.4%, p < 0.01), and cervical spine CT scans (23% vs. 45%, p < 0.01) compared to adult or mixed trauma centers (ATCs/MTCs). PTCs had a pooled rate of 54% for receiving at least one CT scan, while ATCs/MTCs had a higher rate of 69.3% (p < 0.05). The studies demonstrated considerable heterogeneity. These findings underscore the need to conduct further research to understand the reasons for the observed variations and to promote appropriate imaging usage, minimize radiation exposure, and encourage collaboration between pediatric and adult trauma centers.
Assessment of exposure to fungi in archives and libraries based on analyses of filter and nasal samples: preliminary investigation
Authors: Cyprowski Marcin , Ławniczek-Wałczyk Anna , Stobnicka-Kupiec Agata , Gołofit-Szymczak Małgorzata , Górny Rafał L.
Published: September 2023

The aim of this study was to characterize the occupational exposure to inhalable dust and airborne fungi among archive and library workers based on qualitative and quantitative analyses of stationary and personal filter samples as well as nasal swabs. The study was carried out in 3 archives and 2 libraries and involved 9 workers of these institutions. Airborne fungi and inhalable dust samples were collected by stationary and personal measurements using filter samplers. Additionally, the nasal swabs from workers were taken after work-shift and microbiologically analysed. The average concentrations of inhalable dust and airborne fungi were 49 µg/m3 (SD = 91) and 299 CFU/m3 (SD = 579), respectively. Both dust and bioaerosol concentrations obtained using personal measurements were significantly higher than that measured by stationary sampling. The correlation analysis showed strong relationships between the concentrations of inhalable dust and airborne fungi (R = 0.57; p < 0.001). The fungal concentrations in swab samples from archive workers (median: 104 CFU/ml) were significantly higher than that in swabs from librarians (median: 1.4 CFU/ml). Among the airborne fungi, the widest spectrum of species was found among Penicillium and Aspergillus (including pathogenic A. fumigatus) genera. However, in samples from archives, yeast-like fungi from Sporidiobolus and Candida (including pathogenic C. albicans) genera predominated among isolated mycobiota. The results of this study revealed that airborne fungi were able to efficiently contaminate the nasal cavity of archive and library employees. The analysis of nasal swabs can be considered as an important analytical tool supporting the assessment of workers’ exposure to bioaerosols.
Virtual Delivery of Parent Coaching Interventions in Early Childhood Mental Health: A Scoping Review
Authors: Hippman Catriona , Mah Janet W. T. , MacFadden Megan
Published: September 2023

Parent–coaching interventions positively impact child development. Virtual delivery of such interventions is supported by literature reviews and a practice guideline, however, none of these focused on children under age six. A scoping review of virtually-delivered parent-coaching interventions for disruptive behaviour, anxiety, and parent–child relationship concerns in children under age six was conducted between Dec. 15, 2020 and April 22, 2021. Iterative searches of the databases PubMed, CINAHL, and PsycINFO were complemented by reference list searches and clinician expert review (N = 1146). After relevance screening and duplicate removal, collaboratively-developed inclusion criteria were applied to records, followed by data extraction from eligible articles (n = 30). Most literature documented behavioural-based interventions targeting disruptive behaviour which were delivered individually, by therapists, to White, non-Hispanic parents. Evidence supports feasibility and efficacy of virtually-delivered parent-coaching interventions to improve child disruptive behaviour (strong), anxiety (moderate), and parent–child relationship (weak). There is a significant gap in the literature regarding the virtual delivery of attachment-based parent-coaching interventions. In sum, virtual parent coaching can be an efficacious approach for children under age six, particularly for behavioural challenges.
Resilience beyond insurance: coordination in crisis governance
Authors: Platzer Eva Katharina , Knodt Michèle
Published: September 2023

The latest report by the Intergovernmental Panel on Climate Change (IPCC) warns of an increase in heavy rainfall events due to global warming and climate change, which can result in significant economic costs for insurance companies and businesses. To address this challenge, insurance companies are focusing on developing new risk management strategies and offering new products such as flood insurance. However, the article argues that effective and feasible coordination shortens recovery time and can therefore drastically reduce the financial costs of a crisis—that is, the insurance costs. The paper analyses the deficit in crisis management during heavy rain events in Germany, based on the 2021 Ahr valley flood. The analysis is conducted based on document analysis and interviews and focuses on three areas of deficit: coordination between crisis staffs and (1) civil society, (2) emergency responders, and (3) political leaders. The paper highlights the importance of coordination during a crisis, which can help to address the crisis more efficiently and effectively, minimise damage and get communities back on their feet faster. The paper recommends policy changes to improve interface management and disaster management coordination.
The Idea That Digital Remote Learning Can Happen Anytime, Anywhere in Forced Online Teacher Education is a Myth
Authors: Šorgo Andrej , Ploj Virtič Mateja , Dolenc Kosta
Published: September 2023

An involuntary international experiment in which the entire student population was switched to digital remote learning due to the measures to stop COVID-19 put the paradigm of "anytime, anywhere learning" to the test. Online survey responses were obtained from 281 preservice primary and subject teachers. Using Structural Equation Modelling, connections were examined by inspection of path coefficients between constructs quality of personal digital technology, satisfaction, health, well-being, motivation, and physical activity. Problems with the quality of personal digital technology had a moderate influence on all constructs except motivation. Satisfaction influenced all constructs, well-being, and health the most. When comparing responses of the bottom and top third students based on the quality of personal digital technology, it was found that students who did not have the appropriate technology and workspace were less satisfied and suffered more. This is reflected in an increased incidence of problems related to health, well-being, and physical activity, along with a decrease in motivation. At least for the technologically deprived, the paradigm of "anytime, anywhere learning" is a myth. The study highlights the need for educational institutions to provide adequate technology and workspaces for all students in order to support their well-being and motivation during remote learning.