bluuebunny/crossref_metadata_2025 huggingface dataset:
Crush syndrome-related acute kidney injury in earthquake victims
Authors: Ramírez-Guerrero Gonzalo , Torres-Cifuentes Vicente
Published: December 2023

Natural disasters are unpredictable and thousands of people are affected yearly. Currently, this risk persists, given the large population living in risk areas prone to suffering another seismic event. Generally, on-site mortality is high and occurs immediately from massive trauma or asphyxia. After surviving the first event, extricated patients are at risk of developing crush syndrome caused by direct physical trauma and compression of the human body with lesions in different tissues. This could lead to several systemic complications, including acute kidney injury (AKI), sepsis, acute respiratory distress syndrome, bleeding, hypovolemic shock, arrhythmias, electrolyte disturbances and disseminated intravascular coagulation. Hence, AKI in this scenario can occur due to many causes, such as rhabdomyolysis, direct renal trauma, hypovolemia and hemodynamic alterations. The most important measure to reduce crush syndrome mortality and prevent the development of crush syndrome-related AKI in disaster situations is the immediate start of treatment. Nevertheless, despite optimal therapy delivery, these previous efforts might not suffice the development and progression of AKI, consequently, the indication of extracorporeal blood purification techniques. This narrative review provides a focused overview of crush syndrome-related AKI, including etiology, mechanisms, diagnosis, current treatment, removal of myoglobin and their limitations.
Using Rasch Wright map to identify hospital employee satisfaction during and before COVID-19
Authors: Chen Mei-Yi , Huang Shyh-Ming , Chou Willy
Published: December 2023

During the surge of the COVID-19 outbreak, medical personnel attended to countless patients, which adversely affected their mental well-being. To support their staff, hospitals implemented guidelines that focused on promoting mental health among medical professionals. The hypothesis that employee satisfaction declined during the COVID-19 pandemic needs confirmation. Several findings were derived from a series of visualizations using Rasch Wright map. The research sample was taken from a medical center in southern Taiwan based on satisfaction survey data from 2017 to 2022 (n = 1222). Perceptions on job satisfaction perceptions during and prior to COVID-19 in 2 stages of 2017 to 2019 and 2020 to 2022 were compared using Rasch Wright map. Through a series of visualizations, including the dimension with the highest satisfaction, the demographical category of hospital employees with the lowest satisfaction during the pandemic, and Rasch Wright map displaying employs’ perfections on 4 domains over years. The results indicated: Employee satisfaction was significantly lower during the COVID-19 period in 2 domains: compensation and benefits, work atmosphere; among the 23 questions, Question 5 (regarding meals provided by the hospital to staff) scored the lowest, while Question 23 (regarding the hospital emergency response and disaster prevention capabilities) scored the highest. Among the 4 domains, organizational leadership had the highest satisfaction; out of 104 demographic variables, 21 groups showed that employee satisfaction during the pandemic was significantly (P < .05) lower than before the pandemic; the selection of specific demographic variables is for top-tier supervisors, and they showed that employee satisfaction during the pandemic was significantly (P < .05) lower than before the pandemic across all 4 dimensions. Therefore, this study accepts the hypothesis that employee satisfaction was negatively affected during the COVID-19 period on 2 domains only: compensation and benefits, work atmosphere. The study visual examination, especially using Rasch Wright map, offers a comparative perspective on hospital staff satisfaction and serves as a methodological guide for subsequent satisfaction research.
Pediatric tuina for recurrent respiratory tract infection in children: A systematic review and meta-analysis
Authors: Wang Xiaoyu , Yin Lianjun , Bai Xue , Mao Zefang , Wang Yikun , Li Huanan , Wang Jingui
Published: December 2023

Background:

To evaluate the effects and safety of pediatric tuina for recurrent respiratory tract infections (RRTIs).

Methods:

Web of Science, PubMed, Cochrane Library, Embase, CNKI, Wanfang Data, VIP, and CBM databases were searched from inception to September 20 2023. Two authors independently selected studies, collected data, and evaluated methodological quality using the Cochrane Risk of Bias tool. Revman 5.4 was used for the meta-analysis.

Results:

Fifteen randomized controlled trials involving 1420 pediatric patients were included in this meta-analysis. The meta-analysis indicated that pediatric tuina significantly reduced the incidence of RRTIs [MD −1.11, 95% confidence interval (CI) (−1.77, −0.46)], decreased infection duration (MD −1.16 days, 95% CI [− 1.66, − 0.66]), improved IgA (MD 0.25 g/L, 95% CI [0.09, 0.41]), IgG (MD 1.64 g/L; 95% CI [0.82, 2.45]), CD3+ (MD 3.33%, 95% CI [0.74, 5.92]), CD4+ (MD 4.78%, 95% CI [2.08, 7.48]), CD4+/CD8+ ratio (MD 0.27%, 95% CI [0.08, 0.47]), and total effective rate (RR 1.19, 95% CI [1.13, 1.25]). However, IgM levels (MD 0.26 g/L, 95% CI [−0.26, 0.81]) and CD8+ (MD −1.36%, 95% CI [− 3.12, 0.41]) were not significantly different between the groups. Moreover, no Tuina-linked adverse reactions were observed.

Conclusion:

Pediatric tuina has shown positive effects in RRTIs treatment. However, these results should be interpreted with caution owing to study quality. Further large-scale and high-quality randomized controlled trials are warranted to confirm these findings.
A case report of near-missed heat stroke
Authors: Yeoh Cheng Wooi , Law Wan Chung
Published: December 2023

Rationale:

Heat-related illnesses have protean manifestations that can mimic other life-threatening conditions. The diagnosis of heat stroke requires a high index of suspicion if the patient has been exposed to a high-temperature environment. Central nervous system dysfunction is a cardinal feature. Strict adherence to temperature criteria can potentially lead to misdiagnosis.

Patient concerns:

A 37-year-old construction worker was brought in by his wife and coworker due to a sudden loss of consciousness while resting after completing his work.

Diagnoses:

Due to challenges faced during the coronavirus disease 2019 pandemic, as well as language barriers, a detailed history from the coworker who witnessed the patient’s altered sensorium was not available. He was initially suspected of having encephalitis and brainstem stroke. However, subsequent investigations revealed multiorgan dysfunction with a normal brain computed tomography and cerebral computed tomography angiogram. In view of the multiple risk factors for heat stroke, pupillary constriction, and urine color suggestive of rhabdomyolysis, a diagnosis of heat stroke was made.

Interventions:

Despite delayed diagnosis, the patient’s multiorgan dysfunction recovered within days with basic supportive care.

Outcomes:

There were no noticeable complications on follow-up 14 months later.

Lessons:

Heat stroke can be easily confused with other neurological pathologies, particularly if no history can be obtained from the patient or informant. When approaching a comatose patient, we propose that serum creatinine kinase should be considered as an initial biochemical screening test.
Upside-down stomach in paraesophageal hernia: A case report
Authors: Zhu Xiuliang , Hu Chengyu , Gong Weihua
Published: December 2023

Rationale:

Paraesophageal hernias, accounting for a mere 5% to 10% of all hiatal hernias, occasionally present an exceedingly uncommon yet gravely consequential complication characterized by the inversion of the stomach. Delving into the clinical manifestations and optimal therapeutic approaches for patients afflicted by this condition merits substantial exploration.

Patient concerns:

A 60-year-old man was referred to our hospital with acute onset of severe epigastric pain, abdominal distension, and vomiting. A chest radiograph unveiled an elevated left diaphragmatic dome accompanied by a pronounced rightward shift of the mediastinum. Subsequent abdominal computed tomography imaging delineated the migration of the stomach, spleen, and colon into the left hemithorax, facilitated by a significant diaphragmatic defect.

Diagnoses:

The diagnosis of a giant paraesophageal hernia with complete gastric inversion was established through a comprehensive evaluation of the patient’s clinical manifestations and imaging findings.

Interventions:

Surgical intervention was performed on the patient. During the procedure, a left diaphragmatic defect measuring approximately 10 × 8 cm was identified and meticulously repositioned, followed by the repair of the diaphragmatic hernia. The herniated contents comprised the pancreas, stomach, spleen, a segment of the colon, and a portion of the greater omentum.

Outcomes:

The patient experienced a smooth postoperative recuperation and was discharged 12 days following the surgical procedure. Subsequently, during a 7-month follow-up period, the patient continued to exhibit favorable progress and recovery.

Lessons:

Paraesophageal hernias are rare, and the presence of an inverted stomach in a giant paraesophageal hernia is exceptionally uncommon. Clinical presentation lacks distinct features and can lead to misdiagnosis. This case emphasizes the importance of timely surgical intervention guided by imaging, offering valuable clinical insights.
Lateral Lymph Node Dissection for Locally Advanced Rectal Carcinoma: A Step-by-Step Description of Surgical Anatomical Planes During Cadaveric Dissection and Minimally Invasive Surgery
Authors: İsmail Erkin , Kutlu Burak , Acar Halil İbrahim , Yörübulut Mehmet , Akkoca Muzaffer , Kocaay Akin Firat , Elhan Atilla , Kuzu Mehmet Ayhan
Published: December 2023

Purpose:

Total mesorectal excision (TME) is accepted as gold standard method in rectal cancer globally. But there is no standard for lateral lymph nodes. Combination of neoadjuvant treatment plus lateral lymph node dissection (LLND) in select patients might be a promising method. Our purpose is to describe the anatomic landmarks of LLND on cadavers and minimally invasive surgery.

Materials and Methods:

Local advanced rectal cancer and lateral lymph node (LLN) metastasis are accepted as an indication of neoadjuvant treatment. LLND was performed according to preoperative imaging after radiochemotherapy.

Results:

Twenty-eight (10.5%) of 267 patients with rectal cancer who had suspected lateral lymph node metastasis (LLNM) with magnetic resonance imaging (MRI) underwent LLND in addition to TME after neoadjuvant chemoradiotherapy. Eight of them had LLNM. Three patients had bilateral LLND and only 1 had LLNM. The median number of harvested lymph nodes was 6. The rates of LLNM increased with the presence of poor prognosis markers. One regional and 1 distant recurrence were detected in patients who had no LLN metastasis compared with2 regional and 4 distant recurrences in the LLN-positive group.

Conclusions:

Local advanced rectal cancer cases may benefit from LLND, but it does not appear to have an effect on overall survival. There is no consensus whether size and/or morphologic criteria in MRI are the ideal guide for LLND.
Thalamic nuclei in patients with chronic facial pain: gray matter volume patterns before and after surgery
Authors: Anton Pashkov , Elena Filimonova , Boris Zaitsev , Azniv Martirosyan , Galina Moysak , Jamil Rzaev
Published: December 2023

Trigeminal neuralgia is a prevalent chronic pain disorder characterized by recurring episodes of intense facial pain, which significantly impairs patients’ quality of life. MRI-based biomarkers have consistently demonstrated their ability to predict pain intensity and treatment outcomes. However, most studies have primarily focused on the trigeminal system, paying less attention to the extensive neural reorganization that occurs throughout the brain in response to chronic pain. In this study, we aimed to examine the thalamus, a key brain structure involved in information processing, and provide a detailed perspective on thalamic remodeling in response to chronic pain at the level of individual thalamic nuclei. We analyzed a sample of 62 patients with primary trigeminal neuralgia undergoing surgical treatment, along with 28 healthy participants. Our results revealed significant gray matter volume changes in thalamic nuclei among patients with trigeminal neuralgia. Notably, the intralaminar nuclei (centromedian/parafascicular) and nuclei associated with visual and auditory signal processing (lateral and medial geniculate bodies) exhibited significant alterations, contrasting with the ventral group nuclei involved in nociceptive processing. Additionally, we found no substantial volume increase in any of the studied nuclei following successful surgical intervention 6 months later. The volumes of thalamic nuclei were negatively correlated with pain intensity and disease duration. The findings obtained in this study, albeit preliminary, have promising clinical implications as they unveil previously unknown facets of chronic pain development.

Perspective

The study examined alterations in gray matter volume within the thalamus of patients diagnosed with trigeminal neuralgia at the level of specific nuclei. The most significant changes were observed in the lateral and medial geniculate bodies, along with the pulvinar nuclei.

Highlights

A detailed investigation of the thalamic nuclei in patients suffering from primary trigeminal neuralgia (TN) has been carried out for the first time.

Patients with TN showed a significant gray matter volume decrease in intralaminar, sensory and associative nuclei.

Following successful surgery, there was no observed increase in the volume of the investigated nuclei.
Status epilepticusduring neurodevelopment increases seizure susceptibility: a model study in zebrafish (Danio rerio)
Authors: Mazon Samara Cristina , Mendes Ellen Jaqueline , Sachett Adrieli , Bertoncello Kanandra Taisa , Marsaro Isabella Bodanese , Daniel Carla Fatima , de Miranda Fernanda Barros , Hort Mariana Appel , Oliveira J. Vladimir , Piato Angelo , Alves Lima-Rezende Cássia , Herrmann Ana Paula , Müller Liz Girardi , Siebel Anna Maria
Published: December 2023

Epilepsy is among the most common neurological diseases, affecting more than 50 million people worldwide. Unfortunately, one-third of people with epilepsy fail to respond to any current treatment and present a decreased quality of life. Nevertheless, different studies suggest that epilepsies acquired from an initial insult asstatus epilepticus(SE) followed byepileptogenesiscan be prevented. Therefore, it is necessary to establish animal models ofepileptogenesisinduced by SE. Thus, here we proposed an animal model ofepileptogenesistriggered by SE that occurred during the neurodevelopment of zebrafish (Danio rerio). Zebrafish larvae at the 7thday post-fertilization (dpf) were randomly assigned to two experimental groups. One group was exposed to embryo medium. The other group was exposed to pentylenetetrazol (15 mM PTZ) to induce SE. At the 8thdpf, each larva was subjected to the open tank test (OTT) to analyze locomotion and behavioral parameters. After the OTT, each initial group was divided into two groups: animals maintained in embryo medium and animals exposed to PTZ (3 mM), and the susceptibility to PTZ-induced seizure-like behavior was analyzed. Data showed that animals submitted to SE on the 7thdpf showed altered locomotion and behavior 24 hours later. Interestingly, zebrafish larvae submitted to SE on the 7thdpf showed decreased latency to reach seizure-like behavioral stages when exposed to a low concentration of PTZ on the 8thdpf. Concluding, our results show that SE during neurodevelopment increases the susceptibility of zebrafish larvae to present PTZ-induced seizure-like behavior. Our study contributes to the establishment of a model ofepileptogenesisin developing zebrafish. Finally, the next step is to improve this model by characterizing molecular, biochemical and physiological markers.
Accounting and neoliberal responsibilisation: a case study on the Australian National Disability Insurance Scheme
Authors: Nikidehaghani Mona
Published: December 2023

Purpose

This paper aims to explore how accounting is fostering neoliberal citizenship through the participants of Australia’s National Disability Insurance Scheme (NDIS). More specifically, this paper aims to understand how accounting discourse and the management accounting technique of budgeting, when intertwined with automated administrative processes of the NDIS, are giving rise to a pastoral form of power that directs people’s behaviour toward certain ends.

Design/methodology/approach

Publicly available data has been crafted into an autoethnographic case study of one fictitious person’s experiences with the NDIS – Mina. Mina is an amalgam created from material submitted to the Joint Parliamentary Standing Committee on the NDIS. Mina’s experiences are then analysed through the lens of Foucault’s concept of pastoral power to explore how accounting has contributed to marketising and digitising public disability services.

Findings

Accounting rhetoric appears to be a central part of rationalising the decision to shift to individualised disability funding. Those receiving payments are treated as self-governable, financially responsible subjects and are therefore expected to have knowledge of management accounting techniques and budgeting. However, NDIS’s strong reliance on the accounting concepts of funds, budgets, cost and price is limiting people’s autonomy and subjecting them to intervention and control.

Originality/value

This paper addresses calls to explore the interplay between accounting and current disability policies. The analysis shows that incorporating accounting into the NDIS’s algorithms serves to conceal the underlying ideology of the programs, subtly driving behaviours towards neoliberal objectives. Further, this research extends the Foucauldian accounting literature by revealing the contribution of accounting to reinforcing the authority of digital pastors in contemporary times.
Digitalization of operations and supply chains: Insights from survey and case studies
Authors: Baycik N. Orkun , Gowda Shimon
Published: December 2023

Purpose

This article aims to understand where industry is in terms of digitalizing their operations, what features of this transformation are essential for practitioners, and what barriers they are facing during their journey. In addition, the authors aim to provide recommendations for organization to start their digital transformation.

Design/methodology/approach

Through literature review, the authors summarize the emerging tools and technologies in operations and supply chains to inform the practitioners. Then, the authors use surveys conducted on 183 operations and supply chain professionals, and use statistical tools to examine the association between variables of the data set. The authors present real-life case studies to explain important steps of a digital transformation project.

Findings

The survey results indicate that real-time monitoring and data analytics are viewed as the most important and needed tools for organizations. High cost, lack of stakeholder buy-in and lack of successful business use cases are major barriers for companies when starting a digital transformation.

Practical implications

The authors provide recommendations for practitioners based on the survey responses, and outline that starting small, focusing on stakeholder buy-in and implementation of software are the three key steps for a successful transformation journey.

Originality/value

Main contributions of this article are to understand practitioner perspectives in digitalization and provide guidelines for organizations to follow when transforming their operations. This research closes the gap between academic research and practice by collaborating with operations and supply chain professionals.
“What is a wave but 1000 drops working together?”: The role of public libraries in addressing LGBTQIA+ health information disparities
Authors: Kitzie Vanessa , Vera A. Nick , Lookingbill Valerie , Wagner Travis L.
Published: December 2023

Purpose

This paper presents results from a participatory action research study with 46 LGBTQIA+ community leaders and 60 library workers who participated in four community forums at public libraries across the US. The forums identified barriers to LGBTQIA+ communities addressing their health questions and concerns and explored strategies for public libraries to tackle them.

Design/methodology/approach

Forums followed the World Café format to facilitate collaborative knowledge development and promote participant-led change. Data sources included collaborative notes taken by participants and observational researcher notes. Data analysis consisted of emic/etic qualitative coding.

Findings

Results revealed that barriers experienced by LGBTQIA+ communities are structurally and socially entrenched and require systematic changes. Public libraries must expand their strategies beyond collection development and one-off programming to meet these requirements. Suggested strategies include outreach and community engagement and mutual aid initiatives characterized by explicit advocacy for LGBTQIA+ communities and community organizing approaches.

Research limitations/implications

Limitations include the sample's lack of racial diversity and the gap in the data collection period between forums due to COVID-19. Public libraries can readily adopt strategies overviewed in this paper for LGBTQIA+ health promotion.

Originality/value

This research used a unique methodology within the Library and Information Science (LIS) field to engage LGBTQIA+ community leaders and library workers in conversations about how public libraries can contribute to LGBTQIA+ health promotion. Prior research has often captured these perspectives separately. Uniting the groups facilitated understanding of each other's strengths and challenges, identifying strategies more relevant than asking either group alone.
Generative AI and generative libraries and beyond –conference report on IFLA and IFA
Authors: Kesselman Martin A. , Esquivel Wilson
Published: December 2023

Purpose

This study aims to provide insight of how conference sessions and poster sessions are relevant to libraries.

Design/methodology/approach

Recently attended IFLA and Internationale Funkaussteilung (IFA) and focused the conference report on generative artificial intelligence (AI).

Findings

Disappointed in the IFLA and IFA conferences and instead find that the email newsletter from Shelly Palmer is much better in keeping up with exponential growth in ChatGPT and other generative AI tools.

Research limitations/implications

This study may provide ideas for libraries to experiment with generative AI tools.

Originality Value

This study is an original report by the authors. All photos were taken by the authors except for a table from the email newsletter of Shelly Palmer, which was included by him from another source.
TPI1 promotes MAPK/ERK‐induced EMT, cell migration and invasion in lung adenocarcinoma
Authors: Li Yu , Pan Bin , Zhang Feiyang , Jia Xinyu , Zhu Xinyu , Tong Xin , Zhao Jun , Li Chang
Published: December 2023

Background

Triosephosphate isomerase 1 (TPI1), as a widely involved glycolytic enzyme, plays a significant role in glucose metabolism and is highly expressed in various tumors. However, its role in lung adenocarcinoma (LUAD) remains incompletely understood.

Methods

Through bioinformatic analysis, we identified a positive association between high expression of TPI1 and metastasis in LUAD. Western blot, RT‐qPCR, wound healing assays and transwell experiments, were employed to investigate potential mechanisms.

Results

In this study, bioinformatic analysis showed that high expression of TPI1 was associated with poor prognosis in LUAD patients. We examined the expression of TPI1 in 29 paired LUAD tissues and found that TPI1 expression was higher in LUAD tissues than in paired adjacent noncancerous tissues. Meanwhile, overexpression of TPI1 promoted the epithelial‐mesenchymal transition (EMT) process in LUAD cells, while silencing TPI1 weakened the EMT process. Furthermore, TPI1 was shown to regulate EMT through the MAPK/ERK signaling pathway.

Conclusion

TPI1 promotes LUAD metastasis by activating the MAPK/ERK signaling pathway.
Genetic context drives age‐related disparities in synaptic maintenance and structure across cortical and hippocampal neuronal circuits
Authors: Heuer Sarah E. , Nickerson Emily W. , Howell Gareth R. , Bloss Erik B.
Published: December 2023

The disconnection of neuronal circuitry through synaptic loss is presumed to be a major driver of age‐related cognitive decline. Age‐related cognitive decline is heterogeneous, yet whether genetic mechanisms differentiate successful from unsuccessful cognitive decline through maintenance or vulnerability of synaptic connections remains unknown. Previous work using rodent and primate models leveraged various techniques to imply that age‐related synaptic loss is widespread on pyramidal cells in prefrontal cortex (PFC) circuits but absent on those in area CA1 of the hippocampus. Here, we examined the effect of aging on synapses on projection neurons forming a hippocampal‐cortico‐thalamic circuit important for spatial working memory tasks from two genetically distinct mouse strains that exhibit susceptibility (C57BL/6J) or resistance (PWK/PhJ) to cognitive decline during aging. Across both strains, synapse density on CA1‐to‐PFC projection neurons appeared completely intact with age. In contrast, we found synapse loss on PFC‐to‐nucleus reuniens (RE) projection neurons from aged C57BL/6J but not PWK/PhJ mice. Moreover, synapses from aged PWK/PhJ mice but not from C57BL/6J exhibited altered morphologies that suggest increased efficiency to drive depolarization in the parent dendrite. Our findings suggest resistance to age‐related cognitive decline results in part by age‐related synaptic adaptations, and identification of these mechanisms in PWK/PhJ mice could uncover new therapeutic targets for promoting successful cognitive aging and extending human health span.
A multi‐scale synthesis of mousedeer habitat associations in Southeast Asia reveals declining abundance but few extirpations in fragments and edges
Authors: Mendes Calebe P. , Liu Xiaohan , Amir Zachary , Moore Jonathan H. , Luskin Matthew Scott
Published: December 2023

Habitat loss and fragmentation profoundly impact Southeast Asian rainforest biodiversity and ecosystem functioning. While many larger herbivores are hunted and area‐demanding apex predators are lost from degraded forests (logged forests, forest fragments and forest edges), smaller herbivore species may be comparatively resilient or even benefit from a release from competition and predation in degraded forests. Mousedeer (or chevrotains) in the Tragulus genus are some of the world's smallest ungulates (1.5–4.5 kg) and are widespread in Southeast Asia. We evaluated mousedeer habitat associations at three spatial scales. At the regional scale, presence‐only species distribution modelling suggested mousedeer are negatively associated with aridity and elevation. At the landscape scale, variation capture rates among 186 published camera trapping studies suggested mousedeer are negatively associated with forest degradation and elevation. At the local scale (within landscapes), mousedeer abundance sampled with 1218 cameras at 10 landscapes and analysed with hierarchical abundance modelling suggested mousedeer are negatively associated with humans and elevation. Mousedeer diel activity patterns shifted towards increased nocturnality in degraded forests, possibly to avoid interactions with diurnal humans. Taken together, mousedeer prefer wet lowland forests and they persist – but decline – in degraded habitats and near humans. One exception was degraded forest fragments of Singapore where mousedeer are very abundant, likely due to the absence of hunting and predators. Our results emphasize that small herbivores persisting in fragmented rainforests decline relative to intact forests and thus are unlikely to be experiencing significant release from competition or predation. They also differ from small omnivorous generalists who experience beneficial foraging opportunities at edges. In degraded forests where larger wildlife has been lost, even low densities of small herbivores may perpetuate important ecological interactions such as herbivory, seed dispersal, or as prey for remaining predators.
Management of acute perianal abscess: is surgeon specialization associated with improved outcomes?
Authors: Turner Gregory A. , Tham Nicole , Chandra Raaj , Read David J. , Chittleborough Timothy J. , McCormick Jacob J. , Hayes Ian P.
Published: December 2023

Background

Acute surgical units (ASU) are increasingly being adopted and in our system are staffed by colorectal and non‐colorectal general surgeons. This study aims to evaluate whether surgeon specialization was associated with improved outcomes in perianal abscess.

Methods

Patients with perianal abscess admitted to the ASU between 2016 and 2020 were identified from a prospective database and their medical records reviewed. Patients with IBD, treatment for fistula‐in‐ano within the preceding year, or perianal sepsis of non‐cryptoglandular origin were excluded. Patients admitted under an ASU colorectal (CR) consultant were compared with those under a non‐CR general surgeon in a retrospective cohort study. Primary outcome was perianal abscess recurrence. For those without initial fistula, hazard of recurrent abscess or fistula was analysed. Multivariable Cox PH regression analysis was performed.

Results

Four‐hundred and eight patients were included (150 CR, 258 non‐CR). The CR group more frequently had a fistula identified at index operation (34.0% versus 10.9%, P < 0.0001). However, Cox multivariable analysis found no difference in hazard of recurrent abscess between groups (HR 1.12, 95% CI 0.65–1.95, P = 0.681)). Abscess recurred in 18.7% CR and 15.5% non‐CR. Subsequent fistula developed in 14.7% in both groups. For patients without initial fistula, there was no difference between groups in hazard of recurrent abscess or fistula (HR 1.18, 95% CI 0.69–2.01, P = 0.539).

Conclusion

Surgeon specialization was not associated with improved outcomes for ASU patients with perianal abscess, albeit with potential selection bias. CR surgeons were more proactive identifying fistulas; this raises the possibility that drainage alone may be adequate treatment.
Suitability of machine learning for atrophy and fibrosis development in neovascular age‐related macular degeneration
Authors: de la Fuente Jesus , Llorente‐González Sara , Fernandez‐Robredo Patricia , Hernandez María , García‐Layana Alfredo , Ochoa Idoia , Recalde Sergio ,   Spanish AMD group
Published: December 2023

Purpose

To assess the suitability of machine learning (ML) techniques in predicting the development of fibrosis and atrophy in patients with neovascular age‐related macular degeneration (nAMD), receiving anti‐VEGF treatment over a 36‐month period.

Methods

An extensive analysis was conducted on the use of ML to predict fibrosis and atrophy development on nAMD patients at 36 months from start of anti‐VEGF treatment, using only data from the first 12 months. We use data collected according to real‐world practice, which includes clinical and genetic factors.

Results

The ML analysis consistently identified ETDRS as a relevant factor for predicting the development of atrophy and fibrosis, confirming previous statistical analyses. Also, it was shown that genetic variables did not demonstrate statistical relevance in the prediction. Despite the complexity of predicting macular degeneration, our model was able to obtain a balance accuracy of 63% and an AUC of 0.72 when predicting the development of atrophy or fibrosis at 36 months.

Conclusion

This study demonstrates the potential of ML techniques in predicting the development of fibrosis and atrophy in nAMD patients receiving long‐term anti‐VEGF treatment. The findings highlight the importance of clinical factors, particularly ETDRS (early treatment diabetic retinopathy study) visual acuity test, in predicting these outcomes. The lessons learned from this research can guide future ML‐based prediction tasks in the field of ophthalmology and contribute to the design of data collection processes.
Clinical factors for central nervous system progression and survival in primary vitreoretinal lymphoma
Authors: Motomura Yotaro , Yoshifuji Kota , Tachibana Takayoshi , Takase Hiroshi , Arai Ayako , Tanaka Keisuke , Okada Keigo , Nogami Ayako , Umezawa Yoshihiro , Sakashita Chizuko , Yamamoto Masahide , Mori Takehiko , Nagao Toshikage
Published: December 2023

Primary vitreoretinal lymphoma (PVRL) is a rare subtype of malignant lymphoma with a poor prognosis because of high frequency of central nervous system (CNS) progression. Identification of factors associated with CNS progression is essential to improve the prognosis of patients with PVRL. We conducted a retrospective study of 54 patients diagnosed with PVRL and treated at our hospital to identify factors associated with CNS progression and prognosis. All patients were treated with intravitreal methotrexate (MTX) injections in the affected eyes until lesion resolution. Twenty‐four patients were treated with systemic administration of high‐dose MTX (systemic HD‐MTX) every other week for a total of five cycles following intravitreal MTX injection. Of 24 patients, 20 completed five cycles of systemic HD‐MTX. The 5‐year cumulative incidence of CNS progression and overall survival (OS) rate were 78.0% and 69.0% respectively. By univariate and multivariate analyses, bilateral disease and the detection of B‐cell clonality confirmed by flow cytometric analysis were risk factors associated with CNS progression. Moreover, systemic HD‐MTX completion reduced the risk of CNS progression and was identified as a factor affecting OS. In this study, factors for CNS progression identified may potentially contribute to the optimized therapeutic stratification to improve the survival of patients with PVRL.
Tobacco consumption in Mozambique in 2005 and 2015
Authors: Fontes Filipa , Suleman António , Silva‐Matos Carla , Mate Celina , Amado Celeste , Damasceno Albertino , Lunet Nuno
Published: December 2023

Introduction

The burden related to smoking exposure is growing in many low‐income settings. We aimed to quantify the use of smoked and smokeless tobacco in Mozambique in 2014/2015, and to compare the estimates with those obtained in 2005.

Methods

A cross sectional study was conducted in 2014/2015 on a representative sample of the Mozambican population aged 15 to 64 years, following the World Health Organization Stepwise Approach to Chronic Disease Risk Factor Surveillance (STEPS). Prevalence estimates with 95% confidence intervals were computed for different categories of tobacco consumption. The age‐standardised prevalence in the age‐group 25–64 years was compared with results from a STEPS survey conducted in 2005.

Results

Between 2005 and 2014/2015, the prevalence of daily smoking decreased from 9.1% to 3.4% (p < 0.05) in women and from 33.6% to 27.3% (p < 0.05) in men. There was a significant decrease in the daily consumption of hand‐rolled cigarettes among women (from 3.1% to 1.4%, p < 0.05). Among men, there was a decrease in the prevalence of daily consumption of smokeless tobacco (from 3.5% to 1.0%, p < 0.05). In 2014/2015, both manufactured and hand‐rolled cigarette consumption were more prevalent among men, while the use of smokeless tobacco was more common among women; the consumption of both hand‐rolled cigarettes and smokeless tobacco were more prevalent in rural settings.

Discussion and Conclusions

In Mozambique, there was a decrease in the prevalence of daily smokers in both genders and of daily consumption of smokeless tobacco among men between 2005 and 2014/2015. Efforts are needed to maintain the positive trends.
Acceptability and feasibility of an intervention for Alaska Native and American Indian couples
Authors: Avey Jaedon P. , Wark Kyle , Andrews Polly , Donadio James , Bradbury Thomas , Outten Bobbi
Published: December 2023

Objective

This acceptability and feasibility study assessed a previously tested movie discussion intervention culturally adapted for a tribal health setting.

Background

Despite family and relationships being important in Alaska Native and American Indian (ANAI) cultures, social health interventions supporting committed ANAI couples have not been investigated. Couples watching and discussing movies can promote and sustain relationship health as effectively as intensive skill‐building classes.

Method

This study culturally adapted a movie discussion intervention. Multiple stakeholders guided adaptations, including changes to intervention duration, recommended movies, discussion guide, and study measures. Eligible participants were cohabitating adults in a committed relationship, with at least one person in the couple being ANAI. Participants watched and discussed movies over 4 weeks at home or in person. Study measures assessed demographics, relationship characteristics, and intervention acceptability and feasibility.

Results

Twenty‐three couples participated: 87% chose at‐home participation, 70% completed the intervention. Almost 90% of couples felt comfortable discussing the movies, felt the discussion guide improved communication, and would recommend the intervention to other couples, but 26% were mildly stressed by the discussions.

Conclusion

This intervention was a feasible and acceptable way to help ANAI couples maintain positive relationship features.

Implications

This intervention could support ANAI couples in regions with limited access to behavioral health services.
Factors associated with Paddlefish (Polyodon spathula) restoration success in Oklahoma
Authors: Gary Ryan A. , Long James M. , Eachus Brian T. , Dzialowski Andrew R. , Schooley Jason D.
Published: December 2023

The Paddlefish (Polyodon spathula) has been extirpated from portions of its native range due to anthropogenic habitat degradation and fragmentation, most notably the impoundment of rivers. To mitigate some of these losses in Oklahoma, Paddlefish have been stocked into reservoirs throughout the state, with variable success in establishing self‐sustaining populations. Two factors thought to contribute to success of Paddlefish stocking are spawning substrate and prey availability, which were quantified in six reservoirs and nine reservoir tributaries. Side‐scan sonar and supervised classification of aerial imagery were used to classify 4517‐ha of river substrate upstream of the river‐reservoir interface in reservoir tributaries. Zooplankton community structure, water clarity, and nutrient availability were also assessed in the same reservoirs and tributaries. One tributary had suitable spawning substrate (>40%), and the rest had minimal (<1.5%), which suggested that availability of suitable spawning substrate was not directly correlated with Paddlefish stocking success. Reservoirs with self‐sustaining Paddlefish populations had higher abundance of large zooplankton (copepods and cladocerans) than reservoirs without a reproducing population. Notably, tributaries associated with Lake Texoma, the one known example of failed restoration, were much more turbid than other rivers. We conclude that abiotic factors such as water clarity may contribute more to variable recruitment than spawning substrate or zooplankton abundance by mediating foraging success of Paddlefish post‐larvae.
Fluidization‐bed drying and microwave radiation effects on drying rate, fatty acid, protein, and germination of flaxseed
Authors: Larbi Bouamrane Omar , Mekhaneg Benyoucef , Panigrahi Shubham Subrot , Hemis Mohamed , Singh Chandra B.
Published: December 2023

Flaxseeds are known for their invaluable omega‐3 fatty acids and proteins. Flaxseeds need to be dried to 10%w.b. moisture for safe long‐term storability. Traditional drying ruptures the nutritional properties, therefore, this study analyzed the effect of fluidized‐bed and microwave drying on the fatty acid and protein constituency of flaxseed. The drying air temperatures in the fluidized‐bed drying tests were 40, 50 and 60°C. Three microwave power densities were selected 0.3, 0.6 and 1 W g−1. Results showed a minor effect on fatty acids whereas a significant effect on protein content with both the drying methods. A protein reduction of 7, 21, and 23% was observed for drying air temperatures of 40, 50, and 60°C, respectively. For the microwave tests, 39, 58, and 63% protein reductions for 0.3, 0.6 and 1  W g−1 power densities were observed, respectively. The fatty acids showed a maximum increase of 0.85% for fluidized bed drying and 1.23% for microwave.

Practical applications

This study contributes a step‐forward knowledge toward adoption of microwave technology in flaxseed oil extraction industry. Previous pilot‐scale studies solely on microwave utilization have shown limited scale‐up due to its high infrastructure cost associated with emitting high‐power densities. However, if explored with a combination approach along with fluidized bed (40°C at 0.3 W g−1) to assist in early removal of surface moisture from flaxseed, it could be a potential platform to increase the productivity in parallel to matching the associated overall cost. A proper cost analysis could be a future aspect of this study.
Unconventional Monetary Policy and Long‐Term Interest Rates
Authors: WU TAO
Published: December 2023

This paper constructs a survey‐based measure capturing the evolution of market's expectations of the Federal Reserve's Large‐Scale Asset Purchases (LSAP) program during 2008–18, and examines the transmission mechanism of unconventional monetary policy. Estimation results suggest that both signaling and portfolio balance channels of the LSAP were important in lowering long‐term interest rates; Moreover, the Federal Reserve's forward guidance policy had led to a gradual extension of market's projections of the duration of the LSAP, making its effects more persistent. Model estimation also explains the 2013 taper tantrum well, and suggests that the LSAP's effects might have declined during QE III.
Organisation of the nervous system in cysts of the freshwater tardigrade Thulinius ruffoi (Parachela, Isohypsibioidea: Doryphoribiidae)
Authors: Janelt Kamil , Poprawa Izabela
Published: December 2023

Encystment is a natural process that involves cyst formation, and at least some species of tardigrades can form cysts. However, the encystment process and cyst structure among tardigrades are still poorly understood. Despite some aspects of the encysted animals' systems organisation being examined in the past, the morphology and structure of the nervous system have never been thoroughly investigated. This study covers anatomical, histological and morphological details and proposes physiological aspects of the nervous system in encysted Thulinius ruffoi up to 11 months duration in encystment. This is the first record of the nervous system organisation in a species belonging to the family Doryphoribiidae. The cyst formation results in morphological changes in the nervous system. It comprises central and peripheral elements, which may be observable even after many months since the cyst formation. Based on the nervous system's organisation in cysts, there is no sign that histolysis is a part of encystment.
Association of multidimensional frailty and quality of life in middle‐aged and older people with stroke: A cross‐sectional study
Authors: Xue Rong , Chen Baoyun , Ma Ronghui , Zhang Yuxin , Zhang Kaili
Published: December 2023

Objectives

The aims of this study were to (i) compare the prevalence of multidimensional frailty in middle‐aged and older people with stroke and to (ii) explore the relationship between multidimensional frailty and quality of life (QoL) in this patient population.

Background

In recent years, stroke patients have become increasingly younger. As an important risk factor for stroke patients, frailty has gradually drawn research attention because of its multidimensional nature.

Design

This study used a cross‐sectional design.

Methods

The study included 234 stroke patients aged 45 and older. Multidimensional frailty was defined as a holistic condition in which a person experiences losses in one or more domains of human functioning (physical, psychological and social) based on the Tilburg Frailty Indicator, and QoL was based on the short version of the Stroke‐Specific Quality of Life Scale. Hierarchical regression was used to analyse the correlation factors of QoL. STROBE checklist guides the reporting of the manuscript.

Results

A total of 128 (54.7%) participants had multidimensional frailty, 48 (44.5%) were middle aged and 80 (63.5%) were older adults. The overall QoL mean score of the participants was 47.86 ± 9.04. Multidimensional frailty was negatively correlated with QoL. Hierarchical regression analysis showed that multidimensional frailty could independently explain 14.6% of the variation in QoL in stroke patients.

Conclusions

Multidimensional frailty was prevalent in middle‐aged and older people with stroke, and it was a significant factor associated with QoL in stroke patients.

Relevance to Clinical Practice

This study emphasises the importance of the early identification of multidimensional frailty. And targeted interventions should be studied to prevent the occurrence of multidimensional frailty and thereby improve the QoL of patients.

Patient or Public Contribution/s

There are no patient or public contributions to this study.
Resilience of tropical invertebrate community assembly processes to a gradient of land use intensity
Authors: Granville Natasha R. , Barclay Maxwell V. L. , Boyle Michael J. W. , Chung Arthur Y. C. , Fayle Tom M. , Hah Huai En , Hardwick Jane L. , Kinneen Lois , Kitching Roger L. , Maunsell Sarah C. , Miller Jeremy A. , Sharp Adam C. , Stork Nigel E. , Wai Leona , Yusah Kalsum M. , Ewers Robert M.
Published: December 2023

Understanding how community assembly processes drive biodiversity patterns is a central goal of community ecology. While it is generally accepted that ecological communities are assembled by both stochastic and deterministic processes, quantifying their relative importance remains challenging. Few studies have investigated how the relative importance of stochastic and deterministic community assembly processes vary among taxa and along gradients of habitat degradation. Using data on 1645 arthropod species across seven taxonomic groups in Malaysian Borneo, we quantified the importance of ecological stochasticity and of a suite of community assembly processes across a gradient of logging intensity. The relationship between logging and community assembly varied depending on the specific combination of taxa and stochasticity metric used, but, in general, the processes that govern invertebrate community assembly were remarkably robust to changes in land use intensity.