bluuebunny/crossref_metadata_2025 huggingface dataset:
The Sensory Experience of Waiting for Parents of Children Awaiting Transplant: A Narrative Ethnography
Authors: Smith Kristina A. , Widger Kimberley , Arbour-Nicitopoulos Kelly P. , Gibson Barbara E.
Published: June 2023

Despite the senses being a valuable source of knowledge, little research has explored the sensory process of medical experiences. This narrative ethnographic study investigated how the senses shaped parents’ experiences of waiting for their child to receive a solid organ, stem cell, or bone marrow transplant. Six parents from four different families primarily participated in sensory interviews as well as observations that explored the question: How do parents experience waiting using the five senses? Our narrative analysis suggested that parents’ bodies stored sense memories, and they re-experienced stories of waiting through the senses and ‘felt realities’. In addition, the senses transported families back to the emotional experience of waiting, which highlighted the longevity of waiting after receiving a transplant. We discuss how the senses provide important information about the body, waiting experiences, and the environmental contexts that mediate waiting. Findings contribute to theoretical and methodological work exploring how bodies are implicated in producing narratives.
Decisional Regret in Long-Term Australian Allogeneic Hematopoietic Stem Cell Transplantation Survivors: A Cross-Sectional Survey
Authors: McErlean Gemma , Tapp Caley , Brice Lisa , Pradhan Anisha , Gilroy Nicole , Kabir Masura , Greenwood Matt , Larsen Stephen R , Moore John , Gottlieb David , Hertzberg Mark , Brown Louisa , Hogg Megan , Huang Gillian , Ward Christopher , Kerridge Ian
Published: June 2023

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an intensive but effective treatment for malignant and non-malignant diseases. However, long-term survival often comes at a cost, with survivors experiencing chronic morbidity and are at risk of relapse and secondary malignancy. This study aimed to describe decisional regret in a large cohort of Australian long-term allo-HSCT survivors. A cross-sectional survey was conducted with 441 adults in New South Wales, assessing quality of life (QoL), psychological, social, demographic, and clinical variables. Less than 10% of survivors expressed regret, with chronic graft-versus-host disease being the most important clinical factor. Psycho-socioeconomic factors such as depression, lower QoL scores, lower household income, higher treatment burden, and not resuming sex post-HSCT were also associated with regret. Findings highlight the need for valid informed consent and ongoing follow-up and support for allo-HSCT survivors dealing with life post-transplant. Nurses and healthcare professionals play a critical role in addressing decisional regret in these patients.
Cardiac Myosin Inhibitors: Expanding the Horizon for Hypertrophic Cardiomyopathy Management
Authors: Sykuta Alyssa , Yoon Connie H. , Baldwin Sarah , Rine Natalie I. , Young Michael , Smith Adam
Published: June 2023

Objective:

To review the current literature on the efficacy and safety of cardiac myosin inhibitors (CMIs) for the treatment of hypertrophic cardiomyopathy (HCM).

Data Sources:

A literature search was conducted on PubMed from origin to April 2023, using the search terms “MYK-461,” “mavacamten,” “CK-3773274,” and “aficamten.” Studies were limited to English-based literature, human subjects, and clinical trials resulting in the inclusion of 13 articles. ClinicalTrials.gov was also used with the same search terms for ongoing and completed trials.

Study Selection and Data Extraction:

Only phase II and III studies were included in this review except for pharmacokinetic studies that were used to describe drug properties.

Data Synthesis:

CMIs enable cardiac muscle relaxation by decreasing the number of myosin heads that can bind to actin and form cross-bridges. Mavacamten, the first Food and Drug Administration (FDA)-approved drug in this class, has been shown to improve hemodynamic, functional, and quality of life measures in HCM with obstruction. In addition, aficamten is likely to become the next FDA-approved CMI with promising phase II data and an ongoing phase III trial expected to release results in the next year.

Relevance to Patient Care and Clinical Practice in Comparison with Existing Drugs:

CMIs provide a novel option for obstructive hypertrophic cardiomyopathy, particularly in those not suitable for septal reduction therapy. Utilization of these agents requires knowledge of drug interactions, dose titration schemes, and monitoring parameters for safety and efficacy.

Conclusions:

CMIs represent a new class of disease-specific drugs for treatment of HCM. Cost-effectiveness studies are needed to delineate the role of these agents in patient therapy.
Biomechanical Comparison of Nonlocked Minimally Invasive and Locked Open Achilles Tendon Simulated Rupture Repairs
Authors: Chuckpaiwong Bavornrit , Glisson Richard R. , Usuelli Federico G. , Madi Naji S. , Easley Mark E.
Published: June 2023

Background:

Open repair of Achilles tendon ruptures is associated with a risk of infection and other wound complications. Although percutaneous repairs reduce these complications, they may increase the risk of nerve injury. This study was designed to determine whether a percutaneous nonlocking repair can approach the gapping resistance offered by a standard open repair under conditions approximating typical postoperative physiotherapy.

Methods:

Ten pairs of cadavers Achilles tendons were transected in situ 5 cm above the insertion. One tendon from each pair was repaired using an open 4-strand Krackow locking loop, and the contralateral tendon was repaired with the Achillon system using the same suture material. Displacement transducers were attached to the medial, lateral, anterior, and posterior aspects of the tendon, spanning the repair. Each tendon underwent 1000 tensile loading cycles to 86.5 N, simulating passive ankle range-of-motion physiotherapy. Gapping was documented on the 1st, 50th, 100th, 500th, and 1000th cycles. The ultimate tensile strength of each repaired tendon was then measured by distracting until gross failure occurred.

Results:

Gapping of the percutaneous repairs exceeded that of conventional open repairs on the first, 500th, and 1000th load cycles. All 10 conventionally repaired tendons withstood 1000 load cycles without gross failure, but 4 of 10 percutaneous minimally invasive repairs failed, one on the 9th load cycle and the others between the 100th and 500th cycles. On average, tendons repaired with the open technique withstood 66% greater tensile load in failure testing than those repaired with the percutaneous technique.

Conclusion:

Open Krackow Achilles tendon repairs may better withstand more aggressive postoperative physiotherapy than nonlocked percutaneous repairs.

Clinical Relevance:

The study suggests that surgeons should consider locking suture approaches to avoid loss of repair integrity with early motion.
Potential Alternative Therapeutic Modalities for Management Head and Neck Squamous Cell Carcinoma: A Review
Authors: Afshari Keihan , Sohal Karpal Singh
Published: June 2023

Head and neck squamous cell carcinoma (HNSCC) includes malignancies of the lip and oral cavity, oropharynx, nasopharynx, larynx, and hypopharynx. It is among the most common malignancy worldwide, affecting nearly 1 million people annually. The traditional treatment options for HNSCC include surgery, radiotherapy, and conventional chemotherapy. However, these treatment options have their specific sequelae, which produce high rates of recurrence and severe treatment-related disabilities. Recent technological advancements have led to tremendous progress in understanding tumor biology, and hence the emergence of several alternative therapeutic modalities for managing cancers (including HNSCC). These treatment options are stem cell targeted therapy, gene therapy, and immunotherapy. Therefore, this review article aims to provide an overview of these alternative treatments of HNSCC.
Project OCCAMS: A Five-Year, Collaborative Intervention of an Online Intensive, Accelerated, Two-Year Language Arts Program Designed to Address Systemic Disparities Among High Ability Middle School Students
Authors: Calvert Eric , Olszeswki-Kubilius Paula , Cross Tracy L. , Cross Jennifer R.
Published: June 2023

Project OCCAMS (Online Consortium for Accelerating Middle School) developed and piloted an accelerated curriculum through a design-based research approach combining the Integrated Curriculum Model, principles of culturally responsive instructional design, and extensive compacting. The program created a pathway for diverse middle school students to complete a 3-year course of study in English Language Arts (ELA) in only 2 years and enter high school a year advanced of grade peers in language arts. Curricula were developed through collaboration of two university-based gifted education centers and a large urban school district. The program was designed primarily to serve students from subgroups underrepresented in gifted education who demonstrated advanced learning potential but did not yet meet state criteria for formal gifted identification. Evaluation data indicate participating students, as a group, made more rapid achievement gains in language arts than local comparison groups and equal to a comparison group of students formally identified as gifted participating in a regional talent search program. The use of a common online learning platform facilitated implementation by providing forums for collaboration and support among educators at multiple schools and universities and opportunities for continuous observation and data collection and allowed frequent iteration of the curriculum.
Low Human Papillomavirus Vaccination in a Low-Income Urban Population
Authors: Rojo Elizabeth M. , Taylor Kelly D. , McFarland Willi
Published: June 2023

Despite widespread availability of human papillomavirus (HPV) vaccines and recommendations for routine use, awareness and uptake of HPV vaccination are not universal. We assessed self-reported history of HPV vaccination in a sample of low-income men and women recruited from the community using respondent-driven sampling as part of the National HIV Behavioral Surveillance (NHBS) survey in San Francisco. Of the 384 respondents, a minority (12.5%) reported they had received the HPV vaccine. In multivariate analysis, independent associations with HPV vaccination history were female sex (adjusted odds ratio [AOR] = 3.76, 95% confidence interval [CI] = [1.73, 8.17]), younger age (AOR = 0.89 per year, 95% CI = [0.86, 0.92]), and education above high school (AOR = 2.84, 95% CI = [1.37, 5.90]). Missed opportunities for HPV vaccination were evident in 84.4% of respondents having visited a health care provider in the last year, including 40.1% tested for a sexually transmitted infection, and entry into higher education programs (33.4%).
Achieving sustainable development in practice?: lessons from the Nijgadh Verdict in Nepal
Authors: Mahaseth Harsh , Risal Pranjal
Published: June 2023

This opinion considers the decision made by the Supreme Court of Nepal in the case of Prakash Mani Sharma v The Government of Nepal which concerns the proposed construction of Nijgadh International Airport in a densely forested area of Nepal. In doing so, it considers the views of environmentalists, developers, airport authorities and the government. It also suggests what lessons can be learned from the decision, and emphasizes the importance of applying the concept of “sustainable development” to evaluating such a problem.
Electoral Crisis Communications: Combatting Disinformation & the Contest for Electoral Legitimacy
Authors: Winger Gregory , Calfano Brian , Vićić Jelena , Harknett Richard
Published: June 2023

In the age of weaponized disinformation, the question for democracies is not merely who will win an election, but whether the outcome will be accepted as legitimate. To assess the challenge faced by U.S. electoral officials in convincing the public of the security of election procedure we conducted a survey experiment on a national sample of 4987 U.S. adults in the lead-up to the 2020 election. Subjects were exposed to claims about voter fraud as well as crisis communication counter-messaging attributed to election officials. We find that regardless of the messaging strategy, subjects were unmoved by the counter-messaging with partisanship being a clear predictor of increased skepticism towards election security. Our findings illustrate the difficulties election officials face in convincing the publics about election legitimacy and highlight the systemic dangers posed by electoral disinformation.
The Role of Positive Psychology in Lifestyle Medicine
Authors: Lianov Liana
Published: June 2023

Lifestyle medicine leverages six pillars—a predominantly plant-based diet, physical activity, sleep, avoiding risky substance, stress management, and social connection. Facilitating behavior change represents the crux of success with each of these pillars. Positive emotions and positive psychology constructs are shown to drive behavior change in the upward spiral theory of lifestyle change. Moreover, positive psychology interventions serve as additional, independent protective health factors. This paper offers a brief review of the empirical evidence for these roles of positive psychology and makes the case for explicitly adding positive psychology to the foundational lifestyle medicine pillars.
Mixed convection MHD hybrid nanofluid flow between two parallel rotating discs with joule heating and chemical reactions using bvp4c
Authors: Rashid Amjid , Ayaz Muhammad , Islam Saeed
Published: June 2023

Several characteristics of the resulting fluid are influenced by the nanoparticle suspension. Understanding the heat transfer mechanism in nanofluids is necessary for many production and manufacturing applications. The current study examines the effects of mixed convection MHD and Joule heating on the flow of ( TiO2– GO/water) hybrid nanofluid and ( TiO2/water) nanofluids in the porous media between two parallel, infinitely spinning discs when radiation occurs. Using the “bvp4c” function in MATLAB, the governing equations are numerically solved. A graphic is used to show how important parameters affect the velocity, temperature, and concentration of nanoparticles. Finally, a table depicting the interactions between several important factors and skin friction, the Nusselt number, and the Sherwood number at the upper and lower discs is created. The findings show that while the local skin fraction drops with an increase in the mixed convection parameter, the heat transmission rate at both discs increases. Additionally, the rate of heat transmission at both the top and lower discs is reduced as the radiation and magnetic parameters increase. This study’s findings will be helpful to numerous nanofluid-based medicinal applications, architectural design systems, better oil recovery systems, and transportation procedures, among other sectors.
Use of comprehensive recruitment strategies in the glycemia reduction approaches in diabetes: A comparative effectiveness study (GRADE) multi-center clinical trial
Authors: Cherrington Andrea L , Krause-Steinrauf Heidi , Aroda Vanita , Buse John B , Fattaleh Basma , Fortmann Stephen P , Hall Stephanie , Hox Sophia H , Kuhn Alexander , Killean Tina , Loveland Amy , Phillips Lawrence S , Jackson Analyn Uy , Waltje Andrea , McKee M Diane ,   the GRADE Research Group
Published: June 2023

Background/Aims

We present and describe recruitment strategies implemented from 2013 to 2017 across 45 clinical sites in the United States, participating in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study, an unmasked, randomized controlled trial evaluating four glucose-lowering medications added to metformin in individuals with type 2 diabetes mellitus (duration of diabetes <10 years). We examined the yield of participants recruited through Electronic Health Records systems compared to traditional recruitment methods to leverage access to type 2 diabetes patients in primary care.

Methods

Site selection criteria included availability of the study population, geographic representation, the ability to recruit and retain a diverse pool of participants including traditionally underrepresented groups, and prior site research experience in diabetes clinical trials. Recruitment initiatives were employed to support and monitor recruitment, such as creation of a Recruitment and Retention Committee, development of criteria for Electronic Health Record systems queries, conduct of remote site visits, development of a public screening website, and other central and local initiatives. Notably, the study supported a dedicated recruitment coordinator at each site to manage local recruitment and facilitate screening of potential participants identified by Electronic Health Record systems.

Results

The study achieved the enrollment goal of 5000 participants, meeting its target with Black/African American (20%), Hispanic/Latino (18%), and age ≧60 years (42%) subgroups but not with women (36%). Recruitment required 1 year more than the 3 years originally planned. Sites included academic hospitals, integrated health systems, and Veterans Affairs Medical Centers. Participants were enrolled through Electronic Health Record queries (68%), physician referral (13%), traditional mail outreach (7%), TV, radio, flyers, and Internet (7%), and other strategies (5%). Early implementation of targeted Electronic Health Record queries yielded a greater number of eligible participants compared to other recruitment methods. Efforts over time increasingly emphasized engagement with primary care networks.

Conclusion

Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness successfully recruited a diverse study population with relatively new onset of type 2 diabetes mellitus, relying to a large extent on the use of Electronic Health Record to screen potential participants. A comprehensive approach to recruitment with frequent monitoring was critical to meet the recruitment goal.
Transbronchial cryobiopsy proven amyloid diffuse cystic lung disease complicating a transthyretin mutated (ATTRm) amyloidosis: a case report
Authors: Gaultier Sébastien , Puscas Tania , Pastre Jean , Gibault Laure , Arlet Jean-Benoît , Cauquil Cécile , Michon Adrien
Published: June 2023

We present a case report of transbronchial cryobiopsy proven diffuse amyloid cystic lung disease complicating a homozygous Val122Ile (V122I) transthyretin mutated amyloidosis (ATTRm). To the best of our knowledge, this is the first case in the literature reporting such pulmonary lesions in ATTRm amyloidosis, and notably diagnosed through cryobiopsy. A 51-year-old man from Mali with a past medical history of bilateral carpal tunnel syndrome presented erectile dysfunction, asthenia and worsening dyspnoea over the past year. He presented signs of cardiac failure; histological and radiological investigations diagnosed cardiac amyloidosis. He was found homozygote for the V122I mutation in transthyretin. A diffuse cystic lung disease (DCLD) was noted on computed tomography (CT) scan. We performed a transbronchial pulmonary cryobiopsy that revealed histological transthyretin amyloid deposits. This case report illustrates the safety and usefulness of cryobiopsy in the setting of DCLD and extends ATTRm amyloidosis as a possible cause of DCLD.
Improving Cranial Vault Remodeling for Unilateral Coronal Craniosynostosis—Introducing Automated Surgical Planning
Authors: Robertson Emilie , Boulanger Pierre , Kwan Peter , Louie Gorman , Aalto Daniel
Published: June 2023

Study Design

Cranial vault remodeling (CVR) for unicoronal synostosis is challenging due to the asymmetric nature of the deformity. Computer-automated surgical planning has demonstrated success in reducing the subjectivity of decision making in CVR in symmetric subtypes. This proof of concept study presents a novel method using Boolean functions and image registration to automatically suggest surgical steps in asymmetric craniosynostosis.

Objective

The objective of this study is to introduce automated surgical planning into a CVR virtual workflow for an asymmetric craniosynostosis subtype.

Methods

Virtual workflows were developed using Geomagic Freeform Plus software. Hausdorff distances and color maps were used to compare reconstruction models to the preoperative model and a control skull. Reconstruction models were rated as high or low performing based on similarity to the normal skull and the amount of advancement of the frontal bone (FB) and supra-orbital bar (SOB). Fifteen partially and fully automated workflow iterations were carried out.

Results

FB and SOB advancement ranged from 3.08 to 10.48 mm, and −1.75 to 7.78 mm, respectively. Regarding distance from a normal skull, models ranged from .85 to 5.49 mm at the FB and 5.40 to 10.84 mm at the SOB. An advancement of 8.43 mm at the FB and 7.73 mm at the SOB was achieved in the highest performing model, and it differed to a comparative normal skull by .02 mm at the FB and .48 mm at the SOB.

Conclusions

This is the first known attempt at developing an automated virtual surgical workflow for CVR in asymmetric craniosynostosis. Key regions of interest were outlined using Boolean operations, and surgical steps were suggested using image registration. These techniques improved post-operative skull morphology
Clinical characteristics of hospitalized patients with metabolic-associated fatty liver disease–related liver cancer: data from a single center, 2010–2019
Authors: Wang Guishuang , Zhao Hong , Sun Lei , Wan Gang , Xie Wen
Published: June 2023

Background:

Metabolic-associated fatty liver disease (MAFLD) has become an important cause of liver cancer. The current understanding of MAFLD-related liver cancer is not sufficient, however.

Objective:

The objective of this study was to investigate the clinical and metabolic characteristics of inpatients with MAFLD-related liver cancer.

Design:

This is a cross-sectional investigation.

Methods:

An investigation was conducted to collect the cases of hepatic malignant tumor hospitalized in Beijing Ditan Hospital, Capital Medical University from 1 January 2010 to December 31 2019. The basic information, medical history, laboratory examination results, and imaging examination results of 273 patients diagnosed with MAFLD-related liver cancer were recorded. The general information and metabolic characteristics of patients with MAFLD-related liver cancer were analyzed.

Results:

In total, 5958 patients were diagnosed with hepatic malignant tumor. Among them, liver cancer due to other causes accounted for 6.19% (369/5958), MAFLD-related liver cancer was diagnosed in 273 cases of them. From 2010 to 2019, MAFLD-related liver cancer showed an increasing trend. Among 273 patients with MAFLD-related liver cancer, 60.07% were male, 66.30% were ⩾60 years old, and 43.22% had cirrhosis. The 273 patients were comprised by 38 patients with evidence of fatty liver and 235 patients without evidence of fatty liver. There was no significant difference in the proportions of sex, age, overweight/obesity, type 2 diabetes, and the presence of ⩾2 metabolic-related factors between the two groups. In the group without evidence of fatty liver, 47.23% patients had cirrhosis, which was significantly higher than 18.42% in the group with evidence of fatty liver ( p < 0.001).

Conclusion:

MAFLD-related liver cancer should be considered in liver cancer patients with metabolic risk factors. Half of MAFLD-related liver cancer occurred in the absence of cirrhosis.
The Perceived Affordances and Challenges in the Newly Introduced OKR-Based Performance Appraisal System in an Omani HEI
Authors: Al-Saadi Zulaikha , Al-Maawali Wafaa , Ali Holi Ibrahim Holi , Al Rushaidi Ibtisam
Published: June 2023

Performance appraisal (PA) is a valuable tool used by organizations to improve and enhance their employees’ competencies and ensure their organizational capability to cope with a dynamic world. The newly introduced Objectives and Key Results (OKR) PA system in Oman has been a source of concern and controversial debate among governmental employees, particularly academics. This exploratory study aims to address the following research questions: (1) What are the perceived affordances of OKR metrics? (2) What difficulties have most academics experienced with the new PA system? (3) What are the perceived challenges in coping with the requirements of OKR metrics? The necessary data were collected through semi-structured interviews with 11 academic staff members at University of Technology and Applied Sciences—Rustaq. The findings of this study have the potential to inform decisions of line managers and any developing performance appraisal system to incorporate types of training suitable to the needs of employees.
The Global Stock Market Reactions to the 2016 U.S. Presidential Election
Authors: Diaconaşu Delia , Mehdian Seyed , Stoica Ovidiu
Published: June 2023

Donald Trump’s victory in the 2016 presidential election was a political surprise to almost everyone, domestically and internationally. This paper investigates international investors’ reaction to this apparent global political surprise. Employing an event study methodology, we test the three widely known behavioral hypotheses concerning international investor reaction to this unexpected news, that is, the Overreaction Hypothesis (OH), the Uncertain Information Hypothesis (UIH), and the Efficient Market Hypothesis (EMH). The study results show that most of the indexes initially reacted unfavorably to the announcement of Trump’s win; however, subsequent stock index returns exhibit corrective upward patterns consistent with the predictions of the OH, except for the Latin American and France markets. The reactions of the other indexes appear to be favorable and in line with the prediction of the UIH. These findings suggest that in most countries under study, investors could utilize contrarian strategies to generate abnormal returns, as evidenced by price reversal following the arrival of the surprise.

JEL classification: G14, G15.
Applying Monte Carlo Simulations to a Small Data Analysis of a Case of Economic Growth in COVID-19 Times
Authors: Thach Nguyen Ngoc
Published: June 2023

Studies on the going-on COVID-19 pandemic face small sample issues. In this context, Bayesian estimation is considered a viable alternative to frequentist estimation. Demonstrating the Bayesian approach’s advantage in dealing with this problem, our research conducted a case study concerning ASEAN economic growth during the COVID-19 pandemic. By using Monte Carlo standard errors and interval hypothesis testing to check parameter bias within a Bayesian MCMC simulation study, the author obtained significant conclusions as follows: first, in insufficient sample sizes, in contrast to frequentist estimation, the Bayesian framework can offer meaningful results, that is, expansionary monetary and contractionary fiscal policies are positively associated with economic growth; second, in the face of a small sample, by incorporating more information into prior distributions for the model parameters, Bayesian Monte Carlo simulations perform so far better than naïve Bayesian and frequentist estimation; third, in case of a correctly specified prior, the inferences are robust to different prior specifications. The author strongly recommends applying specific informative priors to Bayesian analyses, particularly in small sample investigations.
BikeDNA: A tool for bicycle infrastructure data and network assessment
Authors: Vierø Ane Rahbek , Vybornova Anastassia , Szell Michael
Published: June 2023

Building high-quality bicycle networks requires knowledge of existing bicycle infrastructure. However, bicycle network data from governmental agencies or crowdsourced projects like OpenStreetMap often suffer from unknown, heterogeneous, or low quality, which hampers the green transition of human mobility. In particular, bicycle-specific data have peculiarities that require a tailor-made, reproducible quality assessment pipeline: For example, bicycle networks are much more fragmented than road networks, or are mapped with inconsistent data models. To fill this gap, we introduce BikeDNA, an open-source tool for reproducible quality assessment tailored to bicycle infrastructure data with a focus on network structure and connectivity. BikeDNA performs either a standalone analysis of one data set or a comparative analysis between OpenStreetMap and a reference data set, including feature matching. Data quality metrics are considered both globally for the entire study area and locally on grid cell level, thus exposing spatial variation in data quality. Interactive maps and HTML/PDF reports are generated to facilitate the visual exploration and communication of results. BikeDNA supports quality assessments of bicycle infrastructure data for a wide range of applications—from urban planning to OpenStreetMap data improvement or network research for sustainable mobility.
A cost-effectiveness analysis of intraoperative autologous transfusion in adolescent idiopathic scoliosis surgery: a single-centre retrospective study
Authors: Chi Wen , Luo Zhenguo , Wu Zanqing , Hao Jianhong
Published: June 2023

Background

Intraoperative autologous transfusion (IAT) has been used in scoliosis surgery for decades; however, its cost-effectiveness remains debatable. This study aimed to evaluate the cost-effectiveness of IAT in adolescent idiopathic scoliosis (AIS) surgery and identify risk factors of massive intraoperative blood during this surgery.

Methods

The medical records of 402 patients who underwent AIS surgery were reviewed. The patients were divided into different groups according to the intraoperative blood loss volume (group A: ≥500 to < 1000 mL, B: ≥1,000 to < 1,500 mL, and C: ≥1,500 mL) and whether IAT was used (i.e., IAT and no-IAT groups). The volume of blood loss, volume of transfused allogeneic red blood cells (RBC), and RBC transfusion costs were analysed. Univariate and multivariate logistic regression analyses were used to identify the independent risk factors of massive intraoperative blood loss (≥ 1,000 mL and ≥ 1,500 mL). A receiver operating characteristic (ROC) curve was used to analyse the cut-off values of the factors contributing to massive intraoperative blood loss.

Results

In group A, no significant difference was observed in the volume of allogeneic RBC transfused during and after procedure between the IAT and no-IAT groups; however, total RBC transfusion costs was significantly higher in the IAT group. In groups B and C, the patients in the IAT group compared with those in the no-IAT group had a lower volume of allogeneic RBC transfused during the operation and on the first day after the operation. However, in group B, the total RBC transfusion cost in the patients who used IAT was significantly higher. In group C, total RBC transfusion cost in the patients who used IAT was significantly lower. The number of fused vertebral levels and Ponte osteotomy were found to be independent risk factors for massive intraoperative blood loss. ROC analysis showed that more than eight and 10 fused vertebral levels predicted ≥ 1,000 mL and ≥ 1,500 mL intraoperative blood loss, respectively.

Conclusion

The cost-effectiveness of IAT in AIS was related to the volume of blood loss, and when the blood loss volume was ≥ 1,500 mL, IAT was cost-effective, drastically reducing the demand for allogeneic RBC and total RBC transfusion cost. The number of fused vertebral levels and Ponte osteotomy were independent risk factors for massive intraoperative blood loss.
Frequency-based rare diagnoses as a novel and accessible approach for studying rare diseases in large datasets: a cross-sectional study
Authors: Tröster Thomas S. , von Wyl Viktor , Beeler Patrick E. , Dressel Holger
Published: June 2023

Background

Up to 8% of the general population have a rare disease, however, for lack of ICD-10 codes for many rare diseases, this population cannot be generically identified in large medical datasets. We aimed to explore frequency-based rare diagnoses (FB-RDx) as a novel method exploring rare diseases by comparing characteristics and outcomes of inpatient populations with FB-RDx to those with rare diseases based on a previously published reference list.

Methods

Retrospective, cross-sectional, nationwide, multicenter study including 830,114 adult inpatients. We used the national inpatient cohort dataset of the year 2018 provided by the Swiss Federal Statistical Office, which routinely collects data from all inpatients treated in any Swiss hospital. Exposure: FB-RDx, according to 10% of inpatients with the least frequent diagnoses (i.e.1.decile) vs. those with more frequent diagnoses (deciles 2–10). Results were compared to patients having 1 of 628 ICD-10 coded rare diseases. Primary outcome: In-hospital death. Secondary outcomes: 30-day readmission, admission to intensive care unit (ICU), length of stay, and ICU length of stay. Multivariable regression analyzed associations of FB-RDx and rare diseases with these outcomes.

Results

464,968 (56%) of patients were female, median age was 59 years (IQR: 40–74). Compared with patients in deciles 2–10, patients in the 1. were at increased risk of in-hospital death (OR 1.44; 95% CI: 1.38, 1.50), 30-day readmission (OR 1.29; 95% CI 1.25, 1.34), ICU admission (OR 1.50; 95% CI 1.46, 1.54), increased length of stay (Exp(B) 1.03; 95% CI 1.03, 1.04) and ICU length of stay (1.15; 95% CI 1.12, 1.18). ICD-10 based rare diseases groups showed similar results: in-hospital death (OR 1.82; 95% CI 1.75, 1.89), 30-day readmission (OR 1.37; 95% CI 1.32, 1.42), ICU admission (OR 1.40; 95% CI 1.36, 1.44) and increased length of stay (OR 1.07; 95% CI 1.07, 1.08) and ICU length of stay (OR 1.19; 95% CI 1.16, 1.22).

Conclusion(s)

This study suggests that FB-RDx may not only act as a surrogate for rare diseases but may also help to identify patients with rare disease more comprehensively. FB-RDx associate with in-hospital death, 30-day readmission, intensive care unit admission, and increased length of stay and intensive care unit length of stay, as has been reported for rare diseases.
Impact of age-friendly living environment and intrinsic capacity on functional ability in older adults: a cross-sectional study
Authors: Jiang Yi-Shan , Shi Hong , Kang Yu-Ting , Shen Ji , Li Jing , Cui Ju , Pang Jing , Zhang Chi , Zhang Jie
Published: June 2023

Background

The World Health Organization (WHO) has proposed healthy aging framework, supposing that intrinsic capacity (IC), environment and their interaction may have influence on functional ability (FA). It was still unclear how the IC level and age-friendly living environment impact on FA. This study aims to confirm the relationship between the IC level and age-friendly living environment with FA, especially in older adults with low IC.

Methods

Four hundred eighty-five community-dwelling residents aged ≥ 60 years were enrolled. IC constructed by locomotion, cognition, psychological, vitality, and sensory domains was assessed using full assessment tools recommended by WHO. Age-friendly living environment was measured with 12 questions adapted from the spatial indicators framework of age-friendly cities. FA was assessed using activities of daily living (ADL) and one question about mobile payment ability. Multivariate logistic regression was used to explore the association between IC, environment and FA. The influence of the environment on electronic payment and ADL under the IC layer was assessed.

Results

Of 485 respondents, 89 (18.4%) had ADL impairment, and 166 (34.2%) had mobile payment function impairment. Limited IC (odds ratio [OR] = 0.783, 95% confidence interval [CI] = 0.621–0.988) and poor environment (OR = 0.839, 95% CI = 0.733–0.960) were associated with mobile payment ability impairment. Our results suggested that a supportive age-friendly living environment influenced FA was more prominent in older adults with poor IC (OR = 0.650, 95% CI = 0.491–0.861).

Conclusions

Our results confirmed IC and the environment had an impact on mobile payment ability. The relationship between environment and FA showed differences according to IC level. These findings suggest that an age-friendly living environment is important to maintain and enhance elders’ FA, especially in those with poor IC.
Eating behaviour, quality of life and cardiovascular risk in obese and overweight children and adolescents: a cross-sectional study
Authors: Santos Fernanda Gabriela Colombo Drumond , Godoy-Leite Mariana , Penido Eduardo Augusto Resende , Ribeiro Kennad Alves , da Gloria Rodrigues-Machado Maria , Rezende Bruno Almeida
Published: June 2023

Background

Childhood obesity is a major cardiovascular risk factor because it predisposes individuals to comorbidities that are implicated in an increased risk of cardiovascular events. Its origin may be related to poor eating habits, such as the intake of foods of low nutritional value or inadequate eating behaviours related to emotional factors. This work aims to evaluate the relationship between the total body mass of children and adolescents and its association with eating habits, quality of life (QoL), and possible changes in early markers of cardiovascular risk.

Methods

This was a cross-sectional observational study that evaluated anthropometric and cardiovascular parameters, QoL, and eating behaviour in 181 children and adolescents aged between 5 and 13 years. Participants were stratified according to BMI/age into three groups (Adequate Weight, Overweight, and Obesity). Anthropometry included weight, height, waist and hip circumferences, waist-hip ratio, and waist-height ratio. QoL was assessed using the Peds-QL 4.0 questionnaire, and eating behaviour was assessed using the Children’s Eating Behaviour Questionnaire (CEBQ). Cardiovascular parameters were assessed using the Mobil-O-Graph® device, which measures the pulse wave velocity (PWV) and augmentation index (AIx@75) to estimate arterial stiffness (AS), which is considered an early marker of cardiovascular disease.

Results

In addition to the increase in anthropometric measurements (p < 0.001), the Obesity group exhibited behaviour related to food intake (p < 0.05). When analysing QoL, a worsening in the social domain was also observed in the Obesity group (p < 0.05). However, PWV and AIx@75 did not differ between groups.

Conclusions

Eating behaviour is related to the development of childhood obesity. However, early markers of cardiovascular risk related to AS did not change as a function of total body mass in the children evaluated.
Connections associated with a healthy spirituality: are these unrecognized intermediary determinants that shape health inequities in Canadian young people?
Authors: Michaelson Valerie , King Nathan , Patte Karen A. , Gardner Pauli , Pickett William
Published: June 2023

Background

The health of adolescents is determined by structural and intermediary factors. Such factors operate through pathways that foster different opportunities to achieve health and wellbeing, contributing to inequities. Past analyses of cross-national adolescent health data show that measures of child spirituality, conceptualized as the strength of the connections in our lives, may operate as intermediary determinants in some Western countries. Inspired by this idea, the current analysis provides an in-depth exploration of such pathways among Canadian adolescents. Our objectives were to confirm the existence of relationships between economic position and seven indicators of adolescent health status, then explore whether any observed inequities could be explained by the strength of connections afforded by a healthy spirituality.

Methods

Cycle 8 of the Canadian Health Behaviour in School-aged Children (HBSC) study was conducted in 2017–18. A school-based sample (n = 18,962) of adolescents was obtained from across Canada following a standard cross-national protocol. Eligible participants completed a general survey about their health, health behaviours and their determinants. Survey data were used to model the potential effect of perceived levels of relative affluence on each of seven health indicators. Comparison of crude and adjusted relative risks estimates from weighted log-binomial regression models provided evidence of indirect mediating effects attributable to each of four domains of spirituality.

Results

As perceived levels of family affluence increased, the percentages of young people who reported each (7/7) of the negative health outcomes decreased. The spiritual health domain “connections to self” (i.e., the importance of meaning, purpose, joy and happiness in life) mediated the strength of relationships between relative affluence and each (7/7) of the outcomes in boys and girls. “Connections to others” (the importance of kindness, respect and forgiveness) mediated the strength of relationships between relative affluence and each (7/7) of the outcomes among girls. Inconsistent evidence of possible mediation was identified for connections to others in boys, as well as the other two domains of spirituality (connections to nature, then connections to the transcendent) in boys and girls.

Conclusion

Specific connections afforded by a healthy spirituality could be intermediary determinants of health in Canadian adolescent populations.
Developing a framework for evaluation: a Theory of Change for complex workplace mental health interventions
Authors: Tsantila Fotini , Coppens Evelien , De Witte Hans , Abdulla Kahar , Amann Benedikt L. , Arensman Ella , Aust Birgit , Creswell-Smith Johanna , D’Alessandro Luigia , De Winter Lars , Doukani Asmae , Fanaj Naim , Greiner Birgit , Griffin Eve , Leduc Caleb , Maxwell Margaret , Connor Cliodhna O’ , Paterson Charlotte , Purebl György , Reich Hanna , Ross Victoria , Van Weeghel Jaap , Van Audenhove Chantal
Published: June 2023

Background

There is a gap between the necessity of effective mental health interventions in the workplace and the availability of evidence-based information on how to evaluate them. The available evidence outlines that mental health interventions should follow integrated approaches combining multiple components related to different levels of change. However, there is a lack of robust studies on how to evaluate multicomponent workplace interventions which target a variety of outcomes at different levels taking into account the influence of different implementation contexts.

Method

We use the MENTUPP project as a research context to develop a theory-driven approach to facilitate the evaluation of complex mental health interventions in occupational settings and to provide a comprehensive rationale of how these types of interventions are expected to achieve change. We used a participatory approach to develop a ToC involving a large number of the project team representing multiple academic backgrounds exploiting in tandem the knowledge from six systematic reviews and results from a survey among practitioners and academic experts in the field of mental health in SMEs.

Results

The ToC revealed four long-term outcomes that we assume MENTUPP can achieve in the workplace: 1) improved mental wellbeing and reduced burnout, 2) reduced mental illness, 3) reduced mental illness-related stigma, and 4) reduced productivity losses. They are assumed to be reached through six proximate and four intermediate outcomes according to a specific chronological order. The intervention consists of 23 components that were chosen based on specific rationales to achieve change on four levels (employee, team, leader, and organization).

Conclusions

The ToC map provides a theory of how MENTUPP is expected to achieve its anticipated long-term outcomes through intermediate and proximate outcomes assessing alongside contextual factors which will facilitate the testing of hypotheses. Moreover, it allows for a structured approach to informing the future selection of outcomes and related evaluation measures in either subsequent iterations of complex interventions or other similarly structured programs. Hence, the resulting ToC can be employed by future research as an example for the development of a theoretical framework to evaluate complex mental health interventions in the workplace.
Prevalence and associated factors of intimate partner violence against pregnant women in urban areas of Japan: a cross-sectional study
Authors: Maruyama Naoko , Horiuchi Shigeko , Kataoka Yaeko
Published: June 2023

Background

Intimate partner violence (IPV) against pregnant women is associated with many negative maternal and fetal outcomes and is a common public health problem all over the world. However, the issue has not been fully explored in Japan. This study aimed to explore the prevalence and risk factors of IPV against pregnant women in urban areas of Japan.

Methods

This study was a secondary data analysis of a cross-sectional survey that was conducted on women beyond 34 weeks’ gestation in five perinatal facilities in urban areas of Japan, from July to October 2015. The sample size was calculated to be 1230. The Violence Against Women Screen was used for IPV screening. Multiple logistic regression analysis was used to calculate the adjusted odds ratio (AOR) with 95% confidence interval (CI) for risks of IPV while adjusting for confounding factors.

Results

Of the 1346 women who participated in this study, 180 (13.4%) were identified as experiencing IPV. Compared to those who did not experience IPV (n = 1166 (86.6%)), women experiencing IPV had higher odds of being single mothers (AOR = 4.8; 95%CI: 2.0, 11.2), having lower household income (< 3 million yen, AOR = 2.6; 95%CI: 1.4, 4.6; ≥ 3 million yen and < 6 million yen, AOR = 1.9; 95%CI: 1.2, 2.9), having junior high school education background (AOR = 2.3; 95%CI: 1.0, 5.3) and being multipara (AOR = 1.6; 95%CI: 1.1, 2.4).

Conclusions

13.4%, or about one in seven women, experienced IPV while pregnant. This high proportion indicates the need for policy to address the issue of violence against pregnant women. There is an urgent need to build a system for the early detection of victims that offers appropriate support to prevent the recurrence of violence while encouraging victim recovery.
Inflation using hydrogen improves donor lung quality by regulating mitochondrial function during cold ischemia phase
Authors: Duan Le , Quan Lini , Zheng Bin , Li Zhe , Zhang Guangchao , Zhang Mengdi , Zhou Huacheng
Published: June 2023

Background

Mitochondrial dysfunction results in poor organ quality, negatively affecting the outcomes of lung transplantation. Whether hydrogen benefits mitochondrial function in cold-preserved donors remain unclear. The present study assessed the effect of hydrogen on mitochondrial dysfunction in donor lung injury during cold ischemia phase (CIP) and explored the underlying regulatory mechanism.

Methods

Left donor lungs were inflated using 40% oxygen + 60% nitrogen (O group), or 3% hydrogen + 40% oxygen + 57% nitrogen (H group). Donor lungs were deflated in the control group and were harvested immediately after perfusion in the sham group (n = 10). Inflammation, oxidative stress, apoptosis, histological changes, mitochondrial energy metabolism, and mitochondrial structure and function were assessed. The expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) were also analyzed.

Results

Compared with the sham group, inflammatory response, oxidative stress, histopathological changes, and mitochondrial damage were severe in the other three groups. However, these injury indexes were remarkably decreased in O and H groups, with increased Nrf2 and HO-1 levels, elevated mitochondrial biosynthesis, inhibition of anaerobic glycolysis and restored mitochondrial structure and function compared with the control group. Moreover, inflation using hydrogen contributed to stronger protection against mitochondrial dysfunction and higher levels of Nrf2 and HO-1 when comparing with O group.

Conclusions

Lung inflation using hydrogen during CIP may improve donor lung quality by mitigating mitochondrial structural anomalies, enhancing mitochondrial function, and alleviating oxidative stress, inflammation, and apoptosis, which may be achieved through activation of the Nrf2/HO-1 pathway.