bluuebunny/crossref_metadata_2025 huggingface dataset:
Preferences for Advance Care Planning in Patients with End-Stage Kidney Disease: A Cross-Sectional Survey among Nephrology Healthcare Providers in a Tertiary Care Center in India
Authors: Naik Bharathi , Ghoshal Arun , Damani Anuja , Singhai Pankaj , Prabhu Attur Ravindra , Salins Naveen , Nayak Ajith M. , Nagaraju Shankar Prasad
Published: September 2024

Introduction: Advance care planning (ACP) is essential in managing patients with end-stage kidney disease (ESKD), yet its integration into clinical practice remains limited, particularly in low- and middle-income countries. This study explores the preferences, attitudes and perceived barriers of nephrology healthcare providers toward ACP for patients with ESKD in a tertiary care center in India. Methods: A cross-sectional survey was conducted among nephrology healthcare providers at a tertiary care center in India. The survey, developed from literature reviews and pretested, covered demographics, ACP knowledge and attitudes, current practices, and perceived barriers and facilitators. Data collection occurred from September 2022 to March 2023. Quantitative data were analyzed descriptively, and qualitative data through thematic analysis. Results: A total of 50 healthcare providers participated. While 36% acknowledged the importance of ACP, only 8% routinely engaged in ACP discussions. Major barriers included inadequate training (22%), lack of awareness about the importance of discussing ACP among stakeholders (20%), cultural barriers (18%), lack of time (14%), and the absence of institutional protocols for discussion on ACP (14%). Additional barriers included instances where families withhold health information from patients due to fear of losing hope (16%) and patient/family discomfort in discussing ACP (12%). Providers expressed a need for structured ACP protocols and educational programs. Conclusion: Despite recognizing its importance, ACP is underutilized in the care of patients with ESKD in India. Addressing the identified barriers through targeted interventions may enhance ACP practices and improve patient outcomes.
Endovascular Treatment of Flow-Limiting Iliofemoral Stenosis Improves Left Ventricular Diastolic Function in Patients With HFpEF by Reducing Aortic Pulsatile Load
Authors: Baasen Sven , Stern Manuel , Wischmann Patricia , Schremmer Johanna , Sansone Roberto , Spieker Maximilian , Wolff Georg , Bönner Florian , Quast Christine , Heiss Christian , Kelm Malte , Busch Lucas
Published: September 2024

BACKGROUND:

Recent research indicates that there is a high prevalence of heart failure with preserved ejection fraction in patients with peripheral artery disease. We hypothesized that endovascular treatment (EVT) of flow-limiting peripheral stenosis improves left ventricular (LV) diastolic function.

METHODS:

Thirty patients with symptomatic peripheral artery disease and heart failure with preserved ejection fraction according to Heart Failure Association−preserved ejection fraction score who were scheduled for EVT or angiography were investigated at baseline, the day after EVT (n=25) or angiography (control, n=5), and at 4 months follow-up. Peripheral hemodynamics were determined by the total peripheral resistance, common femoral artery flow, and ankle brachial index. Aortic function was measured by arterial compliance, augmentation index, and pulse wave velocity. Aortic pulsatile load was estimated as the characteristic impedance of the proximal aorta and the magnitude of wave reflection (reflection coefficient). LV mass index, LV mean wall thickness, and systolic and diastolic function were assessed using echocardiography. Patient-centered outcomes were treadmill walking distance and New York Heart Association class.

RESULTS:

After EVT, peripheral hemodynamics changed significantly with a decrease in total peripheral resistance and an increase in common femoral artery flow and ankle brachial index. Aortic function improved after EVT, with significantly reduced augmentation index and pulse wave velocity and increased compliance immediately and at follow-up, resulting in a reduction in aortic pulsatile load (characteristic impedance of the proximal aorta and reflection coefficient). Concurrently, LV diastolic function improved after EVT compared with control, acutely and at follow-up, with increased septal and lateral e´ velocities and decreased
E
/
e
´ and left atrial volume index. The LV mass index and LV mean wall thickness decreased at follow-up. The New York Heart Association class and treadmill walking distance improved post-EVT at follow-up. Augmentation index, pulse wave velocity, and arterial compliance were identified as independent contributors to
E
/
e
´.

CONCLUSIONS:

Endovascular treatment of flow-limiting iliofemoral stenosis reduces aortic pulsatile load and concurrently lowers total peripheral resistance. This beneficial effect is associated with an acute and sustained improvement of left ventricular diastolic function.

REGISTRATION:

URL:
http://www.clinicaltrials.gov
; Unique identifier: NCT02728479.
Hospital and Physician Variability in Revascularization Decisions and Outcomes for Patients With 3‐Vessel and Left Main Coronary Artery Disease: A Population‐Based Cohort Study
Authors: Wilson Todd , James Matthew T. , Southern Danielle , Har Bryan , Graham Michelle M. , Brass Neil , Bainey Kevin , Fedak Paul W. M. , Sajobi Tolulope T. , Wilton Stephen B.
Published: September 2024

Background

Hospital‐ and physician‐level variation for selection of percutaneous coronary intervention versus coronary artery bypass grafting (CABG) for patients with coronary artery disease has been associated with outcome differences. However, most studies excluded patients treated medically.

Methods and Results

From 2010 to 2019, adults with 3‐vessel or left main coronary artery disease at 3 hospitals (A, B, C) in Alberta, Canada, were categorized by treatment with medical therapy, percutaneous coronary intervention, or CABG. Multilevel regression models determined the proportion of variation in treatment attributable to patient, physician, and hospital factors, and survival models assessed outcomes including death and major adverse cardiovascular events over 5 years. Of 22 580 patients (mean age, 67 years; 80% men): 6677 (29%) received medical management, 9171 (41%) percutaneous coronary intervention, and 6732 (30%) CABG. Hospital factors accounted for 10.8% of treatment variation. In adjusted models (site A as reference), patients at sites B and C had 49% (95% CI, 44%–53%) and 43% (95% CI, 37%–49%) lower rates of medical therapy, respectively, and 31% (95% CI, 24%–38%) and 32% (95% CI, 24%–40%) lower rates of CABG. During 5.0 years median follow‐up, 3287 (14.6%) patients died, with no intersite mortality differences. There were no between‐site differences in acute coronary syndromes or stroke; patients at sites B and C had 24% lower risk (95% CI, 13%–34% and 11%–35%, respectively) of heart failure hospitalization.

Conclusions

Hospital‐level variation in selection of percutaneous coronary intervention, CABG, or medical therapy for patients with complex coronary artery disease was not associated with differences in 5‐year mortality rates. Research and quality improvement initiatives comparing revascularization practices should include medically managed patients.
Gut Dysbiosis in Patients With Fontan Circulation
Authors: Ohuchi Hideo , Asano Ryotaro , Mori Aki , Ishibashi Tomohiko , Motooka Daisuke , Nakai Michikazu , Nakaoka Yoshikazu
Published: September 2024

Background

The process underlying Fontan pathophysiology is multifactorial and may include gut dysbiosis (GD). We investigated the presence of GD and elucidated its correlation with Fontan pathophysiology.

Methods and Results

Gut microbiomes of 155 consecutive patients with Fontan pathophysiology and 44 healthy individuals were analyzed using 16S rRNA sequencing of bacterial DNA extracted from fecal samples. GD was evaluated on the basis of α and ß diversities of the gut microbiome and was compared with natural log‐transformed C‐reactive protein, hemodynamics, von Willebrand factor antigen (a bacterial translocation marker), Mac‐2 binding protein glycosylation isomer (a liver fibrosis indicator), peak oxygen uptake, and heart failure hospitalization. Patients with Fontan exhibited GD in terms of α and ß diversities as compared with controls (
P
<0.01). Reduced α diversity was associated with a failed hemodynamic phenotype, hypoxia, high natural log‐transformed C‐reactive protein levels, and elevated von Willebrand factor antigen and Mac‐2 binding protein glycosylation isomer levels (
P
<0.05–0.01). In addition to elevated von Willebrand factor antigen and hypoxia, decreased α diversity was independently correlated with a high natural log‐transformed C‐reactive protein level (
P
<0.05), which was associated with liver imaging abnormalities and a heightened risk of heart failure hospitalization (
P
<0.01 for both).

Conclusions

Patients with Fontan pathophysiology exhibited GD compared with healthy individuals, and GD was linked to failed hemodynamics and systemic inflammation with a poor prognosis. Therefore, GD may play a pivotal role in a failing Fontan status, including Fontan‐associated liver disease, through GD‐associated systemic inflammation.
Smaller Left Ventricular Size But Preserved Function in Adolescents and Adults Born Preterm
Authors: Barton Gregory P. , Chandra Alvin , Sanchez‐Solano Nataly , Berry Jarett D. , Goss Kara N.
Published: September 2024

Background

Prematurely born adults have increased risk for cardiovascular disease. There are limited cardiac data on US‐born preterm individuals. We aimed to determine whether adolescents and adults born prematurely have altered left ventricular (LV) structure and function, and to interrogate diastolic function using isometric handgrip exercise.

Methods and Results

Adolescents and adults born moderately to extremely preterm (≤32 weeks gestation or <1500 g birth weight) were recruited from the Parkland Health Neonatal Intensive Care Unit Registry. Full‐term participants were recruited from the local area. Study procedures included anthropometrics and vitals, handgrip testing, and echocardiography performed at rest and during isometric handgrip exercise. Data were reported as mean±SD. The study enrolled 107 preterm and 48 term participants. Preterm participants (gestational age: 29.5±2.5 weeks) were shorter with higher body mass index (
P
<0.001) compared with term participants. Preterm participants exhibited smaller LV end‐diastolic volume index (50.8±10.1 versus 56.9±10.0 mL/m
2
,
P
<0.001), LV stroke volume index (29.6±6.0 versus 34.1±6.5 mL/m
2
,
P
<0.001), and LV mass index (67.2±13.1 versus 73.3±14.2 g/m
2
,
P
=0.002) compared with term individuals. Preterm participants also had subclinical reductions in LV peak systolic tissue velocity and peak early diastolic tissue velocity lateral at rest. Isometric handgrip exercise promoted a reduction in diastolic function and an increase in hemodynamic measures, but changes during isometric handgrip exercise were similar between groups.

Conclusions

Adolescents and adults born preterm exhibit overall normal cardiac function despite smaller cardiac volumes and mass compared with individuals born full term. Effects are most pronounced at the lowest gestational ages.
Cardiovascular Disease Risk Factor Control Following Release From Carceral Facilities: A Cross‐Sectional Study
Authors: Aminawung Jenerius A. , Puglisi Lisa B. , Roy Brita , Horton Nadine , Elumn Johanna E. , Lin Hsiu‐Ju , Bibbins‐Domingo Kirsten , Krumholz Harlan , Wang Emily A.
Published: September 2024

Background

Incarceration is a social determinant of cardiovascular health but is rarely addressed in clinical settings or public health prevention efforts. People who have been incarcerated are more likely to develop cardiovascular disease (CVD) at younger ages and have worse cardiovascular outcomes compared with the general population, even after controlling for traditional risk factors. This study aims to identify incarceration‐specific factors that are associated with uncontrolled CVD risk factors to identify potential targets for prevention.

Methods and Results

Using data from JUSTICE (Justice‐Involved Individuals Cardiovascular Disease Epidemiology), a prospective cohort study of individuals released from incarceration with CVD risk factors, we examine the unique association between incarceration‐specific factors and CVD risk factor control. Participants (N=471), with a mean age of 45.0±10.8 (SD) years, were disproportionately from racially minoritized groups (79%), and poor (91%). Over half (54%) had at least 1 uncontrolled CVD risk factor at baseline. People released from jail, compared with prison, had lower Life's Essential 8 scores for blood pressure and smoking. Release from jail, as compared with prison, was associated with an increased odds of having an uncontrolled CVD risk factor, even after adjusting for age, race and ethnicity, gender, perceived stress, and life adversity score (adjusted odds ratio 1.62 [95% CI, 1.02–2.57]).

Discussion

Release from jail is associated with poor CVD risk factor control and requires tailored intervention, which is informative as states design and implement the Centers of Medicare & Medicaid Services Reentry 1115 waiver, which allows Medicaid to cover services before release from correctional facilities.
Dendrobium namdongense (D. sect. Dendrobium), a new miniature orchid from limestone mountains of northern Vietnam
Authors: NGUYEN CUONG HUU , DANG HA VAN , NGUYEN YEN THI , NGUYEN LY VAN , AVERYANOV LEONID V. , MAISAK TATIANA V. , SHVANOVA VALERIA V.
Published: September 2024

Dendrobium namdongense is described here as a new species from limestone areas of the Nam Dong Conservation Area, Thanh Hoa Province, Quan Hoa District (northern Vietnam). This species inhabits primary evergreen broad-leaved and mixed forests on karstic limestone at elevations of 900–1100 m a.s.l. in a zone of humid, cool tropical climate. A detailed illustrated description and comparison of the discovered plant with the morphologically closest species, D. fuscifaucium and D. hekouense is provided, along with data on its distribution, ecology, and phenology. The new species has a potential in ornamental horticulture. According to the criteria of the IUCN Red List, the conservation status of the species is determined as Critically Endangered (CR).
Development of a Wave Model Component in the First Coupled Global Ensemble Forecast System at NOAA
Authors: Alves Jose-Henrique , Padilla-Hernandez Roberto , Spindler Deanna , Kolczynski Walter , Rajan Bhavani , Spindler Todd , Abdolali Ali , Campos Ricardo , Banihashemi Saeideh , Meixner Jessica
Published: September 2024

We describe the development of the wave component in the first global-scale coupled operational forecast system using the Unified Forecasting System (UFS) at the National Oceanic and Atmospheric Administration (NOAA), part of the U.S. National Weather Service (NWS) operational forecasting suite. The operational implementation of the atmosphere–wave coupled Global Ensemble Forecast System, version 12 (GEFSv12), in September 2020 was a critical step in NOAA’s transition to the broader community-based UFS framework. GEFSv12 represents a significant advancement, extending forecast ranges and empowering the NWS to deliver advanced weather predictions with extended lead times for high-impact events. The integration of a coupled wave component with higher spatial and temporal resolution and optimized physics parameterizations notably enhanced forecast skill and predictability, particularly benefiting winter storm predictions of wave heights and peak wave periods. This successful endeavor encountered challenges that were addressed by the simultaneous development of new features that enhanced wave model forecast skill and product quality and facilitated by a multidisciplinary team collaborating with NOAA’s operational forecasting centers. The GEFSv12 upgrade marks a pivotal shift in NOAA’s global forecasting capabilities, setting a new standard in wave prediction. We also describe the coupled GEFSv12-Wave component impacts on NOAA operational forecasts and ongoing experimental enhancements, which altogether represent a substantial contribution to NOAA’s transition to the fully coupled UFS framework.
Understanding the Effect of Climate Risk on Banking Business—A Panel Data Analysis of Indian Firms
Authors: Bandyopadhyay Arindam , Kashyap Ashutosh
Published: September 2024

The enormous phenomenon of climate change, which is affecting many organisations of different sectors today, has a special impact on the financial sector in terms of credit risk. Awareness and action on environmental, social and governance (ESG) goals and climate change impacts have been rapidly increasing worldwide. In this article, we present a firm-level panel data analysis to link ESG ratings and CO2 emissions with the default risk and solvency position of selected companies. We perform various univariate and multivariate analyses on selected top Bombay Stock Exchange (BSE) top 200 companies that have disclosures in Carbon Disclosure Project (CDP) reports over 5 years (2017–2021). We find strong empirical evidence that a firm’s risk of default is linked to its environmental performance along with the level of carbon emission. Our findings will enable banks to establish a linkage between credit risk and climate change risk. This will assist banks as well as policymakers to adjust borrower-level ratings and align their lending and investments with net zero emissions.

JEL Codes: G32, G33, Q2, Q5
Michelangelo Antonioni, Tourist Snapshots, and the Politics of the ‘Backward Scene’ in 1970s China
Authors: Healy Gavin
Published: September 2024

In 1972, Radio Televisione Italiana, Italy's state broadcaster, commissioned famed director Michelangelo Antonioni to film a documentary in the People's Republic of China, following the resumption of diplomatic relations between the two nations. Socialist China, in the throes of the Cultural Revolution, was a subject of intense Western fascination at the time. Radical activists worldwide were drawn to Maoism, and references to the Cultural Revolution abounded in European popular culture. Against this backdrop, Antonioni's Chung kuo/Cina found a receptive audience in Europe and North America. Yet by early 1974 the director's ‘anti-China film,’ which had not yet had a public screening in the nation, became the subject of strident condemnation in China's state media, caught up in struggles between competing political factions. This article presents a close reading of Chung kuo/Cina, and examines how the campaign condemning the film spilled over into stricter management of foreign tourists and the production of new forms of tourist literature by state publishers. Examining how notions of China's ‘backwardness’ implicated photographic practice, this article explores how Chinese officials regulated tourist photography, how foreign tourists understood those regulations, and how guides and ordinary Chinese citizens entered into the visual discourse of tourism on their own terms.
How practical is tactical? Political sociology, militarization, and police tactical teams in Canada
Authors: Towns Zachary , Ricciardelli Rosemary
Published: September 2024

Emergency Response Teams (ERT), commonly referred to as Special Weapons And Tactics (SWAT) teams, are the specialized police unit responsible for mitigating violent and dangerous conflict beyond the capacity of general duty to handle effectively. Debates surrounding the application and effectiveness of ERTs in policing highlight a need to keep ERT members safe due to adequacy and occupational health and safety standards while concurrently managing the expectations of community groups. These groups include those calling for defunding or de-militarization. Explored in the current article, is a thematic analysis of popularized media to unpack the arguments that police, government officials and community activist groups make to help shift opinions on police militarization. However, we frame these media account within Bourdieusian concepts of symbolic power, habitus or field struggle to provide insight into, arguably conflicting, interpretations of police militarization.
Emotion–Identity–Agency Triangle in Practicum Experience: A Pre-service Second Language Teacher's Development of Critical Emotional Reflexivity
Authors: Toker-Bradshaw Şeyma , Tezgiden-Cakcak Yasemin
Published: September 2024

Earlier research has established that language teachers’ identity work is intertwined with emotions and called for incorporating emotions in language teacher education. Yet, there is limited research investigating how teacher education programmes pedagogize identity, emotions and agency to help pre-service teachers gain critical emotional reflexivity. To respond to this gap in the literature, we pedagogized Kayi-Aydar’s emotion–identity–agency triangle via three teacher learning activities in a critical practicum course in a pre-service English language teaching programme in Turkey: reflective emotion diary; auto-ethnography; and critical issues analysis and advocacy project. In this study, we explore a Korean pre-service language teacher's (Iris's) case to demonstrate how she navigated her emotions, identity and agency throughout the practicum course with the help of these teacher learning activities and critical, dialogical supervision in our course. At the beginning of the term, Iris expressed anxiety due to her novice non-native pre-service teacher identity. Yet, as she gained critical emotional reflexivity, Iris could reflect on her emotions critically, transform her internalized deficit view of her identity as a novice non-native pre-service teacher and perform her multicultural and multilingual identity in her emerging pedagogy. We argue that findings from this study offer evidence that when intentionally and systematically supported by second language (L2) teacher educators through the design of teacher learning activities, pre-service L2 teachers can develop critical reflexivity of their emotions and emotion labour and recruit this awareness for teacher agency even over a short period of time and in contexts of power imbalance such as pre-service practicum experience. We offer recommendations for L2 teacher educators.
Additional injection laryngoplasty as a salvage treatment for unilateral vocal fold paralysis
Authors: Kim Taegyeong , Jung Go Eun , Kwon Minsu , Jung Young Ho , Choi Seung-Ho , Nam Soon Yuhl , Lee Yoon Se
Published: September 2024

Objectives

Injection laryngoplasty (IL) has been widely used as an initial treatment option for unilateral vocal fold paralysis (UVFP). An additional (second) IL is considered a salvage treatment for unsatisfactory outcomes of initial IL resulting from inadequate injection or early resorption of the injection material. This study aims to evaluate the efficacy of additional IL, distinguishing between “salvage” (within 4 months) and “repeated” injections (beyond 4 months), and to analyze prognostic factors for successful outcomes.

Methods

This retrospective study involved patients who received IL at Asan Medical Center from January 2014 to December 2020. Voice parameters were collected after each procedure, and those who conducted the statistical analysis were blinded to the study subjects. Among the 65 patients who underwent additional IL, 51 patients were enrolled in this study. Postinjection grade, roughness, breathiness, asthenia, strain (GRBAS) scales were used to determine satisfactory treatment outcomes. Success of the additional IL was defined as a postinjection grade of dysphonia score of 0 or 1, with a reduction in grade compared with the preinjection grade.

Results

The mean age of the patients was 61.6 years. Out of a total of 51 patients, 37 were men participating in the study. The odds ratio represents the likelihood of success in the second IL. Improved voice outcome after the additional IL was maintained in 23 (45%) patients. Compared with the failure group, the success group had a longer injection time interval between the initial and additional injection (9.1 vs. 7.4 months, respectively, p = 0.010). The success group had a higher proportion of patients with injection intervals >6 months (73.9% vs. 42.9%, p = 0.026). Logistic regression analysis revealed an injection interval >6 months had an odds ratio of 0.265 (confidence interval: 0.080–0.874, p = 0.029).

Conclusions

Additional injections would benefit the patients whose voice outcomes are maintained for a longer period (>6 months) after the first injection.
Freestyle SGAP flaps for sacral ulcers
Authors: Singh Kuldeep , Aggarwal Krittika
Published: September 2024

Study Design: Retrospective case study. Objective: To study the feasibility and ease of freestyle SGAP perforator flaps for sacral ulcers. Setting: This study was conducted in tertiary care hospital in India.

Sacral ulcers are commonly encountered in long-term bedridden patients. Various options to cover these ulcers include the gluteus muscle flaps (v-y, rotation and advancement), fascio-cutaneous flaps, superior and inferior gluteal artery perforator flaps. The superior gluteal artery perforator (SGAP) flap is a reliable option for sacral sore management. Using this flap, only one out of ten patients had partial flap necrosis. None had wound dehiscence nor seroma formation. No recurrence was seen at three months follow-up. This flap can safely be used as a ‘free style’ flap.
Study on shot peening strengthening 42CrMoA steel and its fretting wear properties
Authors: Wang Zhiyuan , Yang Xuefeng , Zhang Zhiqiang , Zhu Yeqi , Song Fei , Dong Wenlong , Wu Min
Published: September 2024

In order to improve the tribological properties of 42CrMoA steel, it was shot peened using different parameters. The surface morphology, residual stresses, hardness, and micromotor properties of the treated specimens were thoroughly evaluated. The results showed that it led to substantial plastic deformation, increased surface roughness, grain refinement, and introduction of residual compressive stresses. In addition, a significant increase in microhardness and depth of hardened layers on the specimen surfaces was observed. Furthermore, a positive correlation between the effect of the shot peening process and the peening duration was observed.

As revealed by the investigation, the shot peening process not only advances the wear resistance of the specimens but also leads to a reduced wear volume compared to untreated specimens. Furthermore, this treatment triggers a shift in the wear mechanism from the predominant occurrence of severe adhesive wear, fatigue wear, and abrasive wear in untreated specimens to a predominant mode of abrasive wear, accompanied by a minor occurrence of adhesive wear.
Hot-dip galvanizing process and coating corrosion behavior of fe-mn-al-c steel
Authors: Zhou Huasheng , Tang Lizhi , Zhang Xiaofeng , Yang Yong
Published: September 2024

The temperature of the zinc bath and the immersion duration are critical factors that significantly impact the surface quality and adhesion of batch hot-dip galvanizing coatings. This study focuses on the influence of different zinc bath temperatures (460, 490, and 520 °C) and immersion duration (1, 3, 5, and 10 min) on the hot-dip galvanized coatings of Fe-Mn-Al-C lightweight steel, which were characterized using scanning electron microscopy and energy dispersive X-ray analysis. The results demonstrate that with the increasing zinc bath temperature and immersion duration, the coating thickness and bond strength initially increase and then decrease. The inhibition layer in the coating gradually fractures and thickens with the rising temperature, leading to changes in the alloy phases within the coating. The optimal batch hot-dip galvanizing condition for the experimental steel is immersing at 490 °C for 3 min. Furthermore, we conducted a neutral salt spray corrosion test on the specimens under the optimal batch hot-dip galvanizing condition to study their corrosion behavior and mechanism and evaluate the impact of batch hot-dip galvanizing on the corrosion resistance of Fe-Mn-Al-C steel.
Paraganglioma-induced pheochromocytoma crisis successfully treated by veno-arterial extracorporeal membrane oxygenation: a case report
Authors: Tong Mengqi , Wang Shan , Bai Ying , Wang Hao
Published: September 2024

Pheochromocytoma crisis is rare but potentially fatal if not recognized early and properly managed. Here, a woman in her 20s with a paraganglioma-induced pheochromocytoma crisis, who was successfully treated by veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and interval tumor resection, is described. In July 2022, the patient was brought to hospital with a complaint of sudden-onset of palpitations with vomiting. The patient developed cardiorespiratory failure with hypoxia. Computed tomography scan showed pulmonary oedema and a mass anterior to the inferior vena cava. She was transferred to the intensive care unit and treated with VA-ECMO. The patient’s ECMO was withdrawn after 6 days without any complications. After hemodynamic stabilization, the patient underwent tumor resection 4 months later. The postoperative course was uneventful and she was discharged on postoperative day 7. Histopathological analysis confirmed a paraganglioma. VA-ECMO may play a significant role in saving lives and providing time for accurate diagnosis and specific treatment of a patient with pheochromocytoma crisis. Appropriate individual management can help avoid the occurrence of ECMO complications.
Causal associations between COVID-19 and erectile dysfunction: a Mendelian randomization study
Authors: Ma Chao , Ma Li , Wang Pu
Published: September 2024

Objective

In this study, we aimed to explore the potential association between COVID-19 infection, hospitalization, severe COVID-19, and erection dysfunction (ED) using the two-sample Mendelian randomization (MR) method.

Methods

Data pertaining to COVID-19 were extracted from the latest version of the COVID-19 Host Genetics Initiative genome-wide association study (GWAS) meta-analyses (Round 7, April 2022), and outcome data were obtained from the Open GWAS database. We applied various MR analysis methods, including the inverse variance weighted method, weighted median method, and MR-Egger regression.

Results

Our investigation revealed a negative causal association between COVID-19 hospitalization and ED (total testosterone levels: beta = −0.026; 95% confidence interval: −0.049 to −0.001). However, no evidence supported causal relationships between COVID-19 infection, hospitalization for COVID-19, or severe COVID-19 and other ED risk factors.

Conclusion

The results of this comprehensive MR analysis suggest a negative causal link between COVID-19 hospitalization and total testosterone levels. Nonetheless, COVID-19 (comprising infection, hospitalization, and severe illness) may not directly correlate with an increased risk of ED. These findings imply that COVID-19 may exert a distinct impact on ED through indirect pathways.
Thermodynamic modelling of liquid steel tapping process to predict carryover slag amount
Authors: Haidar Sk Wasim , Rozario Albin , Kumar Deepoo
Published: September 2024

Control of carryover slag is essential during transfer of liquid steel from basic oxygen furnace to ladle to maintain preferred steel cleanliness. Carryover slag is oxidising in nature and its higher amount will lead to higher refractory wear rate, low alloy recovery and increased secondary steelmaking treatment time. Measuring the amount of carryover slag is essential for evaluating current tapping practices and implementing necessary precautions when needed. In the present study, a kinetic process model has been developed using FactSage macro processing code. Steel lollipop and slag samples were collected between tapping start and onset of ladle refining process for a medium carbon aluminium killed grade. Liquid steel-slag interaction, flux addition to slag, various metallic additions to steel and refractory dissolution to slag were taken into account in the model. Multiple simulations were performed with varying amounts of carryover slag and composition of steel and slag of initial samples from the ladle furnace were equated with the predicted values from FactSage kinetic model to determine the carryover slag amount. Apart from predicting the carryover slag amount, this model can be useful to understand the effect of tapping parameters on variations in liquid steel and slag chemistry during tapping.
Triptan non-response in a London tertiary headache centre: What can we learn? A retrospective study
Authors: Wilcha Robyn-Jenia , Goadsby Peter J.
Published: September 2024

Background

Triptans revolutionized the acute treatment of migraine; however, varied responses to triptans, as a result of poor efficacy and tolerability, are reported. A standardized definition of triptan non-response was recently proposed by the European Headache Federation (EHF). There is currently limited data available on the prevalence of triptan non-response.

Methods

We used clinic letters over a two-year duration to evaluate the triptan response and triptan efficacy or tolerability failure, or both, in a London-based tertiary headache service.

Results

In total, 419 adult migraine patients (females: 83.8%, age: 46 ± 18 years, chronic migraine: 88.5%) were included in a service evaluation. In line with the EHF definitions, “triptan non-response” was seen in 63.8% of patients (264/414), whereas 37.7% of patients (156/414) had failed at least two triptans (EHF “triptan resistant”) and 4.6% of patients (19/414) had failed at least three triptans, including a subcutaneous formulation (EHF “triptan refractory”). Notably, 21.3% of patients (88/414) had failed at least three triptans inclusive and exclusive of subcutaneous triptan use. Advancing age ( p < 0.001) and the presence of medication overuse ( p = 0.006) increased the probability of triptan response, whereas an increased number of failed preventives ( p < 0.001) and the use of calcitonin gene-related peptide monoclonal antibodies ( p = 0.022) increased the probability of triptan non-response. The largest proportion of patients responded to eletriptan (49.5%), followed by nasal zolmitriptan (44.4%) and rizatriptan (35.7%).

Conclusions

Our findings highlight an alarming prevalence of triptan non-response among adult migraineurs receiving treatment in a London-based tertiary headache service. It is imperative for clinicians to explore methods to optimize acute medication efficacy, whether this comprises changing to a triptan with a superior response rate, advocating for early intervention or considering alternative acute medication classes, such as gepants or ditans.
Childhood in the Jewish History of Southern Ukraine in 1919–1920: Family Experience of Violence during the Pogroms
Authors: Kuzovova Natalia
Published: September 2024

The article focuses on how the anti-Jewish pogroms of 1919–1920 affected Jewish children through the lens of family history. It explores demographic data and factors that influenced children and families in Southern Ukraine during that period. The article attempts to reconstruct the children's experience through their parents’ testimonies and the memories of individuals who endured the anti-Jewish pogroms during childhood. It also analyzes how the experience of the anti-Jewish pogroms has transformed in historical memory and its current influence on public opinion.
Spinal Cord Infarction During Extracorporeal Membrane Oxygenation：A Case Series and Review of the Literature
Authors: Meng Hui , He Fang , Yan Xianrang , Chen Lanchun , lin Xiaohong , She Xiaolong , Yu Xuetao
Published: September 2024

Background: Little is known about extracorporeal membrane oxygenation (ECMO)-related spinal cord infarction (SCI), and reports regarding this rare and catastrophic complication are rare. Here, we report two cases of ECMO-related SCI that occurred between April and December 2023. Data were collected from patients’ medical records, with SCI as the endpoint. We reviewed previously published reports by searching PubMed and summarizing the findings. Case summary: One female patient presenting with multiple traumas required oxygenation support through veno-venous ECMO (VV ECMO) due to pulmonary hemorrhage, while one male patient required circulatory support via veno-arterial ECMO (VA ECMO) concurrently with an intra-aortic balloon pump due to cardiac arrest. Neither patient had preexisting neurological deficits; however, upon weaning from ECMO, they presented with severe neurological deficits of uncertain etiology, subsequently confirmed as SCI using magnetic resonance imaging. Conclusion: ECMO-related SCI remains elusive and intricate, and this is the first report of adult VV ECMO-related SCI.
The Alienation–Insulation Dynamic and the Low-Wage Migrant Work Ethic
Authors: Scott Sam , Rye Johan Fredrik
Published: September 2024

Low-wage labour migrants moving from lower- to higher-income countries have been celebrated for their strong work ethic over recent decades. The paper draws on qualitative insights from European horticulture to explore why low-wage migrants work as hard as they do. We centre our analysis on an ‘alienation–insulation’ dynamic. Specifically, we show how migrants are particularly alienated in ways that are different to that of the immobile working class. However, we also argue that migrants’ spatial (their dual frame of reference) and temporal (their liminal) agency insulates them from this alienation to some degree. It is important, in this respect, to differentiate between alienation as ostensibly encountered (an objective phenomenon) and the actual felt experiences of alienation (as a subjective phenomenon). We conclude that the alienation–insulation dynamic is a key, but underexplored, element in understanding the complex relationship between labour mobility and labour power.
Laser heat conduction joining of polycarbonate and aluminum alloy
Authors: Goyal Dhruva Kumar , Kant Ravi
Published: September 2024

The present work demonstrates the laser heat conduction joining (LHCJ) of polycarbonate and aluminum alloy. The experiments are performed to examine the impact of scan speed and laser power on the joint’s strength and quality. The bonding between the substrates was assessed by examining the cross-section using a scanning electron microscope and conducting energy-dispersive X-ray spectroscopy. The fractured surfaces are inspected by an optical microscope to explore the bond morphology. A finite-element-based numerical model is developed for the estimation of interface temperature and validated with the experimental results. Results of lap shear tests show that the weld strength is significantly affected by the laser power, scan speed, interface temperature, and bubble area. Microscopic observations of the joint interface disclose bubble area and mechanical interlocking between polycarbonate and aluminum. Through X-ray photoelectron spectroscopy (XPS) analysis, it was discovered that the interface experiences chemical bonding facilitated by the formation of Al-O-C bonds, which effectively enhances the strength of the joint.
A forgotten pioneer in Australian psychiatry: Dr Edward Waldegrave Wardley (1813–1872)
Authors: Luke Sarah
Published: September 2024

British-born Dr Edward Waldegrave Wardley (MRCSL, 1842) is an unacknowledged pioneer in the history of mental health care in Australia. Between 1857 and 1872, he assisted in the development of a policy of non-restraint across lunatic asylums in New South Wales (NSW). He then went on to extend this approach to the treatment of NSW's criminally insane patients. In addition, he trialled experiments to intellectually engage educated psychiatric patients across the colony. A prolific writer, and sufferer of chronic depression, Dr Wardley serves as a unique example of a nineteenth-century alienist with lived experience of mental illness.
The Correlation Between Quality of Care and Mental Health and Behavioral Problems Among Vietnamese Adolescents in Social Support Facilities
Authors: Pham Sy Tien , Duong Thanh Thanh Thi , Nguyen Hoai Phuong Thi , Truong Xuan Nhi Thi
Published: September 2024

Background:

Previous studies have shown the negative impact of institutional care on children’s physical and mental health. However, in addition to the form of care, the quality of care is an important factor in children’s mental health. This study explored the quality of care and the association between the quality of care and mental health issues among adolescents in Vietnam social support facilities (SSFs).

Methods:

A cross-sectional study was conducted with 273 institutionalized adolescents who lived in SSFs and 273 adolescents cared for by family. Depressive symptoms, anxiety symptoms, sleep problems, behavioral problems, and quality of care were measured. Descriptive statistics were calculated, and multiple linear regression analysis was performed.

Results:

The quality of care was rated as quite high by institutionalized adolescents. However, the mean score for quality of care was significantly lower for institutionalized adolescents than for the comparison group. The quality of physical care did not show a significant relationship with mental health risk, except for anxiety. In contrast, emotional care was negatively associated with all common mental health problems including anxiety (beta = –0.40, P < .001), depression (beta = –0.31, P < .01), conduct behavior (beta = –0.30, P < .01) and sleep problems (beta = –0.30, P < .01). An increase in emotional care was therefore associated with a decrease in mental health problems.

Conclusions:

Emotional care is more important than physical care for adolescents in SSFs. It is necessary to improve the quality of care, particularly emotional care, for adolescents to reduce the risk of mental health problems.
Study of Correlation of Apgar Score and Thompson Score with Hepatic Function in Perinatal Asphyxia Affected Neonates—A Prospective Observational Study
Authors: Siddhanta Meghna , Ghoshal Bhaswati , Basu Kaushambi
Published: September 2024

Background

Perinatal asphyxia is one of the leading causes of neonatal morbidity and mortality in the country. It leads to multi-organ failure with brain involvement as the major organ of concern (hypoxic-ischemic encephalopathy). Hepatic dysfunction is also a feature of perinatal asphyxia.

Objectives

To detect hepatic dysfunction in birth asphyxia. To correlate the liver damage with increasing severity of birth asphyxia and hypoxic-ischemic encephalopathy through Apgar score and Thompson score.

Methods

In this prospective observational study, after ethical clearance and informed consent from the parents, babies of gestational age >35 weeks weighing >1.8 kg, Apgar score <7 at 1 minute received in the newborn unit of a tertiary care hospital in West Bengal, India were enrolled. Thompson’s score was assessed every day. The liver function test of these patients was assessed on days 1, 3, 10, and 15. Ultrasonography of the whole abdomen was performed on days 1 and 14 of life to rule out other probable causes of hepatic injury.

Results

A total of 308 neonates were studied, of which Apgar score at 1 minute indicates that 99 (32.14%) of the newborns had severe birth asphyxia and the rest had moderate birth asphyxia. All the liver enzymes except total protein and albumin showed a significant rise on days 1 and 3 with increasing severity of asphyxia. This correlation was seen with Apgar score at 1 minute on day 1 with TSB (r = -0.256, P < .001), AST (r = -0.209, P < .01), ALT (r = -0.178, P < .002), ALP (r = -0.174, P < .002). As per Thompson score, total serum bilirubin, aspartate aminotransferase and alkaline phosphatase showed maximum correlation on days 1 (r = 0.253, P < .001, r = 0.187, P < .001 and r = 0.268, P < .001, respectively) and on day 3 (r = 0.159, P < .005, r = 0.231, P < .001, and r = 0.190, P < .002, respectively).

Conclusion

Thompson score and Apgar score can be correlated to perinatal asphyxia-related hepatic injury.
Efficacy and Safety of Testosterone Replacement in Testicular Cancer Survivors With Treatment-Influenced Hypogonadism: A Systematic Review
Authors: Fritz Andrew A. , Reinert Justin P.
Published: September 2024

Objective:

The objective is to evaluate the efficacy and safety of testosterone supplementation in testicular cancer survivors with treatment-related hypogonadism.

Data Sources:

This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards and used Embase, PubMed/MEDLINE, Cochrane Central, Web of Science Core Collection, Korean Journal Index, SciELO, and Global Index Medicus to obtain data in June of 2024.

Study Selection and Data Extraction:

Analyses evaluating testosterone supplementation in testicular cancer survivors with treatment-induced hypogonadism were included. Any analyses not assessing supplementation in this population or deemed unretrievable were excluded.

Data Synthesis:

Ten analyses were included for analysis. A total of 332 bilateral or unilateral testicular cancer survivors with treatment-influenced hypogonadism were reviewed, with 238 patients receiving testosterone replacement. Eight of the 10 analyses assessed participants without poor quality-of-life (QOL) metrics, metabolic factors, and bone mineral density (BMD) at baseline and only found a significant benefit in fat distribution metrics with testosterone supplementation. Two analyses evaluated participants with poor QOL metrics or BMD at baseline and showed improvements in QOL or BMD with testosterone supplementation.

Relevance to Patient Care and Clinical Practice:

There is robust evidence regarding the efficacy and safety of testosterone replacement in hypogonadal individuals but limited evidence specifically evaluating supplementation in testicular cancer survivors with treatment-influenced hypogonadism.

Conclusions:

The results suggest testosterone replacement may be beneficial in patients with impaired QOL metrics, metabolic factors, and BMD at baseline; the results also suggest that routine supplementation for all individuals in this patient population lacks efficacy.
The Expression and Clinicopathological Significance of BRAF V600E and Mucin 6 in Intrahepatic Cholangiocarcinoma: A Retrospective Study
Authors: Wu Shurui , Wang Meihong , Zhou Qinghai , Tang Haowen , Wang Zhanbo
Published: September 2024

Aim. The study aims to explore the expression levels and clinicopathological significance of BRAF V600E and mucin 6 in intrahepatic cholangiocarcinoma. Method. Immunohistochemistry for BRAF V600E and mucin 6 was performed in 110 patients with intrahepatic cholangiocarcinoma. Subsequently, a comprehensive review of medical records and clinicopathological analysis was undertaken. Results. BRAF V600E expression was detected in 11 patients (10%); mucin 6 expression was observed in 19 intrahepatic cholangiocarcinoma specimens (17%). Thereafter, Cox regression models indicated that positive expression of either MUC6 positive (hazard ratio = 0.091, 95% confidence interval = 0.034-0.247, P < .001) and BRAF V600E positive (hazard ratio =0.150, 95% confidence interval = 0.058-0.388, P < .001) was significantly linked with longer overall survival for intrahepatic cholangiocarcinoma patients. Conclusion. The study concludes that positive expression of BRAF V600E and mucin 6 could potentially implied significant survival benefits for patients diagnosed with intrahepatic cholangiocarcinoma.