bluuebunny/crossref_metadata_2025 huggingface dataset:
Repertoire Communities in American Popular Music, 1900–1949
Authors: Roy William G.
Published: April 2022

What are the social factors shaping musical repertoires? This paper analyzes repertoires as social relations among performers, refracted through factors such as the organization of industry, genres, race, and gender. Using data from American popular music recordings, performers and songs are treated as a two-mode network and repertoire communities are operationalized as bicliques. The production of culture perspective, the sociology of genres, and theories of race and gender imply hypotheses that are tested diachronically. Analysis finds support for the first two, with genres becoming the strongest basis of repertoire community membership while race and gender are surprisingly weak. Importantly, these factors worked in tandem as reflexive mechanisms for each other. The repertoire community system documents the rise of genre as the primary means of categorizing American popular music in the early twentieth century and mediated the effect of other factors.
Use of Ceftriaxone as a Predictor of Good Outcome in Stroke Patients: A Retrospective Chart Review
Authors: Dev Priya , Singh Varun Kumar , Kumar Anand , Chaurasia Rameshwar Nath , Singh Neelima Alka , Gautam Priyanka , Dhimani Neetu Rani , Mishra Vijaya Nath , Joshi Deepika , Pathak Abhishek
Published: April 2022

Background:

Whether ceftriaxone (CEFT) has any added advantage other than its antibiotics effect in stroke as a neuroprotective agent is not known, and this forms the base of this study.

Purpose:

We tried to assess the predictive role of the use of CEFT with respect to outcome in stroke patients.

Methods:

A retrospective chart review was conducted from a stroke registry over consecutive stroke patients admitted at a tertiary teaching institute from January 2017 to December 2018. Patients were categorized into three groups on the basis of antibiotics they received; patients without antibiotic treatment (NAB), piperacillin plus tazobactam treatment, and the CEFT treatment group. The outcome was assessed by the modified Rankin Scale at three months in good (0–3) and poor outcomes (4–6).

Results:

A total of 390 stroke patients were analyzed with ages ranging between 20 and 95 years and 151 of them were females. It was found that the severity at three months was significantly lower in those patients who were given CEFT antibiotic ( P = 0.04; OR = 0.626; 95% CI [0.396, 0.990]).

Conclusion:

Stroke patients in CEFT-treated group have a better outcome compared to piperacillin–tazobactam therapy or without antibiotics use at three months. This study indicates the possibility of an additional neuroprotective effect of CEFT apart from its antibacterial property.
Darwinian Dentistry? Social Media, Smartphones and Selfie Sticks
Authors: Ruparelia Roshni , Kelleher Martin G.D. , Dhanda Lakhandeep S.
Published: April 2022

The COVID-19 pandemic produced numerous challenges for clinical dentistry which necessitated adaptation and innovation. This article will illustrate the use of selfie stick devices and ring lights for dental care practitioners to create customised ‘selfie’ videos of them using very effective cleaning devices on the patient’s own smartphone. Because these short, engaging videos are now readily available to the patient at their home it reminds them which brushes to use, where and how. Patients are empowered by these videos which put them at the centre, reinforcing the key preventive message that they can improve and maintain their oral health by introducing effective oral hygiene behaviours. The many advantages, both for patients and for their practice teams, will be discussed in detail.
Techniques for Retrieval of Lacerated Flexor Tendons: A Scoping Review
Authors: Kadar Assaf , Gur Shanny , Schermann Haggai , Iordache Sorin D.
Published: April 2022

Introduction: Flexor tendon laceration is often followed by retraction of the proximal stump. The goals of this review were to describe the myriad of proximal stump retrieval surgical techniques and where available to provide the clinical evidence associated with each. Methods: A Medline and Web of Science search was performed to identify any publication whose primary purpose was to describe a tendon retrieval technique. The techniques were assigned to 8 groups. Clinical outcomes, where reported, and advantages and disadvantages of the technique as reported by the authors of the articles were analyzed. Results: Eight-hundred and forty-one publications complied with the search terms, and 33 articles were included in the current analysis. Only 2 of these articles were randomized controlled trials, and they were of low quality. Conclusion: There is no high-quality evidence to allow quantitative comparison of tendon retrieval techniques. An incremental approach can be recommended based on the qualitative review. After failed atraumatic attempts to retrieve the tendon by milking, retrieval should be done through proximal incision at the A1 pulley level, preferably without pulling the tendon out of the wound. When available, using an endoscope to retrieve the tendon appears to be a promising alternative.
Easier said than done? Involving citizens in the smart city
Authors: Sweeting David , de Alba-Ulloa Jessica , Pansera Mario , Marsh Alex
Published: April 2022

Much of the smart cities literature urges greater citizen participation in smart city innovation. However, there is often little consideration given to how citizens might be more meaningfully involved in the processes of governance around smart cities, what enables their involvement, or what might need to change in order to facilitate their participation. Taking an institutional perspective, this paper seeks to move this aspect of the smart city debate forward. Using Mexico City as an exemplar, it examines the broader institutions of urban governance within which citizen-oriented smart city activities operate, identifying those which help and hinder citizen participation. It then considers the extent to which unhelpful institutions are embedded, and to what extent they are amenable to change to allow successful smart city participation initiatives to flourish. Our argument is that when considering citizen participation in smart city activities we need to attend more closely to the institutions which represent their context and the extent to which those institutions can be changed, where necessary, to create a more conducive environment. Many institutions will be beyond the reach of local actors to change or to deinstitutionalise; thus involving citizens in the smart city is ‘easier said than done’.
Adopting an Organismic Perspective on Adolescent Academic Motivation for Instrumental Ensemble Participation
Authors: Holster Jacob D.
Published: April 2022

Students’ motivation to engage in elective music courses can be complicated or nuanced and is often informed by myriad personal and environmental factors. In this review of literature, I examine general education and music education research related to organismic perspectives on the development and maintenance of academic motivation among middle school students. The motivational constructs considered were Eccles’ task values (i.e., interest, attainment, utility, and cost) and Deci and Ryan’s psychological needs (i.e., autonomy, competence, and relatedness). When adolescents evaluate the importance, usefulness, enjoyment, and cost of the electives in which they take part, they are formulating task value beliefs. The more that students value a task, the greater the likelihood they will continue to engage in the task despite the costs. Continued task engagement, however, may require that students’ psychological needs for autonomy, competence, and relatedness be met. Implications and suggestions for music teachers are also presented.
Evolving Trends in Scholarly Publishing and Impact on the Monotony of Predators
Authors: Kalra Neetu , Seetharaman A. , Maddulety K. , Bakhshi Priti
Published: April 2022

Open access (OA) journals have emerged in the past two decades and have influenced scholarly publications to a great extent, contributing to the benefits of OA publishing. The research focuses on the evolving trends of OA and the measures required to address the issue of exponentially growing predatory publishing. The study concludes the research by proposing measures for the scholarly world to address predatory publishing globally. The scope of the research is qualitative, discussing the fair publishing practices and implications of Plan S and open peer review. In the methodology, the study reviews the wealth of published literature in the discipline to decide the variables and impact on the dependent variable.
Investigating treatment-effect modification by a continuous covariate in IPD meta-analysis: an approach using fractional polynomials
Authors: Sauerbrei Willi , Royston Patrick
Published: April 2022

Background

In clinical trials, there is considerable interest in investigating whether a treatment effect is similar in all patients, or that one or more prognostic variables indicate a differential response to treatment. To examine this, a continuous predictor is usually categorised into groups according to one or more cutpoints. Several weaknesses of categorization are well known. To avoid the disadvantages of cutpoints and to retain full information, it is preferable to keep continuous variables continuous in the analysis. To handle this issue, the Subpopulation Treatment Effect Pattern Plot (STEPP) was proposed about two decades ago, followed by the multivariable fractional polynomial interaction (MFPI) approach. Provided individual patient data (IPD) from several studies are available, it is possible to investigate for treatment heterogeneity with meta-analysis techniques. Meta-STEPP was recently proposed and in patients with primary breast cancer an interaction of estrogen receptors with chemotherapy was investigated in eight randomized controlled trials (RCTs).

Methods

We use data from eight randomized controlled trials in breast cancer to illustrate issues from two main tasks. The first task is to derive a treatment effect function (TEF), that is, a measure of the treatment effect on the continuous scale of the covariate in the individual studies. The second is to conduct a meta-analysis of the continuous TEFs from the eight studies by applying pointwise averaging to obtain a mean function. We denote the method metaTEF. To improve reporting of available data and all steps of the analysis we introduce a three-part profile called MethProf-MA.

Results

Although there are considerable differences between the studies (populations with large differences in prognosis, sample size, effective sample size, length of follow up, proportion of patients with very low estrogen receptor values) our results provide clear evidence of an interaction, irrespective of the choice of the FP function and random or fixed effect models.

Conclusions

In contrast to cutpoint-based analyses, metaTEF retains the full information from continuous covariates and avoids several critical issues when performing IPD meta-analyses of continuous effect modifiers in randomised trials. Early experience suggests it is a promising approach.

Trial registration

Not applicable.
Balance recovery stepping responses during walking were not affected by a concurrent cognitive task among older adults
Authors: Paran Inbal , Nachmani Hadas , Salti Moti , Shelef Ilan , Melzer Itshak
Published: April 2022

Background

Most of older adults’ falls are related to inefficient balance recovery after an unexpected loss of balance, i.e., postural perturbation. Effective balance recovery responses are crucial to prevent falls. Due to the considerable consequences of lateral falls and the high incidence of falls when walking, this study aimed to examine the effect of a concurrent cognitive task on older adults’ balance recovery stepping abilities from unannounced lateral perturbations while walking. We also aimed to explore whether cognitive performance accuracy is affected by perturbed walking and between task trade-offs.

Methods

In a laboratory-based study, 20 older adults (> 70 years old) performed the following test conditions: (1) cognitive task while sitting; (2) perturbed walking; and (3) perturbed walking with a concurrent cognitive task. The cognitive task was serial numbers subtraction by seven. Single-step and multiple-step thresholds, highest perturbation achieved, 3D kinematic analysis of the first recovery step, and cognitive task performance accuracy were compared between single-task and dual-task conditions. Between task trade-offs were examined using dual-task cost (DTC).

Results

Single-step and multiple-step thresholds, number of recovery step trials, number of foot collision, multiple-step events and kinematic recovery step parameters were all similar in single-task and dual-task conditions. Cognitive performance was not significantly affected by dual-task conditions, however, different possible trade-offs between cognitive and postural performances were identified using DTC.

Conclusions

In situations where postural threat is substantial, such as unexpected balance loss during walking, balance recovery reactions were unaffected by concurrent cognitive load in older adults (i.e., posture first strategy).

The study was approved by the Helsinki Ethics Committee of Soroka University Medical Center in Beer-Sheva, Israel (ClinicalTrials.gov Registration number NCT04455607, ID Numbers: Sor 396–16 CTIL; 02/07/2020).
Perceptions of and hesitancy toward COVID-19 vaccination in older Chinese adults in Hong Kong: a qualitative study
Authors: Siu Judy Yuen-man , Cao Yuan , Shum David H.K.
Published: April 2022

Background

COVID-19 vaccination is recommended for older adults by the World Health Organization. However, by July 15, 2021, only 26% of individuals over 60 years old in Hong Kong had received a first dose of the vaccine. The health belief model and the theory of planned behavior have been used to understand the determinants for COVID-19 vaccination in past literature. However, vaccination determinants can be complex and involve social and cultural factors that cannot be explained by micro-individual factors alone; hence, the health belief model and the theory of planned behavior cannot provide a complete understanding of vaccine hesitancy. Few studies on the barriers to, hesitancy toward, and motivations for COVID-19 vaccination among older Chinese adults have been performed. The aim of this study is to fill this gap by conducting a comprehensive analysis of this subject using the critical medical anthropology framework, extending the health belief model and the theory of planned behavior in understanding vaccination determinants among the older adult population.

Methods

Between November 2020 and February 2021, 31 adults (24 women and 7 men) over the age of 65 took part in semi-structured, one-on-one interviews. The data we gathered were then analyzed through a phenomenological approach.

Results

Two major themes in the data were examined: barriers to vaccination and motivations for vaccination. The participants’ perceptions of and hesitancy toward vaccination demonstrated a confluence of factors at the individual (trust, confidence, and social support networks), microsocial (stigma toward health care workers), intermediate-social (government), and macrosocial (cultural stereotypes, civic and collective responsibility, and economic considerations) levels according to the critical medical anthropology framework.

Conclusions

The decision to receive a COVID-19 vaccination is a complex consideration for older adults of low socioeconomic status in Hong Kong. Using the critical medical anthropology framework, the decision-making experience is a reflection of the interaction of factors at different layers of social levels. The findings of this study extend the health belief model and the theory of planned behavior regarding the understanding of vaccination perceptions and relevant behaviors in an older adult population.
High hemoglobin level is a risk factor for maternal and fetal outcomes of pregnancy in Chinese women: A retrospective cohort study
Authors: Wu Lanlan , Sun Ruifang , Liu Yao , Liu Zengyou , Chen Hengying , Shen Siwen , Wei Yuanhuan , Deng Guifang
Published: April 2022

Background

To examine the association of hemoglobin (Hb) levels during gestation with the risk of selected adverse pregnancy outcomes such as preterm birth (PTB), low-birth-weight infants (LBW) and small-for-gestational-age infants (SGA) in Chinese women.

Methods

This retrospective cohort study was conducted in the Department of Gynecology and Obstetrics at the Union Shenzhen Hospital of the Huazhong University of Science and Technology, using routinely collected maternity and hospital data on pregnancies (2015–2018). Hb levels were measured during the second (16–18th weeks) and third (28–30th weeks) trimesters of pregnancy, and pregnancy outcomes were recorded in the hospital information system. Hb levels were categorized into four groups as follows: < 110 g/L, 110–119 g/L, 120–130 g/L, and > 130 g/L. The second group (Hb 110–119 g/L) was defined as the reference group. Statistical analysis was performed using multivariate logistic regression.

Results

A total of 1911 singleton mothers were included. After multivariable adjustment, Hb levels > 130 g/L in the second trimester increased the risk of LBW (odds ratio [OR], 2.54; 95% confidence interval [CI], 1.12–5.76). In the third trimester of gestation, compared with women whose Hb levels between 110 and 119 g/L, women with Hb levels > 130 g/L had an increased risk of LBW (OR, 2.20; 95% CI, 1.07–4.51) and SGA (OR, 2.00; 95% CI, 1.05–3.80). When we compared the highest and lowest quartiles of changes in the Hb across the second and third trimesters, the adjusted ORs were 0.35 (95% CI: 0.18–0.68) for PTB and 0.47 (95% CI: 0.23–0.98) for LBW.

Conclusion

Maternal Hb > 130 g/L was associated with increased risk of adverse pregnancy outcomes. Reduction of the risks of PTB and SGA were observed with the appropriate increase of Hb level during the third trimester.
Association between cannabis use and physical health problems in Norwegian adolescents: a cross-sectional study from the youth survey Ungdata
Authors: Mæland Ragnhild , Lien Lars , Leonhardt Marja
Published: April 2022

Background

Cannabis use is increasing among young Norwegians and several studies show a high incidence of common physical health problems. An association has previously been found between cannabis use and mental health problems. Since physical and mental health problems often co-occur, the aim of this study is to explore the relationship between cannabis use and physical health problems.

Methods

In 2017–2019, the Norwegian youth survey Ungdata collected data from 249,100 Norwegian adolescents, which equalled around 80% of all lower secondary school pupils (13–15 years) and about 50% of upper secondary pupils (16–19 years) in Norway. Descriptive analysis was used to calculate the prevalence of cannabis use and bi- and multivariate logistic regression analysis to examine the association between cannabis use and physical health problems, controlled for sociodemographics and mental health problems.

Results

Almost 10% of Norwegian adolescents had used cannabis once or more in the previous 12 months. The use of cannabis increased with age and it was more prevalent among boys. There is a clear connection between physical health problems and cannabis use (OR = 1.582 (CI: 1.527–1.638)) even after adjusting for sociodemographic variables and mental health problems (OR = 1.366 (CI: 1.312–1.423)).

Conclusion

More studies are needed to explore if there might a bidirectional relationship between cannabis use and physical health problems where physical problems increase cannabis use and cannabis use increases the risk of physical health problems. More knowledge on the effect of and motivation for cannabis use are important for policy makers and health care professionals involved in young people.
How do medical students learn conceptual knowledge? High-, moderate- and low-utility learning techniques and perceived learning difficulties
Authors: Franz Anne , Oberst Sebastian , Peters Harm , Berger Ralph , Behrend Ronja
Published: April 2022

Background

Acquiring medical knowledge is a key competency for medical students and a lifelong requirement for physicians. Learning techniques can improve academic success and help students cope with stressors. To support students’ learning process medical faculties should know about learning techniques. The purpose of this study is to analyse the preferred learning techniques of female and male as well as junior and senior medical students and how these learning techniques are related to perceived learning difficulties.

Methods

In 2019, we conducted an online survey with students of the undergraduate, competency-based curriculum of medicine at Charité – Universitätsmedizin Berlin. We chose ten learning techniques of high, moderate and low utility according to Dunlosky et al. (2013) and we asked medical students to rate their preferred usage of those techniques using a 5-point Likert scale. We applied t-tests to show differences in usage between female and male as well as junior and senior learners. Additionally, we conducted a multiple regression analysis to explore the predictive power of learning techniques regarding perceived difficulties.

Results

A total of 730 medical students (488 women, 242 men, Mage = 24.85, SD = 4.49) use three techniques the most: ‘highlighting’ (low utility), ‘self-explanation’ (moderate utility) and ‘practice testing’ (high utility). Female students showed a significantly higher usage of low-utility learning techniques (t(404.24) = -7.13, p < .001) and a higher usage of high-utility learning techniques (t(728) = -2.50, p < .05) than male students (M = 3.55, SD = .95). Compared to junior students (second to sixth semester; M = 3.65, SD = .71), senior students (seventh semester to final clerkship year; M = 3.52, SD = .73) showed a lower use of low-utility learning techniques (t(603) = 2.15, p < .05). Usage of low-utility techniques is related to more difficulties (β = .08, t(724) = 2.13, p < .05). Usage of moderate-utility techniques is related to less learning difficulties (β = -.13, t(599) = -3.21, p < .01).

Conclusions

Students use a wide range of low-, moderate- and high-utility learning techniques. The use of learning techniques has an influence on the difficulties perceived by students. Therefore, they could benefit from knowing about and using high-utility learning techniques to facilitate their learning. Faculties should inform their students about effective learning and introduce them to useful learning techniques.
Identifying primary care datasets and perspectives on their secondary use: a survey of Australian data users and custodians
Authors: Canaway Rachel , Boyle Douglas , Manski-Nankervis Jo-Anne , Gray Kathleen
Published: April 2022

Background

Most people receive most of their health care in in Australia in primary care, yet researchers and policymakers have limited access to resulting clinical data. Widening access to primary care data and linking it with hospital or other data can contribute to research informing policy and provision of services and care; however, limitations of primary care data and barriers to access curtail its use. The Australian Health Research Alliance (AHRA) is seeking to build capacity in data-driven healthcare improvement; this study formed part of its workplan.

Methods

The study aimed to build capacity for data driven healthcare improvement through identifying primary care datasets in Australia available for secondary use and understand data quality frameworks being applied to them, and factors affecting national capacity for secondary use of primary care data from the perspectives of data custodians and users. Purposive and snowball sampling were used to disseminate a questionnaire and respondents were invited to contribute additional information via semi-structured interviews.

Results

Sixty-two respondents collectively named 106 datasets from eclectic sources, indicating a broad conceptualisation of what a primary care dataset available for secondary use is. The datasets were generated from multiple clinical software systems, using different data extraction tools, resulting in non-standardised data structures. Use of non-standard data quality frameworks were described by two-thirds of data custodians. Building trust between citizens, clinicians, third party data custodians and data end-users was considered by many to be a key enabler to improve primary care data quality and efficiencies related to secondary use. Trust building qualities included meaningful stakeholder engagement, transparency, strong leadership, shared vision, robust data security and data privacy protection. Resources to improve capacity for primary care data access and use were sought for data collection tool improvements, workforce upskilling and education, incentivising data collection and making data access more affordable.

Conclusions

The large number of identified Australian primary care related datasets suggests duplication of labour related to data collection, preparation and utilisation. Benefits of secondary use of primary care data were many, and strong national leadership is required to reach consensus on how to address limitations and barriers, for example accreditation of EMR clinical software systems and the adoption of agreed data and quality standards at all stages of the clinical and research data-use lifecycle. The study informed the workplan of AHRA’s Transformational Data Collaboration to improve partner engagement and use of clinical data for research.
Improving safety and efficacy with pharmacist medication reconciliation in orthopedic joint surgery within an enhanced recovery after surgery program
Authors: Zheng Xiaoying , Xiao Lei , Li Ying , Qiu Feng , Huang Wei , Li Xinyu
Published: April 2022

Purpose

To investigate the impact of medication reconciliation (MR), through avoidance of unintentional medication discrepancies, on enhanced recovery after surgery programs designed for older patients undergoing orthopedic joint surgery. 

Method

Our study was divided into two phases. In the first phase, MR was performed for elderly patients undergoing orthopedic joint surgery. Types of medication discrepancies and their potential risks were analyzed. In the second phase, a controlled study was conducted in a subgroup of patients diagnosed with periprosthetic joint infection (PJI) and who were scheduled for two-stage revision. The primary goal was to investigate the impact of MR on length of stay for the first stage. The secondary goal was to investigate the time between the first admission and the reimplantation of a new prosthesis, the number of readmissions within 30 days, hospitalization cost.

Results

A total of 506 medication discrepancies were identified in the included 260 patients. Intolerance had the highest incidence (n = 131, 25.7%). The Bayliff tool showed that 71.9% were assessed as level 2 risk, and 10.3% had a life-threatening risk. For patients with PJI, MR reduced the average length of stay in the first stage (16.3 days vs. 20.7 days, P = 0.03) and shortened the time (57.3 days vs. 70.5 days, P = 0.002) between the first admission and the reimplantation of a new prosthesis. The average cost of hospital stay ($8589.6 vs. $10,422.6, P = 0.021), antibiotics ($1052.2 vs. $1484.7, P = 0.032) and other medications ($691.5 vs. $1237.6, P = 0.014) per patient at our hospital were significantly decreased. Notably, significant improvements in patient satisfaction were seen in participants in the MR group.

Conclusion

Through MR by clinical pharmacists, medication discrepancies within the orthopedic ERAS program could be identified. For patients with periprosthetic joint infection, better patient satisfaction and clinical and economical outcomes can be achieved with this method.
“A place to be safe, feel at home and get better”: including the experiential knowledge of potential users in the design of the first wet service in Montreal, Canada
Authors: Motta-Ochoa Rossio , Incio-Serra Natalia , Poliquin Hélène , MacDonald Sue-Ann , Huỳnh Christophe , Côté Philippe-Benoit , Fallu Jean-Sébastien , Flores-Aranda Jorge
Published: April 2022

Background

The harmful use of alcohol is one of the leading health risk factors for people’s health worldwide, but some populations, like people who experience homelessness, are more vulnerable to its detrimental effects. In the past decades, harm reduction interventions that target these complex issues has been developed. For example, wet services include a wide range of arrangements (wet shelters, drop-in centers, transitory housing, etc.) that allow indoor alcohol use and Managed Alcohol Programs provide regulated doses of alcohol in addition to accommodation and services. Although the positive impacts of these interventions have been reported, little is known about how to integrate the knowledge of people experiencing homelessness and alcohol dependence into the design of such programs. The aim of this study is to present the findings of such an attempt in a first wet service in Montreal, Canada.

Methods

Community based participatory research approach and qualitative methods—including semi-structured interviews and focus groups—were used to collect the knowledge of potential users (n = 34) of the wet service. The data collected was thematically analyzed.

Results

Participants reported experiencing harsh living conditions, poverty, stigmatization and police harassment, which increased their alcohol use. The intersection between participants’ alcohol dependence and homelessness with the high barriers to access public services translated into their exclusion from several of such services. Participants envisioned Montreal’s wet service as a safe space to drink, a place that would provide multiple services, a home, and a site of recovery.

Conclusions

Integrating the knowledge of potential users into the design of harm reduction interventions is essential to develop better and more adapted services to meet complex needs. We propose that it could fosters users’ engagement and contribute to their sense of empower, which is crucial for a group that is typically discriminated against and suffers from marginalization.
Effect of dexmedetomidine supplementation for thoracoscopic surgery: a meta-analysis of randomized controlled trials
Authors: Song Chengjun , Lu Quan
Published: April 2022

Introduction

The efficacy of dexmedetomidine supplementation for thoracoscopic surgery remains controversial. We conduct a systematic review and meta-analysis to explore the impact of dexmedetomidine for thoracoscopic surgery.

Methods

We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through September 2020 for randomized controlled trials (RCTs) assessing the effect of dexmedetomidine supplementation on thoracoscopic surgery. This meta-analysis is performed using the random-effect model.

Results

Six RCTs involving 510 patients are included in the meta-analysis. Overall, compared with control group for thoracoscopic surgery, dexmedetomidine supplementation results in significantly reduced pain scores (SMD = − 1.50; 95% CI = − 2.63–− 0.37; P = 0.009), anesthetic consumption (SMD = − 3.91; 95% CI = − 6.76–− 1.05; P = 0.007), mean heart rate (SMD = − 0.41; 95% CI = − 0.65–− 0.18; P = 0.0007), and the risk ratio (RR) of ICU stay (RR = 0.39; 95% CI = 0.19–0.80; P = 0.01), but showed no obvious effect on mean blood pressure (SMD = − 0.07; 95% CI = − 0.45–0.31; P = 0.72) or hospital stay (SMD = − 0.61; 95% CI = − 1.30–0.08; P = 0.08).

Conclusions

Dexmedetomidine supplementation can substantially improve the analgesic efficacy for thoracoscopic surgery.
Assessments of prolonged effects of desflurane and sevoflurane on motor learning deficits in aged AppNL-G-F/NL-G-F mice
Authors: Niikura Ryo , Miyazaki Tomoyuki , Takase Kenkichi , Sasaguri Hiroki , Saito Takashi , Saido Takaomi C. , Goto Takahisa
Published: April 2022

As the proportion of elderly in society increases, so do the number of older patients undergoing surgical procedures. This is concerning as exposure to anesthesia has been identified as a risk factor for Alzheimer’s disease (AD). However, the causal relationship between clinical AD development and anesthesia remains conjectural. Preclinical studies have demonstrated that anesthesia, such as halothane, isoflurane, and sevoflurane, induces AD-like pathophysiological changes and cognitive impairments in transgenic mouse models of AD. Desflurane does not have these effects and is expected to have more potential for use in elderly patients, yet little is known about its effects, especially on non-cognitive functions, such as motor and emotional functions. Thus, we examined the postanesthetic effects of desflurane and sevoflurane on motor and emotional function in aged AppNL−G−F/NL−G−F (App-KI) mice. This is a recently developed transgenic mouse model of AD exhibiting amyloid β peptide (Aβ) amyloidosis and a neuroinflammatory response in an age-dependent manner without non-physiological amyloid precursor protein (APP) overexpression. Mice were subjected to a short behavioral test battery consisting of an elevated plus maze, a balance beam test, and a tail suspension test seven days after exposure to 8.0% desflurane for 6 h or 2.8% sevoflurane for 2 h. App-KI mice showed significant increments in the percentage of entry and time spent in open arms in the elevated plus maze, increments in the number of slips and latency to traverse for the balance beam test, increments in the limb clasping score, increments in immobile duration, and decrements in latency to first immobile episode for the tail suspension test compared to age-matched wild type (WT) controls. Desflurane- and sevoflurane-exposed App-KI mice showed a delayed decrement in the number of slips for each trial in the balance beam test, while air-treated App-KI mice rapidly improved their performance, and increased their clasping behavior in the tail suspension test. Furthermore, App-KI inhibited the change in membrane GluA3 following exposure to anesthetics in the cerebellum. These results suggest high validity of App-KI mice as an animal model of AD.
Machine Learning–Based Analysis and Prediction of Unplanned 30-Day Readmissions After Pituitary Adenoma Resection: A Multi-Institutional Retrospective Study With External Validation
Authors: Crabb Brendan T. , Hamrick Forrest , Campbell Justin M. , Vignolles-Jeong Joshua , Magill Stephen T. , Prevedello Daniel M. , Carrau Ricardo L. , Otto Bradley A. , Hardesty Douglas A. , Couldwell William T. , Karsy Michael
Published: April 2022

BACKGROUND:

Unplanned readmission after transsphenoidal resection of pituitary adenoma can occur in up to 10% of patients but is unpredictable.

OBJECTIVE:

To develop a reliable system for predicting unplanned readmission and create a validated method for stratifying patients by risk.

METHODS:

Data sets were retrospectively collected from the National Surgical Quality Improvement Program and 2 tertiary academic medical centers. Eight machine learning classifiers were fit to the National Surgical Quality Improvement Program data, optimized using Bayesian parameter optimization and evaluated on the external data. Permutation analysis identified the relative importance of predictive variables, and a risk stratification system was built using the trained machine learning models.

RESULTS:

Readmissions were accurately predicted by several classification models with an area under the receiving operator characteristic curve of 0.76 (95% CI 0.68-0.83) on the external data set. Permutation analysis identified the most important variables for predicting readmission as preoperative sodium level, returning to the operating room, and total operation time. High-risk and medium-risk patients, as identified by the proposed risk stratification system, were more likely to be readmitted than low-risk patients, with relative risks of 12.2 (95% CI 5.9-26.5) and 4.2 (95% CI 2.3-8.7), respectively. Overall risk stratification showed high discriminative capability with a C-statistic of 0.73.

CONCLUSION:

In this multi-institutional study with outside validation, unplanned readmissions after pituitary adenoma resection were accurately predicted using machine learning techniques. The features identified in this study and the risk stratification system developed could guide clinical and surgical decision making, reduce healthcare costs, and improve the quality of patient care by better identifying high-risk patients for closer perioperative management.
Recurrence in Plasmodium vivax malaria: a prospective cohort study with long follow-up from a coastal region in South-West India
Authors: Gandrala Divya , Gupta Nitin , Lavu Alekhya , Nallapati Vishnu Teja , Guddattu Vasudeva , Saravu Kavitha
Published: April 2022

Background:  India is endemic for Plasmodium vivax (Pv) malaria. Despite a decrease in incidence, its elimination is hampered by recurrences. This study aimed to characterize recurrences in Pv malaria and study its association with primaquine (PQ) usage.

Methods:  Symptomatic adult Pv patients were followed-up for up to 23 months for recurrences. The time to recurrence was compared by the PQ dosage they received using a log-rank test.

Results: Of the 294 malaria patients, 206 (70%) patients had Pv infection during the study period. A total of 20 (9.7%) recurrences were seen in 17 (8.2%) patients of Pv. The percentage of first-time recurrences were highest in the no PQ group (25%), followed by the weekly PQ group (20%), low dose daily PQ (8.2%) group, and high dose daily PQ group (3.1%).

Conclusions: Recurrence in Pv malaria is common, especially in those who receive an incorrect prescription of primaquine.
Prehabilitation-plus for patients undergoing major lower limb amputation may reduce acute hospital and total hospital length of stay: a retrospective, matched, case-controlled pilot service evaluation
Authors: Fulton Shelley , Baird Tyson , Naik Siang , Stiller Kathy
Published: April 2022

Background/Aims

‘Prehabilitation’ refers to interventions that seek to enhance a person's functional capacity to help withstand a forthcoming stressor, such as major surgery. There is little research evaluating prehabilitation before major lower limb amputation. This study evaluated if a comprehensive multidisciplinary pre-admission programme, which included prehabilitation plus other interventions (eg education, home assessment and modifications), hereinafter called ‘prehabilitation-plus’, might shorten hospital length of stay by allowing earlier discharge home from hospital after major lower limb amputation. The aim of this study was to investigate the effect of prehabilitation-plus on hospital length of stay and discharge destination for patients undergoing major lower limb amputation.

Methods

Seven patients receiving prehabilitation-plus were retrospectively matched with seven control patients in this case-controlled pilot service evaluation. Prehabilitation-plus was provided by a multidisciplinary team. Hospital length of stay was compared using Mann–Whitney U tests and discharge destination using Fisher's exact test.

Results

Acute hospital and total hospital length of stay were significantly lower in the prehabilitation-plus group than the control group (P=0.038 and 0.011 respectively). No significant difference was seen for rehabilitation hospital length of stay (P=0.400). More prehabilitation-plus patients were discharged directly home after their acute hospital stay, but this was not significant (P=0.286).

Conclusions

Patients who received prehabilitation-plus had reduced acute hospital and total hospital length of stay compared to matched control patients. While these preliminary results are promising for the ability of programmes such as prehabilitation-plus to reduce hospital length of stay, further studies with more robust designs are required to confirm and extend this finding.
Quality of life impacts and wider benefits following upper limb surgery for spasticity management
Authors: Duke Lynsay , Salam Sohail , Stevenson Susan
Published: April 2022

Background/Aims

A new, collaborative, multidisciplinary clinic for the management of people with upper limb spasticity and contracture was established between two healthcare trusts. The aim of this study was to determine the perceived benefits to patients of this new clinic and of upper limb surgery, where performed.

Methods

A service evaluation of a collaborative upper limb surgical assessment clinic for patients with complex problems of their upper limbs as a result of spasticity was undertaken. Questionnaires were distributed to 21 patients who attended the clinic in its first year (December 2017–2018), with follow-up focus groups. A rough cost–benefit review was undertaken.

Results

Patients highlighted benefits in both passive and active care tasks. They chose outcome measures that they felt were most useful to measure these benefits and coproduced multimedia information resources. The cost–benefit review indicated that a break-even point could be reached in as little as 1 year.

Conclusions

The team has gained a broad perspective of potential impacts on the patient and their carers, as well as future service development and research options.
COREAT: Developing a Mobile Application to Assess the Severity of Repetitive Behavior in Autism
Authors: Martínez-González Agustín E.
Published: April 2022

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterised by difficulties in communication and repetitive behaviors. The early detection of ASD is a clinical priority in education centres and medical services. COREAT is a computer adaptation of the Repetitive Behavior Scale-Revised (RBS-R) which has been designed to facilitate the diagnosis of individuals with ASD and intellectual disability. This article describes the development, an initial evaluation of the feasibility and the preliminary outcomes of COREAT. The development of COREAT consists of two phases. Phase 1: Performing a prior analysis of the psychometric properties of the RBS-R scale. Phase 2: Developing the mobile application (pilot tests, testing real cases n = 11, and final feedback). Descriptive data of the pilot study shows that 91.31% of participants indicate that COREAT is very accessible and intuitive. COREAT proves to be a useful diagnostic resource for professionals and families. Cross-cultural differences must be analysed.
Training leaders for the future? Leadership models for emerging and aspiring civil society leaders in Sweden and the UK
Authors: Ivanovska Hadjievska Milka , Johansson Håkan , Altermark Niklas
Published: April 2022

This article aims to understand the prevalent leadership models in seven prominent leadership development programmes targeting emerging and aspiring civil society leaders in Sweden and the United Kingdom (UK), which have two different civil society regimes. An analytical framework based on ideal-typical leadership models (transactional, transformational and collaborative) helps us distil how programmes conceptualise first the relationship between leaders and the subjects of leadership, and second, how they conceptualise core leadership qualities. Our analysis of documents and interviews with programme designers finds that programmes in both contexts predominantly conceptualise leadership in an individualistic and personalised way. Yet, Swedish programmes have a stronger focus on top-down leadership models, whereas programmes in the UK increasingly incorporate elements of the collaborative leadership model. The identified similarities and differences call for further systematic analysis of the relationship between external, structural and organisational factors and the content of leadership development programmes across civil society regimes.
Ultrawide-range radiation detection based on dynamic identification and analysis of the response of a monolithic active pixel sensor
Authors: Shoulong Xu , Zhiwei Qin , Yongchao Han , Hanfeng Dong , Youjun Huang , Fang Zhao , Yang Zou , Yang Liu , Dawei Gong , Ling XU , Shuliang Zou , Xiuwu Yu , Huaiqing Yang
Published: April 2022

In this paper, we present an ultrawide-range radiation detection method based on dynamic recognition and analysis of the response signal of a monolithic active pixel sensor (MAPS). Our analysis of the MAPS response mechanism determined that adaptive adjustment of the sensor’s integral time is key to quantification of ionizing radiation in an ultrawide range. We also determined that different data processing methods are required for accurate quantification of high and low radiation dose rates. The results of experiments conducted after calibration demonstrate that our technique is capable of radiation detection across five orders of magnitude (ranging from milligrays per hour to hundreds of grays per hour), with errors of less than 5%. Chip-based nuclear radiation detection can be realized using our technique, enabling MAPS to be used as a supplement to traditional detectors in characterization of unknown and complex radiation environments.
Optimizing clinical dosing of combination broadly neutralizing antibodies for HIV prevention
Authors: Mayer Bryan T. , deCamp Allan C. , Huang Yunda , Schiffer Joshua T. , Gottardo Raphael , Gilbert Peter B. , Reeves Daniel B.
Published: April 2022

Broadly neutralizing antibodies (bNAbs) are promising agents to prevent HIV infection and achieve HIV remission without antiretroviral therapy (ART). As with ART, bNAb combinations are likely needed to cover HIV’s extensive diversity. Not all bNAbs are identical in terms of their breadth, potency, andin vivolongevity (half-life). Given these differences, it is important to optimally select the composition, or dose ratio, of combination bNAb therapies for future clinical studies. We developed a model that synthesizes 1) pharmacokinetics, 2) potency against a wide HIV diversity, 3) interaction models for how drugs work together, and 4) correlates that translatein vitropotency to clinical protection. We found optimization requires drug-specific balances between potency, longevity, and interaction type. As an example, tradeoffs between longevity and potency are shown by comparing a combination therapy to a bi-specific antibody (a single protein merging both bNAbs) that takes the better potency but the worse longevity of the two components. Then, we illustrate a realistic dose ratio optimization of a triple combination of VRC07, 3BNC117, and 10–1074 bNAbs. We apply protection estimates derived from both a non-human primate (NHP) challenge study meta-analysis and the human antibody mediated prevention (AMP) trials. In both cases, we find a 2:1:1 dose emphasizing VRC07 is nearly optimal. Our approach can be immediately applied to optimize the next generation of combination antibody prevention and cure studies.