bluuebunny/crossref_metadata_2025 huggingface dataset:
Antithrombin during veno-venous extracorporeal membrane oxygenation with heparin anticoagulation: A single-center cohort study
Authors: Hileman Bethany A , Martucci Gennaro , Rizzitello Nicolò , Occhipinti Giovanna , Rossetti Matteo , Tuzzolino Fabio , Lorusso Roberto , Panigada Mauro , Tanaka Kenichi , Arcadipane Antonio , Panarello Giovanna
Published: June 2024

Introduction

Antithrombin (AT) is a natural anticoagulant essential to enhancing the unfractionated heparin (UFH) anticoagulant effect. Its supplementation in the management of UFH-based anticoagulation during veno-venous extracorporeal membrane oxygenation (VV ECMO) has a strong pathophysiological rationale.

Methods

This is a single-center, retrospective cohort study of adult VV ECMO patients with anticoagulation maintained by UFH targeting an activated partial thromboplastin time (aPTT) of 40–50 s and AT activity >80%. We compare anticoagulation management and survival outcomes between AT subpopulations, defined by a threshold AT activity ≥80%. Linear and logistic regression analyses were used to evaluate the variation in AT activity and its association with ICU survival.

Results

In 244 patients enrolled from 2009 to 2022, anticoagulation was maintained by a median heparin dose of 11.4 IU/kg/h [IQR: 8.2–14.7] with a mean aPTT of 46.1 s (±7.3) and AT activity of 88.9% (±17.0). A lower mean aPTT, higher dose of UFH and shorter fraction of time without UFH were associated with higher AT activity ( p < .01). Higher AT activity showed a consistent association with ICU survival (for 10% increase of AT, odds ratio for ICU mortality: 0.95; 95% CI 0.93–0.97; p value <.01).

Conclusions

There is a positive association between AT activity and UFH requirements but no significant difference in the rate of bleeding events. A higher mean AT during VV ECMO was associated with ICU survival. Future studies are needed to differentiate between exogenously supplemented versus endogenous AT effect.
Edible Mushrooms of Peri-Urban Kichwa Communities in the Andes-Amazon Piedmont, Ecuador
Authors: Vicente-Pérez Katia , Vasco-Palacios Aída M. , Zurita-Benavides Maria Gabriela , Peñuela Mora Maria Cristina
Published: June 2024

Ecuador is a multicultural and megadiverse country where nearly 50 species of wild edible macrofungi (WEM), used by 12 indigenous peoples, have been reported. The Kichwa use 29 species of mushrooms, but aspects of their ecology are unknown. The aim of this study was to study the richness, use, substrates and fruiting seasons of WEM consumed by two peri-urban Kichwa communities settled in the piedmont between the Andes and the Amazon. Between May 2019 to April 2020, we conducted 56 interviews with adults and 12 walks in the chagras and forests. People recognized 26 fungal names related to 12 species of mushrooms, 11 basidiomycetes and one ascomycete. Three species were the most culturally important : Favolus tenuiculus, Bresodolia paradoxa and Lentinus concavus, defined by their abundance, economic importance and taste. Six mushroom species were newly reported for the Kichwa group and four species added to the list of species in the country. All the fungi were lignicolous; they were found on the trunks of 16 species of plants in the chagras. The plant-trees: P. discolor, Inga edulis and C. alliodora were the most common substrates. These species are abundant in the chagras and frequently used for their wood. Ecological and traditional knowledge related to WEM is important to enhance management practices in situ and ex situ.
Adaptation and Validation of the Chinese Version of Fear of Failure in Learning Scale
Authors: Chen Yikang , Chui Harold , Huang Yanghua , King Ronnel B.
Published: June 2024

Fear of failure undermines students’ learning and well-being. However, despite the prevalence of fear of failure, there is a lack of a measurement tool explicitly designed to assess the fear of failure in learning among Chinese students. This study aimed to adapt and validate the Chinese version of the Fear of Failure in Learning Scale (C-FOFLS). Exploratory factor analyses were conducted for the adaptation group ( N = 353) and a four-factor solution was found. The construct validity of the four-factor structure was subsequently confirmed by item-level analysis and confirmatory factor analysis for the validation group ( N = 366). The final scale was comprised of 22 items and had four underlying dimensions: shame, performance avoidance, learned helplessness, and self-handicapping. Pearson correlation analyses demonstrated satisfactory convergent validity and concurrent validity of the C-FOFLS. C-FOFLS could be a valuable tool for conducting research on the fear of failure in learning of Chinese students.
Hungry, Stressed, and Away From “Home”: Predictors of Food Security and Perceived Stress Among International Students
Authors: Ibiyemi Temitope , Najam Wasiuddin , Oldewage-Theron Wilna
Published: June 2024

Purpose

Examine the predictors of food security and perceived stress among international students.

Design

Cross-sectional Design.

Settings

A public university in the Southwest United States.

Subjects

Sample size of Seventy-three participants (≥18 years).

Measures

Self-report measures of food insecurity and perceived stress. The U.S. Department of Agriculture (USDA) Adult Food Security Survey Module (AFSSM) to assess food security status, and the Perceived Stress Scale (PSS-10) questionnaire to evaluate stress levels.

Analysis

Logistic regression was performed to identify predictors of food security and perceived stress.

Results

Duration of stay in the U.S. was a predictor of food security status, while gender was a predictor of perceived stress. International students in the U.S. for less than a year had a lower chance of being food secure [OR (95% CI) = 0.22 (0.05 - 0.74)]. Female international students had a lower chance of experiencing low perceived stress [OR (95% CI) = 0.07 (0.00 - 0.51)].

Conclusion

In supporting international students, targeted nutrition and stress management interventions should be emphasized, particularly for females and those who recently moved to the U.S.
Sensitivity, robustness, and reproducibility of U-shaped delamination test for evaluation of candidate ultra-high molecular weight polyethylene materials for joint replacements
Authors: Sakoda Hideyuki , Tamazawa Kengo , Shoyama Yuichi , Osaka Yuta , Uetsuki Keita , Okamoto Yoshihiro , Yamamoto Eiichi
Published: June 2024

The delamination of ultra-high molecular weight polyethylene (UHMWPE) in artificial joints is a major cause limiting the long-term clinical results of arthroplasty. However, the conventional test method using simple reciprocation to evaluate the delamination resistance of UHMWPE materials has insufficient detection sensitivity. To reproduce delamination, the unconformity contact must be maintained throughout the test so that the maximum stress is generated below the surface. Therefore, a test method that applies a U-shaped motion comprising two long-linear and one short linear sliding motion was developed. The sensitivity, robustness, and reproducibility of the U-shaped delamination test were investigated and compared with the traditional test method. The traditional test method could reproduce delamination only in materials that had degraded considerably, whereas the U-shaped delamination test could reproduce delamination in a wide range of materials, demonstrating its superior sensitivity. Additionally, using a higher load helped accelerate the test without affecting the test results. The optimal length of the short linear sliding motion was confirmed to be 1 mm. Finally, the inter-laboratory reproducibility of the U-shaped delamination test was confirmed using the round-robin test. The U-shaped delamination test demonstrates high sensitivity, robustness, and reproducibility and contributes to the selection and development of UHMWPE materials and artificial joints with a lower risk of delamination.
Half of the soil erosion in the Alps during the Holocene is explained by transient erosion crises as a consequence of rapid human land clearing
Authors: Mazure Théo , Saulnier Georges-Marie , Giguet-Covex Charline , Sabatier Pierre , Bajard Manon , Chanudet Vincent , Arnaud Fabien , Jenny Jean-Philippe
Published: June 2024

Human land use changes have altered soil erosion for millennia with extensive consequences on terrestrial and aquatic ecosystems as well as on biogeochemical cycles along the land-ocean continuum. Despite their great importance, past erosion trends have high uncertainties limiting quantitative estimates of long-term erosion dynamics. Here, we applied a new approach combining well-dated paleo-records of soil erosion from lake sediments and a spatially distributed semi-empirical model to simulate annual soil erosion in six lake watershed systems in the Northwestern Alps during the Holocene. Progressive and abrupt changes in soil erosion are detected in the six watersheds. Progressive erosion explains most of the soil exports observed during the Early to Mid-Holocene period (from 11,700 to 3000 cal. yr. BP), while transient erosion crises (i.e., periods of abrupt increase in the erosion rates spanning approximately 1000 ± 500 years) led to massive soil losses during the Late-Holocene period (from 3000 to 1000 cal. yr. BP). Our coupled approach of proxy-model reconstruction shows that the transient erosion crises represent the half of the total soil erosion exports during the Holocene. These estimates defy current representations of large-scale soil erosion during the Holocene that do not consider transient erosion crises, hence potentially underestimating the anthropogenic perturbation of lateral fluxes and fate along the land-ocean continuum. Our results further suggest that erosion and/or land cover proxies need to be consistently integrated into model approaches when attempting to estimate past variations in mass exports from terrestrial to aquatic ecosystems over centennial to millennial timescales.
‘On the cusp of something huge’: Anticipatory subjectivities in freelance fashion work
Authors: Melkumova-Reynolds Jana
Published: June 2024

This article draws on an (auto)ethnographic study of a group of freelance fashion professionals, known as ‘fashion agents’, with a particular focus on their relationship to time. It aims to elucidate the temporalities that permeate their work lives and shape their subjectivities, which I coin as anticipatory subjectivities. Such subjectivities, I posit, are emblematic of the conditions of flexibilisation, precarity and hopeful investment in the future characteristic of contemporary cultural industries and, more broadly, late capitalist knowledge economies. I propose that agents’ life-worlds are permeated by a promissory regime – i.e., living in anticipation of constantly deferred, adjourned and unsecured rewards. Such a regime produces subjectivities that are premised on a hopeful emotional investment in the future, coupled with a preparedness for, and a capacity to navigate, incalculable risks. Another feature of the ‘timescapes’ that agents have to negotiate is the simultaneity of multiple fluid, unstructured and often conflicting temporalities and tempos, which requires a particular kind of time-competence. Finally, the article also foregrounds the importance, in agents’ temporal orientations, of kairos: the right, opportune moment. Such a moment is normally perceived as being just about to happen; yet, it cannot be orchestrated or precipitated. As a result, one of agents’ key temporal experiences is that of waiting, which de-subjectivises them and inhibits their capacity to act. Together, these time-orientations – anticipation, managing multiple temporalities and a hopeful waiting for kairos – underpin and foster subjectivities and forms of affective labour that sustain the cultural industries; they are also emblematic of the temporal conditions of late capitalism.
Lower-Stakes Legislative Collaborations, Ethnicity, and Gender
Authors: O’Brochta William
Published: June 2024

How do legislators decide with whom to collaborate? I argue that legislative collaborations are shaped by ethnicity and gender, with legislators from dominant ethnic groups and men legislators having more opportunities to collaborate than non-dominant legislators. These dynamics are likely present even when the nature of the collaboration is not particularly electorally salient. I test this hypothesis using newly collected data on question-asking from local legislators in Delhi. Dominant caste men legislators tend to dominate question-asking collaborations as expected, with men legislators consistently having more collaboration opportunities. The results suggest that legislative power dynamics are present even in lower-stakes interactions and may mean that simply encouraging additional legislator collaborations does not address underlying discriminatory patterns in how dominant legislators select their collaborators.
What Is the Impact of Baseline Inflammatory and Hemostatic Indicators with the Risk of Mortality in Severe Inpatients with COVID-19: A Retrospective Study
Authors: Zhu Huiqi , Li Yeping , Su Hua , Yan Chao , Xin Wanghao , Ying Kejing
Published: June 2024

The purpose of the study was to investigate baseline inflammatory, hemostatic indicators and new-onset deep vein thrombosis (DVT) with the risk of mortality in COVID-19 inpatients. In this single-center study, a total of 401 COVID-19 patients hospitalized in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine were enrolled from December 1, 2022 to January 31, 2023. The basic information, first laboratory examination results, imaging examination, and outcome-related indicators were compared between patients in the moderate and severe subgroups. We found that baseline D-dimer and baseline absolute neutrophil count (ANC) levels were associated with new-onset DVT and death in severe hospitalized patients with COVID-19. The odds ratio (OR) of baseline D-dimer and baseline ANC with mortality was 1.18 (95% confidence interval [CI], 1.08–1.28; P < .001) and 1.13 (95% CI, 1.06–1.21; P < .001). Baseline ANC was associated with the risk of death in severe hospitalized COVID-19 patients, irrespective of the DVT status. In addition, a significantly higher serum neutrophil activity was observed in severe COVID-19 inpatients with DVT or those deceased during hospital stay. New-onset DVT partially mediated the association between baseline D-dimer (indirect effect: 0.011, estimated mediating proportion: 67.0%), baseline ANC (indirect effect: 0.006, estimated mediating proportion: 48.7%), and mortality in severe hospitalized patients with COVID-19. In summary, baseline D-dimer and baseline absolute neutrophil count (ANC) levels were associated with the mortality in severe hospitalized patients with COVID-19, especially DVT inpatients. New-onset DVT partially mediated the association between baseline D-dimer, baseline ANC, and mortality in severe hospitalized patients with COVID-19.
Effect of Cytokeratin-18, C-peptide, MHR, and MACK-3 Biomarkers in Metabolic Dysfunction-Associated Fatty Liver Disease After Laparoscopic Sleeve Gastrectomy
Authors: Hany Mohamed , Demerdash Hala M , Abouelnasr Anwar Ashraf , Torensma Bart
Published: June 2024

Background:

Laparoscopic sleeve gastrectomy (LSG) has emerged as a valuable treatment for various metabolic disorders, including metabolic dysfunction-associated fatty liver disease (MAFLD) in patients with obesity. Consequently, there is a pressing need to develop noninvasive biomarkers for diagnosing and monitoring disease progression.

Objectives:

This study aimed to evaluate specific biomarkers, including Cytokeratin-18 (CK-18), C-peptide, monocyte to HDL cholesterol ratio (MHR), and MACK-3, in patients with obesity with MAFLD undergoing LSG.

Design:

A prospective cohort study on patients with obesity before and 6 months after the LSG procedure.

Methods:

70 patients with obesity with confirmed MAFLD, determined by Transient Elastography (TE), were pre- and 6 months postoperatively tested. Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), lipid profile, ghrelin, leptin, peptide YY, GLP-1, and liver fibrosis scores, including AST/ALT ratio (AAR), Fibrosis-4 index (FIB-4), and BARD Score were tested.

Results:

BMI significantly decreased in all participants, with a % excess weight loss of 62.0% ± 15.4%. TE measurements revealed a significant postoperative reduction from 100% to 87.1% ( P = .006). All selected biomarkers showed significant postoperative improvement—a significant association of CK-18 with MAFLD markers, including AAR, FIB-4, and BARD score, were found. MACK-3 had positive associations with FIB-4. C-peptide and MHR showed no association with MAFLD markers. Furthermore, there was a positive correlation between CK-18 and MACK-3 tests and between C-peptide and CK-18 and MACK-3. Additionally, a receiver operating characteristic (ROC) curve was constructed, with CK-18 performing the best, with an estimated area under the curve of 0.863.

Conclusion:

Serum CK-18 outperformed other selected biomarkers in predicting and monitoring MAFLD in patients with obesity, suggesting its prospective utility in clinical practice. Further studies are needed to validate the accuracy of the MACK-3 test.
A Study of the Relationship Between the Triglyceride-Glucose Index and Skeletal Muscle Mass in a General Chinese Population
Authors: Liu Yue , Chen Hongwei , Wei Ziyi , Han Tingting , Chen Ningxin , Weng Yurong , Hu Yaomin
Published: June 2024

Objective:

There is no study on the relationship between triglyceride-glucose index (TyG index) and skeletal muscle mass in middle-aged and elderly C population. Therefore, the aim of the study is to investigate the relationship between the TyG index and weight-adjusted relative skeletal muscle index (RSMI) in middle-aged and elderly C population.

Methods:

We retrospectively studied 947 aged ⩾40 years subjects who got a routine medical examination in the Department of Geriatrics of R Hospital from May 2021 to March 2023. The RSMI was designed to evaluate skeletal muscle mass and calculated based on lean mass of the limbs(kg)/body weight(kg) × 100%. Skeletal muscle mass reduction was defined as a RSMI of 1-2 standard deviations (SD) below of healthy adults aged 30-49 years old. Considering the quartile groups of the TyG index, the subjects were assigned to 4 groups: Q1 (less than or equal to 8.171), Q2 (from 8.172 to 8.569), Q3 (from 8.570 to 8.992), and Q4 (greater than or equal to 8.993).

Results:

With TyG index increased, RSMI levels significantly reduced( P < .001). Spearman’s correlation analysis showed that the TyG index was negatively correlated with RSMI in males (r = −0.320) and females (r = −0.240). The TyG index was positively correlated with body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) ( P < .05). Besides, binary logistic regression analysis showed that the risk of developing reduced skeletal muscle mass in the group Q4 was 2.131 (95%CI:1.118-4.064) in males; and was 2.472 (95%CI:1.581-3.867) in females compared to the Q1 group.

Conclusion:

TyG index was negatively correlated with relative skeletal muscle index, and a higher TyG index was associated with the development of reduced skeletal muscle mass independently of other influencing factors. Therefore, the TyG index promises to be a predictor of skeletal muscle mass loss.
Mortgage debt and domestic and outbound travel expenditures: International evidence
Authors: Gholipour Hassan F , Farzanegan Mohammad Reza , Bassil Charbel , Zhao Xuan
Published: June 2024

We explore the relationship between the mortgage debt of households and their spending on domestic and outbound tourism and travel. We estimate a dynamic panel data model for a sample of 27 countries for 2010-2021, and find evidence for a negative relationship. Hence, we show that in countries where the mortgage per capita is high, residents allocate fewer expenditures on domestic and outbound tourism. We also find that the reduction in outbound tourism spending is more pronounced than the decrease in domestic tourism spending. Our findings can benefit policymakers and firms in the tourism industry by providing the knowledge necessary for creating successful promotional strategies.
Upholding social hierarchies: Social dominance orientation moderates the link between (intergroup) conspiracy exposure and violent extremism
Authors: Schrader Tanya , Jolley Daniel , Jolley Richard P. , Krahenbuhl Sarah
Published: June 2024

Across two experimental studies, we explored whether exposure to intergroup conspiracy theories can increase violent reactions towards targeted groups. We also examined how ideological attitudes may moderate the effect. In Study 1 ( N = 160, preregistered), we found that exposure to immigrant conspiracy theories (vs. control) increased the willingness to use violence for those who reported higher social dominance orientation (SDO) and right-wing authoritarianism (RWA). Study 2 ( N = 211, preregistered) sought to extend these results by focusing on a specific target: Muslim immigrants. Exposure to Muslim immigrant conspiracy theories (vs. control) increased motivation and willingness to use violence for those with higher SDO (but not RWA). These findings showcase how exposure to intergroup conspiracy theories and violent reactions are conditional on specific ideological attitudes. Thus, when considering interventions, we argue that it is crucial to consider the role of ideological worldviews when seeking to combat conspiracy-inspired violence.
A Single Center, Randomized Controlled Trial on the Efficacy of Topical Application of ReGenerating Tissue Agents (RGTA) Technology in Diabetic Foot Ulcers
Authors: Samakidou Georgia , Eleftheriadou Ioanna , Anastasiou Ioanna A. , Kosta Ourania , Tentolouris Anastasios , Evangelou Konstantinos , Tentolouris Nikolaos
Published: June 2024

Diabetic foot ulcers (DFUs) are a serious complication of diabetes mellitus. Clinical data from the use of ReGenerating Tissue Agents (RGTA) technology in patients with DFUs are scarce. The objective of this randomized controlled study was to evaluate the efficacy of RGTA technology in the management of DFUs. Patients with chronic, neuroischemic diabetic foot ulcers were randomized 1:1 to the control group, that received the standard of care, and to the intervention group, that additionally received RGTA twice per week. The duration of the intervention was 12 weeks. Skin biopsies for histological and immunohistochemical analyses from a sample of participants were also performed. About 31 patients completed the study. Five (31.2%) patients in the intervention group achieved complete healing at the end of the intervention period versus 0 patients in the control group ( P = .043), [RR: 0.688 (95% CI: 0.494-0.957)]. The intervention group had more ulcers with at least 80% healing of their surface [10 (66.7%) versus 2 (13.3%), P = .008, RR: 0.385 (95% CI: 0.183-0.808)], higher absolute surface reduction [1.5 (0.7, 5.2) versus 0.6 (0.3, 1.0), P = .026] and higher percentages of surface reduction [94 (67, 100) versus 40 (26, 75), P = .001] at the end of the intervention period. More patients in the intervention group achieved at least 50% healing at the fourth week of the study [9 (64.3%) versus 2 (14.3%) P = .018, RR: 0.417 (95% CI: 0.200-0.869)]. Immunohistochemical analyses were performed in a sample of participants that revealed higher expression of CD163, COL3 and VEGFR in the intervention group. The adverse effects were similar between the 2 groups. The data from the present study suggest that the adjunction of RGTA technology in the management of diabetic foot ulcers is a safe practice that promotes wound healing.
Weighing Mixing in a Decision About Priority in Mixed Methods Research
Authors: Creamer Elizabeth G.
Published: June 2024

Priority is a dimension of research design in a mixed method study that provides a signpost to signify how a study’s principal findings were derived. The contribution of mixing has not typically been considered as an explicit component of the weighting of the priority of a mixed methods study. Adding the expression mixed priority to the terminology used to provide transparency about priority is one way to distinguish research with an interactive design where qualitative and quantitative data are merged during analysis to create a sum that is greater than its parts. The most significant implication of this discussion is to add integration as a third factor in the conceptualization of priority in mixed method research.
Introducing Interrelated Models Appropriate for Designing a Mixed Research Design Within a Hybrid Design
Authors: Collins Kathleen M.T.
Published: June 2024

In this article, interrelated models appropriate for conceptualizing a mixed research design within a hybrid design are presented. Initially, the discussion centers on outlining the core principles defining community-based participatory research and characteristics defining mixed research. The design model presents selective examples of mixed research elements to be considered when the researcher is strategizing the design. The integration model details the language of integration and the role of legitimation as it relates to integration. The integrity model presents selective quality criteria designed to elevate credibility of the conclusions. The contribution of this article lies in its focus on mixed research design within the hybrid design, and the presentation of interrelated models, namely, design, integration, and integrity models that address this focus.
Distal mechanical thrombectomy using beveled tip aspiration zoom catheters: A preliminary study
Authors: Dallas Jonathan , Nguyen Vincent N. , Sequeiros Joel M. , Graham Shelby , Burns-Martin Jared , Goyal Nitin , Khatibi Kasra
Published: June 2024

Introduction

Distal medium vessel occlusion (DVO) thrombectomy has been shown to be efficacious with safety profiles comparable to large vessel occlusion (LVO) thrombectomy. A novel, highly-trackable, bevel-tipped Zoom 35 catheter can be used as an aspiration catheter for DVO thrombectomy.

Methods

This is a retrospective, single-arm, multi-institutional observational study evaluating the efficacy and safety of aspiration thrombectomy for DVO using the Zoom 35 catheter. Patient demographics, presenting and discharge NIHSS, primary and rescue thrombectomy, site of occlusion, TICI score, and intracranial hemorrhage were chart abstracted. Descriptive statistics were used to evaluate the efficacy and safety of thrombectomy.

Results

Fourteen patients (mean age 66.64 ± 13.75 years) were included. The mean NIHSS at presentation was 10.79 ± 5.48, and the mean ASPECTS was 9.00 ± 0.89. Nine patients (64.3%) received tPA. Primary occlusion location was M3 in nine cases (64.3%), M2/M3 junction in two cases (14.3%), A2 in one case (7.1%), A3 in one case (7.1%), and P1 in one case (7.1%). TICI scores were 3 in seven cases (50.0%), 2C in three cases (21.4%), and 2B in four cases (28.6%). There was one postoperative SAH (7.1%) and one asymptomatic ICH (7.1%). Mean discharge NIHSS was 3.38 ± 4.44, with a mean decrease of 7.31 from presentation (p < 0.0001, t-test).

Conclusion

Zoom 35 beveled-tip aspiration microcatheters are highly trackable and associated with improved radiographic and clinical outcomes for the treatment of DVO with a good safety profile.
On periodic maintenance for a protection system
Authors: Scarf Phil , Alotaibi Naif , Cavalcante Cristiano AV , Rodrigues Augusto JS , Melo Yan R
Published: June 2024

This article presents a model for maintenance planning of protection systems, such as isolation valves, circuit breakers, and other safety barriers. These systems are designed to operate on demand and prevent environmental catastrophes. The proposed model is novel because: (i) inspections (functional tests) are fixed and periodic; and (ii) the replacement policy has three-phases, corrective, opportunistic-preventive, and scheduled-preventive. Thus, the system is replaced: at a positive test; at a test regardless of the outcome either if an opportunity arises or when the system reaches a critical age. The model is relevant because periodic inspections are largely the practical, engineering reality, and particularly useful for geographically distributed systems, for which there is limited time and resources for maintenance. The paper provides a web-based application as a demonstrator of the proposed model. The study extends and refines well-known policies from the literature, providing valuable insights about applicability across various parameter settings.
Screening Greenland in Borgen—Power & Glory: The on- and off-screen contestedness of Arctic landscapes and locations
Authors: Grønlund Anders , Waade Anne Marit Risum
Published: June 2024

This article shows how the Arctic landscapes in the Danish political drama series Borgen—Power & Glory (2022) demonstrate Greenland as a contested land in distinct ways: culturally due to the postcolonial tension between Denmark and Greenland; politically due to the conflicted interests from Denmark and other nations for the country’s natural resources; environmentally due to the looming transformation of the Arctic landscapes due to global warming, and commercially due to increasing interest in screen production from Greenlandic tourism actors. Furthermore, we contribute to the location study method approach by focusing on location management and the contestedness of the industry itself.
Dexmedetomidine and surgical field visibility in nasal surgery: A systematic review and meta-analysis
Authors: Warner Brendon K , Munhall C Cooper , Nguyen Shaun A , Schlosser Rodney J , Guldan George J , Meyer Ted A
Published: June 2024

Introduction:

Nasal and sinus surgery, especially using endoscopy, relies upon adequate haemostasis to be safe and effective. Often other haemostatic methods, such as cautery are not viable, and other methods must be employed. This study examines the effectiveness of dexmedetomidine in controlled hypotension and for surgical field visibility in endoscopic sinus surgery and other nasal surgeries.

Review Methods:

A literature search was conducted in PubMed, Scopus, CINAHL and Central for randomised controlled trials using dexmedetomidine for controlled hypotension in adult patients undergoing endoscopic sinus surgery or other nasal surgery. Meta-analysis of mean differences and single means were performed.

Results:

Of 935 identified studies, 31 met the inclusion criteria. A statistically significant difference in Fromme–Boezaart surgical field visibility scores was found comparing dexmedetomidine to placebo (p < 0.00001) and propofol (p < 0.0001), but not other agents. A significant difference in intraoperative blood loss volume was found compared with placebo (51.5mL, p < 0.00001) and propofol (13.6mL, p < 0.0001), but not other agents.

Conclusion:

Dexmedetomidine demonstrated significantly improved surgical field visibility and blood loss volume compared with placebo and propofol, but not other agents. Dexmedetomidine is viable and useful for controlled hypotension in nasal surgery. Choice of controlled hypotension agent should follow patient and procedure-specific considerations.
An anatomical feasibility study using the first metatarsal head as a vascularized bone graft for proximal pole of scaphoid reconstruction
Authors: Everitt Rebecca Samantha , Jose Rajive , Yaseen Irfan
Published: June 2024

A cadaveric study showed that vascularized transfer of the articular surface of the ipsilateral first metatarsal head with the lateral collateral ligament could be suitable for reconstruction of the proximal pole of scaphoid and scapholunate ligament. Further study of the technique is recommended.
A Case of Ischemic Pituitary Apoplexy Secondary to ACTH-Secreting Macroadenoma
Authors: Clerici Luca , Lucotti Pietro , Lombardi Francesco , Spena Giannantonio , Lovati Elisabetta , Di Sabatino Antonio , Zoia Cesare
Published: June 2024

Background: Pituitary apoplexy (PA) represents a rare but extremely serious complication of pituitary adenoma. It is characterized by the rapid onset of headache, nausea and vomiting, changes in vision, paralysis of the oculomotor nerves and alteration of the sensory. Due to the rarity of this complication and the non-specificity of symptoms, the patient’s clinical presentation may not be interpreted correctly, leading to a diagnostic delay and a worsening of prognosis. Case Description: This case report relates to a 73-year-old man with ACTH-secreting macroadenoma infiltrating the cavernous sinuses bilaterally and causing the rapid onset of headache, bilateral eyelid ptosis, complete bilaterally ophthalmoplegia and bitemporal hemianopia. The patient underwent urgent surgery to remove the lesion by transsphenoidal route and subsequent monitoring of pituitary function by endocrinologist specialist obtaining a near-total recovery from illness. Conclusions: PA is often characterized by the appearance of unilateral ocular or neurological deficits, while a clinical presentation given by ophthalmoplegia and bilateral ptosis is a very rare condition, difficult to find in the literature. Therefore, similar symptoms should not be underestimated and should raise the diagnostic suspicion of PA. In this case, in fact, a prompt treatment and multidisciplinary management of the patient allowed to markedly improve the prognosis. Furthermore, the instrumental findings supported a picture of ischemic pituitary apoplexy without signs of haemorrhage, a condition reported only sporadically in the literature.
Factors Influencing Electronic Health Record Workflow Integration Among Nurses in Saudi Arabia: Cross-Sectional Study
Authors: Asiri Saeed
Published: June 2024

Introduction

Globally, healthcare organizations have transitioned from paper-based documentation to electronic health records (EHR), including in Saudi Arabia. However, the adoption of EHR at the national level in Saudi Arabia needs more attention. Thus, this study aimed to determine the workflow integration of EHR and associated factors.

Objectives

The specific aims were to examine the level of EHR use and workflow integration among nurses, to determine the differences in EHR use and workflow integration based on nurses’ demographic characteristics, and to determine the association between the predictive factors and EHR workflow integration.

Methods

This is a cross-sectional, correlational descriptive study. The data were collected from 293 nurses using the convenience sampling method. The participating nurses completed a questionnaire that included two measures: the Information System Use Survey and the Workflow Integration Survey (WIS). The data were analyzed using descriptive and multivariate statistics with SPSS software.

Results

The nurses had a positive perception of EHR use and workflow. The EHR use scores differed based on workplace ( P < .01), education level ( P < .05), and area of practice ( P < .001). Similarly, the EHR workflow integration scores varied according to workplace ( P < .05), education level ( P < .05), and area of practice ( P < .001). Education level and workplace significantly predicted information system use. Furthermore, education level and information system use significantly predicted the EHR integration into nurses’ workflow.

Conclusion

The nurses expressed a greater perceived use of EHR regarding the integrated health information system, which was a predictor of EHR integration into nurses’ workflow.
Troponin I levels in systemic sclerosis patients with myocardial involvement
Authors: Hoekstra Eva M , Liem Sophie IE , Ahmed Saad , Levarht Nivine , Fehres Cynthia M , Giuca Adrian , Ajmone Marsan Nina , Huizinga Tom WJ , de Vries-Bouwstra Jeska K
Published: June 2024

Objectives:

Troponin I has been suggested as a more specific diagnostic biomarker for myocardial involvement in systemic sclerosis than the frequently used troponin T. The aim of this study is to evaluate the additive value of troponin I to detect myocardial involvement in systemic sclerosis. To this end, we evaluated the association between troponin I levels and myocardial involvement in systemic sclerosis patients.

Methods:

A cross-sectional observational study was performed, including 20 healthy controls and four groups of each 20 systemic sclerosis patients from the Leiden Combined Care in Systemic Sclerosis cohort: (1) patients with myocardial involvement, (2) patients with myositis, (3) patients with elevated troponin T and creatine kinase levels but without organ involvement, and (4) patients without any signs of organ involvement. Troponin I levels were measured using enzyme-linked immunosorbent assay. Troponin I levels were compared between the different groups using the Mann–Whitney U and Kruskal–Wallis tests.

Results:

The mean age of the 80 included patients was 56 years; 61% of the study population was female. Troponin I levels were not significantly different between patients with and without myocardial involvement (2.7 (0.5–15.3) vs 1.2 (0.1–6.6) ng/L; p = 0.117). Systemic sclerosis patients were more often positive for troponin I than healthy controls (70.0% vs 30.0%; p = 0.001).

Conclusion:

Elevated troponin I was not of additional value to diagnose myocardial involvement in systemic sclerosis patients.
Preoperative Degenerative Changes at the Tibial Sesamoid-Metatarsal Joint in Hallux Valgus: Association With Postoperative Patient-Reported Outcomes After Modified Lapidus Procedure
Authors: Kush Sophie , Streeter Stone R. , Jones Agnes D. Cororaton , Steineman Brett , Ellis Scott J. , Conti Matthew S.
Published: June 2024

Background:

Degenerative changes at the sesamoid-metatarsal joints (SMJs) may be a source of pain following hallux valgus surgery. The aims of this study were to describe degenerative changes at the SMJs on weightbearing computed tomography (WBCT) scans and, secondarily, investigate their association with 1-year patient-reported outcome scores following a modified Lapidus procedure for hallux valgus. We hypothesized that reduced joint space in the SMJs would correlate with worse patient-reported outcomes.

Methods:

Fifty-seven hallux valgus patients who underwent a modified Lapidus procedure had preoperative and minimum 5-month postoperative WBCT scans, and preoperative and at least 1-year postoperative PROMIS physical function (PF), pain interference, and pain intensity scores were included. Degenerative changes at the SMJs were measured using distance mapping between the sesamoids and first metatarsal head on preoperative and postoperative WBCT scans. The minimum and average distances between the first metatarsal head and tibial sesamoid (tibial-SMJ) for each patient preoperatively and postoperatively were measured. Sesamoid station was measured on WBCT scans using a 0 to 3 grading system. Linear regression was used to investigate the correlations between minimum preoperative and postoperative tibial-SMJ distances and 1-year postoperative PROMIS scores.

Results:

The median minimum and average tibial-SMJ distances increased from 0.82 mm (interquartile range [IQR] 0.40-1.03 mm) and 1.62 mm (IQR 1.37-1.75 mm) preoperative to 1.09 mm (IQR 0.96-1.23 mm) and 1.73 mm (IQR 1.60-1.91 mm) postoperative (P < .001 and P < .001), respectively. In a subset of patients with complete sesamoid reduction, we found an association between preoperative minimum tibial-SMJ distance and 1-year postoperative PROMIS PF scores (coefficient 7.2, P = .02).

Conclusion:

Following the modified Lapidus procedure, there was a statistically significant increase in the tibial-SMJ distance. Additionally, in patients with reduced sesamoids postoperatively, reduced preoperative tibial-SMJ distance correlated with worse PROMIS PF scores.

Level of Evidence:

Level IV, case series.
Determinants of Private Infrastructure Investment in India: A Post-liberalization Analysis
Authors: Unnikrishnan Nishija , M Biju John , Kattookaran Thomas Paul
Published: June 2024

In spite of the initiatives by the Government of India for reviving private infrastructure investment, its growth is not up to the mark, especially after the COVID-19 pandemic. It is well known that the contribution of the private sector to infrastructure is inevitable to the overall growth of a country. An enquiry into its determining factors will help to explore the reasons behind the ebb and flow of private infrastructure investment in India and helps in finding solutions to revive it. This paper aims to identify the macroeconomic determining factors of private infrastructure investment in India after the liberalization period. ARDL-bound test results show that in the long run, there exists a positive long-run relationship between private infrastructure investment with gross domestic product (GDP), public infrastructure investment and domestic credit to the private sector, whereas in the short run, it was found that only the GDP and domestic credit to the private sector are statistically significant. Although there are many empirical studies that presented the contribution of macroeconomic factors to the growth of private investment in general, this study stands out as this is the first attempt to identify the determinants of private infrastructure investment.
The strain-rate-dependent tensile failure and energy-absorbing behavior of sheet molding compounds
Authors: Li Yanbo , Chen Zishan , Yang Guangmeng , Han Zhenyu , Shen Qingliang
Published: June 2024

Sheet molding compounds (SMCs) as an alternative material for low-cost and lightweight automotive structural components require special attention to their failure behavior and collision safety. This study aims to analyze the energy-absorbing response and variability of unsaturated polyester matrix SMCs under the range of strain rates from 10−3/s to 500/s through quasi-static and dynamic tensile tests. Additionally, the tensile process and fracture morphology were characterized using Digital Image Correlation and Scanning Electron Microscopy to reveal the underlying rate-dependent failure mechanism. The results demonstrate a pronounced positive correlation between the tensile strength and absorbed energy of SMCs with strain rates. Specially, the absorbed energy exhibits substantial variability, primarily attributable to the plastic damage behavior during the nonlinear phase. A transition in the failure mode from debonding to pseudo-delamination, accompanied by a more extensive failure area at high strain rates, serves as the main mechanism for enhancing the material energy absorption capacity.
Beyond the 9-to-5: How Meaningful and Challenging Work Drives Employee Engagement
Authors: Rathee Rupa , Sharma Vandana
Published: June 2024

This study examines the relationship between meaningful and challenging work, workplace environment and employee engagement. It addresses the dearth of empirical research in this area and utilises Khan’s (1990) model of engagement as the theoretical framework. The research design employed a cross-sectional descriptive approach, with a sample of 981 employees from the IT, banking, telecommunications and education sectors, selected using quota non-probability sampling. A self-reported questionnaire measured the hypothesised relationships between job design characteristics (JDC), workplace environment (WPE) and employee engagement, analysed using structural equation modelling and AMOS. The findings indicate that both meaningful and challenging work and workplace environment significantly impact employee engagement. However, meaningful and challenging work demonstrates a stronger effect ( = 0.79, p < .000) compared to the workplace environment ( = 0.24, p < .000) in predicting employee engagement. These results contribute to the academic literature by emphasising the importance of integrating meaningful and challenging work and cultivating a positive workplace environment to enhance employee engagement. The study offers practical implications for HR managers, highlighting the need to focus on job design characteristics and improve the workplace environment to foster meaningfulness in work. By doing so, organisations can enhance employee performance and productivity and reduce turnover intentions.
Plasma calcitonin gene-related peptide levels in idiopathic intracranial hypertension: an exploratory study
Authors: Krajnc Nik , Frank Florian , Macher Stefan , Michl Martin , Müller Nina , Maier Sarah , Zaic Sina , Wöber Christian , Pemp Berthold , Broessner Gregor , Bsteh Gabriel
Published: June 2024

Background

Idiopathic intracranial hypertension (IIH) is a debilitating condition characterized by increased intracranial pressure often presenting with chronic migraine-like headache. Calcitonin gene-related peptide (CGRP) plays an important pathophysiological role in primary headaches such as migraine, whilst its role in IIH has not yet been established.

Methods

This longitudinal exploratory study included patients with IIH, episodic migraine (EM) in a headache-free interval and healthy controls (HC). Blood samples were collected from a cubital vein and plasma CGRP (pCGRP) levels were measured by standardized ELISA.

Results

A total of 26 patients with IIH (mean age 33.2 years [SD 9.2], 88.5% female, median BMI 34.8 kg/m2 [IQR 30.0–41.4]), 30 patients with EM (mean age 27.6 years [7.5], 66.7% female) and 57 HC (mean age 25.3 years [5.2], 56.1% female) were included. pCGRP levels displayed a wide variation in IIH as well as in EM and HC on a group-level. Within IIH, those with migraine-like headache had significantly higher pCGRP levels than those with non-migraine-like headache (F(2,524) = 84.79; p < 0.001) and headache absence (F(2,524) = 84.79; p < 0.001) throughout the observation period, explaining 14.7% of the variance in pCGRP levels. CGRP measurements showed strong intraindividual agreement in IIH (ICC 0.993, 95% CI 0.987–0.996, p < 0.001). No association was found between pCGRP levels and ophthalmological parameters.

Conclusions

Although interindividual heterogeneity of pCGRP levels is generally high, migraine-like headache seems to be associated with higher pCGRP levels. CGRP may play a role in the headache pathophysiology at least in a subgroup of IIH.