bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome and Timing of Ostomy Reversal Surgery for Diverticular Disease in Veterans Administration Hospitals
Authors: Napolitano Michael A. , Holleran Timothy J. , Sparks Andrew D. , Zimmermann Jason , Brody Fredrick J. , Duncan James E. 
Published: August 2021

Background Veterans undergoing elective surgery for diverticular disease have an ostomy creation rate of 18%. The purpose of this study was to analyze the outcomes and timing of ostomy reversal surgery, perioperative complications, and differences between colostomy and ileostomy reversal outcomes. Methods A retrospective review of the Veterans Affairs Surgical Quality Improvement Project (VASQIP) database was performed. Patients undergoing elective colectomy for diverticular disease between 2004 and 2018 were identified. Demographics, comorbidities, ostomy type, time to reversal, and postoperative complications were analyzed. Results 4,198 patients underwent elective colectomy for diverticular disease, with 751 patients (17.9%) receiving an ostomy. Of patients who received an ostomy, 407 had ostomy reversal surgery within the Veterans Health Administration system (54.2%), with 243 colostomies, 149 ileostomies, and 15 unspecified. Median time to ostomy reversal was 5.0 months (interquartile range 3.2, 7.8). Complication rate after reversal was 23.1%; surgical site infection was most common (9.1%). Patients with American Society of Anesthesiologists classification >3 (adjusted odds ratio (aOR) = .40[.22-.72]), increasing age (aOR = .98[.97-.99]), laparoscopic index procedure (aOR = .42[.27-.63]), and hypertension (aOR = .63[.46-.87]) were less likely to have their ostomy reversed. There were no differences in postoperative complication rates after ostomy vs ileostomy reversals. Reversals after 4.6 months were associated with 3.4-times higher odds of complications. Conclusion Ostomy creation and reversal rates are similar between the veteran and non-veteran populations in the United States. Delays in reversal surgery were associated with worse postoperative outcomes, which underscore the importance of close follow-up for patients with an ostomy after elective colectomy for diverticular disease.
How Do Human Resource Management Practices Affect Innovation of Small- and Medium-sized Enterprises in a Transition Economy?
Authors: Nam Vu Hoang , Luu Hiep Ngoc 
Published: August 2021

Small- and medium-sized enterprises (SMEs) are one of the engines for inclusive economic growth. Yet little is known about the contribution of human resource management (HRM) practices to the success of SMEs. This study empirically examines how HRM practices determine different categories of innovation of SMEs in the context of a transition economy. Using a longitudinal dataset and applying the instrumental variable methodology to correct for endogeneity problems, our study uncovers that HRM practices positively affect the quality of employed human and physical capital assets of SMEs. More importantly, we find that that HRM practices significantly contribute to the launch of new products and improvement of existing products. In addition, we also find that the adoption of HRM practices facilitate labour productivity and value added. Taken together, these findings highlight that HRM practices are a strategic resource for innovation and development of SMEs in transition economies by rewarding them with higher-quality capital assets. JEL: L25, O15, O31
Outcome of simultaneous angioembolization and nephron sparing surgery in large renal angiomyolipomas
Authors: Malik Abdul Rouf , Ali Shayesta , Kumar Venkatesh , Sharma Mahendra , Rawat Vijay , Agarwal Anshuman 
Published: August 2021

Aim: To study the outcome of simultaneous angioembolization and nephron sparing surgery in large renal angiomyolipomas. Materials and methods: A prospective study of carried out from 2016 to 2019. A total of 15 patients were included in the study with a lesion (angiomyolipoma) more than 10 cm in size, suitable for nephron sparing surgery. The workup of the patients included history, baseline blood investigations, ultrasonography, and CT urography including angiographic films. All the patients were taken up for selective of angioembolization of the feeding vessels of the AML carried out by the interventional radiologist followed by nephron sparing surgery in the same sitting. The short term outcomes studied were warm ischemia time, average blood loss, and length of post-operative hospital stay. The oncological outcome was evaluated by noting the surgical margins of histopathological specimen and functional outcome by assessing the function of the preserved renal parenchyma. Results: Twelve out of fifteen cases were female. The mean age was 42.25 years. All the patients had lesion more than 10 cm with seven tumors located at the lower pole, four at mid-pole, and four at upper pole. Eight patients had low complexity score on RENAL score (i.e. 4–6), five patients medium complexity score (i.e. 7–9), and two had high complexity score (i.e. ⩾10). Average blood loss was 200 ml, warm ischemia time was 18.46 min and postoperative stay was 3.55 days. All the 15 specimens sent for histopathology were confirmed as AML (angiomyolipomas) with margins free of tumor. Follow up CECT done at 4 months postoperatively revealed functioning residual renal parenchyma with prompt excretion of contrast. Conclusion: Large AML’s are also amenable to nephron sparing surgery. However patient should always be warned about the possibility of total nephrectomy. Selective angioembolization helps in reducing the blood supply and risk of torrential bleeding thus facilitates in the removal of the tumor and increasing the chances of nephron sparing surgery.
Downregulation of miR-29b is associated with Peyronie’s disease
Authors: dos Santos Vinicius Genuino , dos Santos Gabriel Arantes , Neto Cristóvão Barbosa , Viana Nayara Izabel , Pimenta Ruan , Guimarães Vanessa Ribeiro , Candido Patrícia , Romão Poliana , de Camargo Juliana A. , Leite Katia Ramos Moreira , Srougi Miguel , Cury José , Nahas William C. , Reis Sabrina Thalita 
Published: August 2021

Background: Peyronie’s disease (PD) is characterized by the formation of fibrous plaque in tunica albuginea, causing several problems in patients. The etiology of this disease is not fully understood, and there are few effective treatments. To better understand the molecular pathways of PD, we studied miR-29b, a microRNA that could be involved with this illness. MicroRNAs are endogenous molecules that act by inhibiting messenger RNA. MiR-29b regulates 11 of 20 collagen genes and the TGF-β1 gene, which are related to PD progression. Methods: We compared miR-29b expression in 11 patients with PD and 14 patients without PD (control group). For the patients with PD, we utilized samples from the fibrous plaque ( n = 9), from the tunica albuginea ( n = 11), and from the corpus cavernosum ( n = 8). For the control group, we utilized samples from the tunica albuginea ( n = 14) and from the corpus cavernosum ( n = 10). MiR-29b expression was determined by q-PCR. Results: We found a downregulation of miR-29b in the fibrous plaque, tunica albuginea and corpus cavernosum of patients with PD in comparison with the control group ( p = 0.0484, p = 0.0025, and p = 0.0016, respectively). Conclusion: Although our study has a small sample, we showed for the first time an evidence that the downregulation of miR-29b is associated with PD.
Patterns of Fitbit Use and Activity Levels Among African American Breast Cancer Survivors During an eHealth Weight Loss Randomized Controlled Trial
Authors: Ferrante Jeanne M. , Lulla Aaron , Williamson Julie D. , Devine Katie A. , Ohman-Strickland Pamela , Bandera Elisa V. 
Published: August 2021

Purpose: This study examined adherence with a physical activity tracker and patterns of activity among different subgroups of African American/Black breast cancer survivors (AABCS). Design: Secondary analysis of weight loss trial that used an activity tracker (FitBit) with or without a commercial eHealth program (SparkPeople) over 12 months. Setting and Subjects: AABCS (N = 44) in New Jersey. Measures and Analysis: Adherence with tracker use, steps per day, and active minutes per week were compared by demographic and clinical characteristics using nonparametric statistics. Results: Median adherence was over 6 days per week throughout the 12-months. Adherence was significantly correlated with steps and active minutes (p < 0.015). Groups with lower adherence included: those with 5 or more conditions (p = 0.039), had higher number of household members (p = 0.008), and younger than 60 years (p = 0.044). Median number of steps per day remained consistently around 7000 throughout 12 months. Factors associated with lower activity included: age > 60; retirement; higher number of household members, comorbidity, or baseline BMI; and those in the SparkPeople + Fitbit group. Self-monitoring, goal setting, and self-efficacy were significantly correlated with activity levels (p < 0.05). Conclusion: Use of a physical activity tracker may help increase activity levels in AABCS. Certain subgroups, e.g. those older than age 60 years, retired, with BMI over 40, higher number of comorbidities or more household members, may require additional interventions.
Analysis of the free-space acoustic signature of a BBMF Rolls-Royce Merlin engine from 842 rpm to 2740 rpm
Authors: Bennett John C 
Published: August 2021

A technique has been developed to analyse the free-space acoustic signature of the Rolls-Royce Merlin engine in order to provide diagnostic information relating to its performance. The work is motivated by a need to maintain the reliability and maximise the lifetime of this historic engine which is an important component of the aircraft operated by the UK Battle of Britain Memorial Flight (BBMF). For convenience, the data were extracted from the soundtrack of a video recording made whilst the aircraft was undergoing a full-power ground-run. The aim of the work is to generate information relating the individual firings of each cylinder and this is presented as a multi-level colour image. Here, the ignition time history for two revolutions (six ignitions) is shown vertically and corresponds to the bank of exhaust ports facing the microphone. Subsequent similar histories are presented along the horizontal time axis. The results are sensitive to engine speed variations, and a correlation between successive vertical columns is carried out to quantify this drift and adjust the data accordingly. Seven engine speeds from 842 to 2740 rpm are examined. The processed data illustrate that some speeds exhibit well-defined, single ignitions whereas others show varying degrees of after-firing type effects. At the higher engine speeds, it would seem that the cylinder ignition amplitudes become much more irregular, and the results for 2740 rpm indicate a breakdown in engine performance. The coefficient of variation (Cv) has been demonstrated as a measure of these factors. Finally, a technique has been proposed and demonstrated for the identification of individual cylinders in the firing sequence. The data acquisition process is relatively straight-forward and should not demand excessive time to cover a full range of engine speeds. With further investigations, it could be possible to readily relate the imaging results to specific engine faults.
Assessment of ethical competence among clinical nurses in health facilities
Authors: Maluwa Veronica Mary , Maluwa Alfred Ochanza , Mwalabu Gertrude , Msiska Gladys 
Published: August 2021

Background: Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty. Objectives: The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi. Methodology: A cross-sectional survey was conducted in four selected hospitals in Malawi with a sample of 271 clinical nurses. Data were collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0. Ethical consideration: The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi. Results: The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p < 0.05) of nurses 57% (n = 135) with low ethical competence. There was no significant association between respondents’ demographic variables and level of ethical competence (p > 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings. Conclusion: The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence.
Respiratory Distress in Hospitalized Non-Mechanically Ventilated COVID-19 Adults: A Retrospective Multicenter Cohort Study
Authors: Liberman Tara , Lopez Santiago , Roofeh Regina , Izard Stephanie , Parikh Sima , Burns Edith 
Published: August 2021

Background: COVID-19 typically presents with respiratory symptoms which may progress with severe disease. There are standard guidelines for managing respiratory distress (e.g. opioids, anxiolytics) and palliative care teams are well versed in managing these symptoms. Aim: Determine the extent to which hospitalized COVID-19 patients with moderate respiratory distress received medications or palliative consultation for symptom management and if these interventions had any association with outcomes. Design: Retrospective chart review for hospitalized COVID-19+ patients from March 2-April 30, 2020. Setting: Large integrated health system in the New York Metropolitan area. Patients: 312 adult patients hospitalized with COVID-19 with an order for a non-rebreather mask and meeting criteria for moderate respiratory distress on the Respiratory Distress Observation Scale: concurrent respiratory rate ≥30 and heart rate ≥110 at any point during hospitalization. Patients receiving mechanical ventilation or intensive care were excluded. Results: Most COVID-19 patients experiencing moderate respiratory distress did not receive medications or palliative consultation for symptom management. Patients who received medications were predominantly white, older, and had a Do-Not-Resuscitate order. Patients who received a palliative consultation were more likely to be older, female, and white, with a Do-Not-Resuscitate order. Mortality was similar between those receiving medication and those who did not. Conclusion: Medications and palliative expertise for symptom management were underused for patients with moderate respiratory distress due to COVID-19. Education and triggers may help providers to identify moderate respiratory distress and consider symptomatic treatment and palliative consultation when appropriate.
Feline urinary incontinence: a retrospective case series (2009–2019)
Authors: Mérindol Isabelle , Dunn Marilyn , Vachon Catherine 
Published: August 2021

Objectives The objective of this retrospective study was to describe the feline population presented for urinary incontinence at a veterinary teaching hospital between 2009 and 2019, with a particular focus on cats with a non-neurologic underlying cause. Methods The medical records of cats diagnosed with urinary incontinence were retrospectively evaluated. Signalment, clinical presentation, results of diagnostic tests, diagnosis of the underlying cause and treatments were recorded. When information was available, outcome was recorded and follow-ups divided into three time frames (0–1 week, 1 week to 3 months and >3 months). Results Thirty-five cats were presented with urinary incontinence. Of these, 18 cats with complete medical records presented urinary incontinence of non-neurologic origin. The most common clinical signs at presentation were urine leakage while resting (12/18), urine-soiled perineum (8/18), urine dribbling (8/18) and no spontaneous micturition (5/18). The most common underlying cause was urethral obstruction (67%; 12/18), with a majority due to urethral strictures (58%; 7/12). Other causes were suspected inflammation (2/12), neoplasia (1/12), urolithiasis (1/12) and foreign body (1/12). In 8/10 cats in which it was performed, cystoscopy and contrast cystourethrography were the methods that led to the diagnosis. Twelve cats with urethral obstruction underwent interventional procedures, resulting in complete resolution of incontinence in 7/12 and improvement in 1/12. Urinary tract infection was a common complication after 3 months (4/18). Conclusions and relevance When incontinence of non-neurologic origin is suspected in a cat, urethral obstruction should be considered. Advanced imaging studies (cystoscopy and contrast studies) are useful for diagnosis. A good prognosis was reported in cats undergoing interventional procedures with no long-term treatment.
Experiences of people with dementia and their caregivers during the COVID-19 pandemic in India: A mixed-methods study
Authors: Rajagopalan Jayeeta , Arshad Faheem , Hoskeri Rakshith Maneshwar , Nair Vasundharaa S , Hurzuk Saadiya , Annam Harikrishna , Varghese Feba , BR Renuka , Dhiren Shah R , Ganeshbhai Patel V , Kammammettu Chandrasekhar , Komaravolu Shashidhar , Thomas Priya T , Comas-Herrera Adelina , Alladi Suvarna 
Published: August 2021

Background The COVID-19 pandemic has unprecedented consequences for the management of chronic diseases such as dementia. However, limited evidence exists on the condition of persons with dementia and their caregivers during the pandemic in lower-middle-income countries (LMICs). The study aimed to provide insights into the experiences of persons with dementia and their families during the early phases of the pandemic in India. Methods This study adopted a mixed-method approach. One hundred and four persons with dementia and their caregivers were evaluated via telephone using validated instruments and a semi-structured interview guide. We used the quantitative data collected to establish a baseline, whereas qualitative data were analysed thematically. Results The study revealed that persons with dementia and their caregivers experienced difficulties during the pandemic, which included worsening of behaviour, problems in accessing care, disruptions in functional activities and struggles in enforcing infection prevention contributing to caregiver distress. An important finding that emerged was the unchanging reality of caregiving for families. The relative success of the public health response to the COVID-19 pandemic contrasted with the lack of awareness and formal support for dementia. Conclusions The COVID-19 pandemic has exposed the vulnerabilities of persons with dementia and their caregivers. This calls for a collaborative reframing of medical care and public health policies to address dementia care.
Resilience and supporting people living with dementia during the time of COVID-19; A qualitative study
Authors: Hanna Kerry , Giebel Clarissa , Butchard Sarah , Tetlow Hilary , Ward Kym , Shenton Justine , Cannon Jacqueline , Komuravelli Aravind , Gaughan Anna , Eley Ruth , Rogers Carol , Rajagopal Manoj , Limbert Stan , Callaghan Steve , Whittington Rosie , Shaw Lisa , Donnellan Warren , Gabbay Mark 
Published: August 2021

Objectives To explore the different factors of resilience for people living with dementia and unpaid carers, in response to sudden changes in care and lifestyle during the COVID-19 pandemic. Methods Unpaid carers and people living with dementia were offered telephone interviews in April 2020 to discuss their experiences since the COVID-19 pandemic. Participants were asked about the benefits and challenges of accessing dementia support, as well as coping, symptoms, strategies and impacts. Each transcript was analysed using inductive and deductive thematic analysis by two researchers. Findings Semi-structured interviews from 50 participants ( n = 42 unpaid carers and n = 8 people living with dementia) reported protective and risk factors of resilience concerning (1) communication, (2) adaptations, (3) support networks and (4) lifestyle factors and coping mechanisms. Conclusions Resilience factors considered both organisational factors for external support, along with individual coping mechanisms. Organisations and social support services should consider resilience factors in future service planning, to better support people living with dementia, or caring someone living with dementia, during times of great stress. The ecological model of resilience established from this research refers to resilience during times of unexpected change in the COVID-19 pandemic; however, it could be considered relevant in other periods of high stress within this cohort.