bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation and Treatment of Acute Laryngeal Injury at Time of Tracheostomy for Prolonged Intubation
Authors: Kavookjian Hannah , Huang Emily Y. , Akst Lee M. , Best Simon R. , Hillel Alexander , Motz Kevin 
Published: November 2024

Objectives: The primary objective was to assess incidence and severity of acute laryngeal injury (ALgI) following intubation at time of tracheostomy using a proposed grading scale. The secondary objective was to evaluate what factors influence the rate of decannulation. Methods: Single institution cohort study with review of prospectively maintained database including patients from October 2021 to October 2022 who underwent tracheostomy for prolonged intubation/critical illness. Severity of ALgI was graded as mild, moderate, or severe based on intraoperative endoscopic findings (laryngeal mucosal ulceration and/or granulation tissue). Rates of tracheostomy decannulation were collected as the secondary outcome measure. Results: Twenty-eight patients met criteria for inclusion. About 60.7% (n = 17) patients were female. Average age was 59.0 ± 13.2 years old. Average body mass index was 32.3 ± 14.0 kg/m2. The most common endotracheal tube size was 7.5 (range = 6.0-8.0) inner diameter (ID) for men and 7.0 (range = 5.5-8.0) ID for women. Average Charlson Comorbidity Index (CCI) was 4.8 ± 2.4. Length of intubation was 15.7 ± 6.5 days (range = 5-30). Direct laryngoscopy at the time of tracheostomy demonstrated ALgI in 92.8% (n = 26) of patients. This was graded as mild (25.0%, n = 7), moderate (42.9%, n = 12), or severe (25.0%, n = 7). Severe ALgI was correlated with a reduced rate of tracheostomy decannulation compared to no/mild/moderate ALgI (28.5% vs 81.2%, P = .04). Conclusions: ALgI is highly prevalent in patients undergoing tracheostomy for prolonged intubation. Severe injury is associated with reduced rates of decannulation. Direct laryngoscopy at time of tracheostomy is warranted to diagnose ALgI and guide interventions. Determining the extent of laryngeal injury is prognostic and could help tailor follow-up and management strategies. Level of evidence: 4.
Prediction of Clinical Response to Dupilumab for CRSwNP Based on the Amsterdam Classification of Completeness of Endoscopic Sinus Surgery (ACCESS) Score
Authors: Pace Gian Marco , Giombi Francesco , Pirola Francesca , Cerasuolo Michele , Heffler Enrico , Paoletti Giovanni , Puggioni Francesca , Mercante Giuseppe , Spriano Giuseppe , Malvezzi Luca 
Published: November 2024

Purpose: Although the effectiveness of molecular antibodies has been established, evidence is still lacking on objective predictors of response. The aim of this study was to assess whether the extent of previous endoscopic sinus surgeries, assessed by means of the Amsterdam Classification of Completeness of Endoscopic Sinus Surgery (ACCESS) score, may influence clinical outcomes in refractory CRSwNP patients treated with dupilumab. Materials and Methods: A consecutive sample of patients treated with dupilumab for previously operated recalcitrant CRSwNP were enrolled in the study. Every patient was required to undergo a CT scan at baseline (T0), at 3 (T1), and 12 (T2) months after treatment start. ACCESS score was calculated at baseline, whilst at every timepoint patients underwent assessment of Nasal-Polyp-Score (NPS), Lund-Kennedy-Score (LKS), and had to fill in the 22-item Sinonasal-Outcome-Test (SNOT-22) and Visual-Analog-Scales (VAS) for sinonasal symptoms. Favorable outcome was considered based on EUFOREA guidelines, namely improving at least 3 of the followings: (i) NPS; (ii) SNOT-22; (iii) VAS-olfaction; and (iv) need for systemic corticosteroids. Results: Overall favorable outcome was achieved in 69.1% (n = 38/55) of cases at T1, while in 89.1% (n = 49/55) at T2. There were no differences in baseline characteristics between responders and non-responders at both timepoints. At T1, out of all the included variables, no statistically significant predictor of favorable outcome was observed. Conversely, at T2, ACCESS score was the only confirmed independent predictive factor of response to dupilumab treatment (OR = 0.81 [95% CI = 0.67-0.92], P = .010). Conclusions: Our findings suggest that the extent of previous endoscopic sinus surgeries may have a role in influencing clinical outcomes in patients with refractory CRSwNP undergoing treatment with dupilumab.
From Setback to Success: A Restorative Momentum Model of Success for Students Returning From Academic Dismissal
Authors: Bledsoe Ripsimé K. 
Published: November 2024

Objective: While much research has been conducted on retention, attrition, and college completion among those who voluntarily withdraw from college, few studies have focused on involuntary withdrawal in the form of academic dismissal. Even less scholarship has examined the subsequent restoration of academic momentum for returning students. Furthermore, the lack of appropriate theoretical models directed at readmitted students with past records of academic failure has created a dilemma for institutions. Particularly, when trying to assess readmission policies and establishing programs or interventions to promote academic success and persistence to graduation. This study explores factors that influence restoration of academic momentum among students returning from academic dismissal. Method: Using a sequential, partial mixed methods approach, descriptive and qualitative data was collected through a survey ( N = 171) and student interviews ( N = 11) at a large, public community college. Results: Findings disconfirmed past research that academically dismissed students are primarily underprepared scholastically while confirming life events as a key contributor to dismissal. Results also demonstrated the importance of faculty support and active learning as well as the value of advisors as contextualized change agents in the academic restoration process. Finally, it was evident that returning students possessed motivational attributes conducive to restoring academic momentum, including a strong growth mindset, academic resilience, and high self-determination. Contributions: This study affords a Reconceptualized Restorative Academic Momentum Model of Success to guide and understand the academic and psychosocial experiences of students returning from academic dismissal centered on pre-college influences, classroom teaching and learning experiences, support services, and student motivational attributes.
Education, Racism, and the Pandemic: A Pedagogical-Critical Analysis for Latin America
Authors: Pons-Giralt Maikel , Ulloa-Guerra Oscar , Martínez-Sierra Ricel , del Prado Morales Mirtha , Ortega-Breña Mariana 
Published: November 2024

The pandemic deepened social and educational inequality for Afro-descendants and indigenous people in Latin America and the Caribbean. A regional analytical overview with a focus on Brazil and on the social and educational challenges faced by these people and the epistemological, ontological, and pedagogical alternatives for the inclusion of racialized persons during the pandemic. The analysis points to the need for and the viabililty of exploring innovative pedagogical paths for promoting ethnic-racial inclusion and an antiracist form of education that responds to our contemporary context. La pandemia profundiza las brechas de desigualdad social y educacional para afrodescendientes e indígenas en América Latina y Caribe. Un panorama analítico regional, con foco en Brasil, acerca de los desafíos sociales y educacionales que enfrentan afrodescendientes e indígenas identifica fundamentos y experiencias que durante la pandemia constituyen alternativas epistemológicas, ontológicas y pedagógicas para la inclusión de personas racializadas. El análisis permite corroborar que es necesario y posible explorar caminos pedagógicos innovadores en la promoción de la inclusión étnico-racial y de una educación antirracista que contesten el escenario contemporáneo.
Multi-Prong Formative Evaluation of a Pediatric Clinical-Community Food Access and Nutrition Education Intervention
Authors: Hamdi Nick , Balestracci Kate , Tovar Alison , Corcoran Celeste , Watts Delma-Jean , Tobar Fatima , Samson Margaret , Amin Sarah 
Published: November 2024

Purpose To understand pediatricians’, community partners’, and food insecure parent/caregivers’ perspectives on addressing food access and nutrition education in clinical settings, and to conduct a formative evaluation of a clinical-community food access and nutrition education intervention. Design A mixed-methods evaluation. Setting Data was collected from pediatricians and parents/caregivers recruited from one urban pediatric primary care clinic, and from community partners involved in food access. Participants Pediatricians (n = 14), parents at risk of food insecurity (n = 7), and community partner staff (n = 8) participated in qualitative interviews. Method A cross-sectional survey among pediatricians assessing demographics, nutrition training, and knowledge of food access programs was administered. Semi-structured virtual interviews were conducted to understand experiences with food insecurity and food access programs, and to identify content and delivery preferences for a clinical-community intervention. Descriptive statistics were used to characterize the pediatrician and parent demographics and pediatrician nutrition knowledge. A hybrid deductive-inductive thematic analysis was used to identify emerging themes from qualitative interviews. Results Few pediatricians (n = 3, 11%) reported receiving previous nutrition training, and knowledge-based food access program questions revealed significant gaps in pediatricians’ understanding of program eligibility. Thematic analyses underscore challenges in addressing food insecurity in the clinical setting, gaps in clinical-community partnerships, and barriers to participating in food access programs. Conclusion Findings provide recommendations for the development of clinical-community food access and nutrition education interventions.
Health Care Provider E-Cigarette-Related Advice and E-Cigarette Harm Perceptions Among Youth
Authors: Agbonlahor Osayande , Mattingly Delvon T. , Hart Joy L. , McLeish Alison C. , Walker Kandi L. 
Published: November 2024

Purpose Health care providers (HCP) are uniquely positioned to advise against electronic cigarette (e-cigarette) use, potentially influencing youth perceptions of e-cigarette harms. However, research examining these associations is scant. We examined whether HCP e-cigarette-related advice is associated with youth e-cigarette harm perceptions. Design Cross-sectional study. Setting National Youth Tobacco Survey data (2022). Subjects 21,254 youth aged 9-18 years. Measures E-cigarette harm perceptions (i.e., relative addictiveness, occasional use harm, and secondhand e-cigarette aerosol (SHA) harm) and HCP advice to abstain from using e-cigarettes (yes/no) were assessed. Analysis Adjusted odds ratios were estimated using multinomial logistic regression models. Results Among the sample, 33.9% perceived e-cigarettes as equally addictive to cigarettes, 39.9% perceived occasional e-cigarette use to cause a lot of harm, and 23.3% perceived SHA to cause a lot of harm. Youth who received HCP advice had higher odds of perceiving e-cigarettes as more addictive than cigarettes (OR: 1.64, 95% CI: 1.35-2.00) and causing a lot of harm (OR: 1.49, 95% CI: 1.16-1.90). Youth who received HCP advice had higher odds of perceiving SHA causing little harm (OR: 1.23, 95% CI: 1.04-1.44). Conclusion HCP advice was associated with youth e-cigarette harm perceptions and perceptions that SHA causes little harm. HCP e-cigarette counseling may help inform understanding of harms, which may reduce or prevent use.
Synthesis of a new flame retardant and performance study of flame retardant epoxy resin
Authors: Meng Bowei , Song Miaohui , Liang Bing , Long Jiapeng 
Published: November 2024

This paper aims to study a new halogen-free flame-retardant curing agent, 6,6'-(1,5-bis((4-(4-aminobenzyl)phenyl)amino)pentane-1,5-diyl)bis(dibenzo-oxaphosphinine 6-oxide) (DOPO-DMG). The DOPO-DMG was synthesized using 9,10-dihydro-9-oxa-10-phosphaphenanthrene-10-oxide (DOPO), 4,4-Diaminodiphenyl methane (DDM), and glutaric dialdehyde as raw materials in this paper. The chemical structures of DMG and DOPO-DMG were characterized by 1H NMR and FTIR. The results showed that the DOPO -DMG was successfully prepared. The thermal stability, mechanical and flame properties, as well as the morphology of the char layer in composite materials were investigated separately using TG (Thermogravimetric analysis), tensile and Charpy impact tests, LOI (Limiting Oxygen Index) and UL-94 (UL-94 HB flammability standard), and SEM (scanning electron microscope). When IFR (Intumescent Flame Retardants) was added to the EP, the LOI of the composite material improved. DOPO-DMG exhibited excellent flame-retardant properties and produced no toxic fumes when burned in case of fire. Under optimal conditions, it was found that adding DOPO-DMG with a phosphorus content of 2.01% to the epoxy resin resulted in an LOI of 28.8, UL 94 rating of V-0, tensile strength of 39.1 MPa, impact strength of 5.2 KJ/m2 respectively, and a char yield at 800°C of 25.63%.
The Potential Application of Moringa oleifera Extracts as Natural Preservatives of Chicken Meat
Authors: Dubeni Zimasa Busisiwe , Buwa-Komoreng Lisa V. , Mthi Siza 
Published: November 2024

Background Chicken meat is vulnerable to contamination during processing and storage, leading to spoilage and economic losses. To find natural alternatives to synthetic preservatives, researchers are exploring plant-based options. Purpose This study was aimed at investigating the potential of Moringa oleifera leaf extracts to inhibit microbial growth in chicken breasts. Materials and Methods M. oleifera leaf extracts were added to chicken breasts at various concentrations (1%, 0.7%, 0.5%, and 0.25%). The samples were then stored at 4°C and 25°C for 4 days. The growth of aerobic plate count, Escherichia coli, Listeria monocytogenes, and Salmonella spp. was monitored and observed on 0, 2, and 4 days. Results Results showed that M. oleifera leaf extracts effectively suppressed and delayed bacterial growth. While there was no Salmonella growth in any sample, some treated samples experienced a slight increase in bacterial growth toward the end of the storage period. However, concentrations of 0.5% and 0.25% significantly reduced bacterial growth, even at higher storage temperatures of 25°C. Conclusion Overall, the study demonstrates the potential of M. oleifera leaf extracts as natural preservatives. They can help ensure the safety, quality, and shelf life of chicken meat by inhibiting microbial growth.
Incidence of Venous Thromboembolism Post-Oral Anticoagulation Reversal in Intracranial Hemorrhage Patients
Authors: Abdulla Aliya , Donahue Kevin R. , Hall Courtney , Culver Lauren G. , Morton Celia 
Published: November 2024

Background: Rates of in-hospital venous thromboembolism (VTE) in the intracranial hemorrhage (ICH) population post oral anticoagulation (AC) reversal are as high as 10%. Guidelines recommend the initiation of prophylactic AC 24 to 48 hours post ICH; however, there is no guidance regarding optimal VTE prophylaxis post-reversal. Objective: This study aimed to identify the incidence of thromboembolism post oral AC reversal in patients presenting with ICH and describe VTE prophylaxis timing and agent selection. Methods: This was a retrospective, descriptive study conducted within a single health system. Patients on AC who received reversal agents 4-factor prothrombin complex concentrate (4F-PCC) with or without vitamin K, andexanet alfa, and/or idarucizumab for AC-associated ICH were included. The primary endpoint was incidence of in-hospital VTE post-reversal. Secondary endpoints included AC utilization specifications, length of stay, and in-hospital mortality. Results: There were 118 patients (57%) who received 4F-PCC and 89 patients (43%) who received andexanet alfa for reversal post-ICH. Overall, 195 patients (94.2%) achieved hemostasis. Eight patients had incidence of VTE (3.9%), and of those, 6 patients (75%) were reinitiated on AC, all of which utilized prophylactic heparin. The median time from reversal to VTE was 55.9 days (interquartile range [IQR] = 21.2-72.4). For all patients on AC, the median time to initiation from reversal was 3.98 days (IQR = 2.5-6.01), and for those with incidence of thrombosis, the median time to AC initiation was 6.4 days (IQR = 2.6-13.1). Mortality occurred in 13 patients (6.3%). Conclusion and Relevance: This patient population is complex in that the need to achieve hemostasis with AC reversal must be balanced with the risk of VTE. Further studies are needed to determine the ideal timing and agent selection for VTE prophylaxis initiation post ICH reversal.
A prospective multicentre study of 82 prosthetic joint infections treated with a standardised debridement and implant retention (DAIR) protocol followed by 6 weeks of antimicrobial therapy: favourable results
Authors: Karlsen Øystein E , Snorrason Finnur , Westberg Marianne 
Published: November 2024

Introduction: Prosthetic joint infection (PJI) is a much-feared complication in total joint arthroplasty. Debridement, antibiotics, irrigation and implant retention (DAIR) is often the preferred treatment in acute PJIs, but with varying results. The primary aim of this study was to evaluate the outcome of a high quality DAIR procedure performed according to a consistently applied surgical protocol in early postoperative and acute haematogenous PJIs in hip and knee, and secondary to study risk factors associated with failure. Methods: We performed a prospective multicentre study to evaluate the effect of a standardised protocol-based surgical management (DAIR) emphasising a thorough debridement, followed by 6 weeks of antimicrobial therapy. Empiric parenteral antimicrobial treatment was administered until the results of susceptibility tests were available. No suppressive antimicrobial therapy was given after the 6-week treatment-period. Primary outcome measure was infection control at the 2-year follow-up. Results: A total of 99 patients from 8 Norwegian hospitals were found eligible and included in the study, and 82 patients were finally analysed. 69 of 82 patients (84% [CI, 76–92%]) were successfully treated with this treatment protocol. We found a reduced success rate when patients were treated with a DAIR procedure following an infected revision arthroplasty compared with an infected primary arthroplasty (11/17 (65 %) versus 58/65 (89 %), respectively ( p = 0.02). Conclusions: The success rate of a standardised DAIR procedure with a 6-week antimicrobial treatment was good in PJI following primary arthroplasties. The success rate following PJI in revision arthroplasty was poor, and other treatment options should be considered.
A comprehensive evaluation tool to assess community capacity and readiness for virtual care implementation
Authors: Deason Joseph P , Adams Scott J , Khan Amal , Lovo Stacey , Mendez Ivar 
Published: November 2024

Introduction The rapid evolution and implementation of virtual care technologies for clinical use often exceeds the development of standardized implementation protocols, leading to gaps in the equitable and sustainable adoption of virtual care services, particularly in rural and remote areas. This paper introduces a comprehensive evaluation tool designed to assess community capacity and readiness for virtual care. Methods The development of the tool was informed by experiences from the Virtual Care and Robotics Program at the University of Saskatchewan. It involved a collaborative, multi-stakeholder approach that engaged healthcare leaders, IT experts and community healthcare workers. This iterative process included defining evaluation categories, mapping evaluative domains and refining the tool into a user-friendly checklist manual. Results The tool identifies three key domains for assessing readiness: clinical needs, technology infrastructure and human resources/workflows. It was piloted in the remote community of Fond du Lac, Saskatchewan, where it successfully qualified the community for implementing telerobotic ultrasound services. The tool facilitated local engagement and highlighted the community's specific needs and readiness, enhancing the implementation process. Conclusion This evaluation tool contributes to bridging the gap between the rapid deployment of virtual care technologies and the need for comprehensive, standardized implementation protocols. It offers a structured, practical approach to assessing and enhancing community readiness for virtual care while promoting successful clinical implementation and equitable access to healthcare.
Swedish female and male general surgeons differ in personality traits
Authors: Blohm My , McGrath Aleksandra , Mukka Sebastian , Jolbäck Per 
Published: November 2024

Background and Aims: Evidence suggests that female surgeons achieve comparable or even more favorable outcomes than male surgeons. It is currently unclear what factors contribute to these potential differences. Possible explanations might be differences in personality traits, communication style, attitude, and risk-taking behavior. This cross-sectional study aimed to examine disparities in personality traits between male and female general surgeons in Sweden. Methods: The research was conducted as a cross-sectional study of personality traits. Between August 29, 2022, and December 15, 2023, Swedish specialists in general surgery were invited to participate in an online survey. The survey, assessed with the Big Five Inventory, collected information on self-reported surgeon gender, years in practice, employment data, and differences in personality traits. Results: The analysis encompassed responses from 223 Swedish general surgeons: 121 (54%) males and 102 (46%) females. In contrast to female surgeons, male surgeons were older and had longer surgical experience. A higher proportion of male surgeons were employed in rural hospitals. Higher mean scores were observed in all personality traits among female surgeons. The adjusted analysis showed significantly higher scores for conscientiousness (p < 0.001), extraversion (p < 0.001), agreeableness (p = 0.006), and neuroticism (p < 0.001); however, no such change was observed for openness. Conclusion: This cross-sectional study demonstrates that Swedish female and male surgeons differ in personality traits. The implications of these results could lead to a deeper understanding of the variations in surgical outcomes based on the gender of the surgeon.
Witchcraft as a case of ethnographic murk: Impasse of knowledge, harshness of experience
Authors: Beneduce Roberto , Taliani Simona 
Published: November 2024

Witchcraft has been described as knowledge that resists knowledge. Drawing on our field research on witchcraft, alienation, and violence in Mali and southern Cameroon as well as with migrants coming from sub-Saharan Africa, we consider two main issues. The first concerns the epistemic challenge of ‘witchcraft’ and its satellite notions (mystical weapons, animal metamorphosis, fetish and so forth). We analyse this ‘challenge’ beyond the problems of translation, both as a particular expression of African perspectivism and an unending struggle concerning epistemic sovereignty. The second issue directly originates from our field research. Prudently, we will try to give a new lease of life to an ethnographic material, studied 20 years ago. We would turn back to some drawings made by students at the primary school of Mbom (Sangmelina, southern Cameroon), and explore the power of what we provisionally define as ‘visual utterances’.