bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of cystoscopy as primary initial investigation in interstitial cystitis/bladder pain syndrome
Authors: Singh Angadjot , Priyadarshi Shivam , Bansal Somendra , Nandwani Sanyam 
Published: September 2023

Introduction: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic painful bladder condition characterized by pelvic pain and urinary symptoms without another identifiable cause. Cystoscopy as primary initial investigation for IC/BPS has not been accepted yet and needs more studies to definitely conclude. Aims and objectives: We aimed to assess cystoscopy findings in patients of interstitial cystitis/bladder pain syndrome and to prove role of cystoscopy as primary initial investigation for interstitial cystitis/bladder pain syndrome. Materials and methods: Our prospective observational study included 35 female patients aged 18–69 years presenting to the Urology OPD at SMS Hospital with suprapubic or pelvic pain for 6 months, bladder pain that worsens with bladder filling and reduced with voiding, dysuria, urinary frequency and urgency, nocturia, dyspareunia. Those with history of bladder capacity more than 350 ml, duration of symptoms less than 6 months, day time frequency less than eight times per day, diagnosis of bacterial cystitis or prostatitis, bladder or ureteral calculi, active genital herpes, any existing urological malignancy, radiation cystitis were excluded from the study. They were then subject to cystoscopy and the findings of the cystoscopy were analyzed. Results: Out of the 35 patients, 11 (31.43%) had a normal cystoscopy. Of the 24 patients (68.57%) who had a positive cystoscopy, cystoscopy in seven patients (20.0%) revealed an ulcer. All these seven patients underwent fulguration. In the remaining 17 patients the abnormal findings were petechiae, large submucosal bleed. The sensitivity of cystoscopy in detecting the ulcerative type of Interstitial cystitis was found to be 20.0%. Conclusion: Our study found that Cystoscopy, if employed in initial investigation can help early detection of ulcerative variety of IC/BPS and can act as therapeutic modality by using fulguration plus hydrodistension. Larger comparative studies are needed for diagnostic/Therapeutic value of cystoscopy.
Assessing pentafecta outcomes post radical cystectomy: A tertiary care center study
Authors: Singh Vikram , Sarangi Shakti Swarup , Bhirud Deepak Prakash , Sharma Kartik , Tripathi Shashank Shekhar , Choudhary Gautam Ram , Singh Mahendra , Navriya Shiv Charan , Sandhu Arjun Singh 
Published: September 2023

Introduction: Bladder cancer is a common and serious disease globally, often requiring radical cystectomy as the preferred treatment. However, this procedure carries substantial risks and complications. To evaluate its success, pentafecta, a five-component measure, was introduced. This study investigates the attainment of pentafecta following radical cystectomy and examines factors that influence its achievement. Methodology: This retrospective, single-group study was conducted at AIIMS Jodhpur. The study population included 42 patients who underwent radical cystectomy for bladder cancer. Various data, including demographic characteristics, clinical features, surgical techniques, and postoperative outcomes, were collected from medical records. The primary outcome measure was the rate of achieving pentafecta, which comprises five parameters. Results: Out of 42 patients, 26 (61.9%) achieved pentafecta. Age, gender, comorbidities and surgical approach did not significantly affect the attainment of pentafecta. Negative surgical margins were achieved in 95.2% of cases, and adequate lymph node dissection (>16 lymph nodes) was performed in 85.7% of cases. The absence of Clavien-Dindo grade 3–5 complications and recurrence was observed in 80.9% and 90.47% of cases, respectively. Uretero-enteric stricture was absent in 95.2% of cases. Conclusion: The study emphasizes the significance of negative surgical margins, thorough lymph node dissection, absence of complications, recurrence, and uretero-enteric strictures in evaluating the success of radical cystectomy as pentafacta outcomes. Patients with higher drain output and wound infections are less likely to achieve pentafacta outcome and indicates poorer outcome. By considering these factors, clinicians can assess patient outcomes and identify areas for improvement.
Does mirabegron have a potential role as a medical expulsive therapy in the treatment of distal ureteral stones? A prospective randomized controlled study
Authors: Samir Mohamed , Awad Ahmed Fouad , Maged Wael Ali 
Published: September 2023

Background: The existence of β3 receptors in the bladder and ureter was documented in many studies on animals and humans, it was documented that relaxation of the lower ureteral segment is achieved by the stimulation of these receptors. Our aim was to assess the efficacy and safety of mirabegron as a medical expulsive therapy (MET) for distal ureteral stones in comparison with silodosin and placebo. Methods: One hundred eighty patients with distal ureteral stone of 5–10 mm size were included in our study. They were divided into three groups, and each one consisted of 60 patients. Group I was given silodosin 8 mg, group II mirabegron 50 mg and group III placebo once daily. The treatment was prescribed for all the cases till stone expulsion or a maximum duration of 4 weeks. Primary outcome was the stone expulsion rate (SER). While secondary outcomes were stone expulsion time, side effects of the used drugs, hospital visits number for pain, and amount of analgesic taken. Results: We found that the SER was significantly higher in silodosin than mirabegron and placebo groups (61%, 38.6%, and 36.7%, respectively) ( p = 0.013). Also, the stone expulsion interval was significantly shorter in silodosin than mirabegron and control groups ( p < 0.001). While hospital visits number for pain, and amount of analgesic taken were comparable. There was no difference between the studied medications in terms of the adverse effects except for retrograde ejaculation (silodosin = 63.3%, mirabegron = 0%, and placebo = 0%; p < 0.001). Conclusion: Mirabegron has no medical expulsive effect. While silodosin improves SER and stone expulsion time. However, retrograde ejaculation was its main side effect and occurred in 63.3% of the male patients. Therefore, more research is needed to discover a more tolerable MET.
The Value Form and the Fetishism of the Commodity
Authors: Nagatani Kiyoshi 
Published: September 2023

Based on Uno’s new insight that in the first chapter on the commodity, the value of a commodity is not yet defined as objectified abstract labor, this article first examines the problems in Marx’s value form theory and presents a new understanding of the simple, the expanded, and the general value form, and reformulates the theory of the commodity into a dialectical whole composed of the world of commodities. Second, the article responds to Elena Lange’s critique of Uno’s value theory. Third, the article argues that fetishism of the commodity never originates from alienated abstract labor but from a specific relationship between commodity owners; therefore, the theories of value form and fetishism of the commodity address the common theme. A reformulated theory of the value form should integrate, not omit, the fetishism of the commodity within it. JEL Classification: B14, B41, D46
An accurate analytical model for stress overload around multiple fiber breakpoints in unidirectional fiber reinforced plastic
Authors: Yu Zhenni , Zhu Fulei , Cheng Yuanqi , Tian Jia 
Published: September 2023

Efficient and accurate calculation of stress overload and stress redistribution near the fiber breakpoint is the basis for simulating the tensile damage evolution of unidirectional fiber reinforced plastic (FRP), and it is also the premise for predicting the tensile-tensile fatigue life. In this study, an efficient finite element (FE) model with a large number of fibers was developed based on the FE method to calculate stress concentration factor (SCF) near multiple breakpoints, and the calculation time only takes 3 min on average. The FE model is used to efficiently calculate multiple breakpoints and the stress distribution near the breakpoint considering the interface debonding. Based on the efficient FE model, an analytical model is developed to calculate the stress overload superposition around multiple breakpoints. In this analytical model, the shear stress distribution near the broken fiber elements is established based on the experiment, and the stress redistribution mechanism near the breakpoint in FRP with random distribution of fibers is established. Moreover, the calculation method of stress overload near multiple break points is established, and the FE method is verified.
Factors influencing left ventricular diastolic dysfunction on echocardiography of people living with HIV in Kunming, China
Authors: Pan Shuishui , Bai Jinsong 
Published: September 2023

Background The widespread use of antiretroviral therapy has prolonged the survival of people living with HIV (PLWH). Among these patients, co-existing cardiovascular diseases, particularly left ventricular diastolic dysfunction (LVDD), are receiving increasing attention. Methods We recruited 386 patients in the PLWH group and 386 sex- and age (± 3 years)-matched individuals in the HIV-negative group, and used logistic regression to determine the risk factors of LVDD. Results Compared to the HIV-negative group, PLWH had a significantly higher prevalence of smoking ( p < .001), alcohol consumption ( p < .001), hypertension ( p = .002), diabetes ( p = .020), and hyperlipidemia ( p < .001) and a lower prevalence of body mass index (BMI) ≥ 24.0 kg/m2 ( p < .001). The prevalence of LVDD on echocardiography was significantly higher in PLWH than in the HIV-negative group (25.9% vs 16.1%, p = .001). The multivariate analysis showed that non-youth (OR = 8.666; 95%CI = 4.310-17.459; p < .001), BMI ≥ 24.0 kg/m2 (OR = 1.992; 95% CI = 1.007-3.939; p = .048), hypertension (OR = 1.888; 95% CI = 1.044-3.415; p = .036), hyperlipidemia (OR = 1.911; 95% CI = 1.068-3.418; p = .029), and HIV infection (OR = 2.003; 95%CI = 1.341-2.992; p = .001) were risk factors for LVDD. Conclusion The rate of echocardiographic abnormalities was higher in PLWH. LVDD was associated with non-youth, BMI ≥ 24.0 kg/m2, hypertension, hyperlipidemia, and living with HIV.
Health and social care workers’ professional values: A cross-sectional study
Authors: Pakkanen Piiku , Häggman-Laitila Arja , Pasanen Miko , Kangasniemi Mari 
Published: September 2023

Background Professional values create a basis for successful collaboration and person-centred care in integrated care and services. Little is known about how different health and social care workers assess their professional values. Research aim To describe and compare professional value orientation among different health and social care workers in Finland. Research design A quantitative cross-sectional study. Participants and research context We carried out an online survey of health and social care workers from 8 March to 31 May 2022, using the Finnish version of the Nurses’ Professional Values Scale-3. The data were analysed using descriptive and advanced statistics. Ethical considerations Permission was received from all participating organizations and those who completed the survey provided informed consent. Results A total of 1823 health and social care workers, representing seven professional groups and students, took part. The overall level of professional values among the participants was relatively high. Commitment to providing patients and clients with equal care was more important than engaging with society and professional responsibilities in the work environment. Professional values were strongest among professionals with higher educational degrees and training in professional ethics. The same was true for workers who received organizational support for ethical practice, were satisfied with their work and had shorter work experience. Discussion Our results showed shared professional values among different health and social care workers and students. These results are meaningful for integrated care and services. At the same time, a clear need for strengthening engagement with society and professional responsibilities for developing work environments were identified. Conclusions Health and social care workers and students need training in professional ethics and organizational support for ethical practice and work satisfaction to maintain their professional values at different stages of their career.
Improving Early Initiation of Breastfeeding in Newborns Delivered at a Tertiary Care Hospital: A Quality Improvement Study
Authors: H Anil , Patel Shradha , Pujara Reshma , Patel Dipen , Nimbalkar Somashekhar 
Published: September 2023

Introduction Neonatal mortality is the major contributor for under five mortality. WHO and UNICEF have mentioned that it is vital to initiate breastfeeding within the first hour of birth for reducing mortality. In India, it has been reported that only 42.7% babies receive breastfeeding within 1 hour of birth, and at our institute, we noticed only 61% of stable babies delivered vaginally received breastfeeding within 1 hour of birth. So, we planned a quality improvement study at our hospital using POCQI (point of care quality improvement). Aims and Objectives To increase the early initiation of breastfeeding (EIBF) practice in neonates born through vaginal delivery at or above 36 weeks of gestation from the observed baseline of 61% to >85% over 3 months period. Methods The study was conducted in Labor Room of a tertiary care hospital over a period of three months (Dec 2022–Feb 2023) and a sustenance phase from April 2023 to June 2023. A root-cause analysis was done using the fishbone framework focusing on various barriers related to mothers, hospital staff, policy, place, and practices. Based on this, a comprehensive early breastfeeding initiation intervention was planned utilizing Plan-Do-Study-Act (PDSA) cycles. Results At the end of the 3 months, we were able to achieve 100% compliance in EIBF from baseline of 61% and same compliance was maintained during sustenance phase. Run charts used for interpretation showed increase in compliance and reduction in time of initiation of breastfeeding. Conclusion This study brought out various hurdles to EIBF and demonstrated that it can be improved by using simple quality improvement model.
Designing Simulation to Improve Production Efficiency of Batik Industry
Authors: Kristiana Stefani Prima Dias , Asih Anna Maria Sri , Sudiarso Andi 
Published: September 2023

Background The study deals with evaluating the production system for manufacturing batik, then developing a scenario for improving the system. Purpose The study aims to point out the possibilities of computerized simulations in designing, testing, and exploring scenario models of real production plants of Small-Medium enterprises (SMEs). Method The research is carried out as a case study, using a simulation approach to achieve the objectives. This study uses three data collection techniques: direct observation, qualitative interviews, and time study. The simulated model of the system is the basis for building improvement strategies. Results The simulation model yields more than 70% of the overall process time mainly consisting of idle time and waiting for the operator. It leads to an inefficient production system. Significant differences in processing time and assigning operators to workstations that are unbalanced cause inefficiency. Although most of the time was not efficient, the average utilization of the operator was 63.96%. The system has a good operator’s utility level because the average total utility value is higher than idle time. The operators are also responsible for other tasks that were included in the simulation. Discussion The study proves that simulation is a very promising approach that allows industrial owners to mimic the production process and resource assignments within the model. The production efficiency with existing resources can be enhanced with the balancing procedure between the workstations and the operators. The suggested system runs on the concept of assigning operators with lower utility to processes with high WIP queues. The operator can interact with multiple workstations. The proposed model reduces the total time required to produce the batik. Contribution The simulation helps the analyzed organization to evaluate the efficiency of the manufacturing process. Changing the parameters in the model can generate new utilization and efficiency for the system.
Trimethoprim/Sulfamethoxazole vs Minocycline for the Treatment of Nonurinary Monomicrobial Stenotrophomonas maltophilia Infections in Hospitalized Patients
Authors: Hevia Emma C. , Wooten Leslie , Carr Amy L. 
Published: September 2023

Background: Stenotrophomonas maltophilia is an opportunistic, gram-negative bacillus with few therapeutic options due to a high level of intrinsic resistance. Trimethoprim/sulfamethoxazole (SXT) is recommended as the first-line treatment; however, minocycline (MIN) has been shown to have similar clinical outcomes in treating S. maltophilia and addresses concern for increasing resistance to SXT. Objective: The objective of this study is to evaluate the efficacy and safety outcomes of nonurinary, monomicrobial infections due to S. maltophilia in hospitalized patients treated with MIN or SXT. Methods: This was a retrospective study of hospitalized adult patients receiving MIN or SXT for nonurinary monomicrobial S. maltophilia infection from April 1, 2018 to March 31, 2020. The primary outcome was clinical disposition classified as rates of clinical failure, clinical improvement, or clinical success. Results: Eighty-two patients (88.2%) received MIN and 11 patients (11.8%) received SXT initially. Clinical failure occurred in 16 (19.5%) patients in the MIN group and in 4 (36.4%) patients in the SXT group ( P = 0.242). Clinical improvement occurred in 11 (13.4%) patients in the MIN group and in 1 (9.1%) patient in the SXT group ( P = 1.0). Clinical success occurred in 55 (67.1%) patients in the MIN group and in 6 (54.5%) patients in the SXT group ( P = 0.503). Total duration of antimicrobial therapy ( P = 0.3198), in-hospital mortality ( P = 1.0), hospital length of stay ( P = 0.9668), intensive care unit (ICU) length of stay ( P = 0.1384), and 30-day readmission ( P = 0.686) were similar between groups. Conclusions and Relevance: Rates of clinical failure, clinical improvement, or clinical success were similar between MIN and SXT for nonurinary monomicrobial S. maltophilia infections.
Pharmacokinetics of Levetiracetam Seizure Prophylaxis in Severe Traumatic Brain Injury
Authors: Harlan Sarah Schuman , Philpott Carolyn D. , Keegan Shaun P. , Droege Molly E. , Karve Aniruddha S. , Foreman Brandon , Wakefield Devin , Mueller Eric W , Sangha Kiranpal , Ngwenya Laura B. , Courter Joshua D. , Desai Pankaj , Droege Christopher 
Published: September 2023

Background: Drug pharmacokinetics (PK) are altered in neurocritically ill patients, and optimal levetiracetam dosing for seizure prophylaxis is unknown. Objective: This study evaluates levetiracetam PK in critically ill patients with severe traumatic brain injury (sTBI) receiving intravenous levetiracetam 1000 mg every 8 (LEV8) to 12 (LEV12) hours for seizure prophylaxis. Methods: This prospective, open-label study was conducted at a level 1 trauma, academic, quaternary care center. Patients with sTBI receiving seizure prophylaxis with LEV8 or LEV12 were eligible for enrollment. Five sequential, steady-state, postdose serum levetiracetam concentrations were obtained. Non-compartmental analysis (NCA) and compartmental approaches were employed for estimating pharmacokinetic parameters and projecting steady-state trough concentrations. Pharmacokinetic parameters were compared between LEV8 and LEV12 patients. Monte Carlo simulations (MCS) were performed to determine probability of target trough attainment (PTA) of 6 to 20 mg/L. A secondary analysis evaluated PTA for weight-tiered levetiracetam dosing. Results: Ten male patients (5 LEV8; 5 LEV12) were included. The NCA-based systemic clearance and elimination half-life were 5.3 ± 1.2 L/h and 4.8 ± 0.64 hours. A one-compartment model provided a higher steady-state trough concentration for the LEV8 group compared with the LEV12 group (13.7 ± 4.3 mg/L vs 6.3 ± 1.7 mg/L; P = 0.008). Monte Carlo simulations predicted regimens of 500 mg every 6 hours, 1000 mg every 8 hours, and 2000 mg every 12 hours achieved therapeutic target attainment. Weight-tiered dosing regimens achieved therapeutic target attainment using a 75 kg breakpoint. Conclusion and Relevance: Neurocritically ill patients exhibit rapid levetiracetam clearance resulting in a short elimination half-life. Findings of this study suggest regimens of levetiracetam 500 mg every 6 hours, 1000 mg every 8 hours, or 2000 mg every 12 hours may be required for optimal therapeutic target attainment. Patient weight of 75 kg may serve as a breakpoint for weight-guided dosing to optimize levetiracetam therapeutic target attainment for seizure prophylaxis.
‘I live in extremes’: A qualitative investigation of Autistic adults’ experiences of inertial rest and motion
Authors: Rapaport Hannah , Clapham Hayley , Adams Jon , Lawson Wenn , Porayska-Pomsta Kaśka , Pellicano Elizabeth 
Published: September 2023

‘Autistic inertia’ is part of the Autistic community’s everyday lexicon, yet the condition has received scant attention in the academic literature. The little attention it has received has focused on the disabling impact of ‘inertial rest’ (difficulty initiating tasks), with minimal exploration of the potential benefits of inertial motion (difficulty stopping tasks). Here, we sought to investigate Autistic people’s phenomenological experiences of inertial rest and motion and to identify factors that might moderate Autistic inertia. Autistic and non-Autistic researchers conducted semi-structured interviews with 24 Autistic adults. We analysed the data using reflexive thematic analysis, adopting an inductive approach within an essentialist framework. Interviewees spoke in-depth of their inertial ‘difficulties moving from one state to another’ and described how these challenges pervade ‘every single day’. While inertia was described as ‘the single most disabling part of being Autistic’, interviewees also described ways to respond to inertia, including taking pleasure in states of flow, whereby they could become completely absorbed in a task. While inertial difficulties are pervasive, our findings reveal the extreme nature of these task-switching difficulties for Autistic people. Our findings also contribute to a more holistic characterisation of inertia as both a disabling and enabling condition. Lay Abstract ‘Autistic inertia’ is a term used by Autistic people to refer to difficulties with starting and stopping tasks. However, there has not been much research on Autistic inertia. The research that is available on Autistic inertia has mostly focused on the negative aspects of inertia, rather than on the possible benefits of needing to continue tasks. In this research, we wanted to understand more about Autistic people’s experiences of inertia and to work out what things might influence these experiences. Autistic and non-Autistic researchers spoke in-depth to 24 Autistic adults. We identified four key ideas from people’s responses. Autistic people spoke about their inertial ‘difficulties moving from one state to another’ and described how these challenges affected them ‘every single day’. While they experienced inertia as ‘the single most disabling part of being Autistic’, people also described the positive aspects of inertia, including the joy they felt when completely immersed in a task. Our Autistic participants emphasised that inertial difficulties are experienced by everyone, the intensity of these task-switching difficulties might be especially challenging for Autistic people. Our findings also reveal how Autistic inertia can be seen both as a disabling and as an enabling condition.