bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disparities in advance care planning rates persist among emergency general surgery patients: Current state and recommendations for improvement
Authors: Johnson Christopher L. , Colley Alexis , Pierce Logan , Lin Joseph A. , Bongiovanni Tasce , Roman Sanziana , Sudore Rebecca L. , Wick Elizabeth 
Published: February 2023

BACKGROUND
Unanticipated changes in health status and worsening of chronic conditions often prompt the need to consider emergency general surgery (EGS). Although discussions about goals of care may promote goal-concordant care and reduce patient and caregiver depression and anxiety, these conversations, as well as standardized documentation, remain infrequent for EGS patients.

METHODS
We conducted a retrospective cohort study using electronic health record data from patients admitted to an EGS service at a tertiary academic center to determine the prevalence of clinically meaningful advance care planning (ACP) documentation (conversations and legal ACP forms) during the EGS hospitalization. Multivariable regression was performed to identify patient, clinician, and procedural factors associated with the lack of ACP.

RESULTS
Among 681 patients admitted to the EGS service in 2019, only 20.1% had ACP documentation in the electronic health record at any time point during their hospitalization (of those, 75.5% completed before and 24.5% completed during admission). Two thirds (65.8%) of the total cohort had surgery during their admission, but none of them had a documented ACP conversation with the surgical team preoperatively. Patients with ACP documentation tended to have Medicare insurance (adjusted odds ratio, 5.06; 95% confidence interval, 2.09–12.23; p < 0.001) and had greater burden of comorbid conditions (adjusted odds ratio, 4.19; 95% confidence interval, 2.55–6.88; p < 0.001).

CONCLUSION
Adults experiencing a significant, often abrupt change in health status leading to an EGS admission are infrequently engaged in ACP conducted by the surgical team. This is a critical missed opportunity to promote patient-centered care and to communicate patients' care preferences to the surgical and other inpatient medical teams.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level IV.
Empty Sella in Neuro-Ophthalmology Patients Without Raised Intracranial Pressure
Authors: Sayal Aman P. , Jhaveri Aaditeya , Diouf Ange A. , Lam Cindy T. Y. , Suthiphosuwan Suradech , Micieli Jonathan A. 
Published: February 2023

Background:
Empty sella often supports a diagnosis of raised intracranial pressure (ICP) but is also seen in normal individuals. This study's objective was to determine the prevalence of empty and partially empty sella in neuro-ophthalmology patients undergoing MRI for indications other than papilledema or raised ICP.

Methods:
Consecutive patients without papilledema or suspected raised ICP who underwent brain MRI between August 2017 and May 2021 were included in this study. Sagittal T1 images were evaluated by 2 independent, blinded neuroradiologists who graded the sella using the published criteria (Categories 1–5, with 1 being normal and 5 showing no visible pituitary tissue). Clinical parameters were also collected.

Results:
A total of 613 patients (309 men; average age 56.69 ± 18.06 years) were included in this study with optic neuropathy as the most common MRI indication. A total of 176 patients had moderate concavity of the pituitary gland (Category 3), 81 had severe concavity (Category 4), and 26 had no visible pituitary tissue (Category 5). Sella appearance was mentioned in 92 patients' radiology reports (15%). There was a statistically significant difference in age between composite Categories 1 and 2 (mean 52.89 ± 18.91; P < 0.001) and composite Categories 4 and 5 (mean 63.41 ± 15.44), but not the other clinical parameters.

Conclusion:
Empty sella is common in neuro-ophthalmology patients without raised ICP; 17.4% of patients have severe concavity or no pituitary tissue visible. An isolated finding of empty or partially empty sella on imaging is therefore of questionable clinical value in this patient population.
Vascular Risk Factors in Isolated Microvascular Ischemic Third Nerve Palsy: A Population-Based Study
Authors: Zhao Bingying , Bhatti M. Tariq , Fang Chengbo , Hodge David O. , Holmes Jonathan M. , Mohney Brian G. , Chen John J. 
Published: February 2023

Background:
Although presumed microvascular third nerve palsies (TNP) have been associated with vascular risk factors and/or stroke, these associations have not been explored in a population-based cohort. The purpose of this population-based case–control study was to determine whether these factors are associated with TNPs that had been classified as isolated microvascular ischemic events and determine future risk of mortality.

Methods:
Participants were subjects >18 years old with new onset of isolated TNP attributed to presumed microvascular ischemia (n = 55) while residing in Olmsted County, Minnesota, from January 1, 1978 to December 31, 2014. Control subjects (n = 55) were randomly selected from the same population and matched for gender, age, and length of medical follow-up. We identified all cases of new-onset isolated presumed microvascular ischemic TNP using the Rochester Epidemiology Project, a record-linkage system of medical records for all patient–physician encounters in Olmsted County, Minnesota. All medical records of cases and controls were reviewed for potential risk factors, including diabetes mellitus, diabetic retinopathy, hypertension, hyperlipidemia, smoking, and symptomatic ischemic stroke. Multivariable and univariate logistic regression analyses were used to compare the prevalence of potential risk factors between microvascular ischemic cases and controls according to the number of subjects, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Kaplan–Meier curves were used to compare mortality between cases and controls.

Results:
The annual incidence of microvascular ischemic TNP was 1.7 per 100,000. Univariate analysis demonstrated that hypertension (P < 0.001; OR, 4.80; 95% CI, 2.11–11.58), diabetes mellitus (P < 0.001; OR, 6.55; 95% CI, 2.72–17.32), diabetic retinopathy (P = 0.014; OR, 13.50; 95% CI, 2.48–251.55), coronary artery disease (P = 0.047; OR, 2.27; 95% CI, 1.02–5.18), and symptomatic ischemic stroke (P = 0.039; OR, 3.56; 95% CI, 1.07–11.85) all occurred more frequently in patients with microvascular ischemic TNP than controls. In multivariate analysis, only hypertension (OR of 4.14, 95% CI, 1.61–10.65, P < 0.001) and diabetes (OR of 4.12, 95% CI, 1.43–11.92, P = 0.003) remained independently statistically significant. There was numerically higher mortality in microvascular cases than in controls, but it did not reach statistical significance.

Conclusions:
There are multiple cardiovascular diseases that are associated with isolated microvascular ischemic TNP, including hypertension, coronary artery disease, diabetes mellitus, diabetic retinopathy, and symptomatic ischemic stroke. Given that the main drivers of this association seem to be diabetes and hypertension, patients with microvascular ischemic TNP should be evaluated for these conditions.
Rates of Visual Field Change in Eyes With Optic Disc Drusen
Authors: Estrela Tais , Jammal Alessandro A. , El-Dairi Mays , Medeiros Felipe A. 
Published: February 2023

Background:
Optic disc drusen (ODD) are calcified deposits in the prelaminar portion of the optic nerve head. Although often asymptomatic, these deposits can cause progressive visual field defects and vision loss. The purpose of this study was to evaluate rates of functional loss in eyes with ODD and to investigate risk factors associated with rates of visual field progression.

Methods:
This was a retrospective cohort study including 65 eyes of 43 patients with ODD from the Duke Ophthalmic Registry. All eyes had at least 12 months of follow-up and at least 3 reliable standard automated perimetry (SAP) tests. Linear mixed models were used to estimate rates of SAP mean deviation (MD) loss over time. Univariable and multivariable models were used to assess the effect of clinical variables and intraocular pressure (IOP) on rates of change.

Results:
Subjects were followed for an average of 7.6 ± 5.3 years. The mean rate of SAP MD change was −0.23 ± 0.26 dB/year, ranging from −1.19 to 0.13 dB/year. Fifty-seven eyes (87.7%) had slow progression (slower than −0.5 dB/year), 6 eyes (9.2%) had moderate progression (between −0.5 dB/year and −1 dB/year), and 2 eyes (3.1%) had fast progression (faster than −1 dB/year). In multivariable models, older age and worse SAP MD at baseline were significantly associated with faster rates of change. Mean IOP was not associated with faster rates of MD change in both univariable and multivariable analyses.

Conclusions:
Most eyes with ODD had slow rates of visual field loss over time. Age and baseline severity were significantly associated with faster rates of visual field loss.
Association between increased anterior cingulate glutamate and psychotic-like symptoms, but not autistic traits
Authors: Demler Verena F , Sterner Elisabeth F. , Wilson Martin , Zimmer Claus , Knolle Franziska 
Published: February 2023

AbstractDespite many differences, autism spectrum disorder and schizophrenia spectrum disorder share environmental risk factors, genetic predispositions as well as neuronal abnormalities, and show similar cognitive deficits in working memory, perspective taking, or response inhibition. These alterations are already present in subclinical traits of these disorders. The literature proposes that alterations in the inhibitory GABAergic and the excitatory glutamatergic system could explain underlying neuronal commonalities and differences. Using magnetic resonance spectroscopy (1H-MRS), we investigated the associations between glutamate concentrations in the anterior cingulate cortex (ACC), the left/right putamen, and left/right dorsolateral prefrontal cortex and psychotic-like experiences (schizotypal personality questionnaire) and autistic traits (autism spectrum quotient) in 53 healthy individuals (28 women). To investigate the contributions of glutamate concentrations in different cortical and subcortical regions to symptom expression and their interactions, we used linear regression and moderation analyses. We found that glutamate concentration in the ACC but in none of the other regions predicted positive-like symptoms. None of the other clinical scores was associated with altered levels of glutamate. Specifying this finding, the moderation analysis showed that increased ACC glutamate was predictive of positive-like symptoms when glutamate concentrations in the right putamen were reduced, and that increased ACC glutamate was predictive of positive-like symptoms when disorganized traits were attenuated. This study provides evidence that an imbalance in the glutamatergic neurotransmitter system involving cortical and subcortical regions is linked to the expression of psychotic-like experiences, especially positive-like symptoms. These findings may facilitate the detection of individuals transitioning into an acute episode of psychosis.
ADO-MEDIATED SYNTHESIS OF TAURINE ALTERS THE CHROMATIN LANDSCAPE OF INGUINAL ADIPOSE TISSUE TO ENHANCE NON-SHIVERING THERMOGENESIS
Authors: Tsai Pei-Yin , Shui Bo , Lee Seoyeon , Liu Yang , Qu Yue , Cheng Chloe , Edwards Kaydine , Wong Callie , Meng-Killeen Ryan , Soloway Paul , Barrow Joeva J 
Published: February 2023

ABSTRACTNon-shivering thermogenesis (NST) has strong potential to combat obesity, however, a safe molecular approach to activate this process has not yet been identified. The sulfur amino acid taurine has the ability to safely activate NST and confer protection against obesity and metabolic disease in both mice and humans, but the mechanism of action is unknown. In this study, we discover that a suite of taurine biosynthetic enzymes, especially that of cysteamine dioxygenase (ADO), significantly increases in response to β3adrenergic signaling in inguinal tissues (IWAT) in order increase intracellular concentrations of taurine. We further show that ADO is critical for thermogenic mitochondrial function as its ablation in thermogenic adipocytes significantly reduces taurine levels which lead to declines in mitochondrial oxygen consumption rates. Finally, we demonstrate via assay for transposase-accessible chromatin with sequencing (ATAC-Seq) that taurine supplementation has the ability to remodel the chromatin landscape to increase the chromatin accessibility and transcription of genes, such as glucose-6-phosphate isomerase 1 (Gpi1), that are critical for NST. Taken together, our studies highlight a potential mechanism for taurine in the activation of NST that can be leveraged toward the treatment of obesity and metabolic disease.
Quercetin selectively reduces expanded repeat RNA levels in models of myotonic dystrophy
Authors: Mishra Subodh K. , Hicks Sawyer M. , Frias Jesus A. , Vangaveti Sweta , Nakamori Masayuki , Cleary John D. , Reddy Kaalak , Berglund J. Andrew 
Published: February 2023

ABSTRACTMyotonic dystrophy is a multisystemic neuromuscular disease caused by either a CTG repeat expansion inDMPK(DM1) or a CCTG repeat expansion inCNBP(DM2). Transcription of the expanded alleles produces toxic gain-of-function RNA that sequester the MBNL family of alternative splicing regulators into ribonuclear foci, leading to pathogenic mis-splicing. There are currently no approved treatments that target the root cause of disease which is the production of the toxic expansion RNA molecules. In this study, using our previously established HeLa DM1 repeat selective screening platform, we identified the natural product quercetin as a selective modulator of toxic RNA levels. Quercetin treatment selectively reduced toxic RNA levels and rescued MBNL dependent mis-splicing in DM1 and DM2 patient derived cell lines and in theHSALRtransgenic DM1 mouse model where rescue of myotonia was also observed. Based on our data and its safety profile for use in humans, we have identified quercetin as a priority disease-targeting therapeutic lead for clinical evaluation for the treatment of DM1 and DM2.One Sentence SummaryThe natural product quercetin reduces toxic RNA in myotonic dystrophy.
Fear of COVID-19 and green bank service purchase intention: the mediating effect of customer empowerment and customers’ perceived value of digital service transactions
Authors: Sakaya Ansgar J. 
Published: February 2023

PurposeThe paper intends to show the role of fear of COVID-19 and the relevance of customer empowerment (CU_EMP) and customers’ perceived value of digital service transactions (CU_PV_DST) in promoting green bank service purchase intention (GBS_PI), despite the antagonistic impacts brought in other sectors and the relevance of customer empowerment (CU_EMP) and customers’ perceived value of digital service transactions (CU_PV_DST) as important mediating variables of the relation.Design/methodology/approachThe structured questionnaire helped collect survey data from 323 small business people. The model relationship was assessed through EFA, CFA by SPSS-AMOS and SEM using bootstrapping procedures in Smart-PLS.FindingsThe findings of this study show that there is a significant effect of fear of COVID-19 pandemic (F_COVID-19P) on CU_EMP and GBS_PI. CU_EMP influences GBS_PI, whereas F_COVID-19P influences GBS_PI indirectly via CU_EMP. Furthermore, there is a substantial effect of F_COVID-19P on CU_PV_DST and GBS_PI. Thus, F_COVID-19P significantly influences GBS_PI indirectly via CU_PV_DST.Practical implicationsCapitalizing on the COVID-19 wave by empowering customers technologically, improving the legal framework and increasing the perceived value of green service by using an innovative mechanism. In addition, fostering cultural change and emphasizing altruistic values through green advertisements have been explored in this study.Social implicationsGreen services are healthier for smart/green economy and are health-protective for coping with health risks.Originality/valueThis study helps in understanding the theories used in this context by linking them to F_COVID-19P with CU_EMP, CU_PV_DST and GBS_PI and contributes to the literature of both. Furthermore, this is the only study that has used SEM to study this kind of interrelation.
Effect of typo-morphological analysis and place understanding on the nature of intervention within historic settings: the case of Amman, Jordan
Authors: Daher Rami Farouk 
Published: February 2023

PurposeThe purpose of this paper is to investigate the effect of different levels of place understanding (primarily typo-morphological analysis) on the nature of interventions within historic urban setting and buildings within the City of Amman.Design/methodology/approachThe research methodology depended on an extensive thematic survey and analysis. The typo-morphological analysis addressed several of Amman's residential hills and their connections with the downtown area. The thematic place survey tool included different units of analysis (e.g. buildings, public spaces, streets and sloped lands between streets) and addressed the values of these various buildings and spaces, their typology, typo-morphology and relation to the urban context, nature of change and transformations over time to mention a few. The extensive survey also included semi-structured interviews about these buildings addressing their emergence, historic context and values.FindingsThe paper presents an architectural typology for Amman's architecture and its relationship with the city's morphology stressing the specificity of Amman's historic core and residential hills. The paper also discusses the effect of this level of place understanding on the nature and levels of interventions within historic settings and buildings.Research limitations/implicationsThis level of place understanding (typo-morphological analysis) can have a positive impact on the practice of architectural and urban conservation by informing the nature of interventions within historic urban setting and buildings within the city. More specifically, this level of place understanding can, first, inform the development of urban and heritage guidelines within conservation areas in one of Amman's residential neighborhoods (Weibdeh) and, second, inform the nature of interventions to existing historic buildings based on respect of building typology.Originality/valueThis paper contributes to the disciplines of architectural and urban conservation illustrating how place understanding can inform practices of heritage conservation and future policies and strategies concerning new intervention within such heritage places.
Race, ethnicity, and discrimination at work: a new analysis of legal protections and gaps in all 193 UN countries
Authors: Heymann Jody , Varvaro-Toney Sheleana , Raub Amy , Kabir Firooz , Sprague Aleta 
Published: February 2023

PurposeWhile only one aspect of fulfilling equal rights, effectively addressing workplace discrimination is integral to creating economies, and countries, that allow for everyone's full and equal participation.Design/methodology/approachLabor, anti-discrimination, and other relevant pieces of legislation were identified through the International Labor Organization's NATLEX database, supplemented with legislation identified through country websites. For each country, two researchers independently coded legislation and answered questions about key policy features. Systematic quality checks and outlier verifications were conducted.FindingsMore than 1 in 5 countries do not explicitly prohibit racial discrimination in employment. 54 countries fail to prohibit unequal pay based on race. 107 countries prohibit racial and/or ethnic discrimination but do not explicitly require employers to take preventive measures against discrimination. The gaps are even larger with respect to multiple and intersectional discrimination. 112 countries fail to prohibit discrimination based on both migration status and race and/or ethnicity; 103 fail to do so for foreign national origin and race and/or ethnicity.Practical implicationsBoth recent and decades-old international treaties and agreements require every country globally to uphold equal rights regardless of race. However, specific national legislation that operationalizes these commitments and prohibits discrimination in the workplace is essential to their impact. This research highlights progress and gaps that must be addressed.Originality/valueThis is the first study to measure legal protections against employment discrimination based on race and ethnicity in all 193 UN countries. This study also examines protection in all countries from discrimination on the basis of characteristics that have been used in a number of settings as a proxy for racial/ethnic discrimination and exclusion, including SES, migration status, and religion.
The effect of full-time culture on quality and safety of care – a literature review
Authors: Magerøy Malin Rosell , Wiig Siri 
Published: February 2023

PurposeThe purpose of this study is to increase knowledge and understanding of the relationship between full-time-culture and the outcome for quality and safety of care.Design/methodology/approachThe paper is a literature review with a qualitatively oriented thematic analysis concerning quality or safety outcomes for patients, or patients and staff when introducing a full-time culture.FindingsIdentified factors that could have a positive or negative impact on quality and patient safety when introducing full-time culture were length of shift, fatigue/burnout, autonomy/empowerment and system/structure. Working shifts over 12 h or more than 40 h a week is associated with increased adverse events and errors, lower quality patient care, less attention to safety concerns and more care left undone. Long shifts give healthcare personnel more flexibility and better quality-time off, but there is also an association between long shifts and fatigue or burnout. Having a choice and flexibility around shift patterns is a predictor of increased wellbeing and health.Originality/valueA major challenge across healthcare services is having enough qualified personnel to handle the increasing number of patients. One of the measures to get enough qualified personnel for the expected tasks is to increase the number of full-time employees and move towards a full-time culture. It is argued that full-time culture will have a positive effect on work environment, efficiency and quality due to a better allocation of work tasks, predictable work schedule, reduced sick leave, and continuity in treatment and care. There is limited research on how the introduction of full-time culture will affect the quality and safety for patients and staff, and few studies have been focusing on the relationship between longer shift, work schedule, and quality and safety of care.