bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Obesity on Early Complications Following Tracheostomy: An Evaluation of a Nationwide Registry
Authors: Aboagye Jonathan K. , Weldeslase Terhas A. , Hartmann Brandon , Akinyemi Oluwasegun A. , Lin Anna M. , Williams Mallory 
Published: April 2023

Introduction The obesity epidemic is an important public health problem in the United States. Previous studies have revealed the association between obesity and various surgical complications. Tracheostomy which is an important lifesaving procedure may prove technically challenging in an obese patient. This study sought to evaluate the association between obesity and early complications following standard tracheostomy using a national registry. Methods Adult patients who underwent tracheostomy from 2007 to 2017 were analyzed using the Nationwide Inpatient Sample (NIS). The population was stratified into obese and non-obese groups. Early complications following standard tracheostomy were identified and compared between the two groups. Multivariable logistic regression analyses were performed to assess the association between obesity and early complications following tracheostomy. Results Data pertaining to 205 032 adult patients were evaluated. Obese patients accounted for 12.1% (n = 21 816) of the entire cohort. The most common complication in the cohort was perioperative bleeding (4316 [2.1%]). A total of 1382 (0.67%), 949 (0.46%), and 134 (0.07%) patients developed pneumothorax/pneumomediastinum, stoma/surgical site infection, and tracheal injury following standard tracheostomy, respectively. There was no difference in the odds of tracheal injury, perioperative bleeding, and pneumomediastinum/pneumothorax following standard tracheostomy in the obese and non-obese group in multivariable analysis. However, obesity was associated with 60% increased odds of developing stoma/surgical site infection following standard tracheostomy (OR 1.60 [1.33-1.92], P < 0.01). Conclusion Obesity is associated with an increased risk of developing stoma/surgical site infection following standard tracheostomy. This adds to the growing need for measures to help curb the obesity epidemic in a bid to improve surgical outcomes.
“Money is not an issue!”: Hospital CFOs’ narratives about handling a sudden shift in managerial focus
Authors: Malmmose Margit , Dahl Pedersen Lars 
Published: April 2023

The sustained political and managerial focus on cost containment and efficiency in hospitals has been altered by COVID-19-related concerns about public health. Through a novel qualitative study in Denmark, we explore CFOs’ narratives of their experiences during a sudden shift in managerial logic. All of the CFOs describe engagement in key operational procedures and change management that was fostered by the constant search for stability that strongly depended on bottom-up decision-making and flexibility. During this process, the existing competing logics of managerialism and medical professionalism vanished. The CFOs describe new forms of dynamic and collaborative approaches. The possibility of adhering to the core logic of administrative accounting techniques combined with urgency and emotional encounters appears to enable this approach. Thus, we document a moment when well-known opposing logics were suspended by exogenous urgency. This finding suggests possibilities for moving beyond deep-rooted views on established public administration structures and logics. Points for practitioners Financial managers show administrative skills that are useful for public administration changes in both administration and daily operations. These managers appear to have a strong core identity and willingness to dynamically engage with and facilitate acute frontline operational issues. In an emergency situation such as COVID-19, we find co-dependency across subject fields (administration and medical professions) which enables collaborations.
Social Media Use as an Impulsive ‘Escape From Freedom’
Authors: Reed Phil , Haas Will 
Published: April 2023

It has been suggested that avoiding choice represents an anxiety-avoidance strategy, which has not been investigated in the context of social media. To this end, the current study explored the relationship between social media dependency and a preference for ‘forced’ choice, along with its association with anxiety, intolerance of uncertainty, and experiential avoidance. The sample comprised 151 volunteer participants (18–32 years) who completed a psychometric test battery, including: the Bergen Social Media Addiction Scale; Spielberger Trait Anxiety Inventory; Intolerance of Uncertainty Scale; and Brief Experiential Avoidance Questionnaire. They also undertook a behavioural assessment based on a paradigm developed for pigeons, in which they selected either a situation with a free choice of alternatives, and one with a forced choice. Intolerance of uncertainty mediated the relationship between social media dependency and anxiety. In addition, those with lower social media dependency preferred being able to choose the contingency they worked on, while those with higher scores exhibited no such preference. This partly confirmed that social media dependency is associated with a reduced preference for freedom, but does not suggest social media dependency actively produced a preference for a lack of freedom. The speed of decision making was also faster in those with high social media dependency scores, in line with previous findings that they show higher levels of impulsive behaviours. The results suggest that anxiety and social media dependency are related, and fear of uncertainty and is linked with digital experiential avoidance.
Investigation of the multidimensional determinants of negative nutrition coping strategies and tradeoffs in adults accessing food relief: A secondary data analysis
Authors: Wright Lauri , Marsland Cheryl , Ross Jen , Arikawa Andrea , Nicholson-Bell Jody , Epps James 
Published: April 2023

Background Multidimensional determinants influence negative nutrition coping strategies and tradeoffs in households accessing food relief. Aims This study examined coping strategies and tradeoffs at different levels of food insecurity from individuals accessing food relief and how these behaviors relate to experience-based food insecurity dimensions and subpopulations at risk. Methods A secondary analysis of cross-sectional data from the Sunshine State Hunger Survey (SSHS) was conducted. The SSHS was a paper-based, 48-question survey, including questions about coping strategies and tradeoffs, use of food assistance programs, and food security. Results Out of 616 respondents who completed the survey, 73.9% identified as food insecure while 19.1%, as food secure. The average age of participants was 59.6 years and 62.6% were female. One-way analysis of variance indicated increases in negative nutrition coping strategies and tradeoffs with increasing levels of food insecurity status. The most common coping strategy reported by those with very low food security was “Eating less so children or others have enough food,” while the most common tradeoff was “Trading off medicine or medical care for food.” Two-step cluster analysis identified homogeneous subgroups by behavior and demographic characteristics: (1) late adult worriers, (2) middle adult traders, and (3) middle/late adult copers. Conclusion Identifying coping strategies and tradeoffs used by participants accessing food relief is a multidimensional approach to addressing determinants of food insecurity. Future research on conceptual pathways is warranted to see if experience-based food insecurity variables help to understand relationships across a continuum, including barriers and influencers.
Diagnostic accuracy of MRI for assessing lymphovascular space invasion in endometrial carcinoma: a meta-analysis
Authors: Meng Xuxu , Yang Dawei , Deng Yuhui , Xu Hui , Jin He , Yang Zhenghan 
Published: April 2023

Background The lymphovascular space invasion (LVSI) status of endometrial cancer (EC) has guiding significance in lymph node dissection. However, LVSI can only be obtained after surgery. Researchers have tried to extract the information of LVSI using magnetic resonance imaging (MRI). Purpose To evaluate the ability of preoperative MRI to predict the LVSI status of EC. Material and Methods A search was conducted by using the PubMed/MEDLINE, EMBASE, Web of Science, and the Cochrane Library databases. Articles were included according to the criteria. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2. A bivariate random effects model was used to obtain pooled summary estimates, heterogeneity, and the area under the summary receiver operating characteristic curve (AUC). A subgroup analysis was performed to identify sources of heterogeneity. Results A total of nine articles (814 patients) were included. The risk of bias was low or unclear for most studies, and the applicability concerns were low or unclear for all studies. The summary AUC values as well as pooled sensitivity and specificity of LVSI status in EC were 0.82, 73%, and 77%, respectively. According to the subgroup analysis, radiomics/non-radiomics features, country/region, sample size, age, MR manufacturer, magnetic field, scores of risk bias, and scores of applicability concern may have caused heterogeneity. Conclusion Our meta-analysis showed that MRI has moderate diagnostic efficacy for LVSI status in EC. Large-sample, uniformly designed studies are needed to verify the true value of MRI in assessing LVSI.
Update on the relationship between the SLC4A7 variant rs4973768 and breast cancer risk: a systematic review and meta-analysis
Authors: Zhou Yuhui , Ma Xiaoxia , Sun Jinglan 
Published: April 2023

Objective This meta-analysis aimed to update knowledge about the association between the SLC4A7 variant rs4973768 and breast cancer incidence. Methods Studies were identified from relevant digital databases. Fixed- or random-effects models were used to calculate odds ratios and 95% confidence intervals. Statistical Q and I2 tests and sensitivity analyses were used to detect interstudy heterogeneity and test the statistical stability of overall estimates, respectively. Egger’s tests were applied to detect publication bias among included studies. In silico analysis was used to ascertain increased expression of SLC4A7 mRNA in rs4973768 with the mutant allele. Trial sequential analysis was used to calculate the study’s sample size. Results The overall odds ratios reflected a positive correlation between the SLC4A7 rs4973768 polymorphism and susceptibility to breast cancer in five genetic comparisons of alleles T and C, and tests revealed significant heterogeneity in the allele comparison. After stratification by ethnicity, heterogeneity in Asian and White populations substantially decreased (Ph = 0.984, I2 = 0%) and remained stable (Ph = 0.083, I2 = 46.3%), respectively. The mutant allele was associated with increased expression of SLC4A7 mRNA in rs4973768. The cumulative z curve indicated that our conclusions were robust. Conclusions Our updated consequence shows that the SLC4A7 rs4973768 polymorphism is associated with increased breast cancer risk.
Tackling Epistemic and Cognitive Injustice in Political Dialogue: The Case of OACPS–EU Relations
Authors: Vihma Katri 
Published: April 2023

This article examines the preconditions for an epistemically and cognitively more just form of political dialogue. Such dialogue requires treating each participant and their knowledges as equal as well as securing the participant’s epistemic and material possibilities to engage in deliberation. Drawing on Iris M. Young’s communicative ethics and both Walter D. Mignolo’s and Sabelo J. Ndlovu-Gatsheni’s decolonial theorising, I suggest three moves for realising these conditions. Thus, I bring feminist epistemology and decolonial thought into a mutually enriching discussion and put forward ideals that are important for improving accounts of political deliberation in world politics. Empirically, the analysis contributes to an understanding of epistemic and cognitive injustices and related colonial tendencies in the relationship between the Organization of African, Caribbean and Pacific States (OACPS) and European Union (EU). Moreover, I provide policy proposals for reducing the identified injustices and other associated asymmetries between the parties in the post-Cotonou era. Lutter contre les injustices épistémiques et cognitives dans le dialogue politique : le cas des relations entre l’OEACP et l’UE
Results of Endoscopic Labral Repair With Concomitant Gluteus Medius and/or Minimus Repair Compared With Outcomes of Labral Repair Alone: A Matched Comparative Cohort Analysis at Minimum 2-Year Follow-up
Authors: Horner Nolan S. , Chapman Reagan S. , Larson Jordan H. , Nho Shane J. 
Published: April 2023

Background: There is a paucity of information available to clinicians on outcomes of patients undergoing endoscopic surgery for labral repairs and femoroacetabular impingement syndrome with simultaneous repair of the gluteus medius and/or minimus muscles. Purpose: To determine whether patients with labral tears and concomitant gluteal pathology who undergo simultaneous endoscopic labral and gluteus medius and/or minimus repair experience similar outcomes to patients with isolated labral tears who undergo endoscopic labral repair alone. Study Design: Cohort study; Level of evidence, 3. Methods: A matched retrospective comparative cohort study was performed. Patients who underwent gluteus medius and/or minimus repair with concomitant labral repair between January 2012 and November 2019 were identified. These patients were matched in a 1:3 ratio by sex, age, and body mass index (BMI) to patients who underwent labral repair alone. Preoperative radiographs were assessed. Patient-reported outcomes (PROs) were assessed preoperatively and 2 years postoperatively. PRO measures included the Hip Outcome Score Activities of Daily Living and Sports subscales, modified Harris Hip Score, 12-Item International Hip Outcome Tool, and visual analog scales for pain and satisfaction. Published labral repair minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) thresholds were utilized for these measures. Results: A total of 31 patients who underwent gluteus medius and/or minimus repair with concomitant labral repair (27 female, 4 male; age, 50.8 ± 7.3 years; BMI, 27.9 ± 5.2) were matched with 93 patients who underwent labral repair alone (81 female, 12 male; age, 50.9 ± 8.1 years; BMI, 28.5 ± 6.2). There were no significant differences in sex ( P > .99), age ( P = .869), or BMI ( P = .592); preoperative radiographic measurements; or preoperative or 2-year postoperative PRO scores ( P≥ .081). Changes between preoperative and 2-year postoperative PRO scores were significantly different for both groups for all PROs assessed ( P < .001 for all). There were no significant differences in MCID or PASS achievement rates ( P≥ .123), with low PASS achievement rates of 40% to 60% found in both groups. Conclusion: Patients who were treated with endoscopic gluteus medius and/or minimus repair with concomitant labral repair demonstrated comparable outcomes with those who were treated with endoscopic labral repair alone.
Thermo-sensitive injectable hydrogel loading with elemene-loaded liposomes for enhanced anti-tumor effect
Authors: Li Yijing , Zhu Yanhui , Chen Jiaqi , Wang Huahua , Zhi Weiwei , Wang Ziang , Guan Yanbin , Wang Baiyan , Jia Yongyan , Huang Shengnan , Zhu Xiali 
Published: April 2023

Due to the heterogeneity and the complexity of the tumor microenvironment, combination therapy, especially the combination of chemotherapy and photothermal therapy (PTT), had received increasing attention. However, the co-delivery of small molecule drugs for chemotherapy and photothermal agents was a key issue. Herein, we prepared a novel thermo-sensitive hydrogel loading with elemene (ELE)-loaded and nano graphene oxide (NGO)-based liposomes for enhanced combined therapy. ELE was applied as the model drug for chemotherapy because it was a natural sesquiterpene drug with broad-spectrum and efficient antitumor activity. NGO was applied as drug carrier and photothermal agent simultaneously due to its two-dimensional structure and high photo-thermal conversion efficacy. NGO was further modified with glycyrrhetinic acid (GA) to improve its water dispersion, biocompatibility and tumor-targeting ability. ELE was loaded by GA-modified NGO (GA/NGO) to prepare the liposomes designated as ELE-GA/NGO-Lip, which was further mixed with chitosan (CS) solution and β-glycerin sodium phosphate (β-GP) solution to prepare the thermo-sensitive hydrogel designated as ELE-GA/NGO-Lip-gel. The obtained ELE-GA/NGO-Lip-gel had the gelling temperature of 37°C, temperature and pH-response gel dissolution and high photo-thermal conversion effect. More importantly, ELE-GA/NGO-Lip-gel upon 808 nm laser irradiation had relative high anti-tumor efficiency against SMMC-7721 cells in vitro. This research might provide a potent platform for the application of thermos-sensitive injectable hydrogel in combined tumor therapy.
APOL1 and the risk of adverse renal outcomes in patients of African ancestry with systemic lupus erythematosus
Authors: Chung Cecilia P , Karakoc Gul , Dickson Alyson , Liu Ge , Gamboa Jorge L , Mosley Jonathan D , Cox Nancy J , Kawai Vivian K 
Published: April 2023

Background Systemic lupus erythematosus (SLE) disproportionately affects individuals of African ancestry (AA) compared to European ancestry (EA). In the general population, high risk (HR) variants in the apolipoprotein L1 ( APOL1) gene increase the risk of renal and hypertensive disorders in individuals of AA. Since SLE is characterized by an interferon signature and APOL1 expression is driven by interferon, we examined the hypothesis that APOL1 HR genotypes predominantly drive higher rates of renal and hypertensive-related comorbidities observed in SLE patients of AA versus those of EA. Methods We performed a retrospective cohort study in patients with SLE of EA and AA using a genetic biobank linked to de-identified electronic health records. APOL1 HR genotypes were defined as G1/G1, G2/G2, or G1/G2 and low risk (LR) genotypes as 1 or 0 copies of the G1 and G2 alleles. To identify renal and hypertensive-related disorders that differed in prevalence by ancestry, we used a phenome-wide association approach. We then used logistic regression to compare the prevalence of renal and hypertensive-related disorders in EA and AA patients, both including and excluding patients with the APOL1 HR genotype. In a sensitivity analysis, we examined the association of end stage renal disease secondary to lupus nephritis (LN-related ESRD) with ancestry and the APOL1 genotype. Results We studied 784 patients with SLE; 195 (24.9%) were of AA, of whom 27 (13.8%) had APOL1 HR genotypes. Eighteen renal and hypertensive-related phenotypes were more common in AA than EA patients ( p-value ≤ 1.4E-4). All phenotypes remained significantly different after exclusion of patients with APOL1 HR genotypes, and most point odds ratios (ORs) decreased only slightly. Even among ORs with the greatest decrease, risk for AA patients without the APOL1 HR genotype remained significantly elevated compared to EA patients. In the sensitivity analysis, LN-related ESRD was more prevalent in SLE patients of AA versus EA and AA patients with the APOL1 HR genotype versus LR ( p-value < .05 for both). Conclusion The higher prevalence of renal and hypertensive disorders in SLE patients of AA compared to those of EA is not fully explained by the presence of APOL1 high risk variants.
An Assessment of Unconventional Monetary Policy During COVID-19 Pandemic in India
Authors: Rao D. Tripati , Kumar Rahul 
Published: May 2023

We employ event study methodology to analyze the impact of unprecedented unconventional monetary policy (UMP) measures employed by the Reserve Bank of India to fortify monetary transmission mechanism and to restore financial stability. We find that the UMP announcements result in a decline in bond yields and yield spread as well as increase in market capitalization and sectoral portfolio of stock returns. Evaluating the relative efficacy of UMP measures, we find that targeted long-term repo operation announcements are more effective in easing bond yields than mere long-term repo operations. Our findings provide beneficial inference for day-traders and investors as asset prices increase significantly and durable goods producing stock returns found to be higher than those of non-durable goods. The lessons that can be drawn for the emerging market economy central banks, who do not have enough space to conduct conventional monetary policy and even when they do not face zero lower bound interest rate, they still can employ UMP tools to directly influence banks cost of funds, and long-term bond yields and interest rates, and in turn, portfolio of stock returns and investments to stimulate aggregate demand. JEL Codes: C13, C54, E52, E65
Advance Care Planning Among Patients With Amyotrophic Lateral Sclerosis: Patient Perspectives on Goals of Care Conversations
Authors: Phillips Joel , Dixon Stacy , Koehler Tracy , Kluger Benzi 
Published: April 2023

Introduction Little is known regarding circumstances surrounding advanced care planning (ACP) for patients with amyotrophic lateral sclerosis (ALS). We aim to describe preferences, and perspectives surrounding ACP in patients with ALS. Methods We conducted a survey of patients with ALS. Survey questions were related to advance directive completion and ACP discussions regarding end-of-life (EoL) choices. Results 49 surveys were included. Patients have given thought to advance directives, goals of care, and EoL treatments within months of diagnosis (Median: 1 month; IQR: .6 – 3 months). Twenty-seven opened dialogue with spouses, 24 with family members, 19 with health professionals and 16 with their lawyer. Eighty percent were comfortable discussing advance directives and power of attorney while fewer (70%) are less comfortable regarding specific aspects of care such as CPR or invasive ventilation. Only one barrier to discussion was identified with one patient reporting they did not wish to talk about the topic. There was no significant correlation between timing of diagnosis and whether an EoL discussion had occurred (τb = .23, P = .14: n = 42). Level of feeling informed was significantly associated with making EoL decisions for CPR, legal arrangements for a decision maker and completion of living will or AD. Conclusion In this small cohort, a substantial proportion of ALS patients initiated EoL conversations early. When feeling informed, patients were more likely to make specific EoL choices. Findings suggest an opportunity for providers to help facilitate conversations, ensuring patient wishes.