bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Motivation Assessment as a Teaching Tool for Large Undergraduate Courses: Reflections From the Teaching Team
Authors: Ferland Melissa , Molinaro Claudia F. , Kosovich Jeff J. , Flake Jessica K. 
Published: February 2022

Introduction Student motivation is a critical predictor of academic achievement, engagement, and success in higher education. Motivating students is a crucial aspect of effective teaching. Statement of the Problem Although there is a wealth of research on student motivation, practical guidance for putting theory into practice in challenging teaching environments (i.e., large-format introductory courses) is lacking. We discuss a first step toward motivating students: understanding how motivated they are and using that information to inform teaching. Literature Review Anxiety, impeded motivation, and high student-to-teacher ratio are all challenges associated with teaching foundational introductory courses, such as statistics. The Expectancy–Value–Cost model of motivation provides theoretical background to assist with these courses. We discuss the implementation and use of motivation assessments as a teaching tool. Teaching Implications Motivation assessments are feasible and useful while teaching large-format introductory courses. Instructor reflections lend insights as to how to use these assessments to improve pedagogy.
Use of lifestyle interventions in primary care for individuals with newly diagnosed hypertension, hyperlipidaemia or obesity: a retrospective cohort study
Authors: Lemp Julia M , Nuthanapati Meghana Prasad , Bärnighausen Till W , Vollmer Sebastian , Geldsetzer Pascal , Jani Anant 
Published: February 2022

Summary Objective Lifestyle interventions can be efficacious in reducing cardiovascular disease risk factors and are recommended as first-line interventions in England. However, recent information on the use of these interventions in primary care is lacking. We investigated for how many patients with newly diagnosed hypertension, hyperlipidaemia or obesity, lifestyle interventions were recorded in their primary care electronic health record. Design A retrospective cohort study. Setting English primary care, using UK Clinical Practice Research Datalink. Participants A total of 770,711 patients who were aged 18 years or older and received a new diagnosis of hypertension, hyperlipidaemia or obesity between 2010 and 2019. Main outcome measures Record of lifestyle intervention and/or medication in 12 months before to 12 months after initial diagnosis (2-year timeframe). Results Analyses show varying results across conditions: While 55.6% (95% CI 54.9–56.4) of individuals with an initial diagnosis of hypertension were recorded as having lifestyle support (lifestyle intervention or signposting) within the 2-year timeframe, this number was reduced to 45.2% (95% CI 43.8–46.6) for hyperlipidaemia and 52.6% (95% CI 51.1–54.1) for obesity. For substantial proportions of individuals neither lifestyle support nor medication (hypertension: 12.2%, 95% CI 11.9–12.5; hyperlipidaemia: 32.2%, 95% CI 31.2–33.3; obesity: 43.9%, 95% CI 42.3–45.4) were recorded. Sensitivity analyses confirm that limited proportions of patients had lifestyle support recorded in their electronic health record before they were first prescribed medication (diagnosed and undiagnosed), ranging from 12.1% for hypertension to 19.7% for hyperlipidaemia, and 19.5% for obesity (23.4% if restricted to Orlistat). Conclusions Limited evidence of lifestyle support for individuals with cardiovascular risk factors (hypertension, hyperlipidaemia, obesity) recommended by national guidelines in England may stem from poor recording in electronic health records but may also represent missed opportunities. Given the link between progression to cardiovascular disease and modifiable lifestyle factors, early support for patients to manage their conditions through non-pharmaceutical interventions by establishing lifestyle modification as first-line treatment is crucial.
Effect of fasting time before anesthesia on postoperative complications in children undergoing adenotonsillectomy
Authors: Huang Yonghao , Tai Junhu , Nan Yongshan 
Published: February 2022

Objectives Although the guidelines clearly recommend the fasting time of children before anesthesia, it is usually difficult to control. For pediatric patients, prolonged fasting time before surgery will lead to dehydration and hypoglycemia. Adenotonsillectomy is one of the most common operations in pediatric patients, but its complications are not rare. The purpose of this study is to analyze the relationship between preoperative fasting time and postoperative complications in children undergoing adenotonsillectomy. Methods The medical and surgical records of 480 pediatric patients who underwent adenotonsillectomy were analyzed retrospectively. They were divided into three groups, including adenoidectomy group, tonsillectomy group, and adenotonsillectomy group. Logistic regression analysis was used to analyze the effect of preoperative fasting time on postoperative complications and hospital stay in pediatric patients of the three groups. Results The postoperative bleeding rate in the adenoidectomy group (5.16%) was lower than tonsillectomy group and adenoidectomy group (P < .001). Logistic regression analysis showed that the fasting time was positively correlated with the vomiting and pain in adenoidectomy group, tonsillectomy group, and adenotonsillectomy group. And, the postoperative hospital stay was also positively correlated with fasting time in three groups. Conclusion The prolonged fasting time before otolaryngology surgery in children is related to the occurrence of postoperative complications like vomiting and pain, and also to the increase of postoperative hospital stay.
Impact of thoracic esophageal displacement after lobectomy on the continuity of oral adjuvant chemotherapy
Authors: Okamoto Keigo , Kaku Ryosuke , Oshio Yasuhiko , Hanaoka Jun 
Published: February 2022

Background Adjuvant tegafur-uracil therapy has prolonged postoperative survival in patients with non-small cell lung cancer. Some patients experience treatment discontinuation due to gastrointestinal disorders such as anorexia, and the associated factors and the impact of lobectomy remain unclear. This study aimed to assess the postoperative esophageal displacement after lobectomy and to clarify its impact on the continuity of tegafur-uracil treatment. Methods Patients who received adjuvant tegafur-uracil therapy after lobectomy between April 2009 and March 2019 were retrospectively analyzed. Patient background, perioperative characteristics, treatment findings, and the degree of esophageal displacement measured by computed tomography were compared between the treatment completion group and the discontinuation group. A subgroup comparative analysis was further performed in the groups divided according to the degree of esophageal displacement. Results A total of 68 patients were reviewed, including 41 males and 27 females with a mean age of 66.2 years old. A total of 41 patients completed the 2-year adjuvant treatment and 27 patients discontinued it. The overall survival and relapse-free survival between the two groups were statistically significant ( p = 0.027, p = 0.010). The degree of esophageal displacement at the Th7 level was a significant predictor of treatment discontinuation ( p = 0.046, odds ratio [OR]: 1.138, 95% confidence interval [CI]: 1.002–1.291). Among the patients with a high degree of esophageal displacement above the baseline determined from the receiver operating characteristic curve, the cause of discontinuation was anorexia, which was significant in multivariate analysis ( p = 0.013, OR: 14.72, 95% CI: 1.745–124.2). Conclusions Our study suggested that anatomical displacement of the esophagus after lobectomy may affect the discontinuation of oral adjuvant chemotherapy in patients with lung cancer.
Hypertonic packs to reverse blindness caused by facial lymphoedema in the setting of head and neck cancer – A case report
Authors: Gurgenci Taylan , Cree Rosalind , Jessop Melissa , Lomas Jonathan , Good Phillip 
Published: February 2022

Background: Severe, cancer-related facial oedema can impair vision. It can result from lymphatic and/or venous obstruction due to disease and/or treatment related fibrosis. There is very limited data on the use of directly applied hypertonic packs for the relief of periorbital oedema. Case: A 63 year old man with recurrent laryngeal squamous cell carcinoma developed functional blindness secondary to periorbital oedema in the setting of severe facial swelling. This was refractory to maximal facial lymphatic massage available in the community setting. Possible courses of action: Management dilemmas included what non-medical interventions may relieve his periorbital oedema and thereby restore his vision outside of daily lymphatic massage from a qualified physiotherapist. Formulation of management plan: The patient agreed to an initial dry hypertonic pack with a great functional improvement of his vision. He was taught how to do this so that he could repeat ad libitum. Outcome: The patient had previously expressed that his most distressing thought was the prospect of becoming functionally blind prior to dying. The provision of an easy additional therapy to relieve his visual obstruction provided him with much comfort. He passed away peacefully a few weeks later. Lessons: The case demonstrates that application of a dry hypertonic pack can relieve periorbital oedema in the setting of facial oedema in cases which are refractory to the combination of self-massage, cold-compress application, and daily lymphatic massage by a certified physiotherapist. Research avenues: A case series to define incidence of adverse effects and duration of treatment effectiveness.
Improvement in arterial enhancement using diluted injection of contrast medium in CT angiography
Authors: Muroga Koji , Minochi Yoshimi , Fukuzawa Akira 
Published: February 2022

Background Arterial enhancement after contrast injection affects the quality of computed tomography angiography (CTA) images. Purpose To evaluate whether the dilution of contrast medium (CM) for CTA increases arterial enhancement after the adjustment of iodine concentration as per the patient's body weight (BW). Material and Methods We retrospectively studied 700 patients who underwent coronary CTA. The first 350 consecutive patients underwent standard CTA with a fixed iodine concentration, whereas the remaining 350 underwent CTA with a diluted CM injection. All patients were classified into three groups according to their BW (<55, 55–65, and 66–73 kg). The mean and proportion of contrast enhancements (CEs) in the ascending aorta of ≥350 Hounsfield units (HUs) (CE350) were compared between the standard CTA and diluted CM injection and among the BW groups. The associations between BW and CE were analyzed using linear regression. Results Receiving diluted CM increased the mean CE in the <55-kg group (403.4 ± 55.4 HU vs. 382.8 ± 59.3 HU; P < 0.01) but not in the groups with heavier BW. The proportion of patients with CE350 increased with BW (<55 kg = 71%, 55–65 kg = 84%, and 66–73 kg = 91%) and increased after dilution (86%, 93%, and 96%, respectively). After CM dilution, the correlation between BW and CE among patients undergoing CTA decreased from 0.37 to 0.22 ( P < 0.05). Conclusion CM dilution for CTA improves arterial enhancement.
Maxillary third molars with horizontal impaction: A cross-sectional study using computed tomography in young Japanese patients
Authors: Matsuda Shinpei , Yoshimura Hitoshi 
Published: February 2022

Objective To examine the anatomical characteristics of impacted maxillary third molars to help predict and prevent possible adverse events during extraction. Methods This retrospective study enrolled young Japanese patients that were assessed for third molar extraction. Patients with maxillary third molar impaction presenting with no space between the maxillary second molar and the occlusal surface of the maxillary third molar were analysed using computed tomography data. Results In this study, a total of 663 patients aged 20–29 years were examined for third molar extraction and 26 teeth in 23 patients were analysed. The mean ± SD angle between the second and third molar axes was 54.2° ± 7.5° and the mean ± SD length of the maxillary third molar was 16.1 ± 1.9 mm. The maxillary third molars showed close or extensive contact with the maxillary sinus and computed tomography did not show any bone from the maxillary sinus floor. Furthermore, in all patients, the crowns of the third molars were not completely covered by the alveolar bone. Conclusions Maxillary third molars with horizontal impaction showed close or extensive contact with the maxillary sinus and their crowns were not completely covered by the alveolar bone.
Critical Care Randomized Trials Demonstrate Power Failure: A Low Positive Predictive Value of Findings in the Critical Care Research Field
Authors: Nostedt Sarah , Joffe Ari R 
Published: February 2022

Background We aimed to determine the post-hoc power of randomized controlled trials (RCTs) in critical care, and describe the implications for long-term positive (PPV) and negative predictive value (NPV) of statistically significant and non-significant findings respectively in the research field. Methods We reviewed three cohorts of RCTs. “Adult-RCTs” were 216 multicenter RCTs with a mortality outcome from a published systematic review. “Pediatric-RCTs” were 120 RCTs with a mortality outcome, obtained by search of picutrials.net. “Consecutive-RCTs” were 90 recent RCTs obtained by screening publications in 6 journals. Post-hoc power for each study was calculated at α 0.05 and 0.005, for measures of small, medium, and large effect-size, using G*Power software. Long-run expected PPV and NPV of critical care research field findings were then calculated. Results With α 0.05, post-hoc power for small effect-size was very low in all RCT-cohorts (eg, median 24% in Adult-RCTs). For medium effect-size, post-hoc power was low, except for Adult-RCTs (eg, median 9% in Pediatric-RCTs). For large effect-size, post-hoc power for non-human-animal Consecutive-RCTs was low (median 32%). With α 0.005, post-hoc power was even lower. The corollary was that both PPV and NPV were poor for small effect-size, unless α 0.005 was used. Even with α 0.005, with realistic (vs. optimistic) prior probability of the alternative hypothesis, the PPV was low (eg, in Adult-RCTs 57.1% vs. 92.3%). Adding mild bias (0.1) reduced the PPV even further. For medium effect-size both PPV and NPV were better; nevertheless, with α 0.05 and realistic prior probability of the alternative hypothesis the PPV was poor, and with α 0.005 and mild bias (0.1) the PPV was very low (eg, Adult-RCTs median 44.1%). Conclusions To improve the predictive value of findings in the critical care research field, RCTs should be designed to have 80% power for realistic effect-size at α 0.005.
Laser surface texturing for enhancing microbial fuel cell-based electricity generation from wastewater
Authors: Govindarajan Prabu , Duraiselvam Muthukannan , Matheswaran Manickam , Prabakaran Amrish , Jayabalan Tamilmani , Muthukrishnan Varatharajulu 
Published: February 2022

A high volume of wastewater is drained out every year from agriculture and industrial operations. In the present study, Microbial Fuel Cells (MFC) are used to generate electricity from sugarcane wastewater using titanium as an anode material. Besides, three different laser texturing such as linear pattern (LP), sinusoidal pattern (SP), and waviness pattern (WP) are created on titanium surface to enhance the electricity production and has been compared with the un-textured surface (UTS). In addition, water contact angle and roughness are measured on un-textured surface, LP, SP, and WP surfaces which are 60°, 45°, 34°, 20° and 2.9 μm, 10.7 μm, 15.9 μm, and 19.0 μm, respectively. Results show that laser textured surfaces exhibit a higher power density than the un-textured surface. The improvement in power density is 2–3.5 times that in un-textured surfaces. The outcome of this study indicates that laser textured microbial fuel cells can be considered as an efficient technique for generating electricity from the wastewater and also this could be considered as a new technique to offset wastewater treatment plant operating costs.
Venetoclax ramp-up with concurrent voriconazole in a patient with chronic lymphocytic leukemia
Authors: Krapfl Aaron , McLeod Caleb , Myers Rebecca , Venugopal Parameswaran , Seddon Amanda 
Published: February 2022

Introduction Chronic lymphocytic leukemia (CLL) is commonly treated with the B-cell lymphoma 2 inhibitor (BCL-2) venetoclax. Venetoclax is associated with an increased risk of tumor lysis syndrome in this patient population. Because venetoclax undergoes CYP3A4 metabolism, strong CYP3A4 inhibitors are contraindicated during the ramp-up phase of venetoclax in patients with CLL. Case report Our case report describes a 58 year old male initially diagnosed with CLL in 2013, whose first-line treatment consisted of ibrutinib. The patient developed a central nervous system (CNS) aspergillosis infection in 2018, and was initiated on voriconazole. He was subsequently under active surveillance until his disease progressed. The patient was started on venetoclax therapy, while on concomitant voriconazole, for management of his CLL. Management and outcome The patient's initial venetoclax dose was 10 mg daily, and he received rasburicase on day 1 of therapy. He tolerated a modified ramp-up phase without complication. After receiving 9 days of inpatient therapy, the patient was discharged on 50 mg of venetoclax to continue outpatient dose escalation. His dose was ultimately escalated to 100 mg daily. Discussion Although this report describes the safe administration of venetoclax with voriconazole, extreme caution should be exercised when administering venetoclax with any strong CYP3A4 inhibitor during the ramp-up phase in patients with CLL.
Endovascular Treatment of Ruptured or Symptomatic Thoracoabdominal and Pararenal Aortic Aneurysms Using Octopus Endograft Technique: Mid-Term Clinical Outcomes
Authors: Wang Mian , Yao Chen , Yin Hen-Hui , Wang Jin-Song , Liao Bing-Ye , Li Zi-Lun , Wu Ri-Dong , Peng Gui-Yan , Chang Guang-Qi 
Published: February 2022

Objective: To evaluate the effectiveness and safety of using off-the-shelf “Octopus” technique to treat ruptured or symptomatic thoracoabdominal aortic aneurysm (TAAA) and pararenal abdominal aortic aneurysm (PRAAA). Methods and Results: All cases who underwent “Octopus” technique from May 2016 to May 2019 at our center were retrospectively analyzed. A total of 10 cases (8 males) were included. The mean age was 54.5±14.2 years (range: 31–80 years). Eight cases presented as aneurysm rupture or impending rupture accepted emergency repair. Technical success, defined by placement of all endografts as planned, was achieved in all cases. A total of 30 target visceral branches were successfully cannulated, 9 celiac arteries were covered intentionally. Intraoperative endoleak was observed in 6 patients, all of them were gutter leak. During hospital stay, there was no death, no side branch occlusion or spinal cord ischemia. Median follow-up was 30 months (range: 12–50 months). One patient died of lung cancer at 14-month follow-up. There was no secondary endoleak. The primary endoleak were found spontaneously resolved in 3 cases at 7 days, 3-month, and 1-year imaging. One persistent endoleak totally resolved after sealing of gutter spaces at 4-month follow-up. The other 2 persistent endoleak decreased during follow-up, which are still under observation. The branch patency rate was 90.3% (28/31). All the 3 occluded branches were renal arteries. Branch occlusion occurred in 2 cases at 1-month follow-up and 1 case at 2-year follow-up, but renal insufficiency was not observed in these cases. Obvious aneurysm sac shrinkage (≥5 mm) was observed in all cases. The aneurysm size shrunk from 7.6±1.9 to 5.5±1.4 cm. No spinal cord ischemia occurred during follow-up. Conclusion: Treatment of ruptured TAAA and PRAAA with “Octopus” technique is feasible and safe for high surgical risk patients in the absence of fenestrated and branched devices. The long-term clinical outcomes needed to be investigated.
Arterial thromboxane A2-induced transient contraction after IL-1β exposure
Authors: Yuui Katsuya , Kudo Risa , Kasuda Shogo 
Published: February 2022

The involvement of thromboxane A2 (TXA2) in systemic inflammation and infection is well recognized. However, there are few reports on the involvement of prostanoids in warm shock (the initial pathology of sepsis). Previous studies showed that interleukin (IL)-1β causes a rapid inducible nitric oxide synthase/nitric oxide (iNOS/NO)-mediated relaxation in peripheral blood vessels during warm shock. Furthermore, a transient contraction was seen before this relaxation occurred. The present study aimed to elucidate the mechanism of this transient contraction. We measured isometric tension changes in the superior mesenteric arteries from normal male Wistar rats by adding IL-1β at the point of maximum contraction by phenylephrine (Ph). The same study was performed for each vessel pretreated with various inhibitors, including SQ29548, a TXA2 receptor antagonist, 30 min before Ph contraction. In addition, the concentration of thromboxane B2 (TXB2) in SMA was measured by probe electrospray ionization. Treatment of endothelial vessels with cyclooxygenase 1 (COX1)/2 inhibitors SC560/NS398 and TXA2 receptor antagonist SQ29548 suppressed IL-1β–induced transient contractions. This transient contraction reaction was derived from TXA2. Additionally, gene expression of COX2/TXA2 synthetase and the concentration of TXB2 were significantly increased in IL-1β-exposed vessels. It was demonstrated for the first time in inflamed blood vessels that endothelial cell-derived COX2/TXA2 is induced before iNOS and causes transient contractions. TXA2 may be considered an early sign of warm shock or as a biological defense mechanism in the early stages of septic shock.