2-year Period Research Articles

Further Evidence That Science-Based Biosecurity Provides Sustainable Prevention of Porcine Reproductive and Respiratory Syndrome Virus Infection and Improved Productivity in Swine Breeding Herds

Porcine reproductive and respiratory syndrome virus (PRRSV) is a globally significant pathogen of pigs. Preventing the entry of PRRSV into swine breeding herds enhances animal health and welfare. A recently published retrospective cohort study reported significant differences in PRRSV incidence risk between breeding herds that practiced Next Generation Biosecurity (NGB) COMPLETE, versus herds that practiced a partial approach (NGB INCOMPLETE) over a 2-year period. This follow-up communication builds on this previous publication and brings new information regarding statistical differences in key performance indicators (KPIs) from 43 NGB COMPLETE herds and 19 NGB INCOMPLETE herds during disease years 1 and 2. Statistically significant differences included higher total born/farrow and pigs weaned/female along with a reduced pre-weaning mortality and wean to 1st service interval, as well as a 0.91 increase in the number of pigs weaned/mated female/year. In addition, this communication reports that PRRSV incidence risk throughout disease years 1–3 was 8.0%, and that the association of NGB status (COMPLETE vs. INCOMPLETE) and disease burden for the cumulative 3-year period was statistically significant (p < 0.0001). These findings support previously published data that NGB, while not perfect, provides sustainable prevention of PRRSV, and may help improve herd productivity.

Chronic shoulder instability using the Latarjet technique: About 20 cases

This retrospective study included 20 patients operated on in the Traumatology and Orthopedics Surgery Department (A) of the HASSAN II University Hospital in Fez, treated with a LATARJET · between January 2016 and December 2023, a 5-year period · In our series, the mean age at surgery was 27 years. · Male predominance was evident, with a traumatic context found in 90% of cases. · The apprehension test was positive in 65% of cases. · Our patients underwent a systematic standard preoperative radiological work-up. · We opted for the LATARJET technique · Elbow-to-body immobilization for 21 days post-operatively. · They were followed up in consultation with a 5-year follow-up. The results of our series are very satisfactory according to the ROWE score: · -85% of patients complained of no pain. Stability was perfect in 18 cases (90%). · -Unrestricted mobility was restored in 80% of cases. · -Only one case of recurrence (5%) · One patient with postoperative osteoarthritis, corresponding to 5%. In all, we had 85% good and excellent results, versus 15% fair and poor results. The results of this study are similar to those found in the literature, confirming that the LATARJET technique is the most reliable in the treatment of anterior shoulder instability, with good functional results and the fewest complications.

The Power of Commitment: Creating an Award-Winning Culture of Health And Well-Being at DTE Energy.

The evidence that a healthy and safe workforce provides a competitive business advantage is increasingly clear. However, how to obtain this may be unclear to many. This article presents a case study showcasing how one large employer worked toward improving its culture of health and well-being. Measuring progress using an established corporate health assessment tool, results improved 75% over a 5-year period. In addition, site scan culture checks showed annual improvement, exceeding best-in-class scores by the fifth year. Building a culture of health and well-being often requires a few years to implement fully and involves a commitment to plan, deploy, improve, and manage over time. Ultimately, by following approaches taken by best-in-class employers, this can be accomplished with some ease and without missteps along the way.

Using an Intraoperative Stress Exam to Direct Treatment in Posterior Femoral Head Fracture-Dislocations.

To examine the results of a treatment algorithm incorporating an EUA performed intraoperatively after fixation of the femoral head through a Smith Petersen approach to determine need for posterior wall or capsule repair. Design: Retrospective review. Two Level 1 trauma centers. All acute, traumatic femoral head fractures from posterior hip dislocations treated at participating centers over a 5-year period from 2017-2022. Injuries were classified according to the Pipkin system. The primary outcome was the result of intraoperative EUA performed after femoral head fixation to determine the need for Kocher-Langenbeck exposure for posterior wall and/or capsule fixation. The secondary outcomes included rates of avascular necrosis, heterotopic bone formation, late instability, and conversion to total hip arthroplasty. Studied were 63 males and 22 females with mean age 32.5 (range 18-71). 79 of 85 (92.9%) patients had a stable EUA after fixation of the femoral head through a Smith-Petersen approach. Six (6/85, 7.1%) underwent an additional Kocher-Langenbeck approach for posterior wall or capsule fixation. This included 1 Pipkin I, 1 Pipkin II, and 4 Pipkin IV injuries. Of the Pipkin IV injuries, 51/55 (92.7%) had stable EUA and did not require fixation of their posterior wall. This included 7 patients with wall involvement >20%. Five patients were excluded because of planned fixation of their posterior wall based on preoperative imaging. Of patients with at least 6 months follow up, 16 of 65 (26.4%) developed radiographic evidence of AVN and 21 of 65 (32.3%) evidence of heterotopic bone formation. Seven out of 65 (10.8%) were converted to total hip arthroplasty over the study period. When comparing patients with a single exposure with those with additional KL exposure, they did not vary in their rate of AVN (27.1% vs. 0.0%, P=0.3228), HO formation (30.5% vs. 50.0%, P=0.3788), or conversion to total hip arthroplasty (10.2% vs. 16.7%, P=0.510). This study found residual posterior hip instability after femoral head fixation in patients with and without posterior wall fractures after posterior dislocations. The results of this study support use of an EUA after femoral head fixation to identify residual posterior hip instability in all femoral head fractures from posterior hip dislocations, regardless of Pipkin type. Use of the Smith-Petersen exposure remains a viable surgical option and may be improved with incorporation of an EUA after femoral head fixation. For Pipkin IV injuries with posterior wall fractures with indeterminate stability, an EUA accurately identifies residual instability. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Association of baseline and changes in health-related quality of life with mortality following myocardial infarction: multicentre longitudinal linked cohort study.

Health-related quality of life (HRQoL) for patients following myocardial infarction (MI) is frequently impaired. We investigated the association of baseline and changes in HRQoL with mortality following MI. Nationwide longitudinal study of 9474 patients admitted to 77 hospitals in England as part of the Evaluation of the Methods and Management of Acute Coronary Events study. Self-reported HRQoL was collected using EuroQol EQ-5D-3L during hospitalization and at 1, 6, and 12 months following discharge. The data was analysed using flexible parametric and multilevel survival models. Of 9474 individuals with MI, 2360 (25%) were women and 2135 (22.5%) died during the 9-year follow-up period. HRQoL improved over 12 months (baseline mean, mean increase: EQ-5D 0.76, 0.003 per month; EQ-VAS 69.0, 0.5 per month). At baseline, better HRQoL was inversely associated with mortality [Hazard ratio (HR) 0.55, 95% CI 0.47-0.63], and problems with self-care (HR 1.73, 1.56-1.92), mobility (1.65, 1.50-1.81), usual activities (1.34, 1.23-1.47), and pain/discomfort (1.34, 1.22-1.46) were associated with increased mortality. Deterioration in mobility, pain/discomfort, usual activities, and self-care over 12 months were associated with increased mortality (HR 1.43, 95% CI 1.31-1.58; 1.21, 1.11-1.32; 1.20, 1.10-1.32; 1.44, 1.30-1.59, respectively). After MI, poor HRQoL at baseline, its dimensions, and deterioration over time are associated with an increased risk of mortality. Measuring HRQoL in routine clinical practice after MI could identify at-risk groups for interventions to improve prognosis.

Major Complications of Deep Venous Stenting.

Deep venous stent placement has developed into a primary treatment modality for venous obstruction in recent decades. Reported rates of complications are low in the literature and are based mainly on case reports and single-centre cohorts. Interventionalists performing these procedures must be aware of the occurrence of complications associated with stent placement to counsel patients adequately and promote avoidance through optimal procedural approach. This study aims to determine the incidence of serious complications associated with iliocaval and iliofemoral stent placement in a cohort of patients from 3 major tertiary deep venous referral centres. Data were collated from January 2014 to September 2023. The following major complications were included in the analysis: death, major bleeding requiring transfusion, massive pulmonary embolism, any complication which required endovascular or open surgical intervention, vessel rupture, acute kidney injury requiring dialysis, stent crushing, fracture, migration, involution or erosion. One thousand eight hundred fourteen (1814) patients were treated for acute or chronic deep venous pathology during the 9-year study period. Sixty-one patients (3.3%) experienced a major stent-related complication. The most frequently reported complication was stent crushing (n = 18, 29.5%), followed by stent fracture (n = 10, 16.4%) and erosion of the stent through the vessel wall (n = 8, 13.1%). Death was a rare event (0.2%). Deep venous stent placement is a safe procedure with low rates of major complications. It is incumbent upon operators to be aware of the risks associated with these procedures, however, rare, so that they may obtain fully informed consent from patients.

Regional Disparities in Kidney Transplant Allocation in Brazil: A Retrospective Cohort Study.

Brazil has a large public transplant program, but it remains unclear if the kidney waitlist criteria effectively allocate organs. This study aimed to investigate whether gender, ethnicity, clinical characteristics, and Brazilian regions affect the chance of deceased donor kidney transplant (DDKT). We conducted a retrospective cohort study using the National Transplant System/Brazil database, which included all patients on the kidney transplant waitlist from January 2012 to December 2022, followed until May 2023. The primary outcome assessed was the chance of DDKT, measured using subdistribution hazard and cause-specific hazard models (subdistribution hazard ratio [sHR]). We analyzed 118 617 waitlisted patients over a 10-year study period. Male patients had an sHR of 1.07 ([95% CI: 1.05-1.10], p<0.001), indicating a higher chance of DDTK. Patients of mixed race and Yellow/Indigenous ethnicity had lower rates of receiving a transplant compared to Caucasian patients, with sHR of 0.97 (95% CI: 0.95-1) and 0.89 (95% CI: 0.95-1), respectively. Patients from the South region had the highest chance of DDKT, followed by those from the Midwest and Northeast, compared to patients from the Southeast, with sHR of 2.53 (95% CI: 2.47-2.61), 1.21 (95% CI: 1.16-1.27), and 1.10 (95% CI: 1.07-1.13), respectively. The North region had the lowest chance of DDTK, sHR of 0.29 (95% CI: 0.27-0.31). We found that women and racial minorities faced disadvantages in kidney transplantation. Additionally, we observed regional disparities, with the North region having the lowest chance of DDKT and longer times on dialysis before being waitlisted. In contrast, patients in the South regions had a chance of DDKT and shorter times on dialysis before being waitlisted. It is urgent to implement approaches to enhance transplant capacity in the North region and address race and gender disparities in transplantation.

Association between change in heart rate over years and life span in the Paris Prospective 1, the Whitehall 1, and Framingham studies.

Heart rate, a measure of the frequency of the cardiac cycle, reflects the health of the cardiovascular system, metabolic rate, and activity of the autonomic nervous system. Whether changes in resting heart rate are related to lifespan has not yet been explored to our best knowledge. In this study, we examined the association between resting heart rate and lifespan using linear regression in the Paris Prospective Study I, the Whitehall I Study, and the Framingham Heart Study. We used Cox proportional hazards regression to relate changes in heart rate over years to mortality risk. We observed a statistically significant association between increases in resting heart rate over a 5-year period and risk of mortality in the Paris Prospective Study I (HR mortality per 10 bpm increase over time: 1.20; 95% CI: 1.13 to 1.27) and over an 8-year period in the Framingham Heart Study (HR: 1.13; 95% CI: 1.07 to 1.19 for men and HR: 1.09; 95% CI: 1.04 to 1.15 for women), after adjusting for classical risk factors and resting heart rate. Our study shows that men and women who increase their resting heart rate over time increase their risk of mortality.

Defining characteristics of categorical general surgery resident lateral transfers

BackgroundFew studies describe rationales for intraspecialty (‘lateral’) general surgery (GS) resident program transfers.ObjectiveWe aimed to describe the key features of GS residency programs reporting lateral transfers, to characterize reasons behind...

Health in children during schooling

Introduction. The basis of preventive activities in pediatrics is medical examination, based on active dynamic monitoring of sick and healthy children. An important part of medical examination is preventive examinations, which are carried out with the aim of timely detection of deviations in the health status in children and the management of necessary treatment, preventive and health measures. Purpose of the study: based on the results of a dynamic 10-year observation, present the data on the health status of a single cohort of schoolchildren to update the main preventive areas for children’s practice over schooling process. Materials and methods. The study was conducted on the basis of a study of the health status of four hundred thirty seven schoolchildren at different stages of schooling (before entering school, at the end of first grade, during the transition to subject education and at the end of school education), according to a single protocol, on one sample and a single methodology with sequential multiple registration of selected indices of the health status in schoolchildren and annual analysis over a period of 10 years. Results. An analysis of the distribution of those examined cases by membership in health groups clearly demonstrated a decrease in the number of children in health groups I and II and an increase in schoolchildren in health groups III and IV. A dynamic assessment of diagnosed pathological conditions in their compliance with a certain ICD-10 class over a 10-year observation period revealed an increase in the proportion of schoolchildren suffering from diseases of the musculoskeletal system, the organ of vision, cardio- and endocrinopathies. Research limitations.The study has regional (Krasnoyarsk Territory) limitations and concerns 6 to 17 year children. Conclusion. The data obtained established the possibilities of early diagnosis in risk groups, and preventive measures aimed at developing healthy lifestyle skills in schoolchildren and their parents within the framework of priority national projects in Russia.

Estimating the value of new antibiotic treatment strategies in Zhejiang province, China: cost-effectiveness analysis based on a validated dynamic model

ObjectivesThis analysis aims to better reflect the value of new antibiotic treatment strategies, thereby informing clinical antibiotic use, antimicrobial reimbursement and/or hospital formulary decision-making in China.DesignWe adapted a published and...

Open access in Ukraine: Characteristics and evolution from 2012 to 2021

Abstract This study investigates the development of open access (OA) to publications produced by authors affiliated with Ukrainian universities and research organizations in the period 2012–2021. To get a comprehensive overview we assembled data from three databases: Dimensions, Web of Science (WoS), and Scopus. Our final data set consisted of 186,000 unique records. To determine the OA status of each article, this study utilized Unpaywall data, which was obtained via API. It was determined that 71.5% of all considered articles during the observed period were openly available at the time of analysis. Notably, 60.9% of the OA papers were disseminated through national journals. Furthermore, our findings indicate that the rate of OA papers was highest in the Humanities, at 89.7%, with 74.8% of papers disseminated through national communication channels. The share of OA papers published in national journals surpassed OA papers in foreign journals across all research areas except Natural Sciences. Another noteworthy finding was that Gold OA emerged as the predominant type of OA over the 10-year period of analysis. We underscore the critical importance of ensuring the FAIRness of national scholarly communication infrastructure for monitoring OA uptake and state support of national publishers.

Despite antiretroviral therapy (ART) rollout, most cases of tuberculosis among people with HIV in Adama, Ethiopia, occur before ART initiation

ABSTRACT Introduction Although antiretroviral therapy (ART) leads to reduced tuberculosis (TB) incidence in people with HIV (PWH), ART recipients remain at higher risk of TB compared to HIV-seronegative people. With accelerated ART rollout in sub-Saharan Africa, increasing proportions of TB cases among PWH in people receiving long-term ART have been reported. Objective To determine TB notifications among PWH by ART status in a mainly urban uptake area in Ethiopia during an 8-year period in connection to the introduction of the ‘test-and-treat’ strategy for HIV. Methods PWH were identified from registers at health facilities providing ART in Adama and surrounding areas, Ethiopia 2015–2022. Annual TB notifications were compared over time. PWH within TB were categorized by ART status at the time of TB diagnosis (pre-ART TB: TB diagnosed before or ≤6 months after starting ART; ART-associated TB: TB diagnosed >6 months after starting ART). Results Among a total of 8,926 PWH, 993 had been diagnosed with TB (11.1%); mean age 40.0 years [SD 11.8], 53.5% were men). Throughout the study period, most TB cases had been notified before ART initiation (617/993; 62.1%). ART-associated TB cases constituted a mean of 37.4% (range 23.8%–44.2%) of all TB cases among PWH annually. Median time from ART initiation to TB diagnosis among ART-associated TB was 6.0 years. Conclusion TB notifications among PWH in this area did not decrease 2015–2022, implying persistently high risk of TB among PWH in this setting. Most TB cases occurred in ART-naïve persons, illustrating late HIV diagnosis in this population.

Trends in HIE and Use of Hypothermia in California: Opportunities forImprovement.

Hypoxic-ischemic encephalopathy (HIE) is a leading cause of neonatal morbidity and mortality. Therapeutic hypothermia (TH), a proven treatment of moderate-severe HIE, was first used clinically after 2006. We describe trends in HIE diagnosis and use of TH over a 10-year period in California. We identified 62 888 infants,≥36 weeks gestation, who were cared for in California Perinatal Quality Care Collaborative-participating NICUs between 2010 and 2019, and linked them to birth certificate data. We evaluated trends in HIE diagnosis and use of TH. Over time, rates of HIE diagnosis increased from 0.6 to 1.7 per 1000 live births, and use of TH increased from 26.5 to 83.0 per 1000 infants. Rates of moderate HIE increased more than mild or severe, although use of TH for mild HIE increased more than for moderate. Of those with moderate-severe HIE, 25% remain untreated. Treatment varied by NICU level of care. The rates of HIE and TH increased steadily. Some infants with moderate-severe HIE remain untreated, suggesting a need for ongoing education. Further evaluation of systems of care is needed to assure all qualifying infants are treated.

The Effect of Income Diversification on Default Risk in Conventional Banking Companies in Indonesia

This study aims to identify variables that affect the risk of bankruptcy in banks listed on the Indonesia Stock Exchange. The research method includes collecting data from 36 listed banks on the Indonesia Stock Exchange over a 5-year period (2018-2022) and using the panel data regression analysis method. The addition of novelty variables in this study, namely bank size, net interest margin, and deposit to total assets that have a negative effect on bankruptcy risk, while the diversification index and gross domestic product variables have no effect on bankruptcy risk. the implication for bank managers is as a reference and consideration in implementing income diversification strategies. this research also provides information that is expected to be used as reference material and expand information and insight in developing research in the banking sector.

Acute Kidney Injury in Rhabdomyolysis: A 5-Year Children’s Hospital Network Study

Rhabdomyolysis is a skeletal muscle injury that can cause myoglobinuria and acute kidney injury (AKI). Risk factors for AKI in children are not clearly understood with no standardized treatment guidelines for rhabdomyolysis. Our study explores factors associated with AKI and management of pediatric patients with rhabdomyolysis. Medical records from a children’s hospital network over a 5-year period were retrospectively reviewed. The results are described with respect to the presence or absence of AKI. Of the 112 patients who met the inclusion criteria, AKI incidence was 7.1% (n = 8), with all affected patients having exertional etiology. The overall mean age was 13.5 years; patients without AKI were younger than patients with AKI (13.3 versus 17; p &lt; 0.001). Using regression models for hypothesis generation, we found that patients with AKI were more likely to be older (OR = 1.44, 95%CI [1.11–2.19]; p = 0.03), have myoglobinuria (OR = 22.98, 95%CI [2.05–432.48]; p = 0.02), and have received intravenous bicarbonate (OR = 16.02, 95%CI [1.44–228.69]; p = 0.03). In our study, AKI was uncommon and associated with older age, myoglobinuria and bicarbonate treatment. Larger, prospective studies are needed to further understand AKI risk factors and optimal management of pediatric rhabdomyolysis.

Assessing urban water-energy nexus characteristics in China and the US

Abstract The water-energy nexus (WEN) provides a comprehensive concept for the cooperative management of resources. Although the WEN system in cities is intricately connected to socioeconomic activities, relationship between WEN and economic systems remains understudied. This study introduces a tri-dimensional Nexus Pressure Index (NPI) to assess the pressure on WEN system. Gross domestic product (GDP) per capita and city tiers in the urban agglomeration were used to assess the relationship between the characteristics of WEN and economic system. We conducted a case study of 296 cities in China and 1,330 counties in the United States from 2012 to 2019. During the 9-year study period, on average, pressure on WEN system have relieved by 22% in China and 27% in the United States, measured by NPI. Cities with most ideal characteristics (low pressure in all dimensions) rank merely in the middle of all eight classes, with GDP per capita 74% and 85% of the highest-GDP-per-capita class in China and the US respectively. Well-performing WEN system does not yield best economic outcomes. High water pressure correlates with better economic performance in the US, while high-energy-pressure cities had GDP per capita about 50% and 70% of the class with highest GDP per capita in China and the US, respectively, suggesting stronger economic constraints from energy stress. Urban agglomeration analysis revealed a negative relationship between WEN and economic performance. NPI in emerging cities is 0.6-1 lower than NPI in regionally-central cities in China, while 0.2-0.5 lower in the US. These results underscore the contradiction between preferred WEN characteristics and higher economic performance, and underpin the resource curse hypothesis at city-level in the two considered giants. A sustainable approach to harmonize WEN and economic system is in urgent need.

Relationship between continuity of primary care and hospitalisation for patients with COPD: population-based cohort study from South Korea

ObjectivesThe existing evidence for the impacts of continuity of care (COC) in patients with chronic obstructive pulmonary disease (COPD) is low to moderate. This study aimed to investigate the associations...

Generalized Propensity Score Methods to Assess CKD-Associated Physiologic Factors and Risk of Kidney Failure in the Chronic Renal Insufficiency Cohort (CRIC) Study.

Epidemiologic studies have identified many biochemical risk factors for chronic kidney disease (CKD) progression that are correlates of kidney function, termed here 'CKD-associated physiologic factors'. Uncertainty remains if these factors are risk factors or risk markers accounting for aspects of kidney function not otherwise captured. We aimed to use flexible machine learning, a dynamic covariate history including kidney function informative markers, and generalized propensity score (GPS) weighting, to better control confounding for such exposures. We studied 3,052 adults with CKD in the Chronic Renal Insufficiency Cohort Study. We established a 2-year run-in period and assembled 90 variables that characterize variability and trends of selected CKD-associated physiologic factors and confounders. Using SuperLearner, we created a GPS for each CKD-associated physiologic factor and performed GPS-weighted Cox regressions. For context, we also evaluated results from traditional multivariable Cox proportional hazards models as in prior studies. Similar to traditional approaches, bicarbonate, calcium, potassium, hemoglobin, and PTH were each associated with risk of kidney failure using GPS weighting. The GPS approach detected non-linear associations in many factors, some of which were not detected with traditional models. We conclude that many associations between CKD-associated physiologic factors and kidney outcomes remain strong after GPS weighting.

Has a dedicated biodiversity offsets policy improved the environmental and social compensation outcomes of development in Australia?

AbstractBiodiversity offsets are used worldwide to provide environmental compensation for the impacts of development and to meet the goals of sustainable development. Australia has embraced the use of offsets and its offset methodologies have been used as models by other jurisdictions. However, the maturity of offset requirements in Australia is unknown. To understand this, development referrals submitted under the Australian Environment Protection and Biodiversity Conservation Act 1999 (Commonwealth) between October 2011 and September 2017 were reviewed to determine if offset requirements in Australia were improving in complexity, transparency and/or environmental outcomes (termed maturity) over time. Despite the implementation of dedicated policy in Australia in 2012, our analysis showed that offset requirements were not on a trajectory towards improvement (maturity) over the 6-year period examined. There was no evidence to suggest the type of offsets required and compensation for impacts to specific species and habitats increased in complexity over time. The level of detail included for offset requirements, mandatory commencement dates and requirements for ecological outcomes similarly did not increase over time. Consequently, dedicated legislation for offsets is recommended to remedy these omissions and enable effective functionality for biodiversity offsets through the protection of the environment and conservation of biodiversity, ecosystem function and ecosystem services.