Pre Period Research Articles

Effectiveness of Culinary Nutrition Workshops on the Mood and Nutritional Interest of Inpatients With Mental Disorder.

Background Promoting healthy eating habits through nutrition education programs is crucial to improving the overall healthof people with mental disorders. This study aims to assess the effectiveness of culinary nutrition workshops on the mood and nutritional interest of hospitalized adults with mental disorders (MD)from the acute psychiatric unit of two general hospitals in Catalonia, Spain. Methods A pilot randomized control trial (RCT) was conducted with MD inpatient. Participants were randomly assigned to two groups: the intervention group receivedweekly culinary nutrition workshops with flexible participation andthe control group continued routinary care. The interest in nutrition was analysed with an ad hoc item pre and post-intervention period. Mood changes were studied with a visual analog scale and analysed pre- and post-intervention periods as well as before and after every session.An ad hoc questionnaire was also used to assess the satisfaction of participants with the intervention. The obtained data were analysed at both descriptive and inferential levels. Results We included 81 participants, with a mean age of 45.3 (SD: 17.0); 66.7% were women, with 41 assigned to the intervention group and 40 to the control group. At the end of every culinary nutrition workshop, a statistically significant improvement in mood was observed in the intervention group (5.9 vs. 7.4 points, p<0.001).However, there were no significant differences in mood changes between the control and intervention groups after the intervention period (control group: 1.0 vs. intervention group: 1.5, p=0.473), while the nutritional interest was significantly improved after the intervention period intergroups (control group: 4.1 vs. intervention group: 37.2, p<0.001). The intervention was excellently valued by the participants regarding content, space, and health professionals, and generated interest and motivation, with scores above 9 on all these items. Conclusion The improvement of interest in nutrition and the satisfaction of hospitalised people with MD with the nutrition culinary workshops emphasizethe need to design more comprehensive RCTs in hospitals and rehabilitation centers.

Building Resilience for Transformational Recovery: An Analysis of Monetary Policy and Economic Growth in West Africa before and Following the COVID-19 Periods

This study investigates the effectiveness of monetary policy in the pre and post COVID-19 periods in West Africa. The panel fully modified ordinary least squares (FMOLS) was used. Before the estimation, the correlation analysis and summary statistics were done. Unit root test was carried out to ascertain whether the data series are stationary or not and the panel cointegration test was used to determine the existence of long run relationship among the variables. The findings indicate that monetary policy has 12.3% negative and significant effects on economic growth in the periods before COVID-19, while it has insignificant effect after the pandemic. Furthermore, monetary policy has 21.01% negative and significance effects on inflation in the pre COVID-19 era, while it has 52.5% negative and significant effect on inflation after the pandemic. This indicates that the effectiveness of the central bank’s efforts to affect and control inflation has declined after COVID-19. Causes for this could include the pandemic’s effect on supply chains, demand, and the weaker economic environment. On this basis, the monetary authority should create an economic environment that will play a crucial role in determining the effectiveness of monetary policy in the post-COVID-19 periods to foster economic recovery.

Practice Patterns of Glucagon-Like Peptide-1 Agonist Use Among Pediatric Bariatric Surgeons: A National Survey

IntroductionGlucagon-like peptide-1 receptor agonist (GLP-1A) medications are gaining widespread popularity for the treatment of obesity. The optimal use of these drugs in pediatric bariatric populations, and especially in those considering metabolic and bariatric surgery (MBS), is yet to be established. We sought to characterize current practice patterns of GLP-1A use at major pediatric bariatric centers across the United States. Materials and MethodsWe administered an online survey to a purposive sample of 46 surgeons who perform MBS on children and adolescents. Survey questions explored practices prescribing GLP-1As in patients considering MBS, holding them prior to elective operations, and restarting them postoperatively following MBS. Responses were summarized with descriptive statistics and inductive content analysis. ResultsThere were 22 responses (48% response rate) representing 19 institutions. Most (86%) respondents do sometimes prescribe GLP-1As for patients considering MBS, but the specific indications vary. Practices for holding GLP-1As preoperatively also vary, from not at all to holding for 2 wk. Over half (55%) of respondents sometimes restart GLP-1As after MBS. Free-response themes included still-evolving preoperative utilization patterns, difficulty with access and insurance coverage, and a lack of data informing GLP-1A use in the pre and postoperative periods. ConclusionsGiven the increasing use of these medications for weight loss purposes, this substantial variation in practice highlights a need for further research to examine the safest and most effective use of GLP-1As in the pre and postoperative periods and for practice guidelines to standardize care pathways in pediatric bariatric contexts.

Tubal ectopic pregnancy: comparative management between pre and Covid-19 pandemic periods.

To evaluate whether there were differences in the presentation of patients with tubal ectopic pregnancy (EP) during the first year of the COVID-19 pandemic. We performed a retrospective cohort study of all cases of tubal EP between March 2019 and March 2020 (pre-pandemic) and between March 2020 and March 2021 (pandemic). We compared between these two groups the risk factors, clinical characteristics, laboratory data, sonographic aspects, treatment applied and complications. We had 150 EP diagnoses during the two years studied, of which 135 were tubal EP. Of these, 65 were included in the pre-pandemic and 70 in the pandemic period. The prevalence of lower abdominal pain was significantly higher in the pandemic compared to the pre-pandemic period (91.4% vs. 78.1%, p=0.031). There was no significant difference in shock index, initial beta-hCG level, hemoglobin level at diagnosis, days of menstrual delay, aspect of the adnexal mass, amount of free fluid on ultrasound, and intact or ruptured presentation between the groups. Expectant management was significantly higher during the pandemic period (40.0% vs. 18.5%, p=0.008), surgical management was lower during the pandemic period (47.1% vs. 67.7%, p=0.023), and number of days hospitalized was lower in the pandemic period (1.3 vs. 2.0 days, p=0.003). We did not observe a significant difference in patient history, laboratory and ultrasound characteristics. Abdominal pain was more common during the pandemic period. Regarding treatment, we observed a significant increase in expectant and a decrease in surgical cases during the pandemic period.

Assessing the environmental and downstream human health impacts of decentralizing cancer care.

1522 Background: Greenhouse gas emissions from healthcare are substantial and harm persons with cancer. Emissions from outpatient cancer care visits are not well described, nor are the downstream reduction in human harms that could be obtained through visit “decentralization” (telemedicine and local care when possible). Methods: This life-cycle assessment (LCA)-based study evaluated changes in emissions and downstream health harms associated with (1) telemedicine visits using retrospective observational analysis and (2) fully decentralized visits using counterfactual modeling. The retrospective observational cohort included persons receiving cancer care at Dana-Farber Cancer Institute (DFCI) and 20 affiliated facilities between 5/2015-12/2020. The main outcome was the adjusted per visit-day difference in emissions (in kilograms carbon dioxide equivalents: kgCO2e) between two periods: an in-person care period (5/2015-2/2020; “Pre”) and a telemedicine period (3/2020-12/2020; “Post”). Mixed effects log-linear model assessed emissions changes adjusted for age, sex, race, ethnicity, and cancer type, with random effects on person. The counterfactual model assessed emissions changes between actual in-person visits during the Pre period and a counterfactual with maximal decentralization. Visit-day eligibility for decentralization was obtained by categorizing appointments (e.g., clinician visit, infusion) as DFCI required, local care possible, or telemedicine possible. This cohort was matched to a national population diagnosed with cancer over the same period (Cancer in North America [CiNA] dataset) using mixed-effects linear modeling, through which annual changes in disability-adjusted life-years (DALY) from clinician visit decentralization were estimated using Eckelman’s mortality cost of carbon conversion. Results: There were123,890 unique patients in the DFCI cohort seen over 1.6 million visit-days (Pre N=110,180, Post N=61,691) at a median of 6 visit-days per patient (IQR 2, 15). An estimated 72,554,006 kgCO2e were within scope of the LCA emitted during the study period. In mixed-effects log-linear regression, the adjusted mean absolute reduction in per visit-day emissions between Pre and Post periods was 36.4 kgCO2e (95%CI 36.2,36.6), or a reduction of 81.3% (95%CI 80.8,81.7) compared to the baseline model. In the counterfactual decentralized care model of the Pre period, there was a relative emissions reduction of 33.1% (95%CI 32.9,33.3). When demographically matched to 10.3 million persons in the CiNA dataset, decentralized care would have reduced national emissions by 75.3 million kgCO2e annually; this corresponds to an estimated annual reduction of 15.0-47.7 DALYs. Conclusions: Employing decentralization through telemedicine and local care can substantially reduce emissions during cancer care delivery; this corresponds to a small reduction in human mortality.

ANAEMIA, EXPECTANT MOTHERS AND DIETARY HABITS: ISSUES AND CONCERNS

The problem of anaemia among expectant mothers, instead of declining has increased over the years at the all India level and also in almost all the states of the country though differentially. These revelations come from the comparative analysis of the NFHS- 4 and NFHS- 5 data on anaemia released in the year 2000 and 2022 respectively. A review of the studies attributes the problem to inadequate nutritious food available to the expectant mothers during the period of pregnancy when the need of the body for iron and calcium increases for the proper growth of the foetus. In the absence of which the women are unable to bear the pressures of bleeding in the pre and post delivery period, leading to low weight baby birth and premature births, and at times resulting in high maternal mortality. This paper examines the status of anaemia among expectant mothers and its relationship with dietary habits.

Lobar Lung Transplantation: A Single-Center 10-Year Experience

IntroductionThe shortage of donors for lung transplant is the main limitation to the preceding. Lobar transplantation is an alternative especially useful in patients with short statute and small thoracic cavities. The aim of this study was to perform a descriptive analysis of Portuguese patients who underwent lobar lung transplantation. MethodsA retrospective study was conducted, and patients submitted to lobar lung transplantation from January 2012 to December 2023 were evaluated. A descriptive analysis was made, including demographic data, lung diseases, waiting list dynamics, pre-transplant evaluations and post-transplant outcomes. ResultsSixteen lobar transplants were performed with a predominance of female patients and median age of 47 years. Most patients had interstitial lung disease or bronchiectasis either due to cystic fibrosis or non-cystic fibrosis. Median pTLC ratio was 0.73. Median waiting list time was 6 months with 9 urgent transplants and 1 emergent lobar retransplant. ECMO was used in pre, intra and postoperative periods. Most transplanted lobes were ML + RUL and LUL. The median length of stay was 58 days with complications such as PDG grade 3, bronchial tree ischemia and concentrical stenosis of bronchial anastomosis. Six patients died in this period, one in the immediate postoperative period and five during the post-transplant hospitalization, with a median survival of 20.7 months and 1-year and 5-year survival rate of 60%. Conclusionour results show a population with increased waiting list converging in many urgent cases, with an early mortality and high PGD rate. Nevertheless, mid-, and long-term survival is promising.

The TransFORmation of IndiGEnous PrimAry HEAlthcare Delivery (FORGE AHEAD): economic analysis

BackgroundIndigenous populations have increased risk of developing diabetes and experience poorer treatment outcomes than the general population. The FORGE AHEAD program partnered with First Nations communities across Canada to improve access to resources by developing community-driven primary healthcare models.MethodsThis was an economic assessment of FORGE AHEAD using a payer perspective. Costs of diabetes management and complications during the 18-month intervention were compared to the costs prior to intervention implementation. Cost-effectiveness of the program assessed incremental differences in cost and number of resources utilization events (pre and post). Primary outcome was all-cause hospitalizations. Secondary outcomes were specialist visits, clinic visits and community resource use. Data were obtained from a diabetes registry and published literature. Costs are expressed in 2023 Can$.ResultsStudy population was ~ 60.5 years old; 57.2% female; median duration of diabetes of 8 years; 87.5% residing in non-isolated communities; 75% residing in communities < 5000 members. Total cost of implementation was $1,221,413.60 and cost/person $27.89. There was increase in the number and cost of hospitalizations visits from 8/$68,765.85 (pre period) to 243/$2,735,612.37. Specialist visits, clinic visits and community resource use followed this trend.ConclusionConsidering the low cost of intervention and increased care access, FORGE AHEAD represents a successful community-driven partnership resulting in improved access to resources.

Abstract PO3-23-02: Delays in breast cancer surgery during the COVID-19 pandemic: A population-based analysis

Abstract BACKGROUND: At various times during the COVID-19 pandemic, access to operating room resources were restricted in Ontario, Canada. This resulted in triaging of all non-urgent cases, including breast cancer (BC) surgery. Recent single institution studies have identified treatment delays during the immediate pandemic time period. The objective of this study was to assess the impact of the pandemic on wait times for breast cancer surgery at a population level. METHODS: We identified patients with a BC diagnosis between January 1, 2018 and November 30, 2021 in Ontario, Canada. Three cohorts were defined based on the following time periods: pre-pandemic (baseline) (January 2018 to 14 March 2020), immediate pandemic (March 15, 2020 to June 13, 2020), and peri-pandemic (June 14, 2020 to November 30, 2021). Time to event analysis was conducted for time to a patient’s first BC surgery. A subgroup analysis was conducted for patients who underwent neoadjuvant chemotherapy (NAC). RESULTS: The study cohort consisted of 36,639 patients with a new diagnosis of BC. Of them 30,862 patients underwent surgery (84.2%) within 18 months after diagnosis. The probability of BC patients undergoing surgery each month from their date of diagnosis was significantly lower (i.e. longer wait times) for patients diagnosed in the immediate and peri-pandemic period compared to patients diagnosed in the pre-pandemic period (log-rank P &amp;lt; 0.001). At eight weeks from date of diagnosis, the probability of having had surgery was 65.1% (95% CI: 64.5-65.8%) for patients diagnosed in the pre-pandemic period, 56.1% (95% CI: 53.6-58.6%) for immediate pandemic and 59.0% (95% CI: 58.2-59.8%) for peri-pandemic. Time for 80% of patients to have BC surgery was 5.4 months in the pre-pandemic, 5.9 months in the immediate pandemic, and 6.0 months in the peri-pandemic period. Among patients who received NAC (N=6,121; 16.7% of cohort), the probability of undergoing surgery in each month from the date of diagnosis was similar for patients diagnosed in the pre and peri-pandemic periods, but was higher (i.e. shorter wait time) for the cohort of patients diagnosed during the immediate pandemic time period (log-rank P &amp;lt; 0.001). At six months from date of diagnosis, the probability of surgery for patients who received NAC was 50.7% (95% CI: 48.9-52.5%), 61.6% (95% CI: 56.6-66.6%), and 50.9% (95% CI: 49.0-52.8%) for patients diagnosed in the pre-, immediate, and peri-pandemic periods respectively. Time for 80% NAC patients to have a surgery was 7.2 months in the immediate pandemic period, shorter than the 8.2 months in the pre-pandemic and 8.0 months in the peri-pandemic periods. CONCLUSIONS: In this large population-based study of BC patients in Ontario, we identified a delay in time to surgery in the immediate pandemic period that persisted into the peri-pandemic period. However, among patients receiving NAC there was a shorter wait time during the immediate pandemic and wait times for this group have returned to pre-pandemic levels. This is likely due to surgical prioritization of this group, despite pandemic related resource restrictions. Further research is needed to explore the regional variability and how use of neoadjuvant endocrine therapy interacted with surgical treatment timelines. Citation Format: Gary Ko, Amanda Roberts, Qing Li, Ning Liu, Toni Zhong, Eitan Amir, Anne Koch, Andrea Covelli, Vivianne Freitas, Emma Reel, Antoine Eskander, Tulin Cil. Delays in breast cancer surgery during the COVID-19 pandemic: A population-based analysis [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-23-02.

Evaluation of some proinflammatory cytokines and biochemical parameters in pre and postmenopausal breast cancer women

The study was planned to evaluate the differences in certain proinflammatory cytokines(IL-6, TNF-α) with CRP and biochemical parameters (E2, D3, LDH, GGT, TSB, Ca, Ph, uric acid), between women with pre- and postmenopausal breast cancer and seemingly healthy women in Iraqi women as controls; at medical city in teaching Oncology hospital,70 breast cancer patients women their ages ranged (47.51 ± 1.18) and 20 healthy women with age (44.45 ± 2.66) begun from September (2020) to February (2021). The aims of this study to investigate the evaluation of chemotherapy effects especially doxorubicin and cyclophosphamide only use in this study in pre and postmenopausal breast cancer women on proinflammatory cytokines(IL-6, TNF-α) with CRP and on biochemical parameters(E2, D3, LDH, GGT, TSB, Ca, Ph, uric acid) in pre and postmenapausal breast cancer women. The patients were divided into five groups and each group contains 14 patients women with breast cancer during pre and postmenopausal periods. The control groups were divided into 10 pre and 10 postmenopausal women(Fig. 1). The results of proinflammatory cytokines of and biochemical parameters in premenopausal groups were as the levels of IL-6 (pg/ml),TNF-α(pg/ml) and CRP (ng/ml) showed significant increase differences (P < 0.01)among breast cancer treated (BCT) groups in comparison with control groups,While the Liver enzymes GGT,LDH and TSB showed highly significant increase (P < 0.01) in BCT groups, Estrogen levels (pg/ml) and D3(ng/ml) increased significantly (P < 0.01)among BCT groups. Blood serum calcium and phosphorus with uric acid levels (mg/dl) showed significant difference (P < 0.01); While the result in postmenopausal of IL-6(pg/ml), TNF-α (pg/ml) and CRP (ng/ml) showed highly significant differences (P < 0.01)among BCT groups.While GGT(IU/L), LDH(IU/L) and TSB (mg/dl) enzymes were increased significantly (p < 0.01), Estrogen (pg/ml) and D3(ng/ml) levels showed significant increase (P < 0.01) among BCT groups.Blood calcium and phosphorus showed significant increase (P < 0.01) while uric acid was non-significant increase (P > 0.05).

Abstract PO1-08-10: Impact of Oncologist-Led Genetic Counseling and Testing on Prophylactic Mastectomy Rates Among Multi-Ethnic Women with Operable Breast Cancer

Abstract Introduction: Approximately 5-10% of breast cancers are attributed to an inherited pathogenic variant (PV) in breast cancer predisposition genes, such as BRCA1 and BRCA2. Identifying women with hereditary breast cancer syndromes is critical to inform risk-appropriate screening and prevention strategies. For example, contralateral prophylactic mastectomy (CPM) has been shown to reduce the risk of new breast primaries without a demonstrated survival benefit. In a prior study, we found that women with pathogenic/likely pathogenic (P/LP) variants were over four times more likely to undergo CPM compared to those with benign/likely benign (B/LB) variants. In recent years due to expanded indications for genetic testing and social distancing during the COVID-19 pandemic, oncologist-led genetic testing and telehealth genetic counseling has gradually replaced in-person genetic counseling visits. We aimed to understand how changes in the delivery of genetic counseling and testing services impacted CPM rates among multi-ethnic women with operable breast cancer in the post COVID-19 period. Methods: We conducted a retrospective cohort study among 1,080 women diagnosed with unilateral breast cancer who underwent germline genetic testing between 2013 and 2022 at Columbia University Irving Medical Center (CUIMC) in New York, NY. The pre COVID-19 period was defined as 2013-2019 and the post COVID-19 period as 2020-2022. Demographics, including age, race/ethnicity and marital status, and clinical characteristics, such as year of diagnosis, breast cancer stage, tumor hormone receptor status, family history of breast cancer, and genetic test results, were extracted from the electronic health record (EHR). We used univariable and multivariable logistic regression analyses to estimate the odds ratio (OR) and 95% confidence interval (95% CI) associated with each variable and receipt of CPM. Results: Among 1080 evaluable women, mean age at diagnosis was 51.2 years old (SD, 12.3) with 39.6% non-Hispanic White, 27.8% Hispanic, 11.4% non-Hispanic Black, 9.0% Asian, and 12.2% multi-racial/other. Within the overall study population, 12.1% of women had P/LP variants and 21.4% had variants of unknown significance (VUS) results. Non-Hispanic Whites and Blacks had the highest frequency of P/LP variants, whereas VUS results were more common among Hispanics and Asians (see Table). Twenty-three percent of women in the study population underwent CPM. In multivariable analysis, younger age at diagnosis, more advanced stage breast cancer, family history of breast cancer, Hispanic race and P/LP results on germline genetic testing were associated with increased CPM rates. Hispanic women were over 60% more likely to undergo CPM compared to non-Hispanic White women (adjusted OR=1.63, 95% CI=1.07-2.47). No significant change in CPM rates was observed in the post-COVID era compared to the pre-COVID era. Conclusion: We aimed to understand how the transition to telehealth and oncologist-led genetic testing affected CPM rates. Although we did not observe a change in CPM rates in the post-COVID era, Hispanic women had significantly more VUS results and were over 60% more likely to undergo CPM compared to non-Hispanic White women. In future studies, we hope to improve risk communication of genetic test results and the risks and benefits of CPM, particularly in vulnerable and underserved populations. Table 1 Genetic testing results and rates of contralateral prophylactic mastectomy stratified by race/ethnicity in women diagnosed with operable breast cancer and undergoing germline genetic testing from 2013-2022 at Columbia University Irving Medical Center, New York, NY Citation Format: Alissa Michel, Kelly Luo, Vicky Ro, Matthew Fine, Meghna Trivedi, Wendy Chung, Roshni Rao, Tarsha Jones, Elana Levinson, Carrie Koval-Burt, Donna Russo, Ilana Chilton, Rita Kukafka, Katherine Crew. Impact of Oncologist-Led Genetic Counseling and Testing on Prophylactic Mastectomy Rates Among Multi-Ethnic Women with Operable Breast Cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-08-10.

Decreasing the blood flow of non-compressible intra-abdominal organs with non-invasive transcutaneous electrical stimulation

Non-invasive neuromodulation of non-compressible internal organs has significant potential for internal organ bleeding and blood-shift in aero/space medicine. The present study aims to investigate the potential influences of the non-invasive transcutaneous electrical nerve stimulation (TENS) on multiple non-compressible internal organs’ blood flow. Porcine animal model (n = 8) was randomized for a total of 48 neuromodulation sessions with two different TENS stimulation frequencies (80 Hz, 10 Hz) and a placebo stimulation. A combination of two different electrode configurations (Abdominal-only or Abdominal and hind limb) were also performed. Intraarterial blood flow measurements were taken during pre and post-stimulation periods at the left renal artery, common hepatic artery, and left coronary artery. Intracranial, and extracranial arterial blood flows were also assessed with digital subtraction angiography. TENS with abdominal-only electrode configurations at 10 Hz demonstrated significant reductions in average peak blood flow velocity (APV) of the common hepatic artery (p = 0.0233) and renal arteries (p = 0.0493). Arterial pressures (p = 0.0221) were also significantly lower when renal APV was reduced. The outcome of the present study emphasises the potential use of TENS in decreasing the blood flow of non-compressible internal organs when the correct combination of electrodes configuration and frequency is used.

Open Bankart repair plus inferior capsular shift versus isolated arthroscopic Bankart repair in collision athletes with recurrent anterior shoulder instability: a prospective study

BackgroundOpen Bankart repair plus inferior capsular shift and isolated arthroscopic Bankart repair have never been prospectively compared under the concept of glenoid track in collision athletes with recurrent anterior shoulder instability. The aim of this study was to compare the functional outcomes, range of motion and recurrence rate between these two surgical techniques. We hypothesized that open Bankart repair plus inferior capsular shift would provide similar functional outcomes to isolated arthroscopic Bankart repair but with a lower recurrence rate. MethodsA prospective cohort study was conducted with 86 collision athletes divided into two groups of 43 patients each. All patients had a subcritical glenoid bone loss ≤ 13.5% and an on-track Hill Sachs lesion. The average follow-up was 66 (60-93) months for the open group and 68 (60-97) months for the arthroscopic group. The primary functional outcomes of each group were evaluated at baseline, 6 months, 1 year and for a minimum of 5 years after surgery. The functional outcomes were also compared between the two groups. The assessment tools included the WOSI and ASES scores. In addition, recurrent instability and range of motion were also evaluated. ResultsIn each group, there were significant differences in WOSI and ASES scores between the pre and postoperative periods. There were no differences between the groups at the end of follow-up (P = 0.47 and 0.22). Three dislocations (6.9%) in the open group and 10 dislocations (23.2%) in the arthroscopic group were reported showing significant differences (P = .012). In addition, there were no differences in range of motion between pre and postoperative periods for each group as well as between them. ConclusionWe found no differences in functional outcomes and range of motion between the two groups. The recurrence rate was significantly higher in the arthroscopic group. We recommend performing open Bankart repair plus inferior capsular shift as a treatment alternative in collision athletes with recurrent anterior shoulder instability.

CONVERSION INTO FULL-FLEDGE ISLAMIC BANKS AND IT’S IMPACT ON ASSET: EVIDENCE FROM INDONESIAN ISLAMIC BANKING INDUSTRY

Objective: This study aims to analyze whether the number of assets differs before and after conversion to an Islamic bank. Theoretical Framework: The theoretical framework provides relevant information on Islamic banking and market structure, which forms the basis for the development of hypothesis. Method: Using regression analysis with dummy variables, the study found differences in assets between the pre and post-conversion periods. Results and Discussion: The findings suggest that conversion could be a recommended approach for the Islamic banking industry in Indonesia to accelerate asset growth. Additionally, it offers an optimal solution for smaller-sized conventional banks as an alternative to spin-offs or mergers. Research Implications: This research provides significant contributions to the study of Islamic banking. This research has the implication that conversion can be an alternative strategy for small parent banks. Originality/Value: Several conventional banks in Indonesia have chosen full conversion into Islamic banks as an exit strategy. This decision is in addition to the spin-off option. Bank of Aceh, Bank of NTB and Bank of Riau Kepri completed the full conversion in 2016, 2018 and 2022, respectively. However, research on Islamic bank conversion is still limited.

Growth, Export Performance and Trade Competitiveness of Lentil (Lens culinaris) From Nepal

The lentil (Lens culinaris) sector in Nepal has realized as an export potential commodity but lacks adequate trade related research and development. To study the growth, export performance and trade competitiveness of Nepalese lentil, secondary data pertaining for the period of 30 years (1990–2019 A.D.) were analyzed classifying as pre and post WTO period for Nepal. Compound annual growth rate (CAGR), Cuddy-Delle Velle instability index, export performance ratio, reveled comparative advantage (RCA), trade specialization and Herfindahl-Hirschman index were analyzed. The trend analysis showed highly fluctuation with the growth rate of 40.31 and 42.24 percent per annum has been noticed in import value and quantity respectively. Whereas; the export quantity is found negative growth of 0.43 percent and export value with the growth of 1.44 percent. High instability was found in all parameters of export and import and highest variation was noticed for pre-WTO period in comparison to post-WTO. Nepal enjoys relatively strong competitiveness in export of lentil with RCA value greater than 1. Trade specialization index fluctuated over the years, it remains in the stage of import substitution declining from growth stage and have witnessed positive direction to revive the lentil export performance from Nepal. Herfindahl-Hirschman index showed that the Nepalese lentil market for export is highly concentrated which can lead to high economic risks. Int. J. Soc. Sc. Manage. Vol. 11, Issue-(1-2): 7-16.

The Impact of the Global Pandemic on Veterans with Serious Mental Illness (SMI): Healthcare Utilization and Mortality.

Individuals with serious mental illness (SMI) experience barriers to accessing and engaging with healthcare, which may have been exacerbated during the emergence of the global pandemic and the rapid shift to telemedicine platforms, substantially decreasing healthcare utilization for non-COVID-19 disorders. Important repercussions on morbidity and mortality may be seen in the months and years to come, which may disproportionately affect high-risk populations, such as patients with SMI, with reduced access to technology platforms. In this study, we explored the impact of the pandemic on healthcare utilization and all-cause mortality rate in SMI compared to non-SMI individuals for the months of March-September 2020 and the same two quarters in 2019. Data were obtained from the VA Corporate Data Warehouse (CDW), a data repository from clinical and administrative VA systems. The sample included veterans with ≥1 outpatient clinical encounter nationally between 1 January 2019 and 31 December 2020. The cohort for this study included 1,018,047 veterans receiving care through the Veterans Health Administration between 2019 and 2020. Of those, 339,349 had a diagnosis of SMI. Patients with SMI had a significantly larger pre-post-pandemic decrease in outpatient (49.7%, p < 0.001), inpatient (14.4%, p < 0.001), and ED (14.5%, p < 0.001) visits compared to non-SMI patients. Overall, 3752 (1.59%) veterans without SMI and 4562 (1.93%) veterans with SMI died during our observation period. Veterans without SMI who died during the observation period were more likely to have had a positive COVID-19 test compared to veterans with SMI. Unadjusted analyses showed that veterans with SMI were approximately 2.5 times more likely to die than veterans without SMI during the first 6 months of the pandemic, compared to the same two quarters of the previous year. However, after adjustment by pertinent covariates, the predictors associated with an increased risk of death from SMI were older age, being male, a higher CAN score, more inpatient stays in the pre period compared to post, and a positive COVID-19 test. Consistent with our initial hypothesis, all the indices of healthcare utilization, namely the number of outpatient, inpatient, and ED visits, significantly decreased between pre- and post-pandemic and did more so for veterans with SMI, despite having more chronic medical illnesses and being prescribed more medications than veterans without SMI. On the other hand, while mortality was greater post-pandemic, factors such as age, morbidity, and having a positive COVID-19 test predicted mortality above and beyond having an SMI diagnosis.

Predicting financial distress in Latin American companies: A comparative analysis of logistic regression and random forest models

Latin America represents a growing financial market. The performance of its private sector corporations is critical, as inadequate performance and financial distress can lead to significant losses for many stakeholders. This study assesses the efficacy of Logistic Regression (LR) and Random Forest (RF) techniques in predicting corporate distress up to three years in advance. Additionally, we discuss relevant indicators and compare our findings in two different scenarios (pre versus pandemic period). The results indicate that RF outperforms LR in terms of predictive power and error levels. The most effective predictors remained consistent over the 20-year period but varied between the two models. Importantly, the performance levels remained unaffected by the COVID-19 pandemic.

Netflix Stock Valuation

The COVID-19 pandemic wrought significant changes in people’s lifestyles, leading them to turn to entertainment options, with online streaming emerging as a popular choice during quarantine periods. In the initial half of 2020, Netflix experienced a surge, gaining over 26 million global subscribers (ACCA, 2020). This surge was mirrored in its stock price, skyrocketing from $287 per share in September 2019 to $690 in October 2021. Despite a subsequent decline to $482 as of January 2024, the stock still maintains nearly double its value from five years ago. As the pandemic’s influence wanes and more leisure options become available, questions arise about the justifiability of Netflix’s current stock valuation. This report employs two approaches to assess the fairness of Netflix’s stock: discounted cash flow valuation (DCF) and comparable companies analysis (CCA). The DCF method indicates a slightly lower intrinsic value than Netflix’s current stock price by half a dollar. The CCA model, utilizing data from Netflix and its six major competitors’ annual reports spanning 2017 to 2023, including the pre and post-pandemic periods, suggests that Netflix is significantly overvalued. Considering Netflix’s overall trend and underlying assumptions, the conclusion is drawn that Netflix’s stock price is overvalued.

Analysing the Impact of Major Financial Crisis on Macroeconomic Variables and Stock Prices: An Empirical Study of Stock Market of United Kingdom

The research paper empirically tests the impact of major financial crisis of 2008 by testing the causality between five macroeconomic variables (interest rate, inflation, money supply, GDP and exchange rate), the FTSE All-Share index and its sectoral indices. Furthermore, it analyses whether the global financial crisis of 2008 affected the direction of the causality or not. For this purpose the causality tests were performed in two sections one on the data for the pre financial crisis period from 1999 to 2007 and another on the data for post financial crisis period from 2008 to 2022. The causality was tested using the quantile Granger causality test, the research findings reveal the complex causality between the UK stock market and the most prevalent macroeconomic factors. The findings of the research are suggestive that the causality between macroeconomic factors changed from pre-crisis period to post-crisis period. This is indicative of the event sensitivity of the stock market of UK. It was found that the direction of this causality varies according to the circumstances of the economy and across different sectors involved, and particular economic conditions at various times. The findings of this research provide important insights for policymakers, investors, and economic analysts, as they shed light on the dynamic and complex relationship between the indicators, both on an aggregate and sectoral level. The research findings also emphasise the importance of considering the variables' distribution when analysing the issue of causality.

Effect of Physiotherapy Treatment in Tertiary Care Hospital on Functional Disability in Frozen Shoulder Patients

Background: Frozen shoulder was introduced as Adhesive capsulitis by Naviesar in 1947. It commonly occurs between 40 and 70 years and is more common in females than males. Bilateral movements occur in 10-40 % of cases. It is mostly seen in patients with Diabetes mellitus. Patients with frozen shoulders are managed by Physiotherapy, medications (NSAIDs), corticosteroid injection, Arthrography infiltration, and manipulation. If not managed conservatively, surgical options are also available. The symptoms of the Frozen Shoulder can be reversed after the treatment has been taken. So, it is important to check whether the physiotherapy treatment is beneficial from a long-term perspective or not. Materials and Methods: A total of 37 patients participated in this study, 20 were females and 17 were males. Previous demographic and assessment data of these patients were recorded. Patients who were undergoing treatment were called to the Physiotherapy OPD and their pain, range of motion, and SPADI scale were assessed- A statistical analysis of comparison of previous and present scores was done by using a computerized method. Results: Statistical analysis showed significant improvement in pain and SPADI score in pre and post-test periods (p values of Visual analogue scale were 0.0628 for at rest, 0.009 for on activity, and 0.0033 for SPADI. Range of motion was not showing significance (p-value is more significant than 0.05), it was maintained throughout during pre and post-test periods. Conclusion: In statistical analysis, Pain and SPADI assessment showed significance, and Range of motion did not show significance in the pre and post-test. Hence, we conclude that treatment taken in Tertiary care hospitals is effective in patients with Frozen shoulders in a long-term perspective.