Short-term Study Research Articles

Diagnostic Accuracy of Somatosensory Evoked Potential and Transcranial Motor Evoked Potential in Detection of Neurological Injury in Intradural Extramedullary Spinal Cord Tumor Surgeries: A Short-Term Follow-Up Prospective Interventional Study Experience from Tertiary Care Center of India.

Objective Intraoperative neuromonitoring (IONM) is an acknowledged tool for real-time neuraxis assessment during surgery. Somatosensory evoked potential (SSEP) and transcranial motor evoked potential (MEP) are commonest deployed modalities of IONM. Role of SSEP and MEP in intradural extramedullary spinal cord tumor (IDEMSCT) surgery is not well established. The aim of this study was to evaluate sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of SSEP and transcranial MEP, in detection of intraoperative neurological injury in IDEMSCT patients as well as their postoperative limb-specific neurological improvement assessment at fixed intervals till 30 days. Materials and Methods Symptomatic patients with IDEMSCTs were selected according to the inclusion criteria of study protocol. On modified McCormick (mMC) scale, their sensory-motor deficit was assessed both preoperatively and postoperatively. Surgery was done under SSEP and MEP (transcranial) monitoring using appropriate anesthetic agents. Gross total/subtotal resection of tumor was achieved as per IONM warning alarms. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of SSEP and MEP were calculated considering postoperative neurological changes as "reference standard." Patients were followed up at postoperative day (POD) 0, 1, 7, and 30 for convalescence. Statistical Analysis With appropriate tests of significance, statistical analysis was carried out. Receiver-operating characteristic curve was used to find cutoff point of mMC for SSEP being recordable in patients with higher neurological deficit along with calculation of sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of SSEP and MEP for prediction of intraoperative neurological injury. Results Study included 32 patients. Baseline mean mMC value was 2.59. Under neuromonitoring, gross total resection of IDEMSCT was achieved in 87.5% patients. SSEP was recordable in subset of patients with mMC value less than or equal to 2 with diagnostic accuracy of 100%. MEP was recordable in all patients and it had 96.88% diagnostic accuracy. Statistically significant neurological improvement was noted at POD-7 and POD-30 follow-up. Conclusion SSEP and MEP individually carry high diagnostic accuracy in detection of intraoperative neurological injuries in patients undergoing IDEMSCT surgery. MEP continues to monitor the neuraxis, even in those subsets of patients where SSEP fails to record.

Seven Days of Voice Rest Post-phonosurgery Is Not Better than 3 days: A Prospective Randomized Short-term Outcome Study.

The aim of the study is to compare the short-term effect of 7 versus 3 days of voice rest (VR) on objective vocal (acoustic) parameters following phonosurgery. A prospective randomized study conducted at a tertiary referral medical center. Patients with vocal fold nodules, polyps, or cysts and scheduled for phonosurgery were recruited from the Voice Clinic. They were randomized into groups of 7- or 3-day postoperative VR periods and their voices were recorded preoperatively and at 4-week postoperatively. A mixed linear model statistical analysis (MLMSA) was used to compare pre- and postoperative jitter, shimmer, harmonic-to-noise ratio, and maximum phonation time between the two groups. Sixty-five patients were recruited, but only 34 fully complied with the study protocol, and their data were included in the final analysis (19 males, 20 females; mean age: 40.6 years; 17 patients in the 7-day VR group and 16 in the 3-day VR group). The groups were comparable in age, sex, and type of vocal lesion distribution. The preoperative MLMSA showed no significant group differences in the tested vocal parameters. Both groups exhibited significant (p < 0.05) and comparable improvement in all vocal parameters at postoperative week 4. A VR duration of 7 days showed no greater benefit on the examined vocal parameters than the 3-day protocol 4-week postoperatively. Our results suggest that a 3-day VR regimen can be followed by patients who undergo phonosurgery without compromising the vocal results. Larger-scale and longer-duration studies are needed to confirm our findings. 2 Laryngoscope, 134:4661-4666, 2024.

Percutaneous endocardial septal radiofrequency ablation on syncope in patients with hypertrophic obstructive cardiomyopathy: a short-term safety and efficacy study.

Syncope is a serious consequence in patients with hypertrophic obstructive cardiomyopathy (HOCM). Percutaneous endocardial septal radiofrequency ablation (PESA) has emerged as a promising intervention to alleviate symptoms and enhance the quality of life for HOCM patients. However, little is known about the effects of PESA on syncope in HOCM. The authors aimed to study the effects of PESA on syncope in patients with HOCM. Nineteen patients with HOCM and syncope were enrolled. The left ventricular outflow tract gradient (LVOTG) of the patients was more than 50mmHg despite medication. The participants underwent PESA under the guidance of intracardiac echocardiography (ICE) combined with a three-dimensional electrophysiological mapping system. The patients were followed for 3 (3-5.5) months. The mean age of the patients was 54.8±13.7 years. Out of the 19 participants, 7 (37%) were females. During the follow-up, the syncope was completely alleviated in 14 patients (73.7%) or the syncope episodes were reduced greater than or equal to 80% in 16 patients (84.2%). The mean NYHA functional class significantly improved from 2.2±0.7 at baseline to 1.7±0.6 during follow-up (P=0.002). The LVOTG and septal thickness showed a decreasing trend from baseline to follow-up (LVOTG: P=0.083, septal thickness: P=0.086). The authors' investigation provides evidence supporting the effectiveness of PESA in reducing syncope episodes in patients with HOCM.

How does family functioning contribute to academic-related outcomes of Chinese adolescents: the mediating role of spirituality.

While family functioning is crucial to adolescent developmental outcomes, the mediating role of spirituality in the relationship between family functioning and academic-related outcomes of adolescents has been sparsely explored, particularly in non-Western contexts. To address this gap, based on a short-term longitudinal study, we examined the influence of family functioning on the academic values and academic anxiety of 4,981 Chinese adolescents in Sichuan, China, with spirituality as the mediator. We gathered data from students aged 11 and above at Wave 1 and at six months later (Wave 2). Analysis utilizing structural equation modeling indicated that prior family functioning positively and negatively predicted subsequent academic values and academic anxiety respectively, with spirituality as a significant mediator. Theoretically, this study helps to build up a conceptual model on how family functioning and spirituality of adolescents shape academic values and academic anxiety of adolescents. Practically, the present findings highlight the significance of enhancing family functioning and adolescent spirituality to help adolescents strive for academic success.

Impaired episodic verbal memory recall after 1 week and elevated forgetting in children after mild traumatic brain injury - results from a short-term longitudinal study.

There is preliminary evidence that children after traumatic brain injury (TBI) have accelerated long-term forgetting (ALF), i.e., an adequate learning and memory performance in standardized memory tests, but an excessive rate of forgetting over delays of days or weeks. The main aim of this study was to investigate episodic memory performance, including delayed retrieval 1 week after learning, in children after mild TBI (mTBI). This prospective study with two time-points (T1: 1 week after injury and T2: 3-6 months after injury), included data of 64 children after mTBI and 57 healthy control children aged between 8 and 16 years. We assessed episodic learning and memory using an auditory word learning test and compared executive functions (interference control, working memory, semantic fluency and flexibility) and divided attention between groups. We explored correlations between memory performance and executive functions. Furthermore, we examined predictive factors for delayed memory retrieval 1 week after learning as well as for forgetting over time. Compared to healthy controls, patients showed an impaired delayed recall and recognition performance 3-6 months after injury. Executive functions, but not divided attention, were reduced in children after mTBI. Furthermore, parents rated episodic memory as impaired 3-6 months after injury. Additionally, verbal learning and group, but not executive functions, were predictive for delayed recall performance at both time-points, whereas forgetting was predicted by group. Delayed recall and forgetting over time were significantly different between groups, both post-acutely and in the chronic phase after pediatric mTBI, even in a very mildly injured patient sample. Delayed memory performance should be included in clinical evaluations of episodic memory and further research is needed to understand the mechanisms of ALF.

Peritumoral HLJ1-STAT3 pathway investigation in carcinogen-induced hepatocellular carcinoma.

e16251 Background: Hepatocellular carcinoma (HCC) is a major global health issue and its treatment options have been limited. Therefore, it is urgent to develop cancer biomarkers for defining cancer risk, diagnosis, prognosis, and even finding new therapeutic targets. Human Liver DnaJ-Like Protein (HLJ1), which belongs to DnaJ heat shock protein family (HSP40) member B4 (DNAJB4), has been identified as a tumor suppressor in various cancers including lung cancer and colorectal cancer. Though the biological function of HLJ1 in either cancer or the liver has emerged in recent years, the precise role of HLJ1 in HCC carcinogenesis is still unclear. Methods: Samples for gene expression cDNA microarray were from 6-8 weeks wild-type (WT) and HLJ1 knockout (HLJ1-/-) mice liver. For the long-term carcinogenesis study, both mice are injected with 20 mg/kgbw diethylnitrosamine (DEN) at postnatal day 15. After that, 50 mg/kgbw DEN was administrated weekly to mice between the ages of 4 to 12 weeks. Mice were sacrificed at ages 30 and 36 weeks to assess the tumor count and size. For the short-term DEN study, 6-8-week-old mice were injected with 100 mg/kg DEN, and 24 and 48 hours after administration the liver tissues were frozen and fixed for western blotting and IHC analysis. Cancer cell transplantation was performed by intrasplenic injection of HLJ1-wildtype LLC and B16F1 cells into both genotypes. Clinical information of 362 liver cancer patients from the TCGA database was analyzed for the correlation between HLJ1 expression and survival. Results: In cDNA microarray analysis, We demonstrated that HLJ1 deficiency led to HCC gene signatures associated with activated IL-6/STAT3 signaling pathways. We used the DEN as a carcinogen and found STAT3 and H2AX phosphorylation induced by short-term DEN treatment was amplified in HLJ1-deficient mice. In long-term DEN experiments, HLJ1 deletion promoted tumor initiation and proliferation at the early and late stages of HCC progression accompanied by pronounced STAT3 phosphorylation in the normal part instead of the tumor part. Furthermore, transplantation of HLJ1-wildtype B16F1 and LLC cell lines into HLJ1-deficient mice led to more tumorigenic phenotype than into wildtype mice. Clinical information of 362 liver cancer patients from the TCGA database exhibited that higher expression of HLJ1 in the tumor part is correlated to a lower disease-specific survival rate. Conclusions: In summary, HLJ1 protects against DEN-induced HCC hepatocarcinogenesis through the regulation of STAT3 signaling in the peritumoral normal cells. Hence, HLJ1 can be a prognostic biomarker for liver cancer and a promising therapeutic target for HCC in the future.

Impact of Perioperative Dexamethasone Administration on Infection and Implant Osseointegration in a Preclinical Model of Orthopedic Device-Related Infection.

Glucocorticoids may be given prior to major orthopedic surgery to decrease postoperative nausea, vomiting, and pain. Additionally, many orthopedic patients may be on chronic glucocorticoid therapy. The aim of our study was to investigate whether glucocorticoid administration influences Orthopedic-Device-Related Infection (ODRI) in a rat model. Screws colonized with Staphylococcus epidermidis were implanted in the tibia of skeletally mature female Wistar rats. The treated groups received either a single shot of dexamethasone in a short-term risk study, or a daily dose of dexamethasone in a longer-term interference study. In both phases, bone changes in the vicinity of the implant were monitored with microCT. There were no statistically significant differences in bacteriological outcome with or without dexamethasone. In the interference study, new bone formation was statistically higher in the dexamethasone-treated group (p = 0.0005) as revealed by CT and histopathological analysis, although with relatively low direct osseointegration of the implant. In conclusion, dexamethasone does not increase the risk of developing periprosthetic osteolysis or infection in a pre-clinical model of ODRI. Long-term administration of dexamethasone seemed to offer a benefit in terms of new bone formation around the implant, but with low osseointegration.

A catalyst for learning or reinforcement of inequities: Using a critical hope lens to understand the potential and limitations of short-term study abroad in fostering students’ ability to effectively interact across differences.

A catalyst for learning or reinforcement of inequities: Using a critical hope lens to understand the potential and limitations of short-term study abroad in fostering students’ ability to effectively interact across differences.

Engagement with language in study abroad: accounts from Korean English-major students in the United States

ABSTRACT This study investigates the emergence and nature of engagement with language during short-term study abroad (STSA). Ten teacher-education students from the same sending university in South Korea participated in a 4-week programme hosted by a U.S. university, with emphasis on multiculturalism and English as a medium of classroom instruction. Adopting the framework of engagement with language and a case study method, the current study focuses on three English majors with a professional stake and expert training as focal cases and their responses to focus group interviews and individual interviews, as well as written reflections. The data reveal the participants’ critical reflections on their prior L2 practices and a complex interplay of cognitive (breakdowns of English and its forms and functions), affective (confidence boosting), and social (interactions for learning) engagement with language in relation to what STSA affords as a context and how the participants negotiate and shape that context. The study further uncovers dynamic interactions of the different forms of engagement, such as juxtaposition of cognitive and affective forms and interconnected forms of cognitive, affective, and social engagement. The findings shed new insight into the complex nature of engagement with language during STSA.

#2491 Survival outcome of tunneled and non-tunneled hemodialysis catheters in incident hemodialysis requiring patients: a short term study

Abstract Background and Aims For long term hemodialysis, tunnel catheters are preferred over non –tunneled as vascular access. High cost and expertise in its catheterization are major limitations. It is unclear about the advantage of low cost non- tunneled catheter preference over costly tunnel catheters as short term access while awaiting AVF maturation. Method All consented incident End Stage Kidney Disease (ESKD) patients requiring hemodialysis from March’ 2021 to October’ 2023 were included. Less than 18 years of age, opting for peritoneal dialysis and patients initiating hemodialysis with AVF or AV Graft were excluded from the study. Subjects were randomized in two catheter groups (Tunneled and Non-tunneled). Under aseptic precautions, all catheters were inserted by ultrasound and C-arm guided following standard protocol. Mechanical, infective and catheter survival outcomes were recorded during dialysis initiation, at 2nd, 6th and 12th weeks. Blood culture samples were sent for those patients who were having fever with chills during dialysis. If the blood culture comes out to be positive for organism, all were treated for one week intravenous antibiotic depending upon the sensitivity or as per standard protocol. Catheter salvage in both the groups was tried till 6 weeks or till AVF maturation. If in any case, AVF is not matured, we continued dialysis with the same catheter. New catheter was inserted if patient do not respond antibiotics after one week of therapy, mechanical complications or due to inadequate flow. Adequacy of the dialysis and overall outcome of patients were monitored in both the groups of catheter. All demography data and survival analysis were analyzed. Results A total 133 patients were randomized into Tunneled-65 (48.87%) and non-tunneled-68 (51.12%). Average patient's age of tunneled and non-tunneled was 45.15 ± 15.89 and 40.39 ± 12.21 respectively. A total of 50 (37.3%) were males in tunneled and 54 (40.3%) males in non tunneled groups. A total 65 (54.2%) patients were complained fever with chills during dialysis, of them 31 (25.8%) in tunneled and 34 (28.3%) in non-tunneled group. Among the CRBSI group a total 3 catheters were removed in non-tunneled group whereas all patients in tunneled group were responded to antibiotic. There were total of 24 (18.2%) infections were reported and labelled as CRBSI. Of them 9 (6.7%) in tunneled and 15 (11.2%) in non-tunneled. Most common organism was Klebsiella and Coagulase negative Staphylococcus (Cons) in both the groups. There was only one mechanical complication in case of non- tunneled catheter. The estimated days for catheter survival is 66 for tunneled and 57 for non tunneled (p-0.001). However, in case of non tunneled catheter, 15 cases were reported in which two times catheter were inserted. A total of 14 (10.5%) patients were lost to follow up 8 (6%) in tunneled and 6 (4.5%) in non- tunneled. A total of 9 (5.8%) patients died, 5 (3.8%) in tunneled and 4 (3%) in non- tunneled within 12 weeks. Conclusion Although tunneled catheter showed longer catheter survival period, low cost and easy cannulation procedure in non-tunneled hemodialysis catheter is a better viable option for all incident ESKD patients while waiting for AVF maturation.

#3007 Association between sarcopenia and clinical outcomes in patients on maintenance hemodialysis

Abstract Background and Aims Sarcopenia is a generalized skeletal muscle disorder characterized by the progressive loss of skeletal muscle mass, strength, and function, resulting in worse quality of life and increased mortality. Chronic kidney disease and hemodialysis (HD) favor the development of sarcopenia; however, factors associated with sarcopenia in HD patients have not been well-studied. This study aimed to determine the prevalence and risk factors for sarcopenia in HD patients and to analyze the relationship between sarcopenia and overall morbidity and mortality. Method We conducted short-term follow-up prospective cohort study among maintenance HD patients. Hand Grip Strength was measured by a resisted hand-held dynamometer to identify muscle strength and Bioimpedance Spectroscopy to calculate appendicular skeletal muscle mass (ASM). Finally, appendicular skeletal muscle index (ASMI) was calculated as ASM (kg) divided by weight squared (m2). Patients were categorized as sarcopenic or non-sarcopenic using Revised European Working Group criteria (EWGSOP2). Low muscle mass was defined as an ASMI value of&amp;lt;7.00 kg/m2 for men and&amp;lt;5.40 kg/m2 for women; low muscle strength was defined as a hand grip strength of&amp;lt;28 kg for men and&amp;lt;18 kg for women. Results Our study enrolled 176 adult HD patients (60% male, 56.1 ± 14.8 years of age). Median follow-up was 15.9 (interquartile range [IQR] 8.6–21) months. Sarcopenia was present in 32.5 % of males and 28% of female patients and associated with older age (55.2 ± 13.4 vs. 64.0 ± 7.3, p&amp;lt;0.001), lower body mass index (25.3 ± 1.3 vs. 22.8 ± 3.1 kg/m2, p&amp;lt;0.05), longer dialysis vintage (9.2 ± 1.1 vs. 6.2 ± 1.9 years, p&amp;lt;0.001) lower Kt/V and lower serum phosphorus and albumin levels (p = 0.037, p = 0.042 and p = 0.048, respectively). In the multivariate analysis, the sarcopenic group had a significantly higher risk for all causes hospitalization than the non-sarcopenic group after adjusting for age and gender (OR 3.92, (95%CI 1.21–12.53, p = 0.031)). Sarcopenia was significantly associated with higher mortality risk (adjusted OR 1.76 (95% CI 1.32 to 2.67)), cardiovascular (adjusted OR 3.31 (95% CI 1.55 to 9.22)) and cerebrovascular events (adjusted OR 2.67 (95% CI 1.52 to 6.03)). Kaplan–Meier survival analysis showed a twelve-month survival rate of 82.1% in sarcopenic patients, which was significantly lower than the non-sarcopenic group (p = 0.034). Finally, both ASM and low muscle strength were independently related to increased mortality risk in dialysis patients (OR 1.86; 95% CI 1.31 to 2.62 and OR 2.31 95% CI 1.49 to 3.93, respectively). Conclusion Our study demonstrated that sarcopenia was highly prevalent among HD patients and was shown to be a significant predictor of poor patients outcomes. Future research should address whether the early diagnosis and treatment of sarcopenia improve outcomes.

Short-term study of biological degradation of diesel oil by bacteria isolated from petroleum-contaminated soil

The use of fossil fuels leads to environmental contamination during their extraction, processing and distribution. Microbial biodegradation provides a sustainable method for cleaning contaminated areas which follows the principles of sustainability. This paper presents the dynamics of biodegradation of hydrocarbon fractions of diesel oil, using Planomicrobium sp. and Rhodococcus sp. isolated from petroleum-contaminated sites. GC–MS analysis was employed to analyse abundances of the specific compounds such as n-alkanes, isoprenoids, sesquitepranes, hopanes, steranes and aromatic compounds (naphthalene and its methylated homologues, phenanthrene and anthracene and their methylated homologues, and dibenzothiophene and its methylated homologues). The obtained results showed that after 30 days of biodegradation of diesel, a significant degradation was achieved, with almost complete degradation of n-alkanes and a decrease in the amount of sesquiterapanes. Rhodococcus sp. had a higher efficiency in degradation of n-alkanes, while Planomicrobium sp. had a higher efficiency in the degradation of branched hydrocarbons. Both strains showed high activity in the biodegradation of sesquitepranes and demonstrate ability to degrade methylated phenanthrenes. Additionally, dimethyl-dibenzothiophenes were almost completely degraded and removed from the system. This study presents the first comprehensive report on the GC–MS analysis of the diesel biodegradation pattern of the Planomicrobium sp., compared with the well-established Rhodococcus sp.

L2 interactional competence in a short-term service-learning and study abroad program

Abstract This case study explores one Spanish L2 learner’s interactional competence (IC) during a short-term study abroad program that featured service-learning (SL). The goal of the study is to describe the learner’s IC in interactions in the SL context. Data for analysis derive primarily from dialogues between the focal participant and interlocutors from her SL network and are analyzed qualitatively using Young’s (2019) categories of identity, linguistic, and interactional resources. Key findings include: (a) the participant co-constructed identities as an American and a teacher with her interlocutors; (b) use of linguistic resources suggests accommodation to Peninsular Spanish, possibly heightened by increased contact with native speakers in SL; and (c) SL afforded a space where the learner felt confident trying out linguistic and interactional features. Findings describe the participant’s IC and suggest the value of the SL context for meaningful interaction in short-term study abroad programs.

Machine-learning-assisted long-term G functions for bidirectional aquifer thermal energy storage system operation

Optimization of aquifer thermal energy storage (ATES) performance in a building system is an important topic for maximizing the seasonal offset between energy demand and supply and minimizing the building's primary energy consumption. To evaluate ATES performance with bidirectional operation, this study develops an analytical solution-based model to simulate the spatiotemporal thermal response in an aquifer. The model consists of three temperature response functions, similar to the G functions in borehole thermal energy storage (BTES), to estimate the transient temperature profile in the aquifer during seasonally varying injection and extraction of hot/cold water. Applying machine learning (ML) based data classification and regression techniques to the results of a series of finite element (FE) benchmark simulations of typical ATES configurations, model input parameters are linked to the subsurface thermal, hydrogeological, and ATES operational properties. Compared to the benchmark simulation results, the errors of the proposed model in estimating the annual energy storage and locating the thermally affected area are about 3 % and 1 %, respectively. The model was applied to a previous short-term case study, and the error in the transient production temperature estimation is about 1 %. The long-term heat recovery ratio estimated from the model also compares well to those calculated from the previous study and the validated numerical model. Because of its fast computation, the proposed model can be coupled with the individual building system simulation and used for preliminary ATES design, and this will allow for greater exploration of ATES operational space and, therefore, better choices of ATES operating conditions. The proposed model can also be coupled with the district heating and cooling network simulation for computationally efficient city-scale long-term ATES potential assessment.

How teaching about peace and conflict in Northern Ireland reformulated our leadership teaching and learning philosophy.

In this reflective article, we offer innovative approaches to creating opportunities for leadership learning through questioning the intentions versus impacts of leading short-term study abroad courses. We consider the critical relevance of approaching a course like this from a learning disposition-recognizing our roles as learners, as well as facilitators of learning. We note the impacts of hegemony and identity, the effort and skills of dialoguing across difference, the complexities of constructive ambiguity, and the necessity to be adaptable as we navigate liminal spaces, concepts, and efforts for peace leadership. In the end, although this was a brief, 10-day experience, we came to realize our entire outlook on facilitating leadership learning shifted to recognize and grapple with these complexities.

As Teachers Not Tourists: Creating Knowledge During a Short-Term Study Abroad Program

Here, I address the call for teacher education programs to feature international elements to help pre-service teachers craft powerful classroom instruction and successfully work with students from culturally diverse backgrounds. I share a qualitative investigation of participants’ experiences during a short-term study abroad program in Japan that explored contemporary disaster preparedness as a result of the Great East Japan Earthquake and Tsunami. The program sponsors, the Japanese Ministry of Foreign Affairs, hoped participants would develop an appreciation for the people and culture of Japan while they learned about disaster preparedness. I wondered if collecting curriculum items during a short-term study abroad program could help social studies pre-service teachers create—not just receive—historical domain knowledge? In Japan, participants collected items to use as featured resources around which they designed classroom activities for secondary students. Their activities demonstrated three levels of second-order historical domain knowledge and two elements of civic competence. This study suggests that pre-service teachers with no previous international experience may require explicit modeling and scaffolding to translate their short-term study abroad participation into dynamic learning. Another implication is that participants need strong support to consider the photographs they capture as artifacts of contemporary material culture.

New horizons in gerotranscendence interventions. Targeting nursing home staff members and other caregivers: a scoping review

PurposeThe aim of this scoping review is to describe the published gerotranscendence interventions targeting older adults’ caregivers and their outcomes.Design/methodology/approachSix databases were searched, and three studies were selected for analysis: one short-term quasi-experimental study and two observational studies.FindingsThe interventions consisted in an instructional moment about the gerotranscendence theory and a moment for sharing personal perceptions.Originality/valueGerotranscendence interventions can be essential for the caregivers to have a better relationship with the older adults, as they could improve their perception on their needs. Even though the interventions presented promising results benefiting caregivers and older adults, none of the studies confirmed that these changes persisted in the long term and additional studies are needed to robustly investigate this subject.

Risk Factors for Acute-Level Hospital Course in Pediatric Craniofacial Fractures.

The pediatric craniofacial trauma literature is limited to single institutions or short study periods. Herein, this study analyzes a national database over 10 years to delineate the epidemiology of pediatric craniofacial fractures and to identify risk factors for acute-level hospital course in the largest series to date. Utilizing the National Trauma Data Bank, pediatric craniofacial fractures admitted between 2010 and 2019 were identified. Descriptive analyses and multivariable regression were performed to identify risk factors for acute-level hospital course. A total of 155,136 pediatric craniofacial fracture cases were reviewed, including cranial vault (49.0%), nasal (22.4%), midface (21.0%), mandibular (20.2%), and orbital floor fractures (13.7%). Midface and orbital floor fractures occurred commonly as multicraniofacial fractures. Cranial vault fractures were the most common among all age groups, but frequency declined with age. In contrast, facial fractures increased with age. Despite the inherent complexity of multicraniofacial trauma, isolated fractures remained a concern for acute-level hospital course.Cranial vault and midface fractures had an increased risk of intracranial injury and intensive care unit admission (P<0.001). Mandibular and midface fractures had an increased risk for cervical spine fracture and tracheostomy (P<0.001). Patient and injury-specific risk factors among the fractures with the strongest association for each outcome-cranial vault and mandible-were identified. The inherent limitations of prior studies-geographical biases, small cohorts, and short-term study periods-were addressed. Describing the independent contribution of each craniofacial fracture to the risk of acute-level hospital course outcomes can be employed to better optimize risk stratification, counseling, and management.

A Comparative Study of Functional Outcomes in Unstable Pelvic Ring Fractures Treated With Internal Fixator (INFIX) With and Without Sacroiliac Joint Screw Fixation.

Introduction Despite constituting only 3-8% of orthopedic trauma cases, pelvic injuries are associated with high mortality rates, emphasizing the critical need for stable fixation rather than merely anatomical alignment. The use of an anterior, subcutaneous, internal pelvic fixator (INFIX), a novel technique, has shown promise in treating these injuries. Posterior pelvic ring injuries are challenging because they require a significant level of surgical training and technical expertise, and each treatment method has disadvantages. The aim of this study is to compare the clinical and biomechanical outcomes of INFIX with and without sacroiliac screw fixation for unstable pelvic fractures. Methods and methodology Retrospectively, we selected 20 patients with unstable pelvic ring injuries who had come to a high-volume tertiary care hospital and medical college in the state of Maharashtra, India. All the patients were operated on with INFIX; 10 with a sacroiliac joint screw and 10 without a sacroiliac joint screw. We followed up with the patients for six months and evaluated them according to the Majeed score. Results Functional outcomesdiffered little between INFIX patients operated on with and without a sacroiliac joint screw. However, morbidity, hospital stay, the need for ICU, radiation exposure, and technical ease of surgery were improved in INFIX patients without the sacroiliac screw procedure. We noted an average Majeed score of 78 in the INFIX-alone group and 77.2 in the group that received INFIX with a sacroiliac joint screw. Six months after the surgery, the patients showed signs of a stable bony union, had achieved a full range of motion, and reported no problems in their day-to-day work. Conclusion Although this was a short-term study, we conclude that INFIX without a sacroiliac joint screw showed a comparable functional outcome compared to INFIX with a sacroiliac joint screw. Patients with INFIX alone showed better results; they had reduced surgical time, reduced radiation exposure, and less evidence of neurological harm to the L5-S1 nerve root. The procedure was less complicated and easier for surgeons to learn. Its simplicity and speed were especially beneficial for obese patients.

COMPARISON OF COMPONENTS OF CENTRAL AORTIC AND PERIPHERAL BLOOD PRESSURE FOR PREDICTION OF CARDIOVASCULAR EVENTS IN A 2-YEAR AND 14-YEAR FOLLOW-UP OF A HYPERTENSIVE COHORT

Objective: The aim of this study was to assess components of central aortic pressure, brachial blood pressure and indices of arterial stiffness for prediction of cardiovascular events in a hypertensive cohort. Design and method: Noninvasive measurements of central aortic blood pressure (SphygmoCor), brachial pressure, central augmentation index (cAIx), augmented pressure (cAP) and carotid intima-media thickness (IMT) were obtained in 681 hypertensive patients (age 61 ± 9 years, 425 males). The primary endpoints were defined as cardiovascular disease (CVD) events or death from CVD. An initial analysis was conducted at mean 2-year follow-up and a second analysis is currently being conducted at mean 14-year follow-up. Results: Total events were 59 (8.7%) for the 2-year follow-up and 265 (38.9%) for the 14-year follow-up. Major cardiovascular events were 49 (83.1%) and 178 (67.2%) respectively. The analysis of the 2-year follow-up suggested that central systolic (cSBP) and pulse pressure (cPP) showed higher hazard ratios (HR/10 mmHg) for cardiovascular events compared to peripheral pressure indices (pSBP, pPP) at age &gt;60 years (cSBP: HR = 1.18, pSBP: HR = 1.17, p = 0.034; cPP: HR = 1.28, pPP: HR = 1.2, p = 0.019). Each SD increase in IMT and in cAP was associated with 1.4 times higher risk of increased total events in elderly patients (age &gt;60 years). Males showed that each SD increase in cAP was associated with significantly higher risk of increased total events than females. The complete data for the 14-year follow-up analysis has only recently become available and the analysis will be completed for the conference presentation. Conclusions: Preliminary analysis in a short-term (2-year) follow-up study of a large hypertensive cohort has shown that central aortic pressure and its components can improve prediction of CVD compared to peripheral pressure. The final analysis of the long-term (14-year) follow-up will determine which components are robust predictors and will provide important information on the clinical and epidemiological relevance of central aortic pressure.