bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of a hand hygiene intervention on the behaviour, practices and health of parents of preschool children in South Africa
Authors: Lange Samantha , Barnard Tobias George , Naicker Nisha
Published: September 2022

Introduction:

Diarrhoea and upper respiratory diseases are a leading cause of child mortality in children under 5 years of age both in South Africa and worldwide. Hand hygiene (HH) interventions play a critical role in reducing HH-related diseases, and the inclusion of all stakeholders in such interventions has improved the success of such interventions. The purpose of this study is to determine the effect of an HH intervention on the behaviour, practices, and health of parents of preschool children.

Methodology:

Seventeen preschools were randomly selected and placed into intervention (IG = 8) and control groups (CG = 9). Parents ( N = 191) were requested to complete questionnaires both pre- and postintervention. An intervention was applied to IG preschool respondents. The data were analysed and compared pre- and postintervention between IG and CG.

Results:

Parents of IG showed a significant difference pre- and postintervention in HH practices such as washing hands after coughing and sneezing, and after using the toilet while parents in CG also indicated significant differences in HH practices of washing hands after coughing and sneezing, and after wiping children’s noses. Postintervention, IG families reporting runny tummies were significantly less than pre-intervention and a decrease in doctor’s visits. There was a 5% improvement of all HH practices in both IG and CG.

Conclusion:

Over 90% of parents in both groups washed hands after using the toilet, both pre- and postintervention. All HH practices for both groups showed increases both pre- and postintervention. By making use of available resources and regular communication with parents of preschoolers they are able to make the small changes necessary to improve their HH and that of their families.
Does Complete Footprint Coverage Affect Outcomes After Conventional Arthroscopic Repair of Large-Sized Rotator Cuff Tears?
Authors: Jeong Eun Taek , Lee Dong Ryun , Lee Jihwan , Lee Jongwon , Lho Taewoo , Chung Seok Won
Published: September 2022

Background:

In large-sized rotator cuff tears, tendon repair with incomplete footprint coverage is performed frequently as a way of tension-free or low-tension repair.

Purpose:

To compare clinical outcomes after arthroscopic repair of large-sized rotator cuff tears between patients with complete versus incomplete footprint coverage.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Among 297 patients who underwent arthroscopic surgery for a large-sized rotator cuff tear, we selected 58 patients (<50% coverage; mean age, 63.34 ± 6.8 years; 34 men and 24 women) with incomplete footprint coverage. Using propensity score matching, another 58 patients with complete footprint coverage (mean age, 63.4 ± 8.03 years; 34 men and 24 women) were selected after 1:1 matching for age, sex, and tear size—the main demographic and prognostic factors of outcomes after rotator cuff repair. Clinical outcomes were compared on magnetic resonance imaging or ultrasonography at minimum of 6 months postoperatively, and functional outcomes were compared using range of motion and pain visual analog scale; American Shoulder and Elbow Surgeons; Constant; University of California, Los Angeles; and Simple Shoulder Test scores at a minimum of 2 years postoperatively.

Results:

A total of 18 patients in the incomplete footprint coverage group (31.0%) and 20 patients in the complete footprint coverage group (34.5%) showed healing failure, with no significant difference between groups ( P = .843). In addition, there were no differences in functional outcomes between groups ( P > .05 for all).

Conclusion:

Whether the rotator cuff footprint was completely covered did not affect clinical outcomes in conventional arthroscopic repair of large-sized rotator cuff tears.
Who Should Be Provided with Pathways toward Citizenship? White and Black Attitudes toward Undocumented Immigrants
Authors: Sheares Alicia
Published: September 2022

Existing studies on attitudes towards immigrants center White public opinion and do not account for the diversity within the immigrant population. I seek to fill these gaps by testing how an undocumented immigrant’s country-of-origin shapes immigrant attitudes among White and Black Americans. Through an experimental survey to 180 Black and 694 White Amazon Mechanical Turk users, I find that White respondents had significantly negative reactions to Nigerian undocumented immigrants relative to Germans, South Koreans, and Mexicans. Yet, this negative sentiment dissipated once the model controlled for cultural similarity. The results demonstrate that cultural attitudes mediate White attitudes towards immigrants, citizenship, and belonging. This study adds to the literature on White and Black attitudes towards immigrants and highlights the enduring role of racialization in influencing both legal and ascriptive notions of citizenship.
History of cluster headache
Authors: Pohl Heiko
Published: September 2022

Objective:

To summarise the history of cluster headache evolving concepts and growing insights.

Background:

Excruciating pain, activation of the parasympathetic nervous system, and circadian rhythmicity characterise cluster headache attacks.

Results:

We find the oldest descriptions of patients suffering from the disorder in case reports of the 17th and 18th centuries. Only in the 19th and early 20th centuries did physicians start hypothesizing its cause. Initially, many researchers suspected the origin of the pain in peripheral nerves or blood vessels. However, eventually, they understood that the cause of the disease lies in the brain. In 1998, Positron emission tomography studies revealed increased activity of the posterior hypothalamus, whose role remains incompletely understood. Only recently have researchers realised that being diseased implies more than dysfunction. Recent studies analysed the consequences of cluster headache for each patient. Many struggle to deal with the disorder even in the absence of pain.

Conclusion:

Physicians have been aware of this type of pain for at least 300 years. Only when researchers studied pathological anatomy and physiology did knowledge accrue. A more comprehensive picture of the disease severity emerged when they also considered its consequences.
Association between cortisol and aging-related hippocampus volume changes in community-dwelling older adults: a 7-year follow-up study
Authors: Orihashi Ryuzo , Imamura Yoshiomi , Yamada Shigeto , Monji Akira , Mizoguchi Yoshito
Published: September 2022

Background

Identifying peripheral biomarkers related to modifiable risk factors to prevent dementia at an early stage will be extremely beneficial. We have been studying how older adults can maintain their mental health and continue to live in a familiar community. The aim of this study is to investigate the association between serum cortisol levels and brain volume among older adults in rural Japan.

Methods

This was a longitudinal study conducted in Kurokawa-cho, Imari, Saga Prefecture, Japan, among people aged 65 years and above, as reported previously. We conducted a survey twice. The first survey was conducted from October 2009 to March 2011 (Timepoint 1) and the second was conducted from November 2016 to September 2017 (Timepoint 2). Blood samples for serum cortisol levels analysis were collected from participants at Timepoint 1. Serum cortisol levels were measured using the enzyme-linked immunosorbent assay. The participants underwent brain MRI examinations, and Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR) for cognitive function assessment at Timepoint 1 and Timepoint 2. We obtained 70 participants (16 men, mean age 72.69 ± 3.18 years; 54 women, mean age 72.69 ± 4.60 years, at Timepoint 1) for analysis. Correlation analysis was performed between serum cortisol levels at baseline (Timepoint 1) and brain volume (Timepoint 1, Timepoint 2, and Timepoint 1–Timepoint 2 difference) using voxel-based morphometry method.

Results

There was no significant difference in serum cortisol levels between men (72.32 ± 17.30 ng/ml) and women (76.60 ± 21.12 ng/ml) at baseline. Additionally, no effect of blood collection time on cortisol levels was observed in these participants. Small volume correction analysis at the cluster level by applying multiple comparison corrections (family-wise error; P < 0.05) showed a negative correlation between serum cortisol levels (Timepoint 1) and brain volume (Timepoint 2) within the region containing the left hippocampus.

Conclusions

Serum cortisol levels may serve as a peripheral biomarker of age-related volume changes involving the hippocampus in older adults aged 65 years and above.
Towards precision home visiting: results at six months postpartum from a randomized pilot implementation trial to assess the feasibility of a precision approach to Family Spirit
Authors: Ingalls Allison , Rebman Paul , Martin Lisa , Kushman Elizabeth , Leonard Amanda , Cisler Aimee , Gschwind Ingrid , Brayak Amanda , Amsler Ann Marie , Haroz Emily E.
Published: September 2022

Background

Shared implementation challenges at scale in early childhood home visiting have led researchers to explore precision home visiting as a promising service delivery mechanism to better address families’ unique needs and build greater program efficiencies. This randomized controlled pilot study aimed to assess the acceptability of a precision approach to one home visiting model, Family Spirit® and explore potential differences between Precision Family Spirit (PFS) and Standard Family Spirit (Standard FS) on participant-home visitor relationship and maternal outcomes.

Methods

Participants (N = 60) were at least 14 years old, pregnant or within 2 months postpartum, and enrolled in Family Spirit. Four sites in Michigan were randomized 1:1 to deliver PFS (up to 17 core lessons plus up to 13 additional lessons as needed) or Standard FS (home visiting services as usual). Primary (program acceptability, participant satisfaction, home visitor-participant relationship quality, retention, adherence) and secondary (knowledge, quality of life, difficulty with parenting problems, substance use, depression, stress) outcomes at 6 months postpartum are presented. PFS participants also self-reported on quality of life, difficulty with parenting problems, stress, substance use, and concerns with sexual and reproductive health and self and child’s nutrition status at each home visit. This informed which lessons they should receive.

Results

Mothers in both groups reported positive program acceptability, satisfaction, and home visitor-participant relationships at 6 months postpartum. However, open-ended feedback from Standard FS participants indicates that some lesson content may not be applicable to all participants. At 6 months, retention was 82.3% for PFS and 66.7% for Standard FS, and adherence was 30.1% for PFS and 20.6% for Standard FS.

Conclusions

Preliminary findings indicate that precision home visiting may be acceptable and feasible. A definitive trial is needed to build on this pilot data, assess outcomes for mothers and children participating in a precision approach to home visiting as compared to standard home visiting, and ready this approach for scale.

Trial registration

ClinicalTrials.govNCT03975530 (first posted on 05/06/2019).
Deep learning-based tumor microenvironment segmentation is predictive of tumor mutations and patient survival in non-small-cell lung cancer
Authors: Rączkowska Alicja , Paśnik Iwona , Kukiełka Michał , Nicoś Marcin , Budzinska Magdalena A. , Kucharczyk Tomasz , Szumiło Justyna , Krawczyk Paweł , Crosetto Nicola , Szczurek Ewa
Published: September 2022

Background

Despite the fact that tumor microenvironment (TME) and gene mutations are the main determinants of progression of the deadliest cancer in the world – lung cancer, their interrelations are not well understood. Digital pathology data provides a unique insight into the spatial composition of the TME. Various spatial metrics and machine learning approaches were proposed for prediction of either patient survival or gene mutations from this data. Still, these approaches are limited in the scope of analyzed features and in their explainability, and as such fail to transfer to clinical practice.

Methods

Here, we generated 23,199 image patches from 26 hematoxylin-and-eosin (H&E)-stained lung cancer tissue sections and annotated them into 9 different tissue classes. Using this dataset, we trained a deep neural network ARA-CNN. Next, we applied the trained network to segment 467 lung cancer H&E images from The Cancer Genome Atlas (TCGA) database. We used the segmented images to compute human-interpretable features reflecting the heterogeneous composition of the TME, and successfully utilized them to predict patient survival and cancer gene mutations.

Results

We achieved per-class AUC ranging from 0.72 to 0.99 for classifying tissue types in lung cancer with ARA-CNN. Machine learning models trained on the proposed human-interpretable features achieved a c-index of 0.723 in the task of survival prediction and AUC up to 73.5% for PDGFRB in the task of mutation classification.

Conclusions

We presented a framework that accurately predicted survival and gene mutations in lung adenocarcinoma patients based on human-interpretable features extracted from H&E slides. Our approach can provide important insights for designing novel cancer treatments, by linking the spatial structure of the TME in lung adenocarcinoma to gene mutations and patient survival. It can also expand our understanding of the effects that the TME has on tumor evolutionary processes. Our approach can be generalized to different cancer types to inform precision medicine strategies.
Modeling the potential economic benefits of an oral SARS-CoV-2 vaccine during an outbreak of COVID-19
Authors: Patenaude Bryan , Ballreich Jeromie
Published: September 2022

Background

Given patient preferences, the choice of delivery modality for vaccines against SARS-CoV-2 has the potential to significantly impact both health and economic consequences of an outbreak of COVID-19. This study models the projected health and economic impact of an oral COVID-19 vaccine in the United States during an outbreak occurring between December 1, 2021 and February 16, 2022. 

Methods

A cost-of-illness economic decision analysis model is utilized to assess both the health and economic impact of an oral vaccine delivery platform compared with the status quo deployment of existing intramuscular vaccines against COVID-19. Health impact is assessed in terms of predicted cases, deaths, hospitalization days, intensive care unit admission days, and mechanical ventilation days averted. Health system economic impact is assessed based on the cost-of-illness averted derived from the average daily costs of medical care, stratified by severity. Productivity loss due to premature death is estimated based on regulatory analysis guidelines proposed by the U.S. Department of Health and Human Services. 

Results

Based upon preference data, we estimate that the availability of an oral COVID-19 vaccine would increase vaccine uptake from 214 million people to 232 million people. This higher vaccination rate was estimated to result in 2,497,087 fewer infections, 25,709 fewer deaths, 1,365,497 fewer hospitalization days, 186,714 fewer Intensive Care Unit (ICU) days, and 80,814 fewer patient days requiring mechanical ventilation (MV) compared with the status quo. From a health systems perspective, this translates into $3.3 billion in health sector costs averted. An additional $139-$450 billion could have been averted in productivity loss due to a reduction in premature deaths.

Conclusions

Vaccine delivery modalities that are aligned with patient preferences have the ability to increase vaccination uptake and reduce both the health and economic impact of an outbreak of COVID-19. We estimate that the total economic impact of productivity loss and health systems cost-of-illness averted from an oral vaccine could range from 0.6%-2.9% of 2021 U.S, Gross Domestic Product (GDP).
Factor structure and longitudinal measurement invariance of the K6 among a national representative elder sample of China
Authors: Zhang Lisong , Li Zhongquan
Published: September 2022

Background

As the number of older people is rapidly growing, prevention, screening, and treatment of mental health problems (including anxiety and depression) in this population increasingly become a heavy burden to individuals, families, and even the whole society. The Kessler-6 screening measure (K6) is an efficient and effective instrument for general mental health problems. However, few studies have examined its measurement invariance across time, which is particularly important in longitudinal studies, such as exploring developmental trajectories of non-specific psychological distress and evaluating the effects of certain interventions.

Methods

The current study investigated the factor structure and the longitudinal measurement invariance of the K6 among a national representative elder sample of China. Longitudinal data in two survey waves (the year 2010, and the year 2014) from the China Family Panel Studies were drawn for secondary data analysis. A total of 3845 participants aged 60 years old and above (52.2% male, mean age = 66.99 years, SD = 5.93 years) responded to both waves of the survey.

Results

A comparison of four existing models with confirmatory factor analysis supported a two-factor solution of the K6. A series of multi-group confirmatory factor analyses further indicated that the K6 held strict longitudinal measurement invariance across time. Additionally, the internal consistency indices across time and the stability coefficients over time were acceptable.

Conclusions

The findings further confirmed the psychometric defensibility of the K6 when used in the old Chinese population. The longitudinal measurement invariance justified comparisons of psychological distress scores among different measurement time points.
Impact of child disability on parental employment and labour income: a quasi-experimental study of parents of children with disabilities in Norway
Authors: Wondemu Michael Yisfashewa , Joranger Pål , Hermansen Åsmund , Brekke Idunn
Published: September 2022

Background

Caring for children with disabilities has both immediate and long-term economic costs that affect the well-being of children, parents, and society. The purpose of this study was to investigate the impact of child disability on parental employment and labour income by examining differences by parental gender, disability severity, and child age.

Methods

The study included children with disabilities born between 2004 to 2011 and their mothers (n = 139,189) and fathers (n = 134,457). Longitudinal data on employment, working hours and labour income was obtained from Statistics Norway, specifically the National Education Database, the Central Population Register and the Event History Database. A quasi-experimental difference-in-differences model was used to examine differences in employment, working hours and labour income.

Results

The results showed that caring for children with disabilities has a negative effect on mothers’ labour market participation, working hours and labour income. The more severe a child’s condition is, the more likely the mother was to work and earn less, or to stop working entirely. Additionally, the differences in labour market participation and income between mothers of children with and without disabilities increased as their children reached school age. Labour market participation, working hours, and labour income for fathers of children with less severe disabilities is comparable to those of fathers of children without disabilities. Caring for children with more severe disabilities reduces fathers’ labour income but has no effect on their working hours or labour market participation.

Conclusion

Policymakers and child welfare stakeholders should evaluate policy options and provide the necessary welfare support particularly to mothers caring for children with a more severe disability.
Hiatal reconstruction is safe and effective for control of reflux after laparoscopic sleeve gastrectomy
Authors: Indja Ben , Chan Daniel L. , Talbot Michael L.
Published: September 2022

Background

Gastroesophageal reflux is a known complication following laparoscopic sleeve gastrectomy (LSG) as anatomical changes predispose to reduced lower esophageal sphincter pressure and development of hiatus hernia. The mainstay of surgical management has been Roux-en-Y gastric bypass (RYGB) which is not without risk. Hiatus hernia repair (HHR) with surgical reattachment of the oesophagus to the crura, recreating the phreno-esophageal ligament is a simple procedure specifically targeting a number of anatomical changes responsible for reflux in this population.

Methods

We conducted a single centre retrospective analysis of adult patients with post-sleeve reflux refractory to medical treatment, managed with either HHR, RYGB or One-anastomosis Duodenal switch (OADS). PPI use and symptoms of reflux were assessed at early and mid-term time points via validated questionnaires.

Results

99 patients were included, of these the surgical procedure was HHR alone in 58, RYGB in 29 and OADS in 12. At early follow-up control of reflux symptoms was achieved in 72.4% after HHR, 82.1% after RYGB and 100% after OADS with no significant difference between groups (p = 0.09). At mid-term followup (median 10 months IQR 7–21) there was no significant difference in the presence of symptomatic reflux as determined by post-op Visick score nor a difference in PPI use. The GerdQ score was significantly lower after OADS as compared to HHR and RYGB (4.6 ± 2.3 vs 7.7 ± 2.2 vs 8.7 ± 3.5, p = 0.006).

Conclusion

HHR with reconstruction of the phreno-esophageal ligament is a safe and effective procedure for patients with reflux after LSG, that avoids more complex operations such as RYGB and OADS and their associated long-term sequelae.
An introduction to the TPSN model: a comprehensive approach to reducing the theory-practice gap in nursing
Authors: Vosoughi Maryam Namadi , Zamanzadeh Vahid , Valizadeh Leila , Ghahramanian Akram , Lotfi Mojgan , Bagheriyeh Farzaneh , Pourmollamirza Afsaneh
Published: September 2022

Background

There are still concerns about the effectiveness of clinical education models which are done with the aim of reducing the theoretical-practical gap in nursing. In this article, we intend to describe an innovative model to create an integration and structured relationship between educational and healthcare provider institutions. The basis of this work is the full-time presence of nursing teacher in the clinical settings and the development of their role to improve the education of students and nurses and the quality of nursing services.

Methods

This was a participatory action research. This action research was implemented in four steps of problem identification, planning, action and reflection. Interviews, focus groups and observation were used for the qualitative part. Clinical Learning Environment Inventory (CLEI), Job Satisfaction in Nursing Instrument questionnaires and Patient Satisfaction with Nursing Care Quality Questionnaire were completed before and after the study. Qualitative content analysis, paired and independent t test were used for data analysis.

Results

The academic-practice integration Model of TPSN is a dynamic and interactive model for accountability in nursing Discipline. Unlike the medical education model that includes patients, students, and physicians as the three points of a triangle, this model, which is shaped like a large triangle, places the person in need of care and treatment (patient, client, family, or society) in the center of the triangle, aiming to focus on the healthcare receiver. The model consists of three components (Mentoring component, Preceptorship component, and integrated clinical education component). Each of the components of this model alone will not be able to eliminate the ultimate goal of bridging the theory-practice gap.

Conclusions

A new and innovative model was proposed to reduce the theory-practice gap in the present study. This model increases the collaboration between educational institutions and healthcare settings compared with the previous models. The TPSN model helps students, nurses, and nursing instructors integrate theoretical knowledge with clinical practice and act as professional nurses.
Actions taken to safeguard the intended health care chain of older people with multiple diagnoses - a critical incident study
Authors: Gustafsson Lena-Karin , Zander Viktoria , Bondesson Anna , Pettersson Tina , Anbacken El-Marie , Östlund Gunnel
Published: September 2022

Background

Older people with multiple diagnoses often have problems coping with their daily lives at home because of lack of coordination between various parts of the healthcare chain during the transit from hospital care to the home. To provide good care to those persons who have the most complex needs, regions and municipalities must work together. It is of importance to develop further empirical knowledge in relation to older persons with multiple diagnoses to illuminate possible obstacles to person-centred care during the transition between healthcare institutions and the persons livelihood. The aim of the present study was to describe nurses’ experienced critical incidents in different parts of the intended healthcare chain of older people with multiple diagnoses.

Methods

The sample consisted of 18 RNs in different parts of the healthcare system involved in the care of older people with multiple diagnoses. Data were collected by semi structured interviews and analysed according to Critical Incident Technique (CIT). A total of 169 critical incidents were identified describing experiences in recently experienced situations.

Results

The result showed that organizational restrictions in providing care and limitations in collaboration were the main areas of experienced critical incidents. Actions took place due to the lack of preventive actions for care, difficulties in upholding patients’ legal rights to participation in care, deficiencies in cooperation between organizations as well as ambiguous responsibilities and roles. The RNs experienced critical incidents that required moral actions to ensure continued person-centred nursing and provide evidence-based care. Both types of critical incidents required sole responsibility from the nurse. The RNs acted due to ethics, ‘walking the extra mile’, searching for person-centred information, and finding out own knowledge barriers.

Conclusions

In conclusion and based on this critical incident study, home-based healthcare of older people with multiple diagnoses requires a nurse that is prepared to take personal and moral responsibility to ensure person-centred home-based healthcare. Furthermore, the development of in-between adjustments of organizations to secure cooperation, and transference of person-centred knowledge is needed.
Digital health applications and the fast-track pathway to public health coverage in Germany: challenges and opportunities based on first results
Authors: Lantzsch Hendrikje , Eckhardt Helene , Campione Alessandro , Busse Reinhard , Henschke Cornelia
Published: September 2022

Objectives

Evidence-based decision-making is the sine qua non for safe and effective patient care and the long-term functioning of health systems. Since 2020 Digital Health Applications (DiHA, German DiGA) in Germany have been undergoing a systematic pathway to be reimbursed by statutory health insurance (SHI) which is attracting attention in other European countries. We therefore investigate coverage decisions on DiHA and the underlying evidence on health care effects, which legally include both medical outcomes and patient-centred structural and procedural outcomes.

Methods

Based on publicly available data of the Institute for Medicines and Medical Devices searched between 08/2021 and 02/2022, all DiHA listed in the corresponding registry and thus reimbursable by the SHI were systematically investigated and presented descriptively on the basis of predefined criteria, such as clinical condition, and costs. The clinical trials on DiHA permanently included in the registry were reviewed with regard to their study design, endpoints investigated, the survey instruments used, and whether an intention-to-treat analysis was performed. Risk of bias was assessed using the ROB II tool.

Results

By February 2022, 30 DiHA had been included in the DiHA registry, one third of them permanently and two thirds conditionally. Most DiHA were therapeutic applications for mental illness based on cognitive behavioural therapy. For all permanently included DiHA, randomised controlled trials were conducted to demonstrate the impact on health care effects. While medical outcomes were investigated for all of these DiHA, patient-centred structural and procedural outcomes were rarely investigated. The majority of clinical trials showed a high risk of bias, mainly due to insufficient reporting quality. Overall, the prices for DiHA covered by SHI are on average around € 150 per month (min. € 40; max. € 248).

Conclusions

Evidence-based decision-making on coverage of DiHA leaves room for improvements both in terms of reporting-quality and the use of patient-centred structural and procedural outcomes in addition to medical outcomes. With appropriate evidence, DiHA can offer an opportunity as an adjunct to existing therapy while currently the high risk of bias of the trials raises doubts about the justification of its high costs.
Long-term variability of impulse oscillometry and spirometry in stable COPD and asthma
Authors: Xu Jianhua , Sun Xingxing , Zhu Hanqing , Cao Yuan , Pudasaini Bigyan , Yang Wenlan , Liu Jinming , Guo Jian
Published: September 2022

Background

While optimizing spirometry is a challenge for lung function labs, long-term variability if any between IOS (impulse oscillometry) parameters and spirometry is not clearly known in stable COPD (chronic obstructive pulmonary disease) and chronic asthma. The forced oscillation technique is increasingly employed in routine lung function testing. Our aim in this study was to determine the variability in oscillometric parameters between clinic visits over weeks or months in two patient groups during a period of clinical stability. Moreover, the research assessed relationships between IOS parameters long-term variability and COPD severity.

Methods

We used data from 73 patients with stable COPD and 119 patients with stable asthma at the Shanghai Pulmonary Hospital Affiliated to Tongji University. Patients were included if they had three or more clinic visits where spirometry and IOS were performed during a clinically stable period. Data recorded from the first three visits were used. The standard deviation (SDbv), the coefficient of variation (COV), intraclass correlation coefficient (ICC) and the coefficient of repeatability (COR) were calculated, Wilcoxon Mann–Whitney test was used for data that did not conform to normality of distributions, Kruskal Wallis test was used to compare with multiple groups, post hoc comparison was analyzed by Bonferroni, Spearman correlation coefficients for non-parametric data, the multiple regression analyses to determine the relationship between long-term variability and airflow obstruction.

Results

(1) The repeatability of IOS resistance parameters with ICC values > 0.8 was high in COPD and asthma. ICC values of IOS resistance parameters were higher than IOS reactance parameters; (2) the repeatability of spirometry parameters with ICC values < 0.8 was lower than IOS resistance parameters in different GOLD (the Global Initiative for Chronic Obstructive Lung Disease) stages, the higher the stage the worse the repeatability; (3) the severity of airflow obstruction was correlated with long-term variability of R5 (R at 5 Hz) (P < 0.05) in GOLD4, not with long-term variability of R20 (R at 20 Hz) (P > 0.05) and R5-R20 (P > 0.05).

Conclusion

IOS resistance parameters have good long-term repeatability in asthma and COPD. Additionally, repeatability of spirometry parameters is lower than IOS resistance parameters in different GOLD stages.
Bone defect development in experimental canine peri-implantitis models: a systematic review
Authors: Solderer A. , de Boer M. , Wiedemeier D. B. , Solderer M. , Liu C. C. , Schmidlin P. R.
Published: September 2022

Purpose

To provide a systematic overview of preclinical research regarding bone defect formation around different implant surfaces after ligature-induced peri-implantitis models in dogs. Two focused questions were formulated: ‘How much bone loss can be expected after a certain time of ligature induced peri-implantitis?’ and ‘Do different implant types, dog breeds and study protocols differ in their extent of bone loss?’

Materials and methods

A systematic literature search was conducted on four databases (MEDLINE, Web of Science, EMBASE and Scopus). Observations, which consisted of bone defects measured directly after ligature removal in canine models, were included and analysed. Two approaches were used to analyse the relatively heterogeneous studies that fulfilled the inclusion criteria. First, separate simple linear regressions were calculated for each study and implant surface, for which observations were available across multiple time points. Second, a linear mixed model was specified for the observations at 12 weeks after ligature initiation, and assessing the potential influencing factors on defect depth was explored using lasso regularisation.

Results

Thirty-six studies with a total of 1082 implants were included after. Bone loss was determined at different time points, either with clinical measurements radiographically or histologically. Different implant groups [e.g. turned, sand-blasted-acid-etched (SLA), titanium-plasma-sprayed (TPS) and other rough surfaces] were assessed and described in the studies. A mean incremental defect depth increase of 0.08 mm (SD: −0.01–0.28 mm) per week was observed. After 12 weeks, the defect depths ranged between 0.7 and 5 mm. Based on the current data set, implant surface could not be statistically identified as an essential factor in defect depth after 12 weeks of ligature-induced peri-implantitis.

Conclusion

Expectable defect depth after a specific time of ligature-induced peri-implantitis can vary robustly. It is currently impossible to delineate apparent differences in bone loss around different implant surfaces.
Towards universal health coverage in the context of population ageing: a narrative review on the implications from the long-term care system in Japan
Authors: Okamoto Shohei , Komamura Kohei
Published: September 2022

The two important elements of universal health coverage—(1) enabling everyone to access the necessary health services and (2) providing financial protection from catastrophic health spending—are vital for not only healthcare but also long-term care in the context of population ageing. In this review, we provide an overview of the public long-term care system in Japan to help other countries that are experiencing (or are expected to experience) problems associated with population ageing. Japan’s approach to long-term care may not be universally generalisable, given the differences in population/geographical sizes, socioeconomic development, population ageing, and cultures across countries. However, the challenges faced by older people may be common. Japan’s long-term care system has several challenges, including financing, labour force shortages, support for people with dementia, an integrated continuum of healthcare and long-term care, and utilising services outside the purview of insurance coverage. We have provided the government’s actions and potential directions to address these challenges.
Insights into the architecture of human-induced polygenic selection in Duroc pigs
Authors: Chen Zitao , Teng Jinyan , Diao Shuqi , Xu Zhiting , Ye Shaopan , Qiu Dingjie , Zhang Zhe , Pan Yuchun , Li Jiaqi , Zhang Qin , Zhang Zhe
Published: September 2022

Background

As one of the most utilized commercial composite boar lines, Duroc pigs have been introduced to China and undergone strongly human-induced selection over the past decades. However, the efficiencies and limitations of previous breeding of Chinese Duroc pigs are largely understudied. The objective of this study was to uncover directional polygenic selection in the Duroc pig genome, and investigate points overlooked in the past breeding process.

Results

Here, we utilized the Generation Proxy Selection Mapping (GPSM) on a dataset of 1067 Duroc pigs with 8,766,074 imputed SNPs. GPSM detected a total of 5649 putative SNPs actively under selection in the Chinese Duroc pig population, and the potential functions of the selection regions were mainly related to production, meat and carcass traits. Meanwhile, we observed that the allele frequency of variants related to teat number (NT) relevant traits was also changed, which might be influenced by genes that had pleiotropic effects. First, we identified the direction of selection on NT traits by $$\hat{G}$$

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, and further pinpointed large-effect genomic regions associated with NT relevant traits by selection signature and GWAS. Combining results of NT relevant traits-specific selection signatures and GWAS, we found three common genome regions, which were overlapped with QTLs related to production, meat and carcass traits besides “teat number” QTLs. This implied that there were some pleiotropic variants underlying NT and economic traits. We further found that rs346331089 has pleiotropic effects on NT and economic traits, e.g., litter size at weaning (LSW), litter weight at weaning (LWW), days to 100 kg (D100), backfat thickness at 100 kg (B100), and loin muscle area at 100 kg (L100) traits.

Conclusions

The selected loci that we identified across methods displayed the past breeding process of Chinese Duroc pigs, and our findings could be used to inform future breeding decision.
Cognitive diagnosis models of students’ skill profiles as a basis for adaptive teaching: an example from introductory accounting classes
Authors: Helm Christoph , Warwas Julia , Schirmer Henry
Published: September 2022

A critical limiting factor for adaptive teaching is the availability of diagnostic tools that allow reliable and valid assessments of students’ domain-specific skills in a way that produces detailed information for planning subsequent instructional strategies. The present study demonstrates how Cognitive Diagnosis Models (CDM) can deliver fine-grained diagnostic information on students’ skills in dealing with domain-specific tasks, using introductory accounting as an exemplary field of application. Based on data from a sample of 773 students from secondary business schools in Austria, statistical analyses that incorporated several criteria for evaluating model fit corroborate theoretical assumptions on distinct skills asmultipledimensions of accounting competence. Moreover, they illustrate that CDMs allow not only to quantify the shares of students who have mastered or still lack each accounting skill but also to identifyindividual skill profiles, which can serve as reliable classification criteria to distinguish homogeneous or heterogeneous ability groups among the learners. We conclude by discussing the practical implications of different diagnostic information obtained from CDM outputs for generic strategies of adaptive teaching, again with an illustrative focus on introductory accounting instruction.
Audiovisual teleconsultation for patients with epilepsy in primary care in rural Germany: a pilot study on feasibility and acceptance
Authors: Feldmeier Gregor , Löffler Christin , Altiner Attila , Wollny Anja , von Podewils Felix , Ritzke Manuela
Published: September 2022

Background

In rural areas, epilepsy patients have limited access to specialist secondary care. Substantial travel and waiting times of several hours are common. Communication between general practitioners (GP) and specialist epileptologists regarding diagnosis and treatment is further complicated by the high workload on both sides and the different prioritisation of treatment goals. This study aims to investigate the feasibility of an interprofessional audiovisual patient-doctor teleconsultation, and its acceptance in clinical practice in patients with epilepsy in a rural region in Germany.

Method

Ten patients participated in telemedicine consultations in their GP practice. The practice was located in a sparsely populated region of Mecklenburg-Western Pomerania, and was equipped with technical equipment specifically procured for the project. An explorative qualitative interview was conducted with all participants. We based this paper on the consolidated criteria for reporting qualitative research (COREQ).

Results

Despite initial uncertainties on the patients’ side regarding the consultation setting, all participants found the teleconsultation helpful. Some patients were initially intimidated and felt slightly overwhelmed by the attention provided and the technology used (multiple HD cameras, large high-resolution screens). However, during the consultation, they felt supported by their GP and were satisfied that their needs were addressed in an appropriate and timely manner. The hardware used was not felt to be a nuisance or to interfere with the conversation between doctor and patient. Patients also appreciated the time saved and the organisational convenience compared to a visit to a university outpatient clinic. Most consultations led to therapeutic consequences. Some patients seemed to benefit particularly, for example those who needed a medication change.

Conclusion

This pilot study provides first evidence that teleconsultations between patients, specialists, and GPs are possible in rural areas. Interprofessional collaboration between GPs and epileptologists can improve the care of patients with epilepsy. Further research should investigate the effectiveness and efficiency of interprofessional telemedicine consultations for epilepsy and other conditions.
Feasibility of a Supervised Virtual Exercise Program for Women on Hormone Therapy for Breast Cancer
Authors: Myers Samantha A. , Weller Sarah , Schwartz Sarah , Van Patten Cheri , LeVasseur Nathalie , Faulkner Guy , Campbell Kristin L.
Published: September 2022

Introduction/Purpose

Adjuvant endocrine therapy significantly improves survival in women with hormone receptor–positive breast cancer and is typically administered for 5 yr or longer. Adverse treatment side effects, including arthralgias, reduce treatment adherence and physical activity levels. Aerobic and resistance exercise is one strategy to decrease treatment side effects and improve treatment adherence. This study aimed to explore the feasibility of a virtually delivered exercise program for women receiving adjuvant endocrine therapy as part of breast cancer treatment.

Methods

This is a single-arm pilot study with recruitment by self-referral or oncologist referral of female breast cancer survivors. To adapt to coronavirus disease 2019 (COVID-19) restrictions, a supervised strength and aerobic group exercise program was delivered virtually twice weekly via Zoom over 6 wk. Feasibility was evaluated based on a priori targets specific to program recruitment (>30% recruitment ratio), transition to virtual delivery (>75%), attendance (>70% virtual session attendance), attrition (<30% dropout), and fidelity of group belongingness (average score ≥15 on belongingness questionnaire) at the end of the program. Physical function (30-s chair stand test), quality of life RAND Short-Form 36-item test, and medication adherence (Voils Domains of Subjective Extent of Nonadherence) were assessed at baseline and 6 wk.

Results

A total of 24 participants completed the program. All feasibility measures were met. Statistically significant changes were found in physical function (P < 0.001), self-reported energy/fatigue (P < 0.001), emotional well-being (P < 0.001), and pain (P = 0.01). There was also a positive trend toward improvement in patient-reported medication adherence (17%).

Conclusion

A 6-wk supervised strength and aerobic group exercise intervention delivered virtually was feasible and improved physical function, energy/fatigue, emotional well-being, and pain. The trend toward improvement in adherence to adjuvant endocrine therapy should be explored further. These findings provide preliminary data to inform a future appropriately powered trial on exercise and physical function using a virtual platform that has the potential for greater reach.
Physiotherapy interventions for head and trunk control in children with developmental disabilities: A scoping review protocol
Authors: Shakya Shristi , Parsekar Shradha S. , Ramachandran Selvam , Madapura S. Shamantha , Balakrishna Shetty Harikishan , Anaby Dana , Gopalakrishna Sivakumar , Venkatesan V. S. , Rao Bhamini Krishna
Published: September 2022

Background: Head and trunk control is prerequisite skill that maximizes engagement and participation in one’s environment by integrating vision, oromotor skill, arm control and respiration. Various physiotherapy and technology-based interventions have been utilized to facilitate head and trunk control in children with developmental disabilities. This scoping review is planned to map and summarize existing studies from the scientific literature on physiotherapy and technology-based interventions for head and trunk control in children with developmental disabilities.

Methods: The scoping review will utilize the Joanna Briggs Institute scoping review methodology. The review will cover studies including children and adolescents aged between two years and 17 years 11 months 29 days, with developmental disabilities where in child finds difficulty aligning head and trunk in sitting position, against gravity, for more than a minute. We will include randomized controlled trial (RCT), non-RCT, quasi-experimental trial, and systematic reviews that have employed physiotherapy and technology-based interventions. Database-specific search strategy will be used to search records in Medline (PubMed and Web of Science), Embase, Scopus, CINAHL, PEDro, and Cochrane Library. Additionally, various grey literatures and clinical-trial registries will be searched. Two reviewers, independently, will screen and extract the data. Tables and visual representations will be utilized to present the extracted data.

Registration details: The protocol has been registered in Open Science Framework, DOI:  10.17605/OSF.IO/B3RSU (22nd August 2022)
Challenges in specifying parameter values for COVID-19 simulation models
Authors: Endo Akira , Nishi Akihiro
Published: September 2022

A recent modelling paper on the coronavirus disease 2019 (COVID-19) epidemic in the US (Bartsch et al.) suggested that maintaining face mask use until a high vaccine coverage (70–90%) is achieved is generally cost-effective or even cost-saving in many of the scenarios considered. Their conclusion was based on the assumed effectiveness of continued face mask use, cited from a study that reported an 18% reduction in the effective reproduction number associated with the introduction of state-level mask mandate policies in the US in the summer of 2020. However, using this value implicitly assumes that the effect of face mask use in 2021 through 2022 is the same as that of summer 2020, when stringent nonpharmaceutical interventions were in place. The effectiveness of universal mask wearing in 2021–2022 is probably more uncertain than considered in Bartsch et al. and rigorous sensitivity analysis on this parameter is warranted.