bluuebunny/crossref_metadata_2025 huggingface dataset:
Critical chemsex studies: Interrogating cultures of sexualized drug use beyond the risk paradigm
Authors: Møller Kristian , Hakim Jamie
Published: June 2021

This article proposes and outlines a critical approach to the study of chemsex. The vast majority of chemsex research takes place within the broad field of health, particularly LGBTQ+ health, which ultimately frames such work using a paradigm of risk. This article follows previous research that calls attention to the limitations of this perspective, and suggests the value in formalising more generative, explorative and critical approaches to the phenomenon. Based on this previous scholarship and the contributions to the special issue, we propose that ‘critical chemsex studies’ operates along three axes: one working within public health that attempts to move beyond the risk paradigm; another which attempts to understand its cultural dimensions as it interrogates the discursive, sociopolitical, technological and economic landscapes in which chemsex has materialised, and finally; a third centering pleasure and its organisation of gay identity, intimacy, and sociability. Finally, we look to the future of critical chemsex studies, calling for more diverse works on national and regional differences in chemsex culture, as well as how the framework can be adapted in order to leverage its capacities for the women, trans and non-binary people who are under-represented in the current literature.
Governing education in times of crisis: State interventions and school accountabilities during the COVID-19 pandemic
Authors: Milner Alison L. , Mattei Paola , Ydesen Christian
Published: June 2021

Strategic government interventions in public education have shifted and blurred the boundaries between state, market and civil society modes of governance. Within this matrix of interdependent relations, schools operate under increasingly hybrid accountability arrangements in which public accountability can both complement and compete with market and social regimes and their associated institutional logics, goals, values and mechanisms. During the first wave of the COVID-19 pandemic, however, national governments implemented a wide range of emergency measures which had consequences for the mixes and layers of school accountabilities. This article examines the principal policy changes in Denmark, England and Italy. Drawing on state theories and the concept of ‘hybrid accountability’, semi-structured interviews with national and local policymakers and school practitioners were analysed thematically. While cultural nuances exist between the cases, our findings reveal that state interventions reinforce a public–professional accountability hybrid and hierarchies of control and command within and outside networks. Concomitantly, state non-interventions and the distinct underlying institutional logics associated with national large-scale assessments suggest policy inertia with implications for professional accountability and institutionalised change. Future research might investigate whether educators’ experiences influence the direction of national and local accountability policy reforms in a post-pandemic era.
A Preliminary Study of Abnormal Centrality of Cortical Regions and Subsystems in Whole Brain Functional Connectivity of Autism Spectrum Disorder Boys
Authors: Chen Bo
Published: June 2021

The abnormal cortices of autism spectrum disorder (ASD) brains are uncertain. However, the pathological alterations of ASD brains are distributed throughout interconnected cortical systems. Functional connections (FCs) methodology identifies cooperation and separation characteristics of information process in macroscopic cortical activity patterns under the context of network neuroscience. Embracing the graph theory concepts, this paper introduces eigenvector centrality index (EC score) ground on the FCs, and further develops a new framework for researching the dysfunctional cortex of ASD in holism significance. The important process is to uncover noticeable regions and subsystems endowed with antagonistic stance in EC-scores of 26 ASD boys and 28 matched healthy controls (HCs). For whole brain regional EC scores of ASD boys, orbitofrontal superior medial cortex, insula R, posterior cingulate gyrus L, and cerebellum 9 L are endowed with different EC scores significantly. In the brain subsystems level, EC scores of DMN, prefrontal lobe, and cerebellum are aberrant in the ASD boys. Generally, the EC scores display widespread distribution of diseased regions in ASD brains. Meanwhile, the discovered regions and subsystems, such as MPFC, AMYG, INS, prefrontal lobe, and DMN, are engaged in social processing. Meanwhile, the CBCL externalizing problem scores are associated with EC scores.
Mangosteen Hinders Gamma Radiation-Mediated Oxidative Stress and Liver Injury by Down-Regulating TNF-α/NF-κB and Pro-Fibrotic Factor TGF-β1 Inducing Inflammatory Signaling
Authors: Hassan Asmaa A. , Moustafa Enas M. , EL-Khashab Iman Hesham , Mansour Somaya Z.
Published: June 2021

Background:

Liver injury due to ionizing radiation exposure either accidental or after radiotherapy treatment, may lead to many alterations in proteins expression related to inflammation or apoptosis. Our study investigated the curative effect of Mangosteen (MGS) extract (fruit rind) against ionizing radiation (IR) induced liver damage.

Methods:

Hepatotoxicity was induced in Wister rats by exposure to an acute single dose (6 Gy) of IR while MGS was given orally to rats (500 mg/kg bwt) and administered daily for 30 days after irradiation.

Results:

MGS treatment has significantly attenuated redox imbalance state and toxicity induced by protracted exposure to gamma-rays in liver tissues, which was substantiated by the significant amelioration of liver function tests, MDA contents, antioxidant enzymes (SOD and CAT) activities and NO level. MGS inhibited also the inflammatory markers (TNF-alpha, IL-6 and CRP) and downregulated transcriptional factor NF-Kappa-B/TGF-β1. These alterations were concomitant with an improvement of the Proliferating cell nuclear antigen (PCNA) which is a protein expressed in the nuclei of cells during cell cycle and is important for both DNA synthesis and DNA repair. These results were confirmed by amelioration in histological and ultrastructural examinations.

Conclusion:

We concluded that MGS could ameliorate via minimizing significantly the amount of oxidative damage, inflammations disturbances and pro-apoptotic alternations induced by IR. MGS may be a promising supplement with protective effects from irradiation-induced injury such as TNF-α/NF-κB/TGF-β1 management.
Protecting Refugee Students’ Wellbeing After Research
Authors: Erden-Basaran Ozlem
Published: June 2021

This study examines how Syrian refugee children’s participation in an ethnographic study affected their well-being, using the premises of attachment theory and listening as care. Three Syrian children, aged 10–12 in Turkish public schools, participated in this study. The data of this study were generated by combining these children’s interviews and observations in 2016 and new interviews in 2018. This study argues that the researcher may be the closest option for these children to develop a long and secure relationship because their teachers and the school community provided misguided messages about the researcher’s role in the school and these children’s expectations from the researcher. Given this situation, the findings of this study suggest that researchers should allocate time after research to understand how their presence affects refugee children and prepare culturally relevant and individualized exit strategies to avoid harming them.
Pregnancy outcomes in women receiving eculizumab for the management of paroxysmal nocturnal haemoglobinuria
Authors: Manning James E , Anderson Rachel M , Hill Anita , Zeidan Doaa , Ciantar Etienne
Published: June 2021

Aims

To report pregnancy outcomes and complications in women receiving eculizumab for the management of paroxysmal nocturnal haemoglobinuria.

Methods

A service evaluation of routinely collected medical records across 49 pregnancies in 21 women.

Results

Eculizumab was used in 37 pregnancies, 31 of which (83.8%) ended in live birth. Eight infants (25.8%) were born prematurely. Over half (54%) of women required increases in their dose of eculizumab to control their haemolysis. There were no reported cases of maternal thrombosis. Major ante/postpartum bleeding necessitating urgent intervention was reported in 10.8% of pregnancies. There were two cases of intrauterine death and three miscarriages. There were no maternal or neonatal deaths. Three newborns required prolonged hospital stays.

Conclusions

Eculizumab appears to benefit pregnant women with paroxysmal nocturnal haemoglobinuria and pregnancy outcomes following its use are largely good.
Antarctica’s Gateways and Gatekeepers: Polar scenarios in a polarising Anthropocene
Authors: Frame Bob , Yermakova Yelena , Flamm Patrick , Nicklin Germana , De Paula Gabriel , Badhe Renuka , Tuñez Francisco
Published: June 2021

As the short to medium-term social and economic impacts of the COVID-19 pandemic dominate world issues, longer-term environmental and geopolitical concerns remain of great concern. However, the appetite for tackling complex transdisciplinary anthropogenic change processes may be receding rather than accelerating. In this essay, we propose that Antarctica, the continent of peace and science, a place that assumes a role as the global imaginary Other, where short- and long-term horizons co-exist, is a site where signs of global regeneration in the Anthropocene should be clear. To provoke discussion, we imagine two scenarios set in the five Gateway Cities of Antarctica to 2050. In the ‘Gatekeepers’ scenario, there is a fragmented global order with minimal unregulated behaviour based on narrowly defined national interests; in the ‘Gateways’ scenario, values-based partnerships generate novel institutional arrangements. By contrasting these polar opposites as a performative act, we highlight the need for future-making at the interface between science and policy.
Postoperative Spinal Implant Infections (PSII)—A Systematic Review: What Do We Know So Far and What is Critical About It?
Authors: Karczewski Daniel , Schnake Klaus J. , Osterhoff Georg , Spiegl Ulrich , Scheyerer Max J. , Ullrich Bernhard , Pumberger Matthias
Published: June 2021

Study Design:

Systematic review.

Objectives:

Postoperative spinal implant infections (PSII) are an increasing challenge in the daily clinical routine. This review summarizes existing knowledge in the field of PSII, including definitions, epidemiology, classifications, risk factors, pathogenesis, symptoms, diagnosis, and treatment.

Methods:

A systematic review was performed using a structured PubMed analysis, based on the PRISMA criteria. The search terminology was set as: “spinal implant associated infection OR spinal implant infection OR spinal instrumentation infection OR peri spinal implant infection.” PubMed search was limited to the categories randomized controlled trials (RCT), clinical trials, meta-analysis and (systematic) reviews, whereas case reports were excluded. Studies from January 2000 to December 2020 were considered eligible. A total of 572 studies were identified, 82 references included for qualitative synthesis, and 19 for detailed sub analysis (12 meta-analysis, 7 prospective RCT).

Results:

Structural problems in the field of PSII were revealed, including (1) limited level of evidence in clinical studies (missing prospective RCT, metanalyzes), (2) small patient numbers, (3) missing standardized definitions, (4) heterogeneity in patient groups, and (5) redundancy in cited literature.

Conclusion:

Evidence-based knowledge about spinal implant-associated infections is lacking. All involved medical fields should come together to define the term PSII and to combine their approaches toward research, training, and patient care.
Specialist Networks Influence Clinician Willingness to Treat Individuals with Special Needs
Authors: Lim M.A.W.T. , Liberali S.A.C. , Calache H. , Parashos P. , Borromeo G.L.
Published: June 2021

Background:

The South Australian Dental Service’s Special Needs Network was established to support oral health professionals working within their statewide government-funded dental service to treat patients with special needs. This study aimed to investigate how a structured network relationship with specialists in special needs dentistry influenced the willingness of dentists to treat this group of patients.

Methods:

Semi-structured interviews were used to explore the views of specialists and dentists involved in the South Australian Dental Service’s Special Needs Network. Inductive thematic analysis identified emerging themes enabling completion of a SWOT (strengths, weaknesses, opportunities, threats) analysis.

Results:

Dentists felt that a strength of the Network was a greater sense of collegiality, particularly for those working in rural areas. Although the inability to get immediate advice was seen as a weakness, dentists felt a more structured relationship with specialists improved communication pathways and resulted in more timely care. The aging workforce, systemic barriers in the public dental system, such as productivity pressures and infrastructure, and the lack of support from other health professionals were seen as ongoing barriers and threats. Regardless, dentists identified the use of telehealth and visiting specialists as future opportunities. Specialists felt that the Network was a valuable resource but were skeptical about its effectiveness, feeling that a limitation was the ability of dentists to recognize the complexity of cases.

Conclusions:

Ongoing support from and communication with specialists in special needs dentistry through a structured network improved the perceived ability and willingness of dentists to treat patients with special needs.

Knowledge Transfer Statement:

This research suggests that providing support to dentists through a hub-and-spoke network that facilitates additional training, professional interaction, and improved communication with specialists in special needs dentistry may help overcome some of the current barriers to access to care experienced by individuals with special needs, particularly those associated with the willingness and capability of clinicians treat them.
Optimizing a knowledge translation intervention: a qualitative formative study to capture knowledge translation needs in nursing homes
Authors: Steinskog Trine-Lise Dræge , Tranvåg Oscar , Nortvedt Monica Wammen , Ciliska Donna , Graverholt Birgitte
Published: June 2021

Background

Knowledge translation (KT) has emerged as an important consideration to reduce knowledge-to-practice gaps in healthcare settings. Research on KT approaches in nursing homes (NHs) is lacking. There is a need to understand the challenges faced in NHs and how these can be managed. This study is part of the larger IMPAKT (IMPlementation and Action for Knowledge Translation) study which addresses KT in NHs. The aim of the study presented here was to identify crucial staff and organizational needs in order to inform the development of a KT intervention in NHs.

Methods

A multimethod qualitative approach was applied. We invited practice development nurses (PDNs) to describe current practice, and to identify problems and needs concerning KT in NHs. We followed the recommendations of the development phase of the MRC framework for developing complex interventions. Data were collected through four focus groups and participatory observations in six NHs. Analysis was conducted according to structural thematic analysis based on a phenomenological hermeneutic method.

Results

We identified three themes that expressed the PDNs’ perceived needs for successful KT implementation: (1) narrowing the PDN role, (2) developing an EBP culture and (3) establishing collaborative alliances. Nine subthemes derived from the PDNs’ experiences and current practice, illustrating needs at individual, relational and organizational levels.

Conclusions

Rigorous development of complex interventions may add relevance to the intervention, increase the likelihood of success and reduce research waste. Insight into the NH context and organization have helped us define problems and articulate needs that must be addressed when tailoring the IMPAKT intervention.

Trial registration

The IMPAKT trial was retrospectively registered in the ISRCTN Registry (Trial ID: 12,437,773) on March 19th, 2020.
Sleep patterns among Norwegian nurses between the first and second wave of the COVID-19 pandemic
Authors: Waage Siri , Pallesen Ståle , Vedaa Øystein , Buchvold Hogne , Blytt Kjersti Marie , Harris Anette , Bjorvatn Bjørn
Published: June 2021

Background

Nurses are in the frontline and play an important role in the battle against the COrona VIrus Disease-2019 (COVID-19) pandemic. Sleep problems among health care workers are likely to increase due to the pandemic. However, it is conceivable that negative health outcomes related to the pandemic fluctuate with the infection rate waves of the pandemic. The present study aimed to investigate sleep patterns among Norwegian nurses, after the first wave, during a period with very low rates of COVID-19.

Methods

Data stemmed from the cohort study “SUrvey of Shift work, Sleep and Health (SUSSH)” among Norwegian nurses. A total of 1532 nurses responded one time to a questionnaire between June and September in 2020 including items about demographics and work, information about COVID-19 and quarantine, sleep patterns and changes in sleep patterns due to the pandemic. Descriptive statistics for all relevant variables were calculated and McNemar tests were used to compare categorical variables.

Results

The majority of nurses (84.2%) reported no change in sleep duration after the first wave of the COVID-19 pandemic compared to before, 11.9% reported less sleep, and 3.9% reported more sleep. Similarly, 82.4% of the nurses reported no change in their sleep quality, whereas 16.2% of the nurses reported poorer sleep quality after the first wave of the pandemic compared to before. The majority of nurses reported no change in their sleep schedule due to the pandemic, although 9.6% of the nurses reported to go to bed later and 9.0% woke up earlier than before the pandemic.

Conclusions

Most existing literature exploring sleep among health care workers during the COVID-19 pandemic has been carried out during periods with high infection rates. In this study we aimed to investigate sleep patterns among Norwegian nurses following the first wave, during a period of low COVID-19 rates in Norway. Most of the nurses reported no change in neither sleep duration, sleep quality, bedtime, nor wake-up times compared to before the pandemic. Still, nearly 12% reported shorter sleep duration, and about 16% reported poorer sleep quality indicating that some nurses experienced worsening of their sleep following the pandemic.
Transcriptomic analysis of primate placentas and novel rhesus trophoblast cell lines informs investigations of human placentation
Authors: Rosenkrantz Jimi L. , Gaffney Jessica E. , Roberts Victoria H. J. , Carbone Lucia , Chavez Shawn L.
Published: June 2021

Background

Proper placentation, including trophoblast differentiation and function, is essential for the health and well-being of both the mother and baby throughout pregnancy. Placental abnormalities that occur during the early stages of development are thought to contribute to preeclampsia and other placenta-related pregnancy complications. However, relatively little is known about these stages in humans due to obvious ethical and technical limitations. Rhesus macaques are considered an ideal surrogate for studying human placentation, but the unclear translatability of known human placental markers and lack of accessible rhesus trophoblast cell lines can impede the use of this animal model.

Results

Here, we performed a cross-species transcriptomic comparison of human and rhesus placenta and determined that while the majority of human placental marker genes (HPGs) were similarly expressed, 952 differentially expressed genes (DEGs) were identified between the two species. Functional enrichment analysis of the 447 human-upregulated DEGs, includingADAM12,ERVW-1,KISS1,LGALS13,PAPPA2,PGF, andSIGLEC6, revealed over-representation of genes implicated in preeclampsia and other pregnancy disorders. Additionally, to enable in vitro functional studies of early placentation, we generated and thoroughly characterized two highly pure first trimester telomerase (TERT) immortalized rhesus trophoblast cell lines (iRP-D26 and iRP-D28A) that retained crucial features of isolated primary trophoblasts.

Conclusions

Overall, our findings help elucidate the molecular translatability between human and rhesus placenta and reveal notable expression differences in several HPGs and genes implicated in pregnancy complications that should be considered when using the rhesus animal model to study normal and pathological human placentation.
The promising shadow of microbubble over medical sciences: from fighting wide scope of prevalence disease to cancer eradication
Authors: Jangjou Ali , Meisami Amir Hossein , Jamali Kazem , Niakan Mohammad Hadi , Abbasi Milad , Shafiee Mostafa , Salehi Majid , Hosseinzadeh Ahmad , Amani Ali Mohammad , Vaez Ahmad
Published: June 2021

Microbubbles are typically 0.5–10 μm in size. Their size tends to make it easier for medication delivery mechanisms to navigate the body by allowing them to be swallowed more easily. The gas included in the microbubble is surrounded by a membrane that may consist of biocompatible biopolymers, polymers, surfactants, proteins, lipids, or a combination thereof. One of the most effective implementation techniques for tiny bubbles is to apply them as a drug carrier that has the potential to activate ultrasound (US); this allows the drug to be released by US. Microbubbles are often designed to preserve and secure medicines or substances before they have reached a certain area of concern and, finally, US is used to disintegrate microbubbles, triggering site-specific leakage/release of biologically active drugs. They have excellent therapeutic potential in a wide range of common diseases. In this article, we discussed microbubbles and their advantageous medicinal uses in the treatment of certain prevalent disorders, including Parkinson's disease, Alzheimer's disease, cardiovascular disease, diabetic condition, renal defects, and finally, their use in the treatment of various forms of cancer as well as their incorporation with nanoparticles. Using microbubble technology as a novel carrier, the ability to prevent and eradicate prevalent diseases has strengthened the promise of effective care to improve patient well-being and life expectancy.
Occupational exposure to polycyclic aromatic hydrocarbons and risk of prostate cancer
Authors: Barul Christine , Parent Marie-Elise
Published: June 2021

Background

Several industries entailing exposure to polycyclic aromatic hydrocarbons (PAHs) are known or suspected carcinogens. A handful of studies have assessed the role of PAHs exposure in prostate cancer risk, but none has examined tumor aggressiveness or the influence of screening practices and detection issues. We aimed to examine the association between lifetime occupational exposure to PAHs and prostate cancer risk.

Methods

Detailed work histories were collected from 1,929 prostate cancer cases (436 aggressive) and 1,994 controls from Montreal, Canada (2005–2012). Industrial hygienists applied the hybrid expert approach to assign intensity, frequency and certainty of exposure to benzo[a]pyrene, PAHs from wood, coal, petroleum, other sources, and any source, in each job held. Odds ratios (ORs) for prostate cancer risk associated with lifetime PAHs exposure, adjusted for age, ancestry, education, lifestyle and occupational factors, and 95% confidence intervals (CI), were estimated using unconditional logistic regression.

Results

After restriction to probable and definite exposures, and application of a 5-year lag, no clear association emerged for any of the PAHs, although small excesses in risk were apparent with 5-year increments in exposure to PAHs from wood (OR = 1.06, 95%CI 0.95 to 1.18). While analyses by cancer aggressiveness suggested no major differences, some elevated risk of high-grade cancer was observed for exposure to PAHs from wood (OR = 1.37, 95%CI 0.65 to 2.89), frequently occurring among firefighters.

Conclusion

Findings provide weak support for an association between occupational exposure to PAHs from wood and prostate cancer risk.
Differential expression of long non-coding RNA Regulator of reprogramming and its molecular mechanisms in polycystic ovary syndrome
Authors: Zhang Zhihong , Sang Min , Liu Siqin , Shao Jing , Cai Yunjiang
Published: June 2021

Background

Polycystic ovary syndrome (PCOS) is a common endocrine disease in women of reproductive age. Multiple studies have shown that long non-coding RNAs (lncRNA) and microRNAs (miRNA) play a role in PCOS. This study aimed to explore the role and molecular mechanism of lncRNA -Regulator of reprogramming (lncROR) in PCOS.

Results

Expression level of lncROR in PCOS patients was up-regulated, while level of miR-206 was down-regulated in comparison with control group (P < 0.001). Logistics regression analysis showed that lncROR and miR-206 were independent predictors of PCOS. The ROC curve showed that lncROR had a high diagnostic value for PCOS with an AUC value of 0.893. Pearson correlation coefficient indicated that the expression level of miR-206 was negatively correlated with the level of lncROR. CCK-8 assay and apoptosis assay revealed that downregulation of lncROR up-regulated the expression of miR-206, thereby inhibiting cell proliferation and promoting cell apoptosis. However, silencing the expression of miR-206 reversed the above effects caused by down-regulation of lncROR expression. Luciferase reporter gene assay suggested that there was a target relationship between lncROR and miR-206. VEGF was proved to be the target gene of miR-206.

Conclusions

Highly expressed lncROR indirectly up-regulated the expression of VEGF by down-regulating the expression of miR-206, thereby promoting the proliferation of KGN cells and inhibiting apoptosis, and further promoting the development of PCOS.
Protocol for a cohort study of the impact of the COVID-19 pandemic on the rate and incidence of bystander cardiopulmonary resuscitation (CPR) after out-of-hospital cardiac arrest
Authors: Tjelmeland Ingvild B. M. , Wnent Jan , Masterson Siobhan , Kramer-Johansen Jo , Gräsner Jan-Thorsten
Published: June 2021

Background

Survival after out-of-hospital cardiac arrest (OHCA) is dependent on early recognition, early cardiopulmonary resuscitation (CPR) and early defibrillation. The purpose of CPR is to maintain some blood flow until the arrival of the emergency medical services (EMS). Our concern is that the COVID-19 pandemic has had a negative effect on the number of patients who get CPR before EMS arrival. The aim of this study is to compare the incidence of bystander CPR during the pandemic with data from before the pandemic.

Methods

The protocol is for a retrospective cohort study where data from existing registries will be used. All participating registries will share aggregated data from 2017 to 2020, and the study team will compare the results from 2020 to results from 2017 to 2019. Due to the General Data Protection Regulation, each participating registry will check for completeness and plausibility, and perform all aggregation of data locally. In the following analysis different registries will be considered as random samples and analysed by means of a generalized linear mixed effects model with Poisson distribution for the outcome, the population covered as offsets, and different registries as random factors.

Discussion

This study does not present the prospect of direct benefit to the patient, but does provide an opportunity to gain a better understanding of the epidemiology of bystander CPR for OHCA patients during a pandemic. By comparing data during the pandemic with already collected information in established registries we believe we can gain valuable information about changes in public response to out-of-hospital cardiac arrest.
Improved couple satisfaction and communication with marriage and relationship programs: are there gender differences?—a systematic review and meta-analysis
Authors: Javadivala Zeinab , Allahverdipour Hamid , Asghari Jafarabadi Mohammad , Azimi Somaye , Gilani Neda , Chattu Vijay Kumar
Published: June 2021

Background

The aspects of marriage and relationship and their effect on couples’ satisfaction are essential and critical aspects to be explored in this globalized and contemporary world. Since there are no reported meta-analysis and systematic reviews conducted in the last two decades in this area, we aimed to investigate the effect of marriage and relationship programs (MRP) on couples’ relationship satisfaction (CRS) and couples’ relationship communication (CRC) and also to determine the gender differences if any.

Method

In this systematic review and meta-analysis, the randomized clinical trials (RCTs) published between 2000 and July 26, 2019, were retrieved from several online electronic databases such as Medline, Embase, ProQuest, and Cochrane Library. Inclusion and exclusion criteria were developed using the PICO (Population, Intervention, Comparison, Outcome) framework of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The mean differences (MDs) and 95% confidence intervals (CIs) were calculated. The reported summary statistics were calculated as random effects models based on the heterogeneity between the studies model. Funnel plots and the Egger regression test was used to confirm the presence of any publication bias.

Results

Of the total 12 intervention studies included, five (5) are education/communication skills programs, three (3) enrichment programs, and four (4) therapy programs. The impact of these programs was investigated on CRS and CRC. Therapy programs had a larger effect than other programs (pooled MD: 0.53 (95% CI = 0.35 to 0.71, I2 = 71.5% p = 0.0001) and had a larger effect size on wives (pooled MD: 0.53 (95% CI 0.25 to 0.80, I2 = 74.1% p = 0.0001) than husbands RS (pooled MD: 0.26 (95% CI 0.25 to 0.76, I2 = 72.4% p = 0.0001). In RC (relationship communication) area, the Enhancement programs showed the small to large effect on CRC (pooled MD: 1.31 (95% CI = 0.13 to 2.50, I2 = 94.7% p = 0.0001)) and educational programs showed small to medium effect (pooled MD: 0.32 (95% CI = 0.13 to 0.50, I2 = 74.5% p = 0.0001) on women and no effect on men.

Conclusion

Due to the high effect of the therapy programs on CRS and enhancement program on CRC in the current meta-analysis, the priority of their utilizations in interventions, especially by psychologists and mental health professionals, should be emphasized. Therefore, mental health planning in communities to develop MRP and care for couples’ health should be given special attention to men’s health. Due to the high heterogeneity of the results and with scanty literature in this specific domain, we are uncertain about their actual effect. However, well-designed RCTs with a larger sample size would be beneficial in closely examining the effect of MRPs on CRS and CRC.
Exploring the comorbidity of musculoskeletal and personality disorders among adults: a scoping review protocol
Authors: Quirk Shae E. , Koivumaa-Honkanen Heli , Honkanen Risto , Heikkinen Jeremi , Kavanagh Bianca E. , Williams Lana J.
Published: June 2021

Background

Separately, mental and musculoskeletal disorders (MSDs) are prevalent across the life course and are leading contributors to disability worldwide. While people with personality disorder (PD) have been shown to have an increased risk of certain physical health comorbidities—associations with MSDs have not been thoroughly explored. The proposed scoping review aims to explore the existing clinical- and population-based literature on the comorbidity of PD and MSDs among adults ≥ 18 years and the burden associated with their comorbidity, identify knowledge gaps on this topic, and propose recommendations for future research.

Methods

This protocol describes the methodology to undertake the scoping review. It is guided by Arksey and O’Malley’s framework and the extensions recommended by the Joanna Briggs Institute. A comprehensive search strategy will be used to identify relevant articles, which will be underpinned by Population, Concept, and Context (PCC) inclusion criteria. One author will perform the search and two authors will independently screen titles/abstracts followed by a full-text review for articles considered relevant. The supervising author will confirm the final selection of articles to be included. One author will extract relevant information from the articles using a predetermined charting form, while a second will perform validation of all information entered.

Discussion

Information will be synthesised to inform a discussion of what is known regarding associations between PD and MSDs, and the burden associated with their comorbidity in different contexts, with future research directions proposed.

Systematic review registration

This protocol is registered in Open Science Framework Registries (https://osf.io/mxbr2/).
Lower and upper solutions method to the fully elastic cantilever beam equation with support
Authors: Wei Mei , Li Yongxiang , Li Gang
Published: June 2021

The aim of this paper is to consider a fully cantilever beam equation with one end fixed and the other connected to a resilient supporting device, that is,$$ \textstyle\begin{cases} u^{(4)}(t)=f(t,u(t),u'(t),u''(t),u'''(t)), \quad t\in [0,1], \\ u(0)=u'(0)=0, \\ u''(1)=0,\qquad u'''(1)=g(u(1)), \end{cases} $${u(4)(t)=f(t,u(t),u′(t),u″(t),u‴(t)),t∈[0,1],u(0)=u′(0)=0,u″(1)=0,u‴(1)=g(u(1)),where$f:[0,1]\times \mathbb{R}^{4}\rightarrow \mathbb{R}$f:[0,1]×R4→R,$g: \mathbb{R}\rightarrow \mathbb{R}$g:R→Rare continuous functions. Under the assumption of monotonicity, two existence results for solutions are acquired with the monotone iterative technique and the auxiliary truncated function method.
Assessment of intention to use contraceptive methods with spatial distributions and associated factors among women in Ethiopia: evidence from EDHS 2016
Authors: Gilano Girma , Hailegebreal Samuel
Published: June 2021

Background

Modern contraceptive methods have immense influences on the health of mothers and their children. Using contraceptive methods is seen to control family size and unnecessary pregnancies. Considering different factors like resources and various cultural aspects, assessing the intention to use contraception might bring areas with these problems into the light for intervention.

Methods

We analyzed the cross-sectional survey data from EDHS 2016, which comprised 5651 reproductive-age women. Spatial autocorrelation was checked with global Moran’s statistics, at ±1 for dispersion and clustering. Aselin Local moran’s statistics also indicated types of clusters. Hot spot(Getis-Ord Gi) statistics further used to measure autocorrelation over different spatial locations. The significance level was checked by calculating Z-score and hot and cold spots indicated the variation in intention to use contraceptives per catchments. Interpolation was also applied to see the number of intents to use contraceptive areas other than the sampled using ordinary Kriging spatial interpolation. We used Kulldorff’s SatScan for specific local clustering and the Bernoulli model test was applied to check significance. Individual and community-level factors were examined using multilevel logistic regression. Due to the clustering nature of data where p-value< 0.05 signaled associations. The disproportional nature of data was adjusted using sampling weights.

Result

From the total sample of women, the intention to use contraceptive methods was 2366.08(44.11%) and was highly clustered in North and Western Ethiopia. The mean number of children was (4.5 ± 2.90); age at first cohabitation was (16.9 ± 3.99); the ideal number of children was (4.77 ± 2.00). Age and the ideal number of children were negatively associated with the use of contraception. Primary education, number of children, counseling at health facilities, and age at first cohabitation were negatively associated.

Conclusion

We observed various distributions among regions. Educational status and various socio-cultural including working with the religious organization might need serious considerations to increase the intention to use contraceptive methods. Besides the efforts done, policy decisions might need to consider this finding and uphill the intervention against the negatively associated socio-cultural and demographic variables in outplayed areas.
Effects of constant and diel cyclic temperatures on the liver and intestinal phospholipid fatty acid composition in rainbow trout Oncorhynchus mykiss during seawater acclimation
Authors: Ge Jian , Zhou Yangen , Huang Ming , Gao Qinfeng , Dong Yunwei , Dong Shuanglin
Published: June 2021

Background

Rainbow trout is an economically important fish in aquaculture and is a model species in environmental physiology. Despite earlier research on the seawater adaptability of rainbow trout at different temperature regimes, the influence on the liver and intestine in this species is still unknown. Two trials were conducted to investigate the effects of constant and diel cyclic temperatures on phospholipid fatty acid (PLFA) composition in the liver and intestine of rainbow trout during seawater acclimation.

Results

At the end of growth trial 1, fish at 9 and 12.5 °C showed significantly higher ratios of unsaturated to saturated (U/S) and unsaturation index (UI) than those at 16 °C in liver and intestine phospholipids. After day 1 of seawater acclimation, the U/S, UI, and average chain length (ACL) of liver and intestinal phospholipids in fish at 16 °C significantly increased. Two weeks after seawater acclimation, the liver and intestinal PLFA composition adapted to salinity changes. In trial 2, significantly higher U/S, UI, and ACL were found in intestinal phospholipids at 13 ± 2 °C. On the first day after seawater acclimation, UI and ACL in liver phospholipids significantly increased at 13 °C, while fish at 13 ± 2 °C showed significantly decreased U/S, UI, and ACL in the intestine. At the end of growth trial 2, liver PLFA compositions were stable, whereas intestinal PLFA at 13 and 13 ± 1 °C showed significantly decreased U/S, UI, and ACL. A two-way analysis of variance and principal component analysis revealed significant effects of different constant temperatures, seawater acclimation, and their interaction on the liver and intestinal phospholipids, a significant effect of diel cyclic temperature on intestinal phospholipids, and the effects of seawater acclimation and its interaction with diel cyclic temperature on liver phospholipids.

Conclusion

Temperatures of 9 and 12.5 °C could elevate membrane fluidity and thickness in the liver and intestine of rainbow trout in freshwater, whereas no significant effects were found with diel temperature variations. After seawater acclimation, constant and diel cyclic temperatures significantly influenced the membrane fluidity and thickness of the liver and intestine. Compared with constant temperature, diel temperature variation (13 ± 2 °C) can enhance the adaptability of rainbow trout during seawater acclimation.
Clinical Efficiency and Safety Outcomes of Virtual Care for Oncology Patients During the COVID-19 Pandemic
Authors: Hsiehchen David , Muquith Maishara , Haque Waqas , Espinoza Magdalena , Yopp Adam , Beg Muhammad S.
Published: June 2021

PURPOSE:

Telehealth has been an integral response to the COVID-19 pandemic. However, no studies to date have examined the utility and safety of telehealth for oncology patients undergoing systemic treatments. Concerns of the adequacy of virtual patient assessments for oncology patients include the risk and high acuity of illness and complications while on treatment.

METHODS:

We assessed metrics related to clinical efficiency and treatment safety after propensity matching of newly referred patients starting systemic therapy where care was in large part replaced by telehealth between March and May 2020, and 206 newly referred patients from a similar time period in 2019 where all encounters were in-person visits.

RESULTS:

Patient-initiated telephone encounters that capture care or effort outside of visits, time to staging imaging, and time to therapy initiation were not significantly different between cohorts. Similarly, 3 month all-cause or cancer-specific emergency department presentations and hospitalizations, and treatment delays were not significantly different between cohorts. There were substantial savings in travel time with virtual care, with an average of 211.4 minutes saved per patient over a 3-month interval.

CONCLUSION:

Our results indicate that replacement of in-person care with virtual care in oncology does not lead to worse efficiency or outcomes. Given the increased barriers to patients seeking oncology care during the pandemic, our study indicates that telehealth efforts may be safely intensified. These findings also have implications for the continual use of virtual care in oncology beyond the pandemic.
Process Optimization for the Continuous Production of a Gastroretentive Dosage Form Based on Melt Foaming
Authors: Haimhoffer Ádám , Vasvári Gábor , Trencsényi György , Béresová Monika , Budai István , Czomba Zsuzsa , Rusznyák Ágnes , Váradi Judit , Bácskay Ildikó , Ujhelyi Zoltán , Fehér Pálma , Vecsernyés Miklós , Fenyvesi Ferenc
Published: June 2021

Several drugs have poor oral bioavailability due to low or incomplete absorption which is affected by various effects as pH, motility of GI, and enzyme activity. The gastroretentive drug delivery systems are able to deal with these problems by prolonging the gastric residence time, while increasing the therapeutic efficacy of drugs. Previously, we developed a novel technology to foam hot and molten dispersions on atmospheric pressure by a batch-type in-house apparatus. Our aim was to upgrade this technology by a new continuous lab-scale apparatus and confirm that our formulations are gastroretentive. At first, we designed and built the apparatus and continuous production was optimized using a Box–Behnken experimental design. Then, we formulated barium sulfate-loaded samples with the optimal production parameters, which was suitable for in vivo imaging analysis. In vitro study proved the low density, namely 507 mg/cm3, and the microCT record showed high porosity with 40 μm average size of bubbles in the molten suspension. The BaSO4-loaded samples showed hard structure at room temperature and during the wetting test, the complete wetting was detected after 120 min. During the in vivo study, the X-ray taken showed the retention of the formulation in the rat stomach after 2 h. We can conclude that with our device low-density floating formulations were prepared with prolonged gastric residence time. This study provides a promising platform for marketed active ingredients with low bioavailability.
Differential Perioperative Outcomes in Patients With Obstructive Sleep Apnea, Obesity, or a Combination of Both Undergoing Open Colectomy: A Population-Based Observational Study
Authors: Stundner Ottokar , Zubizarreta Nicole , Mazumdar Madhu , Memtsoudis Stavros G. , Wilson Lauren A. , Ladenhauf Hannah N. , Poeran Jashvant
Published: June 2021

BACKGROUND:

An increasing body of evidence demonstrates an association between obstructive sleep apnea (OSA) and adverse perioperative outcomes. However, large-scale data on open colectomies are lacking. Moreover, the interaction of obesity with OSA is unknown. This study examines the impact of OSA, obesity, or a combination of both, on perioperative complications in patients undergoing open colectomy. We hypothesized that while both obesity and OSA individually increase the likelihood for perioperative complications, the overlap of the 2 conditions is associated with the highest risk.

METHODS:

Patients undergoing open colectomies were identified using the national Premier Healthcare claims-based Database (2006–2016; n = 340,047). Multilevel multivariable models and relative excess risk due to interaction (RERI) analysis quantified the impact of OSA, obesity, or both on length and cost of hospitalization, respiratory and cardiac complications, intensive care unit (ICU) admission, mechanical ventilation, and inhospital mortality.

RESULTS:

Nine thousand twenty-eight (2.7%) patients had both OSA and obesity diagnoses; 10,137 (3.0%) had OSA without obesity; and 33,692 (9.9%) had obesity without OSA. Although there were overlapping confidence intervals in the binary outcomes, the risk increase was found highest for OSA with obesity, intermediate for obesity without OSA, and lowest for OSA without obesity. The strongest effects were seen for respiratory complications: odds ratio (OR), 2.41 (2.28–2.56), OR, 1.40 (1.31–1.49), and OR, 1.50 (1.45–1.56), for OSA with obesity, OSA without obesity, and obesity without OSA, respectively (all P < .0001). RERI analysis revealed a supraadditive effect of 0.51 (95% confidence interval [CI], 0.34–0.68) for respiratory complications, 0.11 (−0.04 to 0.26) for cardiac complications, 0.30 (0.14–0.45) for ICU utilization, 0.34 (0.21–0.47) for mechanical ventilation utilization, and 0.26 (0.15–0.37) for mortality in patients with both OSA and obesity, compared to the sum of the conditions’ individual risks. Inhospital mortality was significantly higher in patients with both OSA and obesity (OR [CI], 1.21 [1.07–1.38]) but not in the other groups.

CONCLUSIONS:

Both OSA and obesity are individually associated with adverse perioperative outcomes, with a supraadditive effect if both OSA and obesity are present. Interventions, screening, and perioperative precautionary measures should be tailored to the respective risk profile. Moreover, both conditions appear to be underreported compared to the general population, highlighting the need for stringent perioperative screening, documentation, and reporting.
Living In/difference; or, How to Imagine Ambivalent Networks
Authors: Albrecht Carina , Chun Wendy Hui Kyong , Kurgan Laura
Published: June 2021

In a 1954 essay Paul Lazarsfeld and Robert K. Merton coined the term homophily to describe similarity-based friendship. They based their findings on friendship patterns among neighbors in a biracial housing project in the United States, using a combined quantitative and qualitative, empirical and speculative analysis of social processes. Since then homophily has become a guiding principle for network science: it is simply presumed that similarity breeds connection. But the unpublished study by Merton, Patricia S. West, and Marie Jahoda, which grounds Lazarsfeld and Merton’s analysis, and the Merton and Bureau of Applied Social Research’s archive reveal a more complex picture. This article engages with the data traces in the archive to reimagine what enabled the residents of the studied housing project to live in difference, as neighbors. The reanimation of this archive reveals the often counterintuitive characteristic of our imagined networks: they are about removal, not addition. It also opens up new imagined possibilities for a digital future beyond the hatred of the different and online echo chambers.