bluuebunny/crossref_metadata_2025 huggingface dataset:
Glucose tolerance of iguanas is affected by high-sugar diets in the lab and supplemental feeding by ecotourists in the wild
Authors: French Susannah S. , Hudson Spencer B. , Webb Alison C. , Knapp Charles R. , Virgin Emily E. , Smith Geoffrey D. , Lewis Erin L. , Iverson John B. , DeNardo Dale F.
Published: April 2022

There is great interspecific variation in the nutritional composition of natural diets, and the varied nutritional content is physiologically tolerated because of evolutionarily based balances between diet composition and processing ability. However, as a result of landscape change and human exposure, unnatural diets are becoming widespread among wildlife without the necessary time for evolutionary matching between the diet and its processing. We tested how a controlled, unnatural high glucose diet affects glucose tolerance using captive green iguanas, and we performed similar glucose tolerance tests on wild Northern Bahamian rock iguanas that are either frequently fed grapes by tourists or experience no such supplementation. We evaluated both short and longer-term blood glucose responses and corticosterone (CORT) concentrations as changes have been associated with altered diets. Experimental glucose supplementation in the laboratory and tourist feeding in the wild both significantly affected glucose metabolism. When iguanas received a glucose-rich diet, we found greater acute increases in blood glucose following a glucose challenge. Relative to unfed iguanas, tourist-fed iguanas had significantly lower baseline CORT, higher baseline blood glucose, and slower returns to baseline glucose levels following a glucose challenge. Therefore, unnatural consumption of high amounts of glucose alters glucose metabolism in laboratory iguanas with short-term glucose treatment and free-living iguanas exposed to long-term feeding by tourists. Based on these results and the increasing prevalence of anthropogenically altered wildlife diets, the consequences of dietary changes on glucose metabolism should be further investigated across species, as such changes in glucose metabolism have health consequences in humans (e.g. diabetes).
Main stages of the development of the specialty "Orthopedics and traumatology"
Authors: Bodnya A.
Published: April 2022

The most significant components of the educational process at the Department of Traumatology and Orthopedics of the Odessa National Medical University (Ukraine) under modern conditions are highlighted. Purpose: To determine the future orthopedist-traumatologist professional training main stages, including the means of implementing the development of the specialty. Materials and methods. The specific conditions of the specialty "Orthopedics and Traumatology" development under certain circumstances (COVID-19 pandemic; martial law) in the phased professional training of specialists. The following empirical methods were used: observation, test, questionnaire method and method of conversation and interview. Results: It has been determined that there is a significant difference between full-time and distance/on-line learning for higher education applicants, since most clinical competencies require the personal presence of a doctor. It is live contact at the bedside of the patient, as well as with the staff of the in - patient departments and colleagues of the chairs will create a situation of real professional growth, which cannot be replaced by any virtual technology of a specialty practical mastery. Conclusions: The main stages of education affect the development of the specialty, depending on the pace and body of acquired knowledge and skills. The professional qualities of an orthopedist- traumatologist are subject to education by all available methods and means, starting from the student bench of a medical university. Further deepening and improvement of knowledge and skills should continue until the end of one’s professional activity, especially in difficult and unforeseen situations.
Service Chains’ Operational Strategies: Standardization or Customization? Evidence from the Nursing Home Industry
Authors: Kong Lu , Hu Kejia , Verma Rohit
Published: April 2022

Problem definition: We investigate how the degree of standardization (DoS) across service chain-belonging units impacts units’ performance outcomes. We study this question in the nursing home industry, focusing on the DoS in three operational dimensions—customer mix, service offering, and service delivery—and its impact on three nursing home outcomes: financial performance, clinical outcome, and resident welfare. Academic/practical relevance: All service chains must decide how unique or standardized each of their units should be, but it is unclear how this decision affects units’ performance outcomes. We assess standardization strategies in multiple operational dimensions in chain-belonging nursing homes and their impact on important operational outcomes, and generalize our findings to other service industries. Methodology: We use a panel data set covering 11 years (2005–2015) of comprehensive measurements of all nursing homes in the United States. We estimate the relationship between the DoS and important nursing home outcomes using fixed-effect models with instrumental variables and clustered standard errors. Results: We find that chain-belonging nursing homes that (1) customize service delivery and standardize customer mix relative to the chain norm tend to experience improved financial performance; (2) standardize customer mix tend to experience improved clinical outcome; and (3) customize service delivery tend to experience enhanced resident welfare. Managerial implications: To our knowledge, this study is the first systematic multidimensional assessment of multiunit service firms’ standardization strategies from a chain perspective. Our results guide nursing home chains in their (1) strategies of within-chain standardization, and (2) investment decisions in acquiring new properties. Our results also provide broader managerial insights for service chains’ standardization strategies and merging and acquisition activities.

Supplemental Material: The e-companion is available at https://doi.org/10.1287/msom.2022.1111 .
When Does a CEO’s Risk Propensity Drive Exploration in Product Development?
Authors: Lavie Dovev , Klarner Patricia
Published: April 2022

We advance research on the managerial antecedents of exploration by studying personal, organizational, and environmental conditions under which a CEO’s risk propensity shapes a firm’s tendency to explore in product development. Our panel data analysis of 219 firms in the prepackaged software industry reveals that, when a CEO is risk-prone, the CEO’s ability to drive exploration increases with the CEO’s power in the firm, which manifests in tenure, duality, and insider origin. Counter to expectations, however, the firm’s accumulated exploration experience does not reinforce, but rather attenuates the effect of the CEO’s risk propensity on exploration. We attribute this to firms’ quest for balance between exploration and exploitation and the need to counter the CEO’s risk propensity when exploration becomes excessive. Finally, we find that competitive pressure in the firm’s product market reinforces the ability of a CEO who is more risk-prone to garner support for further exploration. Our study advances a dynamic perspective that relates the heterogeneity in firms’ exploration tendencies to the behavioral inclinations of their CEOs.

Funding: Dovev Lavie acknowledges his fellowship with the Invernizzi Center for Innovation, Organization, Strategy and Entrepreneurship and the ICRIOS Seed [Grant 25435].
Federated Learning-Based Privacy Preservation with Blockchain Assistance in IoT 5G Heterogeneous Networks
Authors: Arumugam Sampathkumar , Shandilya Shishir Kumar , Bacanin Nebojsa
Published: April 2022

In the area where privacy is of greater concern, federated learning,a distributed machine learning strategy for preserving privacy,is widely employed in several privacy concern applications. In the meantime, neural architectures became familiar with deep learning approaches for automatic tuning of the architecture of deep neural networks (DNN). While searching with neural architecture and federated learning has experienced several challenges, optimized neural architecture research in federated learning is extensively on demand. DNN faces numerous issues while training such user privacy and ensuring the integrity of the aggregated results obtained from a server. To provide solutions for the above-mentioned issues, enormous federated learning techniques worked towards preserving privacy and were applied in different situations. Still, it is an open challenge that enables users to verify if the cloud server functions appropriately while ensuring users’ privacy while training. Federated Learning Method is a new way to improve the accuracy and precision, since the previous approach failed to opt the solutions. Here, Elliptical Curve Cryptography with Blockchain-based Federated Learning (ECC-BFL)is proposed to ensure the confidentiality of users’ local gradients while performing federated learning. The parameters such as classification accuracy, running time, Communication overhead, Computation overhead, and transaction speed are considered. The values obtained for these parameters are compared against three standard methods, namely Biparing Method (BM) Homomorphic Cryptosystem (HC), and Multiple Authorities with Attribute-Based Signature scheme (MA-ABS)against proposed Elliptical Curve Cryptography with Blockchain-based Federated Learning (ECC-BFL). As a result, the proposed ECC-BFL achieved 95% of classification accuracy, 65 sec of running time, 76% of communication overhead, 63% of computation overhead, and 92% of transaction speed.
Why Has the COVID-19 Pandemic Had a Limited Impact on the Primary Housing Market in Poland?
Authors:   Narodowy Bank Polski, Augustyniak Hanna , Łaszek Jacek ,   Narodowy Bank Polski, Olszewski Krzysztof ,   Narodowy Bank Polski, Waszczuk Joanna ,   Narodowy Bank Polski
Published: April 2022

In this paper we present the first insights into the as yet unexamined impact of the COVID-19 pandemic on the primary housing market in Poland, with a focus on Warsaw, which is the largest real estate market in the country. We explain the structural features that allowed the market to return to pre-shock levels after the pandemic shock. After the 2007–2008 global financial crisis the negative consequences lasted for several years. This time a sharp monetary policy and fiscal intervention was carried out. Moreover, the developer sector has expanded its production capacity. We show empirically that through monopolistic competition developers were able to restrict the excessive demand that was observed before the COVID-19 pandemic broke out. Another important structural change was the increase in the demand for housing, mainly for investment purposes, which was financed predominantly with cash and contributed to the growth of the rental market.
Housing as a Political Tool: Gender Inequality in Student Accommodation in Iran
Authors:   University of Shahid Beheshti, Hoseini Parian , Mohseni Pooriya ,   The University of Melbourne
Published: April 2022

This paper studies the gender inequalities in university-provided student accommodation in Babolsar, Iran, in relation to the role of the dominant political power and its approach in shaping the physical form of public dormitories and the living conditions of students. Secondary data analysis based on a questionnaire survey is utilised, and the results show that in numerous physical and non-physical ways women’s public dormitories are designed and controlled in favour of the dominant political power and against the wishes of their residents. This research examines how the ideological and cultural background permeates institutional practices in housing and affects the living conditions of a disadvantaged social group, which can open a discussion on the role of housing in social exclusion.
Scarring of the Eustachian tube: an unusual presentation following septoplasty and inferior turbinate reduction
Authors: Sheik-Ali S , Ellis S , Bondin D
Published: April 2022

Septoplasty and inferior turbinate reduction is a common operation performed by ear, nose and throat surgeons for obstructive nasal symptoms. We present a case of complete unilateral scarring of the Eustachian tube orifice, a previously unreported complication, following septoplasty and inferior turbinate reduction for nasal obstruction. It is important to consider this differential diagnosis in patients presenting with unilateral middle ear effusion postoperatively.
Acute limb ischaemia: not an uncommon complication of COVID-19 infection
Authors: Vasudeva Rao U , Wasim MD , Rajeev P , Rai S , Pradeep Kumar K
Published: April 2022

A new variant of coronavirus (2019-nCoV) causing acute respiratory distress in humans was identified for the first time in 2019, in Wuhan, China. One of the many complications of infection with this coronavirus is hypercoagulopathy, resulting in acute thrombosis; often leading to acute limb ischaemia. Herein, we report 20 cases of COVID-19 with peripheral arterial thrombosis involving either upper or lower limbs. Some patients underwent vascular procedures and most had to undergo amputation at some level. All the cases (n=20) were referred to us during the 8-month period June 2020 to March 2021. The most common age group was between 51 and 60 years, of whom 80% were males; all the patients had diabetes. The right lower limb was most affected (50%); 15 patients underwent embolectomy. Twenty-five per cent of patients presented with wet gangrene. One patient with upper limb thrombosis recovered after embolectomy and did not require any amputation. Eighty-five per cent of patients underwent some form of amputation and the mortality rate was 10%. Arterial thrombosis is one complication patients may develop during COVID-19 illness, which may affect the outcome. Patients with comorbid conditions like diabetes are at higher risk of developing arterial thrombosis during COVID-19 infection. Susceptibility to coagulopathy may continue even after patient discharge and it is important that both patients and treating physicians are aware of this limb-threatening complication and seek early medical attention.
A national survey on enhanced recovery for renal transplant recipients: current practices and trends in the UK
Authors: Amer A , Scuffell C , Dowen F , Wilson CH , Manas DM
Published: April 2022

Introduction

Enhanced recovery after surgery (ERAS) is well established in many specialties but has not been widely adopted in renal transplantation. The aim of this survey was to understand current national practices and sentiment concerning ERAS for renal transplant recipients in the UK.

Methodology

A national web-based survey was sent to consultant surgeons at all 23 UK adult renal transplant units. Completed questionnaires were collected between May and July 2020. Data were analysed according to individual responses and grouped according to the existence of formal ERAS pathways within units.

Results

All transplant units were represented in this survey. Three units had a formal ERAS pathway for all recipients. Of the remaining units, 65.9% considered implementing an ERAS pathway in the near future. The most commonly perceived barrier to ERAS implementation was ‘embedded culture within transplant units’ (54.8% of respondents). A fifth of respondents insert surgical drains selectively and 11.7% routinely discontinue patient-controlled analgesia on postoperative day 1. Most respondents routinely remove urinary catheters on day 5 (70%) and ureteric stents 4–6 weeks post-transplantation (81.7%). Median length of stay for deceased donor kidney transplant recipients was lower in units with ERAS programmes (5–7 days versus 8–10 days, respectively). The main cited barriers for discharge were ‘suboptimal fluid balance’ and ‘requirement of treatment for rejection’.

Conclusions

Despite slow uptake of ERAS in kidney transplantation, appetite appears to be increasing, particularly in the post-COVID-19 era. The current practice and opinions of transplant specialists highlighted in this survey may help to establish nationally agreed ERAS guidelines in this field.
Severe acute pancreatitis in the early postoperative period due to afferent loop syndrome following gastrectomy for gastric cancer
Authors: Kandhala S , Kumar N , Goswami AG , Rai A , Mallik D , Chauhan U , Basu S
Published: April 2022

Afferent loop syndrome (ALS) is an uncommon complication of gastrojejunostomy. It may be acute or chronic depending on whether symptoms manifest within 7 days of surgery. Rarely acute ALS may give rise to acute pancreatitis. It may present early in the postoperative course and, if diagnosed late, may result in organ failure within 48h. We report a middle-aged woman with carcinoma of the stomach managed by subtotal gastrectomy with Billroth II gastrojejunostomy and Braun jejunojejunostomy. The patient developed vomiting and abdominal pain in the first postoperative day with acute renal shutdown and about 500ml drain output of dirty fluid. On investigation, a diagnosis of acute pancreatitis due to afferent loop syndrome was made, and the patient was resuscitated in the intensive care unit. However, she showed early signs of organ failure and succumbed to her condition within 6 days of surgery. Since the complication is rare following gastrojejunostomy and often mimics ALS, an early diagnosis becomes difficult. If delay in management happens, premature organ failure may lead to high morbidity and mortality.
Paediatric quality-of-life following adenotonsillectomy: an evaluation of T14 paediatric throat disorder quality-of-life outcomes according to operative indication
Authors: Puttasiddaiah PM , Morris S , Costello RC , Whittet HB
Published: April 2022

Introduction

Adenotonsillectomy is the most common surgical intervention for obstructive sleep apnoea (OSA) or recurrent tonsillitis. The Paediatric Throat Disorder Quality of Life Outcome (T14) questionnaire is a validated tool completed by parents to compare the outcome of surgery by measuring the pre- and postoperative scores. This study was undertaken to evaluate the quality-of-life outcome in children undergoing surgical intervention for recurrent tonsillitis and/or OSA.

Methods

This was a prospective, uncontrolled study of 117 children who underwent adenotonsillectomy and tonsillectomy at a single tertiary ear, nose and throat department. An analysis of pre- and postoperative T14 paediatric throat disorder quality-of-life outcomes was undertaken at 12 months.

Results

Of the 117 children, 105 were included in the study sample; 75 with recurrent tonsillitis, 8 with OSA and 22 with both tonsillitis and OSA. All children had an improved T14 score postoperatively. The greatest change in pre- and postoperative T14 score was observed in the tonsillitis and OSA combined group (mean change −29.36, p<0.001). However, an improvement in T14 score was also noted in the tonsilitis (−24.453, p<0.001) and OSA groups (−14.25, p<0.001).

Conclusions

This study found a statistically significant improvement in the T14 quality-of-life score at 12 months postoperatively in children undergoing adenotonsillectomy. This demonstrates improved parental perception of their child’s symptoms for all operative indications of adenotonsillectomy.
Revisiting the Fabry–Perot reflectivity method for mid-infrared optical index measurement: case study of InGaAs, AlInAs, and InP
Authors: Quinchard G. , Poletti T. , Zakhama R. , Pereira J. , Larrue A. , Badano G. , Licitra C. , de Lamaestre R. Espiau , Reverchon J. L. , Delga A.
Published: April 2022

We revisit the Fabry–Perot (FP) reflectivity method to measure optical indices in the mid-infrared spectrum. This simple approach can be readily implemented using a standard Fourier transform infrared spectrometer. Measuring samples with multiple heights allows for enhanced precision of the measurement, making the FP method consistent in values and uncertainties with more advanced ellipsometric measurements. An extensive discussion about experimental errors is carried out. Results between 4 and 12 µm for AlInAs, n-doped InGaAs, and InP, which are the most standard materials for quantum cascade lasers, are given.
Host phenotype classification from human microbiome data is mainly driven by the presence of microbial taxa
Authors: Giliberti Renato , Cavaliere Sara , Mauriello Italia Elisa , Ercolini Danilo , Pasolli Edoardo
Published: April 2022

Machine learning-based classification approaches are widely used to predict host phenotypes from microbiome data. Classifiers are typically employed by considering operational taxonomic units or relative abundance profiles as input features. Such types of data are intrinsically sparse, which opens the opportunity to make predictions from the presence/absence rather than the relative abundance of microbial taxa. This also poses the question whether it is the presence rather than the abundance of particular taxa to be relevant for discrimination purposes, an aspect that has been so far overlooked in the literature. In this paper, we aim at filling this gap by performing a meta-analysis on 4,128 publicly available metagenomes associated with multiple case-control studies. At species-level taxonomic resolution, we show that it is the presence rather than the relative abundance of specific microbial taxa to be important when building classification models. Such findings are robust to the choice of the classifier and confirmed by statistical tests applied to identifying differentially abundant/present taxa. Results are further confirmed at coarser taxonomic resolutions and validated on 4,026 additional 16S rRNA samples coming from 30 public case-control studies.
Concomitant pyroptotic and apoptotic cell death triggered in macrophages infected by Zika virus
Authors: Wen Chunxia , Yu Yufeng , Gao Chengfeng , Qi Xian , Cardona Carol J. , Xing Zheng
Published: April 2022

Zika virus (ZIKV) is a positive-sense RNA flavivirus and can cause serious neurological disorders including microcephaly in infected fetuses. As a mosquito-borne arbovirus, it enters the bloodstream and replicates in various organs. During pregnancy, it can be transmitted from the blood of the viremic mother to the fetus by crossing the placental barrier. Monocytes and macrophages are considered the earliest blood cell types to be infected by ZIKV. As a first line defense, these cells are crucial components in innate immunity and host responses and may impact viral pathogenesis in humans. Previous studies have shown that ZIKV infection can activate inflammasomes and induce proinflammatory cytokines in monocytes. In this report, we showed that ZIKV could infect and induce cell death in human and murine macrophages. In addition to the presence of cleaved caspase-3, indicating that apoptosis was involved, we identified the cleaved caspase-1 and gasdermin D (GSDMD) as well as increased secretion of IL-1β and IL-18. This suggests that the inflammasome was activated and that may lead to pyroptosis in infected macrophages. The pyroptosis was NLRP3-dependent and could be suppressed in the macrophages treated with shRNA to target and knockdown caspase-1. It was also be inhibited by an inhibitor for caspase-1, indicating that the pyroptosis was triggered via a canonical approach. Our findings in this study demonstrate a concomitant occurrence of apoptosis and pyroptosis in ZIKV-infected macrophages, with two mechanisms involved in the cell death, which may have potentially significant impacts on viral pathogenesis in humans.
Identifying indicators influencing emergency department performance during a medical surge: A consensus-based modified fuzzy Delphi approach
Authors: Etu Egbe-Etu , Monplaisir Leslie , Aguwa Celestine , Arslanturk Suzan , Masoud Sara , Markevych Ihor , Miller Joseph
Published: April 2022

During a medical surge, resource scarcity and other factors influence the performance of the healthcare systems. To enhance their performance, hospitals need to identify the critical indicators that affect their operations for better decision-making. This study aims to model a pertinent set of indicators for improving emergency departments’ (ED) performance during a medical surge. The framework comprises a three-stage process to survey, evaluate, and rank such indicators in a systematic approach. The first stage consists of a survey based on the literature and interviews to extract quality indicators that impact the EDs’ performance. The second stage consists of forming a panel of medical professionals to complete the survey questionnaire and applying our proposed consensus-based modified fuzzy Delphi method, which integrates text mining to address the fuzziness and obtain the sentiment scores in expert responses. The final stage ranks the indicators based on their stability and convergence. Here, twenty-nine potential indicators are extracted in the first stage, categorized into five healthcare performance factors, are reduced to twenty consentaneous indicators monitoring ED’s efficacy. The Mann-Whitney test confirmed the stability of the group opinions (p< 0.05). The agreement percentage indicates that ED beds (77.8%), nurse staffing per patient seen (77.3%), and length of stay (75.0%) are among the most significant indicators affecting the ED’s performance when responding to a surge. This research proposes a framework that helps hospital administrators determine essential indicators to monitor, manage, and improve the performance of EDs systematically during a surge event.
Epidemiological studies of sleep disorder in educational community of Pakistani population, its major risk factors and associated diseases
Authors: Umar Ali , Khan Muhammad Saleem , Sehgal Sheikh Arslan , Jafar Kamran , Ahmad Shabbir , Waheed Ahmad , Aslam Muhammad Waseem , Wajid Muhammad , Rehman Tanzil Ur , Khan Tehmina , Ditta Allah , Akmal Hasnain , Ashfaq Muhammad , Javed Tariq , Tahir Rida
Published: April 2022

Sleep is one of the most important functions of the life. The disturbance in sleep or quality of sleep leads to several dysfunctions of the human body. This study aimed to investigate the prevalence of sleep disorders, their possible risk factors and their association with other health problems. The data was collected from the educational community of the Pakistani population. The Insomnia Severity Index (ISI) was used to evaluate the insomnia and the sleep apnea was evaluated through a simple questionnaire method. The blood samples were collected to perform significant blood tests for clinical investigations. Current research revealed that the individuals in the educational community had poor sleep quality. A total of 1998 individuals from the educational community were surveyed, 1584 (79.28%) of whom had a sleep disorders, including insomnia (45.20%) and sleep apnea (34.08%). The measured onset of age for males and females was 30.35 years and 31.07 years respectively. The Clinical investigations showed that the sleep had significant impact on the hematology of the patients. Higher levels of serum uric acid and blood sugar were recorded with a sleep disorder. The individuals of the educational community were using the sleeping pills. The other associated diseases were mild tension, headaches, migraines, depression, diabetes, obesity, and myopia. The use of beverage, bad mood, medical condition, mental stress, disturbed circadian rhythms, workload and extra use of smartphone were major risk factors of sleep disorders. It was concluded that the insomnia was more prevalent than the sleep apnea. Furthermore, life changes events were directly linked with disturbance of sleep. Tension, depression, headaches, and migraine were more associated with sleep disorders than all other health issues.
Development and evaluation of ActSeq: A targeted next-generation sequencing panel for clinical oncology use
Authors: Shi Zonggao , Lopez Jacqueline , Kalliney William , Sutton Bobbie , Simpson Joyce , Maggert Kevin , Liu Sheng , Wan Jun , Stack M. Sharon
Published: April 2022

Purpose

The demand for high-throughput genetic profiling of somatic mutations in cancer tissues is growing. We sought to establish a targeted next generation sequencing (NGS) panel test for clinical oncology practice.

Methods

Customized probes were designed to capture exonic regions of 141 genes selected for the panel, which was aimed for the detection of clinically actionable genetic variations in cancer, including KRAS, NRAS, BRAF, ALK, ROS1, KIT and EGFR. The size of entire targeted regions is 0.8 Mb. Library preparation used NEBNext Ultra II FS kit coupled with target enrichment. Paired-end sequencing was run on Illumina NextSeq 500 at a read length of 150 nt. A bioinformatics workflow focusing on single nucleotide variant and short insertions and deletions (SNV/indel) discovery was established using open source, in-house and commercial software tools. Standard reference DNA samples were used in testing the sensitivity and precision and limit of detection in variant calling.

Results

The general performance of the panel was observed in pilot runs. Average total reads per sample ranged from 30 million to 48 million, 73% ~82% unique reads. All runs had more than 99% average mapping rate. Mean target coverage ranged from 727x to 879x. Depth of coverage at 50x or more reached 87% of targeted region and 60% of targeted region received 500x or more coverage depth. Using OncoSpan HD827 DNA, which bears 144 variants (SNV/indel) from 80 genes that are within the targeted region on the panel, our somatic variant calling pipeline reached 97% sensitivity and 100% precision respectively, with near 48 million reads. High concordance with orthogonal approaches in variant detection was further verified with 7 cancer cell lines and 45 clinical specimens.

Conclusion

We developed a NGS panel with a focus on clinically actionable gene mutations and validated the performance in library construction, sequencing and variant calling. High concordance with reference materials and orthogonal mutation detection was observed.
Patients’ experiences and perspectives of patient-reported outcome measures in clinical care: A systematic review and qualitative meta-synthesis
Authors: Carfora Liam , Foley Ciara M. , Hagi-Diakou Phillip , Lesty Phillip J. , Sandstrom Marianne L. , Ramsey Imogen , Kumar Saravana
Published: April 2022

Background

Patient-reported outcome measures (PROMs) or patient-reported outcomes (PROs) are used by clinicians in everyday clinical practice to assess patients’ perceptions of their own health and the healthcare they receive. By providing insight into how illness and interventions impact on patients’ lives, they can help to bridge the gap between clinicians’ expectations and what matters most to the patient. Given increasing focus on patient-centred care, the objective of this meta-synthesis was to summarise the qualitative evidence regarding patients’ perspectives and experiences of the use of PROMs in clinical care.

Methods

A systematic search of the following databases was undertaken in August 2020: Medline, EMBASE, EMCARE, PsychINFO, Scopus and the Cochrane Library. This review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Methodological quality of the included studies was assessed using the Critical Appraisal Skills Programme checklist for qualitative research (CASP). A meta-ethnographic approach was used for data extraction and meta-synthesis of findings (PROSPERO registration: CRD42020202506).

Results

Fourteen studies from a range of countries with differing qualitative research methodologies were identified. Three themes were identified, namely ‘patient preferences regarding PROMs’, ‘patient perceived benefits’ and ‘barriers to patient engagement with PROMs’. The perspectives of patients suggested they preferred PROMs that were simple and relevant to their conditions and found benefits in the way they facilitated self-reflection and effective communication with their clinicians. Patients, however, questioned the relevance of some individual questions and purpose.

Conclusion

PROMs can be a useful tool in the clinical setting by enabling individualisation and patient centred care. This meta-synthesis provides insights into what patients find beneficial as well as barriers to their engagement, highlighting the importance of educating patients about PROMs.
GNSS multipath suppression technology based on postcorrelation and independent component analysis
Authors: Xu Jian , Ding Jicheng
Published: April 2022

In urban and other complex environments, satellite navigation signals are vulnerable to multipath interference, especially medium- and short-delay multipath interference, which seriously affects the positioning accuracy. Aiming at the problem that the effect of traditional methods on medium and short multipath suppression is not obvious and it is difficult to accurately estimate the direction of arrival (DOA) when beamforming is used, a multipath suppression scheme based on a postcorrelation and independent component analysis (ICA) algorithm is proposed in this paper. First, the satellite navigation signal on each array element is despread and demodulated by postcorrelation technology to improve the signal-to-noise ratio (SNR), and then the direct signal component is directly extracted by the ICA algorithm to filter the noise while suppressing the multipath interference. Simulation results show that this method can effectively suppress medium and short multipath interference when the SNR of satellite navigation signals is as low as -30 dB, significantly improve the SNR of navigation messages and reduce the bit error rate, which provides a new solution for global navigation satellite system (GNSS) multipath suppression.
The physical activity health paradox and risk factors for cardiovascular disease: A cross-sectional compositional data analysis in the Copenhagen City Heart Study
Authors: Johansson Melker S. , Holtermann Andreas , Marott Jacob L. , Prescott Eva , Schnohr Peter , Korshøj Mette , Søgaard Karen
Published: April 2022

Background

Studies indicate that physical activity during leisure and work have opposite associations with cardiovascular disease (CVD) risk factors, referred to as the physical activity health paradox. We investigated how sedentary behaviour and physical activity types during leisure and work are associated with systolic blood pressure (SBP), waist circumference (WC), and low-density lipoprotein cholesterol (LDL-C) in an adult general population sample using compositional data analysis.

Methods

Participants wore accelerometers for 7 days (right thigh and iliac crest; 24 h/day) and had their SBP, WC, and LDL-C measured. Accelerometer data was analysed using the software Acti4 to derive daily time spent in sedentary behaviour and physical activity types. The measure of association was quantified by reallocating time between sedentary behaviour and 1) walking, and 2) high-intensity physical activity (HIPA; sum of climbing stairs, running, cycling, and rowing), during both domains.

Results

In total, 652 participants were included in the analyses (median wear time: 6 days, 23.8 h/day). During leisure, the results indicated that less sedentary behaviour and more walking or more HIPA was associated with lower SBP, while during work, the findings indicated an association with higher SBP. During both domains, the findings indicated that less sedentary behaviour and more HIPA was associated with a smaller WC and lower LDL-C. However, the findings indicated less sedentary behaviour and more walking to be associated with a larger WC and higher LDL-C, regardless of domain.

Conclusions

During leisure, less sedentary behaviour and more walking or HIPA seems to be associated with a lower SBP, but, during work, it seems to be associated with a higher SBP. No consistent differences between domains were observed for WC and LDL-C. These findings highlight the importance of considering the physical activity health paradox, at least for some risk factors for CVD.
Interest in Infectious Diseases specialty among Japanese medical students amidst the COVID-19 pandemic: A web-based, cross-sectional study
Authors: Hagiya Hideharu , Otsuka Yuki , Tokumasu Kazuki , Honda Hiroyuki , Nishimura Yoshito , Obika Mikako , Otsuka Fumio
Published: April 2022

Introduction

The emergence of the novel coronavirus disease of 2019 (COVID-19) has led to huge disruptions in the medical field and society. The significance of training and education for experts has been increasingly acknowledged in Japan, where the number of infectious disease (ID) specialists is reportedly insufficient. In this paper, we report the results of a web-based survey that was conducted to reveal the ways in which the COVID-19 pandemic has influenced medical students’ awareness of ID specialists and future career choices.

Method

This cross-sectional descriptive study was conducted in March 2021 and targeted 717 medical students belonging to Medical School of Okayama University, Japan. The questionnaire consisted of four questions meant to assess students’ knowledge and future intentions of becoming ID specialists.

Results

We obtained 328 eligible questionnaires (response rate: 45.7%). Of 227 (69.2%) students who were aware of ID specialists, 99 (43.6%) answered that they came to know about them only after the pandemic, 12 (3.7%) answered that their interest in being an ID specialist arose during the pandemic, while 36 (11.0%) responded that they would rather not become ID specialists. At the time of the survey, 5 students (1.5%) were aiming to become ID specialists.

Conclusion

We observed a very low rate of interest to be an ID specialist among medical students. The experience of the pandemic does not seem to have influenced Japanese medical students to choose ID as a specialty for their careers. Continuous efforts to increase the number of ID specialists are necessary in Japan as a countermeasure against the coming pandemic.
Blood vessel occlusion by Cryptococcus neoformans is a mechanism for haemorrhagic dissemination of infection
Authors: Gibson Josie F. , Bojarczuk Aleksandra , Evans Robert J. , Kamuyango Alfred Alinafe , Hotham Richard , Lagendijk Anne K. , Hogan Benjamin M. , Ingham Philip W. , Renshaw Stephen A. , Johnston Simon A.
Published: April 2022

Meningitis caused by infectious pathogens is associated with vessel damage and infarct formation, however the physiological cause is often unknown.Cryptococcus neoformansis a human fungal pathogen and causative agent of cryptococcal meningitis, where vascular events are observed in up to 30% of patients, predominantly in severe infection. Therefore, we aimed to investigate how infection may lead to vessel damage and associated pathogen dissemination using a zebrafish model that permitted noninvasivein vivoimaging. We find that cryptococcal cells become trapped within the vasculature (dependent on their size) and proliferate there resulting in vasodilation. Localised cryptococcal growth, originating from a small number of cryptococcal cells in the vasculature was associated with sites of dissemination and simultaneously with loss of blood vessel integrity. Using a cell-cell junction tension reporter we identified dissemination from intact blood vessels and where vessel rupture occurred. Finally, we manipulated blood vessel tension via cell junctions and found increased tension resulted in increased dissemination. Our data suggest that global vascular vasodilation occurs following infection, resulting in increased vessel tension which subsequently increases dissemination events, representing a positive feedback loop. Thus, we identify a mechanism for blood vessel damage during cryptococcal infection that may represent a cause of vascular damage and cortical infarction during cryptococcal meningitis.
Surveying the art history mystery: Student opinions of outcomes and value
Authors: Meloche Alysha , May Toni
Published: April 2022

Higher education professionals in art history agree that the downward trend of funding and enrolment will continue if changes to art history curriculum are not made that bring to light how relevant and helpful art history can be to students of all demographic populations and academic majors. This study seeks to explore student perspectives of how art history is currently being taught and their opinions on what outcomes art history class offers that they value. Current art history students completed a survey that assessed student perspectives about their art history class. Findings indicate that students value art history knowledge (AHKO) and find lecture to be efficient. However, they would also appreciate other instructional methods such as in-class activities, which they believe would help them learn critical thinking (CTO), and discussion and homework projects, which they believe would help them learn creativity. Students of all majors find AHKO, CTO, creativity to be valuable skills that are taught in art history.
Drawing matters
Authors: Riley Howard , Darlington Michelle
Published: April 2022

As the faculties of literacy and numeracy are universally recognized as worthy of pedagogical nurturing, so this article champions an older, graphic articulacy: visualcy. An articulacy with the language of drawing that distinguishes the visual arts from other disciplines. Its nurturing has been compromised by the shift away from teaching drawing in UK secondary schools and HE art schools, even before COVID. We argue that this shift is in part a consequence – perhaps unintended – of the neo-liberal values permeating the UK education sector. The article presents a critique of the those values seen as a significant obstacle to drawing’s educational benefits, and offers an optimistic basis for its place in the curriculum.
Journalism, Society and Politics in the Digital Media Era, Nael Jebril, Stephen Jukes, Sofia Iordanidou and Emmanouil Takas (eds) (2020)
Authors: LeGrand Cathleen
Published: April 2022

Review of: Journalism, Society and Politics in the Digital Media Era, Nael Jebril, Stephen Jukes, Sofia Iordanidou and Emmanouil Takas (eds) (2020)

Bristol: Intellect, 211 pp.,

ISBN 987-1-78938-168-9, h/bk, £100
Successful treatment of Budd-Chiari Syndrome with Rivaroxaban in a six week old Bangladeshi infant
Authors: Khadga Mukesh , Begum Ferdous Ara , Mazumder Mohammad Wahiduzzaman , Benzamin Mohammad , Rony Nazmul Ahamed , Rahman Abu Zafor Mohammad Raihanur , Siddiqua Ayesha , Hassan Nazmul , Karim Abu Sayed Mohammad Bazlul
Published: April 2022

Budd-Chiari syndrome (BCS) is the clinical spectrum presenting with hepatic venous outflow obstruction from the hepatic veins to the junction of the inferior vena cava (IVC) and the right atrium. This syndrome is rare in infants and children, which leads to misdiagnoses or delayed diagnoses. Clinical presentations may be non-specific. A high index of suspicion and imaging findings may help in early diagnosis of this condition. We report a rare case of BCS in a 6-week-old male infant who presented with jaundice and gradual abdominal distension. He was successfully treated with rivaroxaban.
グローバル・スマートフォン : A Japanese Translation of The Global Smartphone
Authors: Miller Daniel , Abed Rahbo Laila , Awondo Patrick , de Vries Maya , Duque Marília , Garvey Pauline , Haapio-Kirk Laura , Hawkins Charlotte , Otaegui Alfonso , Walton Shireen , Wang Xinyuan
Published: April 2022

スマートフォンはいつも文字通り私たちの鼻先にあり、スマートフォンとは何かという疑問を持つことはなかなかありません。しかし、私たちは本当にスマートフォンを理解しているのでしょうか？より深く理解を掘り下げるために、11人の人類学者が16ヶ月間それぞれアフリカ、アジア、ヨーロッパ、南アメリカの各地域で暮らし、高齢者へのスマートフォンの普及について調査しました。この調査によって、スマートフォンは若者だけでなく、すべての世代が利用するテクノロジーであることが明らかになりました。 『グローバル・スマートフォン』は、独自の観点をそのグローバルな比較研究から提示します。スマートフォンは常に身近にあり、「絶え間なき機会主義（Perpetual Opportunism）」を満たすデバイスであるだけでなく、今や私たちの生活の場そのものにさえなっています。本著は、スマートフォンが単なる「アプリデバイス」以上のものであることを示し、人々が口にするスマートフォンへの意見と、実際にはどのようにスマートフォンを使用しているのか、その違いを探ります。 マートフォンは、私たち使用者が変容させることができるその程度において、未だかつてなく自由度の高いデバイスです。この自由さにより、スマートフォンには使用者個人の価値観が急速に反映されます。この価値観を理解するためには、各地域における民族的・文化的差異を考慮する必要があります。例えば、アル＝クドゥス（エルサレム）、ブラジル、そしてイタリアなど、各地域がたどる高齢化の軌跡の多様性に加えて、中国と日本のビジュアル・コミュニケーション、カメルーンとウガンダのモバイルマネー、チリとアイルランドの保健情報へのアクセスの仕方など、これらの差異を考察して初めて、スマートフォンとは何か、そしてスマートフォンがもたらす生活の変容を理解することができるのです。
Numéro 170 - avril2022
Authors: Guichard Lucas , Machado Joël , Maystadt Jean-François
Published: April 2022

L’afflux de réfugiés ukrainiens est inédit dans l’histoire de l’Europe depuis la Seconde Guerre mondiale. Fin mars 2022, le Haut-Commissariat aux Réfugiés enregistre plus de 4 millions de réfugiés en provenance d’Ukraine. D’autres sources prédisent un total proche de 10 millions si la guerre perdure. Dans ce numéro de Regards économiques, nous discutons d’abord des potentielles conséquences économiques associées, avant de souligner l’importance d’une coordination renforcée entre pays de l’Union européenne.

Le caractère historique de cet afflux de réfugiés ne doit pas faire oublier que la grande majorité des réfugiés continuera à résider dans des pays à faible ou moyen revenu, hors Union européenne. Une mise en perspective s’impose également quant à la capacité d’absorption des pays européens. Sans même évoquer les différences de richesse, le nombre de réfugiés ukrainiens représenterait à peine plus d’1% de la population européenne. Sans pour autant sous-estimer les défis liés à l’accueil des individus originaires d’Ukraine, la distribution des réfugiés au sein de l’Union européenne aura sans doute une incidence considérable sur les conséquences de cet épisode migratoire.

La littérature économique nous montre qu’à terme la migration n’a pas d’effets néfastes sur les finances publiques ou sur le marché du travail. Au contraire, les réfugiés peuvent contribuer de manière positive à leur économie d’accueil en occupant, par exemple, des emplois en manque de main d’oeuvre, en créant eux-mêmes du travail pour la population du pays d’accueil, ou simplement en consommant ou en investissant dans le pays de destination. Toutefois, il faudra du temps pour voir se matérialiser de tels effets économiques et ceux-ci sont sans doute conditionnés à une réception et une intégration réussies des réfugiés ukrainiens à court terme. À cet égard, nous soutenons qu’une plus grande coordination entre pays de l’Union européenne est nécessaire.

À l’aide de différentes clés de répartition, nous proposons certaines pistes pour déterminer une répartition plus équilibrée des réfugiés en fonction des capacités d’absorption de chaque pays. Un manque de coordination aboutirait certainement à une situation asymétrique où des pays comme l’Allemagne, la Pologne, la Tchéquie, la Hongrie et la Roumanie, caractérisés par une forte diaspora ukrainienne et proche géographiquement de l’Ukraine, accueilleraient la majorité des réfugiés. En supposant un rôle de soutien identique des réseaux ukrainiens entre les destinations, la Belgique en accueillerait moins de 40.000. Une entente sur la distribution des réfugiés ukrainiens à moyen terme, en fonction de critères comme la population, le PIB ou une combinaison des deux favoriserait une responsabilité partagée entre pays européens en fonction de leurs capacités d’absorption. Selon un scénario pessimiste de 10 millions de réfugiés ukrainiens, la Belgique devrait accueillir entre 259.000 et 305.000 individus.