bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing the Effects of Financial Inclusion on Reducing Poverty and Income Inequality in South Asia: Evidence from a CS-ARDL Approach
Authors: Azimi Mohammad Naim
Published: December 2022

This study aims to examine the effects of financial inclusion on poverty reduction and income inequality with a focus on South Asian economies from 2004 to 2020 by employing dynamic panel models augmented with a comprehensive composite financial inclusion index and a set of well-known macroeconomic predictors. The primary results confirm the long-run relationships between financial inclusion, poverty headcount ratio and the Gini index, while the results of the cross-sectionally augmented autoregressive distributed lags model indicate that financial inclusion is significantly effective in reducing poverty and income disparities. Moreover, the findings reveal that real per capita income, institutional quality, age dependency ratio, credit to the private sector, inflation rate, school enrolment rate, trade openness, ratio of mobile users, and information and communication technologies are highly significant in intermediating the aggregate effects of financial inclusion on reducing poverty and income inequality. The findings clearly show that the greater impact of financial inclusion on reducing poverty and income inequality is primarily based on the development, enhancement and promotion of financial inclusion in South Asian economies, where the financially excluded segment constitutes a significant proportion of society.
Effect of the posterior sagging control device to the posterior tibial translation during posterior-stabilized total knee arthroplasty with modified gap technique
Authors: Maeyama Akira , Asayama Isao , Ishimatsu Tetsuro , Yamamoto Takuaki
Published: December 2022

Purpose

In modern total knee arthroplasty (TKA), flexion and extension gaps between the femur and tibia are equilibrated before implanting the final components. Uncontrolled intraoperative posterior tibial translation (PTT) could cause an artifactual widening of the flexion gap, which could lead surgeons to alter the femoral component size. We designed an intraoperative posterior sagging control device to prevent intraoperative PTT. In this study, we investigated whether the use of this device could prevent artifactual widening of the flexion gap.

Methods

Twenty-five patients, 21 women and four men, aged 74.2 years, were enrolled in this prospective study. All patients underwent postero-stabilized TKA using a navigation system. Intraoperative PTT, flexion and extension gaps with or without using the posterior sagging control device were measured with navigation system. These measurements were compared with or without the posterior sagging control device and after the final implantation also.

Results

There were significant differences between the measurements performed with or without the posterior sagging control device when compared to the post-implantation measurements. The use of the device reduced the number of patients with a >3 mm increase in flexion gap from 7 (28%) to 1 (4%).

Conclusion

This study suggests that the posterior sagging control device prevents PTT and artificial flexion gap widening. This could prevent an unnecessary increase in component size.
A new approach to design electromagnetic transducers for wideband electrically-tuned vibration energy harvesting
Authors: Delattre Gallien , Vigne Sébastien , Brenes Alexis , Garraud Nicolas , Freychet Olivier , Boisseau Sébastien
Published: December 2022

This paper focuses on the opportunities offered by electrical tuning to widen the bandwidth of Vibration Energy Harvesters (VEH) based on electromagnetic conversion. The paper shows that some electromagnetic transducer topologies are more likely than others to take advantage of the wide bandwidth performance offered by electrical tuning. Using a general model including both a resonant electromagnetic VEH and a resistive-capacitive interface with electrical tuning, we highlight the parameters of interest influencing the bandwidth of the system. Based on these results, we develop an efficient optimization approach suitable for any electromagnetic transducer topology. The full optimization of different transducer topologies shows that the one that is based on variable reluctance is the best in terms of bandwidth-related performances.
Evaluation of flow-induced vibration suppression performances of magneto-rheological damping pipe clamp using PID algorithm
Authors: Hong Ruidong , Nie Songlin , Ji Hui , Nie Shuang , Gong Fei
Published: December 2022

In order to suppress the low-frequency flow-induced vibration of fluid conveying pipeline, this paper develops a magnetorheological damping (MRD) pipe clamp due to its simple structure and strong dynamic adjustability. The mechanical dynamic model of MRD pipe clamp is established, and the vibration control algorithm based on PID is simulated. Comparison analysis on the vibration damping performance of the MRD pipe clamp under uncontrol, passive control, and PID control are conducted. The damping performances of MRD pipe clamp are tested under uncontrol, passive control, and PID control algorithm. The experiment results exhibited that the attenuation rate of each axial displacement and acceleration of pipe system using PID algorithm were more than 80% under sinusoidal excitation force of 600 N and excitation frequency of 2.5 Hz. The experiment results have verified the correctness of the simulation analysis in terms of value and trend. This research will provide the guide for the design and engineering application of MRD pipe clamp system.
Ponesimod: An Oral Second-Generation Selective Sphingosine 1-Phosphate Receptor Modulator for the Treatment of Multiple Sclerosis
Authors: Alnaif Amal , Oiler Isabelle , D’Souza Manoranjan S.
Published: December 2022

Objective:

To describe the safety, efficacy, and potential role in therapy of ponesimod, which was recently approved by the Food and Drug Administration (FDA) as a therapeutic option for the treatment of multiple sclerosis (MS).

Data Sources:

A PubMed literature search using the following terms: ponesimod and MS (January 1, 2012-October 31, 2022). FDA product labeling was also reviewed for pertinent data sources.

Study Selection and Data Extraction:

All relevant English-language articles examining efficacy and/or safety of ponesimod were considered for inclusion.

Data Synthesis:

Ponesimod is an orally administered second-generation sphingosine 1-phospate (S1-P) receptor modulator classified as a disease modifying treatment (DMT) for MS. Clinical studies have shown that ponesimod prevents relapse in patients with relapsing-remitting MS (RRMS) and has superior efficacy compared with teriflunomide. Nasopharyngitis, upper respiratory tract infections, headache, high blood pressure, and liver dysfunction were some of the common adverse effects associated with ponesimod. Dyspnea, bradyarrhythmias, atrioventricular conduction delays, and macular edema were some of the rare but serious adverse effects associated with ponesimod.

Relevance to Patient Care and Clinical Practice in Comparison With Existing Agents:

Some advantages of ponesimod over other S1-P receptor modulators approved for RRMS include selectivity for the S1-P1 receptor and short half-life, which allows for quick reversal of immunosuppressive effects. However, data from long-term efficacy and safety studies and more direct comparison studies with other DMTs are required.

Conclusion:

Currently available data suggest that ponesimod is a useful addition to other high-efficacy DMTs available to treat patients with MS.
Reduced Risk Information Seeking Model (RISK): A Meta-Analysis
Authors: Liu Zhuling , Yang Janet Zheng , Feeley Thomas Hugh
Published: December 2022

This meta-analysis synthesizes research findings from 50 studies to assess the explanatory power of the reduced risk information seeking model (RISK). The results show that informational subjective norms have the largest effect size, followed by sufficiency threshold and current knowledge. This finding suggests that risk information seeking behavior is largely determined by social motivations. In addition, the relationships between current knowledge and seeking, as well as between sufficiency threshold and seeking, are stronger when a risk is viewed as personally relevant. Moreover, the relationship between current knowledge and seeking is stronger in studies where participants report higher risk perception.
The Impact of Prior Antithrombotic use on Thromboembolic Events in Patients with Cardiovascular Disease and Severe COVID-19 Infection
Authors: Bouchlarhem Amine , Boulouiz Soumia , el Aidouni Ghizlane , Bkiyar Houssam , Bazid Zakaria , Ismaili Nabila , Housni Brahim , El Ouafi Noha
Published: December 2022

Objective

Our objective in this study was to determine the predictive factors of thromboembolic complications in patients with previous heart disease and severe covid-19 infection and the impact of previous use of antithrombotics on protection against these complications.

Methods

We conducted a single-center retrospective study of 158 patients with heart disease admitted to an intensive care unit for severe SARS-COV-2 infection. In order to determine the predictive factors, we used logistic regression analysis.

Results

Out of 158 patients, 22 were complicated by a thrombo-embolic event (13.9%), mean age of our population 64.03 (SD = 15.27), with a male predominance of 98 (62%). For the predictive factors of thromboembolic complications, and after multivariate analysis, we find the short duration of hospitalization (OR = 0.92; 95%CI (0.863–0.983), P = .014, previous use of antithrombotic drugs ((OR = 0.288, 95%CI (0.091–0.911), P = .034 for antiplatelet agents) and (OR = 0.322, 95% CI (0, 131–0.851), P = .021) for anticoagulants) as protective factors, and admission thrombocytosis as a risk factor (OR = 4.58, 95%CI (1.2–10.627), P = .021). D-dimer was not detected as a risk factor, and this can be explained by the characteristics of our population. Although prior use of antithrombotic drugs protects against thromboembolic complications during severe infection, there was no benefit in mortality.

Conclusion

Prior use of antithrombotic drugs is a protective factor against thromboembolic complications in patients with a history of heart disease but without effect on mortality.
A Novel Indicator of Myocardial Injury after Acute Myocardial Infarction: ‘DPP-3’
Authors: Ozden Ozge , Yesildas Cuma , Demir Mustafa , Surmeli Ali Orcun , Yesil Emrah , Orscelik Ozcan , Celik Ahmet
Published: December 2022

Background

Dipeptidyl peptidase 3 (DPP-3) is an intracellular enzyme that causes hemodynamic instability and cardiac depression in several cases such as cardiogenic shock, sepsis and burns where DPP-3 is released into the blood due to cell death. Data on the effect of higher DPP-3 levels on acute coronary syndrome (ACS) patients are currently lacking. The aim of this study was to evaluate the effect of DPP-3 levels on ACS patients.

Methods

In this prospective study, we included ACS patients including STEMI and non-STEMI groups and a control group to compare various demographic, echocardiographic and laboratory parameters including DPP-3. DPP-3 levels were measured at 24th, 48th, and 72nd h from the onset of symptoms in ACS patients and then compared with left ventricle ejection fraction (LVEF) for the assessment of left ventricle systolic function.

Results

A total of 70 ACS patients (age 62.5 ± 11 years, 68.6% male) were recruited and 48 normal individuals were included as control group (age 61.1 ± 10 years, 66.7% male). It has been demonstrated that DPP-3 levels are significantly higher in the ACS group than the control group like troponin I levels. DPP-3 levels were found to be one of the independent predictors of LVEF similar to NT-proBNP and troponin I.

Conclusions

This study suggests that DPP-3 could be an important indicator of myocardial depression predicting left ventricle systolic function in ACS.
Collagen Remodeling and Fatty Acid Regulation Biomarkers in Understanding the Molecular Pathogenesis of Atrial Fibrillation
Authors: Odeh Ameer , Dungan Gabriel D. , Darki Amir , Hoppensteadt Debra , Siddiqui Fakiha , Kantarcioglu Bulent , Fareed Jawed , Syed Mushabbar A.
Published: December 2022

Introduction

Atrial Fibrillation (AF) is the most common cardiac arrythmia in the world. Structural remodeling and fatty acid metabolism dysregulation are believed to play a role in the development of AF. This study explored different biomarkers in the blood of AF patients and a control population to determine if there was a significant difference between the two groups.

Material and Methods

Plasma samples were collected from 73 patients with confirmed diagnosis of AF from Loyola University Clinic. Control group represented commercially available plasma ( n = 50). Sandwich ELISA kits were used to quantify the collagen remodeling proteins and liver type fatty acid binding protein (L-FABP) in the AF population and the control population. Non-esterified fatty acids (NEFAs) were measured using an enzymatic colorimetric kit from Wako Diagnostics. Statistical analyses were performed using GraphPad Prism.

Results

All the collagen remodeling biomarkers were significantly higher in AF patients compared to the control group. The fatty acid dysregulation biomarkers were elevated in the AF patients. Spearman correlation analyses yielded significant correlations between L-FABP and TIMP-1 ( r = 0.47, P < 0.001), NEFA and TIMP-2 ( r = 0.41, P = 0.002), NEFA and ICTP ( r = 0.41, P =0 .002), and NEFA and PIIINP ( r = 0.61, P < 0.0001).

Summary and Conclusions

The elevation of collagen remodeling biomarkers suggests an upregulation of these biomarkers and their potential role in AF, which may contribute to atrial fibrosis. L-FABP and NEFAs were elevated in AF patients. The correlations between the collagen remodeling and fatty acid dysregulation biomarkers may be due to their involvement in structural remodeling of the atria.
Potter Deformation Sequence Caused by 17q12 Deletion: A Lethal Constellation
Authors: Molina Laura M. , Salgado Claudia M. , Reyes-Múgica Miguel
Published: December 2022

17q12 deletion syndrome causes developmental abnormalities of the kidneys, pancreas, genital tract, and neurodevelopment, and it has a wide range of phenotypes ranging from fetal demise to normal adulthood with minimal renal impairment. Here we describe a rare case of 17q12 deletion diagnosed prenatally, complicated by anhydramnios and Potter sequence. The baby was born but necessitated life-saving interventions due to pulmonary and renal insufficiency and ultimately succumbed to multi-organ failure. We present full autopsy results describing findings linked to 17q12 deletion, including severe bilateral multicystic renal dysplasia, pancreatic hypoplasia, and cysts adjacent to the Fallopian tubes. We also describe pulmonary hypoplasia and Potter facies as consequences of anhydramnios. We correlate these findings to our current understanding of molecular signals altered by 17q12 deletion, notably affecting HNF1B and LHX1 genes, which are known to mediate renal and genitourinary tract development.
Thermal behavior in rolling bearing applications: Comparison of steel and ceramic materials applied to tapered rollers
Authors: Fossier Charlotte , Touret Thomas , Lefort Guillaume , Changenet Christophe
Published: December 2022

Due to their properties, ceramic materials can improve both reliability and efficiency of rolling bearings. Most of the studies have investigated the power losses and temperatures of ball bearings with balls made of silicon nitride (Si3N4) versus steel ones. This study thus focuses on tapered rollers. Thanks to experimental and numerical means, the thermal behavior of tapered roller bearings is investigated for both steel and silicon nitride rollers. Various operating conditions (rotational speed, oil flow rate and oil temperature) are tested to allow the comparison of the behavior of both bearing set-ups (full-steel and hybrid). A thermal model is developed according to the thermal network method and is validated thanks to experimental results. It is then used to analyze behaviors observed during experiments, related to thermal exchanges and power losses. The effect of changing the mechanical and thermal properties of the roller material is investigated.
Longitudinal study of Spanish vowel acquisition by Australian students
Authors: Herrero de Haro Alfredo , Delicado Cantero Manuel
Published: December 2022

A growing body of research, especially on second language (L2) English, has shown the positive effects of explicit pronunciation teaching. However, some beliefs which prevent explicit pronunciation teaching still remain, notably, the belief that regular speaking during class time is enough to improve pronunciation outcomes. This article analyses the evolution of L2 Spanish vowels in four students at an Australian university. An analysis of 1,387 vowels from the first, third and sixth semesters of a Spanish major with no particular focus on explicit pronunciation teaching shows minimal change in the quality of the students’ vowels, indicating very little improvement in pronunciation across their six-semester language major. The results suggest that speaking during class is not enough to improve L2 Spanish pronunciation and support explicit pronunciation teaching in the language classroom.
Developments in a teacher’s cognition about written feedback: A sociocultural theory-driven perspective
Authors: Saeli Hooman , Rahmati Payam
Published: December 2022

In the current study, we aimed to investigate an Iranian English as a foreign language (EFL) teacher’s cognitions about second language (L2) writing and feedback. Using longitudinal data from a writing instructor (i.e. Moe) over the course of eight years, we examined data from three rounds of interviews (i.e. in 2013, 2016, and 2021), stimulated recalls (i.e. in 2016 and 2021), and textual analysis of students’ essays with Moe’s feedback on them. We also employed a sociocultural-theory-driven approach to analysing these data in order to gain an understanding of the genesis, development, and mediation in his cognitions. Our analysis showed that Moe’s cognitions about L2 writing and feedback developed in a nonlinear fashion. For instance, his feedback provision developed from comprehensive grammar correction into selective grammar feedback. In addition, Moe’s 2016 feedback practices included mostly negative feedback, while, in 2021, his feedback incorporated instances of positive feedback at the end of essays. We also pinpointed the variables which mediated these developments in Moe’s cognitions. Specifically, we found out that Moe’s expanding teaching experiences, his interactions with colleagues/mentors, and his professors at different institutions mediated the developments we identified in his cognitions in 2013, 2016, and 2021.
The use of and need for data and information by health professionals supporting the delivery of palliative cancer care services in sub-Saharan Africa: A qualitative study
Authors: Akeju David , Ziegler Friederike , Dandadzi Adlight , Nabirye Elizabeth , Namisango Eve , Namukwaya Elizabeth , Adejoh Samuel O , Okunade Kehinde , Fu Yu , Ebenso Bassey , Nkhoma Kennedy , Allsop Matthew
Published: December 2022

Purpose

The ability to develop and evaluate approaches to the management of advanced cancer in sub-Saharan Africa is limited by the lack of local, reliable and valid data to ensure that practice is evidence-based, replicable and reflects the needs of the population served.

Methods

A secondary qualitative analysis of in-depth interviews with 59 health professionals delivering palliative cancer care in Nigeria, Uganda and Zimbabwe were conducted to determine the use and needs for data and information for patient care and service delivery. Framework analysis was used, informed by a conceptual model for data use in low and middle-income countries.

Results

Three meta-themes include: (1) Current practice in data gathering and use; (2) Gaps for capturing, storing information and supporting communication, and; (3) Needs and opportunities for data use. Deficits in current data access and use were identified, alongside targets for improving the quality, accessibility and utility of data to inform the development of palliative cancer care.

Conclusions

The availability and use of relevant and reliable data relating to the current provision of palliative cancer care are requisite for the contextually appropriate and effective development of health services. The requirements and constraints articulated by participants can guide future development and optimisation of digital health approaches for palliative cancer care in the participating countries, with relevance to the wider sub-Saharan Africa region.
An intersectional approach to evaluating the effectiveness of women’s sexualized body-positive imagery on Instagram
Authors: Vendemia Megan A , Brathwaite Kyla N , DeAndrea David C
Published: December 2022

Our work adopted an intersectional approach to investigate how women’s racial identity may influence how they evaluate and are impacted by body-positive imagery of women on social media. In a 2 × 2 × 2 experiment ( N = 975), we examined how source race (Black vs White) and sexualization (non-sexualized vs sexualized) in body-positive images affect Black and White viewers’ impressions of self-interest, moral appropriateness, and body positivity. Results indicated that viewers generally responded more favorably to non-sexualized (vs sexualized) images: Participants reported less self-interested motivations for sharing, found the images more morally appropriate, and believed they were more effective representations of body positivity. Results also revealed that Black (vs White) viewers tended to express more appreciation for body-positive imagery, regardless of source race or sexualization. Findings not only advance our theoretical understanding of sexual objectification with more diverse depictions and broader sampling, but also provide practical suggestions for advocates of the body-positive movement.
Using Community-Based Participatory Research to Create Animated Videos to Attenuate Disparities in Access to Kidney Transplant Information
Authors: Kayler Liise K. , Breckenridge Barbara , Thomas Cheryl , Brinser-Day Sherry , Sierra Esmeralda , Cadzow Renee B. , Feeley Thomas H. , Tumiel-Berhalter Laurene
Published: December 2022

Introduction: Community-based participatory research and animated video offer promising approaches to attenuate disparities in access to kidney transplant information. Project Aims: We refined an evidence-based animated video curriculum (Kidney Transplant and Donation Information Made Easy) designed for diverse individuals, that is currently being trialed to advance kidney transplant access among referred patients at a single transplant center, to further accommodate information needs in earlier stages of the path to transplant (pre-referral) and to enhance fit for Black and Hispanic people. Design: We describe formation of an academic–community partnership and the application of qualitative research methods and partnership discussions to refine the Kidney Transplant and Donation Information Made Easy videos. A simple content analysis was undertaken of intervention refinement transcriptions, minutes, and meeting notes. Results: We formed a community steering committee and advisory board of local members predominantly of minoritized race or ethnicity. Full engagement with community members is evident in the program's adaptation process. Essential refinement elements were adaptation of 17 original videos and iterative development of 8 new videos with the community, conducting parallel cognitive interviews of an expanded sample of stakeholders, maintaining the theoretical grounding of Elaboration Theory, communication/multimedia learning best practices, and self-efficacy framework, and doing Spanish-language translation. Conclusions: Applying community-based participatory research principles and qualitative methods, we produced a culturally grounded adaptation of the Kidney Transplant and Donation Information Made Easy videos that provides information about kidney transplantation from primary care to transplantation. This approach is likely to strengthen our community partnership and eventual community acceptance of the intervention during the implementation phase. Challenges were achieving consensus and adding Spanish-language translation.
Higher Adherence to Anterior Cruciate Ligament Injury Prevention Programs Is Associated With Lower Injury Rates: A Meta-Analysis and Meta-Regression
Authors: Halvorsen Kristin C. , Marx Robert G. , Wolfe Isabel , Taber Caroline , Jivanelli Bridget , Pearle Andrew D. , Ling Daphne I.
Published: December 2022

Background: Athletes who participate in sports that involve cutting and pivoting movements are particularly susceptible to anterior cruciate ligament (ACL) injury. Preventing this injury is the best way to combat its health consequences and costs. There may be a dose-response relationship between adherence and injury reduction. Purpose: We sought to examine whether athletes’ adherence to injury prevention programs (IPPs) is associated with reductions in ACL and lower extremity (LE) injuries. Methods: We conducted a systematic review of the PubMed, EMBASE, and Cochrane Library databases, searching for studies published between 2011 and 2021. Studies were included if they reported on the use of an ACL IPP compared with a control group and recorded the rate of injuries to calculate a rate ratio, as well as adherence to the program as a percentage of sessions performed. For the meta-analysis, the rate ratios were pooled using the DerSimonian-Laird random-effects model. Results: For the 15 studies included (11 randomized controlled trials and 4 cohort studies), the random-effects model grouped athletes’ adherence to an IPP as high (76% or more of the sessions), moderate (51%–75% of the sessions), and low (50% or fewer of the sessions). We found that athletes with the highest level of IPP adherence had a significantly lower incidence of ACL injury. The rate ratios for moderate and low adherence did not demonstrate a reduced incidence of ACL injury. Injury prevention program participation was also associated with a decrease in LE injury rates. Conclusion: This systematic review and meta-analysis found that athletes with high adherence to IPPs had reduced rates of ACL and LE injuries. Our findings suggest that educating coaches and athletes on the dose-dependent benefits of IPPs may promote the routine incorporation of these programs into warm-up sessions to decrease the risk of ACL and LE injuries.
Basilar artery occlusion management: An international survey of middle versus high-income countries
Authors: Drumm Brian , Herning Ana , Klein Piers , Raymond Jean , Abdalkader Mohamad , Huo Xiaochuan , Chen Yimin , Siegler James E. , Peacock Meabh , Schonewille Wouter J. , Liu Xinfeng , Hu Wei , Ji Xunming , Li Chuanhui , Alemseged Fana , Liu Liping , Nagel Simon , Strbian Daniel , Rebello Leticia C. , Yaghi Shadi , Qureshi Muhammad M. , Fischer Urs , Tsivgoulis Georgios , Kaesmacher Johannes , Yamagami Hiroshi , Puetz Volker , Sylaja PN , Marto João Pedro , Sacco Simona , Kristoffersen Espen Saxhaug , Demeestere Jelle , Conforto Adriana B. , Meyer Lukas , Kaiser Daniel P.O. , Reiff Tilman , Aydin Kubilay , Romoli Michele , Diana Francesco , Lobotesis Kyriakos , Roi Dylan , Masoud Hesham E. , Ma Alice , Mohammaden Mahmoud H. , Doheim Mohamed F. , Zhu Yuyou , Sang Hongfei , Sun Dapeng , Ton Mai Duy , Raynald  , Li Fengli , Lapergue Bertrand , Hanning Uta , Yang Qingwu , Lee Jin Soo , Thomalla Götz , Yang Pengfei , Liu Jianmin , Campbell Bruce C.V. , Chen Hui-Sheng , Zaidat Osama O. , Qiu Zhongming , Nogueira Raul G. , Miao Zhongrong , Nguyen Thanh N. , Banerjee Soma
Published: December 2022

Background and Purpose

Two early basilar artery occlusion (BAO) randomized controlled trials (RCTs) did not establish the superiority of endovascular thrombectomy (EVT) over medical management. Yet many providers continued to recommend EVT. The goal of the present article is to compare physicians’ diagnostic and management strategies of BAO among middle-income and high-income countries (MICs and HICs, respectively).

Methods

We conducted an international survey from January to March 2022 regarding management strategies in acute BAO, to examine clinical and imaging parameters influencing clinician management of patients with BAO. We compared responses between physicians from HIC and MIC.

Results

Among the 1245 respondents from 73 countries, 799 (64.2%) were from HIC, with the remaining 393 (31.6%) from MIC. Most respondents perceived that EVT was superior to medical management for acute BAO, but more so in respondents from HIC (98.0% vs. 94.2%, p < 0.01). MIC respondents were more likely to believe further RCTs were warranted (91.6% vs. 74.0%, p < 0.01) and were more likely to find it acceptable to enroll any patient who met a trial’s criteria in the standard medical treatment arm (58.8% vs. 38.5%, p < 0.01).

Conclusions

In an area where clinical equipoise was called into question despite the lack of RCT evidence, we found that respondents from MIC were more likely to express willingness to enroll patients with BAO in an RCT than their HIC counterparts.
A phenomenological insight into what final year undergraduate student nurses perceive is the role of the Registered Nurse and who they learn this from
Authors: Morrell-Scott Nicola
Published: December 2022

Background:

This paper considers the perceptions of 18 final year student nurses around their perception of the role of the nurse.

Methods:

A qualitative phenomenological research study was undertaken, with final year student nurses as the data source, undertaking semi-structured interviews from a United Kingdom Higher Education Institution. Data analysis was undertaken by using interpretative phenomenological analysis.

Results:

Findings indicate that student nurses had little insight as to the role of the nurse when commencing the programme. Being on the programme has led them to understand there are many aspects of a nurse’s role including, surprisingly for them, much responsibility. It was also found that a lot of the learning that takes place comes from working with healthcare assistants, and due to this, the student nurses perceive that the role of the modern nurse is task orientated and there is little holistic care.

Conclusions:

The future practice of this group of registrants may be affected depending on how they move forward with their role, alongside the holistic role of the nurse being detracted from. While phenomenology does not account for generalisations but does seek to illuminate this phenomenon; however if this view were to be shared globally, then the caring aspect of nursing may well be in danger of being lost. If this assumption of the role of the nurse is shared globally, then there are inevitably implications for the nursing profession, and more importantly patient care may be affected.
Effect of mobile health interventions in increasing utilization of Maternal and Child Health care services in developing countries: A scoping review
Authors: Venkataramanan Ramachandran , Subramanian S.V. , Alajlani Mohannad , Arvanitis Theodoros N
Published: December 2022

Background

Mobile health (mHealth) technology is being used predominantly in low- and middle-income countries. Developing countries with low level of investment in health infrastructure can augment existing capacity by adopting low-cost affordable technology. The aim of the review was to summarize the available evidence on mHealth interventions that aimed at increasing the utilization of Maternal and Child Health (MCH) care services. Further, this review investigated the barriers which prevent the use of mHealth among both health care workers as well as beneficiaries.

Methodology

A scoping review of literature was undertaken using the five-stage framework developed by Arksey and O’Malley. The articles published between 1990 and 2021 were retrieved from three databases (PubMed, Cochrane Reviews, and Google Scholar) and grey literature for this review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist was followed to present the findings.

Result

A total of 573 studies were identified. After removing duplicates, studies not related to mHealth and MCH and publications of systematic reviews and protocols for studies, a total of 28 studies were selected for review. The study design of the research articles which appeared during the search process were mostly observational, cross-sectional, and randomized controlled trials (RCTs). We have classified the studies into four categories based on the outcomes for which the mHealth intervention was implemented: MCH care services, child immunization, nutrition services, and perceptions of stakeholders toward using technology for improving MCH outcomes.

Conclusion

This brief review concludes that mHealth interventions can improve access to MCH services. However, further studies based on large sample size and strong research design are recommended.
Human-centered design development of mHealth patient-to-peer referral tool in the emergency department
Authors: Hyde Zak , Roura Raúl , Varanasi Kesav , McGinn Tanner , Evans Julie , Verschoore Benjamin , Yang Cui , Labrique Alain , Ricketts Erin P , Rothman Richard E , Latkin Carl A , Hsieh Yu-Hsiang
Published: December 2022

Background

Given the steady increase of emergency department (ED) visits related to opioid overdoses, this study aims to determine the design and usability of an ED-centered mHealth patient-to-peer referral prototype tool that allows patients to refer peers to comprehensive HIV/HCV and opioid misuse prevention services.

Methods

Two iterative focus group discussion (FDG) sessions and one use-case session were conducted. Eligible participants who were ≥18 years, had a history of injection drug use (IDU), and had utilized the ED in the past year were recruited through the distribution of flyers at the study institution, including the study ED. Human-centered design process was completed by using participant feedback on perceived utility, usability/accessibility, tool design, and clarity/readability to fine-tune prototype version and drive subsequent discussion sessions.

Results

Sixteen consented individuals participated in at least one of the sessions. Feedback revealed that participants favored the inclusion of the webpage link on the referral card as means to bypass QR code if needed, more descriptions highlighting the exact services offered, and the fact that no personal information was required to complete the referral process. The prototype underwent several adjustments between user-centered FDG sessions, which ultimately ended in including features such as an online webpage with educational videos, SMS text-message communication system, and QR code usage into the final patient-to-peer referral tool prototype.

Conclusion

The findings of this study suggest a human-centered designed patient-to-peer referral tool could be a feasible approach to linking community members at risk of IDU to HIV/HCV and opioid use-related preventive services from ED patients.
Trends and Early Complications in Direct-to-Implant Breast Reconstruction: An Updated Analysis of the ACS-NSQIP Database
Authors: Plotsker Ethan L. , Rubenstein Robyn N. , Graziano Francis D. , Haglich Kathryn , Disa Joseph J. , Stern Carrie S. , Nelson Jonas A.
Published: December 2022

Background: Rates of direct-to-implant (DTI) breast reconstruction, in which breast implants are placed at the time of mastectomy, have been consistently rising. Advances in surgical adjuncts and technology, such as acellular dermal matrices (ADM), have made DTI reconstruction safer and more reliable. However, few studies have characterized early (30-day) postoperative complications following DTI. The aim of this study was to obtain a current understanding of early postoperative outcomes following DTI breast reconstruction. Methods: Using data from the American College of Surgeons-National Surgical Quality Improvement Program, we analyzed complications for female patients who underwent DTI reconstruction from 2017 to 2019, as well as trends in DTI reconstruction from data on mastectomy and DTI reconstruction from 2010 to 2019. We grouped complications into major surgical (including return to the operating room) or medical complications. Statistical analysis was performed using Fischer's exact test for categorical variables, Student's t-test for continuous variables, and logistic regression. Results: DTI breast reconstruction rates have increased since 2010. Among our 2017-2019 cohort of 4204 patients, the early major surgical complication rate was approximately 10% (422 patients) and the major medical complication rate was 0.83% (35 patients). Regression modeling identified body mass index, smoking status, hypertension, bleeding disorders, and intraoperative blood transfusion as having a relationship with surgical complications ( P < .001). Conclusions: Despite increased use of ADM and indocyanine green angiography, compared to prior studies, early postoperative complications have remained stable. Further studies are needed to assess long-term complications and patient-reported outcomes in DTI breast reconstruction.
Exploration of Factors Influencing Nurses’ Preparedness and Response to the COVID-19 Outbreak
Authors: Fernandez Daphne Fernandez Dicson , Phoon Yan Ling , Soon Margaret Mei Ling , Tiow Shen Chua
Published: December 2022

Introduction and Objective

Nurses as the core of the health care workforce affect an organization's preparedness and response. This study explores the factors and unique determinants influencing nurses’ preparedness and response to the coronavirus disease 2019 (COVID-19) outbreak in Singapore.

Methods

This qualitative phenomenological study utilized purposive sampling and in-depth interviews with 10 registered nurses and two enrolled nurses who had worked or were still working in an infectious disease (ID) hospital during the COVID-19 outbreak at the point of recruitment. The data were collected from September 2020 to December 2020.

Results

(1) Before the outbreak: Factors such as knowledge, skills, and experiences that enhanced nurses’ adaptability and response through training and exposure prior to the outbreak influenced preparedness. In addition, the importance of nurses’ knowing their purpose and the role of their institute during the outbreak also influenced preparedness. (2) The COVID-19 phase: Factors such as the novelty of the disease, communication, load and demand, and coping mechanisms affected participants’ working response to the outbreak. (3) Learning and looking forth: Lessons learnt to enhance preparedness and response to future outbreaks, and positive sentiments as part of the nation's effort to combat the disease.

Conclusion

Ground nurses should be actively involved in outbreak planning to gain a better view of their responsibilities and unpredictable events that may occur. A transparent and bidirectional communication among management and nurses is crucial amidst rapid changes in an outbreak to strike a balance between the needs of nurses and leadership and to enhance nurses’ resilience throughout this challenging journey.
Freelisting: A Technique for Enhancing the Community Health Needs Assessment
Authors: Decker-Palmer Marquita , Klodowski David , Thompson Trina , Lanoue Marianna , Messina Allison , Schroeder Diana , Barto Shiryl , Oglesby Billy , Frasso Rosemary
Published: December 2022

US health systems are required to conduct community health needs assessments (CHNAs). These assessments often rely solely on publicly reported disease prevalence data. The objective of this study was to identify a feasible qualitative method that can be implemented into CHNAs to confirm existing information and enhance them with new data and community narrative. Freelisting interviews were conducted in 2017 throughout a county in Pennsylvania. Individuals listed (1) things that improve health, (2) health problems, and (3) health barriers. Responses were grouped into like terms, Smith’s salience index was calculated for each, subgroup variation was assessed. Community-reported health priorities were identified by salient terms juxtaposed with publicly reported disease prevalence data. 98 respondents throughout the county participated in freelisting interviews. Demographics resembled the population: median age 55, 46% female, 88% Caucasian, 9% uninsured. Salient terms that improve health included: “physical activity”, “healthy eating”, and “health services”. Salient terms describing health problems included: “cardiovascular disease” and “spine and joint disease”. Centers for Disease Control and Prevention (CDC)-reported chronic disease prevalence in the county included heart disease mortality (22% of deaths) and arthritis (26% of adults). Salient barriers to health included: “weight, physical activity, and dietary concerns”, as well as “occupational concerns”. This is in line with 2017 County Health Rankings related to obesity (reported 29%), however, while 10% were uninsured in the community, this was not a salient term. Freelisting can augment and inform CHNAs. In this single-county study, freelisting responses supported publicly available disease/mortality prevalence data and provided insight into community perceptions of health issues.
Coping with the COVID-19 lockdown: The role of household and family responsibilities in Beijing
Authors: Xu Weilin , Dijst Martin , Chai Yanwei
Published: December 2022

The COVID-19 pandemic combined with lockdown measures fundamentally changed urban family life worldwide. This article compares how different household types—singles, couples, nuclear families, and extended families—experienced the lockdown during the first wave of the COVID-19 pandemic in Beijing. It argues that not only the household responsibilities associated with household types at the household level, but also the family responsibilities on a larger geographical scale must be considered to understand the challenges faced by different households under the COVID-19 lockdown in urban China, where intergenerational supports such as family responsibilities to other generations living apart are prevalent during the pre-pandemic stage due to the collectivist culture. This article contributes the lens of household diversity and geographic distance to understanding everyday lives of families under lockdown and to reflect on family transformation in urban China over the past decades more broadly. Through the study of families, it also has implications for neighborhood planning and management aimed at mitigating a pandemic’s negative impacts.
Circulating tumour cells in patients with lung cancer universally indicate poor prognosis
Authors: Jin Fukang , Zhu Lei , Shao Jingbo , Yakoub Mina , Schmitt Lukas , Reißfelder Christoph , Loges Sonja , Benner Axel , Schölch Sebastian
Published: December 2022

Background:

In lung cancer, the relevance of various circulating tumour cell (CTC) subgroups in different lung cancer subtypes is unclear. We performed a comprehensive meta-analysis to assess the prognostic value of CTCs in the different histological types of lung cancer, with particular respect to CTC subtypes, cut-offs and time points of CTC enumeration.

Methods:

We searched MEDLINE, Web of Science and Embase alongside relevant studies evaluating the prognostic value of CTCs in lung cancer patients. A random-effects model was used for meta-analysis, calculating hazard ratios (HRs), 95% confidence intervals and p-values.

Results:

27 studies enrolling 2957 patients were included. CTC detection indicates poor prognosis, especially in small cell lung cancer (SCLC) patients (overall survival HR 3.11, 95% CI 2.59–3.73) and predicts a worse outcome compared to nonsmall cell lung cancer patients. Epithelial CTCs predict a worse outcome for lung cancer than mesenchymal CTCs or epithelial–mesenchymal hybrids.

Conclusion:

CTCs indicate poor prognosis in patients with primary lung cancer, with CTCs in SCLC having a more pronounced prognostic effect. The prognostic value of CTCs detected by different markers varies; most evidence is available for the strong negative prognostic effect of epithelial CTCs.
Exploring resident experiences of person-centred care at mealtimes in long-term residential care: a rapid ethnography
Authors: Davies Megan , Zúñiga Franziska , Verbeek Hilde , Staudacher Sandra
Published: December 2022

Introduction

Poor nutrition is a common ongoing problem in long-term residential care, often resulting in reduced quality of life. Previous research has concluded that the content of the meal, dining environment, service style and general atmosphere all add to the mealtime experience, suggesting that person-centred mealtimes are optimal. However, knowledge about which elements of person-centred care can be achieved in a mealtime setting in a given context is currently lacking. We aimed to understand the mealtime experience in long-term residential care by exploring (missed) opportunities for person-centred care in different settings.

Methods

As part of the TRANS-SENIOR research network, rapid ethnographies, were conducted across multiple sites (including interviews, observations and informal conversations), in a long-term residential care home in the UK, Switzerland and the Netherlands between October 2020 and December 2021. 

Results

Following analysis and interpretation of observations, interviews and informal conversations, the following themes were developed where either successfully achieved or missed opportunities for person-centred moments were observed: 1) considering the setting, 2) listening to and implementing resident choice, 3) enabling residents to help/care for themselves and others, 4) providing individualised care in a communal setting, and 5) knowing the person in the past and present. Residents experienced moments of participatory choice, interaction, independence and dignity, but opportunities for these were often missed due to organisational or policy constraints.

Conclusions

There are opportunities for person-centred moments during the mealtime, some of which are taken and some missed. This largely depended on the setting observed, which includes the overall environment (size of dining area, seating arrangements etc.) and allocation of staff resources, and the level of resident involvement in mealtimes, from preparation to the actual activity.