bluuebunny/crossref_metadata_2025 huggingface dataset:
The Unfortunate Wording of Article 121(3) of unclos and Its Interpretation in the 2016 South China Sea Arbitration Award
Authors: Pichel Christine
Published: July 2022

Article 121(3) of the 1982 United Nations Convention on the Law of the Sea (unclos) provides for the legal definition of the term “rocks” in international law. This article focuses on key aspects of the interpretation of this provision by the South China Sea Arbitral Tribunal in its Award of 12 July 2016 taking into consideration the current state and prospects of development of international law regarding Article 121(3) of unclos. This research discusses in particular, the method of interpretation applied by the Arbitral Tribunal to define the terms established in Article 121(3) of unclos as well as the meaning given to those terms by the Arbitral Tribunal. In addition, this article examines the (potential) impact of the South China Sea Arbitral Tribunal Award of 12 July 2016 on future State practice and jurisprudence as regards the interpretation and application of Article 121(3) of unclos.
The Problem with the Concept of ‘Single Continental Shelf’
Authors: Bernard Leonardo
Published: July 2022

The United Nations Convention on the Law of the Sea has established one legal limit of the continental shelf at 200 M. However, it set out another limit for situations when the extent of the actual or ‘physical’ continental shelf may be greater than 200 M. Despite these distinctions, the concept of the ‘single continental shelf’ has gained traction, particularly in international jurisprudence. This article challenges the idea that there is only a ‘single continental shelf’. The article will first explore the history of the continental shelf regime, before examining the emergence of the concept of a ‘single continental shelf’, how the concept was used and the context of its usage. Then the article will analyse the differences between the inner and outer continental shelf, including the relevance of the principle of natural prolongation. The article will finally answer the question of whether the phrase ‘single continental shelf’ is an accurate term to describe the continental shelf regime.
Education Effect of the Belt and Road Initiative–an Empirical Study on International Students in China
Authors: Fan Sha , Liu Qingjie , Zhang Kunling , Hu Biliang , Ma Liwen
Published: July 2022

International student education in China is an important aspect of the Belt and Road Initiative (bri) construction, as well as a beginning point for enhancing the internationalization level of education. China has become the world’s top ten recipients of international students, and its worldwide influence on education is increasing. This research investigates the factors that influence the scale of international students in China and the impact of the bri on education by employing the “Push-Pull Theory”. In particular, we find that joining the bri will significantly increase a country’s student scale in China, both for degree and non-degree education. This effect is especially noticeable in the African region, as well as in middle- and low-income countries. These empirical findings support policy implications for international student education in China.
Platelet activation and partial desensitization are associated with viral xenophagy in patients with severe COVID-19
Authors: Garcia Cédric , Au Duong Jonathan , Poëtte Michael , Ribes Agnès , Payre Bruno , Mémier Vincent , Sié Pierre , Minville Vincent , Voisin Sophie , Payrastre Bernard , Vardon-Bounes Fanny
Published: July 2022

Mild thrombocytopenia, changes in platelet gene expression, enhanced platelet functionality, and presence of platelet-rich thrombi in the lung have been associated with thromboinflammatory complications of patients with COVID-19. However, whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) gets internalized by platelets and directly alters their behavior and function in infected patients remains elusive. Here, we investigated platelet parameters and the presence of viral material in platelets from a prospective cohort of 29 patients with severe COVID-19 admitted to an intensive care unit. A combination of specific assays, tandem mass spectrometry, and flow cytometry indicated high levels of protein and lipid platelet activation markers in the plasma from patients with severe COVID-19 associated with an increase of proinflammatory cytokines and leukocyte-platelets interactions. Platelets were partly desensitized, as shown by a significant reduction of αIIbβ3 activation and granule secretion in response to stimulation and a decrease of surface GPVI, whereas plasma from patients with severe COVID-19 potentiated washed healthy platelet aggregation response. Transmission electron microscopy indicated the presence of SARS-CoV-2 particles in a significant fraction of platelets as confirmed by immunogold labeling and immunofluorescence imaging of Spike and nucleocapsid proteins. Compared with platelets from healthy donors or patients with bacterial sepsis, platelets from patients with severe COVID-19 exhibited enlarged intracellular vesicles and autophagolysosomes. They had large LC3-positive structures and increased levels of LC3II with a co-localization of LC3 and Spike, suggesting that platelets can digest SARS-CoV-2 material by xenophagy in critically ill patients. Altogether, these data show that during severe COVID-19, platelets get activated, become partly desensitized, and develop a selective autophagy response.
Clinical characteristics and outcomes of IgD myeloma: experience across UK national trials
Authors: Agbuduwe Charles , Iqbal Gulnaz , Cairns David , Menzies Tom , Dunn Janet , Gregory Walter , Kaiser Martin , Owen Roger , Pawlyn Charlotte , Child J. Anthony , Davies Faith , Morgan Gareth J. , Jackson Graham H. , Drayson Mark T. , Basu Supratik
Published: July 2022

Immunoglobulin D (IgD) myeloma is a subtype often considered to have adverse features and inferior survival, but there is a paucity of data from large clinical studies. We compare the clinical characteristics and outcomes of patients with IgD myeloma from UK phase 3 myeloma trials analyzed in 2 groups: old (1980-2002) and recent (2002-2016) clinical trials, based on the time of adoption of novel myeloma therapies. Patients with IgD myeloma comprised 44 of 2789 (1.6%) and 70 of 5773 (1.2%) of the old and recent trials, respectively. Overall, IgD myeloma was associated with male predominance, low-level paraproteinemia (<10g/L), and λ light chain preference. The frequency of ultra-high-risk cytogenetics was similar in IgD myeloma compared with other subtypes (4.3% vs 5.3%, P > .99). Despite the old trial series being a younger group (median age: 59 vs 63 years, P = .015), there was a higher frequency of bone lesions, advanced stage at diagnosis, worse performance status, and severe renal impairment compared with the recent trials. Furthermore, the early mortality rate was significantly higher for the old trial series (20% vs 4%, P = .01). The overall response rate following induction therapy was significantly higher in the recent trials (89% vs 43%, P < .0001), and this was consistent with improved median overall survival (48 months; 95% confidence interval [CI] 35-67 months vs 22 months; 95% CI, 16-29 months). Survival outcomes for IgD myeloma have significantly improved and are now comparable to other myeloma types because of earlier diagnosis, novel therapies, and improved supportive care. This trial was registered at clinicaltrials.gov as # NCT01554852.
The influence of anaesthetic choice on seizure duration of electroconvulsive therapy; etomidate versus methohexital
Authors: Chomrikh Laila , Ahmadi Mustafa , Kuijper T. Martijn , van der Vlugt Joris J. B. , Koopman Seppe J. H. A.
Published: July 2022

Background

Many of the anaesthetic drugs used for electroconvulsive therapy have anticonvulsant properties and may influence efficacy of electroconvulsive therapy. With this study we aim to provide more information on the effect of etomidate and methohexital on seizure duration. We explore the relationship between induction drug, motor and electroencephalography seizure duration. Moreover, we study the relationship of seizure duration and number of therapies.

Methods

In this retrospective study we collected data from patient records from 2005 until 2016. Inclusion criteria were the use of etomidate and/or methohexital and documentation of dosage, electroconvulsive therapy dosage and seizure duration. Exclusion criteria were missing data on either induction drug, dosage or seizure duration.

Results

Thirty seven patients were analysed. The mean age was 52 years and seventy six percent were female. Most patients were suffering from affective disorders (81%). Motor and electroencephalography seizure duration were analysed in 679 and 551 electroconvulsive therapies, respectively. Compared to methohexital, motor and electroencephalography seizures under etomidate were 7 and 13 s longer, respectively. Furthermore, there was a negative association between seizure duration and number of treatment and a negative association between seizure duration and electroconvulsive therapy dosage.

Conclusions

This study demonstrates significant longer motor and electroencephalography seizure duration using etomidate compared to methohexital. Etomidate might therefore increase the effectiveness of electroconvulsive therapy. Moreover, we observed a negative association between seizure duration, number of treatment and electroconvulsive therapy dosage. With this study we contribute to the available literature comparing methohexital and etomidate as induction agents for electroconvulsive therapy.
More than one third of clinical practice guidelines on low back pain overlap in AGREE II appraisals. Research wasted?
Authors: Gianola Silvia , Bargeri Silvia , Cinquini Michela , Iannicelli Valerio , Meroni Roberto , Castellini Greta
Published: July 2022

Background

Systematic reviews can apply the Appraisal of Guidelines for Research & Evaluation (AGREE) II tool to critically appraise clinical practice guidelines (CPGs) for treating low back pain (LBP); however, when appraisals differ in CPG quality rating, stakeholders, clinicians, and policy-makers will find it difficult to discern a unique judgement of CPG quality. We wanted to determine the proportion of overlapping CPGs for LBP in appraisals that applied AGREE II. We also compared inter-rater reliability and variability across appraisals.

Methods

For this meta-epidemiological study we searched six databases for appraisals of CPGs for LBP. The general characteristics of the appraisals were collected; the unit of analysis was the CPG evaluated in each appraisal. The inter-rater reliability and the variability of AGREE II domain scores for overall assessment were measured using the intraclass correlation coefficient and descriptive statistics.

Results

Overall, 43 CPGs out of 106 (40.6%) overlapped in seventeen appraisals. Half of the appraisals (53%) reported a protocol registration. Reporting of AGREE II assessment was heterogeneous and generally of poor quality: overall assessment 1 (overall CPG quality) was rated in 11 appraisals (64.7%) and overall assessment 2 (recommendation for use) in four (23.5%). Inter-rater reliability was substantial/perfect in 78.3% of overlapping CPGs. The domains with most variability were Domain 6 (mean interquartile range [IQR] 38.6), Domain 5 (mean IQR 28.9), and Domain 2 (mean IQR 27.7).

Conclusions

More than one third of CPGs for LBP have been re-appraised in the last six years with CPGs quality confirmed in most assessments. Our findings suggest that before conducting a new appraisal, researchers should check systematic review registers for existing appraisals. Clinicians need to rely on updated CPGs of high quality and confirmed by perfect agreement in multiple appraisals.

Trial Registration

Protocol Registration OSF:https://osf.io/rz7nh/
Utilization of antenatal care among adolescent and young mothers in Ghana; analysis of the 2017/2018 multiple indicator cluster survey
Authors: Anaba Emmanuel Anongeba , Alor Stanley Kofi , Badzi Caroline Dinam
Published: July 2022

Background

Complications during pregnancy and childbirth are the leading cause of death among adolescent girls. In Ghana, the prevalence of adolescent pregnancy remains high. Yet, little is known about ANC utilization among adolescent and young mothers. This study aimed to assess the prevalence of obtaining 4 or more ANC visits and associated factors among adolescent and young mothers.

Methods

We analysed secondary data from the sixth round of the Ghana Multiple Indicator Cluster Survey. A total of 947 adolescent and young mothers were included in this study. Data were analysed using STATA/SE, version 16, employing descriptive statistics and Binary Logistic Regression.

Results

It was found that majority of the participants were aged 20-24 years (70%), married/in union (61%) and non-insured (64%). The prevalence of obtaining 4 or more ANC visits was 84%. Adolescent and young mothers with junior high school education, in the second wealth quintile, exposed to the internet, and resided in the Upper East region had a higher likelihood of obtaining 4 or more ANC visits (p < 0.05).

Conclusions

This study demonstrated that optimal ANC utilization among adolescent and young mothers were determined by socio-economic factors. Going forward, maternal healthcare interventions must prioritize adolescent and young mothers from poor socio-economic backgrounds.
Previous trauma exposure and self-mastery as moderators of psychiatric effects of home isolation during the Covid-19 pandemic: a field study
Authors: Slone Michelle , Pe’er Ayelet , Mor Flora
Published: July 2022

Background

Limiting contagion during the Covid-19 pandemic has necessitated employment of drastic measures ranging from complete lockdown to home isolation and quarantines. This study examined the psychiatric effects of home isolation, the effects of interacting previous traumatic events and the moderating effect of self-mastery as a resilience factor that could mitigate negative effects.

Methods

Six hundred forty-five adults aged 18–67 completed an online survey during the first wave lockdown during the Covid-19 outbreak in Israel. Participants completed a demographic questionnaire including measures of strictness of adherence to home isolation, a traumatic life events measure, the Mastery Scale, and the Brief Symptom Inventory. Data was analyzed using Structural Equation Model.

Results

Findings showed positive relations between strictness of home isolation adherence and psychiatric symptoms, and between previous trauma exposure and psychiatric symptoms. A negative relation between self-mastery and psychiatric symptoms emerged. During home isolation, effects of previous trauma exposure on psychiatric symptoms was moderated by self-mastery. Individuals with high self-mastery showed less psychiatric symptoms than those with low self-mastery, at both high and low levels of previous trauma exposure.

Conclusions

Home isolation adherence is associated with significant psychological distress and symptomatology and, thus, should be of great concern for public mental health service providers. The present study offers a new slant on appropriate clinical interventions during this period with a focus on strengthening resilience factors that can moderate mental health decline. Therapy and interventions based on promoting self-mastery could exert a significant effect on lowering psychiatric symptoms during stressful periods of home isolation.

Trial registration

Not relevant.
The role of chronic disease in the disparity of influenza incidence and severity between indigenous and non-indigenous Australian peoples during the 2009 influenza pandemic
Authors: Dixit Rashmi , Webster Fleur , Booy Robert , Menzies Robert
Published: July 2022

Background

The 2009 H1N1 influenza pandemic (influenza A(H1N1)pdm09) disproportionately impacted Indigenous peoples. Indigenous Australians are also affected by a health gap in chronic disease prevalence. We hypothesised that the disparity in influenza incidence and severity was accounted for by higher chronic disease prevalence.

Methods

We analysed influenza data from Western Australia, South Australia, the Northern Territory, and Queensland. We calculated population prevalence of chronic diseases in Indigenous and non-Indigenous Australian populations using nationally-collected health survey data. We compared influenza case notifications, hospitalisations, intensive care admissions, and deaths reported amongst the total population of Indigenous and non-Indigenous Australians ≥ 15 years. We accessed age-specific influenza data reported to the Australian Department of Health during the 2009 ‘swine flu’ pandemic, stratified by Indigenous status and the presence of one of five chronic conditions: chronic lower respiratory conditions, diabetes mellitus, obesity, renal disease, and cardiac disease. We calculated age-standardised Indigenous: non-Indigenous rate ratios and confidence intervals.

Findings

Chronic diseases were more prevalent in Indigenous Australians. Rates of influenza diagnoses were higher in Indigenous Australians and more frequent across all indices of severity. In those with chronic conditions, Indigenous: non-Indigenous influenza notification rate ratios were no lower than in the total population; in many instances they were higher. Rate ratios remained above 1·0 at all levels of severity. However, once infected (reflected in notifications), there was no evidence of a further increase in risk of severe outcomes (hospitalisations, ICU admissions, deaths) amongst Indigenous Australians compared to non-Indigenous Australians with a chronic disease.

Interpretation

Higher rates of influenza infection was observed amongst those Indigenous compared to non-Indigenous Australians, and this difference was preserved amongst those with a chronic condition. However, there was no further increase in prevalence of more severe influenza outcomes amongst Indigenous Australians with a chronic condition. This suggests that the prevalence of chronic disease, rather than Indigenous status, affected influenza severity. Other factors may be important, including presence of multiple morbidities, as well as social and cultural determinants of health.
Efficacy analysis of anterior debridement and bone graft fusion in the treatment of sacroiliac joint tuberculous arthritis: a retrospective analysis of 17 patients
Authors: Tian Qi , Peng Cong , Liu Kai , Luan Haopeng , Liu Xiaokang , Na Linhao , Cao Shicong , Tian Zheng
Published: July 2022

Background

Sacroiliac joint tuberculous arthritis is a relatively rare site of tuberculosis infection, but it can lead to severe sacroiliac joint destruction and dysfunction. Since there are few studies on the surgical methods of sacroiliac joint tuberculosis (SJT), we adopted three different surgical methods based on different degrees of destruction of sacroiliac joint tuberculous arthritis. While revealing its clinical symptoms to improve the diagnostic accuracy, and to determine the safety and feasibility of this surgical approach in the treatment of sacroiliac joint tuberculous arthritis.

Methods

We retrospectively analyzed 17 patients with tuberculous arthritis of the sacroiliac joint treated by anterior debridement. All these patients underwent anterior debridement of tuberculosis with or without bone graft fusion. Mean postoperative follow-up was 17.2 months (12–25 months). The erythrocyte sedimentation rate (ESR) was used to judge the general situation after surgery, and the fusion of sacroiliac joints was observed by X-ray films and CT scans. And VAS and ODI were used to score to observe postoperative functional recovery.

Results

Anterior approach debridement is an effective surgical approach for sacroiliac joint tuberculous arthritis. All patients achieved effective relief of lower back and hip pain. The pain was significantly relieved 3 months after the operation, and the pain basically disappeared 6 months after the operation. The erythrocyte sedimentation rate was also significantly reduced after the operation, and it can basically return to the normal level 3 months after the operation. The VAS score and ODI index of the other 16 patients after surgery were significantly lower than those before surgery, except for 1 patient who died of severe type I respiratory failure and septic shock 3 months after surgery, The surviving patients were basically able to achieve stable fusion of the sacroiliac joint at 12 months postoperatively. None of the patients reported significant pain until the last follow-up visit.

Conclusions

The anterior approach is a very effective surgical method for the treatment of sacroiliac joint tuberculous arthritis, and it is safe and feasible. A clear operative field of view facilitates complete debridement and reduces recurrence, and its function recovers well with stable arthrodesis.
Subjective well-being’s alterations as risk factors for major depressive disorder during the perimenopause onset: an analytical cross-sectional study amongst Mexican women residing in Guadalajara, Jalisco
Authors: Hernández-Muñoz Adrián Enrique , Méndez-Magaña Ana , Fletes-Rayas Ana Lilia , Rangel Miguel A. , García Lenin Torres , de Jesús López-Jiménez José
Published: July 2022

Background

Subjective well-being (SWB) can be defined as a self-report evaluation that reflects the satisfaction, and emotional level, over several social and personal indicators. Alterations in these indicators could become risk factors (RF) for major depressive disorder (MDD), but this association has not been studied at women’s life stages such as the perimenopause onset, despite its increasing prevalence for depressive symptomatology. Therefore, the aim of this study was to identify if SWB’s alterations determine RF for MDD during the perimenopause.

Methods

An analytical cross-sectional study was realized in 252 Mexican women with perimenopause’s age range (48 ± 1.7) and menopausal symptomatology, treated on Medical Units belonging to Jalisco’s 13th Health-Region. We applied the INEGI’s Basic Self-Reported Wellbeing Survey (BIARE) that measured 30 SWB’s indicators. To identify MDD’s presence, the Beck’s Depression Inventory-II (BDI-II) was applied. The sample was studied with associative analysis, along with logistic regression models, to determine adjusted odds ratio (aOR) and corresponding 95% confidence interval (95% CI).

Results

Trough the BDI-II we identified 40.5% women with MDD. When compared with the undepressed group we found lower scores in all the SWB’s indicators, along with significant associations for depressive symptomatology. However, the logistic regression allowed us to identify significant RF when the women specifically reported personal life-dissatisfaction (aOR 9.6, 95% CI 1.90–17.68), emotional imbalances between happiness/sadness (aOR 7.1, 95% CI 1.49–13.57) and concentration/boredom (aOR 6.7, 95% CI 1.43–13.48); free-time dissatisfaction (aOR 5.5, 95% CI 1.17–5.70), public security unconformity (aOR 5.4, 95% CI 2.20–11.3), and sense of purposelessness (aOR 4.2, 95% CI 1.07–19.41).

Conclusion

The main objective of the study was to determine if SWB’s alterations are RF for depressive symptomatology, finding that social indicators with low scores are associated with MDD by means of aOR -Which were higher when compared to international research studies. Considering this, we suggest that more studies should be implemented, in order to understand and correctly attend the women’s social conditions during their perimenopause transition.
Reversal of cisplatin triggered neurotoxicity by Acacia hydaspica ethyl acetate fraction via regulating brain acetylcholinesterase activity, DNA damage, and pro-inflammatory cytokines in the rodent model
Authors: Afsar Tayyaba , Razak Suhail , Almajwal Ali
Published: July 2022

Background

Cisplatin (CisPT) is a chemotherapeutic that outcome in adverse effects including neurotoxicity. We examined the efficacy of hydaspica ethyl acetate extract (AHE) against CisPT-prompted neurotoxicity.

Methods

Group I: Distilled water; Group II: CisPT (12 mg/kg b.w. i.p) on the 13th day of treatment. Group III: received AHE (400 mg/kg b.w) orally for 16 days. Group IV and V received 200 and 400 mg/kg b.w AHE orally for 16 days while CisPT injection on day 13, respectively. Group VI: received Silymarin (100 mg/kg b.w) orally for 16 days and CP (12 mg/kg b.w., i.p.) on day 13. TNF-α, IL6, brain acetylcholinesterase activity (AChE), oxidative trauma markers, genotoxicity, antioxidant enzymes, and morphological alterations in cerebral hemispheres were inspected.

Results

AHE administration before CisPT considerably reduced both tissue TNF-α and IL 6 expressions compared to CisPT treated group in a dose-dependent manner. AHE treatment (400 mg/kg b.w) significantly ameliorated brain AChE activity. Brain tissue MDA, H2O2, and NO content were markedly (p < 0.001) elevated after CisPT inoculation while a noticeable (p < 0.001) diminution was observed in AHE treatment groups. AHE treatment significantly (p < 0.001) improved brain antioxidant defense in a dose-dependent manner. Furthermore, AHE efficiently recused CisPT to induce DNA damage in brain tissue as revealed by ladder assay and DNA fragmentation patterns. Histopathological findings revealed severe neurodegenerations in CisPT treated group, however, AHE treatment noticeably precluded morphological alterations and neuron damages induced by CisPT.

Conclusion

A. hydaspica AHE extract may be provided as a prospective adjuvant that precludes CisPT-induced neurotoxicity due to its radical scavenging and antioxidant potential.
A hospital-based independent domestic violence advisor service: demand and response during the Covid-19 pandemic
Authors: Elvey Rebecca , Mason Thomas , Whittaker William
Published: July 2022

Background and aim

Recent UK policy has focussed on improving support for victims of domestic violence and abuse (DVA), in healthcare settings. DVA victims attending hospital are often at highest risk of harm, yet DVA support in hospitals has been inadequate. A targeted service supporting high risk DVA victims, was implemented at a hospital Trust in North West England. The service was provided by Independent Domestic Violence Advisors (IDVAs). This paper assesses the activity in the hospital-based IDVA service during the COVID-19 pandemicand addresses the research questions: What was the demand for the service? How did the service respond? What facilitated this response?

Methods

A mixed-methods study was undertaken. Quantitative data on referrals to the service were examined using simple descriptive statistics and compared to other DVA services. Semi-structured interviews were undertaken with IDVAs and other hospital staff involved with the service and the data subjected to thematic analysis.

Results

The quantitative analysis showed that referrals dropped at the start of lockdown, then increased and continued to rise; the qualitative findings reiterated this pattern. Referrals came from a range of departments across the Trust, with the majority from A&E. Pre-pandemic, the population supported by the service included higher proportions of males and people aged 40 and over than at other IDVA services; this continued during the pandemic. The qualitative findings indicated a flexible response during the pandemic, enabled by strong working relationships and by using workarounds.

Conclusions

The hospital-based IDVAs provided an efficient, flexible serviceduring the COVID-19 pandemic. Referrals increased during the first lockdown and subsequent relaxing of restrictions. Locating the IDVAs within a team working across the organisation, and building good working relationships facilitated an effective disclosure and referral route, which endured through social restrictions. The IDVAs supported high-risk victims who may otherwise not have been identified in traditional community-based DVA settings during the pandemic. Hospital-based IDVA services can broaden access by supporting vulnerable, at risk populations whose needs may not be identified at other services.
Quality indicators for acute cardiovascular diseases: a scoping review
Authors: Kanaoka Koshiro , Iwanaga Yoshitaka , Tsujimoto Yasushi , Shiroshita Akihiro , Suzuki Takaaki , Nakai Michikazu , Miyamoto Yoshihiro
Published: July 2022

Background

Although many quality indicator (QI) sets have been developed for acute cardiovascular diseases, a comprehensive summary is lacking. In this scoping review we aimed to summarize the available evidence on the QI sets for acute cardiovascular diseases, and assess the QI set development process. We followed the Joanna Briggs Institute framework and the PRISMA extension for scoping reviews.

Methods

We conducted a systematic search of MEDLINE, EMBASE, and major international guidelines on QIs for acute major cardiovascular diseases. The study included articles published after 2000.

Results

Among the 3112 articles screened, 18 were included in this scoping review. Among the 18 articles included, 12 were on acute coronary syndrome (ACS), five on acute heart failure (AHF), and two on acute aortic dissection (AAD); one article included QIs for both ACS and AHF. Only four of these studies conducted a systematic search with a search strategy. From the 18 articles, 268 QIs containing duplication between articles were identified (191 QIs were for ACS, 57 were for AHF, and 20 were for AAD) and QI measurements varied across articles.

Conclusions

This scoping review provides a comprehensive list of QIs for acute cardiovascular diseases. Our results may be helpful to clinicians and organizations seeking to develop QIs for acute cardiovascular care in the future.
Protecting, managing and bending boundaries: a biomedicalization perspective on Swedish youth clinics’ responses to mental (ill) health
Authors: Goicolea Isabel , Wiklund Maria , Linander Ida , Sundberg Linda Richter
Published: July 2022

Background

Sweden has provided around 300 youth clinics (YCs) to address the health needs of young people since the 1970s. During the last few years, and as part of an effort to strengthen mental healthcare for young people, YCs’ role in the provision of mental healthcare has been widely debated. With such debates as background, the aim of this study is to analyse Swedish YCs’ responses to the mental (ill) healthcare needs of young people, from the perspective of national level stakeholders.

Methods

We used thematic analysis of interviews with eight national level stakeholders in the field of youth mental health in Sweden. Building upon the concept of biomedicalization we examined the discourses on mental (ill) health, healthcare and youth that such responses reproduce.

Results

YCs engage in the three simultaneous, but at times contradictory, responses of protecting, managing and bending boundaries. Remaining true to their mission as a health-promotion service compels them to protect their boundaries and limit the type of mental health issues they address. However, the perceived malfunctioning of specialized services has led them to bend these boundaries to allow in more young people with severe mental health problems. Caught between protecting and bending boundaries, the response of managing boundaries to decide who should be allowed in and who should be sent elsewhere has emerged as a middle-way response. However, it is not free from conflicts.

Conclusion

Building upon the concept of biomedicalization, this study poses two questions. The first relates to whether it is possible to support young people and their health without reinforcing discourses that represent young people as collectively at risk, and if so how this can be done. The second relates to the provision of mental healthcare for young people, and the need to identify conditions for integrating diagnosis and treatment within YCs, without hindering their holistic and youth-centred approach.
A study of the evacuation and allocation of hospital beds during the Covid-19 epidemic: a case study in Iran
Authors: Soroush F. , Nabilou B. , Faramarzi A. , Yusefzadeh H.
Published: July 2022

Background

Shortage of resources, such as hospital beds, needed for health care especially in times of crisis can be a serious challenge for many countries. Currently, there is no suitable model for optimal allocation of beds in different hospital wards. The Data Envelopment Analysis method (DEA) has been used in the present study to examine the evacuation and allocation of hospital beds during the covid-19 pandemic in order to contribute to effective planning for fighting the spread the covid-19 virus.

Methods

The present study was conducted in two stages in hospitals affiliated with Urmia University of Medical Sciences (UUMS) in 2021. First, the number of excess beds was determined by calculating the technical efficiency using the DEA method and Deap2.1 software. To reallocate excess beds to covid-19 patients, the types of hospital wards were considered. As a result of this analysis, the inefficient hospitals with excess beds in different wards, which could be used for covid-19 patients with more serious symptoms, were identified.

Results

The results of the study show that the average technical efficiency of the studied hospitals was 0.603. These hospitals did not operate efficiently in 2021 and their current output can be produced with less than 61% of the used input. Also, the potential of these hospitals, over a period of 1 year, for the evacuation of beds and reallocation of them to covid-19 patients was calculated to be 1781 beds, 450 of which belonged to general wards and 1331 belonged to specialized wards.

Conclusions

The DEA method can be used in the allocation of resources in hospitals. Depending on the type of hospital wards and the health condition of patients, this method can help policy-makers identify hospitals with the best potential but less emergency services for the purpose of reallocation of resources, which can help reduce the severe effects of crises on health resources.
Development and evaluation of a bead-based Multiplexed Fluorescent ImmunoAssay (MFIA) for detection of antibodies to Salmonella enterica serogroup B and C1 in pigs
Authors: Berger Sanne Schou , Riber Ulla , Jensen Vibeke Frøkjær , Lauritsen Klara Tølbøll , Andresen Lars Ole
Published: July 2022

Background

Since 1995, a surveillance program forSalmonellahas been applied in the Danish pig industry in order to reduce cases of human salmonellosis. The objective of this study was to develop a bead-based Multiplexed Fluorometric ImmunoAssay (MFIA) as an improved serological surveillance method compared to theSalmonellamix ELISA, which has been the national reference immunoassay in the DanishSalmonellasurveillance program for about 20 years.

Results

An MFIA for detection of antibodies toSalmonellaserogroup B and C1was developed and optimized with regard to coupling of beads withSalmonellalipopolysaccharide antigens and establishing suitable assay conditions. TheSalmonellaMFIA was validated by testing sera from experimentally infected pigs as well as field sera from non-infected and infected pig herds, and by comparing to results from theSalmonellamix ELISA, which was run in parallel. Sensitivity and specificity was evaluated using receiver operating curve analysis showing an area under curve for the serogroup B and C1MFIA of 0.984 and 0.998, respectively. TheSalmonellaMFIA was shown to detect more antibody-positive samples in seropositive herds compared to theSalmonellamix ELISA, and Bayesian statistics confirmed that the MFIA had a considerably higher sensitivity (94.5%) compared to the mix ELISA (75.1%). The assay specificity was slightly lower for theSalmonellaMFIA (96.8%) compared toSalmonellamix ELISA (99.5%). Coupled beads were stable for at least 1 year at 4˚C, and MFIA reproducibility and repeatability of theSalmonellaMFIA were acceptable. Results from proficiency tests also indicated that theSalmonellaMFIA was more sensitive than theSalmonellamix ELISA and that they had similar specificity.

Conclusions

A bead-based MFIA for simultaneous detection of porcine serum antibodies toSalmonella entericaserogroup B and C1was developed and implemented in the Danish porcine serologicalSalmonellasurveillance program in 2018. TheSalmonellaMFIA can distinguish, as opposed to theSalmonellamix ELISA, between antibodies to serogroup B and C1and the MFIA shows considerably better sensitivity.
A scoping review protocol on in vivo human plastic exposure and health impacts
Authors: Goodes Louise M. , Wong Enoch V. S. , Alex Jennifer , Mofflin Louise , Toshniwal Priyanka , Brunner Manuel , Solomons Terena , White Emily , Choudhury Omrik , Seewoo Bhedita J. , Mulders Yannick R. , Dale Tristan , Newman Hamish J. , Naveed Alina , Lowe Andrew B. , Hendrie Delia V. , Symeonides Christos , Dunlop Sarah A.
Published: July 2022

Background

Global plastic production has increased exponentially since the 1960s, with more than 6300 million metric tons of plastic waste generated to date. Studies have found a range of human health outcomes associated with exposure to plastic chemicals. However, only a fraction of plastic chemicals used have been studied in vivo, and then often in animals, for acute toxicological effects. With many questions still unanswered about how long-term exposure to plastic impacts human health, there is an urgent need to map human in vivo research conducted to date, casting a broad net by searching terms for a comprehensive suite of plastic chemical exposures and the widest range of health domains.

Methods

This protocol describes a scoping review that will follow the recommended framework outlined in the 2017 Guidance for the Conduct of Joanna Briggs Institute (JBI) Scoping Reviews, to be reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. A literature search of primary clinical studies in English from 1960 onwards will be conducted in MEDLINE (Ovid) and EMBASE (Ovid) databases. References eligible for inclusion will be identified through a quality-controlled, multi-level screening process. Extracted data will be presented in diagrammatic and tabular form, with a narrative summary addressing the review questions.

Discussion

This scoping review will comprehensively map the primary research undertaken to date on plastic exposure and human health. Secondary outputs will include extensive databases on plastic chemicals and human health outcomes/impacts.

Systematic review registration

Open Science Framework (OSF)-Standard Pre-Data Collection Registration, https://archive.org/details/osf-registrations-gbxps-v1, https://doi.org/10.17605/OSF.IO/GBXPS
Nature-based recreation for the elderly in urban areas: assessing opportunities and demand as planning support
Authors: Wen Chen , Albert Christian , von Haaren Christina
Published: July 2022

Background

With elderly people comprising a growing share of the population, landscape planners need to consider their specific requirements to enhance the opportunities for them to engage in nature-based recreation (NBR). However, few studies have spatially assessed the recreation potential, demand, and opportunities for elderly people in cities. Thus, this paper aimed to spatially model and investigate the NBR opportunities for and demand of elderly people in urban areas. A spatial framework based on the ESTIMAP recreation model was developed, considering special factors to better reflect elderly people’s preferences regarding NBR at the city scale. In particular, NBR opportunities were assessed considering landscape aesthetics, various types of facilities, and proximity. The street network was used to understand elderly people’s walking behaviours regarding green spaces and related facilities.

Results

A case study in Hannover, Germany, demonstrated the applicability of the proposed method. The results illustrate the spatial heterogeneity of recreation options for the elderly. Only parts of Hannover’s green spaces offer high recreation opportunities for elderly people. Many of the existing green spaces lack diverse landscape components and sufficient supply of facilities, resulting in a compromise to aesthetics and recreational opportunities.

Conclusions

The proposed method contributes to research on spatial planning and environmental justice by incorporating vulnerable groups’ preferences and needs in spatially assessing NBR. The planning implications highlight pocket gardens and greenways connecting communities and parks as development opportunities in the city.
The prognostic value of 18F-FDG PET/CT intra-tumoural metabolic heterogeneity in pretreatment neuroblastoma patients
Authors: Liu Jun , Si Yukun , Zhou Ziang , Yang Xu , Li Cuicui , Qian Luodan , Feng Li Juan , Zhang Mingyu , Zhang Shu Xin , Liu Jie , Kan Ying , Gong Jianhua , Yang Jigang
Published: July 2022

Background

Neuroblastoma (NB) is the most common tumour in children younger than 5 years old and notable for highly heterogeneous. Our aim was to quantify the intra-tumoural metabolic heterogeneity of primary tumour lesions by using18F-FDG PET/CT and evaluate the prognostic value of intra-tumoural metabolic heterogeneity in NB patients.

Methods

We retrospectively enrolled 38 pretreatment NB patients in our study.18F-FDG PET/CT images were reviewed and analyzed using 3D slicer software. The semi-quantitative metabolic parameters of primary tumour were measured, including the maximum standard uptake value (SUVmax), metabolic tumour volume (MTV), and total lesion glycolysis (TLG). The areas under the curve of cumulative SUV-volume histogram index (AUC-CSH index) was used to quantify intra-tumoural metabolic heterogeneity. The median follow-up was 21.3 months (range 3.6 - 33.4 months). The outcome endpoint was event-free survival (EFS), including progression-free survival and overall survival. Survival analysis was performed using Cox regression models and Kaplan Meier survival plots.

Results

In all 38 newly diagnosed NB patients, 2 patients died, and 17 patients experienced a relapse. The AUC-CSHtotal(r=0.630, P<0.001) showed moderate correlation with the AUC-CSH40%. In univariate analysis, chromosome 11q deletion (P=0.033), Children's Oncology Group (COG) risk grouping (P=0.009), bone marrow involvement (BMI, P=0.015), and AUC-CSHtotal(P=0.007) were associated with EFS. The AUC-CSHtotal(P=0.036) and BMI (P=0.045) remained significant in multivariate analysis. The Kaplan Meier survival analyses demonstrated that patients with higher intra-tumoural metabolic heterogeneity and BMI had worse outcomes (log-rank P=0.002).

Conclusion

The intra-tumoural metabolic heterogeneity of primary lesions in NB was an independent prognostic factor for EFS. The combined predictive effect of intra-tumoural metabolic heterogeneity and BMI provided prognostic survival information in NB patients.
Design, implementation, and evaluation of self-care program in the prevention of breast cancer among women in Isfahan: a community-based participatory action research protocol
Authors: Kianpour Maryam , Taleghani Fariba , Noroozi Mahnaz , Savabi-Esfahani Mitra , Boroumandfar Zahra , Changiz Tahereh , Ravankhah Zahra , Javanmard Shaghayegh Haghjooy , Hashemi Maryam Sadat
Published: July 2022

Introduction

Breast cancer is one of the most prevalent cancers among women in Isfahan, Iran; however, its prevention is not desirable in this city. This disease poses several health, social and economic challenges for women. To promote women's self-care in breast cancer prevention, this study aims to design, implement and evaluate a self-care program among women in Isfahan through using a community-based participatory action research method.

Methods

The present study is based on a community-based participatory action research approach. In this study, the participatory action research includes four general phases of organizing, action planning, action, and rethinking. These phases are summarized as follows: In the organizing phase, the needs of the participants and the action research settings are examined. This means that the current situation is identified and the views of the process owners are assessed. In the action planning phase, using the results of the first phase, some strategies are designed to promote self-care behaviors in the prevention of breast cancer among women in Isfahan. In the implementation phase, the selected strategies are implemented with the help of the process owners. Finally, in the rethinking phase, the results of the implementation of the strategies are monitored and evaluated. This cycle continues until the intended results are achieved.

Discussion

Changing the role of individuals from a passive status to an aware and active status in the care process requires motivation, responsibility, and active participation of individuals in the disease control process. Moreover, many cultural and social factors affect the active participation of Iranian women. Therefore, individuals can be involved in promoting their health using a community-based participatory action research approach.
Investor sentiments and stock markets during the COVID-19 pandemic
Authors: Cevik Emre , Kirci Altinkeski Buket , Cevik Emrah Ismail , Dibooglu Sel
Published: July 2022

This study examines the relationship between positive and negative investor sentiments and stock market returns and volatility in Group of 20 countries using various methods, including panel regression with fixed effects, panel quantile regressions, a panel vector autoregression (PVAR) model, and country-specific regressions. We proxy for negative and positive investor sentiments using the Google Search Volume Index for terms related to the coronavirus disease (COVID-19) and COVID-19 vaccine, respectively. Using weekly data from March 2020 to May 2021, we document significant relationships between positive and negative investor sentiments and stock market returns and volatility. Specifically, an increase in positive investor sentiment leads to an increase in stock returns while negative investor sentiment decreases stock returns at lower quantiles. The effect of investor sentiment on volatility is consistent across the distribution: negative sentiment increases volatility, whereas positive sentiment reduces volatility. These results are robust as they are corroborated by Granger causality tests and a PVAR model. The findings may have portfolio implications as they indicate that proxies for positive and negative investor sentiments seem to be good predictors of stock returns and volatility during the pandemic.
Advances on the modification and biomedical applications of acellular dermal matrices
Authors: Chen Yining , Liu Xinhua , Zheng Xin , Huang Xuantao , Dan Weihua , Li Zhengjun , Dan Nianhua , Wang Yunbing
Published: July 2022

Acellular dermal matrix (ADM) is derived from natural skin by removing the entire epidermis and the cell components of dermis, but retaining the collagen components of dermis. It can be used as a therapeutic alternative to “gold standard” tissue grafts and has been widely used in many surgical fields, since it possesses affluent predominant physicochemical and biological characteristics that have attracted the attention of researchers. Herein, the basic science of biologics with a focus on ADMs is comprehensively described, the modification principles and technologies of ADM are discussed, and the characteristics of ADMs and the evidence behind their use for a variety of reconstructive and prosthetic purposes are reviewed. In addition, the advances in biomedical applications of ADMs and the common indications for use in reconstructing and repairing wounds, maintaining homeostasis in the filling of a tissue defect, guiding tissue regeneration, and delivering cells via grafts in surgical applications are thoroughly analyzed. This review expectedly promotes and inspires the emergence of natural raw collagen-based materials as an advanced substitute biomaterial to autologous tissue transplantation.

Graphical Abstract