bluuebunny/crossref_metadata_2025 huggingface dataset:
Service quality in outpatient teaching hospital pharmacies based on the SERVQUAL model: An assessment in the south of Iran
Authors: Kashfi Seyyed Mansour , Karimian Elham , Ravangard Ramin , Mehralian Gholamhossein , Bastani Peivand
Published: January 2022

Objectives

The present study assessed the quality of services in the outpatient teaching hospital pharmacies affiliated to Shiraz University of Medical Sciences, Iran, in 2019 according to the SERVQUAL model to identify areas for improvement.

Methods

The research was cross-sectional, descriptive and analytical. Patients referred to the outpatient teaching hospital pharmacies affiliated to Shiraz University of Medical Sciences formed the study population. The sample size was 300 people chosen through the stratified sampling method proportional to the size as well as the convenience sampling method. The modified SERVQUAL questionnaire developed by Mohammadi et al. (in Eftekhar Ardabili H, Akbari Haghighi F, Mahmoudi M, Poorreza A. Evaluation of service quality based on the patients’ expectations and perceptions in Zanjan hospitals. J Sch Public Health Inst Public Health Res. 2003;2:71-84) was used for data collection. Data analysis was performed by SPSS 24.0 using statistical tests of paired t-test, independent t-test and ANOVA. A P-value of <0.05 showed statistical significance. Moreover, EXCEL 2013 was used to draw the graphs.

Key findings

The results showed that the participants had higher expectations regarding the quality of pharmacy services in all six dimensions compared to their perceptions (negative gaps) and the difference was statistically significant (P <0.05). The largest gap was in the ‘access’ dimension (G = −0.44 ± 1.15) and the smallest one was in the ‘reliability’ dimension (G = −0.21 ± 1.30). Also, the mean of overall quality gap, among the patients’ demographic characteristics, had a significant relationship only with having supplementary health insurance coverage (P = 0.03).

Conclusions

It seems that hospital managers and technical managers of pharmacies should make several interventions in the field of staff empowerment and training empathy and teamwork skills. Also, strengthening the system of receiving quick and easy feedback from patients and paying attention to the voice of customers can pave the way for hospital managers and technical managers of pharmacies to enhance the service quality with subsequence reduction of the existing gaps.
Incidence of Malignancies Among Patients With Chronic Hepatitis B in US Health Care Organizations, 2006–2018
Authors: Spradling Philip R , Xing Jian , Zhong Yuna , Rupp Loralee B , Moorman Anne C , Lu Mei , Teshale Eyasu H , Schmidt Mark A , Daida Yihe G , Boscarino Joseph A , Gordon Stuart C
Published: January 2022

Hepatitis B virus (HBV) infection causes hepatocellular carcinoma but its association with other cancers is not well established. We compared age-adjusted incidence of primary cancers among 5773 HBV-infected persons with US cancer registries during 2006–2018. Compared with the US population, substantially higher incidence among HBV-infected persons was observed for hepatocellular carcinoma (standardized rate ratio [SRR], 30.79), gastric (SRR, 7.95), neuroendocrine (SRR, 5.88), cholangiocarcinoma (SRR, 4.62), and ovarian (SRR, 3.72) cancers, and non-Hodgkin lymphoma (SRR, 2.52). Clinicians should be aware of a heightened potential for certain nonhepatic malignancies among hepatitis B patients, as earlier diagnosis favors improved survival.
A time-resolved experimental–mathematical model for predicting the response of glioma cells to single-dose radiation therapy
Authors: Liu Junyan , Hormuth David A , Davis Tessa , Yang Jianchen , McKenna Matthew T , Jarrett Angela M , Enderling Heiko , Brock Amy , Yankeelov Thomas E
Published: January 2022

Purpose

To develop and validate a mechanism-based, mathematical model that characterizes 9L and C6 glioma cells’ temporal response to single-dose radiation therapy in vitro by explicitly incorporating time-dependent biological interactions with radiation.

Methods

We employed time-resolved microscopy to track the confluence of 9L and C6 glioma cells receiving radiation doses of 0, 2, 4, 6, 8, 10, 12, 14 or 16 Gy. DNA repair kinetics are measured by γH2AX expression via flow cytometry. The microscopy data (814 replicates for 9L, 540 replicates for C6 at various seeding densities receiving doses above) were divided into training (75%) and validation (25%) sets. A mechanistic model was developed, and model parameters were calibrated to the training data. The model was then used to predict the temporal dynamics of the validation set given the known initial confluences and doses. The predictions were compared to the corresponding dynamic microscopy data.

Results

For 9L, we obtained an average (± standard deviation, SD) Pearson correlation coefficient between the predicted and measured confluence of 0.87 ± 0.16, and an average (±SD) concordance correlation coefficient of 0.72 ± 0.28. For C6, we obtained an average (±SD) Pearson correlation coefficient of 0.90 ± 0.17, and an average (±SD) concordance correlation coefficient of 0.71 ± 0.24.

Conclusion

The proposed model can effectively predict the temporal development of 9L and C6 glioma cells in response to a range of single-fraction radiation doses. By developing a mechanism-based, mathematical model that can be populated with time-resolved data, we provide an experimental–mathematical framework that allows for quantitative investigation of cells’ temporal response to radiation. Our approach provides two key advances: (i) a time-resolved, dynamic death rate with a clear biological interpretation, and (ii) accurate predictions over a wide range of cell seeding densities and radiation doses.
Vγ5Vδ1 TCR signaling is required to different extents for embryonic versus postnatal development of DETCs
Authors: Sudo Koichi , Todoroki Takero , Ka Yuyo , Takahara Kazuhiko
Published: January 2022

γδ T cells expressing Vγ5Vδ1 TCR originally develop in the embryonic thymus and migrate to the epidermis, forming dendritic epidermal T cells (DETCs) throughout life. It is thought that a TCR signal is essential for their development; e.g., lack of TCR signal-transducer ZAP70 significantly decreases DETC numbers. On the other hand, lack of ZAP70 does not affect Vγ5Vδ1+ T cells in the embryonic thymus; thus, the involvement of TCR signaling remains elusive. Here, we used SKG mice with attenuated TCR signaling rather than gene-knockout mice. In SKG mice, Vγ5+ T cells showed a marked decrease [10% of wild-type (WT)] in adult epidermis; however, there was just a moderate decrease (50% of WT) in the embryonic thymus. In early postnatal epidermis in SKG mice, substantial numbers of Vγ5+ T cells were observed (50% of WT). Their activation markers including CD122, a component of the IL-15 receptor indispensable for DETC proliferation, were comparable to those of WT. However, the Vγ5+ T cells in SKG mice did not proliferate and form DETCs thereafter. Furthermore, in SKG/+ mice, the number of thymic Vγ5Vδ1+ T cells increased, compared to SKG mice; however, the number of DETCs remained significantly lower than in WT, similar to SKG mice. Our results suggest that signaling via Vγ5Vδ1 TCR is indispensable for DETC development, with distinct contributions to embryonic development and postnatal proliferation.
BCS impact report: winter 2021
Authors: Penketh Claire
Published: January 2022

BCS members speak out about Green IT, the future of AI — and a global social media outage. Senior Media Offcer Claire Penketh reports.

As part of its Open Technology for Sustainability Day at COP26, Claire Penketh also spoke to Amanda Brock, CEO of OpenUK about how rethinking tech could help save the planet.
Insight: business analysis
Authors: Lovelock Christina
Published: January 2022

Business analysts often consider options and their feasibility, but should we also analyse the sustainability of those options? asks Business Analysis Leader, Christina Lovelock MBCS.
Why agility needs different leadership
Authors: Law Ali
Published: January 2022

Agility is a capability that many IT organisations are embracing. So, how can agile increase the chances of being successful? Ali Law FBCS explains.
What were punch cards and how did they change business?
Authors: Grinyer Peter H
Published: January 2022

Peter H. Grinyer MBCS shares his memories of punch cards, their uses, evolution and a family celebration.
Genomic analyses of Staphylococcus aureus isolated from yaks in Ganzi Tibetan Autonomous Prefecture, China
Authors: Zou Geng , Matuszewska Marta , Bai Fenglan , Wang Suya , Wang Shuang , Li Huaixia , Ke Yan , Tang Cheng , Li Jinquan , Tang Junni , Zhou Rui
Published: January 2022

Objectives

To investigate the transmission and origination of MRSA in livestock with limited antimicrobial use. Yak (Bos grunniens) herds in Ganzi Tibetan Autonomous Prefecture, China were chosen for sampling.

Methods

The yaks from all 18 districts of Ganzi were sampled (anal swabs, n = 657; nasal swabs, n = 634). Based on the WGS data of 83 Staphylococcus aureus isolates, the novel structure of the yak S. aureus population was described. Phylogenetic analyses were utilized for determining the origin of the MRSA lineage in yaks.

Results

The yak S. aureus population consisted of 11 STs, 6 of which were previously undescribed, with ST6267 being the predominant novel ST. These isolates were generally susceptible to most of the tested antibiotics and lacked the associated antimicrobial resistance genes (ARGs) but showed high penicillin MIC values (MIC90 = 32 mg/L), which were consistent with the high positivity rate for blaZ (61/83). The MRSA identified in yaks were all ST59 and most likely of human origin. The yak ST59 MRSA each carried the human immune evasion cluster (IEC) while lacking the ARGs that are identified in the majority of reported Chinese human ST59 MRSA isolates [erm(B), ant6-Ia and aph(3″)-III].

Conclusions

The yak herds living on the Qinghai–Tibet Plateau are important livestock and follow the traditional free-grazing farming model. We surveyed the yak S. aureus population and found that all the yak MRSA isolates belonged to the lineage that might originate from the prevalent community-acquired MRSA ST59 in China. From a ‘One Health’ perspective, the transmission of human MRSA to farming animals with limited antimicrobial exposure highlights the multiple roles of animals in the expansion of MRSA.
Sleep apnea phenotyping and relationship to disease in a large clinical biobank
Authors: Cade Brian E , Hassan Syed Moin , Dashti Hassan S , Kiernan Melissa , Pavlova Milena K , Redline Susan , Karlson Elizabeth W
Published: January 2022

Objective

Sleep apnea is associated with a broad range of pathophysiology. While electronic health record (EHR) information has the potential for revealing relationships between sleep apnea and associated risk factors and outcomes, practical challenges hinder its use. Our objectives were to develop a sleep apnea phenotyping algorithm that improves the precision of EHR case/control information using natural language processing (NLP); identify novel associations between sleep apnea and comorbidities in a large clinical biobank; and investigate the relationship between polysomnography statistics and comorbid disease using NLP phenotyping.

Materials and Methods

We performed clinical chart reviews on 300 participants putatively diagnosed with sleep apnea and applied International Classification of Sleep Disorders criteria to classify true cases and noncases. We evaluated 2 NLP and diagnosis code-only methods for their abilities to maximize phenotyping precision. The lead algorithm was used to identify incident and cross-sectional associations between sleep apnea and common comorbidities using 4876 NLP-defined sleep apnea cases and 3× matched controls.

Results

The optimal NLP phenotyping strategy had improved model precision (≥0.943) compared to the use of one diagnosis code (≤0.733). Of the tested diseases, 170 disorders had significant incidence odds ratios (ORs) between cases and controls, 8 of which were confirmed using polysomnography (n = 4544), and 281 disorders had significant prevalence OR between sleep apnea cases versus controls, 41 of which were confirmed using polysomnography data.

Discussion and Conclusion

An NLP-informed algorithm can improve the accuracy of case-control sleep apnea ascertainment and thus improve the performance of phenome-wide, genetic, and other EHR analyses of a highly prevalent disorder.
The Original Scientific Description of the Lone Star Tick (Amblyomma americanum, Acari: Ixodidae) and Implications for the Species’ Past and Future Geographic Distributions
Authors: Rochlin Ilia , Egizi Andrea , Lindström Anders
Published: January 2022

Amblyomma americanum L. is an important vector in North America originally described by Linnaeus based on Pehr Kalm’s 1754 report. While Kalm’s ‘Travels into North America’ is well known, his 1754 report remains obscure. Some authors were skeptical that Kalm referred to A. americanum because he encountered them at sites farther north outside of the species’ range. However, the details in 1754 report leave no doubt that Kalm described lone star ticks. In this historical review, we provide support for Kalm’s identification using a modern translation of his 1754 report and other sources. We also delineate distributional changes of lone star ticks from the pre-colonization era to the present and interpret them in the context of large-scale anthropogenic changes in the landscape. In this framework, the lone star tick’s current northward expansion is a recolonization of their former range. Extensive deforestation and extirpation of their principal host species, white-tailed deer, led to A. americanum’s disappearance from the northern parts of its range by the 20th century. Subsequent recolonization by second-growth forest and increases in white-tailed deer populations by the mid-20th century is now allowing A. americanum to reclaim its former range. These changes in the land appear to be the driving force behind A. americanum’s present expansion. Understanding this species’ history and the factors contributing to its current expansion will enable better predictions about its future distribution and potential to transmit human pathogens.
Diversity of Mosquitoes (Diptera: Culicidae) in the Bom Retiro Private Natural Heritage Reserve, Rio de Janeiro State, Brazil
Authors: Bastos Amanda Queiroz , de Mello Cecilia Ferreira , dos Santos Silva Júlia , Gil-Santana Hélcio Reinaldo , Silva Shayenne Olsson Freitas , Alencar Jeronimo
Published: January 2022

This study registers the diversity of Culicidae in the Bom Retiro Private Natural Heritage Reserve (RPPNBR), Rio de Janeiro state, Brazil, based on the collection of the immature stages in natural and artificial larval habitats. Larvae and pupae were collected monthly at two sites of the RPPNBR from May 2014 to July 2015 using dippers and aquatic pipettes. The diversity of the mosquito community was described using the Shannon–Wiener Diversity Index (H′), as well as diversity, richness, and dominance of species found in different larval habitats (lake, bamboos, bromeliads, and artificial vessels). The Mann–Whitney test was used to calculate differences between the two natural and artificial habitats. Overall, 15,659 specimens belonging to 25 species, ten genera, and two subfamilies were collected. The most abundant species collected at sites that were reforested recently were Culex pleuristriatus Theobald, 1903, Limatus durhamii (Theobald, 1901), Aedes albopictus (Skuse, 1895), Culex neglectus (Lutz, 1904), and Culex retrosus (Lane & Whitman, 1951). In a forest preserved site, the most abundant species were Cx. neglectus, Culex iridescens (Lutz, 1905), Sabethes identicus (Dyar & Knab, 1907), Wyeomyia arthrostigma (Lutz, 1905), and Li. durhamii. With respect to larval habitats, 0.1% of the specimens were collected along the edge of a lake, 5.5% in bamboos, 35.9% in bromeliads, and 58.4% in artificial containers. Only 5.5% of the specimens were collected in the forest preserved site, with the remaining samples from the site with altered vegetation. A greater species richness and diversity were found in forest-altered sites compared to the forest preserved site. Several species were collected in the water accumulated in the nylon lids of plastic water tanks. Such vessels can promote an increase in mosquito population density in the environment surrounding the study area.
Trends in the Incidence of Human Papillomavirus-Associated Cancers by County-Level Income and Smoking Prevalence in the United States, 2000-2018
Authors: Lin Yueh-Yun , Damgacioglu Haluk , Suk Ryan , Wu Chi-Fang , Zhu Yenan , Ortiz Ana P , Hara Sehej Kaur , Sonawane Kalyani , Deshmukh Ashish A
Published: January 2022

Human papillomavirus (HPV)-associated cancer burden is rising in the United States. Trends in the incidence by county-level income and smoking prevalence remain undescribed. We used the Surveillance, Epidemiology, and End Results 21 database to ascertain HPV-associated cancers during 2000-2018. Trends were estimated by county-level income and smoking prevalence quartiles. Anal and vulvar cancer incidence among women and anal cancer incidence among men increased markedly in the lowest-income counties, whereas the increases were slower in the highest-income counties (eg, for vulvar cancer, incidence increased 1.9% per year, 95% confidence interval [CI] = 0.9% to 2.9%, in the lowest-income counties vs 0.8% per year, 95% CI = 0.6% to 1.1%, in the highest-income counties). In recent years, cervical cancer incidence plateaued (0.0% per year [95% CI = −0.5% to 0.5%]) in the highest-income counties; in the lowest-income counties, the annual percentage change was 1.6% per year (95% CI = −0.7% to 4.0%). Counties with high smoking prevalence had marked increases in incidence compared with their counterparts (eg, anal cancer among men increased 4.4% per year [95% CI = 2.7% to 6.0%] for those living in counties with the highest smoking prevalence vs 1.2% per year [95% CI = 0.7% to 1.7%] for those living in counties with the lowest smoking prevalence). Improved and targeted prevention is needed to combat the widening disparities.
The Effects of Tobacco Coverage in the Public Communication Environment on Young People’s Decisions to Smoke Combustible Cigarettes
Authors: Hornik Robert , Binns Steven , Emery Sherry , Epstein Veronica Maidel , Jeong Michelle , Kim Kwanho , Kim Yoonsang , Kranzler Elissa C , Jesch Emma , Lee Stella Juhyun , Levin Allyson V , Liu Jiaying , O’Donnell Matthew B , Siegel Leeann , Tran Hy , Williams Sharon , Yang Qinghua , Gibson Laura A
Published: January 2022

In today’s complex media environment, does media coverage influence youth and young adults’ (YYA) tobacco use and intentions? We conceptualize the “public communication environment” and effect mediators, then ask whether over time variation in exogenously measured tobacco media coverage from mass and social media sources predicts daily YYA cigarette smoking intentions measured in a rolling nationally representative phone survey (N = 11,847 on 1,147 days between May 2014 and June 2017). Past week anti-tobacco and pro-tobacco content from Twitter, newspapers, broadcast news, Associated Press, and web blogs made coherent scales (thetas = 0.77 and 0.79). Opportunities for exposure to anti-tobacco content in the past week predicted lower intentions to smoke (Odds ratio [OR] = 0.95, p < .05, 95% confidence interval [CI] = 0.91–1.00). The effect was stronger among current smokers than among nonsmokers (interaction OR = 0.88, p < .05, 95% CI = 0.77–1.00). These findings support specific effects of anti-tobacco media coverage and illustrate a productive general approach to conceptualizing and assessing effects in the complex media environment.
The response of soil respiration to different N compounds addition in a saline–alkaline grassland of northern China
Authors: Diao Huajie , Chen Xiaopeng , Wang Ge , Ning Qiushi , Hu Shuya , Sun Wei , Dong Kuanhu , Wang Changhui
Published: January 2022

The increase in atmospheric nitrogen (N) deposition has profound effects on soil respiration (SR). However, the responses of SR to the addition of different N compounds, particularly in saline–alkaline grasslands remain unclear. A 3-year controlled field experiment was conducted to investigate the responses of SR to different N compounds (NH4NO3, (NH4)2SO4 and NH4HCO3) during the growing seasons in a saline–alkaline grassland located in the agro-pastoral ecotone of northern China. Our results demonstrated that SR showed a bimodal pattern and a significant interannual difference that was regulated by air or soil temperature and precipitation. Nitrogen addition had a significant effect on SR, and the effect of N addition on SR varied yearly, which was related to seasonal precipitation. The mean SR across 3 years (2017–2019) was increased by 19.9%, 13.0% and 16.6% with the addition of NH4NO3, (NH4)2SO4 and NH4HCO3, respectively. The highest effect of NH4NO3 addition on SR across 3 years was ascribed to the highest aboveground net primary production, belowground net primary production (BNPP) and soil NO3− concentrations. SR (C loss) was significantly increased while plant productivity (C input) did not significantly change under NH4HCO3 addition, indicating a decrease in C sequestration. In addition, BNPP was the main direct factor influencing SR in this saline–alkaline grassland, and soil salinization (e.g. soil base cations and pH) indirectly affected SR through soil microorganisms. Notably, NH4NO3 addition overestimated the response of SR to N addition, and different N compounds should be considered, especially in saline–alkaline grassland.
Urbanization and plant pathogen infection interact to affect the outcome of ecological interactions in an experimental multitrophic system
Authors: Srisakrapikoop Ussawit , Pirie Tara J , Fellowes Mark D E
Published: January 2022

Urbanization can change interactions in insect communities, and the few studies of tritrophic interactions in urban settings focus on interactions between plants, herbivorous insects and their mutualists and natural enemies. Plant pathogen infection is also widespread and common, and infection may also alter such interactions, but we have no understanding of whether the ecological consequences of pathogen infection vary with urbanization. Using replicated aphid colonies on experimental plants, we investigated how infection by the plant pathogen Botrytis cinerea influences interactions between plants, aphids and the aphid natural enemies and ant mutualists in highly urbanized, suburban and rural study sites. Aphid and natural enemy abundance were highest in the suburban site, while mutualist ants were most abundant in the urban site, reversing the usual positive density-dependent relationship between natural enemies and aphids. The effect of pathogen infection varied with trait and site, mediated by natural enemy preference for hosts or prey on uninfected plants. The effect of infection on aphid abundance was only seen in the suburban site, where natural enemies were most abundant on uninfected plants and aphid numbers were greatest on infected plants. In the urban site, there was no effect of infection, while in the rural site, aphid numbers were lower on infected plants. Uninfected plants were smaller than infected plants and differed between locations. This study suggests that the effects of urbanization on ecological interactions may become more complex and difficult to predict as we study ecological assemblages and communities at greater levels of structural complexity.
Readability Analysis of Otolaryngology Consent Documents on the iMed Consent Platform
Authors: Hannabass Kyle , Lee Jivianne
Published: January 2022

Introduction

The American Medical Association (AMA) and National Institutes of Health (NIH) recommend all patient information and consent materials be provided at the fourth- to sixth-grade level. The iMed Consent platform is used nationally by the Veterans Health Administration and private hospitals. We aimed to assess the readability of otolaryngology consents at the West Los Angeles Veterans Affairs (WLA-VA) hospital to determine whether they conform with AMA/NIH guidelines.

Materials and Methods

A readability analysis of 27 otolaryngology iMed consent documents was performed. The main outcome measure was the Flesch–Kincaid Grade Level (FKGL). The setting of the study was an otolaryngology clinic at a major VA hospital. All consents used in the WLA-VA otolaryngology clinic for the month of October 2018 were analyzed using readability metrics. These included the Flesch Reading Ease (FRE) score, the FKGL, the Gunning Fog Index (GFI), Simple Measure of Gobbledygook (SMOG), and Coleman–Liau Index (CLI).

Results

The following means of all consents were calculated for each of the readability metrics: FRE 56.3, FKGL 8.3, GFI 14.5, SMOG 11.3, and CLI 11.2. The standardized anesthesia and blood consent were analyzed separately with the following scores: FRE 45.1, FKGL 11.7, GFI 15.5, SMOG 14.6, and CLI 12.6. The average FKGL of the consents was found to be significantly above the sixth-grade level (P: .0013).

Conclusion

The average grade level of the otolaryngology iMed consents reviewed was at a reading level above the AMA/NIH recommendations. This objective measure should be taken into consideration when revising the iMed system and in the creation of future standardized consents. Readability analysis does not take into consideration the significant variance that exists as part of the verbal consent process that takes place between patient and provider.
The Primary Care Management of Headache: Synopsis of the 2020 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline
Authors: Sico Jason J , Macedo Franz , Lewis Jeffrey , Spevak Christopher , Vogsland Rebecca , Ford Aven , Skop Karen , Sall James
Published: January 2022

Introduction

In June of 2020, the U.S. DVA and DoD approved a new joint clinical practice guideline for assessing and managing patients with headache. This guideline provides a framework to evaluate, treat, and longitudinally manage the individual needs and preferences of patients with headache.

Methods

In October of 2018, the DVA/DoD Evidence-Based Practice Work Group convened a guideline development panel that included clinical stakeholders and conformed to the National Academy of Medicine’s tenets for trustworthy clinical practice guidelines.

Results

The guideline panel developed key questions, systematically searched and evaluated the literature, created a 1-page algorithm, and advanced 42 recommendations using the Grading of Recommendations Assessment, Development, and Evaluation system.

Conclusion

This synopsis summarizes the key features of the guideline in three areas: prevention, assessing and treating medication overuse headache, and nonpharmacologic and pharmacologic management of headache.
What Did We Miss? Analysis of Military Personnel Responses to an Open-Ended Question in a Post-Deployment Health Survey
Authors: Runge Catherine E , Moss Katrina M , Dean Judith A , Waller Michael
Published: January 2022

Introduction

Post-deployment health surveys completed by military personnel ask about a range of deployment experiences. These surveys are conducted to determine if there are links between experiences and poor health. Responses to open-ended questions in these surveys can identify experiences that might otherwise go unreported. These responses may increase knowledge about a particular deployment and inform future surveys. This study documented deployment experiences described by Australian Defence Force personnel who were deployed to the Middle East.

Materials and Methods

A survey completed by 14,032 personnel examined health outcomes and over 100 experiences relating to their Middle East deployment. Responses to two open-ended questions captured additional experiences. Descriptive statistics reveal the characteristics of those who did and did not describe additional experiences, and a content analysis details the nature and frequency of the experiences reported. The study was approved by an Institutional Review Board.

Results

Five percentage (n = 692) of personnel who completed the survey described additional deployment experiences. The most frequently reported experiences were specific Navy experiences; experiences of poor leadership; administrative or organizational issues; the anthrax vaccine; and traumatic events/potentially morally injurious experiences.

Conclusions

The findings suggest that post-deployment health surveys should have questions about certain deployment experiences tailored by military service (i.e., Air Force, Army, and Navy). Researchers could consider including questions about personnel experiences of leadership for its impact on health and about potentially morally injurious experiences that may help explain adverse mental health. Clear wording of open-ended questions and participant instructions may improve response rates and reduce response biases.
The Battle of Two Oaths: Finding Peace Between Two Conflicting Careers
Authors: Hallstead Serica J
Published: January 2022

On the surface, the Commissioning Oath and modernized Hippocratic Oath can contradict one another. This piece aims to provide a foundation upon which trainees and providers can grapple with dueling obligations as they stand in the crosshairs of the intersection between medicine and the military.
Numerical simulations of bar formation in the Local Group
Authors: Marioni Ornela F , Abadi Mario G , Gottlöber Stefan , Yepes Gustavo
Published: January 2022

More than 50 per cent of present-day massive disc galaxies show a rotating stellar bar. Their formation and dynamics have been widely studied both numerically and observationally. Although numerical simulations in the Lambda cold dark matter (ΛCDM) cosmological framework predict the formation of such stellar components, there seems to be a tension between theoretical and observational results. Simulated bars are typically larger in size and have slower pattern speed than observed ones. We study the formation and evolution of barred galaxies, using two ΛCDM zoom-in hydrodynamical simulations of the CLUES project that follow the evolution of a cosmological Local Group-like volume. We found that our simulated bars, at z = 0, are both shorter and faster rotators than previous ones found in other studies on cosmological simulations alleviating the tension mentioned above. These bars match the short tail-end of the observed bar-length distribution. In agreement with previous numerical works, we find that bars form in those systems where the disc self-gravity is dominant over the dark matter halo, making them unstable against bar formation. Our bars developed in the last 3–4 Gyr until they achieve their current length and strength; as bars grow, their lengths increase while their rotation speeds decrease. Despite this slowdown, at redshift z = 0 their rotation speeds and size match well the observational data.
The vertical shear instability in poorly ionized, magnetized protoplanetary discs
Authors: Latter Henrik N , Kunz Matthew W
Published: January 2022

Protoplanetary discs should exhibit a weak vertical variation in their rotation profiles. Typically, this ‘vertical shear’ issues from a baroclinic effect driven by the central star’s radiation field, but it might also arise during the launching of a magnetocentrifugal wind. As a consequence, protoplanetary discs are subject to a hydrodynamical instability, the ‘vertical shear instability’ (VSI), whose breakdown into turbulence could transport a moderate amount of angular momentum and facilitate, or interfere with, the process of planet formation. Magnetic fields may suppress the VSI, however, either directly via magnetic tension or indirectly through magnetorotational turbulence. On the other hand, protoplanetary discs exhibit notoriously low ionization fractions, and non-ideal effects, if sufficiently dominant, may come to the VSI’s rescue. In this paper, we develop a local linear theory that explores how non-ideal magnetohydrodynamics influences the VSI, while exciting additional diffusive shear instabilities. We derive a set of analytical criteria that establish when the VSI prevails, and then show how it can be applied to a representative global model of a protoplanetary disc. Our calculations suggest that within ∼10 au the VSI should have little trouble emerging in the main body of the disc, but beyond that, and in the upper regions of the disc, its onset depends sensitively on the size of the preponderant dust grains.
The Emergence of SARS-CoV-2 Variants of Concern Is Driven by Acceleration of the Substitution Rate
Authors: Tay John H , Porter Ashleigh F , Wirth Wytamma , Duchene Sebastian
Published: January 2022

The ongoing SARS-CoV-2 pandemic has seen an unprecedented amount of rapidly generated genome data. These data have revealed the emergence of lineages with mutations associated to transmissibility and antigenicity, known as variants of concern (VOCs). A striking aspect of VOCs is that many of them involve an unusually large number of defining mutations. Current phylogenetic estimates of the substitution rate of SARS-CoV-2 suggest that its genome accrues around two mutations per month. However, VOCs can have 15 or more defining mutations and it is hypothesized that they emerged over the course of a few months, implying that they must have evolved faster for a period of time. We analyzed genome sequence data from the GISAID database to assess whether the emergence of VOCs can be attributed to changes in the substitution rate of the virus and whether this pattern can be detected at a phylogenetic level using genome data. We fit a range of molecular clock models and assessed their statistical performance. Our analyses indicate that the emergence of VOCs is driven by an episodic increase in the substitution rate of around 4-fold the background phylogenetic rate estimate that may have lasted several weeks or months. These results underscore the importance of monitoring the molecular evolution of the virus as a means of understanding the circumstances under which VOCs may emerge.
TOPORS-mediated RAD51 SUMOylation facilitates homologous recombination repair
Authors: Hariharasudhan Gurusamy , Jeong Seo-Yeon , Kim Min-Ji , Jung Sung Mi , Seo Gwanwoo , Moon Ju-Ran , Lee Sumi , Chang In-Youb , Kee Younghoon , You Ho Jin , Lee Jung-Hee
Published: January 2022

Homologous recombination (HR) is critical for error-free repair of DNA double-strand breaks. Chromatin loading of RAD51, a key protein that mediates the recombination, is a crucial step in the execution of the HR repair. Here, we present evidence that SUMOylation of RAD51 is crucial for the RAD51 recruitment to chromatin and HR repair. We found that topoisomerase 1-binding arginine/serine-rich protein (TOPORS) induces the SUMOylation of RAD51 at lysine residues 57 and 70 in response to DNA damaging agents. The SUMOylation was facilitated by an ATM-induced phosphorylation of TOPORS at threonine 515 upon DNA damage. Knockdown of TOPORS or expression of SUMOylation-deficient RAD51 mutants caused reduction in supporting normal RAD51 functions during the HR repair, suggesting the physiological importance of the modification. We found that the SUMOylation-deficient RAD51 reduces the association with its crucial binding partner BRCA2, explaining its deficiency in supporting the HR repair. These findings altogether demonstrate a crucial role for TOPORS-mediated RAD51 SUMOylation in promoting HR repair and genomic maintenance.
Long-term effectiveness of Gliadel implant for malignant glioma and prognostic factors for survival: 3-year results of a postmarketing surveillance in Japan
Authors: Iuchi Toshihiko , Inoue Akihiro , Hirose Yuichi , Morioka Motohiro , Horiguchi Keishi , Natsume Atsushi , Arakawa Yoshiki , Iwasaki Koichi , Fujiki Minoru , Kumabe Toshihiro , Sakata Yukinori
Published: January 2022

Background

Adjuvant treatment with Gliadel wafers may prolong overall survival (OS) for malignant glioma patients without increasing toxicity. In Japan, the long-term OS of these patients treated with Gliadel 7.7 mg implants has not been studied. We evaluated OS and prognostic factors that might affect OS in Japanese patients with malignant glioma who received the Gliadel 7.7 mg implant.

Methods

This observational, long-term, postmarketing surveillance was an extension of a previous surveillance. Data were collected through case report forms at 2 and 3 years after Gliadel implant. Up to 8 Gliadel wafers (61.6 mg of carmustine) were placed over the tumor resection site. Primary endpoints were OS and prognostic factors that may influence OS.

Results

Among the 506 patients analyzed, 62.6% had newly diagnosed disease, and 37.4% had recurrent disease; 79.1% had glioblastoma histological type and 79.6% had World Health Organization Grade IV disease. Patients received a median of 8 wafers. The median OS was 18.0 months; OS rates were 39.8% and 31.5% at 2 and 3 years, respectively. Age ≥65 years (hazard ratio [HR]: 1.456; P = .002), lower resection rate (HR: 1.206; P < .001), recurrence (HR: 2.418; P < .001), and concomitant radiotherapy (HR: 0.588; P < .001) were identified as significant prognostic factors.

Conclusions

This study confirmed the 2- and 3-year OS of Japanese malignant glioma patients with varied backgrounds after Gliadel implant. With a careful interpretation of indirect comparisons with previously reported data, the results suggest that prognosis could be improved with Gliadel implants.

Clinical Trial Registration

NCT02300506
Evaluating a Tobacco Treatment Program’s Transition to Telehealth Using a Social Determinants of Health Lens
Authors: Shoenbill Kimberly A , Baca-Atlas Michael H , Smith Caleb A , Wilhoit-Reeves Stephanie B , Baca-Atlas Stefani N , Goldstein Adam O
Published: January 2022

Introduction

While strong associations exist between social determinants of health (SDOH), socioeconomic status, and smoking, these factors are not routinely assessed in tobacco treatment programs (TTP). This study addresses this gap by evaluating a composite metric of SDOH and a measure of access to care to determine program reach before and after the implementation of telehealth tobacco treatment delivery.

Aims and Methods

We examined inpatient data from a large TTP during two comparable time periods from April 1, 2019 to September 30, 2019 (pre-telehealth) and from April 1, 2020 to September 30, 2020 (telehealth). The populations were compared using point-of-care data, including 5-digit zip codes mapped to the CDC’s Social Vulnerability Index (SVI) and driving distance (in 60-min increments) to the study hospital. Chi-square tests for homogeneity were performed for SVI and driving distance comparisons.

Results

While distance distributions were significantly different between the pre-telehealth and telehealth populations (χ 2 = 13.5 (df = 3, N = 3234), p = .004, no significant differences existed in the proportion of SVI categories between the two populations (χ 2 = 5.8 (df = 3, N = 3234), p = .12). In the telehealth population, patients with the highest SVI vulnerability had the greatest proportions living >1 h from the hospital.

Conclusions

This study offers a novel evaluation of tobacco treatment in relation to an SDOH metric (SVI) and care access (distance to the hospital) for inpatient populations. Patient reach, including to those with high vulnerabilities, remained consistent in a transition to telehealth. These methods can inform future reach and engagement of patients who use tobacco products, including patients with high vulnerability or who reside at greater distances from treatment programs.

Implications

This study provides the first analysis of inpatient tobacco use treatment (TUT) transition to telehealth delivery of care during the COVID-19 pandemic using the CDC’s SVI metric and patient distance to the hospital. The transition resulted in consistent reach to patients at the highest vulnerability. These findings can inform efforts to evaluate SDOH measures and improve reach, engagement, and research on telehealth delivery of inpatient TUT.
Humanizing Bureaucracy: Applying the Human Rights-Based Approach to Weber’s Bureaucracy
Authors: Borry Erin L , Reuter Tina Kempin
Published: January 2022

Weber’s bureaucracy has persisted in the public administration literature as a lens through which to analyze organizational structures. The “ideal type,” however, was never meant to be ideal; despite this, it has become a default framework for structuring and studying organizations, as if they should be structured as such. At the same time, research on bureaucracy often explores its negative impacts, such as the value of merit that has become so enmeshed in law and policies, it can neglect to account for performance and diverse abilities, and rules that have evolved into red tape and constrain bureaucratic behavior. These raise questions about the dehumanizing effects of bureaucracy, something Weber himself cautioned. Using a human rights-based approach, we seek to understand Weber’s bureaucracy through the lens of human rights, and offer suggestions for how to structure organizations that are fair, equitable, and oriented around the human condition. We argue that a human- and human rights-centered approach to bureaucracy requires rethinking the way in which we assess bureaucratic outcomes by prioritizing fundamental human rights values, such as nondiscrimination, participation, freedom, access, and inclusion over neoliberal preferences, which in turn impact employee and client well-being and the structure of the organization itself.
Exposure in Vivo as a Treatment Approach to Target Pain-Related Fear: Theory and New Insights From Research and Clinical Practice
Authors: den Hollander Marlies , Smeets Rob J E M , van Meulenbroek Thijs , van Laake-Geelen Charlotte C M , Baadjou Vera A , Timmers Inge
Published: January 2022

Pain-related fear (PRF) can be a significant factor contributing to the development and maintenance of pain-related disability in individuals with persistent pain. One treatment approach to target PRF and related avoidance behavior is exposure in vivo (EXP). EXP has a long history in the field of anxiety, a field that is constantly evolving. This Perspective outlines recent theoretical advancements and how they apply to EXP for PRF, including suggestions for how to optimize inhibitory learning during EXP; reviews mechanistic work from neuroimaging supporting the targeting of PRF in people with chronic pain; and focuses on clinical applications of EXP for PRF, as EXP is moving into new directions regarding who is receiving EXP (eg, EXP in chronic secondary pain) and how treatment is provided (EXP in primary care with a crucial role for physical therapists). Considerations are provided regarding challenges, remaining questions, and promising future perspectives.

Impact

For patients with chronic pain who have elevated pain-related fear (PRF), exposure is the treatment of choice. This Perspective highlights the inhibitory learning approach, summarizes mechanistic work from experimental psychology and neuroimaging regarding PRF in chronic pain, and describes possible clinical applications of EXP in chronic secondary pain as well as in primary care.
Titanium alloy composited with dual-cytokine releasing polysaccharide hydrogel to enhance osseointegration via osteogenic and macrophage polarization signaling pathways
Authors: Wang Yaping , Feng Zujian , Liu Xiang , Yang Chunfang , Gao Rui , Liu Wenshuai , Ou-Yang Wenbin , Dong Anjie , Zhang Chuangnian , Huang Pingsheng , Wang Weiwei
Published: January 2022

Titanium alloy has been widely used in orthopedic surgeries as bone defect filling. However, the regeneration of high-quality new bones is limited due to the pro-inflammatory microenvironment around implants, resulting in a high occurrence rate of implant loosening or failure in osteological therapy. In this study, extracellular matrix-mimetic polysaccharide hydrogel co-delivering BMP-2 and interleukin (IL)-4 was composited with 3D printed titanium alloy to promote the osseointegration and regulate macrophage response to create a pro-healing microenvironment in bone defect. Notably, it is discovered from the bioinformatics data that IL-4 and BMP-2 could affect each other through multiple signal pathways to achieve a synergistic effect toward osteogenesis. The composite scaffold significantly promoted the osteoblast differentiation and proliferation of human bone marrow mesenchyme stem cells (hBMSCs). The repair of large-scale femur defect in rat indicated that the dual-cytokine-delivered composite scaffold could manipulate a lower inflammatory level in situ by polarizing macrophages to M2 phenotype, resulting in superior efficacy of mature new bone regeneration over the treatment of native titanium alloy or that with an individual cytokine. Collectively, this work highlights the importance of M2-type macrophages-enriched immune-environment in bone healing. The biomimetic hydrogel–metal implant composite is a versatile and advanced scaffold for accelerating in vivo bone regeneration, holding great promise in treating orthopedic diseases.
The Transition to Siblinghood: An Understudied Yet Influential Process Pertinent to Social Work Research
Authors: Ward Kaitlin P
Published: January 2022

Across cultures, the majority of individuals will have a sibling relationship in their lifetime. Of particular importance to parents and children is the transition to siblinghood, which refers to the process wherein a child becomes a sibling. Although many parents are concerned about how their children will adjust during the transition to siblinghood, scant empirical work on this subject exists. Available empirical work on the transition to siblinghood has stemmed from developmental psychology; however, social work researchers have yet to deeply explore this body of work. The transition to siblinghood is a topic that is rife with opportunity for social work researchers, who have the ability to study this transition from culturally sensitive, person-in-environment, and social justice perspectives. This article provides an overview of the elements and importance of the transition to siblinghood, introduces a theoretical framework relevant to social workers, reviews existent empirical work on the transition to siblinghood, and elucidates limitations in the literature that social work researchers are adept to address. The article concludes with four recommendations to researchers who are interested in studying the transition to siblinghood through a social work lens.