bluuebunny/crossref_metadata_2025 huggingface dataset:
The why and how of co-production between professionals and volunteers: a qualitative study of community-based healthcare in Denmark
Authors: Rasmussen Lene Gissel , Skjerning Halfdan Thorsø , Burau Viola
Published: May 2022

Purpose

The present paper describes the interplay between the “why” and “how” in co-production based on a case study of community-based healthcare in Denmark involving municipalities and voluntary sports clubs. So far, policy practice and research have focussed on the “why” – the rationales and pre-requisites – of co-production. However, there seems to be a lack of knowledge about the “how” of co-production in the interplay between professionals and volunteers. The paper asks how co-production is being perceived and practised according to existing norms and objectives of public healthcare and civil society, drawing on the theory of institutional logics.

Design/methodology/approach

The paper uses a critical case study approach to examine the practice of co-production. The analysis builds on qualitative data from nine semi-structured interviews, two information interviews and project documents. Interviews were recorded, transcribed verbatim and coded.

Findings

This paper demonstrates that compatibility of institutional logics was not given, nor did the co-existence of potentially competing logics necessarily result in conflict in co-production. Instead, in this case study co-production emerged as highly contingent, reflecting the dynamic interaction between logics and context-specific management.

Originality/value

This paper makes an original contribution to the conceptual understanding of co-production in emphasising the benefit of paying attention to the network logic when building bridges between public healthcare and civil society – and to unite the seemingly contradictory “why” and “how” of co-production in practice.
The effect of individual auditor quality on audit outcomes: opening the black box of audit quality
Authors: Stice Derrald , Stice Han , White Roger
Published: May 2022

Purpose

This study aims to examine the effect of individual auditor quality (below the partner level) on overall audit quality.

Design/methodology/approach

We aggregate audit employee-level individual performance evaluations to create a measure of auditor quality at the office level.

Findings

We find that high-quality audit offices are associated with a lower likelihood of client restatement, fewer client abnormal accruals and a higher likelihood of a client receiving a going concern opinion. We partition employees into low, medium and high level, based on job title, to investigate which employee levels drive these results. We find that the restatement results are driven by high quality high-level employees (Senior Managers/Directors), whereas the going concern results are driven by high quality low-level employees (Seniors). Furthermore, we find evidence that high-quality audit teams are associated with all aspects of audit quality and the magnitude of these team effects are much larger than those of the effects for any individual employee type.

Originality/value

Our findings are consistent with higher-level auditors preventing the most serious financial statement deficiencies, low-level employees contributing to audit firm independence and overall team quality creating synergy which has the strongest effect on all aspects of audit quality. These insights based on individual auditor evaluations are new to the literature. Overall, our empirical results suggest that individual auditor quality is associated with higher quality audits and that employees at all levels affect audit outcomes.
A novel framework for the automated healthcare disaster based on intellectual machine learning
Authors: Julie Aarthy C. Catherene , N. Rajkumar , Sriram V.P. , M.K. Badrinarayanan , Raj K. Bhavana , Patel Rajan
Published: May 2022

Purpose

The purpose of this paper used for catastrophe and pandemic preparedness was the craft of machine learning calculations. ML is the latest globe learning technique to assist in the identification and remediation of medical care catastrophes.

Design/methodology/approach

To the greatest extent possible, countries are terrified about debacles and pandemics, which, all in all, are exceptionally improbable occurrences. When health emergencies arise on the board, several issues arise for the medical team because of the lack of accurate information from numerous diverse sources, which is required to be available by suitable professionals.

Findings

Thus, the current investigation’s main objective is to demonstrate a structure that is dependent on the incorporation of recent advances, the Internet of Things and large information and which can settle this issue by using machine learning (ML) in all stages of catastrophe and providing accurate and compelling medical care.

Originality/value

The system upholds medical services characters by empowering information to be divided between them, enabling them to perform insightful estimations and enabling them to find significant, legitimate and precise patterns that are required for functional arrangement and better readiness in the event of crises. It is possible that the results of the system’s work may be used by the executives to assist chiefs in differentiating and forecasting the wellbeing repercussions of the fumbles.
Inversion using adaptive physics‐based neural network: Application to magnetotelluric inversion
Authors: Alyousuf Taqi , Li Yaoguo
Published: May 2022

A new trend to solve geophysical problems aims to combine the advantages of deterministic inversion with neural network inversion. The neural networks applied to geophysical inversion have had limited success due to the need for extensive training of datasets and the lack of generalizability to out‐of‐sample scenarios. Deterministic regularized inversion often requires a good starting model to avoid possible local minima in highly nonlinear problems. We have developed a physics‐based neural network procedure that combines the advantages of deterministic and neural network inversions in a coupled inversion scheme. The new inversion algorithm is formulated as a constrained minimization problem with a composite objective function composed of data misfit, neural network training function and a coupling model objective function that links the two inversion schemes through a reference model. We investigate two strategies to update the reference model in the coupling model objective function using either a fully trained network or an adaptively trained network that keeps evolving and learning during the inversion. First, we propose a procedure to generate the training dataset required for the fully trained network to improve the network generalization. Second, we extend the analysis of the adaptively trained network inversion without preparing a training dataset, so it is suitable for most exploration scenarios. Our approach enables the network to learn only the relevant model distribution. Predictions from the network are used to constrain the deterministic inversion using a new predicted reference model. We demonstrate the convergence of our procedure in recovering high‐resolution resistivity models when applied to synthetic magnetotellurics data. We compare the recovered resistivity model from a deterministic inversion, a neural network inversion and physics‐based neural network inversions using fully and adaptively trained networks, respectively. The results indicate that the adaptive physics‐based neural network is superior as it does not require preparing a training dataset but can still recover reliable resistivity models.
ROLLIS roll‐out: Pitfalls, errors, lessons learned and recommendations from Australian and New Zealand experience during the randomised controlled trial, implementing a novel localisation method for impalpable malignant breast lesions, radio‐guided occult lesion localisation with iodine‐125 (125I) seed (ROLLIS)
Authors: Bourke Anita G , Taylor Donna , Saunders Christobel
Published: May 2022

Introduction

Breast cancer surgery aims to excise lesions with clear margins and provide optimal cosmesis with a low re‐excision rates. These aims are aided by accurate lesion localisation and a surgical choice of incision site with minimal removal of healthy tissue. Problems associated with hookwires have led to adoption of non‐wire methods including radioguided occult lesion localisation using iodine‐125 (ROLLIS). This paper outlines the problems encountered and lessons learnt during the largest RCT involving 659 participants, conducted at eight sites (seven Australian, one New Zealand centres) between September 2013 and April 2018.*

Methods

Data, along with substantive comments, regarding each ROLLIS procedure, documenting each step from the seed insertion, ease of operative retrieval, to return of the seed to medical physics, from a shared on‐line secure database and a separate site email survey, were synthesised and categorised.

Results

The Australian and New Zealand ROLLIS RCT experience highlights several important issues. Lessons learned were related to licencing the seed and tracking protocols. A Designated Team Lead, who is a good communicator, ensuring the Tracking Protocols were accurately followed and updated, subspecialty leads and a Co‐ordinator, responsible for training, logbook maintenance and seed ordering, enhanced the success and acceptance of the programme. Addressing radiation issues, fears, education of staff and seed loss was imperative.

Conclusion

The Australian and New Zealand ROLLIS RCT experience highlights the need for adherence to local licencing laws and protocols, appointing a dedicated ROLLIS Designated Team Lead with good communication and a ROLLIS Co‐ordinator. These facilitate the adoption of a successful ROLLIS programme.
Is ASEAN ready to move to multilateral cross‐border electricity trade?
Authors: Do Thang Nam , Burke Paul J.
Published: May 2022

This paper reviews progress towards the establishment of an Association of Southeast Asian Nations (ASEAN) Power Grid (APG) and the key barriers to multilateral cross‐border electricity trade in ASEAN. An analysis across political, technical, institutional, economic, environmental, social and time dimensions is employed. Using a policy sequencing framework, the paper concludes it remains premature for ASEAN to pursue a strong form of power sector market integration on account of the sizeable barriers that currently remain, especially economic and institutional barriers. Focusing on bilateral power purchase agreements and large‐scale investments in solar and wind power over 2022–2030 would help to develop stronger foundations for ASEAN to make steps towards deeper regional integration in the electricity sector in subsequent years, while also being consistent with renewables adoption goals.
Effect of high‐concentrate diets on mRNA expression of genes related to muscle fiber type and metabolism of psoas major muscle in goats
Authors: Ren Qijun , Li Hanmei , Xu Fengping , Zhu Yihan , Zhang Xiangying , Fan Tingting , Wei Zhangyi , Yuan Feifan , Han Fei , Cong Rihua
Published: May 2022

In the process of modern breeding, high‐concentrate diets are widely used to meet the high energy nutritional requirements of animals but change the form of access to energy and nutrients and the way the organism metabolizes them. Goat psoas major (PM) muscle is a hybrid skeletal muscle whose characteristics are important for the motility and meat quality of goats. However, there are few studies on the effects of high‐concentrate diets on the muscle type and metabolic characteristics of PM in goats. In this study, two treatment groups were set up: high concentrate group (HC) and control group (C). The expression of genes related to muscle type and metabolism of the PM was examined by quantitative PCR. The results showed that high concentrate promoted the conversion of PM fibers from intermediate to slow type at the mRNA level, improved the absorption, transport, and oxidation of fat by PM, and upregulated the expression of calpain system. These changes may be regulated by the involvement of differential expression of MSTN, Myf‐5, and IGF‐2. These results suggest that high concentrate may exert a positive effect on skeletal muscle function, metabolism, and meat quality in goats by affecting the expression of muscle type and metabolism‐related genes.
Delineation of the GPR15 receptor‐mediated Gα protein signalling profile in recombinant mammalian cells
Authors: Deng Yufang , Moo Ee Von , Almería Claudia Victoria Pérez , Gentry Patrick R. , Vedel Line , Mathiesen Jesper M. , Bräuner‐Osborne Hans
Published: May 2022

The GPR15 receptor is a G protein‐coupled receptor (GPCR), which is activated by an endogenous peptide GPR15L(25–81) and a C‐terminal peptide fragment GPR15L(71–81). GPR15 signals through the Gi/o pathway to decrease intracellular cyclic adenosine 3′,5′‐monophosphate (cAMP). However, the activation profiles of the GPR15 receptor within Gi/o subtypes have not been examined. Moreover, whether the receptor can also couple to Gs, Gq/11 and G12/13 is unclear. Here, GPR15L(25–81) and GPR15L(71–81) are used as pharmacological tool compounds to delineate the GPR15 receptor‐mediated Gα protein signalling using a G protein activation assay and second messenger assay conducted on living cells. The results show that the GPR15 receptor preferentially couples to Gi/o rather than other pathways in both assays. Within the Gi/o family, the GPR15 receptor activates all the subtypes (Gi1, Gi2, Gi3, GoA, GoB and Gz). The Emax and activation rates of Gi1, Gi2, Gi3, GoA and GoB are similar, whilst the Emax of Gz is smaller and the activation rate is significantly slower. The potencies of both peptides toward each Gi/o subtype have been determined. Furthermore, the GPR15 receptor signals through Gi/o to inhibit cAMP accumulation, which could be blocked by the application of the Gi/o inhibitor pertussis toxin.
Young children expect pretend object identities to be known only by their partners in joint pretence
Authors: Andrási Krisztina , Schvajda Réka , Király Ildikó
Published: May 2022

The present study examined whether three‐year‐old children (age = 42–48 months, n = 57; 31 boys) understand that object identities stipulated during pretend play could only be known by people witnessing the stipulation. Children participated in pretend scenarios that included some objects and two experimenters. Two pretend episodes corresponded to an object: one connected to its conventional function, the other to a pretend identity made‐up on the spot. These episodes happened either in the presence or absence of the other person. In the test phase, this experimenter expressed an intention to do something with an object and asked for a ‘missing’ prop. The prediction was that in case she was present previously, children would be more likely to select the prop corresponding to a pretence stipulation, compared to when she was absent. The results confirmed this pattern: in the absent condition, 68.42% of the participants chose the prop connected to the conventional use of the object, while 31.58% chose the prop corresponding to its identity stipulated in pretend play. It seems that preschool aged children refrain from generalizing their knowledge about the pretend identity of an object, in case their interactive partner could not know of this identity.
Skin symptoms in veterinary assistant staff and veterinarians: A cross‐sectional study
Authors: Beine Alexandra , Gina Michal , Hoffmeyer Frank , Lotz Anne , Nöllenheidt Christoph , Zahradnik Eva , Sander Ingrid , Kleinmüller Olaf , Fartasch Manigé , Nienhaus Albert , Raulf Monika
Published: May 2022

Background

Veterinary assistants and veterinarians are at an increased risk of developing an occupational skin disease, for example, irritant/allergic contact dermatitis, contact urticaria and hand eczema (HE).

Objectives

We aimed to investigate the prevalence of skin problems and the influence of predisposing factors especially among veterinary assistants.

Methods

We conducted a cross‐sectional study among veterinary assistant staff (n = 103) and veterinarians (n = 19). A questionnaire, specific IgE determination and photographs of hands were evaluated for skin symptoms. Logistic regression models assessed predisposing factors.

Results

Over 50% (n = 62/122) of our study population reported hand eczema (HE) in the last 12 months (1‐year prevalence). Twenty‐seven subjects reported redness and contact urticaria directly after animal contact, 35 had a positive history of allergic contact dermatitis. HE was associated with (i) increased frequency of hand washing (11–15 times per day; OR 4.15, confidence interval [CI] 95% 1.18–14.6, p = 0.027, univariate model) and (ii) unprotected contact to fluids and tensides >5 times per day (OR 4.56, CI 95% 1.53–13.6, multivariate model).

Conclusions

We observed a high prevalence of self‐reported HE among staff in veterinary practices. Excessive hand washing, unprotected contact with irritants and long‐term glove use should be avoided.
Organ donation after self‐inflicted injury: A single institution analysis
Authors: Meyer Courtney H. , Grant April A. , Enofe Nosayaba , Matey Andrew , Frankinburger Emil , Sola Richard , Nguyen Jonathan , Andrade Ivan F. Pradilla , Veselsky Steven L. , Sciarretta Jason , Williams Keneeshia N. , Kim Steven , Smith Randi N.
Published: May 2022

Background

This study sought to determine the contribution of self‐inflicted injury‐related deaths to local organ donation rates and analyze contributing factors.

Methods

A retrospective review of adult patients with traumatic self‐inflicted injuries was performed at a Level I trauma center from 2013 to 2017. Data were obtained from the institutional trauma registry and cross‐referenced with the local organ procurement organization (OPO). Referral rates were analyzed and outcomes, demographics and injury characteristics were compared between patients who underwent donation versus those who did not.

Results

142 adult patients presented with traumatic self‐inflicted injury, and 100 (70.4%) had referral calls made to the local OPO. These patients were predominantly male (83%), and gunshot injuries accounted for 75% of all mechanisms. Sixty‐four percent had organ referrals versus tissue referrals (34%), and 17 (26.6%) of those patients went on to donate. The median number of organs procured was 4 [IQR 0‐5]. In multivariate analysis, for each year increase in age, patients were less likely to have an organ referral (OR = .96 [95% CI .93–.99]; p = .0134) and less likely to undergo donation (OR = .95 [95% CI .90–.99]; p = .0308).

Conclusions

Self‐inflicted injury, though tragic, may provide a significant contribution to the limited organ donor registry.
Fundoscopy use in neurology departments and the utility of smartphone photography: a prospective prevalence and crossover diagnostic accuracy study amongst neurology inpatients
Authors: He George , Dunn Hamish P. , Ahmad Kate E. , Watson Eloise , Henderson Andrew , Tynan Dominique , Leaney John , White Andrew J. , Hewitt Alex W. , Fraser Clare L.
Published: May 2022

Background and purpose

Although fundoscopy is a crucial part of the neurological examination, it is challenging, under‐utilized and unreliably performed. The aim was to determine the prevalence of fundus pathology amongst neurology inpatients and the diagnostic accuracy of current fundoscopy practice compared with systematic screening with smartphone fundoscopy (SF) and portable non‐mydriatic fundus photography (NMFP).

Methods

This was a prospective cross‐sectional surveillance and diagnostic accuracy study on adult patients admitted under neurology in an Australian hospital. Inpatients were randomized to initial NMFP (RetinaVue 100, Welch Allyn) or SF (D‐EYE) followed by a crossover to the alternative modality. Images were graded by neurology doctors, using telemedicine consensus neuro‐ophthalmology NMFP grading as the reference standard. Feasibility parameters included ease, comfort and speed.

Results

Of 79 enrolled patients, 14.1% had neurologically relevant pathology (seven, disc pallor; one, hypertensive retinopathy; three, disc swelling). The neurology team performed direct ophthalmoscopy in 6.6% of cases and missed all abnormalities. SF had a sensitivity of 30%–40% compared with NMFP (45.5%); however, it had a lower rate of screening failure (1% vs. 13%, p < 0.001), a shorter examination time (1.10 vs. 2.25 min, p < 0.001) and a slightly higher patient comfort rating (9.2 vs. 8/10, p < 0.001).

Conclusion

Our study demonstrates a clinically significant prevalence of fundus pathology amongst neurology inpatients which was missed by current fundoscopy practices. Portable NMFP screening appears more accurate than SF, whilst both are diagnostically superior to routine fundoscopic practice, feasible and well tolerated by patients.
Provoked seizures and status epilepticus in a pediatric population with COVID‐19 disease
Authors: Thongsing Apirada , Eizadkhah Donya , Fields Cheryl , Ballaban‐Gil Karen
Published: May 2022

We are reporting 16 pediatric patients (ages 0–18‐years‐old) who presented to our urban hospital emergency room with seizures and coronavirus disease 2019 (COVID‐19) during the surge of the Omicron variant. There was an increased number of pediatric patients with seizures and COVID‐19 during this period as compared to prior COVID‐19 surges. The 16 patients ranged in age from 3 months to 12 years of age. Five of the 16 patients (31%) had a prior history of epilepsy. Eight patients (50%) presented in status epilepticus, and in six patients (38%) the seizures appeared to have focal features. Fourteen patients (88%) presented with a complex provoked seizure defined as exhibiting either focality, seizure >5 min in length, or more than one seizure in 24 h. We suggest that in the pediatric population, when compared to prior variants of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), the Omicron variant is more likely to be associated with neurologic symptoms, including complex provoked seizures.
A snapshot of the economic benefits from foreign bottom trawling in coastal West Africa: A mutually‐beneficial trade in services, no winners or extractivism?
Authors: Virdin John , Vegh Tibor , Akester Stephen , Chu Jingjie , Baio Andrew , Hamilton Jill , Macias Javier , Matthiasson Steinar , Sherif Sheck , Grieco Dana I.
Published: May 2022

Large‐scale fishing effort in the waters of tropical and lower income countries is predominantly driven by ‘distant water fishing fleets’ often owned by companies based in a small number of countries and has been associated with a range of negative environmental and social outcomes. West Africa is an example where such fleets are a dominant feature. In the waters of Guinea‐Bissau, Guinea, Sierra Leone, Liberia and Ghana, 75% of all licensed bottom trawl vessels in 2017 either registered (‘flagged’) or largely owned in China. In this context, we examined the size and distribution of the economic outcomes from operation of these vessels in above five countries to better understand the impacts of these coastal states’ decision for allocating access to the distant water bottom trawl fleet. Based on analysis of heterogeneous sources of data, we estimate that in 2017 the China‐flagged or owned coastal bottom trawl fleets generated little to no net economic benefits in terms of resource rent for either the companies or the coastal states in Sierra Leone, Liberia and Ghana. Significantly higher economic benefits were generated from the offshore fishery in Guinea‐Bissau (US$31 million) and Guinea (US$25–38 million), largely captured by the companies owning the China‐flagged fleet. The size and distribution of the resource rent suggest that based solely of economic measures, the five coastal states may want to better assess the terms of these access arrangements for the foreign‐flagged or owned bottom trawl fleets. The fishing companies may need to reassess the sustainability of their operations, particularly in the southern states for long‐term economic benefits.
Platelet function testing: Current practice among clinical centres in Northern Europe
Authors: Szanto Timea , Zetterberg Eva , Ramström Sofia , Leinøe Eva B. , Holme Pål A. , Antovic Jovan P. , Holmström Margareta , Onundarson Pall T. , Pikta Marika , Vaide Ines , Olsson Anna , Magnusson Maria , Kärkkäinen Satu , Bitar Manar , Poulsen Lone Hvitfeldt , Lassila Riitta ,   the Nordic Haemophilia Council
Published: May 2022

Introduction

Platelet function tests are used to screen and diagnose patients with possible inherited platelet function defects (IPFD). Some acquired platelet dysfunction may be caused by certain drugs or comorbidities, which need to be excluded before testing.

Aims

To identify current practice among centres performing platelet function tests in Northern Europe.

Methods

A total of 14 clinical centres from Sweden (six), Finland (two), Denmark (two), Norway (one), Estonia (two) and Iceland (one) completed the survey questionnaire, the population capture area of about 29.5 million.

Results

Six of the 14 (42.8%) centres providing platelet function assessment represent comprehensive treatment centres (EUHANET status). A Bleeding score (BS) or ISTH bleeding assessment tool (ISTH BAT score) is evaluated in 11/14 (78.6%) centres and family history in all. Five/14 centres (35.7%) use structured preanalytical patient instructions, and 10/14 (71.4%) recorded questionnaire on the preassessment of avoidance of any drugs or natural products affecting platelet functions. Preliminary investigations of screening tests of coagulation are performed in 10/14 (71.4%), while in 4/14 (28.6%), the diagnostic work‐up of IPFD and von Willebrand disease (VWD) is performed simultaneously. The work‐up of IPFD includes peripheral blood smear in 10/14 (71.4%), platelet aggregometry in all, flow cytometry in 10/14 (71.4%) and Platelet Function Analysis (PFA) in 3/11 (28.6%). Molecular genetic diagnosis is available in 7/14 (50%) centres.

Conclusions

The considerable variability in the current practice illustrates the need for harmonization between the Northern European centres according to the international registers (i.e. EUHASS) and IPFD guidelines (ISTH, EHA).
Novel histological scoring for predicting disease outcome in primary sclerosing cholangitis
Authors: Sjöblom Nelli , Boyd Sonja , Kautiainen Hannu , Arola Johanna , Färkkilä Martti
Published: May 2022

Background

Primary sclerosing cholangitis (PSC) is a progressive cholestatic liver disease that may lead to liver cirrhosis or cholangiocarcinoma. Liver histology and fibrosis stage are predictive markers of disease progression, and histological cirrhosis is defined as a significant endpoint. PSC‐specific histological scoring methods are lacking at present. We aimed to develop a tailored classification system for PSC, the PSC histoscore, based on histological features associated with disease progression.

Methods

In total, 300 PSC patients diagnosed between 1988 and 2018 were enrolled; their data were collected from the PSC registry (Helsinki University Hospital), and liver specimens were obtained from the Biobank of Helsinki. Five histological features included in the adapted Nakanuma scoring system and three additional parameters typical for PSC histology were evaluated and compared with the clinical and laboratory data. A compound endpoint consisting of liver transplantation, development of cholangiocarcinoma, or death was used as outcome measurement.

Results

Stage (fibrosis, bile duct loss, ductular reaction, and chronic cholestasis) and grade (portal inflammation, portal edema, hepatitis activity, and cholangitis activity) parameters were found to be independent predictive risk factors for the compound endpoint (P < 0.001). High disease grade (2–6) and stage (2–4) better correlated with clinical endpoints when evaluated with the PSC histoscore system compared to the adapted Nakanuma classification. The risk for disease progression in sequential endoscopic retrograde cholangiography (ERC) examinations was increased with elevated total PSC histoscores.

Conclusion

The PSC histoscore is a novel histological classification system for PSC. Our findings support the applicability of liver histology as a marker for disease progression.
Bictegravir/emtricitabine/tenofovir alafenamide in older individuals with HIV: Results of a 96‐week, phase 3b, open‐label, switch trial in virologically suppressed people ≥65 years of age
Authors: Maggiolo Franco , Rizzardini Giuliano , Molina Jean‐Michel , Pulido Federico , De Wit Stephane , Vandekerckhove Linos , Berenguer Juan , D'Antoni Michelle L. , Blair Christiana , Chuck Susan K. , Piontkowsky David , Martin Hal , Haubrich Richard , McNicholl Ian R. , Gallant Joel
Published: May 2022

Objectives

Bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) is an effective treatment for HIV‐1 infection; however, clinical trial data in older people living with HIV (PLWH) are lacking. The primary 24‐week and secondary 48‐week analyses of study GS‐US‐380‐4449 (NCT03405935), which assessed the efficacy and safety of switching to B/F/TAF in older PLWH, have been published. Here we report the results of the final 96‐week analyses from the study.

Methods

In this 96‐week, phase 3b, open‐label, single‐arm trial, virologically suppressed PLWH aged ≥65 years switched from elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide or a tenofovir disoproxil fumarate‐based regimen to B/F/TAF. Viral suppression, resistance, immune response, safety, tolerability and adherence were evaluated through week 96.

Results

Of 90 participants screened, 86 were enrolled and switched to B/F/TAF. No participants had HIV‐1 RNA ≥50 copies/ml (by FDA Snapshot algorithm) at weeks 72 or 96; virologic suppression rates were 94.2% (81/86; 95% CI 87.0–98.1) and 74.4% (64/86; 95% CI 63.9–83.2), respectively. No treatment‐emergent resistance was observed, and CD4 counts remained stable. There were no study drug‐related serious adverse events. Three participants experienced drug‐related treatment‐emergent adverse events that led to premature drug discontinuation. There were no clinically relevant changes from baseline to week 96 in fasting lipid parameters, and the median change in body weight at week 96 was 0.0 kg (IQR −2.3, 2.0). Median self‐reported adherence was 100% (IQR 100–100%).

Conclusions

Switching to B/F/TAF is an effective long‐term option for virologically suppressed adults ≥65 years of age, with favourable safety and tolerability profiles in this population.
The intellectual capital supporting nurse practice in a post‐emergency state: A case study
Authors: Ridge Laura Jean , Liebermann Erica Jean , Stimpfel Amy Witkoski , Klar Robin Toft , Dickson Victoria Vaughan , Squires Allison Patricia
Published: May 2022

Aim

To explore the resources supporting current nurse practice in the post‐emergency country of Liberia, using the nursing intellectual capital framework, as nurses work to meet the targets set by Government of Liberia's Essential Package of Health Services.

Design

Case study.

Methods

Data were collected in Liberia February–June 2019. Direct observation, semi‐structured interviews and photographs were used to investigate how nurse practice is supported. Field notes, transcripts and photographs were coded using both directed and conventional content analysis. Reports were then generated by code to triangulate the data.

Results

Thirty‐seven nurses at 12 health facilities participated. The intellectual capital supporting inpatient and outpatient nurse practice differs in important ways. Inpatient nurse practice is more likely to be supported by facility‐based protocols and trainings, whereas outpatient nurse practice is more likely to be supported by external protocols and trainings, often developed by the Liberian government or non‐governmental organizations. This can lead to uneven provision of inpatient protocols and trainings, often favouring private facilities. Similarly, inpatient nurses rely primarily on other nurses at their facilities for clinical support while outpatient nurses often have external professional relationships that provided them with clinical guidance.

Conclusion

Much has been accomplished to enable outpatient nurses to provide the primary‐ and secondary‐care target services in the Essential Package of Health Services. However, as the Liberian government and its partners continue to work towards providing certain tertiary care services, developing analogous protocols, trainings and clinical mentorship networks for inpatient nurses will likely be fruitful, and will decrease the burden on individual facilities.

Impact

Nurses are often expected to meet new service provision targets in post‐emergency states. Further research into how best to support nurses as they work to meet those targets has the potential to strengthen health systems.
Niche and geographical expansions of North American trees and tall shrubs in Europe
Authors: Sychrová Martina , Divíšek Jan , Chytrý Milan , Pyšek Petr
Published: May 2022

Aim

We examine how the climatic niches of North American tree and tall‐shrub species change after their introduction to Europe and how these shifts affect their potential geographical distributions in the new range. We ask whether patterns of niche shifts differ among species confined to different biomes in North America and whether the expansions of species' climatic niches and potential distribution ranges are related to their residence time in Europe and native range size.

Location

North America and Europe.

Taxon

Vascular plants (trees and shrubs).

Methods

We used principal component analysis to quantify post‐introduction shifts in climatic niches of 59 species native to North America and alien to Europe. We modelled the expansions of their potential geographical ranges using Maxent. Differences in niche shifts and geographical expansion among species introduced from different biomes were tested using the Kruskal–Wallis test. Spearman correlation was used to relate niche and geographical expansions to residence time and native range size.

Results

Alien trees and tall shrubs introduced from North America to Europe exhibited greater niche stability and unfilling than niche expansion, except for the species from Coastal Plain forests. The latter species showed the largest niche and geographical expansions. Species with a small native range in North America introduced to Europe long ago were more likely to expand to new climatic conditions and geographical areas.

Main conclusions

We show that (i) most North American tree and tall‐shrub species introduced to Europe still do not occupy all areas with suitable climatic conditions in their secondary distribution range, but species from Coastal Plain forests tend to expand into areas with climates not found in their native ranges; (ii) the potential of the studied species to spread in Europe depends on the climatic conditions in the biome of origin, the size of their native range and the time since the first introduction.
Warmth and reciprocity with mothers, and young children's resilience to exposure to community violence in Colombia: findings from the La Sabana Parent–Child Study
Authors: Obando Diana , Wright Nicola , Hill Jonathan
Published: May 2022

Background

Exposure to community violence is common worldwide and is associated with emotional and behavioural problems in children. Little is known about sources of resilience. Building on our previous work on the contribution of callous‐unemotional (CU) traits to child aggression in Colombia, we examined whether positive parenting is protective for children whose families are exposed to community violence.

Methods

Families were recruited from three demographically contrasting regions of Colombia. The sample comprised 235 children aged 3.5 years and their mothers, of whom 220 (93%) were followed up at age 5.0 years. Positive parenting was assessed as the average of maternal warmth and reciprocity, and as praise, and negative parenting as the average of negative affect and conflict seen in video recordings of standardized procedures. CU traits and oppositional defiant disorder were assessed by maternal report at ages 3.5 and 5.0 years, and mothers reported exposure to community violence over the 18 months between assessments. A range of potential confounds was included in adjusted analyses.

Results

In the families who were exposed to community violence, but not in the unexposed, maternal warmth and reciprocity were associated prospectively with lower CU traits (interaction, p = .007). In the exposed group maternal warmth and reciprocity explained 10% of the variance (β = −.34, p = .001). Maternal praise was not associated with CU traits. Maternal negative parenting predicted higher CU traits as the main effect but not in interaction with community violence exposure.

Conclusions

Maternal warmth and reciprocity with young children may promote resilience in the face of community violence. Programmes to enhance these protective processes may be needed especially where prospects for reducing community violence are limited. The centrality of parents for these children highlights the plight of those exposed to community violence, and also either separated from parents or orphaned.
Combination of anti‐CD25 antibody and poly I:C treatment in pregnant NOD mice may be used as ‘pregnancy‐related’ type 1 diabetes model
Authors: Shimada Akira , Toda Kyoko , Inoue Ikuo , Yamada Taketo , Oikawa Yoichi
Published: May 2022

Aims/Introduction

Some women develop type 1 diabetes during pregnancy or immediately after delivery. However, the underlying pathophysiology remains largely unknown, probably because of the lack of a suitable animal model. In this study, we administered pregnant NOD mice with an anti‐CD25 antibody to reduce regulatory T cells along with poly I:C and examined the onset of diabetes.

Materials and Methods

Anti‐CD25 antibody and poly I:C were intraperitoneally administered to mated female NOD mice. Mice delivered within 3 weeks after the treatment, and the onset of diabetes during pregnancy or within 6 weeks after delivery was examined. Some mice were killed 1 week after treatment, and their spleen and pancreas were excised to examine the expression levels of cytokines and for histological examination.

Results

Half of the mice treated with anti‐CD25 antibody plus poly I:C developed diabetes, as compared with none of the poly I:C‐injected mice (P < 0.05). The ratios of interleukin‐18/forkhead box P3 and granzyme B/forkhead box P3 were higher in the pancreas of anti‐CD25 antibody plus poly I:C‐treated mice than in the pancreas of control mice. The insulitis score decreased in the pancreas of anti‐CD25 antibody plus poly I:C‐injected pregnant NOD mice.

Conclusions

We describe the use of anti‐CD25 antibody to reduce regulatory T cells and poly I:C as a Toll‐like receptor 3 stimulator to mimic viral infection in a pregnant NOD mouse, which can be used as a model of ‘pregnancy‐related’ type 1 diabetes.
Effects of induced voltage on pectin extraction from apple pomace compared with conventional heat extraction
Authors: Han Aye Myo , Yang Na , Jin Yamei , Ali Barkat , Xu Xueming
Published: May 2022

The induced voltage was applied to assist extracting the pectin from apple pomace. At an optimum voltage of 1200 V, frequency of 20 kHz within 20 min at 55°C, the pectin yield was higher (32.5%) when compared to conventional heat extraction (CHE) at 90°C for 2 h (16.6%). Meanwhile, the induced voltage‐assisted extraction's (IVAE) pectin had higher DE%, GalA%, acetyl value% and low molecular weight with well‐preserved color than those of CHE pectin. Its functional properties, such as water‐holding capacity (WHC) and oil holding capacity (OHC) had better performance than those of CHE pectin. The results for emulsifying activity and stability were also investigated for one month during the storage at 4°C and 25°C. Based on the observation of pomace morphology, its structure was punctured when subjected to this electrical effect. Comparing these two extraction methods, the IVAE method has proven to be a time‐saving and eco‐friendly process.
Implementation of an electronic solution to improve malnutrition identification and support clinical best practice
Authors: McCray Sally , Barsha Laura , Maunder Kirsty
Published: May 2022

Background

Routine malnutrition risk screening of patients is critical for optimal care and comprises part of the National Australian Hospital Standards. Identification of malnutrition also ensures reimbursement for hospitals to adequately treat these high‐risk patients. However, timely, accurate screening, assessment and coding of malnutrition remains suboptimal. The present study aimed to investigate manual and digital interventions to overcome barriers to malnutrition identification for improvements in the hospital setting.

Methods

Retrospective reporting on malnutrition identification processes was conducted through two stages: (1) manual auditing intervention and (2) development of a digital solution – the electronic malnutrition management solution (eMS). Repeated process audits were completed at approximately 6‐monthly intervals through both stages between 2016 and 2019 and the results were analysed. In Stage 2, time investment and staff adoption of the digital solution were measured.

Results

Overall, the combined effect of both regular auditing and use of the eMS resulted in statistically significant improvements across all six key measures: patients identified (97%–100%; p < 0.001), screened (68%–95%; p < 0.001), screened within 24 h (51%–89%; p < 0.001), assessed (72%–95%; p < 0.001), assessed within 24 h (66%–93%; p < 0.001) and coded (81%–100%; p = 0.017). The eMS demonstrated a reduction in screening time by over 60% with user adoption 100%. Data analytics enabled automated, real‐time auditing with a 95% reduction in time taken to audit.

Conclusions

A single digital solution for management of malnutrition and automation of auditing demonstrated significant improvements where manual or combinations of manual and electronic systems continue to fall short.
Clinical efficacy and safety of polynucleotides highly purified technology (PN‐HPT®) and cross‐linked hyaluronic acid for moderate to severe nasolabial folds: A prospective, randomized, exploratory study
Authors: Araco Antonino , Araco Francesco , Raichi Mauro
Published: May 2022

Introduction

The mandibular profile undergoes progressive wasting with aging, and the deepening of nasolabial folds (NLFs) has a leading role. Hyaluronic acid (HA) efficiently controls tissue hydration and permeability to small and large molecules. NLFs are an acknowledged HA target; at the same time, another class of agents, PN‐HPT® (Polynucleotides Highly Purified Technology), enjoy growing acknowledgement in aesthetic medicine. This exploratory, prospective study probed the rationale of sequentially associating PN‐HPT® as a first priming agent acting in the skin followed by HA dermal filler injections for correcting moderate to severe NLFs.

Methods

Following strict inclusion and exclusion criteria, the authors screened Caucasian ambulatory women aged 40–65 with moderate to severe NLFs and randomly selected two NLFs for each enrolled woman. Due to the purely explorative nature of the study, the authors initially planned to enroll no >10 women. According to a split‐face design, the selected right‐side NLFs received 4 ml of PN‐HPT® intradermally in the initial priming phase (“NLF Rx group”); the selected left‐side NLFs received 4 ml of saline (placebo) (“NLF Lx group”). After 3 and 6 weeks, all patients received 2 ml of subdermal cross‐linked HA over both NLF areas (4 ml overall). The total study follow‐up was 6 months after the first injection, with objective assessments, based on the qualitative and quantitative Antera 3D® and Vectra H2® skin imaging technologies, after 6 weeks and 3 and 6 months.

Results

Because of the favorable early outcomes, the authors let enrollment progress between January and June 2020 up to a total of 20 women and 40 NLFs. All treated women completed the six‐month follow‐up without reporting side effects, even clinically minor. The Antera 3D® device demonstrated that wrinkles and skin texture significantly improved in the NLF Rx after 6 weeks (monotherapy phase) and 3 and 6 months (PN‐HPT® priming + HA phase) compared with baseline. HA levels, measured with the quantitative Vectra H2® assessment technology in the right NLFs, were significantly higher than contralaterally at both 3 and 6 months.

Conclusions

Although conceived only as an exploratory investigation, the study confirmed that PN‐HPT® monotherapy might be a valuable and effective option to rapidly improve the skin dermis texture and quality in individuals with moderate to severe NLFs. Acting as a priming agent in the skin, PN‐HPT® prolong the clinical efficacy of cross‐linked HA. Well‐designed trials in larger treatment groups will hopefully confirm these early promising results.
Adults hospitalized with breakthrough COVID‐19 have lower mortality than matched unvaccinated adults
Authors: Myers Laura C. , Kipnis Patricia , Greene John , Lawson Brian , Escobar Gabriel J. , Fireman Bruce H. , Klein Nicola P. , Liu Vincent X.
Published: May 2022

Background

Coronavirus disease 2019 (COVID‐19) breakthrough infections are common.

Objective

Evaluate in‐hospital mortality of patients with COVID‐19 by vaccination status using retrospective cohort study.

Methods

We generated propensity scores for receipt of full vaccination in adults requiring supplemental oxygen hospitalized at Kaiser Permanente Northern California (1 April 2021 to 30 November 2021) with positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction tests. Optimal matching of fully vaccinated/unvaccinated patients was performed comparing in‐hospital mortality.

Results

Of 7305 patients, 1463 (20.0%) were full, 138 (1.9%) were partial, and 5704 (78.1%) were unvaccinated. Fully vaccinated were older than partial or unvaccinated (71.0, 63.0, and 54.0 years, respectively, p < 0.001) with more comorbidities (Comorbidity Point Scores 33.0, 22.0, and 10.0, p < 0.001) and immunosuppressant (11.5%, 8.7%, and 3.0%, p < 0.001) or chemotherapy exposure (2.8%, 0.7%, and 0.4%, p < 0.001). Fewer fully vaccinated patients died compared to matched unvaccinated (9.0% vs. 16.3%, p < 0.0001).

Conclusion

Fully vaccinated patients are less likely to die compared to matched unvaccinated patients.