bluuebunny/crossref_metadata_2025 huggingface dataset:
Uniportal video‐assisted thoracic surgery approach for simultaneous lung cancer and thymic carcinoma: Case report and literature review
Authors: Frasca Luca , Tacchi Giovanni , Longo Filippo , Marziali Valentina , De Peppo Valerio , Moscardelli Alessandro , Crucitti Pierfilippo
Published: December 2021

Thymic carcinoma is an epithelial tumor derived from thymic epithelial cells. Thymic tumors may be associated with other simultaneous and/or metachronous extra‐thymic tumors (e.g., lung cancer). Here, we report a case of simultaneous surgical management of lung and mediastinal neoplasm together with a review of the literature. During radiological follow‐up for prostate and colorectal cancer, an 82‐year‐old man was diagnosed with lung cancer with simultaneous mediastinal suspected neoplasm. Both were surgically removed with a single intervention performed via a uniportal video‐assisted thoracic surgery (uni‐VATS) approach. The literature emphasizes how extra‐thymic cancer can be diagnosed before, concurrently and consecutively with thymic neoplasia. The surgical treatment of such simultaneous cancer is challenging. We succeeded in the excision of both neoplasia with a mini‐invasive surgical technique. This report highlights the feasibility of uniportal VATS in a patient with very unusual clinical and oncological history.
Soil type, vegetation cover and temperature determinants of the diversity and structure of dung beetle assemblages in a South African open woodland and closed canopy mosaic
Authors: Daniel Gimo M. , Noriega Jorge Ari , da Silva Pedro G. , Deschodt Christian M. , Sole Catherine L. , Scholtz Clarke H. , Davis Adrian L. V.
Published: December 2021

Regional biogeographical patterns result from a complex combination across habitat, climate and environmental variables. Biotic and abiotic variables strongly influence the diversity and spatial distribution patterns. However, very few studies analyse the close interaction and effect of environmental variables on diversity at fine spatiotemporal scales. In this study, we evaluated the influence of soil type, vegetation cover and temperature on species diversity and functional structure of dung beetle assemblages. Dung beetle species were sampled using pitfall traps baited with cattle dung from sandy and clay soils in open woodland and closed canopy areas in Mkhuze Game Reserve, KwaZulu‐Natal, South Africa. We performed a PERMANOVA, a PERMDISP and an NMDS to analyse differences in species composition between soil and vegetation cover types. To test the effect of environmental variables on species richness and abundance, we performed a generalised least squares model. Lastly, we searched for nodes using a bipartite analysis to evaluate network’s potential modularity. We collected 1439 specimens comprising 27 species and 13 genera. Species composition differed between environmental variables. Soil type was the most important driver for changes in dung beetle species composition. Species richness and abundance were influenced by the interaction between soil type and vegetation cover. The combination of microenvironmental preferences potentially influenced the dung beetle assemblage diversity and functional structure. Combining all these preferences may act as a dilution mechanism of interspecific competition in saturated habitat conditions, reducing the number of species that potentially interact and generating a modular network structure of the assemblage.
Developing online training in using music for carers of people with dementia: A focus group study
Authors: Garrido Sandra , Markwell Holly , Andreallo Fiona , Hatcher Deborah
Published: December 2021

Objective

This study aimed to identify the core content and design issues in developing an online training course in the effective use of music for people with dementia.

Methods

A co‐design approach was taken in which focus groups were conducted with aged care staff and family caregivers (n = 17; 76.5% female). A general inductive approach was taken to data analysis. The consolidated criteria for reporting qualitative research (COREQ) guidelines were followed to ensure rigour in this study.

Results

Participants identified five core concepts for inclusion in the training program including the benefits of music, the need to assess for vulnerability to negative responses, music selection strategies, timing of use and equipment selection. Themes on design and implementation such as the need for role‐specific content for care staff at all levels and scenario‐based learning were identified.

Conclusions

The development of online training in music use for carers of people with dementia needs to consider the demands on carers and develop training that is informative and engaging without placing large time demands on the user. Support at a management and executive level will be important to the implementation of such training in residential aged care contexts.
Border Orientation in a Globalizing World
Authors: Simmons Beth A. , Kenwick Michael R.
Published: December 2021

Border politics are a salient component of high international politics. States are increasingly building infrastructure to ‘‘secure’’ their borders. We introduce the concept of border orientation to describe the extent to which the state is committed to the spatial display of capacities to control the terms of penetration of its national borders. Border orientation provides a lens through which to analyze resistance to globalization, growing populism, and the consequences of intensified border politics. We measure border orientation using novel, geospatial data on the built environment along the world's borders and theorize that real and perceived pressures of globalization have resulted in more controlling forms of border governance. Empirical evidence supports this claim: States build more along their borders when faced with economic, cultural, and security‐based anxieties. Border orientation enhances the study of border politics, complementing the politics of territorial division with a richer politics of liminal securitization and its consequences.
Glucose participates in the formation of goose fatty liver by regulating the expression of miRNA‐33/CROT
Authors: Lin Xiao , Xing Ya , Zhang Yihui , Dong Biao , Zhao Minmeng , Wang Jian , Geng Tuoyu , Gong Daoqing , Zheng Yun , Liu Long
Published: December 2021

Glucose oversupply promotes formation of fatty liver, and fatty liver is usually accompanied with hyperglycemia. However, the mechanism by which glucose promotes formation of fatty liver is not very clear. In this study, fatty liver was successfully induced in Landes goose by 19 days of overfeeding with corn‐based feed, the overfed geese had a significantly higher level of blood glucose than the normally fed geese (control group). In goose primary liver cells, high level of glucose promoted fat deposition and induced the expression of SREBF2(or SREBP2), a key regulator of lipid metabolism, and its intronic gene, miR‐33. Moreover, overexpression of miRNA‐33(miR‐33) promotes lipid accumulation in goose primary liver cells. Consistently, miR‐33 inhibitor suppressed glucose induced lipid accumulation in liver cells. Interestingly, the relative abundance of miR‐33 in goose fatty liver was significantly higher than that in normal liver, while the relative mRNA and protein abundances of CROT, the target gene of miR‐33, in goose fatty liver were significantly lower than those in goose normal liver. Taken together, these findings suggest that miR‐33 mediates glucose promotion of lipid accumulation in goose primary liver cells, and that glucose participates in formation of goose fatty liver by regulating the expression of miR‐33/CROT.
Prognostic impact of TP53 mutation in newly diagnosed diffuse large B‐cell lymphoma patients treated in the FIL‐DLCL04 trial
Authors: Chiappella Annalisa , Diop Fary , Agostinelli Claudio , Novo Mattia , Nassi Luca , Evangelista Andrea , Ciccone Giovannino , Di Rocco Alice , Martelli Maurizio , Melle Federica , Moia Riccardo , Motta Giovanna , Righi Simona , Santambrogio Elisa , Tucci Alessandra , Balzarotti Monica , Ladetto Marco , Pileri Stefano A. , Gaidano Gianluca , Vitolo Umberto ,   Fondazione Italiana Linfomi (FIL)
Published: December 2021

The prognostic role of TP53 disruption has been established in diffuse large B‐cell lymphoma (DLBCL). Aim of this analysis was to correlate TP53 mutations by Sanger sequencing, cell of origin (COO) profile by Lymph2Cx panel on the NanoString platform and MYC, BCL2 and BCL6 overexpression or re‐arrangements by immunohistochemistry (IHC) and fluorescent in‐situ hybridization (FISH), with outcome in DLBCL patients enrolled into the FIL‐DLCL04 trial (NCT00499018). One hundred and twenty‐five DLBCL patients with tumour block available were analyzed. TP53 was mutated in 11/125 (9%) cases; 60/125 patients received high‐dose chemoimmunotherapy up‐front, as for the randomization arm; COO was reported in 88 patients: 48 germinal centre B‐cell like, 25 activated B‐cell like and 17 unclassified; 26 patients were double expressors in IHC and 11 double hit in FISH. After a median follow‐up of 72 months, five‐year failure‐free survival (FFS) for TP53 mutated versus wild‐type was 24% and 72%, and five‐year overall survival (OS) was 34% and 83%, respectively. Adjusted hazard ratio (HR) was 2·28 [95% confidence interval (CI) 0·89–5·86, p = 0·086] and 4·05 (95% CI 1·37–11·97, p = 0·011) for FFS and OS, respectively. In this series of young DLBCL patients, TP53 gene mutation identified a poor prognosis subgroup, regardless of treatment and other biological markers.
The role of the mineralocorticoid receptor in immune cells in cardiovascular disease
Authors: van der Heijden Charlotte D. C. C. , Bode Marlies , Riksen Niels P. , Wenzel Ulrich O.
Published: December 2021

Chronic low‐grade inflammation and immune cell activation are important mechanisms in the pathophysiology of cardiovascular disease (CVD). Therefore, targeted immunosuppression is a promising novel therapy to reduce cardiovascular risk. In this review, we identify the mineralocorticoid receptor (MR) on immune cells as a potential target to modulate inflammation. The MR is present in almost all cells of the cardiovascular system, including immune cells. Activation of the MRs in innate and adaptive immune cells induces inflammation which can contribute to CVD, by inducing endothelial dysfunction and hypertension. Moreover, it accelerates atherosclerotic plaque formation and destabilization and impairs tissue regeneration after ischaemic events. Identifying the molecular targets for these non‐renal actions of the MR provides promising novel cardiovascular drug targets for mineralocorticoid receptor antagonists (MRAs), which are currently mainly applied in hypertension and heart failure.

LINKED ARTICLES

This article is part of a themed issue on Emerging Fields for Therapeutic Targeting of the Aldosterone‐Mineralocorticoid Receptor Signaling Pathway. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v179.13/issuetoc
Commentary: The Signal and the Noise—questioning the benefits of puberty blockers for youth with gender dysphoria—a commentary on Rew et al. (2021)
Authors: Clayton Alison , Malone William J. , Clarke Patrick , Mason Julia , D’Angelo Roberto
Published: December 2021

This commentary is a critique of a recent systematic review of the evidence for the use of puberty blockers for youth with gender dysphoria (GD) by Rew et al. (2021). In our view, the review suffers from several methodological oversights including the omission of relevant studies and suboptimal analysis of the quality of the included studies. This has resulted in an incomplete and incorrect assessment of the evidence base for the use of puberty blockers. We find that Rew et al.’s conclusions and clinician recommendations are problematic, especially when discussing suicidality. A key message of the review’s abstract appears to be that puberty blockers administered in childhood reduce adult suicidality. However, the study used for the basis of this conclusion (Turban et al., 2020) did not make a causal claim between puberty blockers and decreased adult suicidality. Rather, it reported a negative association between using puberty blockers and lifetime suicidal ideation. The study design did not allow for determination of causation. Our commentary concludes by demonstrating how the GD medical literature, as it moves from one publication to the next, can overstate the evidence underpinning clinical practice recommendations for youth with GD.
Discovery of a novel and orally active Farnesoid X receptor agonist for the protection of acetaminophen‐induced hepatotoxicity
Authors: Cai Zongyu , Wang Bin , Zhou Zongtao , Zhao Xin , Hu Lijun , Ren Qiang , Deng Liming , Li Zheng , Wang Guangji
Published: December 2021

Acetaminophen (APAP) overdose is a leading cause of acute hepatic failure and liver transplantation, while the existing treatments are poorly effective. Therefore, it is necessary to develop effective therapeutic drugs for APAP‐induced hepatotoxicity. Farnesoid X receptor (FXR) is a potential target for the treatment of liver disease, and the activation of FXR protects mice against APAP‐induced hepatotoxicity. Compound 5, a glycine‐conjugated derivative of FXR agonist 4, was designed to extend the chemical space of existing FXR agonists. Molecular modeling study indicated that compound 5 formed hydrogen bond network with key residues of FXR. Moreover, compound 5 (10 mg/kg) revealed better protective effects against APAP‐induced hepatotoxicity than parent compound 4 (30 mg/kg). Further mechanical research indicated that compound 5 regulated the expressions of genes related to FXR and oxidative stress. These findings suggest that compound 5 is a promising FXR agonist suitable for further research, and it is the first time to verify that the glycine‐conjugated derivative five exerted better protective effects than its parent compound.
Genetics of monogenic disorders of calcium and bone metabolism
Authors: Newey Paul J. , Hannan Fadil M. , Wilson Abbie , Thakker Rajesh V.
Published: December 2021

Disorders of calcium homeostasis are the most frequent metabolic bone and mineral disease encountered by endocrinologists. These disorders usually manifest as primary hyperparathyroidism (PHPT) or hypoparathyroidism (HP), which have a monogenic aetiology in 5%–10% of cases, and may occur as an isolated endocrinopathy, or as part of a complex syndrome. The recognition and diagnosis of these disorders is important to facilitate the most appropriate management of the patient, with regard to both the calcium‐related phenotype and any associated clinical features, and also to allow the identification of other family members who may be at risk of disease. Genetic testing forms an important tool in the investigation of PHPT and HP patients and is usually reserved for those deemed to be an increased risk of a monogenic disorder. However, identifying those suitable for testing requires a thorough clinical evaluation of the patient, as well as an understanding of the diversity of relevant phenotypes and their genetic basis. This review aims to provide an overview of the genetic basis of monogenic metabolic bone and mineral disorders, primarily focusing on those associated with abnormal calcium homeostasis, and aims to provide a practical guide to the implementation of genetic testing in the clinic.
Enzymatic synthesis of sodium alginate‐g‐poly (acrylic acid) grafting copolymers as a novel printing thickener
Authors: Zhang Nan , Tian Zhensheng , Yu Yuanyuan , Wang Ping , Zhou Man , Wang Qiang
Published: December 2021

Grafting modification is a common method for improving the specific properties of polysaccharides. Herein, we synthesised sodium alginate‐g‐poly (acrylic acid) (NaAlg‐g‐PAA) as a novel printing thickener via catalysis of horseradish peroxidase and hydrogen peroxide in the presence of acetylacetone. The synthesised products were characterised by Fourier Transform–infrared spectroscopy and polar nuclear magnetic resonance spectroscopy, which confirmed that the PAA was successfully grafted onto the hydroxyl groups at carbon atoms (C2) of sodium alginate. The optimal grafting percentage and grafting efficiency reached 51% and 96%, respectively. Compared with native sodium alginate, the grafted copolymer NaAlg‐g‐PAA exhibited better thermal stability, rheological and printing properties. This work provides an efficient and promising approach for modifying polysaccharides like alginates and could be used as an alternative to conventional chemical modification.
Kidney transplant outcomes among recipients with post‐transplant hip or knee joint replacement surgery
Authors: Dodin Ban , Breyer Isabel , Osman Fauzia , Alstott James , Aziz Fahad , Garg Neetika , Mohamed Maha , Mandelbrot Didier , Djamali Arjang , Parajuli Sandesh
Published: December 2021

Introduction

Patients with end‐stage renal disease (ESRD) are at a higher risk of needing hip or knee replacement (joint replacement) surgery due to the high prevalence of degenerative joint disease and other conditions. However, there remains a large debate about the timing of joint replacement surgery and whether it should be pre‐ vs post‐transplant.

Methods

We conducted a retrospective study analyzing all adult kidney transplant recipients (KTRs) at our university hospital who had undergone subsequent joint replacement between 2001 and 2017. Transplant‐specific outcomes of acute rejection, death censored graft failure (DCGF), and patient death post‐joint replacement surgery were outcomes of interest. Controls were selected at a 1:3 ratio based on the incidence density sampling of post‐transplant interval.

Results

There were 101 KTRs in the joint replacement group and were compared with 281 controls. In the multivariate analysis, the need for joint replacement was not associated with acute rejection (HR: 1.59; 95% CI: 0.77‐3.29; P = 0.21); DCGF (HR: 0.89; 95% CI: 0.49‐1.60; P = 0.70) or patient death (HR: 0.84, 95% CI: 0.55‐1.38, P = 0.42).

Conclusion

In selected KTRs, joint replacement surgery was not associated with detrimental transplant‐specific outcomes.
The change in glycaemic control immediately after COVID‐19 vaccination in people with type 1 diabetes
Authors: Heald Adrian H. , Stedman Michael , Horne Linda , Rea Rustam , Whyte Martin , Gibson J. Martin , Anderson Simon G. , Ollier Willam
Published: December 2021

Aims

Evidence suggests that some people with type 1 diabetes mellitus (T1DM) experience temporary instability of blood glucose (BG) levels after COVID‐19 vaccination. We aimed to assess this objectively.

Methods

We examined the interstitial glucose profile of 97 consecutive adults (age ≥ 18 years) with T1DM using the FreeStyle Libre® flash glucose monitor in the periods immediately before and after their first COVID‐19 vaccination. The primary outcome measure was percentage (%) interstitial glucose readings within the target range 3.9–10 mmol/L for 7 days prior to the vaccination and the 7 days after the vaccination. Data are mean ± standard error.

Results

There was a significant decrease in the % interstitial glucose on target (3.9–10.0) for the 7 days following vaccination (mean 52.2% ± 2.0%) versus pre‐COVID‐19 vaccination (mean 55.0% ± 2.0%) (p = 0.030). 58% of individuals with T1DM showed a reduction in the 'time in target range' in the week after vaccination. 30% showed a decrease of time within the target range of over 10%, and 10% showed a decrease in time within target range of over 20%. The change in interstitial glucose proportion on target in the week following vaccination was most pronounced for people taking metformin/dapagliflozin + basal bolus insulin (change −7.6%) and for people with HbA1c below the median (change −5.7%).

Conclusion

In T1DM, we have shown that initial COVID‐19 vaccination can cause temporary perturbation of interstitial glucose, with this effect more pronounced in people talking oral hypoglycaemic medication plus insulin, and when HbA1c is lower.
Fringe banking and financialization: Pawnbroking in pre‐famine and famine Ireland
Authors: McLaughlin Eoin , Pecchenino Rowena
Published: December 2021

Pawnbroking, one of the oldest and most accessible forms of credit, was a common feature of life in pre‐famine and famine Ireland. This article studies the role of pawnbroking in the Irish financial system during this important period, applying insights from modern studies on fringe banking. In the period under study, a formal tiered financial system existed; regulated joint‐stock banks offered services to industry and the better off, while fringe banks provided financial services largely, but not exclusively, to unbanked groups. The main findings are that pawnbrokers provided a steady source of credit throughout the island of Ireland and that this credit stream was more durable than that provided by alternative financial service providers in the fringe banking market, especially during the famine. Our findings suggest a nuanced interpretation is needed as we find strong interrelationships between the various financial service providers.
Clinical decision‐making in complex endodontic cases between postgraduate students across dental specialties at a UK dental school: A pilot study
Authors: Liew Jonathan , Zainal Abidin Imran , Cook Neil , Kanagasingam Shalini
Published: December 2021

Introduction

Treatment decisions for a heavily restored endodontically treated tooth vary amongst clinicians owing to multitude of factors. This phenomenon not only often poses dilemmas to clinicians of different clinical backgrounds, but also exerts a degree of treatment difficulty to the treating clinician. Previous studies indicated that specialty training and clinical experience significantly impacted clinical decision‐making process.

Materials and methods

Master of Science postgraduate students in endodontics, prosthodontics, periodontics, oral surgery and implantology participated in a questionnaire‐based cross‐sectional study. The dental specialties were further categorised into restorative and surgical dentistry. A multiple‐choice questionnaire with three clinical cases was distributed to the students. Data were analysed for trends using descriptive statistics.

Results

There was a 44% response rate; the majority of respondents were from restorative dentistry specialties. Cases 1 and 2 were rated as moderate to high difficulty, and Case 3 was predominantly rated as high difficulty with procedure predictability being the main factor affecting their clinical decision‐making in three cases. Endodontic retreatment was selected as the preferred treatment in Cases 1 and 2 and periradicular surgery in Case 3. The students were fairly confident in managing Cases 1 and 2, but not in Case 3. Referral patterns were consistent in Cases 1 and 2 with endodontists being the first choice of referral except for Case 3 where 48% preferred to refer to oral surgeons and 35% choosing endodontists. Some indication of differences between specialties were noted throughout. Years in practice appeared to be related to the importance of predictability in Case 3 only.

Conclusion

Considerable inter‐clinician variability was noted whereby specialty postgraduate training impacted on clinical decision‐making. Overall, procedural predictability, technical difficulty, risk of damage to the tooth and patient preference were the most highly ranked factors affecting clinical decision‐making. Evidence‐based treatment guidelines and dental curricula should be reviewed to enhance inter‐clinician agreement in clinical decision‐making, ultimately improving patient care.
Dental students’ attitude towards propranolol non‐medical use: A multi‐institutional cross‐sectional study in Riyadh, Saudi Arabia
Authors: Tounsi Abrar A , Alnowaiser Alhanouf , Alsuhibani Amal , Alsadhan Lama , Hamdan Hebah M
Published: December 2021

Introduction

The lives of college students are full of various stressors. Students seek a number of stress‐relieving modalities as self‐prescribed beta‐blockers to improve their academic performance. The aim of this study was to assess the extent of beta‐blockers (propranolol) usage amongst Saudi dental students and their attitude towards its use to enhance academic performance.

Methods

A cross‐sectional study involving a convenient sample was conducted on a group of undergraduate dental students enrolled in Riyadh dental schools during the academic year of 2019/2020. A paper format closed‐ended questionnaire was used.

Results

A sample of 680 students participated in the survey (43% response rate). Approximately 12% of dental students used propranolol for non‐medical reasons. The prevalence did not differ significantly with the gender or year of study. A significantly higher percentage of students from private dental schools reported using propranolol for non‐medical reasons (odds ratio (OR), 3.1; 95% confidence interval (CI), 1.7–5.4; p < .001). Propranolol users were significantly more likely to connect with other students using the medication. Both students, those who used and those who did not use propranolol, similarly, highly endorsed the need for being informed about the risk of using propranolol. Compared with non‐users, there was more disagreement amongst propranolol users on the necessity for placing school regulations controlling medication use.

Conclusion

The use of propranolol to enhance academic performance amongst dental students in Saudi Arabia should not be disregarded. The study findings emphasise the importance of regulating students’ usage of beta‐blockers to promote a fair academic environment.
International branch campuses of Chinese universities in Europe: Motivations, governance and challenges
Authors: Zhang Mengqi , You Zheng
Published: December 2021

This article presents two Chinese international branch campuses located in Europe as cases. Semi‐structured interviews and document analysis were undertaken to clarify the motivations of establishing international branch campuses, their governance models, and operational challenges. We found that authorities' regulatory policies and public norms impact the decision making of Chinese universities. Universities are also eager to uphold their vision of internationalisation, opening up, through the establishment of international branch campuses. The governance of Chinese international branch campuses mainly depends on bilateral cooperation rather than on adoption of the host or home university's governance modus operandi, which indicates a kind of transitional approach. Joint decision‐making, limited financial resources and institutional distance between the home and host universities have led to a type of balance seeking programme operation, that seeks to accommodate both Chinese policies, institutional practices as well as European higher education practices and policies. Overall, the self‐proclaimed orientation of Chinese international branch campuses in Europe has not yet been fully achieved, and a series of ongoing issues remains to be resolved.
A comparative study on periodontitis and periodontitis‐associated bacteria in Somali and non‐Somali children and adolescents living in Trollhättan, Sweden
Authors: Thorbert‐Mros Sara , Ali Nawal , Ali Meis , Ayas Mert , Trullenque‐Eriksson Anna , Dahlén Gunnar
Published: December 2021

The reported prevalence of periodontitis in children and adolescents varies considerably between populations globally. This cross‐sectional study compares clinical and microbiological findings on 83 Somali immigrants and 96 non‐Somali children aged 10–17 years old living in Trollhättan, Sweden. The clinical examination included registration of bleeding on probing, plaque, and calculus on incisors and first molars. The distance between cemento‐enamel junction and bone level was measured on bitewing radiographs. Pooled microbiological samples (1 μL) were taken from the mesial surface of 16, 11, 31, 36, and analyzed by culture and real‐time polymerase chain reaction for seven periodontal associated bacterial species. The Somali participants had poorer oral hygiene and more bleeding, plaque, and calculus. Ten of the Somali but none of the non‐Somali participants showed periodontal breakdown (radiographical bone loss > 3 mm), corresponding to a prevalence of 12% (95% CI: 5.9, 21.0%). The presence of A. actinomycetemcomitans was almost exclusively associated with Somali participants. Further, the JP2 clone was found in five Somalis (including two periodontitis cases) confirming the association of this clone with African populations. The Somali group showed significantly higher frequencies and numbers of Porphyromonas gingivalis and Treponema denticola, implying a mature and adult type of subgingival microbiota.
Anticipating Connectivity in (UX) Design Practices: Reframing Challenges by Introducing Theory Cards
Authors: KJÆRSGAARD METTE GISLEV , MOSLEH WAFA SAID , BUUR JACOB , SORENSON JESSICA
Published: December 2021

This paper presents a design anthropological study with User Experience design departments from five large companies in Denmark, ranging from manufacturers of medical equipment through toys to control systems for industrial infrastructures We explore the challenges they face as products, services, and user research are increasingly connected. Our research shows that current methods, development processes, and organizational structures do not sufficiently support User Experience design teams in dealing with emerging design and organizational challenges that follow from increased digitalization. As a result, UX designers are struggling to anticipate the future of product interaction, user data, and their organizational role. In this paper, we explore how playing with theoretical concepts and introducing a new vocabulary may facilitate fundamental shifts in perspective necessary to instigate change. We deploy ‘theory cards’ in an experiment with one of the companies to see if theories might serve as instruments for seeing field material and design problems in ways more supportive for future design endeavours.
Black and (thin) blue (line): Corruption and other political determinants of police killings in America
Authors: Dincer Oguzhan , Johnston Michael
Published: December 2021

Police violence is not uncommon in America, and the risk of civilians' being killed by police is considerably higher here than in similar countries, making it a major public health issue. For Black Americans the risk is significantly higher. In this study, we analyze the political determinants of police killings of Black Americans, with a specific focus on corruption in American states. Our evidence suggests that police can kill Black Americans with impunity because of a lack of accountability—exemplified by corruption—that is largely determined by political influences. Our findings point to ways in which the responsibility for police violence and killings is deeply rooted and influenced by the values of the wider society.
Swallowing the pill of adverse effects: A qualitative study of patients' and pharmacists' experiences and decision‐making regarding the adverse effects of chronic pain medications
Authors: Dassieu Lise , Paul‐Savoie Emilie , Develay Élise , Villela Guilhon Ana Cecilia , Lacasse Anaïs , Guénette Line , Perreault Kadija , Beaudry Hélène , Dupuis Laurent ,   the Quebec Consortium on Adverse Effects of Pain Medications
Published: December 2021

Introduction

Pharmacological treatments of chronic pain can lead to numerous and sometimes serious adverse effects. Drawing on a social science approach to chronic illness, this study aimed to understand the experiences of people living with chronic pain and community pharmacists regarding the definition, prevention and management of analgesic adverse effects.

Methods

This qualitative study proceeded through 12 online focus groups (FGs) with people living with chronic pain (n = 26) and community pharmacists (n = 19), conducted between July 2020 and February 2021 in the province of Quebec, Canada. The semistructured discussion guides covered participants' definitions of adverse effects and decision‐making regarding their prevention and management. Discussions were audio‐recorded, transcribed verbatim and analysed using grounded theory.

Results

Both people with chronic pain and pharmacists provided varying definitions of analgesic adverse effects depending on patients' social and clinical characteristics. Present quality of life and serious long‐term risks related to treatment were described as key dimensions influencing adverse effect appraisal. Dilemmas and discrepancies occurred between patients and pharmacists when choosing to prioritize pain relief or adverse effect prevention. Some patients lacked information about their medications and wanted to be more involved in decisions, while many pharmacists were concerned by patients' self‐management of adverse effects. Preventing opioid‐related overdoses often led pharmacists to policing practices. Despite most pharmacists wishing they could have a key role in the management of pain and adverse effects face organizational and financial barriers.

Conclusion

Defining, preventing and managing adverse effects in the treatment of chronic pain requires a person‐centred approach and shared decision‐making. Clinical training improvements and healthcare organization changes are needed to support pharmacists in providing patients with community‐based follow‐up and reliable information about the adverse effects of chronic pain treatments.

Patient or Public Contribution

A person with lived experience of chronic pain was involved as a coinvestigator in the study. He contributed to shaping the study design and objectives, including major methodological decisions such as the choice of pharmacists as the most appropriate professionals to investigate. In addition, 26 individuals with chronic pain shared their experiences extensively during the FGs.
Adolescents encouraging healthy lifestyles through a peer‐led social marketing intervention: Training and key competencies learned by peer leaders
Authors: Llauradó Elisabet , Aceves‐Martins Magaly , Prades‐Tena Jordi , Besora‐Moreno Maria , Papell‐Garcia Ignasi , Giralt Montse , Davies Amy , Tarro Lucia , Solà Rosa
Published: December 2021

Background

Adolescents who participate as peer leaders can benefit and acquire competencies from their peer leadership experience.

Objectives

To identify the competencies gained by adolescents who participated as peer leaders in a healthy lifestyle study and to determine whether the training characteristics were related to improvement in competencies.

Design

The present study was part of the European Youth Tackling Obesity (EYTO) project, a multicentre social marketing intervention involving four European countries.

Setting and Participants

Eighteen peer leaders (aged 13–15 years, three or five leaders per country) from disadvantaged neighbourhoods received training in designing and implementing activities for their peers.

Measures

The peer leaders' confidence, experience and interest in 11 tasks related to lifelong learning competencies were assessed with questions rated on a colour scale at baseline and at the end of the study.

Results

The peer leaders demonstrated improvements in experience, confidence and interest in different tasks, such as research, website or logo design, oral presentations, social media use and collaboration with people from other countries. They increased their confidence in management tasks (p = 0.03) and their confidence and experience in communication tasks (p = 0.01). The peer leaders from Spain and Portugal had greater improvements than those from the other countries.

Conclusion

The peer leaders improved their confidence in management tasks and their confidence and experience in communication tasks. Slight differences were detected in improvement in competencies by country, likely due to the differences in the peer training applied. Recommendations for peer leader training are proposed, although these results should be verified with larger sample size.

Patient or Public Contribution

The peer leaders contributed to the design and implementation of the training and intervention.
Artificial intelligence for histological subtype classification of breast cancer: combining multi‐scale feature maps and the recurrent attention model
Authors: Li Junjie , Mi Weiming , Guo Yucheng , Ren Xinyu , Fu Hao , Zhang Tao , Zou Hao , Liang Zhiyong
Published: December 2021

Aims

The aim of this study was to apply a two‐stage deep model combining multi‐scale feature maps and the recurrent attention model (RAM) to assist with the pathological diagnosis of breast cancer histological subtypes by the use of whole slide images (WSIs).

Methods and results

In this article, we propose an integrated framework combining multi‐scale feature maps from Inception V3 and the recurrent attention model to classify the six histological subtypes of breast cancer. This model was trained with 194 WSIs, and on 63 validation WSIs the model achieved accuracies of 0.9030 for patch‐level classification and 0.8889 for WSI‐level classification. In the testing stage, a total of 65 WSIs were used to achieve an accuracy of 0.8462 without any form of data curation. The t‐distributed stochastic neighbour embedding showed that features extracted by the feature network of the RAM from WSIs of the same category can cluster together after training, and the visualization of decision steps showed that the decision‐making glimpses are focused on the middle tumour area of an example from test WSIs. Finally, the false classification patches indicated that the morphological similarities between tumour tissues of different subtypes or non‐tumour tissues and tumour tissues in patches might contribute to misclassification.

Conclusions

This model can imitate the diagnostic process of pathologists, pay attention to a series of local features on the pathology image, and summarize related information, in order to accurately classify breast cancer into its histological subtypes, which is important for treatment and prognosis.
Occupational stress, dyadic adjustment and quality of work‐life in married nurses: Moderating effects of dyadic coping
Authors: Fallahchai Reza
Published: December 2021

Aims

This study aimed to evaluate whether stress communication and supportive dyadic coping moderate the effects of occupational stress on dyadic adjustment and the quality of work‐life of nurses.

Background

Nurses are at higher risk for occupational stress, work–family conflict, and the challenge of balancing job and family roles. However, in recent studies, the impact of dyadic coping strategies in dealing with work–family stress in those couples has not received adequate attention.

Design

This study was a cross‐sectional study.

Methods

The research sample comprised 591 nurses recruited through announcements in hospitals and health centres in Iran between May 2018 and February 2019. They completed the Expanded Nursing Stress Scale, the Dyadic Coping Inventory, the Dyadic Adjustment Scale, and the Quality of Nursing Work Life questionnaire. Hierarchical regression was utilized.

Results

Results indicated that there was a negative relationship between occupational stress and dyadic adjustment, and quality of work‐life. Stress communication and supportive dyadic coping moderated the association between occupational stress and dyadic adjustment as well as the quality of work‐life.

Conclusion

The current findings suggest that the nurses who use dyadic coping strategies to deal with occupational stress report a higher level of adjustment and quality of work‐life.
Diagnosis and treatment guideline for Chinese medicine on acute trachea‐bronchitis
Authors: Li Jiansheng , Chen Yaolong , Yu Xueqing , Xie Yang , Li Xuanlin ,   Diagnosis and Treatment Guideline for Chinese Medicine on Acute Trachea‐Bronchitis working team, Respiratory Disease Branch of China Association of Chinese Medicine, Respiratory Disease Branch of China Medical Association of Minorities
Published: December 2021

Chinese medicine (CM) has significant clinical effects in the treatment of trachea‐bronchitis. It is of important clinical significance to formulate guidelines for the diagnosis and treatment of tracheal‐bronchitis based on the characteristics of TCM syndrome differentiation. The Respiratory Disease Branch of China Association of Chinese Medicine and Respiratory Disease Branch of China Medical Association of Minorities have organized and established a multidisciplinary working group, based on the World Health Organization Handbook for Guideline Development and the Guideline Development Handbook for Diagnosis and Therapy of Integrative Medicine to develop this guideline. It has been developed through technical links such as clinical problem investigation, evidence collection and evaluation, Delphi method, and expert consensus meetings. Based on the current best evidence, CM intervention costs and expert experience, 25 recommendations were established to standardize the etiology and pathogenesis of tracheal‐bronchitis, syndrome differentiation and treatment, prevention, and care, etc., which can be used by respiratory physicians at all levels of TCM medical institutions.
A method of fabricating computer aided design‐computer aided manufacturing implant‐supported provisional restorations with clear aligner attachments: A technical report
Authors: Liu Yushu , Li Dan , Cao Jia , Liu Shuai
Published: December 2021

Objective

To provide a method of fabricating implant‐supported provisional restorations with orthodontic attachments by digital technique.

Clinical consideration

Polymethylmethacrylate (PMMA) provisional restorations are usually necessary when dental implants are serving as anchors for orthodontic treatments. For clear aligner treatment, it is possible to setup the teeth virtually and determine the final position of the implants, indicating that the provisional restorations can be also predetermined. However, attachments on PMMA restorations have a higher risk of debonding due to low bond strength. To fabricate provisional restorations with predetermined shape and position and no risk of attachment debonding immediately after implant placement, a digital workflow is introduced in this article.

Conclusions

By combining “pick‐up” technique and prefabricated monolithic PMMA provisional restorations, this technique is recommended for making implant‐supported provisional restorations with integrated orthodontic attachments based on the digitally designed positions of the teeth.

Clinical significance

The present protocol describes a digital workflow of designing and manufacturing implant‐supported PMMA provisional restorations with orthodontic attachments in the predetermined position of implants, which should lead to more reliable and predictable orthodontic treatment outcomes.
Efficacy of amitriptyline in pediatric functional abdominal pain disorders: A randomized placebo‐controlled trial
Authors: Seetharaman Jayendra , Poddar Ujjal , Yachha Surender Kumar , Srivastava Anshu , Sen Sarma Moinak
Published: December 2021

Background and Aim

Amitriptyline improves symptoms in functional abdominal pain disorders (FAPD) in adults with variable results in pediatric studies. The study aims to evaluate the efficacy of amitriptyline in pediatric FAPD.

Methods

In this open‐label trial, children (≤ 18 years) diagnosed as FAPD based on ROME IV criteria were randomized to amitriptyline or placebo for 12 weeks. Post‐treatment improvement of pain and quality of life (QOL) from the baseline were compared between the two groups.

Results

The mean age of 149 children (amitriptyline 75, placebo 74) was 11.3 ± 3.5 years (79 boys). There was a significant difference in pain improvement in terms of reduction in scores for intensity (3.4 vs 0.9), frequency (3.6 vs 0.6), duration (3.5 vs 0.9), and QOL (2.3 vs 0.9) between amitriptyline and placebo group (P < 0.001 in all). Responders (> 50% reduction) in pain was seen in 76% in amitriptyline compared with 14.9% in the placebo group (P < 0.001). On multivariate analysis, the use of amitriptyline was the only factor predictive of response (odds ratio 24.1, 95% confidence interval: 9.1–64.6, P < 0.001). Minor adverse events were comparable between the groups (25.3% vs 13.5%, respectively, P = 0.07). Eighty‐nine percent of children (24/27) who had extended treatment duration (6.8 ± 1.8 months) had pain improvement. After discontinuation of amitriptyline, 70% had sustained response over a mean follow up of 15.84 ± 5.6 months.

Conclusions

A 3‐month trial of amitriptyline gives sustained relief of pain in two‐thirds of children with FAPD. The safety profile of the drug and its efficacy necessitate more frequent use in the clinical settings.
Genetic polymorphisms are not associated with energy intake 1 year after Roux‐en‐Y gastric bypass in women
Authors: Novais Patrícia Fatima Sousa , Crisp Alex Harley , Leandro‐Merhi Vania Aparecida , Cintra Renata Maria Galvão , Rasera Irineu , Oliveira Maria Rita Marques de
Published: December 2021

Background

The present study aimed to investigate the influence of food intake on body weight loss (WL) and the association of gene polymorphisms, 1 year after Roux‐en‐Y gastric bypass (RYGB) surgery.

Methods

In total, 95 obese women (age ranged 20–50 years) in a Brazilian cohort underwent RYGB surgery and completed the study. Anthropometric measurements and food intake were assessed before and 1 year after surgery. Twelve gene polymorphisms (GHRL rs26802; GHSR rs572169; LEP rs7799039; LEPR rs1137101; 5‐HT2C rs3813929; UCP2 rs659366; UCP2 rs660339; UCP3 rs1800849; SH2B1 rs7498665; TAS1R2 rs35874116; TAS1R2 rs9701796; and FTO rs9939609) were determined using a real‐time polymerase chain reaction and a TaqMan assay. The subjects were divided into quartiles regarding percentage of excess weight loss (%EWL). The effect of genetic variants on energy and macronutrient intake was evaluated by simple logistic regression, followed by multiple logistic regression.

Results

Subjects in the first and second quartiles showed a higher initial body mass index. Energy and macronutrient intake before and 1 year after RYGB surgery did not differ between the %EWL quartiles. None of gene polymorphisms investigated showed an association with the estimated energy intake 1 year after surgery.

Conclusions

In conclusion, the estimate energy and food intake did not predict a greater body WL 1 year after RYGB surgery. In addition, the 12 gene polymorphism investigated did not affect the energy intake among female patients.
Demand Shocks for Public Debt in the Eurozone
Authors: LENGYEL ANDRAS , GIULIODORI MASSIMO
Published: December 2021

In this paper we use intraday government bond futures price changes around German and Italian Treasury auctions to identify unexpected shifts in the demand for public debt. Estimates show that positive demand shocks lead to large negative movements in Treasury yields. Evidence shows significant spillover effects into Treasury bond, equity, and corporate bond markets of other eurozone countries. We find interesting differences in the effects of demand shocks between the two countries, consistent with the “safe‐haven” status of German bonds versus the “high‐debt” status of Italian Treasuries. Results suggest that these effects are stronger during periods of high financial stress.