bluuebunny/crossref_metadata_2025 huggingface dataset:
Expert Perspectives on the Additional Benefit of Day Hospices and Palliative Day Care Clinics in Germany: A Qualitative Approach
Authors: Apolinarski Beate , Huperz Carolin , Röwer Hanna A. A. , Schneider Nils , Stiel Stephanie , Herbst Franziska A.
Published: April 2023

Background: In Germany, hospice and palliative care is well covered through inpatient, outpatient, and home-based care services. It is unknown if, and to what extent, there is a need for additional day care services to meet the specific needs of patients and caregivers. Methods: Two day hospices and two palliative day care clinics were selected. In the first step, two managers from each facility ( n = 8) were interviewed by telephone, using a semi-structured interview guide. In the second step, four focus groups were conducted, each with three to seven representatives of hospice and palliative care from the facilities’ hospice and palliative care networks. Interviews and focus groups were audio recorded, transcribed verbatim and analyzed using qualitative content analysis. Results: The interviewed experts perceived day care services as providing additional patient and caregiver benefits. Specifically, the services were perceived to meet patient needs for social interaction and bundled treatments, especially for patients who did not fit into inpatient settings (due to, e.g., their young age or a lack of desire for inpatient admission). The services were also perceived to meet caregiver needs for support, providing short-term relief for the home care situation. Conclusions: The results suggest that inpatient, outpatient, and home-based hospice and palliative care services do not meet the palliative care needs of all patients. Although the population that is most likely to benefit from day care services is assumed to be relatively small, such services may meet the needs of certain patient groups more effectively than other forms of care.
Extended-Release Viloxazine for the Treatment of Attention-Deficit Hyperactivity Disorder in School-Age Children and Adolescents
Authors: Raible Haley , D’Souza Manoranjan S.
Published: April 2023

Objective:

To describe the efficacy and safety of extended-release viloxazine (viloxazine ER; Qelbree) for the treatment of attention-deficit hyperactivity disorder (ADHD) in school-age children and adolescents (6-17 years).

Data Sources:

A literature search was conducted with PubMed using the following terms: viloxazine and ADHD (August 1, 2017 to February 1, 2023).

Study Selection and Data Extraction:

All relevant English-language articles examining the efficacy and safety of viloxazine ER were considered for inclusion.

Data Synthesis:

Phase III studies reported significant improvement in ADHD symptoms after viloxazine ER treatment in both school-age children (100 mg/d, P = 0.0004 and 200 mg/d, P < 0.0001; NCT03247530) and adolescents (200 mg/d, P = 0.0232; 400 mg/d, P = 0.0091; NCT03247517) compared with placebo. Common adverse effects associated with viloxazine ER included somnolence, fatigue, irritability, decreased appetite, and headache. Together, the studies demonstrated the efficacy and safety of viloxazine ER in patients with ADHD.

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

Viloxazine ER is a serotonin-norepinephrine modulator, which is administered once daily orally. It is classified as a nonstimulant medication, which can be used in patients with ADHD who do not respond to or cannot tolerate stimulant medications. Even though atomoxetine and viloxazine ER have not been directly compared, clinical studies have suggested that viloxazine ER has a faster onset of action (~1-2 weeks) compared with atomoxetine (~4 weeks). Like atomoxetine, viloxazine ER carries a boxed warning for suicidal ideation and/or behavior.

Conclusion:

Viloxazine ER is a useful addition to other nonstimulant medications available to treat patients with ADHD.
Canadian monitoring program of the surface contamination with 11 antineoplastic drugs in 124 centers
Authors: Pinet Emma , Cirtiu Ciprian Mihai , Caron Nicolas , Bussières Jean-François , Tanguay Cynthia
Published: April 2023

Introduction

Occupational exposure to antineoplastic drugs can lead to long-term adverse effects on workers’ health. A reproducible Canadian surface monitoring program was established in 2010. The objective was to describe contamination with 11 antineoplastic drugs measured on 12 surfaces among hospitals participating in this annual monitoring program.

Methods

Each hospital sampled six standardized sites in oncology pharmacies and six in outpatient clinics. Ultra-performance liquid chromatography coupled with tandem mass spectrometry was used for cyclophosphamide, docetaxel, doxorubicin, etoposide, 5-fluorouracil, gemcitabine, irinotecan, methotrexate, paclitaxel, and vinorelbine. Platinum-based drugs were analyzed by inductively coupled plasma mass spectrometry; this excludes inorganic platinum from the environment. Hospitals filled out an online questionnaire about their practices; a Kolmogorov–Smirnov test was used for some practices.

Results

One hundred and twenty-four Canadian hospitals participated. Cyclophosphamide (405/1445, 28%), gemcitabine (347/1445, 24%), and platinum (71/756, 9%) were the most frequent. The 90th percentile of surface concentration was 0.01 ng/cm² for cyclophosphamide and 0.003 ng/cm² for gemcitabine. Centers that prepared 5000 or more antineoplastic per year had higher concentrations of cyclophosphamide and gemcitabine on their surfaces ( p  =  0.0001). Almost half maintained a hazardous drugs committee (46/119, 39%), but this did not influence the cyclophosphamide contamination ( p  =  0.051). Hazardous drugs training was more frequent for oncology pharmacy and nursing staff than for hygiene and sanitation staff.

Conclusions

This monitoring program allowed centers to benchmark their contamination with pragmatic contamination thresholds derived from the Canadian 90th percentiles. Regular participation and local hazardous drug committee involvement provide an opportunity to review practices, identify risk areas, and refresh training.
Promoting Community Health and Understanding of Science Topics by Reading Graphic-Style Stories Aloud Together
Authors: Kohli Eshika , Morris Edith , Humphries Jaqueline , Gertz Susan , Mabisi Keren , Hershberger Susan , Butsch Kovacic Melinda
Published: April 2023

Limited health literacy and access to engaging, relevant, understandable health promotion and disease prevention materials are barriers to achieving and maintaining health. The We-Engage-4-Health program co-created the graphic-style story “Foamy Soap Fun” with community members to reinforce the importance of the primary preventive strategy—handwashing—in limiting spread of COVID-19. Pre/postsurveys were administered, and a modified focus group was conducted to learn community participants’ preferences for reading stories (aloud together and/or silently to themselves), versus reading typical health promotion information sheets. Three themes were identified related to reading the story aloud: increased enthusiasm, increased attentiveness, and improved interpretation skills, vocabulary, and information processing skills. Educational constructs included: empathy with the story’s characters, engagement with previous health experiences, enthusiasm with sharing health information, and explanation of complex health topics. This study supports the value of graphic-style stories in helping communities to better understand the science behind health topics.
A prospective observation of PICC related anaphylactoid reactions
Authors: Cao Xiuzhu , Zhao Linfang
Published: April 2023

Purpose:

To explore the incidence, signs and symptoms, causes and prognosis of anaphylactoid reactions in PICC catheterization.

Methods:

Prospectively observe the occurrence of anaphylactoid reactions in coated and uncoated PICC during insertion from November 2018 to April 2020. A diagnosis of anaphylactoid reactions was based on the signs and symptoms and laboratory results, and then collect data for analysis.

Results:

A total of 1439 coated catheters were inserted, of which 30 resulted in anaphylactoid reactions (2.08%). The signs and symptoms were mainly skin system symptoms, combined with respiratory, cardiovascular, and digestive system symptoms. The anaphylactoid reaction rates of coated catheters were higher than those of uncoated catheters (χ2 = 38.417, 19.352, p < .01). A 29 of 30 patients completed catheterization after symptoms were resolved, these catheters were removed after treatment completion. Catheterization was terminated in one patient. There were no anaphylactoid reactions in 2850 uncoated catheters.

Conclusion:

Anaphylactoid reactions may occur during catheterization when using the coated PICC, which should be paid attention to in clinical application.
Peer-Facilitated Tobacco Cessation in a Prison Setting: A Proof of Concept Study
Authors: Garver-Apgar Christine E. , Morris Chad M. , Pavlik Jim , Lenartz Tracy , Hamm Michele
Published: April 2023

Background

Despite the vast human and economic costs associated with tobacco use among U.S. inmates, smoking remains a largely ignored public health epidemic. Incarcerated individuals smoke at 3 to 4 times the rate of the general population and face tobacco-related health disparities.

Purpose

This paper reports results from a single arm, pre/post pilot study designed to test the feasibility and initial effectiveness of an inmate-administered group tobacco cessation intervention within a men’s pre-release program run by the Arizona Department of Corrections.

Methods

Corrections staff and inmate peer mentors were trained in the DIMENSIONS: Tobacco Free Program, a manualized 6-session tobacco cessation group curriculum. Group sessions used evidence-based interventions for assisting inmates develop skills to live tobacco and nicotine free. In 2019-2020, 39 men who reported tobacco use voluntarily participated in one of three cessation groups. Wilcoxen signed-rank tests evaluated changes across group sessions in frequency of tobacco use and attitudes about nicotine-free living post release.

Results

Most participants attended all six group sessions (79%) and made one or more quit attempts (78%). Overall, 24% of the sample reported quitting tobacco, and significant reductions in tobacco use were reported after only two sessions. Participants further reported significant positive changes in knowledge, plans, support, and confidence to live tobacco-free lives post-release.

Conclusions

To our knowledge, this is the first study to demonstrate that, with minimal investment, implementation of an evidence-based, peer-led tobacco free program is feasible and effective within an incarcerated population uniquely vulnerable to the burden of tobacco.
An advanced method for predicting the axial compressive bearing capacity of fiber-reinforced polymer-strengthened hollow section metal columns
Authors: Hu Lili , Cao Heng , Zhang Zihan , Wang Yequan
Published: April 2023

Successful experimental and theoretical studies have promoted fiber-reinforced polymer (FRP) as an innovative strengthening material for metal columns in structural engineering, highlighting the necessity for an effective and reliable calculation method for such strengthened members. Here, based on existing experimental data, an advanced method using an artificial neural network (ANN) is developed to predict the axial compression bearing capacity (ACBC) of FRP-strengthened hollow section metal (FSHM) columns, where FRP strengthening includes wrapping/bonding FRP sheets/laminates; this method considers realistic conditions, incorporates a variety of parameters, and produces accurate and fast predictions. First, a multilayer perceptron (MLP) neural network was applied. By studying the optimization algorithm, learning rate, hidden vector and activation function, an optimal ANN model was established, which yielded better predictive accuracies and safety than existing calculation methods. Using the validated model, an prediction program was developed that promptly generated predictions of ACBC with a high reliability. Finally, a sensitivity analysis was performed to further assess the effects of key parameters on the behavior of FSHM columns to provide practical recommendations for their design.
A systematic review of technology-mediated social work practice: Benefits, uncertainties, and future directions
Authors: Afrouz Rojan , Lucas James
Published: April 2023

Social workers are increasingly using digital technology and online platforms in service delivery, with many services having moved online in 2020 following the emergence of the COVID-19 pandemic. A systematic literature review was conducted to synthesize research on the benefits and uncertainties of technology-mediated social work practice. Relevant keywords were searched in the following databases, Scopus, EbscoHost, SocINDEX, and Google Scholar. A total of 28 articles were included in this review, and their findings were synthesized thematically.

Findings

The review revealed several benefits of using digital tools and online platforms, including providing services to the larger population and making social work more available and accessible. However, while technology was widely employed in social work practice, there were some uncertainties about the impacts of technology on practice, maintaining professional boundaries, and concerns over privacy and confidentiality.

Implication

There is a need for further support for social workers to access flexible, efficient, and creative tools to maintain the quality of service delivery. The interdisciplinary collaboration between social work bodies and organizations with technology developers will improve technology-mediated social work practice to be aligned with professional principles, ethics, and values.
Tackling the COVID elective surgical backlog: Prioritising need, benefit or equality?
Authors: Pugh Jonathan , Seah Matthew , Carr Andrew , Savulescu Julian
Published: April 2023

The National Health Service (NHS) in the UK is currently facing a significant waiting list backlog following the disruption of the COVID-19 pandemic, with millions of patients waiting for elective surgical procedures. Effective treatment prioritisation has been identified as a key element of addressing this backlog, with NHS England's delivery plan highlighting the importance of ensuring that those with ‘the clinically most urgent conditions are diagnosed and treated most rapidly’. Indeed, we describe how the current clinical guidance on prioritisation issued by The Federation of Surgical Specialty Associations serves this aim. However, whilst there are strong reasons to prioritise elective surgery in accordance with clinical need, we argue that it would be a mistake to assume that prioritisation in accordance with clinical need requires only a clinical or scientific judgement. The understanding of clinical need that we choose to employ in a prioritisation system will be grounded by some key ethical judgements. Moreover, we may also have to make trade-offs between addressing clinical need, safeguarding equality, and achieving other benefits. As the UK faces up to the backlog, it is important that surgical prioritisation guidelines enshrine a broad range of values that we believe ought to determine access to care in non-emergency circumstances. Our analysis suggests that the current approach to prioritisation is not a sufficiently nuanced way of balancing the different moral values that are operative in this context.
Investigation the effect of geotextiles on the absorption of oil contamination and soil geotechnical properties
Authors: Shahnamnia Alireza , Sadeghi Masoud Mirmohammad , Hejazi Seyed Mahdi , Abtahi Sayed Mahdi
Published: April 2023

Oil-contaminated soil is detrimental to the ecosystem. There are various methods for purifying and controlling oil-contaminated soil. Among these, the use of oil absorbent geotextiles is considered a new method, and its performance requires more research. The separating by geotextiles has the advantages such as absence of chemicals in the separation process, less energy, simple control and implementation. This study presents an environmentally friendly sustainable solution using spacer geotextile layers to absorb crude oil and improve the geotechnical properties of contaminated soil. The variables include contamination percentage, number of fibrous substrate layers, soil overhead load pressure and duration of exposure to contaminated soil. The response variable is the internal friction coefficient of soil obtained from the direct shear test. By comparing soil samples containing geotextiles with samples without geotextiles, it was concluded that spacer geotextile layers could increase the internal friction coefficient of the soil and thus lead to improved soil properties. Increasing the number of geotextile layers, loading and the presence time of geotextile layers in the soil had increased the internal friction angle. But as the oil percentage in the soil increases, the internal friction angle of the soil decreases. Also, in this study, a linear regression model has been used to investigate the effect of existing parameters and the model was in good agreement with the experimental data.
Analyzing the changes in anthropometric measurements with various postures using three-dimensional scanning technology
Authors: Kang Yeonghoon , Kim Sungmin
Published: April 2023

In this study, the dynamic changes in human body shape according to movement have been analyzed using three-dimensional scanning system. For this, 12 male subjects were scanned in six postures and the amount of changes in 32 anthropometric measurement items were examined. As for the height items, all items changed in walking pose, and for the length items, the shoulder and chest lengths were affected by arm movement. For circumference items, considerable changes were observed in the chest and waist region according to the movement. A body cross section analysis software has been developed to analyze the change in body shape according to movement in various perspectives. As a result, the chest region was found to be affected by the movement of the arms, the waist region by the movement of the trunk, and hip region was by the movement of the leg.
Ground Zero in Lifestyle Medicine: Changing Mindsets to Change Behavior
Authors: Moore Margaret
Published: April 2023

The aspiration of lifestyle medicine practitioners is a healthy population engaged daily in lifestyle behaviors that generate the vitality needed to live a good life. That said, we are aware that there is a high population prevalence of low readiness to change behavior. This article proposes that we can improve readiness to change by shifting our expert mindsets to coaching mindsets. We focus first on helping others mobilize resources that improve readiness to change, including motivation and confidence—rather than beginning with expert education and training on new skills and behaviors. We call this coaching activity tilling the (patient’s) ground, which then germinates an interest in a mindset shift from an unresolved state ( e.g., I don’t have time to exercise) to a new state ( e.g., I might feel better and be more productive, if I exercise). In a generative conversation, moving from unresolved to resolved improves confidence in behavior change. This mindset shift is called integration—connecting and integrating an unresolved state to new thoughts, ideas, or perspectives (the ah-hah experience). We use the ground zero metaphor in multiple ways, and invite readers to till their own ground, generate potential, and enable integration as role models.
Feature extraction and matching combined with depth information in visual simultaneous localization and mapping
Authors: Sun Yunpeng , Li Xiaoli
Published: April 2023

Estimating the camera trajectories is very important for the performance of visual simultaneous localization and mapping. However, visual simultaneous localization and mapping systems based on RGB image are generally not robust in complex situations such as low-textures or large illumination variations. In order to solve this problem, more environmental information is added by introducing depth information, and a feature extraction and matching algorithm combining depth information is proposed. In this article, firstly, the intrinsic mechanism that depth image is used to extract and match feature points is discussed. Then depth information and appearance information are comprehensively considered to extract and describe feature points. Finally, the matching problem of feature points is transformed into a regression and classification problem, with which a matching model is presented in a data-driven way. Experimental results show that our algorithm has better distribution uniformity and matching accuracy and can effectively improve the trajectory accuracy and drift degree of the simultaneous localization and mapping system.
Transformational school leadership and the COVID-19 pandemic: Perceptions of teachers in Cyprus
Authors: Menon Maria Eliophotou
Published: April 2023

The role of contextual factors has been highlighted in the school leadership literature. This points to the importance of examining the extent to which leadership models apply to, or are useful in, specific contexts. The paper investigates the extent to which school leaders adopted transformational leadership behaviours and practices during the pandemic crisis based on the perceptions of teachers. Qualitative research was conducted with 30 primary school teachers in Cyprus. The findings of the research show that overall, school leaders used behaviours and practices associated with transformational leadership to a great extent. Of the five transformational leadership dimensions proposed by Bass and Avolio, teachers were more likely to report weaknesses in the area of individualised consideration. Moreover, the perceptions of teachers suggest that the behaviours and practices of school leaders during the pandemic crisis can be linked to different leadership conceptualisations and/or models. The paper provides implications regarding educational policy and practice.
Thailand as a new international higher education hub: Major challenges and opportunities, a policy analysis
Authors: Pongsin Viseshiri , Lawthong Nuttaporn , Fry Gerald W , Ransom Lakeesha , Kim Seongdok , Thi My Ngoc Nguyen
Published: April 2023

The major analytical research question addressed in this paper is: What are Thailand’s strengths and weaknesses as an international education hub for students from the Asian region? The key descriptive research question is: What is the nature of the educational experience of Asian students in Thailand? The two major research methodologies of the study are mixed research methods and comparative case studies, with the use of in-depth interviews of influential experts, surveys, and an autoethnography. In terms of major findings, there has been a dramatic growth of Asian students at Thai universities during the past two decades. Thailand’s major advantages relate to low costs, location, quality campus facilities, and a welcoming attitude toward outsiders, while major disadvantages are the quality of many of Thailand’s international programs often related to low English language capabilities. The paper concludes by presenting a creative new architecture for thinking about Asian study abroad in Thailand.
Age-related changes in patients with upper limb thalidomide embryopathy in the United Kingdom
Authors: Markiewicz Magdalena , Stirling Paul , Brennan Susan , Hooper Geoffrey , Lam Wee
Published: April 2023

We report the  long-term upper limb disability, health-related quality of life (HRQoL), functional impairment, self-perception of appearance and prevalence of neuropathic pain in patients with upper limb thalidomide embryopathy in the United Kingdom. One-hundred and twenty-seven patients responded to our electronic questionnaire. Mean Quick Version of the Disabilities of Arm, Shoulder, and Hand score was 54.3 (SD 22.6). Median EuroQoL 5-Dimension 5-Likert index, Work and Social Adjustment Scale, Derriford Appearance Scale 24 and Neuropathic Pain Scale were 0.6 (IQR 0.4 to 0.7), 15.5 (IQR 8.0 to 23.5), 35.5 (IQR 28.0 to 50.5), and −0.8 (IQR −1.4 to 0.8), respectively. Thirty-three patients (26%) reported neuropathic pain. Finger changes associated with radial longitudinal deficiency were an independent predictor of more severe upper limb disability. Eighty-nine patients (70%) reported deteriorating HRQoL with increasing age. Patients with upper limb thalidomide embryopathy experience age-related worsening of symptoms and function, highlighting the need for ongoing specialist care and support.

Level of evidence: IV
From Practices to Praxis: ASEAN's Transnational Climate Governance Networks as Communities of Practice
Authors: Salazar Virgemarie
Published: April 2023

In the Association of Southeast Asian Nations (ASEAN), member states recognise the need for multi-sectoral and multi-stakeholder engagement on climate change, but the participation of non-state actors in regional processes remains limited. This research focuses on the case study of three transnational governance networks on climate change in ASEAN and their efforts to participate in regional governance mechanisms. Data from semi-structured interviews of network members and texts of relevant documents are analysed from the perspectives of the communities of practice theory and participatory governance. This study finds that transnational networks in ASEAN provide non-state actors with opportunities to participate in regional governance of climate change by engaging in shared practices. However, the question on whether their practices can be considered as meaningful participation needs to be addressed. Hence, analysing transnational networks as communities of practice can help explain how practices bring about continuity and change in ASEAN's governance of climate change.
Designing a Child-, Family-, and Healthcare Provider–Centered Procedure Room in a Tertiary Care Children’s Hospital
Authors: Litwin Sasha , Clarke Lindsay , Copeland Jocelyne , Tyrrell Jennifer , Tait Caleb , Mohabir Vina , Campbell Fiona
Published: April 2023

Aim:

The study aim was to co-design new pediatric procedure room prototypes with children, caregivers, and healthcare providers (HCPs).

Background:

Medical procedures can cause pain and anxiety for children and their families. If spaces are not designed for patients’ needs, procedures may take longer, require sedation, and result in an inferior care experience. Involving HCPs in co-designing optimal spaces can result in more efficient and safer environments. co-designing spaces with patients and their families can inform psychologically safer and less traumatic environments.

Methods:

We followed human-centered design methodology. Data were collected via semi-structured interviews, field observations, and two multidisciplinary design workshops with patients, caregivers, and HCPs. Themes from the data were extracted using a content analysis and used to make evidence-informed recommendations for design features.

Results:

The study took place from October 2021 to February 2022. Patients, families, and HCPs reported similar needs: (1) control over the environment, including the ability to adjust lighting, temperature, and sound; (2) space that supports patient privacy; (3) the use of evidence-based pain reduction and distraction methods; (4) attention to the sensory environment, including visual (light, color), tactile (textures of furniture and equipment), auditory, and olfactory stimuli; (5) human factors organization of the space and equipment; (6) accessible and equitable spatial design; and (7) the significance of the journey leading up to and after the procedure.

Conclusions:

It is feasible to co-design procedure rooms that support evidence-based psychological, physical, and pharmacological interventions that are known to minimize pain for children.
Decriminalization of drug possession in Oregon: Analysis and early lessons
Authors: Russoniello Kellen , Vakharia Sheila P. , Netherland Jules , Naidoo Theshia , Wheelock Haven , Hurst Tera , Rouhani Saba
Published: April 2023

In November 2020, Oregon voters approved Measure 110, a ballot initiative that decriminalized possession of small quantities of all drugs and allocated hundreds of millions of dollars annually to health services for people who use drugs. Implementation of Measure 110 is ongoing, but several effects are noticeable in the first two years since the measure passed. Among these are substantial decreases in possession of controlled substances arrests and an infusion of funding into harm reduction services that have not traditionally enjoyed a sustainable funding source. This paper analyzes the provisions of Measure 110, examines its early impacts, successes, and challenges, and outlines lessons that jurisdictions contemplating decriminalizing drug possession in the U.S. and globally should consider.
Theory as guide to the analysis of polygyny and conflict: A response to Ash (2022)
Authors: Neupert-Wentz Clara , Koos Carlo
Published: April 2023

Ash (2022, "Ash" hereafter), in this journal, re-assesses our 2020 article “Polygynous Neighbors, Excess Men, and Intergroup Conflict in Africa.” The article analyzed the relationship between polygyny (one man marrying several wives) and intergroup conflict events in Africa. Ash includes assessments that support our original results, though others lead Ash to call our findings into question. While some of Ash’s data transformations are reasonable robustness tests, others seem to be insufficiently rooted in theory and ignore statistical power. Specifically, using fatality counts as an outcome requires theorization, in particular against the backdrop of different underlying theoretical mechanisms, issues of measurement accuracy, and other statistical considerations. Overall, we argue that there are good theoretical and statistical reasons why some of the operationalizations in Ash are not appropriate substitutes for our outcome variable. We appreciate the re-assessment but dismiss the claim in Ash that its findings give sufficient evidence to change the conclusion in our article.
Impact of a telerehabilitation programme combined with continuous positive airway pressure on symptoms and cardiometabolic risk factors in obstructive sleep apnea patients
Authors: Bughin François , Mendelson Monique , Jaffuel Dany , Pépin Jean-Louis , Gagnadoux Frédéric , Goutorbe Frédéric , Abril Beatriz , Ayoub Bronia , Aranda Alexandre , Alagha Khuder , Pomiès Pascal , Roubille François , Mercier Jacques , Molinari Nicolas , Dauvilliers Yves , Héraud Nelly , Hayot M
Published: April 2023

Background

Obstructive sleep apnea syndrome is a common sleep-breathing disorder associated with adverse health outcomes including excessive daytime sleepiness, impaired quality of life and is well-established as a cardiovascular risk factor. Continuous positive airway pressure is the reference treatment, but its cardiovascular and metabolic benefits are still debated. Combined interventions aiming at improving patient's lifestyle behaviours are recommended in guidelines management of obstructive sleep apnea syndrome but adherence decreases over time and access to rehabilitation programmes is limited. Telerehabilitation is a promising approach to address these issues, but data are scarce on obstructive sleep apnea syndrome.

Methods

The aim of this study is to assess the potential benefits of a telerehabilitation programme implemented at continuous positive airway pressure initiation, compared to continuous positive airway pressure alone and usual care, on symptoms and cardiometabolic risk factors of obstructive sleep apnea syndrome. This study is a 6-months multicentre randomized, parallel controlled trial during which 180 obese patients with severe obstructive sleep apnea syndrome will be included. We will use a sequential hierarchical criterion for major endpoints including sleepiness, quality of life, nocturnal systolic blood pressure and inflammation biological parameters.

Discussion

m-Rehab obstructive sleep apnea syndrome is the first multicentre randomized controlled trial to examine the effectiveness of a telerehabilitation lifestyle programme in obstructive sleep apnea syndrome. We hypothesize that a telerehabilitation lifestyle intervention associated with continuous positive airway pressure for 6 months will be more efficient than continuous positive airway pressure alone on symptoms, quality of life and cardiometabolic risk profile. Main secondary outcomes include continuous positive airway pressure adherence, usability and satisfaction with the telerehabilitation platform and medico-economic evaluation.

Trial registration

Clinicaltrials.gov Identifier: NCT05049928. Registration data: 20 September 2021
Image-quality characteristics in the longitudinal direction from different image-reconstruction algorithms during single-rotation volume acquisition on head computed tomography: A phantom study
Authors: Watanabe Ryo , Zensho Ayako , Ohishi Yoshitaka , Funama Yoshinori
Published: April 2023

Background

A multi detector computed tomography (CT) scanner with wide-area coverage enables whole-brain volumetric scanning in a single rotation.

Purpose

To investigate variations in image-quality characteristics in the longitudinal direction for different image-reconstruction algorithms and strengths with phantoms.

Material and methods

Single-rotation volume scans were performed on a 320-row multidetector CT volume scanner using three types of phantoms. Tube current was set to 200 mA (standard dose) and 50 mA (low dose). All images were reconstructed with filtered back projection (FBP), mild and strong levels with hybrid iterative reconstruction (HIR), and model-based IR (MBIR). Computed tomography numbers, image noise, noise power spectrum (NPS), task-based transfer function (TTF), and visual spatial resolution were used to evaluate uniformity of image quality in the longitudinal direction ( Z-axis).

Results

The MBIR images showed smaller variation in CT numbers in the Z-axis. The difference in the highest and lowest CT numbers was smaller (5.0 Hounsfield units [HU]) for MBIR than for FBP (6.6 HU) and HIR (6.8 HU). The variations in image noise were the smallest for strong MBIR and the largest for FBP. The low-frequency component at NPS0.2 was lower for strong MBIR than for other algorithms. The high-frequency component at NPS0.8 was low in all reconstructions. For MBIR, the image resolution and TTFs were higher in the outer portion than in the center.

Conclusion

Model-based IR is the optimal image-reconstruction algorithm for single-volume scan of spherical subjects owing to its high in-plane resolution and uniformity of CT numbers, image noise, and NPS in the Z-axis.
Growth experiences of the older generation of women scientists in China: Historical lessons and recommendations for women's career development
Authors: Zhang Meifang , Ma Yanyang
Published: April 2023

Women scientists are an important part of the community of science and technology (S&T) professionals and are an indispensable force in China's S&T undertakings. Using data relating to women scientists from the ‘Project on the Collection of Historic Data of Chinese Scientists’ Academic Life’, this paper reviews the academic growth processes of women scientists in China. It analyses the complex factors that have affected them (such as family background, education, marriage, choice of major, research environment and social culture) and sums up their experiences of success. Finally, specific measures for boosting the status and role of female S&T professionals are proposed based on the realities and problems that they face in their career development.
Perspectives from the Netherlands on women in science
Authors: Dijkstra Anne M
Published: April 2023

The first woman to graduate from a Dutch university achieved that milestone more than 140 years ago in 1879, yet women's participation in science in the Netherlands still needs to improve. This paper presents and puts into perspective the country's latest figures for gender participation in science. It also discusses recent developments in the Netherlands regarding gender and diversity, particularly for women in science. Finally, the paper reflects on measures to increase women's participation in science in terms of both research and policy, and in relation to current Dutch developments in science communication.
Oncogenic role and target properties of the lysine-specific demethylase KDM1A in chronic lymphocytic leukemia
Authors: Jiang Qu , Stachelscheid Johanna , Bloehdorn Johannes , Pacholewska Alicja , Aszyk Christoph Markus , Grotenhuijs Francien , Müller Tony Andreas , Onder Ozlem , Wagle Prerana , Herling Carmen Diana , Kleppe Maria , Wang Zhefang , Coombes Kevin R. , Robrecht Sandra , Dalvi Priya S. , Lungu Bianca Andra , Mayer Petra , Abruzzo Lynne V. , Altmüller Janine , Gathof Birgit Sybille , Persigehl Thorsten , Fischer Kirsten , Jebaraj Billy Michael Chelliah , Rienhoff Hugh Young , Ecker Rupert C. , Zhao Yue , Bruns Christiane Josephine , Stilgenbauer Stephan , Elenitoba-Johnson Kojo S. J. , Hallek Michael , Schweiger Michal R. , Odenthal Margarete , Vasyutina Elena , Herling Marco
Published: April 2023

In chronic lymphocytic leukemia (CLL), epigenetic alterations are considered to centrally shape the transcriptional signatures that drive disease evolution and that underlie its biological and clinical subsets. Characterizations of epigenetic regulators, particularly histone-modifying enzymes, are very rudimentary in CLL. In efforts to establish effectors of the CLL-associated oncogene T-cell leukemia 1A (TCL1A), we identified here the lysine-specific histone demethylase KDM1A to interact with the TCL1A protein in B-cells in conjunction with an increased catalytic activity of KDM1A. We demonstrate that KDM1A is upregulated in malignant B-cells. Elevated KDM1A and associated gene expression signatures correlated with aggressive disease features and adverse clinical outcomes in a large prospective CLL trial cohort. Genetic Kdm1a knockdown (Kdm1a-KD) in Eμ-TCL1A mice reduced leukemic burden and prolonged animal survival, accompanied by upregulated p53 and pro-apoptotic pathways. Genetic KDM1A depletion also affected milieu components (T-, stromal, monocytic cells), resulting in significant reductions of their capacity to support CLL cell survival and proliferation. Integrated analyses of differential global transcriptomes (RNA-seq) and H3K4me3 marks (ChIP-seq) in Eµ-TCL1A vs. iKdm1aKD;Eµ-TCL1A mice (confirmed in human CLL) implicate KDM1A as an oncogenic transcriptional repressor in CLL by altering histone methylation patterns with pronounced effects on defined cell death and motility pathways. Finally, pharmacologic KDM1A inhibition altered H3K4/9 target methylation and revealed marked anti-B-cell-leukemic synergisms. Overall, we established the pathogenic role and effector networks of KDM1A in CLL, namely via tumor-cell intrinsic mechanisms and impacts in cells of the microenvironment. Our data also provide rationales to further investigate therapeutic KDM1A targeting in CLL.
How I Communicate with Patients and Families about Germline Genetic Information
Authors: Hamilton Kayla V , Fox Lucy C , Nichols Kim E
Published: April 2023

As germline genetic testing is increasingly integrated into the clinical care of patients with hematologic malignancies, it is important for hematologists to effectively communicate with patients and families about the genetic testing process and to relay the results in a concise and understandable manner. Effective communication facilitates trust between patients and providers and allows patients to feel empowered to ask questions and actively participate in their healthcare. Especially for inherited conditions, patient understanding of germline genetic information is critical as it enables them to share this information with at-risk relatives, thereby promoting cascade testing and providing potentially life-saving information to family members who may be similarly affected. Accordingly, a hematologist's skills in understanding the importance and implications of germline genetic information and the ability to convey this information in patient-friendly language is a critical first step and can have a far-reaching impact. In this "How I Treat" article, we outline a straightforward approach to discussing genetic information and provide the reader with practical tips that can be used when consenting patients to germline genetic testing and disclosing subsequent test results. We also review special considerations and ethical concerns arising when offering genetic evaluation and germline testing to patients and related donors for allogeneic hematopoietic stem cell transplantation.
IL7-receptor expression is frequent in T-cell acute lymphoblastic leukemia and predicts sensitivity to JAK-inhibition
Authors: Courtois Lucien , Cabannes-Hamy Aurelie , Kim Rathana , Delecourt Marine , Pinton Antoine , Charbonnier Guillaume , Féroul Mélanie , Smith Charlotte , Tueur Giulia , Pivert Cecile , Balducci Estelle , Simonin Mathieu , Angel Laure Hélène , Spicuglia Salvatore , Boissel Nicolas , Andrieu Guillaume P , Asnafi Vahid , Rousselot Philippe , Lhermitte Ludovic
Published: April 2023

T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive hematological malignancy with a dismal prognosis related to refractory/relapsing diseases, raising the need for new targeted-therapies. Activating mutations of the IL7-receptor pathway genes (IL7Rp) play a proven leukemia-supportive role in T-ALL. JAK-inhibitors such as ruxolitinib have recently demonstrated preclinical efficacy. However, prediction markers for sensitivity to JAK-inhibitors are still lacking. Herein, we show that IL7R (CD127) expression is more frequent (~70%) than IL7Rp-mutations in T-ALL (~30%). We compared the so-called non-expressers (no IL7R-expression/IL7Rp-mutation), expressers (IL7R-expression without IL7Rp-mutation) and mutants (IL7Rp-mutations). Integrative multi-omics analysis outlined IL7R-deregulation in virtually all T-ALL subtypes, at the epigenetic-level in non-expressers, genetic-level in mutants, and post-transcriptional level in expressers. Ex-vivo data using primary-derived xenografts support that IL7Rp is functional whenever the IL7R is expressed, regardless of the IL7Rp mutational status. Consequently, ruxolitinib impaired T-ALL survival in both expressers and mutants. Interestingly, we show that expressers displayed ectopic IL7R-expression and IL7Rp-addiction conferring a deeper sensitivity to ruxolitinib. Conversely, mutants were more sensitive to venetoclax than expressers. Overall, combination of ruxolitinib and venetoclax resulted in synergistic effects in both groups. We illustrate the clinical relevance of this association by reporting achievement of complete remission in two patients with refractory/relapsed-T-ALL. This provides proof of concept for translation of this strategy into clinics as bridge to transplant. Altogether, IL7R-expression can be used as a biomarker for sensitivity to JAK-inhibition, thereby expanding the fraction of T-ALL patients eligible to ruxolitinib up to nearly ~70% of T-ALL.
Validating the Breathing Vigilance Questionnaire for use in dysfunctional breathing
Authors: Steinmann Jennifer , Lewis Adam , Ellmers Toby J. , Jones Mandy , MacBean Vicky , Kal Elmar
Published: April 2023

Background

Dysfunctional breathing is common among people with and without primary respiratory pathology. While anxiety can contribute to dysfunctional breathing, the underpinning mechanism is unclear. One explanation is that anxiety induces conscious, vigilant monitoring of breathing, disrupting “automatic” breathing mechanics. We validated a new tool that quantifies such breathing-related “vigilance”: the Breathing Vigilance Questionnaire (Breathe-VQ).

Methods

323 healthy adults (mean (range) age 27.3 (18–71) years; 161 males) were analysed. We developed an initial Breathe-VQ (11 items, 1–5 Likert scale) based on the Pain Vigilance and Awareness Scale, using feedback from the target population and clinicians. At baseline, participants completed the Breathe-VQ, Nijmegen Questionnaire (NQ), State-Trait Anxiety Inventory form 2 and Movement-Specific Reinvestment Scale (assessing general conscious processing). 83 people repeated the Breathe-VQ 3 weeks later.

Results

Five items were removed based on item-level analysis. The resulting six-item Breathe-VQ questionnaire (score range 6–30) has excellent internal (α=0.892) and test–retest reliability (intraclass correlation 0.810), a minimal detectable change of 6.5 and no floor/ceiling effects. Validity was evidenced by significant positive correlations with trait anxiety and conscious processing scores (r=0.35–0.46). Participants at high risk of having dysfunctional breathing (NQ >23; n=76) had significantly higher Breathe-VQ score (mean±sd19.1±5.0) than low-risk peers (n=225; mean±sd13.8±5.4; p<0.001). In this “high risk of dysfunctional breathing” group, Breathe-VQ and NQ scores were significantly associated (p=0.005), even when controlling for risk factors (e.g.trait anxiety).

Conclusions

The Breathe-VQ is a valid and reliable tool to measure breathing vigilance. High breathing vigilance may contribute to dysfunctional breathing and could represent a therapeutic target. Further research is warranted to test Breathe-VQ's prognostic value and assess intervention effects.
Increasing airway obstruction through life following bronchopulmonary dysplasia: a meta-analysis
Authors: Gibbons James T.D. , Course Christopher W. , Evans Emily E. , Kotecha Sailesh , Kotecha Sarah J. , Simpson Shannon J.
Published: April 2023

Background

Few studies exist investigating lung function trajectories of those born preterm; however growing evidence suggests some individuals experience increasing airway obstruction throughout life. Here we use the studies identified in a recent systematic review to provide the first meta-analysis investigating the impact of preterm birth on airway obstruction measured by the forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio.

Methods

Cohorts were included for analysis if they reported FEV1/FVC in survivors of preterm birth (<37 weeks’ gestation) and control populations born at term. Meta-analysis was performed using a random effect model, expressed as standardised mean difference (SMD). Meta-regression was conducted using age and birth year as moderators.

Results

55 cohorts were eligible, 35 of which defined groups with bronchopulmonary dysplasia (BPD). Compared to control populations born at term, lower values of FEV1/FVC were seen in all individuals born preterm (SMD −0.56), with greater differences seen in those with BPD (SMD −0.87) than those without BPD (SMD −0.45). Meta-regression identified age as a significant predictor of FEV1/FVC in those with BPD with the FEV1/FVC ratio moving −0.04sds away from the term control population for every year of increased age.

Conclusions

Survivors of preterm birth have significantly increased airway obstruction compared to those born at term with larger differences in those with BPD. Increased age is associated with a decline in FEV1/FVC values suggesting increased airway obstruction over the life course.