bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiovascular and cerebrovascular–associated mortality in patients with preceding bronchiectasis exacerbation
Authors: Lee Sang Chul , Son Kang Ju , Hoon Han Chang , Park Seon Cheol , Jung Ji Ye
Published: December 2022

Background:

Bronchiectasis is associated with an increased incidence of atherosclerotic cardiovascular disease (ASCaVD) and atherosclerotic cerebrovascular disease (ASCeVD). Its effect on associated mortality is unclear.

Objectives:

This study investigated the effects of bronchiectasis exacerbation prior to ASCaVD or ASCeVD events on mortality in patients with bronchiectasis using a large population–based database.

Methods:

A retrospective cohort of patients with bronchiectasis who experienced ASCaVD ( n = 1066) or ASCeVD ( n = 825) was studied for the first time using a nationwide population–based database (National Health Insurance Service-National Sample Cohort, Korea, 2002–2015). We classified each cohort according to the presence of moderate bronchiectasis exacerbation within 1 year before the ASCaVD or ASCeVD event. We evaluated 90-day, 1-year, and all-cause mortalities risk.

Results:

Within 1 year before the index ASCaVD or ASCeVD event, 149 (13.9%) and 112 (13.6%) patients with bronchiectasis experienced moderate exacerbation(s), respectively. Mild exacerbations did not different in frequency between the survivors and nonsurvivors. In both cohorts, more nonsurvivors experienced moderate exacerbations than survivors. The odds ratios of 90-day and 1-year mortalities and hazard ratios of all-cause mortalities on experiencing moderate exacerbations were 2.27 [95% confidence interval (CI) = 1.26–4.10], 3.30 (95% CI = 2.03–5.38), and 1.78 (95% CI = 1.35–2.34) in the bronchiectasis-ASCaVD cohort and 1.73 (95% CI = 0.94–3.19), 1.79 (95% CI = 1.07–3.00), and 1.47 (95% CI = 1.10–1.95), in the bronchiectasis-ASCeVD cohort.

Conclusion:

Hospitalization or emergency room visit for bronchiectasis exacerbation within 1 year before ASCaVD or ASCeVD is associated with an increased ASCaVD- or ASCeVD-associated mortality.
A phase II study of S-1 and cisplatin with concurrent thoracic radiotherapy followed by durvalumab for unresectable, locally advanced non-small-cell lung cancer in Japan (SAMURAI study): primary analysis
Authors: Tanaka Hisashi , Tanzawa Shigeru , Misumi Toshihiro , Makiguchi Tomonori , Inaba Megumi , Honda Takeshi , Nakamura Junya , Inoue Koji , Kishikawa Takayuki , Nakashima Masanao , Fujiwara Keiichi , Kohyama Tadashi , Ishida Hiroo , Kuyama Shoichi , Miyazawa Naoki , Nakamura Tomomi , Miyawaki Hiroshi , Oda Naohiro , Ishikawa Nobuhisa , Morinaga Ryotaro , Kusaka Kei , Fujimoto Nobukazu , Fukuda Yasushi , Yasugi Masayuki , Tsuda Takeshi , Ushijima Sunao , Shibata Kazuhiko , Shibayama Takuo , Bessho Akihiro , Kaira Kyoichi , Shiraishi Kenshiro , Matsutani Noriyuki , Seki Nobuhiko
Published: December 2022

Background:

The standard of care for unresectable, locally advanced non-small-cell lung cancer (LA-NSCLC) is chemoradiotherapy (CRT) followed by durvalumab, based on the PACIFIC study. Although multiple Japanese phase II studies have shown high efficacy and tolerability of CRT with cisplatin plus S-1 (SP), no prospective study using durvalumab after SP-based CRT has been reported.

Objectives:

We conducted a multicenter phase II study of this approach, the interim analysis of which showed a high transition rate to durvalumab consolidation therapy. Here, we report the primary analysis results.

Design:

In treatment-naïve LA-NSCLC, cisplatin (60 mg/m2, day 1) and S-1 (80–120 mg/body, days 1–14) were administered with two 4-week cycles with concurrent thoracic radiotherapy (60 Gy) followed by durvalumab (10 mg/kg) every 2 weeks for up to 1 year.

Methods:

The primary endpoint was 1-year progression-free survival (PFS). The expected 1-year PFS and its lower limit of the 80% confidence interval (CI) were set as 63% and 47%, respectively, based on the results of TORG1018 study.

Results:

In all, 59 patients were enrolled, with 51 (86.4%) proceeding to durvalumab. The objective response rate throughout the study was 72.9% (95% CI: 59.7–83.6%). After median follow-up of 21.9 months, neither median PFS nor OS was reached. The 1-year PFS was 72.5% (80% CI: 64.2–79.2%, 95% CI: 59.1–82.2%), while the 1-year overall survival was 91.5% (95% CI: 80.8–96.4%). No grade 5 adverse events were observed throughout the study. The most common adverse event during the consolidation phase was pneumonitis (any grade, 78.4%; grade ⩾3, 2.0%). Eventually, 52.5% of patients completed 1-year durvalumab consolidation therapy from CRT initiation.

Conclusion:

This study of durvalumab after SP-based CRT met its primary endpoint and found a 1-year PFS of 73% from CRT initiation. This study provides the first prospective data on the prognosis and tolerability of durvalumab consolidation from the initiation of CRT.

Trial registration:

Japan Registry of Clinical Trials, jRCTs031190127, registered 1 November, 2019, https://jrct.niph.go.jp/latest-detail/jRCTs031190127
Circulating tumor DNA in early-stage colon cancer: ready for prime time or needing refinement?
Authors: Solar Vasconcelos Joao Paulo , Boutin Melina , Loree Jonathan M.
Published: December 2022

Liquid biopsies are the detection of molecular information in fluids from patients with cancer. In colorectal cancer (CRC), the most promising liquid biopsy strategy is the use of circulating tumor DNA (ctDNA) from plasma. In early-stage CRC, the potential for ctDNA to impact care stems from the detection of minimal residual disease (MRD) to guide adjuvant therapy after curative intent treatment and in identifying recurrences during surveillance. As for any new diagnostic test, ctDNA assays must overcome pre-analytical and analytical challenges before clinical implementation. We will discuss important logistical and assay considerations that clinicians and patients should understand when assessing ctDNA assays. We will also delve into important concepts to aid in interpreting ctDNA results and potential incidental findings that may arise. Sequencing errors, germline variants, and clonal hematopoiesis of indeterminate potential (CHIP) must be addressed to properly interpret results. CHIP is also an important consideration that impacts patient prognosis through association with cardiovascular and hematologic diseases. With this background in place, we next review the best available evidence for the use of ctDNA in early-stage colon cancer. Observational cohorts have established MRD after surgery as a significant prognostic factor for recurrence in stage II and III colon cancer. It also has the ability to anticipate clinical recurrence before standard investigations when used in surveillance. The first and only interventional randomized trial to date evaluating ctDNA is DYNAMIC. The study demonstrated the noninferiority of a MRD detection-guided approach in selecting patients with stage II colon cancer for adjuvant treatment. Notwithstanding the important results, there are still important questions to be answered before ctDNA enters prime time in the clinic. However, future appears bright and ongoing trials will help clarify how to best use this technology in early-stage colon cancer.
Secondary Metabolites From the Grasshopper-Derived Entomopathogenic Fungus Aspergillus Tamarii NL3 and Their Biological Activities
Authors: Ton That Huu Dat , Phuong Ha Tran , Diem Tran Phan Thi , Souvannalath Bakeo , Trung Hieu Le , Ho Duc Viet , Viet Cuong Le Canh
Published: December 2022

Chromatographic purification of the ethyl acetate extract of the entomopathogenic fungus Aspergillus tamarii NL3 culture broth led to the isolation of griseofulvin (1), isogriseofulvin (2), cytochalasin J (3), solamargine (4), and solasonine (5). The chemical structures of these compounds were identified by HRESIMS and NMR spectra, as well as by comparison with literature data. This is the first report on the isolation of 1-4 from the Aspergillus genus and compound 5 from A tamarii. Compounds 1 and 2 exhibited antifungal activity against the reference fungi with MICs of 16 to 128 µg/mL. Compound 3 displayed weak antimicrobial activity against most of the tested microorganisms with MICs ≥ 128 µg/mL, except for Bacillus subtilis and Aspergillus niger with MICs of 64 µg/mL. Compounds 4 and 5 showed activity against a wide spectrum of the reference microorganisms with MICs of 16 to 128 µg/mL but showed stronger antifungal than antibacterial activity. Furthermore, all isolates exhibited weak ABTS and DPPH scavenging activities with scavenging rates of 18.92% to 32.64% and 24.62% to 31.06%, respectively, at the concentration of 100 µg/mL.
Effect of High-Intensity Interval Training on Exercise Capacity, Blood Pressure, and Autonomic Responses in Patients With Hypertension: A Systematic Review and Meta-analysis
Authors: de Souza Mesquita Fabricio Olinda , Gambassi Bruno Bavaresco , de Oliveira Silva Marcio , Moreira Sérgio Rodrigues , Neves Victor Ribeiro , Gomes-Neto Mansueto , Schwingel Paulo Adriano
Published: December 2022

Context:

Despite the well-known positive effects of exercise in hypertensive patients, the best mode of exercise is still under discussion.

Objective:

A systematic review of the literature, synthesizing data on the effects of high-intensity interval training (HIIT) on peak oxygen consumption (VO2 peak), blood pressure (BP), cardiac autonomic modulation, and resting heart rate (HR) in patients with hypertension.

Data Sources:

MEDLINE (via PubMed), CENTRAL, PEDro database, and SciELO (from the earliest date available to December 31, 2020).

Study Selection:

Randomized controlled trials (RCTs) that evaluated the effects of HIIT in hypertensive patients.

Study Design:

Systematic review and meta-analysis.

Level of Evidence:

Level 2.

Data Extraction:

Mean differences (MDs) with a 95% CI were calculated, and heterogeneity was assessed using the I2 test.

Results:

Nine RCTs encompassing 569 patients met the eligibility criteria and were included in the systematic review. Five trials compared supervised HIIT with moderate-intensity continuous training (MICT) and a control; 1 trial compared HIIT with MICT, and 3 compared HIIT with a control. In comparison with MICT, HIIT improved VO2 peak MD (3.3 mL.kg-1.min-1; 95% CI, 1.4-5.3; N = 130). In comparison with controls, HIIT improved VO2 peak MD (4.4 mL.kg-1.min-1; 95% CI, 2.5-6.2; N = 162).

Conclusion:

Despite the low quality of the evidence, HIIT is superior to MICT in improving VO2 peak in patients with hypertension. HIIT effectively improved VO2 peak, BP, and resting HR when compared with controls. HIIT appears to be safe only when performed in a supervised manner for stage 1 hypertension patients without associated risk factors.
The angio-architectural features of brain arteriovenous malformations: is it possible to predict the probability of rupture?
Authors: Rustici Arianna , Vari Francesca , Sturiale Carmelo , Conti Alfredo , Scibilia Antonino , Bortolotti Carlo , Agati Raffaele , Zenesini Corrado , Maria Beatrice Belotti Laura , Tonon Caterina , Lodi Raffaele , Mazzatenta Diego , Zoli Matteo , Princiotta Ciro , Dall’Olio Massimo , Cirillo Luigi
Published: December 2022

Background

Hemorrhage is the most devastating complication of brain arteriovenous malformations (bAVMs), and to date, there is still concern about the needing for treatment in case of unruptured and asymptomatic bAVM. In fact, the morbidity and mortality of treatments may exceed that of the AVM’s natural history. None of the classifications and scores for bAVM allows to predict the risk of bleeding. In this study, we aimed to identify the angio-architectural characteristics of brain AVMs associated with bleeding.

Methods

We retrospectively evaluated all consecutive patients diagnosed with cerebral AVMs, between January 2010 and December 2019 from our prospective bAVM database. Univariate and multivariate logistic regression analysis were used to evaluate relationships between angio-architectural features of ruptured and unruptured bAVMs.

Results

Of the 143 retrieved bAVMs, 65 were unruptured and 78 were ruptured. The univariate logistic regression analysis demonstrated statistically significant differences into angio-architectural features of unruptured and ruptured bAVMs. The multivariate logistic regression analysis fitted well ( p =.113) with a good discrimination capacity (ROC = 0.83) of three independent angio-architectural features mainly related to bleeding in bAVMs: a smaller diameter of the nidus ( p < .001), the absence of venous drainage alterations ( p = .047), of the presence of prenidal aneurysms ( p = .005).

Conclusions

In our study, several features resulted related to an increased probability of rupture for bAVMs, among which the more relevant were a small diameter of the nidus, the absence of venous drainage alterations, and the presence of prenidal aneurysms.
Features and management of a schwannoma of the chorda tympani and review of the literature
Authors: Maccarrone Francesco , Lo Manto Alfredo , Piccinini Silvia , Tassi Sauro , Negri Maurizio
Published: December 2022

Intrinsic facial nerve tumors are rare lesions. Among the different histology types, schwannomas is the most frequently reported in literature. Other histological types of facial nerve tumors are hemangiomas, meningiomas, and neurofibromas. Chorda tympani schwannomas (CTSs) are extremely rare entities and are considered as an independent subgroup of facial nerve schwannomas because of their clinical characteristics. The aim of this report is to present the clinical and radiological features and the management of a CTS in a 27-year-old male presenting with conductive hearing loss.
Digital Analysis of the Dimensional Change Of an Irreversible Hydrocolloid Impression Material (Alginate) with Varying Storage Times
Authors: Ibrahem Fatemah , Giugliano Thomas , Ruff Ryan Richard , Choi Mijin
Published: December 2022

Aim:

The aim of this study was to digitally measure the dimensional changes in an irreversible hydrocolloid impression material (alginate) resulting from varying storage times under optimal storage conditions.

Materials and methods:

A single type V dental stone control cast was used to make 25 alginate impressions using perforated stock trays. The impressions were randomly assigned into five groups of five samples each (n=5 per group) with varying storage times: Group 1, poured at 15 minutes; Group 2, poured at one hour; Group 3, poured at 24 hours (one day); Group 4, poured at 72 hours (three days); Group 5, poured at 168 hours (seven days). All impressions were stored in sealed Ziploc® plastic bags with a wet paper towel (100% relative humidity) at room temperature and stored according to the assigned group storage times. All impressions were poured in type V dental stone according to the manufacturer’s instructions. The casts were scanned with a digital 3D desktop scanner and saved as electronic stereolithography (.stl) files. Each .stl file of the scanned casts were superimposed on the .stl file of the control cast using Geomagic® Control X™ software. Three preselected fixed comparison measuring points (CMP) on each cast were compared to the control cast. Point one (CMP1) was on the midfacial surface of central incisor. Point two (CMP2) and point three (CMP3) were on the mesiobuccal proximal marginal ridge areas of third molars. The discrepancies between the files at each point were analysed with colour maps, and quantified (Table 1). The tolerance was set at ±10μm. CMP scores were analysed using one-way analysis of variance (ANOVA) and Kruskal-Wallis (K-W) non-parametric H tests.

Results:

Average gap distances across groups ranged from 0.04mm (seven-day group) to 0.06mm (one hour and 24-hour groups). Colour maps indicated increased dimensional change with increased storage time up to one day. After three days, shrinkage up to 139μm was measured. ANOVA results for CMP1 (F[4,20] = 1.65, p = 0.020) and CMP3 (F[4,20] = 0.44, p = −0.78) were not statistically significant. Similarly, K-W results for CMP2 were not significant (χ2= 3.62, p = 0.46).

Conclusions:

Under optimal storage conditions, there were no significant dimensional changes in casts poured from alginate up to seven days.
The development of digital dentistry in the UK: An overview
Authors: Eaton Kenneth A.
Published: December 2022

The COVID-19 pandemic has highlighted the benefits which digital technology offers to all aspects of dental practice and education. This paper provides an overview of how digital technology has enhanced clinical and administrative procedures within dental practice, including computer-aided design/computer-aided manufacture (CAD/CAM), digital radiography, 3D printing, patient records, electronic patient referrals and electronic communications from dental practices. It then considers the development of teledentistry (mHealth) and its benefits in enabling distant consultations with patients, who for one reason or another are unable to visit dental practices easily. It then goes on to consider how and why digital dental distance learning materials were provided to general dental practitioners in England by the Department of Health (DoH) (England) and how they evolved. Finally, this paper considers the use of digital technology in dental education by dental schools.
Beppu Bay, Japan, as a candidate Global boundary Stratotype Section and Point for the Anthropocene series
Authors: Kuwae Michinobu , Finney Bruce P , Shi Zhiyuan , Sakaguchi Aya , Tsugeki Narumi , Omori Takayuki , Agusa Tetsuro , Suzuki Yoshiaki , Yokoyama Yusuke , Hinata Hirofumi , Hatada Yoshio , Inoue Jun , Matsuoka Kazumi , Shimada Misaki , Takahara Hikaru , Takahashi Shin , Ueno Daisuke , Amano Atsuko , Tsutsumi Jun , Yamamoto Masanobu , Takemura Keiji , Yamada Keitaro , Ikehara Ken , Haraguchi Tsuyoshi , Tims Stephen , Froehlich Michaela , Fifield Leslie Keith , Aze Takahiro , Sasa Kimikazu , Takahashi Tsutomu , Matsumura Masumi , Tani Yukinori , Leavitt Peter R , Doi Hideyuki , Irino Tomohisa , Moriya Kazuyoshi , Hayashida Akira , Hirose Kotaro , Suzuki Hidekazu , Saito Yoshiki
Published: December 2022

For assessment of the potential of the Beppu Bay sediments as a Global boundary Stratotype Section and Point (GSSP) candidate for the Anthropocene, we have integrated datasets of 99 proxies. The datasets for the sequences date back 100 years for most proxy records and 1300 years for several records. The cumulative number of occurrences of the anthropogenic fingerprint reveal unprecedented increases above the base of the 1953 flood layer at 64.6 cm (1953 CE), which coincides with an initial increase in global fallout of 239Pu+240Pu. The onset of the proliferation of anthropogenic fingerprints was followed by diverse human-associated events, including a rapid increase in percent modern 14C in anchovy scales, changes in nitrogen and carbon cycling as recorded by anchovy δ15N and δ13C, elevated pollution of heavy metals, increased deposition of novel materials (spheroidal carbonaceous particles, microplastics, polychlorinated biphenyls), the occurrence of hypoxia (Re/Mo ratio) and eutrophication (biogenic opal, TOC, TN, diatoms, chlorophyll a), unprecedented microplankton community changes (compositions of carotenoids, diatoms, dinoflagellates), abnormally high spring air temperatures as inferred from diatom fossils, and lithological changes. These lines of evidence indicate that the base of the 1953 layer is the best GSSP level candidate in the stratigraphy at this site.
Exergaming delivery of a balance and fall prevention program for older adults: A feasibility study
Authors: Ren Ivy , Rozanski Gabriela , Fernandez Naiara , Zabala Amaia , Ramos Amaia , Arrinda Ismene , Tabacof Laura , Putrino David
Published: December 2022

Objective

Older adults are at high risk of falls and this problem calls for efficient and scalable interventions. This study investigated whether a motion capture system paired with balance training exergaming software is a feasible strategy to deliver therapeutic exercise to older adults in an aged care facility.

Methods

This study analyzed data from a quality improvement rehabilitation initiative. Two convenience samples of older adults were included: a usual care group ( n = 12), admitted to a rehabilitation hospital and receiving standard in-patient therapy 5×/week and the Evolv group ( n = 12), admitted to an aged care facility, prescribed exergaming 3×/week. All participants performed 30-minute exercise sessions based on a fall prevention program over 3 months. The Short Physical Performance Battery (SPPB) and Tinetti Performance Oriented Mobility Assessment test were administered pre- and post-treatment.

Results

No adverse events were recorded during the interventions. Mean SPPB increase for Evolv participants was 2.25 ± 1.35 ( p < .001, CI for mean = 1.39 to 3.11, d = 1.66), compared with a non-significant change in the usual care group (mean increase = 2.25 ± 3.82, p = .066, CI for mean = −0.18 to 4.68, d = 0.59). Tinetti improvement was significant for the individuals receiving usual care (3.83 ± 2.82, p = .012, CI for mean = 1.01 to 6.66, d = 0.86) but there were no significant between-group differences in outcomes.

Conclusions

Exergaming with the Evolv system for balance and strength training may be a feasible strategy to improve physical function for older adults recovering in an aged care facility.
Anomalous Right Coronary Artery Originating From the Pulmonary Artery (ARCAPA): A Rare Presentation in the Fifth Decade
Authors: Sharma V. , Doig F. , Maxwell Ryan , Grout D. , Saeed U. , Wall D.
Published: December 2022

Presented is a case report of a 54-year-old male Jehovah's Witness diagnosed with an anomalous right coronary artery originating from the main pulmonary artery with the initial presentation with a history of episodic fatigue, chest pain, palpitation, and bodily weakness. The patient was managed with reimplantation of the anomalous coronary artery onto the ascending aorta.
Subcutaneous Lumbar Spine Index (SLSI) as a Risk Factor for Surgical Site Infection After Lumbar Fusion Surgery: A Retrospective Matched Case–Control Study
Authors: Shen Xu , Gao Yucheng , Zhang Pei , Zhu Lei , Jiang Zanli , Shi Hang , Xuan Wenbin , Qian Yulei , Gao Zengxin
Published: December 2022

Study Design

A retrospective matched case–control study.

Objective

This study aims to investigate the value of Subcutaneous Lumbar Spine Index (SLSI) as a predictor of early surgical site infection (SSI) after lumbar intervertebral fusion surgery.

Methods

A retrospective case–control study was performed on patients who underwent transforaminal lumbar interbody fusion (TLIF) from January 1, 2014 to December 31, 2019 in a single institution. Cases were defined as those who developed early SSI according to the US Center for Disease Control and Prevention criteria, and controls were matched from those patients without early SSI using the following matched criteria: gender, age, time of surgery and diabetes. Subcutaneous fat thickness (SFT) and SLSI were measured on preoperative MRI mid-sagittal T2 weighted images.

Results

A total of 3615 patients who underwent TLIF were enrolled in this study. Thirty-three patients were included in early SSI, and sixty-six patients were selected as matched controls. Univariate analysis indicated that fusion levels ( P = .007), operation time ( P = .022), obesity ( P = .013), SFT ( P = .002) and SLSI ( P = .001) were significantly associated with early SSI. Multiple logistic regression analysis revealed that multilevel fusion levels ( P = .021), obesity ( P = .035), a large SFT ( P = .026) and a high SLSI (P = .012) were independent risk factors. Body mass index (BMI) and SLSI were moderately correlated ( r2 = .55). ROC curve demonstrated that SLSI was more sensitive than SFT to predict the early SSI.

Conclusion

SLSI is a novel radiological risk factor for early SSI development and is a better indicator than SFT to predict early SSI risk after lumbar intervertebral fusion.
Determinants of Farmers’ Vulnerability to Poverty Due to Crop Loss: The Case of Assam, India
Authors: Das Daisy
Published: December 2022

This article tries to assess the determinants of farmers’ vulnerability to poverty due to crop loss and to find out how they cope with it. To carry out the aforesaid study, we have conducted a field survey in Assam, India. Using ordered probit regression, we find that vulnerability is determined by a host of factors such as age, family size, social group, monthly expenditure, loss due to crop damage, coping measures, crop insurance, use of chemical fertilizers and irrigation. However, access to institutional support does not reduce vulnerability significantly. Coping measures are mostly destructive, and farmers with these coping strategies are more vulnerable to poverty. Social safety nets such as public distribution and ad hoc employment facilities are available, but the safety nets needed for farming and basic measures required for increasing productivity have been lacking. The study recommends affordable irrigation, training and awareness programmes and the provision of the resource base for successful coping. It is also important to provide opportunities for livelihood diversification to maintain the inflow of cash during crop loss. Finally, farmers who are on the margins of subsistence require institutions for social security to reduce vulnerability and bring about transformation.

JEL Classification: C83
Does Risk Perception Endogenously Cause Smokers to Switch to Smoking Smuggled Cigarettes?
Authors: Chen Hsin-Fan , Chen Sheng-Hung , Lee Jie-Min
Published: December 2022

Risk perception is a crucial component in evaluating the rationality of smoking decisions, but there are few studies that have examined its effect on the smoking of smuggled cigarettes. The purpose of this article is to empirically investigate whether risk perceptions affect the smoking of smuggled cigarettes in Taiwan in the context of socio-economic status. Since risk perception may be endogenous with regard to smoking smuggled cigarettes, the endogenous switching model is utilised to evaluate the effect of risk perception in relation to the smoker’s being concerned with health risks and tobacco quality. Our empirical results indicate that smokers with higher degrees of risk perception are less likely to smoke smuggled cigarettes. In addition, the relevant characteristics of the socio-economic status of smokers, such as weekly cigarette expenditure, gender, age, and whether or not they reside in the southern region of Taiwan, are also statistically significant in terms of smoking smuggled cigarettes. Therefore, the public health authorities in Taiwan should actively broadcast information on the fatal consequences of smoking smuggled cigarettes, thereby enhancing the smoker’s risk perceptions in regard to smuggled cigarettes.

JEL Classifications: I12, I18, D81, C25
Staff Experience in the NHS: A National Study—An Experience-Based Design Approach
Authors: Johnson Amoy , Conroy Simon , Thompson Deborah , Hassett Grace , Clayton Alice , Backhouse Emma
Published: December 2022

Introduction: A positive patient experience is a key component of good quality of care. Post-pandemic healthcare systems face the challenge of addressing burnout among healthcare staff, who are directly involved in the delivery of healthcare, which has implications for the patient experience. There is an established association between staff and patient experience; exploring the experience of staff may give insights into factors that negatively impact the patient experience. Experience-based design (EBD) is a quality improvement approach that uses the experience of service users to derive improvements. The purpose of this study is to design, validate, and test an EBD tool that may be used to capture the staff experience. Methods: A focus group of clinical and nonclinical staff (identified through the NHS Elect networks) and the development team coproduced an EBD survey based on nine “touch-points” of a typical working day. Once the survey questionnaire was tested and agreed with it was distributed to 1300 members of NHS networks. Results: A total of 377 NHS staff responded to the questionnaire. Analysis revealed effective teamwork had a positive psychological impact on staff. However, increased workload, missed meal breaks, and an increased administrative/IT burden were associated with the greatest negative responses by clinical and nonclinical staff. Conclusion: Overall, factors impacting staff well-being are multifaceted and varied between trusts. However, leaders in healthcare can use EBD to identify targeted improvements for the day-to-day experiences of staff.
Displaced Dalits and Their Issues of Human Rights: A Case Study on the Stone Crushers of Balasan River Bed
Authors: Bhattacharjee Somenath
Published: December 2022

Human rights actually refer to those elemental rights which any human deserves to have honoured in order to survive, enjoy well-being and flourish or fulfil him or herself by virtue of being a human. But today, the wave of the new world order, exploitative attitude, consumerism and greed of a few are refuting the needs of many. In this regard, along with a number of factors, the issues related to the displacement of the population have emerged as major ones. Particularly due to this factor, the concerned people have to lose their permanent settlement and stable economic pursuit and they are forced to face severe inconveniences in every aspect of their livelihood. Ultimately, the different aspects of their fundamental human rights are being seriously violated. These issues have been observed among the stone crushers of Balasan river bed, who were displaced from their earlier settlement and are struggling for their common minimum livelihood.
Reconsidering the goals of evolution education: defining evolution and evolutionary literacy
Authors: Kampourakis Kostas
Published: December 2022

In this paper, I argue that for both theoretical and practical purposes, it is useful for science education to clearly distinguish between science content knowledge and skills on the one hand, and the competencies related to their application in everyday life. This can be based on a distinction made by Douglas Roberts between two visions of literacy, and it can be effectively reconceptualized as the distinction between two types of literacy relevant to science:Science literacy, which is literacy relevant to the processes and products of science, related to the content of science taught in classrooms (literacy about issues within science); andScientific literacy, which is literacy relevant to questions that students may encounter as citizens and to the socio-ethical implications of scientific knowledge (literacy about the implications of science for society). Based on this, we can in turn distinguish between two types of literacy related to evolution:Evolution literacy, which is literacy relevant to the evolution content taught in classrooms; andEvolutionary literacy, which is literacy relevant to questions that students may encounter as citizens and to the socio-ethical implications of scientific knowledge. In this article I argue that whereas a lot of attention has been given to evolution literacy as a learning goal, there has been less reflection and discussion about evolutionary literacy—and it is exactly the distinction between these two types of literacy that helps one realize this. Teaching for evolutionary literacy requires specific skills from teachers, which go beyond their ability to teach concepts and explanations. My aim is to initiate a discussion about how to set evolutionary literacy as a learning objective at schools along evolution literacy. A key issue in such a case is how we could prepare teachers who would be capable, and confident, to address issues going beyond the typical science content, and which are often related to worldviews, in the classroom.
JCBIE: a joint continual learning neural network for biomedical information extraction
Authors: He Kai , Mao Rui , Gong Tieliang , Cambria Erik , Li Chen
Published: December 2022

Extracting knowledge from heterogeneous data sources is fundamental for the construction of structured biomedical knowledge graphs (BKGs), where entities and relations are represented as nodes and edges in the graphs, respectively. Previous biomedical knowledge extraction methods simply considered limited entity types and relations by using a task-specific training set, which is insufficient for large-scale BKGs development and downstream task applications in different scenarios. To alleviate this issue, we propose a joint continual learning biomedical information extraction (JCBIE) network to extract entities and relations from different biomedical information datasets. By empirically studying different joint learning and continual learning strategies, the proposed JCBIE can learn and expand different types of entities and relations from different datasets. JCBIE uses two separated encoders in joint-feature extraction, hence can effectively avoid the feature confusion problem comparing with using one hard-parameter sharing encoder. Specifically, it allows us to adopt entity augmented inputs to establish the interaction between named entity recognition and relation extraction. Finally, a novel evaluation mechanism is proposed for measuring cross-corpus generalization errors, which was ignored by traditional evaluation methods. Our empirical studies show that JCBIE achieves promising performance when continual learning strategy is adopted with multiple corpora.
VirPool: model-based estimation of SARS-CoV-2 variant proportions in wastewater samples
Authors: Gafurov Askar , Baláž Andrej , Amman Fabian , Boršová Kristína , Čabanová Viktória , Klempa Boris , Bergthaler Andreas , Vinař Tomáš , Brejová Broňa
Published: December 2022

Background

The genomes of SARS-CoV-2 are classified into variants, some of which are monitored as variants of concern (e.g. the Delta variant B.1.617.2 or Omicron variant B.1.1.529). Proportions of these variants circulating in a human population are typically estimated by large-scale sequencing of individual patient samples. Sequencing a mixture of SARS-CoV-2 RNA molecules from wastewater provides a cost-effective alternative, but requires methods for estimating variant proportions in a mixed sample.

Results

We propose a new method based on a probabilistic model of sequencing reads, capturing sequence diversity present within individual variants, as well as sequencing errors. The algorithm is implemented in an open source Python program called VirPool. We evaluate the accuracy of VirPool on several simulated and real sequencing data sets from both Illumina and nanopore sequencing platforms, including wastewater samples from Austria and France monitoring the onset of the Alpha variant.

Conclusions

VirPool is a versatile tool for wastewater and other mixed-sample analysis that can handle both short- and long-read sequencing data. Our approach does not require pre-selection of characteristic mutations for variant profiles, it is able to use the entire length of reads instead of just the most informative positions, and can also capture haplotype dependencies within a single read.
Joint learning sample similarity and correlation representation for cancer survival prediction
Authors: Hao Yaru , Jing Xiao-Yuan , Sun Qixing
Published: December 2022

Background

As a highly aggressive disease, cancer has been becoming the leading death cause around the world. Accurate prediction of the survival expectancy for cancer patients is significant, which can help clinicians make appropriate therapeutic schemes. With the high-throughput sequencing technology becoming more and more cost-effective, integrating multi-type genome-wide data has been a promising method in cancer survival prediction. Based on these genomic data, some data-integration methods for cancer survival prediction have been proposed. However, existing methods fail to simultaneously utilize feature information and structure information of multi-type genome-wide data.

Results

We propose a Multi-type Data Joint Learning (MDJL) approach based on multi-type genome-wide data, which comprehensively exploits feature information and structure information. Specifically, MDJL exploits correlation representations between any two data types by cross-correlation calculation for learning discriminant features. Moreover, based on the learned multiple correlation representations, MDJL constructs sample similarity matrices for capturing global and local structures across different data types. With the learned discriminant representation matrix and fused similarity matrix, MDJL constructs graph convolutional network with Cox loss for survival prediction.

Conclusions

Experimental results demonstrate that our approach substantially outperforms established integrative methods and is effective for cancer survival prediction.
Knowledge, experiences, and attitudes of Australian General Practitioners towards medicinal cannabis: a 2021–2022 survey
Authors: Bawa Zeeta , McCartney Danielle , Manocha Ramesh , McGregor Iain S.
Published: December 2022

Background

Medicinal cannabis (MC) products have been available on prescription in Australia for around six years. General practitioners (GPs) are at the forefront of MC prescribing and recent years have seen substantial increases in prescription numbers. This study examined the current knowledge, experiences, and attitudes of Australian GPs around MC. We also compared our findings to those of an earlier 2017 investigation.

Method

We conducted a cross-sectional study using a 42-item on-line questionnaire adapted from our earlier 2017 survey. The current survey was completed by GPs attending an on-line, multi-topic educational seminar. Australian GPs (n = 505) completed the survey between November 2021 and February 2022. Data were synthesised using descriptive statistics. MC ‘prescribers’ and ‘non-prescribers’ responses were compared using Pearson’s χ2 tests.

Results

While most GPs (85.3%) had received patient enquiries about MC during the last three months, only half (52.3%) felt comfortable discussing MC with patients. Around one fifth (21.8%) had prescribed a MC product. GPs strongly supported MC prescribing for palliative care, cancer pain, chemotherapy-induced nausea and vomiting, and epilepsy, more so than in our 2017 survey. Prescribing for mental health conditions (e.g., depression, anxiety) and insomnia received less support. Opioids, benzodiazepines, and chemotherapy drugs were rated as more hazardous than MC. GPs correctly endorsed concerns around Δ9-tetrahydrocannabinol-related driving impairment and drug-seeking behaviour. However, additional concerns endorsed around cannabidiol causing addiction and driving impairment do not agree with current evidence. Consistent with this, many GPs (66.9%) felt they had inadequate knowledge of MC.

Conclusion

Acceptance of MC as a treatment option has increased among Australian GPs since 2017. However, there is a clear need for improved training and education of GPs around cannabis-based medicines to provide increased numbers of skilled prescribers in the community.
Strategies to build more effective interventions for elder abuse: a focus group study of nursing and social work professionals in Hong Kong
Authors: Yan Elsie , To Louis , Wan Debby , Xie Xiaojing , Wong Frances , Shum David
Published: December 2022

Background

One in six older adults living in communities experience abuse and neglect. Elder abuse has serious consequences for individuals, families, and society, including mortality, physical and psychological morbidities, and increased care requirements. Timely and effective interventions for elder abuse should therefore be a priority. This study used a qualitative focus group approach to address the following questions: What are the essential elements of elder abuse interventions? What can be done to improve current interventions?

Method

The 32 participants in this focus group study included social workers, medical social workers, and nurses from seven organizations who shared their knowledge and insights. All sessions were conducted online, audio-recorded, and transcribed verbatim. Three researchers with backgrounds in social work and psychology independently coded the transcripts and agreed on the themes emerging from the focus groups.

Results

Based on the experiences of frontline helping professionals in Hong Kong, we highlighted the key factors for effective elder abuse intervention: 1) identification and assessment; 2) essential skills and attitudes; 3) elements of effective interventions; 4) collaborative efforts across disciplines and agencies; and 5) raising awareness among professionals and the public.

Conclusions

Training can equip frontline professionals with the necessary skills to identify elder abuse cases and to assess the risk of abuse. Effective interventions should not only address clients’ safety and need for tangible support but also respect their autonomy and privacy. A client-centered, strength-based approach that involves supportive peers and addresses the complex family relationships involved can be useful. Interventions should also involve cross-discipline and cross-agency collaboration.
Could combined rapid diagnostic testing for malaria and c-reactive protein be helpful for the diagnosis and management of febrile illnesses in children under-5 years of age in rural Burkina Faso?
Authors: Bonko Massa dit Achille , Karama Ibrahima , Kiemde Francois , Lompo Palpouguini , Garba Zakaria , Yougbaré Sibidou , Mens Petra F. , Tinto Halidou , Tahita Marc Christian , Schallig Henk. D. F. H.
Published: December 2022

Background

Febrile illnesses are among the most important reasons for medical consultation in sub-Saharan Africa and are frequently treated with antimicrobials due to the unavailability of appropriate diagnostic tools. This practice leads to antimicrobial resistance, with increasing mortality and morbidity as result. One of the few accessible diagnostic tools available in low resource settings is malaria rapid diagnostic tests (mRDTs) which contributed to reducing the over-prescription of anti-malarials, but cannot guide antibiotic prescriptions. To circumvent this problem, we explored whether combined testing with mRDT and c-reactive protein (CRP) could improve the diagnosis of febrile illnesses and subsequent prescription of antibiotics.

Methods

Clinical specimens (blood, stool and urine) collected from 396 febrile children (axillary temperature of ≥ 37.5 °C) were analyzed with rapid diagnostic tests (malaria and CRP) and microbiology culture to establish the possible cause of fever. Actual antimicrobial prescriptions given to the children were compared with those that could be given based on combined CRP-malaria testing.

Results

In total, 68.7% (272/396) of malaria cases were diagnosed by mRDT-Pf-HRP-2. CRP test was positive in 84.3% (334/396) of the children, but bacterial infections were confirmed in 12.4% (49/396) of them. A possible cause of fever could not be established in 20.5% (81/396) of cases. Based on the diagnostic practice in place, 265 of the children with a positive mRDT-Pf-HRP-2 received anti-malarial treatment. Furthermore, 89.5% (111/124) of negative mRDT results received antibiotic treatment and 37.1% (46/124) received antimalarial treatment. Of these 124 cases, 80 had positive CRP tests and 44 negative CRP tests. If the results of CRP testing are considered, 44 CRP/mRDT negative children would not get antibiotic treatment, resulting in a 35.5% reduction in antibiotic prescriptions. However, 2 cases with a bacterial infection would be denied appropriate treatment.

Conclusion

Combining mRDT-PfHRP2 with CRP testing is particularly useful in children for whom both tests are negative as it results in a reduction of antibiotics prescriptions. However, there is a risk to miss potential severe bacterial infections and a close follow-up of these cases is strongly recommended.
Exploring human mixing patterns based on time use and social contact data and their implications for infectious disease transmission models
Authors: Hoang Thang Van , Willem Lander , Coletti Pietro , Van Kerckhove Kim , Minnen Joeri , Beutels Philippe , Hens Niel
Published: December 2022

Background

The increasing availability of data on social contact patterns and time use provides invaluable information for studying transmission dynamics of infectious diseases. Social contact data provide information on the interaction of people in a population whereas the value of time use data lies in the quantification of exposure patterns. Both have been used as proxies for transmission risks within in a population and the combination of both sources has led to investigate which contacts are more suitable to describe these transmission risks.

Methods

We used social contact and time use data from 1707 participants from a survey conducted in Flanders, Belgium in 2010–2011. We calculated weighted exposure time and social contact matrices to analyze age- and gender-specific mixing patterns and to quantify behavioral changes by distance from home. We compared the value of both separate and combined data sources for explaining seroprevalence and incidence data on parvovirus-B19, Varicella-Zoster virus (VZV) and influenza like illnesses (ILI), respectively.

Results

Assortative mixing and inter-generational interaction is more pronounced in the exposure matrix due to the high proportion of time spent at home. This pattern is less pronounced in the social contact matrix, which is more impacted by the reported contacts at school and work. The average number of contacts declined with distance. On the individual-level, we observed an increase in the number of contacts and the transmission potential by distance when travelling. We found that both social contact data and time use data provide a good match with the seroprevalence and incidence data at hand. When comparing the use of different combinations of both data sources, we found that the social contact matrix based on close contacts of at least 4 h appeared to be the best proxy for parvovirus-B19 transmission. Social contacts and exposure time were both on their own able to explain VZV seroprevalence data though combining both scored best. Compared with the contact approach, the time use approach provided the better fit to the ILI incidence data.

Conclusions

Our work emphasises the common and complementary value of time use and social contact data for analysing mixing behavior and analysing infectious disease transmission. We derived spatial, temporal, age-, gender- and distance-specific mixing patterns, which are informative for future modelling studies.