bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and psychometric testing of the Perceived Organizational Climate Scale for nurses
Authors: Sein Myint Nwe Ni , Kunaviktikul Wipada , Akkadechanunt Thitinut , Wichaikhum Orn‐Anong , Turale Sue
Published: August 2022

Aim

Retaining nurses on the job is vital, and their successful retention is related to the organizational climates (OC) of healthcare settings. The purpose was to develop and test the psychometric properties of the Perceived Organizational Climate Scale (POCS).

Design

The methodologic research design was used by following the scale development strategies by DeVellis (2017). The conceptual framework for this study was based on the broader theoretical framework of the Competing Value Framework (CVF) of Quinn et al. (2015), the concept analysis and extensive literature review (1939–2018), and combined with the inductive qualitative data.

Methods

A two‐phase study of scale construction and psychometric testing was conducted for content validation, construct validation and internal consistency reliabilities of the instrument. An expert panel validated the 4‐point scale, followed by exploratory factor analysis, the known‐group approach and split groups. Data were collected from (1161) registered nurses in eight general hospitals across Myanmar from August 2019 to September 2020.

Results

The 35 items with four essential dimensions: transformational climate, bureaucratic climate, team climate and strategic climate, explained almost 50% of the variation with all factor loading greater than .40. The internal consistency reliabilities of the instrument showed the Cronbach's alpha coefficient of .93, and the dimensions were from .82 to .85. As hypothesized, the known‐group approach demonstrated that experienced nurses had higher mean scores than novices. The internal consistency reliabilities of the scale and dimensions across the splitting groups illustrated the stability.

Conclusion

This evidence supports this instrument as having satisfactory initial psychometric properties with a comprehensive picture of OC by its essential components contributing to an inclusive understanding of this climate globally.

Impact

This instrument can be used as an objective tool for evaluating OC as perceived by nurses in healthcare settings to inform improvements in working environments.
Network analysis reveals aggregation behaviour for an endangered predator at an offshore island
Authors: Spector Michael , Clevenstine Alyssa J. , Cajandig Mari , Caldow Chris , Duncan Elizabeth A. , Peavey Reeves Lindsey E. , Freedman Ryan M.
Published: August 2022

Site fidelity and aggregation behaviour were assessed for giant sea bass Stereolepis gigas (GSB) at Santa Barbara Island, California, USA, from 2018 to 2020. Results indicate seasonal variation in GSB presence, and network analyses revealed a preferred location in a spatially constrained pattern, indicative of aggregation behaviour. Results show GSB aggregated annually during spawning months in the same location, confirming the first known aggregation of GSB at Santa Barbara Island. Identifying and monitoring aggregation sites is vital to ensuring proper protection and ultimate recovery for this protected species in a changing climate.
Self‐reported fraud victimization and objectively measured blood pressure: Sex differences in post‐fraud cardiovascular health
Authors: Lamar Melissa , Yu Lei , Leurgans Sue , Aggarwal Neelum T. , Wilson Robert S. , Han S. Duke , Bennett David A. , Boyle Patricia
Published: August 2022

Background

Over 5 million older Americans are victims of financial exploitation, schemes, and/or scams per year. Such victimization is associated with increased hospitalizations, admittance to skilled nursing facilities, and lower 5‐year all‐cause mortality survival rates. Despite this, associations with medical comorbidities like elevated blood pressure (BP) have not been examined.

Methods

We investigated the association of self‐reported fraud victimization (presence/absence) with objectively measured BP metrics leveraging cross‐sectional and longitudinal data from over 1200 non‐demented adults (75% female; age ~81 years) from the Rush Memory and Aging Project. We first examined cross‐sectional associations between baseline fraud victimization and BP, then used longitudinal data to test the hypothesis that fraud victimization is associated with increases in BP after incident fraud. During up to 11 years of annual observation, participants were queried for fraud victimization and underwent serial BP measurements to calculate per visit averages of systolic and diastolic BP, mean arterial pressure (MAP), and pulse pressure.

Results

Cross‐sectional analyses established that fraud victimization at baseline was associated with higher BP values. Next, using longitudinal changepoint analyses, we showed that fraud victimization was associated with elevations in BP among men but not women. Specifically, men who reported incident fraud exhibited increases in all BP metrics post‐fraud.

Conclusion

Results suggest an important link between fraud victimization and BP, particularly among men. Older men showed significant elevations in BP after incident fraud that, compounded over time, may portend other adverse health outcomes.
Agrarian movements and rural populism in Indonesia
Authors: White Ben , Graham Colum , Savitri Laksmi
Published: August 2022

In this article, we reflect on the changing trajectories of agrarian movements in Indonesia. In the two decades after independence, a left‐populist alliance of peasants, plantation workers, and other affiliate organizations achieved a mass following and were embraced by President Sukarno. In the aftermath of their violent destruction, the Suharto regime reordered agrarian movements into a single corporatist model. Suharto's downfall opened the way for the re‐emergence of agrarian organizations and movements. But two decades later, they remain small and fragmented, with little influence at the national level. In the changing conditions of rural life, and the increasingly authoritarian political context, progressive rural movements face dilemmas on questions both of their focus and goals and of tactical alliances with other progressive movements and political elites. A broader, more inclusive progressive populist alliance is a possibility, but with the continuing danger of co‐optation by forces of the populist right.
Beyond environmental imagination: Revisiting J.R.R. Tolkien's literary landscapes inThe Lord of the Rings(1954–1955)
Authors: Mohammadi Farid
Published: August 2022

J.R.R. Tolkien (1892–1973) was highly influential in shaping modern fantasy literature and popularising medievalism. Scholarship has examined various aspects of Tolkien's literary imagination inThe Lord of the Rings(1954–1955); however, to date, there has been no thorough scrutiny of the significance of aesthetics in his creative works. This paper contends that Tolkien's magnum opus as part of his long‐life myth‐making project was shaped profoundly by the late 18th‐century aesthetics of the sublime. It draws on Burkean physiological sublime to argue that contrary to Kantian rationality, certain Tolkienian landscapes demonstrate the qualities of the natural sublime and generate physical experiences on the observer that accentuates the primacy of emotions over reason. The article proposes a new direction in Tolkien studies by highlighting the aesthetic overtones of Tolkien's engagement with the sublime, which played a significant role in constructing his English mythology.
Clinico‐laboratory findings of Malassezia folliculitis in Indonesia: A multicentre study
Authors: Niode Nurdjannah J. , Suling Pieter L. , Adji Aryani , Miranda Eliza , Bramono Kusmarinah , Astari Linda , Ervianti Evy , Sondakh Oktavia R. L. , Rusmawardiana  , Yenny Satya W. , Widasmara Dhelya , Lubis Flora M. , Widaty Sandra
Published: August 2022

Background

Malassezia folliculitis (MF) is a humid‐favoured fungal skin disease caused by Malassezia species. Inaccurate treatments, changes in skin flora and disease exacerbation are often occurred due to oversights in the diagnosis. Several diagnostic methods are established for MF.

Objective

To identify clinico‐laboratory findings of Malassezia folliculitis in Indonesia.

Methods

The study was conducted from January 2014 to December 2018 in seven referral teaching hospitals. Medical records of MF‐diagnosed patients were obtained and analysed using the binomial test, chi‐square test and Cohen's Kappa coefficient in SPSS 26.0.

Results

A total of 353 cases of MF were identified in seven referral teaching hospitals in Indonesia, 66.3% of which were males and 33.7% were females, dominated by the 17–25 years old group (44.5%). Itchy sensation (83.9%) was a major subjective complaint. Lesions were majorly found on the trunk‐chest, back and shoulder (68.3%), while the clinical manifestation are mostly follicular papule‐pustular lesions (62.1%). Patients were 87.4% positive by KOH examination (modified Jacinto Jamora's criteria) and 69.1% positive by Wood's lamp. Generally, sex, age, subjective complaint, lesion location, clinical manifestation and both examinations were statistically significant (p < .001). A significant relationship between all the clinical criteria of the patients in the KOH especially the clinical manifestation was significantly related to Wood's lamp. The Cohen's Kappa assessment suggested that there was an agreement between KOH and Wood's lamp (κ = −0.272, p < .001).

Conclusion

The clinical symptoms of Malassezia folliculitis are dominated by pruritus, papulopustular follicular lesions on the trunk and the presence of spore load.
Historical and future dynamics of land use land cover and its drivers in Ajora‐Woybo watershed, Omo‐Gibe basin, Ethiopia
Authors: Toma Meseret B. , Belete Mulugeta D. , Ulsido Mihret D.
Published: August 2022

Land use land cover (LULC) dynamics have long been recognized as a significant driver of natural resource change. As a result, understanding the spatial and temporal variation of LULC in the watershed is essential for effective natural resource management and long‐term development. This study attempts to analyze the dynamics and change drivers from 1990 to 2020 and predict the situation for 2035 and 2050 in the Ajora‐Woybo watershed. ArcGIS 10.3 and ERDAS 2015 were used to analyze quantitative data from Landsat imagery. For supervised image classification, a Maximum‐Likelihood classification algorithm was used. To identify driver variables, focus groups and key informants' interviews were done. TerrSet 18.31 software was used to predict LULC utilizing the Multi‐Layer Perceptron Neural Network and Cellular Automata‐Markov Chain models incorporated in Land Change Modeler. Six LULC classes were discovered: cultivated land, built‐up, shrub land, forest land, bare land, and water body. Cultivated land, built‐up area, and bare land have increased at the expense of shrub land and forest land over the last three decades. Trends in water bodies show both decreasing and increasing trends. According to the predicted outcomes, cultivated land, built‐up and bare land has increased, while shrub land and forest land have declined. Finally, agricultural expansion, population growth, wood extraction, resettlement, urbanization, and lack of environmental consideration were identified as the major drivers of LULC change. The study demonstrated that there have been significant changes in the watershed LULC. As a result, reversing the predicted conditions is critical to ensuring the watershed long‐term viability.
Erythema nodosum associated with COVID19 infection: A pediatric case report and review of the literature
Authors: Zambrano‐Mericq María José , Lam Joseph M.
Published: August 2022

Erythema nodosum (EN) is a common panniculitis characterized by tender erythematous nodules predominantly on the pretibial area and represents a hypersensitivity reaction to multiple triggers. COVID19 infection and vaccination have been associated with EN in the adult population. We report a pediatric case of EN following COVID19 infection and review the literature on COVID19 infection and COVID19 immunization‐related EN.
Facilitation of weed seed predation by living mulch and cover crops
Authors: Schumacher Matthias , Gerhards Roland
Published: August 2022

Weed seed predation (WSP) is an important agro‐ecosystem service that naturally suppresses weed populations. Disturbances directly interfere with the activity of the seed predators, for example, harvest and soil tillage during a peak in weed seed availability (around cereal harvest). Plant soil cover and reduced soil tillage are factors that might positively affect WSP. We investigated cover crops and living mulch along with soil disturbance (no‐till and conventional seeding) in comparison to a fallow and repeated stubble tillage with a chisel plough in terms of WSP, activity‐density of carabid beetles and soil cover. A field experiment with a randomised complete block design and four replications was conducted at two sites from 2017 until 2019. WSP rates were assessed with seed cards and exclosure cages from July until November during a period of eight consecutive days each month. Living mulch exhibited the highest WSP rates of 72% with a maximum of 95% immediately following cereal harvest in August and September of 2017 and 2019, while the remainder of the treatments ranged from 2% to 5% WSP. In October and November mustard showed on average twice as high WSP rates compared to the other treatments (50% vs. 10%–25%). Seeding and soil tillage did not significantly influence carabid beetle activity‐density and WSP, except for living mulch. Predator groups (invertebrates and vertebrates) were not influenced by the various treatments, rather year and month determined the predator groups dominance. Besides their weed suppressive effects, living mulches and cover crops also facilitate WSP.
Recognizing The Importance of Physical Activity and Cultivating Body Posture Among Israeli-Arab Kindergarten Teachers
Authors: Gil Iris
Published: August 2022

Of the population in Israel, approximately 80% is Jewish and approximately 20% is Arab. In the first years following the establishment of the State of Israel, education in the Arab sector suffered from discrimination and neglect, and it appears that programs to reduce the gaps have only been introduced in recent years i.e., since 2007. The aim of the present study is to examine, in the Arab sector, kindergarten teachers’ level of awareness of the overall importance of physical activity and its importance for cultivating correct posture. To this end, a qualitative study – interviews and category analysis – of eight Israeli-Arab kindergarten teachers was conducted. The study’s findings and conclusions are that the kindergarten teachers who participated in the study had high awareness of the importance of physical activity, which should be maintained. However, their awareness of the importance of physical activity in kindergarteners for the cultivation of correct posture is very low, and there are a variety of ways to enrich them in this area.
A política identitária em questão: reflexões a partir de Judith Butler e Achille Mbembe
Authors: Alves Marco Antônio Sousa , Alkmin Gabriela Campos
Published: August 2022

A noção de “identidade” adquiriu, nas últimas décadas, grande importância no cenário político e cultural, ao ser apropriada pelas chamadas “políticas identitárias”. Neste artigo, pretendemos desenvolver uma reflexão crítica dessa apropriação a partir das contribuições de Judith Butler e de Achille Mbembe. Analisaremos diferentes obras desses autores, em especial os livros Problemas de gênero (1990), Quadros de guerra (2009) e Corpos em aliança e a política das ruas (2015), da filósofa norte-americana, e Sair da grande noite (2010), Crítica da razão negra (2013), Políticas da inimizade (2016) e Brutalismo (2020), do pensador camaronês. Pretendemos mostrar que ambos desenvolvem uma crítica, tanto teórica quanto prática, que se volta contra a ideia de identidade-substância e, também, contra determinados usos políticos que privilegiam as diferenças e as separações. Seja ao repensar o feminismo e o movimento LGBT+, seja ao rever criticamente as lutas antirracistas e anticoloniais, Butler e Mbembe, respectivamente, apontam para novas maneiras de fundamentar teoricamente a ação política e de organizar a luta desses grupos assujeitados e subalternizados. Butler e Mbembe, em nossa interpretação, caminham juntos no esforço de pensar para além da identidade e de promover alianças mais amplas, apontando em uma direção mais universalista, que privilegia o comum e volta-se para o futuro.
¿Tomarnos en serio la igualdad? Algunas reflexiones sobre el establecimiento de acciones positivas en Argentina.
Authors: Ronconi Liliana
Published: August 2022

El objetivo de este artículo es reflexionar sobre el impacto del sistema de cuotas en Argentina y sobre como debe ser interpretada esta herramienta a fin de tomarnos en serio a la igualdad. Para esto, en primer lugar (I), me enfocaré en reflexionar sobre las distintas concepciones de igualdad y de acciones positivas. Luego (II), reflexionaré sobre el sistema de cuotas en Argentina, en especial en lo que se refiere a cargos públicos electivos. Posteriormente (III), me referiré a los posibles problemas que pueden surgir de una norma que establece la obligación para sociedades y asociaciones de cumplir con un porcentaje de mujeres en los cargos de administración y fiscalización, en especial  sobre ciertas cuestiones particulares que aparecen cuando se busca limitar el accionar de los particulares. Así, podré realizar algunas críticas más generales a este tipo de acciones como herramienta eficiente para lograr la igualdad real (IV). Finalmente, estableceré algunas conclusiones.
É Possível Pensar em um Local "Ideal" para Mulheres Trans/Travestis nas Prisões Brasileiras? Uma Reflexão a Partir da Experiência Pernambucana
Authors: Doering Morais Neon Bruno , Montenegro Pessoa de Mello Marilia , Lopes de Almeida Amazonas Maria Cristina
Published: August 2022

O Conselho Nacional de Justiça (CNJ) aprovou a Resolução nº 348, que estabelece di-retrizes e procedimentos a serem observados pelo Poder Judiciário com relação ao tratamento da população LGBTI privada de liberdade. Dessa forma, a determinação do local de privação de liberdade da mulher trans/travesti cabe à magistratura após a consulta à pessoa sobre sua escolha em decisão fundamentada. Esse artigo se baseia em pesquisa de campo exploratória a partir de uma análise multissituada e apresenta como objetivo principal refletir, com a lupa da criminologia queer, sobre a existência de um local “ideal” nas prisões brasileiras para o cumprimento de pena pelas mulheres trans/travestis. A metodologia abrangeu abordagens qualitativas, a partir de entrevistas com nove travestis e visitas in locu. O quadro que apresentamos aponta para a impossibilidade de idealizar um espaço adequado. No atual contexto, a leitura dos dados permite reforçar a necessidade de reduzir a dor por meio da garantia de direitos básicos, estando a escolha do local de custódia condicionada à vontade da mulher trans/travesti.
Igualdade Revisitada: sobre a interpretaçãodo Artigo 3º da Lei Fundamental Alemã e dos Princípios Internacionais sobre Tratamento Igualitário
Authors: Baer Susanne
Published: August 2022

A europeização e globalização demandam um resgate dos desafios fundamentais na aplicação e interpretação do mandamento constitucional da igualdade de tratamento. Tais desafios não devem ser reduzidos a uma fórmula ou a uma agenda limitada, uma vez que aí se encontra o perigo de hierarquizar desigualdades. O que se busca é uma compreensão não enviesada sobre o direito ao tratamento igualitário, sobretudo nos casos que suscitam polêmicos debates sociopolíticos.
Local Mesh Refinement and Coarsening Based on Analysis-Suitable T-Splines Surface and Its Application in Contact Problem
Authors: Wang Yue , Yu Zuqing , Lan Peng , Lu Nianli
Published: August 2022

In contact analysis, reducing the computing time has been an issue under the premise of ensuring calculation accuracy around the region with violent stress changes. To improve computational efficiency for contact analysis in flexible multibody system, this paper proposes an adaptive local mesh refinement and coarsening approach based on analysis-suitable T-splines (ASTS). First, the kinematic model of thin plate is established based on analysis-suitable T-spline surface, and large deformation of flexible thin plate is described by the elastic model created by nonlinear Green–Lagrange strain. Second, to reduce computing time in contact analysis and ensure analysis accuracy, based on contact state and refinement distance, an effective adaptive local element mesh update method is proposed, which only refine locally on subject's refinement region and integrate redundant elements to reduce the degree-of-freedom (DOF) of system. Third, to analyze the system with varying mesh, a new solving algorithm with dynamic variables and geometry update routine is developed. Finally, performance of the proposed method in static and dynamic simulation is validated by four numerical examples. Results and consuming time of ASTS-based varying mesh prove the feasibility of the proposed method in contact problems.
Discrete Phase Analysis of Self Heating Particles Over an Immersion Liquid Cooled High Power Blue Light-Emitting Diode With Suspended Phosphor Particles
Authors: Cengiz Ceren , Muslu Ahmet Mete , Azarifar Mohammad , Arik Mehmet , Dogruoz Baris
Published: August 2022

In recent years, the interaction of unrestricted particles with dispersed multiphase flows has been linked to a number of important engineering applications. Among these applications, the novel idea of immersion-cooled phosphor particles, which has the potential of significantly increasing the thermal limits of phosphor converted white light-emitting diode (LEDs) (Pc-WLEDs), has yet to be thoroughly investigated. With this objective, this research utilizes the discrete phase modeling (DPM) technique for the characterization of phosphor location and movements within a buoyancy-driven flow, which is the determining factor in the optical behavior of the newly proposed Pc-WLED configuration. Two-phase flow analysis is conducted to characterize particle movement. Heat transfer, flow, and energy paths of self-heating phosphor particles are extracted, and the influence of particle sizes is analyzed in detail. The results show that with immersion liquid cooling, the highest phosphor particle temperature is recorded to be under 420 K, while larger size particles introduce higher heat transfer rates to the Pc-WLED package for the same number of particles. Moreover, depending on the particle size and position, individual phosphor particles can follow a different trajectory that can affect the probability of obtaining white light emission.
Regulation of membrane homeostasis by TMC1 mechanoelectrical transduction channels is essential for hearing
Authors: Ballesteros Angela , Swartz Kenton J.
Published: August 2022

The mechanoelectrical transduction (MET) channel in auditory hair cells converts sound into electrical signals, enabling hearing. Transmembrane-like channel 1 and 2 (TMC1 and TMC2) are implicated in forming the pore of the MET channel. Here, we demonstrate that inhibition of MET channels, breakage of the tip links required for MET, or buffering of intracellular Ca
...
induces pronounced phosphatidylserine externalization, membrane blebbing, and ectosome release at the hair cell sensory organelle, culminating in the loss of TMC1. Membrane homeostasis triggered by MET channel inhibition requires
Tmc1
but not
Tmc2
, and three deafness-causing mutations in
Tmc1
cause constitutive phosphatidylserine externalization that correlates with deafness phenotype. Our results suggest that, in addition to forming the pore of the MET channel, TMC1 is a critical regulator of membrane homeostasis in hair cells, and that
Tmc1
-related hearing loss may involve alterations in membrane homeostasis.
A SOX2-engineered epigenetic silencer factor represses the glioblastoma genetic program and restrains tumor development
Authors: Benedetti Valerio , Banfi Federica , Zaghi Mattia , Moll-Diaz Raquel , Massimino Luca , Argelich Laura , Bellini Edoardo , Bido Simone , Muggeo Sharon , Ordazzo Gabriele , Mastrototaro Giuseppina , Moneta Matteo , Sessa Alessandro , Broccoli Vania
Published: August 2022

Current therapies remain unsatisfactory in preventing the recurrence of glioblastoma multiforme (GBM), which leads to poor patient survival. By rational engineering of the transcription factor SOX2, a key promoter of GBM malignancy, together with the Kruppel-associated box and DNA methyltransferase3A/L catalytic domains, we generated a synthetic repressor named SOX2 epigenetic silencer (SES), which induces the transcriptional silencing of its original targets. By doing so, SES kills both glioma cell lines and patient-derived cancer stem cells in vitro and in vivo. SES expression, through local viral delivery in mouse xenografts, induces strong regression of human tumors and survival rescue. Conversely, SES is not harmful to neurons and glia, also thanks to a minimal promoter that restricts its expression in mitotically active cells, rarely present in the brain parenchyma. Collectively, SES produces a significant silencing of a large fraction of the SOX2 transcriptional network, achieving high levels of efficacy in repressing aggressive brain tumors.
Ferroelectric/paraelectric superlattices for energy storage
Authors: Aramberri Hugo , Fedorova Natalya S. , Íñiguez Jorge
Published: August 2022

The polarization response of antiferroelectrics to electric fields is such that the materials can store large energy densities, which makes them promising candidates for energy storage applications in pulsed-power technologies. However, relatively few materials of this kind are known. Here, we consider ferroelectric/paraelectric superlattices as artificial electrostatically engineered antiferroelectrics. Specifically, using high-throughput second-principles calculations, we engineer PbTiO
3
/SrTiO
3
superlattices to optimize their energy storage performance at room temperature (to maximize density and release efficiency) with respect to different design variables (layer thicknesses, epitaxial conditions, and stiffness of the dielectric layer). We obtain results competitive with the state-of-the-art antiferroelectric capacitors and reveal the mechanisms responsible for the optimal properties.
Safety and Pharmacokinetics of Taniborbactam (VNRX-5133) with Cefepime in Subjects with Various Degrees of Renal Impairment
Authors: Dowell James A. , Marbury Thomas C. , Smith William B. , Henkel Tim
Published: August 2022

Taniborbactam, an investigational β-lactamase inhibitor that is active against both serine- and metallo-β-lactamases, is being developed in combination with cefepime to treat serious infections caused by multidrug-resistant Gram-negative bacteria. Anticipating the use of cefepime-taniborbactam in patients with impaired renal function, an open-label, single-dose clinical study was performed to examine the pharmacokinetics of both drugs in subjects with various degrees of renal function.
Synthetic Genetic Interactions Reveal a Dense and Cryptic Regulatory Network of Small Noncoding RNAs in Escherichia coli
Authors: Rachwalski Kenneth , Ellis Michael J. , Tong Madeline , Brown Eric D.
Published: August 2022

sRNAs have long been purported to be a critical mechanism by which bacteria respond to stress; however, uncovering growth phenotypes for sRNA deletion strains in
E. coli
and related bacteria has proven particularly challenging. In contrast, the deletion of
hfq
, a chaperone required for the activity of many sRNAs in
E. coli
, results in striking growth defects in
E. coli
under a variety of medium conditions and chemical stressors.
Disaster Microbiology—a New Field of Study
Authors: Smith Daniel F. Q. , Casadevall Arturo
Published: August 2022

Natural and human-made disasters can cause tremendous physical damage, societal change, and suffering. In addition to their effects on people, disasters have been shown to alter the microbial population in the area affected.
Racial discrimination and adverse pregnancy outcomes: a systematic review and meta-analysis
Authors: van Daalen Kim Robin , Kaiser Jeenan , Kebede Samuel , Cipriano Gabriela , Maimouni Hassan , Olumese Ekiomoado , Chui Anthea , Kuhn Isla , Oliver-Williams Clare
Published: August 2022

Introduction

Racial discrimination has been consistently linked to various health outcomes and health disparities, including studies associating racial discrimination with patterns of racial disparities in adverse pregnancy outcomes. To expand our knowledge, this systematic review and meta-analysis assesses all available evidence on the association between self-reported racial discrimination and adverse pregnancy outcomes.

Methods

Eight electronic databases were searched without language or time restrictions, through January 2022. Data were extracted using a pre-piloted extraction tool. Quality assessment was conducted using the Newcastle–Ottawa Scale (NOS), and across all included studies using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Random effects meta-analyses were performed on preterm birth and small for gestational age. Heterogenicity was assessed using Cochran’s χ2test and I2statistic.

Results

Of 13 597 retrieved records, 24 articles were included. Studies included cohort, case–control and cross-sectional designs and were predominantly conducted in the USA (n=20). Across all outcomes, significant positive associations (between experiencing racial discrimination and an adverse pregnancy event) and non-significant associations (trending towards positive) were reported, with no studies reporting significant negative associations. The overall pooled odds ratio (OR) for preterm birth was 1.40 (95% CI 1.17 to 1.68; 13 studies) and for small for gestational age it was 1.23 (95% CI 0.76 to 1.99; 3 studies). When excluding low-quality studies, the preterm birth OR attenuated to 1.31 (95% CI 1.08 to 1.59; 10 studies). Similar results were obtained across sensitivity and subgroup analyses, indicating a significant positive association.

Conclusion

These results suggest that racial discrimination has adverse impacts on pregnancy outcomes. This is supported by the broader literature on racial discrimination as a risk factor for adverse health outcomes. To further explore this association and underlying mechanisms, including mediating and moderating factors, higher quality evidence from large ethnographically diverse cohorts is needed.
Epidemiology of uterine fibroid in black African women: a systematic scoping review
Authors: Morhason-Bello Imran O , Adebamowo Clement A
Published: August 2022

Objective

Studies, mainly from high-income countries, suggest that there are ethnic and racial variations in prevalence of uterine fibroids (UF). However, there have been few studies of the epidemiology of UF in sub-Saharan Africa (SSA). We reviewed published articles on the epidemiology of UF in SSA.

Design

This was a scoping review of literature.

Settings

We searched three databases (PubMed, African Wide Information (EBSCO) and African Journals OnLine (AJOL)). The search for eligible articles was conducted between December 2019 and January 2021.

Primary and secondary outcome measures

To describe the reported prevalence/incidence of, and risk factors for UF in SSA.

Results

Of the 1052 articles retrieved, 9 met the inclusion criteria for review. The articles were from Nigeria (4/9), Ghana (2/9), Cameroon (1/9), Kenya (1/9) and South Africa (1/9). Two studies from pathology departments and three studies from radiology departments reported prevalence of UF. We did not find any study on the incidence or genomics of UF in SSA. Of the three studies that reported on the risk factors of UF, only one case–control study that was conducted using retrospective data of attendees at a gynaecological clinic conducted multivariable analysis.

Conclusion

There is lack of robust epidemiological studies of the prevalence, incidence and risk factors of UF in SSA. There is urgent need to study epidemiological and genomics risk factors of UF in SSA because UF is the most common gynaecological neoplasm in this population where it is associated with significant morbidity and occasional, usually perioperative, mortality.
Short-term and long-term prognostic value of histological response and
intensified chemotherapy in osteosarcoma: a retrospective reanalysis of the
BO06 trial
Authors: Musta Eni , van Geloven Nan , Anninga Jakob , Gelderblom Hans , Fiocco Marta
Published: August 2022

Objectives

Cure rate models accounting for cured and uncured patients, provide
additional insights into long and short-term survival. We aim to
evaluate the prognostic value of histological response and chemotherapy
intensification on the cure fraction and progression-free survival (PFS)
for the uncured patients.

Design

Retrospective analysis of a randomised controlled trial, MRC BO06
(EORTC 80931).

Setting

Population-based study but proposed methodology can be applied to
other trial designs.

Participants

A total of 497 patients with resectable highgrade osteosarcoma, of
which 118 were excluded because chemotherapy was not started,
histological response was not reported, abnormal dose was reported or
had disease progression during treatment.

Intervention(s)

Two regimens with the same anticipated cumulative dose (doxorubicin
6×75 mg/m2/week; cisplatin
6×100 mg/m2/week) over different time
schedules: every 3 weeks in regimen-C and every 2 weeks in
regimen-DI.

Primary and secondary outcome measures

The primary outcome is PFS computed from end of treatment because
cure, if it occurs, may happen at any time during treatment. A mixture
cure model is used to study the effect of histological response and
intensified chemotherapy on the cure status and PFS for the uncured
patients.

Results

Histological response is a strong prognostic factor for the cure
status (OR 3.00, 95% CI 1.75 to 5.17), but it has no clear effect on PFS
for the uncured patients (HR 0.78, –95% CI 0.53 to 1.16). The cure
fractions are 55% (46%–63%) and 29% (22%–35%), respectively, among
patients with good and poor histological response (GR, PR). The
intensified regimen was associated with a higher cure fraction among PR
(OR 1.90, 95% CI 0.93 to 3.89), with no evidence of effect for GR (OR
0.78, 95% CI 0.38 to 1.59).

Conclusions

Accounting for cured patients is valuable in distinguishing the
covariate effects on cure and PFS. Estimating cure chances based on
these prognostic factors is relevant for counselling patients and can
have an impact on treatment decisions.

Trial registration number

NCT86294690.
Retrospective evaluation of ophthalmological and neurological outcomes for infants born before 24 weeks gestational age in a Swedish cohort
Authors: Hellström Ann , Jacobson Lena , Al-Hawasi Abbas , Hellström-Westas Lena , Rakow Alexander , Johnson Mats , Sävman Karin , Holmstrom Gerd , Larsson Eva , Gränse Lotta , Saric Marie , Sunnqvist Birgitta , Smith Lois , Hård Anna‐Lena , Morsing Eva , Lundgren Pia
Published: August 2022

Objectives

To retrospectively evaluate ophthalmological and neurological outcomes in a Swedish cohort of infants born before 24 weeks gestational age (GA) and explore risk factors for visual impairment.

Setting

Eye and paediatric clinics in Sweden.

Participants

Infants screened for retinopathy of prematurity (ROP) (n=399), born before 24 weeks GA, 2007–2018. Cases were excluded if ophthalmological follow-up records could not be traced.

Primary and secondary outcome measures

Primary outcomes were ophthalmological, including visual acuity (VA), refractive error, strabismus, nystagmus and cerebral visual impairment (CVI). Secondary outcomes comprised neonatal and neurological morbidities. Data were retrospectively retrieved from medical records.

Results

The 355 assessed children had a median GA of 23 weeks and 2 days and a median birth weight of 565 g. At the last available ophthalmological examination, the median age was 4.8 years (range 0.5–13.2 years). Nystagmus was recorded in 21.1%, strabismus in 34.8%, and 51.0% wore spectacles. Seventy-three of 333 (21.9%) were visually impaired, defined as being referred to a low vision clinic and/or having a VA less than 20/60 at 3.5 years of age or older. ROP treatment was a significant risk factor for visual impairment (OR 2.244, p=0.003). Visually impaired children, compared with children without visual impairment, more often had neurological deficits such as intellectual disability 63.8% versus 33.3% (p<0.001), epilepsy 21.1% versus 7.5% (p=0.001) and autism spectrum disorders 32.8% versus 20.9% (p=0.043). Nine of the 355 children had been diagnosed with CVI.

Conclusions

Children born before 24 weeks GA frequently had visual impairment in association with neurological deficits. CVI was rarely diagnosed. A multidisciplinary approach for the evaluation and habilitation of these vulnerable infants is warranted. National follow-up guidelines need to be developed and implemented.
Brain Injury Screening Tool (BIST): test–retest reliability in a community adult sample
Authors: Shaikh Nusratnaaz , Tokhi Yelda , Hardaker Natalie , Henshall Kevin , Forch Katherine , Fernando Kris , King Doug , Fulcher Mark , Jewell Sam , Bastos-Gottgtroy Renata , Hume Patria , Theadom Alice
Published: August 2022

Objective

To determine the test–retest reliability of the Brain Injury Screening Tool (BIST), which was designed to support the initial assessment of mild traumatic brain injury (mTBI) across a variety of contexts, including primary and secondary care.

Design

Test–retest design over a 2-week period.

Setting

Community based.

Participants

Sixty-eight adults (aged 18–58 years) who had not experienced an mTBI within the last 5 years and completed the BIST on two different occasions.

Measures

Participants were invited to complete the 15-item BIST symptom scale and the Depression, Anxiety and Stress Scale (DASS-21) online at two time-points (baseline and 2 weeks later). To account for large variations in mood affecting symptom reporting, change scores on the subscales of the DASS-21 were calculated, and outliers were removed from the analysis.

Results

The BIST total symptom score and subscale scores (physical-emotional, cognitive and vestibular) demonstrated moderate to good test–retest reliability with intraclass correlation coefficients ranging between 0.51 and 0.83. There were no meaningful differences between symptom reporting on the total scale or subscales of the BIST between time1 and time2 at the p<0.05 level when calculated using related samples Wilcoxon signed-rank tests.

Conclusion

The BIST showed evidence of good stability of symptom reporting within a non-injured, community adult sample. This increases confidence that changes observed in symptom reporting in an injured sample are related to actual symptom change rather than measurement error and supports the use of the symptom scale to monitor recovery over time. Further research is needed to explore reliability of the BIST within those aged <16 years.
Existing barriers and recommendations of real-world data standardisation for clinical research in China: a qualitative study
Authors: Lai Junkai , Liao Xiwen , Yao Chen , Jin Feifei , Wang Bin , Li Chen , Zhang Jun , Liu Larry
Published: August 2022

Objective

To investigate the existing barriers and recommendations of real-world data (RWD) standardisation for clinical research through a qualitative study on different stakeholders.

Design

This qualitative study involved five types of stakeholders based on five interview outlines. The data analysis was performed using the constructivist grounded theory analysis process.

Setting

Eight hospitals, four hospital system vendors, three big data companies, six medical products companies and four regulatory institutions were included.

Participants

In total, 62 participants from 25 institutions were interviewed through purposive sampling.

Results

The findings showed that the lack of clinical applicability in existing terminology standards, lack of generalisability in existing research databases, and lack of transparency in existing data standardisation process were the barriers of data standardisation of RWD for clinical research. Enhancing terminology standards by incorporating locally used clinical terminology, reducing burden in the usage of terminology standards, improving generalisability of RWD for research by using clinical data models, and improving traceability to source data for transparency might be feasible suggestions for solving the current problems.

Conclusions

Efficient and reliable data standardisation of RWD for clinical research can help generate better evidence used to support regulatory evaluation of medical products. This research suggested enhancing terminology standards by incorporating locally used clinical terminology, reducing burden in the usage of terminology standards, improving generalisability of RWD for research by using clinical data models, and improving traceability to source data for transparency to guide efforts in data standardisation in the future.
Life satisfaction and its influencing factors of middle-aged and elderly stroke patients in China: a national cross-sectional survey
Authors: Liu Ying , Liu Jieyu , Zhou Shangcheng , Xu Xingying , Cheng Yu , Yi Ying , Zou Guanyang
Published: August 2022

Objectives

This study reports the life satisfaction of middle-aged and elderly patients who had a stroke in China, and explores its association with patients’ sociodemographic characteristics, health status, lifestyles and family relationship.

Design

Cross-sectional survey.

Setting and participants

The samples of this study were selected from the data of China Health and Retirement Longitudinal Study (CHARLS) in 2018, which covered 28 provinces, 150 countries/districts and 450 village/urban communities. 1154 patients who had a stroke aged 45 and over were included in this study as qualified samples.

Outcome measures

Descriptive analysis was used to report sociodemographic characteristics, health status, lifestyles, family relationship and life satisfaction of middle-aged and elderly patients who had a stroke. χ2 analysis and binary logistic regression were used to analyse the factors influencing the life satisfaction of the patients who had a stroke.

Results

Overall, 83.1% of patients who had a stroke were satisfied with their lives, although only 8.7% rated their own health as being good. Patients who had a stroke who were male, elderly, married, living with their spouses and having a pension were more likely to report satisfaction with life (p<0.05). Self-rated health, health satisfaction, chronic lung disease, fall, pain, ability to work and family relationships were also significantly associated with life satisfaction (p<0.05). Patients who drank alcohol (86.8% vs 81.7%, p=0.041), had physical activity (84.4% vs 75.6%, p=0.004) and had social activity (85.3% vs 80.8%, p=0.041) were more satisfied with their lives than those who did not. Multivariable analysis confirmed that age, health satisfaction, physical pain, working ability, relationships with spouse and with children had significant effects on life satisfaction of patients who had a stroke (p<0.05).

Conclusions

Our study indicates the importance of improving the overall health of patients who had a stroke and mediating factors, such as pain management, and work ability, spouse and children relationship in improving the life satisfaction of patients in the poststroke rehabilitation.
Effectiveness of mRNA COVID-19 vaccines against Omicron and Delta variants in a matched test-negative case–control study among US veterans
Authors: Young-Xu Yinong , Zwain Gabrielle M , Izurieta Hector S , Korves Caroline , Powell Ethan I , Smith Jeremy , Balajee Abirami , Holodniy Mark , Beenhouwer David O , Rodriguez-Barradas Maria C , Brown Sheldon T , Marconi Vincent C
Published: August 2022

Objective

To estimate the effectiveness of messenger RNA (mRNA) booster doses during the period of Delta and Omicron variant dominance.

Design

We conducted a matched test-negative case–control study to estimate the vaccine effectiveness (VE) of three and two doses of mRNA vaccines against infection (regardless of symptoms) and against COVID-19-related hospitalisation and death.

Setting

Veterans Health Administration.

Participants

We used electronic health record data from 114 640 veterans who had a SARS-CoV-2 test during November 2021–January 2022. Patients were largely 65 years or older (52%), male (88%) and non-Hispanic white (59%).

Main outcome measures

First positive result for a SARS-CoV-2 PCR or antigen test.

Results

Against infection, booster doses had higher estimated VE (64%, 95% CI 63 to 65) than two-dose vaccination (12%, 95% CI 10 to 15) during the Omicron period. For the Delta period, the VE against infection was 90% (95% CI 88 to 92) among boosted vaccinees, higher than the VE among two-dose vaccinees (54%, 95% CI 50 to 57). Against hospitalisation, booster dose VE was 89% (95% CI 88 to 91) during Omicron and 94% (95% CI 90 to 96) during Delta; two-dose VE was 63% (95% CI 58 to 67) during Omicron and 75% (95% CI 69 to 80) during Delta. Against death, the VE with a booster dose was 94% (95% CI 90 to 96) during Omicron and 96% (95% CI 87 to 99) during Delta.

Conclusions

Among an older, mostly male, population with comorbidities, we found that an mRNA vaccine booster was highly effective against infection, hospitalisation and death. Although the effectiveness of booster vaccination against infection was moderately higher against Delta than against the Omicron SARS-CoV-2 variant, effectiveness against severe disease and death was similarly high against both variants.
Understanding the factors influencing the implementation of accreditation in Jordanian Hospitals: the nurses’ view
Authors: Algunmeeyn Abdullah , Mrayyan Majd T
Published: August 2022

Background

Accreditation practices are influenced by many variables, resulting in positive outcomes, such as enhanced motivation among the hospital staff. Motivation among the physician and nurses directly impacts the service quality of the hospitals. Accreditation increases organisational capacity, which may improve hospitals’ overall performance. This study aimed at assessing the factors influencing the implementation of accreditation in Jordanian hospitals.

Method

This study employed a qualitative approach. As a result, 40 nurses were recruited from two public hospitals with varying experience and specialties. Data were gathered through face-to-face interviews. Interviews were conducted with a total of 40 hospital nurses, who were selected based on convenience and purposeful sampling.

Results

Communication, recruiting qualified and effective hospital directors, patient involvement and engagement and teamwork influenced the implementation of accreditation in Jordanian hospitals.

Conclusion

The implementation of the accreditation process is influenced by many factors. Therefore, focusing more on these factors while using the views and experiences of nurses involved in this process will significantly impact the implementation of the accreditation process in various clinical settings, particularly hospitals.
Gram-scale synthesis of the N-phenyl phenothiazine photocatalyst by benzyne addition
Authors: Welsh Erin N. , Robertson Katherine N. , Speed Alexander W.H.
Published: August 2022

N-phenyl phenothiazine is one of the most reducing photoredox catalysts. Its synthesis commonly requires transition metal-catalyzed cross-coupling reactions. Here, we show the syntheses of four aryl phenothiazines via a benzyne route, including a multigram-scale synthesis of N-phenyl phenothiazine. While yields are modest, the simplicity, low cost, and lack of requirement for cross-coupling catalysts in this synthesis will be attractive to users of this photocatalyst.