bluuebunny/crossref_metadata_2025 huggingface dataset:
Does it get better? An ongoing exploration of physician experiences with and acceptance of telehealth utilization
Authors: Wilhite Jeffrey A , Phillips Zoe , Altshuler Lisa , Fisher Harriet , Gillespie Colleen , Goldberg Eric , Wallach Andrew , Hanley Kathleen , Zabar Sondra
Published: October 2022

Introduction

COVID-19 forced health systems to rapidly implement telehealth for routine practice, often without sufficient training or standards. We conducted a longitudinal survey of physicians to explore changes in their perceptions of the challenges and benefits of telehealth and identify recommendations for future practice.

Methods

An anonymous online survey was distributed to a cohort of internal medicine physicians in May to June 2020 and March to June 2021. Changes in responses between 2020 and 2021 and by site (private vs. public) were described. These findings, along with those of a thematic analysis of open-ended responses to questions on telehealth experiences, informed a set of recommendations.

Results

The survey response rate was 111/391 in 2021 compared to 122/378 in 2020. Fewer physicians reported that telehealth was more difficult than in person with regards to taking a history (49% in 2020, 33% in 2021, p= 0.015), maximizing patient adherence (33% in 2020, 19% in 2021, p = 0.028), and maintaining patient relationships (31%, 25%, p = 0.009) in 2021. Similar proportions of physicians reported continued challenges with building new patient relationships (75%, 77%, p = 0.075), educating patients (40%, 32%, p = 0.393), and working collaboratively with their team (38%, 41%, p = 0.794). Physicians reported increased satisfaction with tele-visits over in-person visits (13%, 27%, p = 0.006) and less worry over doing future tele-visits (45%, 31%, p = 0.027). Physicians’ open-ended responses identified recommendations for further improving the design and use of telehealth.

Discussion

Results suggest that physician experience with telehealth improved but opportunities for training and improved integration remain. Longitudinal assessment can deepen understanding of the evolution of telehealth care.
‘Managing an unexpected life - a caregiver’s career’: Parents’ experience of caring for their child with a non-malignant life-limiting condition
Authors: Price Jayne , Hurley Fiona , Kiernan Gemma
Published: October 2022

Parents of children with non-malignant life-limiting conditions frequently accept roles that exceed the conventional activities of parenting in relation to the intensity, complexity and temporal nature of the family caregiver experience. This paper explores the prevalent and all-consuming experiences of parents caring for their children. A qualitative descriptive study design was used. Twenty-three parents (both mothers and fathers) were interviewed. Transcribed interview data were analyzed using thematic analysis. ‘Managing an unexpected life’ was the central concept when parents recounted ongoing efforts to address the emotional and practical effects of their child’s condition on their life and that of their family. Analysis revealed three main distinct but interrelated themes within the concept of ‘Managing an unexpected life’ helping us enhance our understanding of parents’ experiences: ‘Striving for normality’, ‘Becoming the expert’ and ‘Fighting for your child’. Findings suggest that the central concept of ‘Managing an unexpected life’ appeared to be in keeping with a caregiver’s career. Findings likewise suggest the need for improved and focused support and services to enhance parents’ career caregiving.
The influence of team cultural value orientations on norms of conduct in hybrid teams: Implications for team cohesion and performance
Authors: Hill N. Sharon , Villamor Isabel
Published: October 2022

We advance team composition research by adopting a team-norms perspective to examine the effects of team members’ cultural value orientations—collectivism and uncertainty avoidance orientation—on team functioning and performance in hybrid teams (i.e., teams combining face-to-face and mediated communication). Using data collected at three points in time from a sample of self-managing project teams, results support our proposed theoretical model. Team members’ mean level of collectivism and uncertainty avoidance both positively relate to norms of conduct in a team. In addition, team norms indirectly influence team performance through cohesion when team virtuality and team task knowledge are both high, with team virtuality moderating the team norms–cohesion relationship, and team task knowledge moderating the team cohesion–performance relationship. Our findings suggest that characteristics of contemporary teams—team cultural value orientation and team virtuality—have important implications for how norms for acceptable conduct develop and their consequences for team performance.
Feminism without “gender identity”
Authors: Gheaus Anca
Published: October 2022

Talk of gender identity is at the core of heated current philosophical and political debates. Yet, it is unclear what it means to have one. I examine several ways of understanding this concept in light of core aims of trans writers and activists. Most importantly, the concept should make good trans people's understanding of their own gender identities and help understand why misgendering is a serious harm and why it is permissible to require information about people's gender identities in public life. I conclude that none of the available accounts meets these essential criteria, on the assumption that the gender norms of femininity and masculinity are unjustified. But we can, and should, pursue the feminist project without “gender identity”. Such feminism can include trans people because it is possible to account for the specific harm of misgendering without assuming a claim to the recognition of our gender identities. I conclude that we should eliminate the concept of “gender identity.” To understand the phenomena that are putatively captured by “gender identity,” we are better off employing other concepts, such as “sexual dysphoria,” (assigned or aspirational) “gender roles,” and (internalised or endorsed) “gender norms”. These concepts can usefully replace “gender identity” in an individual evaluation of each of the trans people's claims to inclusion into particular spaces.
A New Inflammatory Marker of Clinical and Diagnostic Importance in Diabetic Foot Infection: Systemic Immune-Inflammation Index
Authors: Ozer Balin Safak , Ozcan Erhan Cahit , Uğur Kader
Published: October 2022

Diabetes and associated complications still pose an important public health problem. Osteomyelitis as especially seen in patients with diabetes is associated with increased rates of morbidity and mortality. The present study aimed to investigate the clinical and diagnostic significance of inflammatory markers, including the systemic immune-inflammation index (SII) and erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and procalcitonin (PCT) to differentiate osteomyelitis and cellulitis. The present study included 96 patients with osteomyelitis (Group 1) and 151 patients with cellulitis (Group 2). Inflammatory markers were significantly elevated in Group 1 compared to Group 2 patients ( p < 0.05). Furthermore, the correlation coefficients (rho) between SII and ESR, CRP, and PCT were 0.466 ( p < 0.001), 0.627 ( p < 0.001), and 0.501 ( p < 0.001), respectively, as a result of Spearman's Rho analysis. Accordingly, a moderately positive relationship was found between the variables. The area under the curve (AUC) values for SII, ESR, CRP, and PCT in diabetic foot infection patients with osteomyelitis were 0.687, 0.722, 0.692, and 0.641, respectively. As a result of the Likelhood Ratio (LR) test, the cut-off values were 2.182 for SII (sensitivity: 39.8% and specificity: 79.8%), 76.5 mm/h for ESR (sensitivity: 59.1% and specificity: 73.1%), 109.5 mg/mL for CRP (sensitivity: 40.9% and specificity: 79.8%), and 0.44 ng/mL for PCT (sensitivity: 26.1% and specificity: 88.2%). In conclusion, given that the patients with osteomyelitis had much higher ESR, CRP, PCT, and SII levels combined with the fact that SII is a low-cost and easy-to-measure index, suggests that the same may serve as an effective and novel marker alternative to other inflammatory markers for predicting diabetic foot osteomyelitis.
An initial framework for use of ultrasound by speech and language therapists in the UK: Scope of practice, education and governance
Authors: Allen Jodi Elizabeth , Cleland Joanne , Smith Mike
Published: October 2022

Background:

There is growing evidence to support the use of ultrasound as a tool for the assessment and treatment of speech, voice and swallowing disorders across the Speech and Language Therapy profession. Research has shown that development of training competencies, engagement with employers and the professional body are vital to progressing ultrasound into practice.

Methods:

We present a framework to support translation of ultrasound into Speech and Language Therapy. The framework comprises three elements: (1) scope of practice, (2) education and competency and (3) governance. These elements align to provide a foundation for sustainable and high-quality ultrasound application across the profession.

Results:

Scope of practice includes the tissues to be imaged, the clinical and sonographic differentials and subsequent clinical decision-making. Defining this provides transformational clarity to Speech and Language Therapists, other imaging professionals and those designing care pathways. Education and competency are explicitly aligned with the scope of practice and include requisite training content and mechanisms for supervision/support from an appropriately trained individual in this area. Governance elements include legal, professional and insurance considerations. Quality assurance recommendations include data protection, storage of images, testing of ultrasound devices as well as continuous professional development and access to a second opinion.

Conclusion:

The framework provides an adaptable model for supporting expansion of ultrasound across a range of Speech and Language Therapy specialities. By taking an integrated approach, this multifaceted solution provides the foundation for those with speech, voice and swallowing disorders to benefit from advances in imaging-informed healthcare.
Parental intimate partner violence and abuse during the COVID-19 pandemic: Learning from remote and hybrid working to influence future support
Authors: Alderson Hayley , Barrett Simon , Addison Michelle , Burns Samantha , Cooling Victoria , Hackett Simon , Kaner Eileen , McGovern William , Smart Deborah , McGovern Ruth
Published: October 2022

Objectives:

The COVID-19 pandemic has exacerbated intimate partner violence and abuse. Incidents of intimate partner violence and abuse have increased as a result of household tensions due to enforced coexistence (multiple national lockdowns and working from home practices), economic stress related to loss of income, the disruption of social and protective networks and the decreased access to support services. This study aimed to understand how female survivors of parental intimate partner violence and abuse have experienced the adapted multi-agency response to intimate partner violence and abuse during the pandemic and consider learning from remote and hybrid working to influence future support.

Method:

This study adopted a qualitative research design, utilizing semi-structured interviews and a focus group. Data collection took place between March and September 2021. In total, 17 female survivors of intimate partner violence and abuse took part in the project; we conducted the semi-structured interviews via telephone (n = 9) and conducted an online focus group (n = 8).

Results:

Findings identified that services for those experiencing intimate partner violence and abuse need to be innovative, flexible and adaptable and ‘reach out’ to survivors rather than waiting for survivors to ‘reach in’ and ask for support. Findings show that the digital space highlights ‘missed opportunities’ for engagement with both professionals and peers and the potential for digital poverty is a key implication, which risks entrenching existing inequalities.

Conclusion:

In-depth consideration needs to be given to the design, delivery and evaluation of online interventions and provision of support to improve access and acceptability of services, maximize their effectiveness and to support the safety of survivors.
Eye examination in general practice
Authors: Kanani Suleman , Mechrgui Monia
Published: October 2022

Eye problems are a common presentation in primary care and they are the presenting problem in about 2–3% of all consultations. GPs are responsible for diagnosing eye conditions and making appropriate specialist referrals. The tools usually available in general practice, such as Snellen charts, penlights, and direct ophthalmoscopy, are sufficient to diagnose most eye disease. This article aims to help GPs approach eye examination in an organised, logical fashion. This article will outline how to perform each step of the examination and the diagnosis of common eye conditions including those that need immediate referral to a specialist. A fictional case scenario is used to illustrate the importance of a good history and accurate eye examination in the diagnosis and management of eye disease.
High tartrate-resistant acid phosphatase (TRACP 5b) level in cystic fluid is a significant prognostic marker for postoperative recurrence in solitary bone cysts
Authors: Hoshi Manabu , Oebisu Naoto , Iwai Tadashi , Shimatani Akiyoshi , Takada Naoki , Ban Yoshitaka , Nakamura Hiroaki
Published: October 2022

Purpose:

The pathogenesis of cystic fluid storage in solitary bone cysts remains unclear. We aimed to compare the results of the biochemical analysis of cystic fluid with clinical findings. We identified a significant marker of postoperative recurrence.

Methods:

Twenty-seven male and eight female patients were studied; the median age at diagnosis was 11 (5–23) years. The mean follow-up period was 60 months (range: 14–146 months). Clinical information including sex, age, affected site, radiological findings of phase (active or latent), surgical procedure, outcome, and biochemical analysis of serum and cystic fluid was obtained.

Results:

The 5-year healing rate was 64.0%. Biochemical analysis revealed that total protein and albumin values in the cystic fluid were significantly lower, compared to those in the serum. Levels of bone turnover markers, such as alkaline phosphatase, bone-specific alkaline phosphatase, and tartrate-resistant acid phosphatase 5b were remarkably elevated in the cystic fluid than in the serum. R values were 0.127, 0.076, and 0.095 for alkaline phosphatase, bone-specific alkaline phosphatase, and tartrate-resistant acid phosphatase 5b, respectively. Areas under the receiver operating characteristic curves, calculated to assess the association of alkaline phosphatase, bone-specific alkaline phosphatase, and tartrate-resistant acid phosphatase 5b levels in the cystic fluid with postoperative recurrence, were 0.57, 0.51, and 0.70, respectively.

Conclusions:

No clear correlation of bone turnover marker levels between the serum and cystic fluid was observed. The high tartrate-resistant acid phosphatase 5b level in the cystic fluid was associated with postoperative recurrence. The bone resorption caused by osteoclasts is considered to affect postoperative recurrence.

Level of evidence:

Level IV.
Restless legs syndrome in patients with chronic low back pain
Authors: Baykal Şahin Hanife , Karacaoğlu Soykan , Çapkın Erhan , Kara Fatma
Published: October 2022

Background:

Based on studies showing that both chronic low back pain (LBP) and restless legs syndrome (RLS) have similar pathophysiological mechanisms, we aimed to investigate the prevalence of RLS in patients with chronic LBP and to define which demographic and clinical features are prominent in those with LBP accompanied by RLS.

Methods:

One hundred and two eligible, volunteer participants with chronic LBP were enrolled in this study. Visual analog scale (VAS), the Oswestry Disability Index (ODI), Pittsburgh Sleep Quality Index, Beck Depression Inventory, and Short Form-36 scales were applied to the patients. All patients were evaluated face-to-face for RLS using the International RLS study group diagnostic criteria.

Results:

Most of our patients were women (52%). The mean age was 40.96±13.34 years and the mean disease duration was 46.16±41.98 months. RLS was detected in 36 (35.3%) of the patients with LBP. It was found that the female gender was more dominant in patients with RLS and the difference was statistically significant ( p < 0.001). The amount of coffee intake was significantly higher in patients with RLS compared to those without RLS ( p = 0.001). The disease duration for LBP was significantly higher in the patients with RLS ( p = 0.003). VAS score, ODI score, PUKI score, and Beck depression score were significantly higher in the RLS group ( p value were 0.048, 0.040, 0.007, and 0.043, respectively). In the evaluation of quality of life, all parameters except role emotional limitations and mental health were found to be significantly worse in the RLS group.
Identifying essential factors that influence user engagement with digital mental health tools in clinical care settings: Protocol for a Delphi study
Authors: Lo Brian , Pham Quynh , Sockalingam Sanjeev , Wiljer David , Strudwick Gillian
Published: October 2022

Introduction

Improving effective user engagement with digital mental health tools has become a priority in enabling the value of digital health. With increased interest from the mental health community in embedding digital health tools as part of care delivery, there is a need to examine and identify the essential factors in influencing user engagement with digital mental health tools in clinical care. The current study will use a Delphi approach to gain consensus from individuals with relevant experience and expertise (e.g. patients, clinicians and healthcare administrators) on factors that influence user engagement (i.e. an essential factor).

Methods

Participants will be invited to complete up to four rounds of online surveys. The first round of the Delphi study comprises of reviewing existing factors identified in literature and commenting on whether any factors they believe are important are missing from the list. Subsequent rounds will involve asking participants to rate the perceived impact of each factor in influencing user engagement with digital mental health tools in clinical care contexts. This work is expected to consolidate the perspectives from relevant stakeholders and the academic literature to identify a core set of factors considered essential in influencing user engagement with digital mental health tools in clinical care contexts.
Ultra-low-dose non-contrast CT and CT angiography can be used interchangeably for assessing maximal abdominal aortic diameter
Authors: Borgbjerg Jens , Christensen Heidi S , Al-Mashhadi Rozh , Bøgsted Martin , Frøkjær Jens B , Medrud Lise , Larsen Nis Elbrønd , Lindholt Jes S
Published: October 2022

Background

Routine CT scans may increasingly be used to document normal aortic size and to detect incidental abdominal aortic aneurysms.

Purpose

To determine whether ultra-low-dose non-contrast CT (ULDNC-CT) can be used instead of the gold standard CT angiography (CTA) for assessment of maximal abdominal aortic diameter.

Materials and Methods

This retrospective study included 50 patients who underwent CTA and a normal-dose non–contrast CT for suspected renal artery stenosis. ULDNC-CT datasets were generated from the normal-dose non–contrast CT datasets using a simulation technique. Using the centerline technique, radiology consultants ( n = 4) and residents ( n = 3) determined maximal abdominal aortic diameter. The limits of agreement with the mean (LOAM) was used to access observer agreement. LOAM represents how much a measurement by a single observer may plausibly deviate from the mean of all observers on the specific subject.

Results

Observers completed 1400 measurements encompassing repeated CTA and ULDNC-CT measurements. The mean diameter was 24.0 and 25.0 mm for CTA and ULDNC-CT, respectively, yielding a significant but minor mean difference of 1.0 mm. The 95% LOAM reproducibility was similar for CTA and ULDNC-CT (2.3 vs 2.3 mm). In addition, the 95% LOAM and mean diameters were similar for CTA and ULDNC-CT when observers were grouped as consultants and residents.

Conclusions

Ultra-low-dose non–contrast CT exhibited similar accuracy and reproducibility of measurements compared with CTA for assessing maximal abdominal aortic diameter supporting that ULDNC-CT can be used interchangeably with CTA in the lower range of aortic sizes.
Theorizing ‘Variegated Bonding as SME Diversification Strategy’ to Extend Business from Traditional to Emergent Sectors
Authors: kyzy Saikal Anvar
Published: October 2022

Few studies on diversification strategies address small and medium-sized enterprises (SMEs) and how they differ from large firms. Although related diversifications tend to be the approach for SME diversifications, we need to know more about unrelated diversifications by SMEs. This study focuses on the process of SME unrelated diversification and conduct ethnographic case study on a family business SME from Kyrgyzstan. The inductive process study offers variegated bonding as a possible process of SME diversification. The process consists of the three steps: appetizing, baby-stepping and reconstructing identity. This study extends the extant literature on SME diversification and investigates how the organizational aspiration of identity reconstructions could lead to the focal organization’s entry to an unrelated sector and establishing connectivity between its core and emergent sector organization that eventually alters its identity.
‘Challenging Stereotypes’ as a Core Competence in Creative Entrepreneurship: Insights from ArtiShock Theatre, Kazakhstan
Authors: Ryabova Kristina , Fomina Victoria , Ghosh Anjan
Published: October 2022

Although scholarly interest in creative entrepreneurship (also known as cultural industry) is gaining traction, the development of organizational competences beyond the creative offerings have remained underexplored. Such omission is surprising as an organization in creative industry cannot be solely dependent on creative offerings. It needs to focus on other aspects of business. To explore the possible link between product creativity and business model, we conduct a study on ArtiShock Theatre—Kazakhstan’s first independent theatre. Our study suggests that a creative enterprise can address both competition and environmental shocks through the process consisting of exploratory re-forming, experimental organizing leading to the development of ‘challenging stereotypes’ as a core competence. Our study shows that such core competence might be evolved into a dynamic capability to handle environmental changes.
Impact of COVID-19 on the Performance of Indian Stock Market: An Empirical Analysis
Authors: Manu K. S.  , Shetty A. Shivakanth
Published: October 2022

The outbreak of COVID-19 epidemic had not only brought destruction to the human lives but also destabilized the financial markets across the world. Although there were some studies conducted on the impact of COVID-19 on the financial markets in the developed economies, very few studies were conducted on the developing economies like India. Hence, this study intends to measure the impact of COVID-19 on the Indian stock market, especially on NIFTY50, and all the major sectorial indices of National Stock Exchange (NSE). The study also makes an attempt to analyze the impact of COVID-19 on the Indian stock market in various time periods (lockdown, pre-lockdown, and full sample time periods). For this purpose, the researchers have used EGARCH and regression models to measure the sectoral impact of COVID-19 on NIFTY. The study finds asymmetrical reactions on positive and negative shocks in the Indian stock market.

The β2 coefficient, which explains asymmetric volatility, is significant and positive for FMCG, realty, oil and gas, and consumer durables, suggesting the presence of asymmetric effect, but has no leverage effect. It implies that positive news has greater effects on volatility than negative news. In other words, investors are more prone to positive shocks than negative shocks with the same magnitude. While β2 is found to be significant and negative for NIFTY, bank, information technology, and financial services, which clearly depicts the presence of leverage effect. It suggests the presence of asymmetrical reactions on unfavorable shocks in these indices.
Turnaround of a Multi-Unit Indian Hospital: A Study on Its Interventions
Authors: Dasgupta Prasanjit
Published: October 2022

For a long time, organizational turnaround was a subject of interest; literature on the financial turnaround of hospitals that faced decline after a major disaster like death due to fire is scarce. An Indian hospital group incurred losses for years after death due to a fire in one of its units and earned an operational surplus for the last few years. This case study explores the strategies for its financial turnaround; hospital documents and interviews with managers provided data for it. The purpose of the study is to investigate the interventions taken by the organization for its financial turnaround. The theoretical framework of the study relied on the turnaround model of Maheshwari (2000), Khandwalla (2001), Chowdhury (2002), Jacobs et al. (2013), and Sylkin et al. (2019). The pragmatism theories advocated by Kahneman and Klein (2009), Ansell and Boin (2019), and Boin and Lodge (2021) were also relied upon.This study contributes to the organizational change literature by highlighting that though the theories of turnaround serve as a foundation, managerial intuition and continuous evaluation are strong driving forces for a financial turnaround.
Trends in Practice Among Shoulder Specialists in the Management of Frozen Shoulder: A Consensus Survey
Authors: Pandey Vivek , Chidambaram Ram , Modi Amit , Babhulkar Ashish , Pardiwala Dinshaw N. , Willems W. Jaap , Thilak Jai , Maheshwari Jitender , Narang Kush , Kamat Nilesh , Gupta Prateek , Reddy Raghuveer , Desai Sanjay , Sundararajan S.R. , Samanta Swarnendu
Published: October 2022

Background:

The management of frozen shoulder (FS) differs depending on experience level and variation between scientific guidelines and actual practice.

Purpose:

To determine the current trends and practices in the management of FS among shoulder specialists and compare them with senior shoulder specialists.

Study Design:

Consensus statement.

Methods:

A team of 15 senior shoulder specialists (faculty group) prepared a questionnaire comprising 26 questions regarding the definition, terminology, clinical signs, investigations, management, and prognosis of FS. The questionnaire was mailed to all the registered shoulder specialists of Shoulder and Elbow Society, India (SESI) (specialist group; n = 230), as well as to the faculty group (n = 15). The responses of the 2 groups were compared, and levels of consensus were determined: strong (>75%), broad (60%-74.9%), inconclusive (40%-59.9%), or disagreement (<40%).

Result:

Overall, 142 of the 230 participants in the specialist group and all 15 participants in the faculty group responded to the survey. Both groups strongly agreed that plain radiographs are required to rule out a secondary cause of FS, routine magnetic resonance imaging is not indicated to confirm FS, nonsteroidal anti-inflammatory drugs should be administered at bedtime, steroid injection (triamcinolone or methylprednisolone) is the next best option if analgesics fail to provide pain relief, passive physical therapy should be avoided in the freezing phase, <10% of patients would require any surgical intervention, and patients with diabetes and thyroid dysfunction tend to fare poorly. There was broad agreement that routine thyroid dysfunction screening is unnecessary for women, a single 40-mg steroid injection via intra-articular route is preferred, and arthroscopic capsular release (ACR) results in a better outcome than manipulation under anesthesia (MUA). Agreement was inconclusive regarding the use of combined random blood sugar (RBS) and glycosylated hemoglobin versus lone RBS to screen for diabetes in patients with FS, preference of ACR versus MUA to treat resistant FS, and the timing of surgical intervention. There was disagreement over the most appropriate term for FS, the preferred physical therapy modality for pain relief, the most important movement restriction for early diagnosis of FS, and complications seen after MUA.

Conclusion:

This survey summarized the trend in prevalent practices regarding FS among the shoulder specialists and senior shoulder surgeons of SESI.
Clinical Usefulness of SPECT/CT for Assessing Postoperative Outcomes After Medial Opening-Wedge High Tibial Osteotomy
Authors: Sung Yong Gyu , Yoon Hyukjin , Park Dong Chul , Kim Man Soo , In Yong
Published: October 2022

Background:

Qualitative studies have explored changes in Tc-99m hydroxymethylene diphosphonate (HDP) uptake on single-photon emission computed tomography and computed tomography (SPECT/CT) as a result of offloading after medial opening-wedge high tibial osteotomy (MOWHTO) in patients with medial compartment knee osteoarthritis. However, whether changes in the Tc-99m HDP uptake on SPECT/CT reflect the degree of clinical improvement in postoperative outcomes, especially when using minimal clinically important differences (MCIDs), has not been investigated.

Purpose:

To investigate the association between changes in Tc-99m HDP uptake on SPECT/CT and MCID-based improvement on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score in patients who underwent MOWHTO.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

The study included 35 knees in 31 patients who underwent MOWHTO. SPECT/CT was performed preoperatively and 3 years postoperatively with clinical and radiological assessments. On SPECT/CT, the knee joint was divided into 10 regions, and the radiotracer uptake amount of each region was divided by the uptake amount of the reference zone. Patients were divided into 2 groups based on whether they achieved the MCID of 16.1 points on the WOMAC at 3 years postoperatively, and changes in uptake amount on SPECT/CT were compared between the groups.

Results:

At 3 years postoperatively, 22 patients achieved the MCID on the WOMAC (62.9%; above-MCID group) and 13 patients did not (37.1%; below-MCID group). In the above-MCID group, significant improvement was observed in the WOMAC after MOWHTO (from 55.8 to 19.6; P < .05); however, significant improvement was not observed in the below-MCID group (from 38.8 to 32.3; P = .100). Based on mean change of uptake on SPECT/CT in each region, the above-MCID group showed significantly greater reduction of uptake on SPECT/CT than the below-MCID group in the femoral anteromedial compartment ( P = .004), tibial anteromedial compartment ( P = .009), and tibial anterolateral compartment ( P = .031).

Conclusion:

Reduction in radiotracer uptake on SPECT/CT of the knee joint reflected clinical improvement in patient-reported outcomes following MOWHTO.
Navayana Buddhism and the Scheduled Castes of West Bengal
Authors: Barman Rup Kumar , Sarkar Sanju
Published: October 2022

Though Buddhism began to revive in India in the late nineteenth century, Buddhist organizations did not pay much attention to bring the Dalits into their folds. Rather, the lower caste communities had aspired for constructing respectable caste identities in the late colonial period. However, conversion of Dr. B. R. Ambedkar (1891–1956) to a modified form of Buddhism (called ‘neo-Buddhism’) has appeared as a sociocultural tool for the Dalits to fight against the casteism. In this paper, we have highlightws the background of the introduction of neo-Buddhism and the location of the Scheduled Castes of West Bengal in it.
Book review: Michele Lancione & Colin McFarlane, Global Urbanism: Knowledge, Power and the City
Authors: Arun-Pina Chan
Published: October 2022

Michele Lancione & Colin McFarlane, Global Urbanism: Knowledge, Power and the City. Routledge, 2021, 370pp, £27.99. ISBN 9780367745349.
Whole-genome analysis identifies novel drivers and high-risk double-hit events in relapsed/refractory myeloma
Authors: Ansari-Pour Naser , Samur Mehmet , Flynt Erin , Gooding Sarah , Towfic Fadi , Stong Nicholas , Estevez Maria Ortiz , Mavrommatis Konstantinos , Walker Brian , Morgan Gareth , Munshi Nikhil , Avet-Loiseau Herve , Thakurta Anjan
Published: October 2022

Large-scale analyses of genomic data from patients with newly diagnosed multiple myeloma (ndMM) have been undertaken, however, large-scale analysis of relapsed/refractory MM (rrMM) has not been performed. We hypothesize that somatic variants chronicle the therapeutic exposures and clonal structure of myeloma from ndMM to rrMM stages. We generated whole-genome sequencing (WGS) data from 418 tumors (386 patients) derived from 6 rrMM clinical trials and compared them with WGS from 198 unrelated patients with ndMM in a population-based case-control fashion. We identified significantly enriched events at the rrMM stage, including drivers (DUOX2, EZH2, TP53), biallelic inactivation (TP53), noncoding mutations in bona fide drivers (TP53BP1, BLM), copy number aberrations (CNAs; 1qGain, 17pLOH), and double-hit events (Amp1q-ISS3, 1qGain-17p loss-of-heterozygosity). Mutational signature analysis identified a subclonal defective mismatch repair signature enriched in rrMM and highly active in high mutation burden tumors, a likely feature of therapy-associated expanding subclones. Further analysis focused on the association of genomic aberrations enriched at different stages of resistance to immunomodulatory agent (IMiD)–based therapy. This analysis revealed that TP53, DUOX2, 1qGain, and 17p loss-of-heterozygosity increased in prevalence from ndMM to lenalidomide resistant (LENR) to pomalidomide resistant (POMR) stages, whereas enrichment of MAML3 along with immunoglobulin lambda (IGL) and MYC translocations distinguished POM from the LEN subgroup. Genomic drivers associated with rrMM are those that confer clonal selective advantage under therapeutic pressure. Their role in therapy evasion should be further evaluated in longitudinal patient samples, to confirm these associations with the evolution of clinical resistance and to identify molecular subsets of rrMM for the development of targeted therapies.
Targeting UBR5 in hepatocellular carcinoma cells and precise treatment via echinacoside nanodelivery
Authors: Wang Menghan , Ma Xing , Wang Guoyu , Song Yanan , Zhang Miao , Mai Zhongchao , Zhou Borong , Ye Ying , Xia Wei
Published: October 2022

Background

Hepatocellular carcinoma (HCC) is among the most common and malignant cancers with no effective therapeutic approaches. Echinacoside (ECH), a phenylethanoid glycoside isolated from Chinese herbal medicine, Cistanche salsa, can inhibit HCC progression; however, poor absorption and low bioavailability limit its biological applications.

Methods

To improve ECH sensitivity to HepG2 cells, we developed a mesoporous silica nanoparticle (MSN)-based drug delivery system to deliver ECH to HepG2 cells via galactose (GAL) and poly(ethylene glycol) diglycidyl ether (PEGDE) conjugation (ECH@Au@MSN-PEGDE-GAL, or ECH@AMPG). Gain- and loss-of-function assays were conducted to assess the effects of UBR5 on HCC cell apoptosis and glycolysis. Moreover, the interactions among intermediate products were also investigated to elucidate the mechanisms by which UBR5 functions.

Results

The present study showed that ubiquitin protein ligase E3 component N-recognin 5 (UBR5) acted as an oncogene in HCC tissues and that its expression was inhibited by ECH. AMPG showed a high drug loading property and a slow and sustained release pattern over time. Moreover, owing to the valid drug accumulation, ECH@AMPG promoted apoptosis and inhibited glycolysis of HepG2 cells in vitro. In vivo experiments demonstrated that AMPG also enhanced the antitumor effects of ECH in HepG2 cell-bearing mice.

Conclusions

Our results indicated the clinical significance of UBR5 as a therapeutic target. On the basis of the nontoxic and high drug-loading capabilities of AMPG, ECH@AMPG presented better effects on HCC cells compared with free ECH, indicating its potential for the chemotherapy of HCC.
A comparative proteomic analysis provides insight into the molecular mechanism of bud break in longan
Authors: Jue Dengwei , Liu Liqin , Sang Xuelian , Shi Shengyou
Published: October 2022

Background

The timing of bud break is very important for the flowering and fruiting of longan. To obtain new insights into the underlying regulatory mechanism of bud break in longan, a comparative analysis was conducted in three flower induction stages of two longan varieties with opposite flowering phenotypes by using isobaric tags for relative and absolute quantification (iTRAQ).

Results

In total, 3180 unique proteins were identified in 18 samples, and 1101 differentially abundant proteins (DAPs) were identified. “SX” (“Shixia”), a common longan cultivated variety that needs an appropriate period of low temperatures to accumulate energy and nutrients for flower induction, had a strong primary inflorescence, had a strong axillary inflorescence, and contained high contents of sugars, and most DAPs during the bud break process were enriched in assimilates and energy metabolism. Combined with our previous transcriptome data, it was observed that sucrose synthase 6 (SS6) and granule-bound starch synthase 1 (GBSSI) might be the key DAPs for “SX” bud break. Compared to those of “SX”, the primary inflorescence, axillary inflorescence, floral primordium, bract, and prophyll of “SJ” (“Sijimi”) were weaker. In addition, light, rather than a high sugar content or chilling duration, might act as the key signal for triggering bud break. In addition, catalase isozyme 1, an important enzyme in the redox cycle, and RuBisCO, a key enzyme in the Calvin cycle of photosynthetic carbon assimilation, might be the key DAPs for SJ bud break.

Conclusion

Our results present a dynamic picture of the bud break of longan, not only revealing the temporal specific expression of key candidate genes and proteins but also providing a scientific basis for the genetic improvement of this fruit tree species.
Effect of temperature and water potential on the germination of seeds from three different populations of Bidens pilosa as a potential Cd hyperaccumulator
Authors: Zhang Rui , Chen Dali , Liu Huizhuan , Guo Changlin , Tang Li , Wang Honggang , Chen Yinhua , Luo Kai
Published: October 2022

Background

Bidens pilosa L., an annual herb, has recently been shown to be a potential Cd-hyperaccumulating plant. The germination characteristics of B. pilosa have been documented, while the difference among populations remains unclear. Understanding variability in seed germination among populations is crucial for determining which populations to use for soil remediation programs.

Results

Present study was conducted to compare the requirements of temperature and water potential for germination of B. pilosa cypselae (the central type, hereafter seeds) from three populations using the thermal time, hydrotime, and hydrothermal time models. Seeds of three populations were incubated at seven constant temperatures (8, 12, 15, 20, 25, 30, and 35 °C) and at each of four water potentials (0, -0.3, -0.6, and -0.9 MPa). The results showed that germination percentage and rate of B. pilosa seeds were significantly by population, temperature, water potential and their interaction except for the interaction of population and water potential. Seeds from Danzhou population displayed a higher base temperature (Tb) for germination than those from Guilin and Baoshan population, however the ceiling temperature (Tc) had no consistent level among the populations but varied according to the water potential. In addition, the median base water potential [ψb(50)] for germination of seeds from Danzhou population was higher than that for seeds from Baoshan and Guilin population at low temperatures (< 25 °C), which was opposite at high temperatures (≥ 25 °C).

Conclusion

Seed germination requirements of B. pilosa on temperature and water differed significantly among populations. Differences in seed germination among populations may be complicated, which could not be simply explained by the temperature and rainfall conditions where the seeds were produced as previously reported. The results suggested that programme management should consider variation in seed germination traits when select which population could be applied to what kind of target remediation sites.
Audit of the functional preparedness of the selected military hospital in response to incidents and disasters: participatory action research
Authors: Heidaranlu Esmail , Amiri Mehdi , Salaree Mohammad Mehdi , Sarhangi Forogh , Saeed Yaser , Tavan Asghar
Published: October 2022

Introduction

Since hospitals play an important role in dealing with disaster victims, this study was conducted to audit the functional preparedness of the selected military hospital in response to incidents and disasters.

Materials and methods

This applied action research was conducted in all wards of a military hospital from September 2020 to September 2021. The functional preparedness of the hospital was assessed using a functional preparedness checklist containing 17 domains and the weaknesses of the hospital were identified. Then, during the hospital audit cycle, a plan was developed to improve work processes and the functional preparedness of different wards of the hospital in response to incidents and disasters using the FOCUS-PDCA model. The functional preparedness of the hospital was compared before and after the intervention and analyzed using SPSS22.

Results

The relative mean score of hospital preparedness in response to disasters was 508 out of 900 (56.44%) before the intervention, which was moderate. The relative mean score of the hospital preparedness in response to disasters was 561 (63.63%) after the intervention, which was good. The highest preparedness was related to risk assessment (85%) and the lowest preparedness was related to victims’ dead bodies (44%).

Conclusion

Considering the effect of action research on improving the hospital’s functional preparedness in response to disasters, other healthcare facilities are encouraged to incorporate auditing into their work plans.
The conduct and reporting of qualitative evidence syntheses in health and social care guidelines: a content analysis
Authors: Carmona Chris , Baxter Susan , Carroll Christopher
Published: October 2022

Background:

This paper is part of a broader investigation into the ways in which health and social care guideline producers are using qualitative evidence syntheses (QESs) alongside more established methods of guideline development such as systematic reviews and meta-analyses of quantitative data. This study is a content analysis of QESs produced over a 5-year period by a leading provider of guidelines for the National Health Service in the UK (the National Institute for Health and Care Excellence) to explore how closely they match a reporting framework for QES.

Methods:

Guidelines published or updated between Jan 2015 and Dec 2019 were identified via searches of the National Institute for Health and Care excellence (NICE) website. These guidelines were searched to identify any QES conducted during the development of the guideline. Data relating to the compliance of these syntheses against a reporting framework for QES (ENTREQ) were extracted and compiled, and descriptive statistics used to provide an analysis of the of QES conduct, reporting and use by this major international guideline producer.

Results:

QES contributed, in part, to 54 out of a total of 192 guidelines over the five-year period. Although methods for producing and reporting QES have changed substantially over the past decade, this study found that there has been little change in the number or quality of NICE QESs over time. The largest predictor of quality was the centre or team which undertook the synthesis. Analysis indicated that elements of review methods which were similar to those used in quantitative systematic reviews tended to be carried out well and mostly matched the criteria in the reporting framework, but review methods which were more specific to a QES tended to be carried out less well, with fewer examples of criteria in the reporting framework being achieved.

Conclusion:

The study suggests that use, conduct and reporting of optimal QES methods requires development, as over time the quality of reporting of QES both overall, and by specific centres, has not improved in spite of clearer reporting frameworks and important methodological developments. Further staff training in QES methods may be helpful for reviewers who are more familiar with conventional forms of systematic review if the highest standards of QES are to be achieved. There seems potential for greater use of evidence from qualitative research during guideline development.
Healthcare professionals’ views following implementation of risk stratification into a national breast cancer screening programme
Authors: Hawkins Rachel , McWilliams Lorna , Ulph Fiona , Evans D Gareth , French David P
Published: October 2022

Background

It is crucial to determine feasibility of risk-stratified screening to facilitate successful implementation. We introduced risk-stratification (BC-Predict) into the NHS Breast Screening Programme (NHSBSP) at three screening sites in north-west England from 2019 to 2021. The present study investigated the views of healthcare professionals (HCPs) on acceptability, barriers, and facilitators of the BC-Predict intervention and on the wider implementation of risk-based screening after BC-Predict was implemented in their screening site.

Methods

Fourteen semi-structured interviews were conducted with HCPs working across the breast screening pathway at three NHSBSP sites that implemented BC-Predict. Thematic analysis interpreted the data.

Results

Three pre-decided themes were produced. (1) Acceptability of risk-based screening: risk-stratification was perceived as a beneficial step for both services and women. HCPs across the pathway reported low burden of running the BC-Predict trial on routine tasks, but with some residual concerns; (2) Barriers to implementation: comprised capacity constraints of services including the inadequacy of current IT systems to manage women with different risk profiles and, (3) Facilitators to implementation: included the continuation of stakeholder consultation across the pathway to inform implementation and need for dedicated risk screening admin staff, a push for mammography staff recruitment and guidance for screening services. Telephone helplines, integrating primary care, and supporting access for all language needs was emphasised.

Conclusion

Risk-stratified breast screening was viewed as a progressive step providing it does not worsen inequalities for women. Implementation of risk-stratified breast screening requires staff to be reassured that there will be systems in place to support implementation and that it will not further burden their workload. Next steps require a comprehensive assessment of the resource needed for risk-stratification versus current resource availability, upgrades to screening IT and building screening infrastructure. The role of primary care needs to be determined. Simplification and clarification of risk-based screening pathways is needed to support HCPs agency and facilitate implementation. Forthcoming evidence from ongoing randomised controlled trials assessing effectiveness of breast cancer risk-stratification will also determine implementation.