bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Research Topic Prevalence by Journal Impact Quartile in Oral Health Sciences Using Bayesian Methods
Authors: Cortes Maria Carolina , Gonzalez Luis Vicente , Gunn Laura H. , ter Horst Enrique , Molina German , Restrepo Silvia , Zambrano Juan Diego
Published: July 2021

The relationship between research topics and academic prestige of journals is of relevance to assess venues for current research as well as trending areas of new research. This is of special relevance for those developing a research agenda or with defined productivity outcome expectations. This manuscript extracts prevalent topics using titles and abstracts from more than 10,000 manuscripts, constituting all published research in International Scientific Indexing (ISI) journals within the oral health specialties of oral surgery, orthodontics, and periodontics during 2018. Journals are clustered across four quartile categories according to their impact factors. The novelty of our work includes (a) an examination of a neglected unit of analysis (bigram) in oral health sciences which is of higher relevance than single-word topic definitions and (b) the use of an efficient Bayesian hierarchical approach to extract and rank topics across quartiles with information borrowing. Some topics persisted across quartile groups, while others show higher prevalence in specific quartiles, indicating that topics may find some journal quartiles a more appropriate venue for publication. All quartile groups show a prevalence of empirical research. The approach described in this manuscript offers the possibility to adjust/generate research agendas based on research topic prevalence and dynamics. This methodology is relevant for researchers looking to define their research agendas with potential outcomes aligned with the expectations of quantity and quartile set by their home institutions. It also serves researchers to assess most likely quartiles for publication of their work.
Structural Sources of Saudi–Iran Rivalry and Competition for the Sphere of Influence
Authors: Mirza Muhammad Nadeem , Abbas Hussain , Qaisrani Irfan Hasnain
Published: July 2021

Saudi Arabia and Iran are engaged in a strenuous competition in the Middle East to protect and promote their respective spheres of influence, to each other’s detriment. This qualitative study traces the structural sources of this competition while taking cue from the history. It argues that demise of Saddam Hussein, Iraq’s plunging into civil war, and Arab Spring leading to violent movements in Syria, Libya, Bahrain, and Yemen accentuated Saudi–Iran competition in the region. Study finds that the sources of their rivalry lie at structural level and can be understood by focusing upon their aspiration for the Muslim world leadership, religio-sectarianism, antithetical governance structure, and Iranian nuclear program.
Lived Experience of Disability Equality Training Facilitators: Narratives of Disabled People From Ulaanbaatar, Mongolia
Authors: Higashida Masateru
Published: July 2021

This study explores the lived experiences of becoming and continuing as facilitators of Disability Equality Training (DET). This study was conducted in Ulaanbaatar, Mongolia, one of the countries where DET has been strategically implemented. Nine facilitators were selected by purposive sampling for semistructured interviews. Thematic analysis was applied to the narrative data for exploring themes with consideration to chronological sequence, namely, before, during, and after DET training of facilitators (DET–TOF). The narratives indicated that DET facilitators had varied personal backgrounds, including experiences of discrimination. Their stories also indicated that some interviewees not only obtained views on the social model of disability and facilitation skills but also reframed their past life experiences both during and after the DET–TOF. While this study considers the potential criticism of the social model, which is the foundation of the DET, these findings can provide helpful insights for future agents of change who engage in a society.
Cloud BIM Technology as a Means of Collaboration and Project Integration in Smart Cities
Authors: Onungwa Ihuoma , Olugu-Uduma Nnezi , Shelden Dennis R.
Published: July 2021

Building Information Modeling (BIM) was created to address the Architecture, Engineering, and Construction (AEC) industry’s lack of collaboration among consultants. Advances in cloud BIM have led to the easy exchange of data and real-time collaboration among consultants from conceptual design to the detailed construction drawing stage and through the project life cycle. This is critical in the development of smart cities. Cloud BIM also facilitates visualization of the city and data exchange for internet of things (IoT). Smart city development involves incorporating data from sensors and hardware attached to existing infrastructure. This article studies cloud BIM technology as a means of project integration in smart city development. To do this, a case study of digital modeling for the development of a smart city was done. Benefits include seamless communication, monitoring real-time progress, and visualization of files. Problems encountered include governance problems, problems preserving work sets, the integrity of drawings, and difficulty specifying coordinates on-site.
Degenerative Cervical Spondylosis: A Cause of Vertigo?
Authors: Shende Chetan , Rathod Tushar , Marathe Nandan , Mohanty Shubhranshu , Kamble Prashant , Mallepally Abhinandan Reddy , Sathe Ashwin
Published: July 2021

Study Design:

Prospective observational study.

Objectives:

Studying the effect of degenerative cervical spondylosis(CS) on blood flow velocity of vertebral artery (VA) during cervical spine rotation in different head positions and its association with vertigo.

Introduction:

Vertigo is one of the most common complaints seen in an out-patient clinic. Its association with CS remains an enigma for a treating physician. This study planned to systematically analyze the association between vertigo and CS by evaluating VA blood flow dynamics in different head positions.

Methods:

100 patients with ages ranging from 20-80 years were recruited. First group of 50 patients with CS with vertigo were compared with second study group of 50 patients having CS without vertigo. Cervical radiographs were used to evaluate CS using cervical degenerative index (CDI). Color doppler was used to measure VA blood flow with head in neutral position and 60° lateral rotation with 30° extension. Same procedure was repeated on opposite side. Measurements performed included peak systolic blood flow velocity(PSV) and end diastolic blood flow velocity (EDV).

Results:

Among patients with CS, patients having vertigo showed significantly more evident degenerative changes (CDI ≥25) ( P=<0.001). High grade CS patients (CDI ≥25) with vertigo had statistically significant lower blood flow parameters with head rotation in the left and right VAs as compared to CS patients without vertigo.

Conclusion:

This study highlights important pathophysiological mechanism of vertigo observed in patients of CS. The magnitude of reduction in VA blood flow was significantly higher in patients with advanced CS presenting as vertigo.
Social Media Conversations About High Engagement Sports Team Brands
Authors: Chadwick Simon , Fenton Alex , Dron Richard , Ahmed Wasim
Published: July 2021

This study conducts an analysis of social media discussions related to high engagement sports brands. More specifically, our study examined the English Premier League (EPL); it sought to retrieve data systematically over the same day, weekly, for a period of five months. After this process, we had built 20 datasets and NodeXL was utilized to analyse the data. After we had this data, we were able to use qualitative observations to identify key users and conversations that formed around the EPL as well as the connections between the conversations that arose from the brand’s posts and the people involved in them. We also analyzed the quantitative data underpinning our network visualisations to provide further insights. The most obvious initial finding was that when the EPL tweets, it prompts a large volume of conversations directly related to these tweets. However, we also noted that EPL tweets also help instigate further, sometimes unrelated, tweets and conversations. More specifically, we identified that the visualized network of conversations was of a broadcast form, which is characterized by messages being generated by a central account (the EPL) and shared by a number of decentralized users. Based on our analysis, we propose guidance around (S)ocial media presence, (C)rafting the message, Planned (i)ntervention, (S)pontaneous follow-up, and (M)essage mortality to form the SCISM framework. This framework is likely to be of interest to brands that wish to promote, sustain and benefit from their instigation of social media.
(In)coherent subjects? The politics of conceptualising resistance in the UK asylum system
Authors: Hughes Sarah M
Published: July 2021

Many accounts of resistance within systems of migration control pivot upon a coherent migrant subject, one that is imbued with political agency and posited as oppositional to particular forms of sovereign power. Drawing upon ethnographic research into the role of creativity within the UK asylum system, I argue that grounding resistance with a stable, coherent and agentic subject, aligns with oppositional narratives (of power vs resistance), and thereby risks negating the entangled politics of the (in)coherence of subject formation, and how this can contain the potential to disrupt, disturb or interrupt the practices and premise of the UK asylum system. I suggest that charity groups and subjects should not be written out of narratives of resistance apriori because they engage with ‘the state’: firstly, because to argue that there is a particular form that resistance should take is to place limits around what counts as the political; and secondly, because to ‘remain oppositional’ is at odds with an (in)coherent subject. I show how accounts which highlight a messy and ambiguous subjectivity, could be bought into understandings of resistance. This is important because as academics, we too participate in the delineation of the political and what counts as resistance. In predetermining what subjects, and forms of political action count as resistance we risk denying recognition to those within this system.
“It Would Be Nice If”: Analysis of Transition Experiences Through Grand Challenges
Authors: Kucharczyk Suzanne , Thomas Johanna , Schaefer Whitby Peggy
Published: July 2021

The adult outcomes of youth with disabilities continue to lag behind those of their peers without disabilities, especially for youth living in rural communities. Interdisciplinary teaming is identified as an important component of effective transition planning. Transition planning and collaborative teaming are challenged further in rural communities due to lack of resources, distances between services and providers, and access for youth and their families. Social workers, given their multisystem perspective on aligning youth and family needs with resources, may be well poised, though currently underutilized, to address the challenges of transition in rural contexts. Through the transition experiences of 20 families and young adults with high need disabilities from a rural southern state, this study analyzes the potential alignment between the tenets of the Individuals with Disabilities Education Act for transition and the priorities of social work described in the Grand Challenges. Implications for practice and policy for special education transition planning in rural communities are offered.
Virulence factors and molecular characteristics of Shigella flexneri isolated from calves with diarrhea
Authors: Zhu Zhen , Wang Weiwei , Cao Mingze , Zhu Qiqi , Ma Tenghe , Zhang Yongying , Liu Guanhui , Zhou Xuzheng , Li Bing , Shi Yuxiang , Zhang Jiyu
Published: July 2021

Background

The natural hosts ofShigellaare typically humans and other primates, but it has been shown that the host range ofShigellahas expanded to many animals. AlthoughShigellais becoming a major threat to animals, there is limited information on the genetic background of local strains. The purpose of this study was to assess the presence of virulence factors and the molecular characteristics ofS. flexneriisolated from calves with diarrhea.

Results

Fifty-fourS. flexneriisolates from Gansun, Shanxi, Qinghai, Xinjiang and Tibet obtained during 2014 to 2016 possessed four typical biochemical characteristics ofShigella. The prevalences ofipaH,virA,ipaBCD,ial,sen,set1A,set1Bandstxwere 100 %, 100 %, 77.78 %, 79.63 %, 48.15 %, 48.15 and 0 %, respectively. Multilocus variable number tandem repeat analysis (MLVA) based on 8 variable number of tandem repeat (VNTR) loci discriminated the isolates into 39 different MLVA types (MTs), pulsed field gel electrophoresis (PFGE) based onNotI digestion divided the 54 isolates into 31 PFGE types (PTs), and multilocus sequence typing (MLST) based on 15 housekeeping genes differentiated the isolates into 7 MLST sequence types (STs).

Conclusions

The findings from this study enrich our knowledge of the molecular characteristics ofS. flexnericollected from calves with diarrhea, which will be important for addressing clinical and epidemiological issues regarding shigellosis.
Using hand grip strength to detect slow walking speed in older adults: the Yilan study
Authors: Lin Yen-Huai , Chen Hsi-Chung , Hsu Nai-Wei , Chou Pesus
Published: July 2021

Background

Walking speed is an important health indicator in older adults, although its measurement can be challenging because of the functional decline due to aging and limited environment. The aim of this study was to examine whether hand grip strength can be a useful proxy for detecting slow walking speed in this population.

Methods

A cross-sectional study was conducted using the cohort from the Yilan Study in Taiwan. Community-dwelling older adults aged 65 years and older were included. Slow walking speed was defined as a 6-meter walking speed < 1.0 m/s, according to the 2019 Asian Working Group for Sarcopenia diagnostic criteria. Stepwise multiple linear regression was used to determine the most significant variables associated with walking speed. Receiver operating characteristic analysis was used to determine the optimal cutoff values for hand grip strength in detecting slow walking speed.

Results

A total of 301 participants with an average age of 73.9 ± 6.8 years were included; 55.1 % participants were women. In stepwise multiple linear regression analysis that included various variables, hand grip strength was found to be the most explainable factor associated with walking speed among all participants and among participants of each sex. The optimal cutoff values for hand grip strength in the detection of slow walking speed were 19.73 kg for all participants (sensitivity: 55 %, specificity: 83 %, area under the curve: 0.74, accuracy: 66.9 %), 35.10 kg for men (sensitivity: 92 %, specificity: 42 %, area under the curve: 0.70, accuracy: 66.4 %), and 17.93 kg for women (sensitivity: 62 %, specificity: 80 %, area under the curve: 0.76, accuracy: 67.9 %).

Conclusions

Hand grip strength was found to be a useful proxy for the identification of slow walking speed in older adults.
COVID-19 viral load not associated with disease severity: findings from a retrospective cohort study
Authors: Abdulrahman Abdulkarim , Mallah Saad I. , Alqahtani Manaf
Published: July 2021

Background

Being able to use COVID-19 RT-PCR Ct values as simple clinical markers of disease outcome or prognosis would allow for the easy and proactive identification and triaging of high-risk cases. This study’s objective was thus to explore whether a correlation exists between COVID-19 viral loads, as indicated by RT-PCR Ct values, and disease severity, as indicated by respiratory indices.

Results

A multi-centre cross-sectional retrospective study was conducted, using data obtained from Bahrain’s National COVID-19 Task force’s centralised database. The study period ranged from May 2, 2020 to July 31, 2020. A multivariable logistic regression was used to assess for a correlation using data from a total of 1057 admitted COVID-19 cases. The covariates adjusted for included sex, age, presentation, and comorbidities. In our cohort, Ct value showed no statistical significance for an association with requirement for oxygenation on admission (Odds ratio 1.046; 95%CI 0.999 to 1.096, p = 0.054).

Conclusion

Viral load, as indicated by Ct values, did not seem to be associated with requirement for oxygenation on admission in our cohort. We postulate however that time since onset of symptom may have acted as an unaccounted-for confounder. As such, RT-PCR Ct values may not be a useful prognostic clinical tool in isolation.
Influenza vaccination during pregnancy and influencing factors in Korea: A multicenter questionnaire study of pregnant women and obstetrics and gynecology doctors
Authors: Kang Byung Soo , Lee San Ha , Kim Woo Jeng , Wie Jeong Ha , Park In Yang , Ko Hyun Sun
Published: July 2021

Background

Although the World Health Organization and health authorities in most countries recommend that pregnant women receive inactivated influenza virus vaccines, coverage remains low. This study aimed to investigate (1) the proportion of pregnant women who received an influenza vaccination and influencing factors and (2) the proportion of obstetrics and gynecology (OBGYN) doctors who routinely recommend influenza vaccination to pregnant women and influencing factors.

Methods

Two separate, anonymized questionnaires were developed for physicians and pregnant and postpartum women and were distributed to multicenters and clinics in South Korea. The proportions of women who received influenza vaccination during pregnancy and OBGYN doctors who routinely recommend the influenza vaccine to pregnant women were analyzed. Independent influencing factors for both maternal influenza vaccination and OBGYN doctors’ routine recommendations to pregnant women were analyzed using log-binomial regression analysis.

Results

The proportion of self-reported influenza vaccination during pregnancy among 522 women was 63.2%. Pregnancy-related independent factors influencing maternal influenza vaccination were “(ever) received information about influenza vaccination during pregnancy” (OR 8.9, 95% CI 4.17–19.01), “received vaccine information about from OBGYN doctors” (OR 11.44, 95% CI 5.46–24.00), “information obtained from other sources” (OR 4.38, 95% CI 2.01–9.55), and “second/third trimester” (OR 2.41, 95% CI 1.21–4.82)..

Among 372 OBGYN doctors, 76.9% routinely recommended vaccination for pregnant women. Independent factors effecting routine recommendation were “working at a private clinic or hospital” (OR 5.33, 95% CI 2.44–11.65), “awareness of KCDC guidelines” (OR 3.11, 95% CI 1.11–8.73), and “awareness of the 2019 national free influenza vaccination program for pregnant women” (OR 4.88, 95% CI 2.34–10.17). OBGYN doctors most commonly chose ‘guidelines proposed by the government or public health (108, 46%) and academic committees (59, 25%), as a factor which expect to affect the future recommendation

Conclusion

This study showed that providing information about maternal influenza vaccination, especially by OBGYN doctors, is crucial for increasing vaccination coverage in pregnant women. Closer cooperation between the government and OBGYN academic societies to educate OBGYN doctors might enhance routine recommendations.
Chemoradiation treatment patterns among United States Veteran Health Administration patients with unresectable stage III non-small cell lung cancer
Authors: Hung Anna , Lee Kyung Min , Lynch Julie A. , Li Yanhong , Poonnen Pradeep , Efimova Olga V. , Hintze Bradley J. , Buckingham Trudy , Yong Candice , Seal Brian , Kelley Michael J. , Reed Shelby D.
Published: July 2021

Background

The Veterans Health Administration (VHA) is the largest integrated health care system in the United States (US). Among VHA patients, the rate of use of concurrent chemoradiation therapy (CCRT) among those with unresectable, stage III non-small cell lung cancer (NSCLC) is unknown. The objective was to report recent CCRT treatment patterns in VHA patients and identify characteristics associated with receipt of CCRT.

Methods

Using Department of Veteran Affairs (VA) Cancer Registry System data linked to VA electronic medical records, we determined rates of CCRT, sequential CRT (SCRT), radiation therapy (RT) only, chemotherapy (CT) only, and neither treatment.

Results

Among 4054 VHA patients who met study criteria, CCRT rates slightly increased from 44 to 50% between 2013 and 2017. Factors associated with decreased odds of CCRT receipt compared to any other treatment included increasing age (adjusted odds ratio [aOR] per 10 years = 0.67; 95% CI: 0.60–0.76) and Charlson-Deyo comorbidity score (aOR = 0.94; 95% CI: 0.91–0.97). White race was associated with increased odds of CCRT receipt (aOR = 1.24; 95% CI: 1.004–1.53). In a chart review sample of 200 patients, less than half (n = 85) had a documented reason for not receiving CCRT. Among these, 29% declined treatment, and 71% did not receive CCRT due to “not being a candidate” for reasons related to frailty or lung nodules being too far apart for radiation therapy.

Conclusions

CCRT rates among VHA patients with unresectable, stage III NSCLC slightly increased from 2013 to 2017; however in 2017, only half were receiving CCRT. Older patients and those with multiple comorbidities were less likely to receive CCRT and even when controlling for these factors, non-white patients were less likely to receive CCRT.
Acceptability, feasibility, and likelihood of stakeholders implementing the novel BPaL regimen to treat extensively drug-resistant tuberculosis patients
Authors: van de Berg S. E. J. , Pelzer P. T. , van der Land A. J. , Abdrakhmanova E. , Ozi A. Muhammad , Arias M. , Cook-Scalise S. , Dravniece G. , Gebhard A. , Juneja S. , Handayani R. , Kappel D. , Kimerling M. , Koppelaar I. , Malhotra S. , Myrzaliev B. , Nsa B. , Sugiharto J. , Engel N. , Mulder C. , van den Hof S.
Published: July 2021

Background

BPaL, a 6 month oral regimen composed of bedaquiline, pretomanid, and linezolid for treating extensively drug-resistant tuberculosis (XDR-TB) is a potential alternative for at least 20 months of individualized treatment regimens (ITR). The ITR has low tolerability, treatment adherence, and success rates, and hence to limit patient burden, loss to follow-up and the emergence of resistance it is essential to implement new DR-TB regimens. The objective of this study was to assess the acceptability, feasibility, and likelihood of implementing BPaL in Indonesia, Kyrgyzstan, and Nigeria.

Methods

We conducted a concurrent mixed-methods study among a cross-section of health care workers, programmatic and laboratory stakeholders between May 2018 and May 2019. We conducted semi-structured interviews and focus group discussions to assess perceptions on acceptability and feasibility of implementing BPaL. We determined the proportions of a recoded 3-point Likert scale (acceptable; neutral; unacceptable), as well as the overall likelihood of implementing BPaL (likely; neutral; unlikely) that participants graded per regimen, pre-defined aspect and country. We analysed the qualitative results using a deductive framework analysis.

Results

In total 188 stakeholders participated in this study: 63 from Kyrgyzstan, 51 from Indonesia, and 74 from Nigeria The majority were health care workers (110). Overall, 88% (146/166) of the stakeholders would likely implement BPaL once available. Overall acceptability for BPaL was high, especially patient friendliness was often rated as acceptable (93%, 124/133). In contrast, patient friendliness of the ITR was rated as acceptable by 45%. Stakeholders appreciated that BPaL would reduce workload and financial burden on the health care system. However, several stakeholders expressed concerns regarding BPaL safety (monitoring), long-term efficacy, and national regulatory requirements regarding introduction of the regimen. Stakeholders stressed the importance of addressing current health systems constraints as well, especially in treatment and safety monitoring systems.

Conclusions

Acceptability and feasibility of the BPaL regimen is high among TB stakeholders in Indonesia, Kyrgyzstan, and Nigeria. The majority is willing to start using BPaL as the standard of care for eligible patients despite country-specific health system constraints.
Identification of factors related to food insecurity and the implications for social determinants of health screenings
Authors: Banks Ashley R. , Bell Bethany A. , Ngendahimana David , Embaye Milen , Freedman Darcy A. , Chisolm Deena J.
Published: July 2021

Background

Food insecurity and other social determinants of health are increasingly being measured at routine health care visits. Understanding the needs and behaviors of individuals or families who screen positive for food insecurity may inform the types of resources they need. The goal of this research was to identify modifiable characteristics related to endorsement of two food insecurity screener questions to better understand the resources necessary to improve outcomes.

Methods

Analysis was conducted focusing on cross-sectional survey data collected in 2015–2016 from participants (N = 442) living in urban neighborhoods in Ohio with limited access to grocery stores. Food insecurity was assessed by the endorsement of at least one of two items. These were used to categorize participants into two groups: food insecure(N = 252) or food secure (N = 190). Using logistic regression, we estimated the association between several variables and the food insecure classification.

Results

Those that used their own car when shopping for food had lower odds of reporting food insecurity, as did those with affirmative attitudes related to the convenience of shopping for and ease of eating healthy foods. As shopping frequency increased, the odds of food insecurity increased. Food insecurity also increased with experience of a significant life event within the past 12 months. There was an 81% increase in the odds of reporting food insecurity among participants who received Supplemental Nutrition Assistance Program benefits compared to those not receiving Supplemental Nutrition Assistance Program benefits.

Conclusions

Along with referrals to SNAP, clinicians can further address screening-identified food insecurity through provision of transportation supports and linkages to other social services while collaborating on community initiatives to promote convenient and easy access to healthy foods. The needs and behaviors associated with screens indicating food insecurity also have implications for impacting other SDH, and thus, health outcomes.
Physical and chemical mechanisms involved in adhesion of orthodontic bonding composites: in vitro evaluations
Authors: Condò R. , Mampieri G. , Cioffi A. , Cataldi M. E. , Frustaci I. , Giancotti A. , Campanella V. , Mussi V. , Convertino A. , Maiolo L. , Pasquantonio G.
Published: July 2021

Background

Bond strength of orthodontic composite is strongly influenced by molecular and structural mechanisms. Aim of this in vitro study was to compare bond strength of light-cure orthodontic composites by measuring debonding forces and evaluating locations of bond failure. Investigations on chemical compositions clarified adhesive behaviors and abilities, exploring effects of ageing processes in this junction materials.

Methods

Twelve enamel discs, from human premolars, were randomly coupled to one orthodontic adhesive system (Transbond XT™ 3 M UNITEK, USA, Light-Cure Orthodontic Paste, LEONE, Italy and Bisco Ortho Bracket Paste LC, BISCO, Illinois) and underwent to Shear Bond Strength test. Metallic brackets were bonded to twenty-seven human premolar, with one of the adhesive systems, to quantify, at FE-SEM magnifications, after debonding, the residual material on enamel and bracket base surfaces. Raman Spectroscopy analysis was performed on eight discs of each composites to investigate on chemical compositions, before and after accelerated aging procedures in human saliva and sugary drink.

Results

Orthodontic adhesive systems showed similar strength of adhesion to enamel. The breakage of adhesive-adherent bond occurs in TXT at enamel-adhesive interface while in Bisco and Leone at adhesive-bracket interface. Accelerated in vitro aging demonstrated good physical–chemical stability for all composites, Bisco only, was weakly contaminated with respect to the other materials.

Conclusion

A similar, clinically adequate and acceptable bond strength to enamel for debonding maneuvers was recorded in all orthodontic adhesive systems under examination. No significant chemical alterations are recorded, even in highly critical situations, not altering the initial mechanical properties of materials.
Dignity of patients with palliative needs in the Middle East: an integrative review
Authors: Dakessian Sailian Silva , Salifu Yakubu , Saad Rima , Preston Nancy
Published: July 2021

Background

Patients with palliative needs experience high psychological and symptom distress that may lead to hopelessness and impaired sense of dignity. Maintaining patient dignity or the quality of being valued is a core aim in palliative care. The notion of dignity is often explained by functionality, symptom relief and autonomy in decision making. However, this understanding and its implications in Middle Eastern countries is not clear.

The aim of this review is to 1) explore the understanding of dignity and how dignity is preserved in adult patients with palliative care needs in the Middle East 2) critically assess the findings against the Dignity Model dominant in western literature.

Method

Using an integrative review we searched four databases EMBASE, Psych-Info, CINAHL, and PubMed. These databases retrieve a broad literature on palliative care and are often chosen in other palliative care reviews. To enhance the search strategy, three online journals were hand searched, reference lists of review papers scanned, and forward citations sought. No time limits were applied. The retrieved papers were assessed independently by two authors including quality assessment using the Hawker’s appraisal tool.

Results

Out of the 5113 studies retrieved, 294 full texts were assessed. Sixteen studies were included for synthesis of which fourteen were published in Iran. Seven themes were developed after data analysis: Maintaining Privacy and Secrecy; Gentle communication with a dialogue that preserves hope instead of blunt truth-telling; Abundance characterised by accessibility to medical supplies and financial stability; Family Support where relatives deliver major assistance in care; Physical Fitness; Reliable health care, and Social justice that endorses equal care to all.

Conclusion

The results are compatible with the existing evidence from the Dignity Model ascertaining that dignity is socially mediated and influenced by interactions and physical fitness. Nevertheless, the findings highlight that patient dignity is also shaped by the socio-political, cultural, and economic conditions of the country, where family support, gentle communication and accessible health care are essential elements.
How can dementia diagnosis and care for Aboriginal and Torres Strait Islander people be improved? Perspectives of healthcare providers providing care in Aboriginal community controlled health services
Authors: Bryant Jamie , Noble Natasha , Freund Megan , Rumbel Jennifer , Eades Sandra , Sanson-Fisher Rob , Lowe Michael , Walsh Justin , Piterman Leon , Koch Susan , Meyer Claudia , Todd Elaine
Published: July 2021

Background

Aboriginal and/or Torres Strait Islander people experience dementia at a rate three to five times higher than the general Australian population. Aboriginal Community Controlled Health Services (ACCHSs) have a critical role to play in recognising symptoms of cognitive impairment, facilitating timely diagnosis of dementia, and managing the impacts of dementia. Little is known about the barriers and enablers to Aboriginal people receiving a timely dementia diagnosis and appropriate care once diagnosed.

This study aims to explore, from the perspective of healthcare providers in the ACCHS sector across urban, regional and remote communities, the barriers and enablers to the provision of dementia diagnosis and care.

Methods

A qualitative study involving semi-structured interviews with staff members working in the ACCHS sector. Aboriginal Health Workers, General Practitioners, nurses, practice or program managers, and Chief Executive Officers were eligible to participate. Consenting ACCHS staff completed a telephone interview administered by a trained interviewer. Interviews were audio-recorded, transcribed, and analysed using qualitative content analysis.

Results

Sixteen staff from 10 ACCHSs participated. Most participants perceived their communities had a limited understanding of dementia. Symptoms of dementia were usually noticed by the GP or another healthcare worker at the ACCHS who had an ongoing relationship with the person. Most participants reported that their service had established referral pathways with either hospital-based geriatricians, geriatricians located with aged care assessment teams, or specialists who visited communities periodically. Key enablers to high quality dementia care included the use of routine health assessments as a mechanism for diagnosis; relationships within communities to support diagnosis and care; community and family relationships; comprehensive and holistic care models; and the use of tailored visual resources to support care. Key barriers to high quality care included: denial and stigma; dementia being perceived as a low priority health condition; limited community awareness and understanding of dementia; lack of staff education and training about dementia; and numerous gaps in service delivery.

Conclusions

Substantially increased investments in supporting best-practice diagnosis and management of dementia in Aboriginal communities are required. ACCHSs have key strengths that should be drawn upon in developing solutions to identified barriers to care.
Therapeutic benefits of recombinant alpha1-antitrypsin IgG1 Fc-fusion protein in experimental emphysema
Authors: Takeda Katsuyuki , Kim Soo-Hyun , Joetham Anthony , Petrache Irina , Gelfand Erwin W.
Published: July 2021

Background

Alpha-1 antitrypsin (AAT) is a major serine protease inhibitor. AAT deficiency (AATD) is a genetic disorder characterized by early-onset severe emphysema. In well-selected AATD patients, therapy with plasma-derived AAT (pAAT), “augmentation therapy”, provides modest clinical improvement but is perceived as cumbersome with weekly intravenous infusions. Using mouse models of emphysema, we compared the effects of a recombinant AAT-IgG1 Fc-fusion protein (AAT-Fc), which is expected to have a longer half-life following infusion, to those of pAAT.

Methods

In an elastase model of emphysema, mice received a single intratracheal instillation of porcine pancreatic elastase (PPE) or human leucocyte elastase (hLE). AAT-Fc, pAAT, or vehicle was administered intraperitoneally 1 day prior to or 3 weeks following elastase instillation. Lung function and histology assessments were performed at 7 and 32 days after elastase instillation. In a cigarette smoke (CS) model of emphysema, mice were exposed to CS daily, 5 days a week, for 6 months and AAT-Fc, pAAT, or vehicle were administered every 10 days during the last 3 months of CS exposure. Assessments were performed 3 days after the last CS exposure. Immune responses to lung elastin peptide (EP) and the effects of AAT-Fc or pAAT treatment on dendritic cell (DC) function were determined ex vivo.

Results

Both elastase instillation and CS exposure triggered emphysema-like alveolar enlargement, increased lung compliance, and increased markers of inflammation compared to controls. Administration of AAT-Fc either prior to or following elastase instillation or during CS exposure provided greater protection than pAAT against alveolar enlargement, lung dysfunction, and airway inflammation. When challenged ex vivo with EP, spleen mononuclear cells from elastase-exposed mice exhibited dose-dependent production of IFNγ and IL-17, suggesting immune reactivity. In co-culture experiments with splenic CD4+ T cells isolated from elastase-exposed mice, AAT-Fc treatment prior to EP-priming of bone marrow-derived dendritic cells inhibited the production of IFNγ and IL-17.

Conclusions

Compared to pAAT, AAT-Fc more effectively prevented or attenuated elastase- and CS-induced models of emphysema. These effects were associated with immunomodulatory effects on DC activity. AAT-Fc may provide a therapeutic option to individuals with AATD- and CS-induced emphysema.
Prognostic value of fibrinogen in patients with coronary artery disease and prediabetes or diabetes following percutaneous coronary intervention: 5-year findings from a large cohort study
Authors: Yuan Deshan , Jiang Ping , Zhu Pei , Jia Sida , Zhang Ce , Liu Yue , Liu Ru , Xu Jingjing , Tang Xiaofang , Zhao Xueyan , Gao Runlin , Yang Yuejin , Xu Bo , Gao Zhan , Yuan Jinqing
Published: July 2021

Background

Fibrinogen (FIB) is an independent risk factor for mortality and cardiovascular events in the general population. However, the relationship between FIB and long-term mortality among CAD patients undergoing PCI remains unclear, especially in individuals complicated with diabetes mellitus (DM) or prediabetes (Pre-DM).

Methods

6,140 patients with CAD undergoing PCI were included in the study and subsequently divided into three groups according to FIB levels (FIB-L, FIB-M, FIB-H). These patients were further grouped by glycemic status [normoglycemia (NG), Pre-DM, DM]. The primary endpoint was all-cause mortality. The secondary endpoint was cardiac mortality.

Results

FIB was positively associated with hemoglobin A1c (HbA1c) and fasting blood glucose (FBG) in CAD patients with and without DM (P < 0.001). During a median follow-up of 5.1 years (interquartile range 5.0–5.2 years), elevated FIB was significantly associated with long-term all-cause mortality (adjusted HR: 1.86; 95% CI 1.28–2.69; P = 0.001) and cardiac mortality (adjusted HR: 1.82; 95% CI 1.15–2.89; P = 0.011). Similarly, patients with DM, but not Pre-DM, had increased risk of all-cause and cardiac mortality compared with NG group (all P < 0.05). When grouped by both FIB levels and glycemic status, diabetic patients with medium and high FIB levels had higher risk of mortality [(adjusted HR: 2.57; 95% CI 1.12–5.89), (adjusted HR: 3.04; 95% CI 1.35–6.82), all P < 0.05]. Notably, prediabetic patients with high FIB also had higher mortality risk (adjusted HR: 2.27; 95% CI 1.01–5.12).

Conclusions

FIB was independently associated with long-term all-cause and cardiac mortality among CAD patients undergoing PCI, especially in those with DM and Pre-DM. FIB test may help to identify high-risk individuals in this specific population.
Psychometric properties of the original and short Hungarian version of the Iowa infant feeding attitude scale
Authors: Ungváry Renáta , Ittzés András , Bóné Veronika , Török Szabolcs
Published: July 2021

Background

The Iowa Infant Feeding Attitude Scale (IIFAS) is a widely used tool to assess attitudes towards infant feeding. Attitudes towards breastfeeding are one of the main influencing factors of feeding choice and breastfeeding duration. Adaptation of the IIFAS to the Hungarian context provides an opportunity for cross-cultural comparisons and helps to target breastfeeding support interventions. The growing number of shortened scales in various fields of research, demonstrates the necessity to adapt to a changing context of data collection to avoid fatigue and dropout among respondents. However, international comparisons are difficult due to the lack of a consensual shortened form of the scale.

The aim of our study was to examine the psychometric properties of the Hungarian version of the IIFAS (IIFAS-H) and propose an 8-item short version that has appropriate construct validity.

Methods

The original IIFAS was translated into Hungarian and then translated back to English. A cross-sectional study based on an internet survey in 2019 was conducted among 553 mothers whose most recent child’s age was between 6 and 36 months. Psychometric properties of the Hungarian IIFAS were determined and compared with international results. In order to obtain a shorter version of the Hungarian scale, we preferably kept those items that are common with other international abbreviated IIFAS versions and deleted items with a corrected item-total correlation or factor loading of less than 0.3, where factor loadings came from a principal component analysis forcing the extraction of one principal component (factor).

Results

The 17-item IIFAS-H showed good psychometric properties with a Cronbach’s alpha of0.73. Further analyses proved that the examined three shortened versions of the IIFAS consisting of 11, 9, and 8 items also showed good properties (Cronbach’s alpha = 0.79, 0.79, 0.76, respectively).

Conclusions

The Hungarian version of the original 17-item long IIFAS proved to be a good measurement tool with good psychometric properties. Based on our analyses, we suggest the use of the 8-item short version (IIFAS-H8) of the scale.
Gene therapies and COVID-19 vaccines: a necessary discussion in relation with viral vector-based approaches
Authors: Aledo-Serrano Angel , Gil-Nagel Antonio , Isla Julian , Mingorance Ana , Mendez-Hermida Fernando , Hernandez-Alcoceba Ruben
Published: July 2021

The COVID-19 pandemic is adding an unanticipated concern for those affected by genetic diseases. Most of the new treatment achievements for these patients are made possible as a result of advances in viral-based products. Among them, adenoviruses (AdV) and especially adeno-associated viruses (AAV) are important players. The concerns and the conversation around this issue have increased as COVID-19 vaccines approach the market. What if the viral vectors become the mainstream strategy for vaccine development? Will the immune response elicited against the vector compromise the efficacy of future gene therapies? Patients with genetic diseases and patient advocacy groups are requesting information to the medical community about the potential impact of these vaccines in future gene therapy treatments, and physicians and scientists are not able to provide satisfactory answer yet. Importantly, the frequency of cross-reactivity among different AAV serotypes can be as high as 50%. This would have potential implications for patients with genetic disorders who could benefit from gene therapies, often coming in the form of AAV-based gene therapies. As in many other aspects, this pandemic is challenging our capacity to coordinate, plan ahead and align different medical objectives. In this case, having such conversation early on might allow us to make the right choices while we are still on time.
Circular RNA circ_001422 promotes the progression and metastasis of osteosarcoma via the miR-195-5p/FGF2/PI3K/Akt axis
Authors: Yang Bingsheng , Li Lutao , Tong Ge , Zeng Zhirui , Tan Jianye , Su Zexin , Liu Zhengwei , Lin Jiezhao , Gao Wenwen , Chen Jianping , Zeng Sisi , Wu Guofeng , Li Lin , Zhu Shuang , Liu Qiuzhen , Lin Lijun
Published: July 2021

Background

Circular RNAs (circRNAs) are involved in diverse processes that drive cancer development. However, the expression landscape and mechanistic function of circRNAs in osteosarcoma (OS) remain to be studied.

Methods

Bioinformatic analysis and high-throughput RNA sequencing tools were employed to identify differentially expressed circRNAs between OS and adjacent noncancerous tissues. The expression level of circ_001422 in clinical specimens and cell lines was measured using qRT-PCR. The association of circ_001422 expression with the clinicopathologic features of 55 recruited patients with OS was analyzed. Loss- and gain-of-function experiments were conducted to explore the role of circ_001422 in OS cells. RNA immunoprecipitation, fluorescence in situ hybridization, bioinformatics database analysis, RNA pulldown assays, dual-luciferase reporter assays, mRNA sequencing, and rescue experiments were conducted to decipher the competitive endogenous RNA regulatory network controlled by circ_001422.

Results

We characterized a novel and abundant circRNA, circ_001422, that promoted OS progression. Circ_001422 expression was dramatically increased in OS cell lines and tissues compared with noncancerous samples. Higher circ_001422 expression correlated with more advanced clinical stage, larger tumor size, higher incidence of distant metastases and poorer overall survival in OS patients. Circ_001422 knockdown markedly repressed the proliferation and metastasis and promoted the apoptosis of OS cells in vivo and in vitro, whereas circ_001422 overexpression exerted the opposite effects. Mechanistically, competitive interactions between circ_001422 and miR-195-5p elevated FGF2 expression while also initiating PI3K/Akt signaling. These events enhanced the malignant characteristics of OS cells.

Conclusions

Circ_001422 accelerates OS tumorigenesis and metastasis by modulating the miR-195-5p/FGF2/PI3K/Akt axis, implying that circ_001422 can be therapeutically targeted to treat OS.
Prediction of combination therapies based on topological modeling of the immune signaling network in multiple sclerosis
Authors: Bernardo-Faura Marti , Rinas Melanie , Wirbel Jakob , Pertsovskaya Inna , Pliaka Vicky , Messinis Dimitris E. , Vila Gemma , Sakellaropoulos Theodore , Faigle Wolfgang , Stridh Pernilla , Behrens Janina R. , Olsson Tomas , Martin Roland , Paul Friedemann , Alexopoulos Leonidas G. , Villoslada Pablo , Saez-Rodriguez Julio
Published: July 2021

Background

Multiple sclerosis (MS) is a major health problem, leading to a significant disability and patient suffering. Although chronic activation of the immune system is a hallmark of the disease, its pathogenesis is poorly understood, while current treatments only ameliorate the disease and may produce severe side effects.

Methods

Here, we applied a network-based modeling approach based on phosphoproteomic data to uncover the differential activation in signaling wiring between healthy donors, untreated patients, and those under different treatments. Based in the patient-specific networks, we aimed to create a new approach to identify drug combinations that revert signaling to a healthy-like state. We performed ex vivo multiplexed phosphoproteomic assays upon perturbations with multiple drugs and ligands in primary immune cells from 169 subjects (MS patients, n=129 and matched healthy controls, n=40). Patients were either untreated or treated with fingolimod, natalizumab, interferon-β, glatiramer acetate, or the experimental therapy epigallocatechin gallate (EGCG). We generated for each donor a dynamic logic model by fitting a bespoke literature-derived network of MS-related pathways to the perturbation data. Last, we developed an approach based on network topology to identify deregulated interactions whose activity could be reverted to a “healthy-like” status by combination therapy. The experimental autoimmune encephalomyelitis (EAE) mouse model of MS was used to validate the prediction of combination therapies.

Results

Analysis of the models uncovered features of healthy-, disease-, and drug-specific signaling networks. We predicted several combinations with approved MS drugs that could revert signaling to a healthy-like state. Specifically, TGF-β activated kinase 1 (TAK1) kinase, involved in Transforming growth factor β-1 proprotein (TGF-β), Toll-like receptor, B cell receptor, and response to inflammation pathways, was found to be highly deregulated and co-druggable with all MS drugs studied. One of these predicted combinations, fingolimod with a TAK1 inhibitor, was validated in an animal model of MS.

Conclusions

Our approach based on donor-specific signaling networks enables prediction of targets for combination therapy for MS and other complex diseases.