bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of First-Person Depression Storytelling Online Video on Men’s Self-Stigma of Seeking Help, Traditional Masculinity Ideology, and Psychological Help-Seeking Attitudes
Authors: Keum Brian TaeHyuk , Ogrodniczuk John S.
Published: June 2022

Men are reluctant to seek psychological help as doing so may label them as weak and vulnerable. Thus, we tested whether a first-person storytelling video could buffer men’s self-stigma of seeking help associated with traditional masculinity ideology. Adult men ( N = 396; Mage = 35.62) were randomly assigned and exposed to one of three conditions: (1) control (nothing), (2) male-sensitive brochure, (3) male-sensitive first-person storytelling video. Controlling for pre-existing depressive symptoms, multi-group path analyses with bootstrapping revealed that greater traditional masculinity ideology was associated with lower psychological help-seeking attitudes via increased self-stigma of seeking help, but this indirect effect was not significant for the video group. The direct effect was significantly lower in the video group compared to the brochure and control groups. The findings suggest that brief male-sensitive storytelling videos may be useful clinical and psychoeducational tools to help men re-examine their resistance toward seeking psychological help for depression.
Pre-bedtime activities and light-emitting screen use in university students and their relationships with self-reported sleep duration and quality
Authors: Huiberts LM , Opperhuizen AL , Schlangen LJM
Published: June 2022

In a three-day field study among 61 university students, we collected data on self-reported light-emitting screen activities (watching TV/series and using social media) and other behaviours (physical activity and food intake) during the 2 hours before bedtime and examined interrelations with self-reported sleep duration and quality. Students spent on average 19 minutes on screens using social media and 29 minutes watching TV/series before going to bed. Linear mixed model analyses revealed that a 10-minute increase in pre-bedtime social media use was associated with a significant decrease in sleep duration of 7 minutes, while 10 extra minutes of watching TV/series tended to increase sleep duration by 3 minutes. Physical activity and food intake before bedtime, and total screen time in bed were not significantly related to sleep duration. Subjective sleep quality was not significantly correlated with any of the investigated pre-sleep activities. In line with previous research, these findings suggest that the influence of pre-bedtime light-emitting screen use on sleep duration might be (partly) attributable to differences in screen activities. Discriminating between various types of screen activities is important when researching and developing recommendations for pre-bedtime behavioural strategies that are supportive for sleep, (school) performance and health.
Quality of life movement: Historical overview of the policies and challenges for the future of education
Authors: Francesconi Denis , Tarozzi Massimiliano , Bykachev Kirsi , Välimäki Tarja , Turunen Hannele , Simovska Venka
Published: June 2022

Since the early 1990s, there has been a paradigm shift in human development theory due to a slow but steady increase in the attention paid to the concepts of quality of life, wellbeing and happiness. Accordingly, some scientists have questioned the validity of Gross Domestic Product as a tool to explain the wealth and development of nations, and several institutions and scholars have started to provide new policies and indexes to measure both subjective and collective wellbeing. These include, among others, the so-called Stiglitz-Sen-Fitoussi report, the OECD's Better Life Initiative, the Quality of Life in Europe and the United Nations' World Happiness Index. At the moment, a comprehensive and critical historical review of this trend is still missing, as well as its impact on education systems. In this paper, we first review the historical development of what has been called the ‘Quality of Life movement’ (QoL movement) and the major trends and indexes currently available for measuring the quality of life and wellbeing. We then present some education policy initiatives as examples of the attempt to implement QoL discourse into education systems. We conclude by outlining critical theoretical considerations of how the QoL movement could impact future education policies and systems.
The prevalence and assessment of pain and dyspnoea in acute exacerbations of COPD: A systematic review
Authors: Clarke Stephanie Y , Williams Marie T , Johnston Kylie N , Lee Annemarie L
Published: June 2022

Background

Dyspnoea and pain are symptoms of chronic obstructive pulmonary disease (COPD). This review focused upon pain and dyspnoea during hospital admissions for acute exacerbations of COPD (AECOPD), with the aim of examining prevalence, assessment, clinical associations, and researcher-reported implications of these symptoms.

Methods

Four electronic databases were searched from inception to 31 May 2021. Full text versions of studies were assessed for methodological quality and data were extracted independently by two reviewers. Where data permitted, pooled prevalence of pain and dyspnoea were calculated by meta-analysis.

Results

Four studies were included. The pooled prevalence of pain and dyspnoea was 44% (95% confidence interval (CI) 35%–52%) and 91% (95% CI 87%–94%) respectively. An array of instruments with varying focal periods were reported (pain: six tools, dyspnoea: four tools). Associations and clinical implications between the two symptoms at the time of hospital admission were rarely reported.

Conclusions

Few studies reported prevalence of pain and dyspnoea during an AECOPD. A greater understanding into the prevalence, intensity and associations of these symptoms during AECOPD could be furthered by use of standardised assessment tools with clearly defined focal periods.
Chest Wall Reconstruction With 3D Printing: Anatomical and Functional Considerations
Authors: Goldsmith Ira
Published: June 2022

Large chest wall defects, as a result of wide local excision of chest wall pathology, require skeletal and soft-tissue reconstruction to restore the anatomical shape, structure, and respiratory function of the thorax. Reconstruction is challenging and requires the surgical reconstructive team to understand the anatomic and physiologic morbidity related to the defect and the choice of reconstructive techniques available to restore form and function. Rapidly emerging 3-dimensional (3D) printing technology allows the reconstructive surgical team to customize the therapeutic process of skeletal reconstruction by accurately mimicking the shape and structure of the chest wall being replaced. An integrated knowledge of the anatomy, physiology, mechanics of breathing, and respiratory tests is important to restore form and function. The focus of this article is to review the anatomy, physiology, and assessment of respiratory function from the classical textbooks and integrate this knowledge with the precise anatomy of the chest wall created by 3D printing technology. By doing so, this article will demonstrate how 3D printing may help the reconstructive team to understand the anatomic and physiologic morbidity related to the chest wall defect and the importance of taking each of these aspects into consideration when undertaking chest wall reconstruction of the thorax.
Redirection of Persistent Left Superior Vena Cava Using a Turned-In Left Atrial Appendage
Authors: Altin Husnu Firat , Altunyuva Kaan , Hekim Yilmaz Emine , Sasmazel Ahmet
Published: June 2022

Persistent left superior cava mostly drains into the right atrium via the coronary sinus. It rarely drains into the left atrium. Extracardiac and intracardiac repair techniques have been described for the repair of persistent left superior vena cava draining into the left atrium. Herein, we report the successful application of a new intracardiac repair technique by using a turned-in left atrial appendage in a 3-year-old male patient with a persistent left superior vena cava draining into the left atrium.
Gout increases length of stay in patients hospitalized for heart failure exacerbation
Authors: DeMizio Daniel , Wu Guojing , Wei Ying , Bathon Joan , Wang Runsheng
Published: June 2022

Background:

It is unclear whether patients with a history of gout have longer hospitalizations in general, or only when suffering a flare. This study examines the effect of gout diagnosis and gout flare on the length of stay (LoS) in patients admitted for heart failure (HF) exacerbation.

Methods:

We conducted a matched retrospective cohort study and searched electronic medical records for patients admitted for HF with a prior diagnosis of gout from 1 July 2012 to 30 June 2017 and matched them to patients admitted for HF without gout. Cases who had a gout flare during the admission were identified. The log of the length of stay (log LoS) was utilized for normalization of the data. We used a linear mixed-effect model to compare the adjusted LoS of gout patient with flare, gout patient without flare, and controls.

Results:

A total of 978 admissions for HF exacerbation in 738 patients, including 246 individual with gout and 492 matched controls, were identified and included in the analysis. The log LoS was significantly longer in cases (1.86 ± 0.95) compared with controls (1.72 ± 0.94; p = 0.0278). The log LoS was significantly longer in those with gout who flared (2.41 ± 0.96) compared to those without gout (1.72 ± 0.94, p < 0.0001). After adjusting for potential confounders, the log LoS of patients who flared ( p < 0.0001) remained significantly longer than controls, as well as those who did not flare ( p = 0.042), but to a lesser extent.

Conclusion:

HF patients with gout had significantly longer hospitalizations than those without gout, a finding driven primarily by gout flare during hospitalization.
Iatrogenic traumatic superficial temporal arteriovenous fistula development post-craniectomy: A case report
Authors: Kons Zachary A , Vranic Justin E , Dmytriw Adam A , Regenhardt Robert W , Patel Aman B , Stapleton Christopher J
Published: June 2022

We report a case of superficial temporal arteriovenous fistula development following frontotemporoparietal hemicraniectomy. This patient presented with intracerebral hemorrhage (ICH) secondary to underlying arteriovenous malformation (AVM) rupture. Following decompressive hemicraniectomy and follow-up successful resection of the underlying AVM, the patient returned to the hospital with a seizure. Repeat angiography was performed, demonstrating no intracranial vascular lesion recurrence. However, an incidental superficial temporal arteriovenous fistula was identified, which was not visualized on initial angiography assessing the prior AVM. These lesions have been treated successfully in the past with surgical, endovascular, or combined approaches. As this patient was scheduled to undergo cranioplasty following AVM resection, the decision to occlude the fistula surgically was made. During cranioplasty, the fistula was identified as an engorged venous complex contiguous with the superficial temporal artery (STA) and was occluded. Follow-up angiography confirmed successful fistula occlusion and the patient has remained asymptomatic.
Early prediction of student engagement in virtual learning environments using machine learning techniques
Authors: Raj Nisha S , V G Renumol
Published: June 2022

Learning analytics aims at helping the students to attain their learning goals. The predictions in learning analytics are made to enhance the effectiveness of educational interferences. This study predicts student engagement at an early phase of a Virtual Learning Environment (VLE) course by analyzing data collected from consecutive years. The prediction model is developed using machine learning techniques applied to a subset of Open University Learning Analytics Dataset, provided by Open University (OU), Britain. The investigated data belongs to 7,775 students who attended social science courses for consecutive assessment years. The experiments are conducted with a reduced feature set to predict whether the students are highly or lowly engaged in the courses. The attributes indicating students' interaction with the VLE, their scores, and final results are the most contributing variables for the predictive analysis. Based on these variables, a reduced feature vector is constructed. The baseline used in the study is the linear regression model. The model’s best results showed 95% accurate, 95% precise, and 98% relevant results with the Random Forest classification algorithm. Early prediction’s relevant features are a subset of click activities, which provided a functional interface between the students and the VLE.
Clozapine blood level assessment using a point-of-care device: feasibility and reliability
Authors: Kamhi-Nesher Shiri , Taub Sharon , Halimi Shikma , Frenkel Maria , Azam Mahmud , Bormant Gil , Isakov Helena , Radzinsky Dikla , Weizman Abraham , Krivoy Amir
Published: June 2022

Background:

Therapeutic drug monitoring (TDM) is useful to assess clozapine adherence and optimize treatment. However, analysis of venous blood levels by liquid chromatography tandem mass spectrometry (LC-MS/MS) is often logistically complicated and process time is prolonged.

Objective:

To assess the feasibility and reliability of a new point-of-care device, (MyCare™ Insite), using capillary blood for clozapine therapeutic monitoring.

Methods:

Matched venous and capillary blood samples were collected from patients treated with clozapine on a stable dose. Samples were analyzed by LC-MS/MS and MyCare Insite Clozapine Test. Clozapine plasma levels were compared between methods using linear regression model. Both patients and treatment team completed questionnaires about the feasibility of blood sampling.

Results:

Of the total sample (44 patients, 61% males, mean age 43 ± 12 years), mean daily clozapine dose was 293 ± 134 mg/day. Linear regression model demonstrated high correlation with R2 = 0.83 ( p < 0.0001) and mean difference of 26 ± 162 ng/ml. More than 60% of the patients found the clozapine TDM to be important. Most of the participants (58%) favored the capillary sampling and 11% claimed that testing method would affect their adherence to TDM. Moreover, a larger portion (72%) strongly preferred to be tested at the office rather than at the lab.

Conclusions:

The point-of-care device offers an accessible and satisfactory measurement of clozapine blood levels. Both patients and healthcare providers reported preference for capillary sampling as well as for the in-office TDM procedure. The immediate results provided by the device can facilitate rapid and informed clinical decisions and therefore improve clozapine treatment outcomes.
Teaching With Conceptboard: A Professional Online Tool for Student Engagement and Collaboration
Authors: Bonner Robert , Desa Geoffrey , Petkova Antoaneta P. , Baack Sally
Published: June 2022

This article reviews Conceptboard, a professional collaborative online whiteboard that can be used to enhance student engagement and collaboration, enable real-time group interaction, and promote active learning. What makes Conceptboard particularly relevant for management educators is its familiarity, flexibility, and versatility. It extends and enhances instructors’ current ways of connecting with students and seamlessly bridges the gap between an in-person classroom and a remote learning environment, allowing for immersive experiences across teaching modalities. Conceptboard can be used for a variety of individual and team assignments in online or face-to-face classes. This article compares the free version of Conceptboard with free versions of similar online platforms and provides suggestions on how to mitigate its limitations.
The Anatomy and Function of the Individual Bands of the Deltoid Ligament—and Implications for Stability Assessment of SER Ankle Fractures
Authors: Gregersen Martin G. , Fagerhaug Dalen Andreas , Nilsen Fredrik , Molund Marius
Published: June 2022

Background:

Deltoid ligament injury occurs often with supination-external rotation (SER) ankle trauma. SER fibula fractures with concomitant deltoid ligament injury are considered unstable—requiring operative fixation. Recent studies have questioned this general practice with emphasis on better defining the medial side ankle ligamentous injury. The function of the individual bands of the deltoid ligament, and the interplay between them, are not fully understood. We undertook this study to develop a better understanding of these complex ligamentous structures and ultimately aid assessment and treatment choice of SER ankle fractures with concomitant deltoid ligament injuries.

Methods:

Ten fresh-frozen cadaveric foot and ankle specimens were studied. We identified the various ligament bands and did a functional analysis by assessment of ligament length and tension at predefined angles of ankle dorsi-plantarflexion combined with valgus/varus and rotation. The results were determined by manual evaluation with calipers and goniometers, manual stress, and direct visualization.

Results:

We recorded primarily 5 different bands of the deltoid ligament: the tibionavicular (TNL; 10/10) tibiospring (TSL; 9/10), tibiocalcaneal (TCL; 10/10), deep anterior tibiotalar (dATTL; 9/10), and deep posterior tibiotalar (dPTTL; 10/10) ligaments. The tibiospring ligament was tense in plantarflexion, while the tibiocalcaneal and deep posterior tibiotalar ligaments were tense in dorsiflexion. The superficial layer ligaments and the deep anterior tibiotalar ligament length and tension were largely affected by changes in varus/valgus and rotation. The deep posterior tibiotalar ligament length and tension was altered predominantly by changes in dorsi-plantarflexion; varus/valgus positioning had a minor effect on this band.

Conclusions:

We confirmed the finding of previous studies that dorsi-plantarflexion affects the tensile engagement of the separate ligament bands differently. Likewise, combined movements with varus/valgus and rotation seem to affect the separate ligament bands differently. Our results suggest that the TNL, TSL, and dATTL are at risk of injury, whereas the TCL and particularly the dPTTL are protected in the event of an SER-type ankle fracture mechanism of injury.

Level of Evidence

Level V, cadaveric study.
Research policy for people with multiple long-term conditions and their carers
Authors: Owen Natalie , Dew Leanne , Logan Stuart , Denegri Simon , Chappell Lucy C
Published: June 2022

People with multiple long-term conditions (MLTC) are a growing population, not only in the United Kingdom but internationally. Health and care systems need to adapt to rise to this challenge. Policymakers need to better understand how medical education and training, and service configuration and delivery should change to meet the needs of people with MLTC and their carers. A series of workshops with people with MLTC and carers across the life-course identified areas of unmet need including the impact of stigma; poorly coordinated care designed around single conditions; inadequate communication and consultations that focus on clinical outcomes rather than patient-oriented goals and imperfectly integrate mental and physical wellbeing. Research which embeds the patient voice at its centre, from inception to implementation, can provide the evidence to drive the change to patient-centred, coordinated care. This should not only improve the lives of people living with MLTC and their carers but also create a health and care system which is more effective and efficient. The challenge of MLTC needs to be bought to the fore and it will require joint effort by policymakers, practitioners, systems leaders, educators, the third sector and those living with MLTC to design a health and care system from the perspective of patients and carers, and provide practitioners with the skills and tools needed to provide the highest quality care.
Justice perceptions of occupational training subsidies: findings from a factorial survey
Authors: Wolff Richard V. , Struck Olaf , Osiander Christopher , Senghaas Monika , Stephan Gesine
Published: June 2022

Workers whose jobs are affected by structural change and digitization are required to continuously adapt their vocational skills to the requirements of the labor market. This adaptation is also essential for the competitiveness of their employer firms. The German legislature addressed this issue with investive measures for unemployment insurance, one of which is the Qualification Opportunities Act (Qualifizierungschancengesetz). Funds taken from unemployment insurance can now be used to provide financial help for employers in a more direct way and on a broader scale than before. It became possible that not only unemployed individuals but also workers in companies receive state assistance. This paper analyses the extent to which citizens accept such public support programs for further training and which principles of justice they apply when assessing a just amount of training subsidies. We conducted two factorial surveys. First, we investigated the justice assessments of training subsidies for different types of firms. The results showed that citizens are inclined to subsidize companies by receiving social security funds for further training of their employees. However, when doing so, the principle of needs-based justice should be complied with. Second, we analyze whether citizens think it is just or unjust to provide training subsidies to different workers, as we present them with changing characteristics of workers. The findings confirmed that in addition to the principle of need, views on performance justice, as well as economic considerations are relevant in assessments of whether training subsidies co-financed by unemployment insurance are just.
Validation and prognostic value of EZ-ALBI score in patients with intermediate-stage hepatocellular carcinoma treated with trans-arterial chemoembolization
Authors: Ananchuensook Prooksa , Sriphoosanaphan Supachaya , Suksawatamnauy Sirinporn , Siripon Nipaporn , Pinjaroen Nutcha , Geratikornsupuk Nopavut , Kerr Stephen J. , Thanapirom Kessarin , Komolmit Piyawat
Published: June 2022

Background

Heterogeneity of liver function and tumor burden in intermediate-stage hepatocellular carcinoma (HCC) results in different outcomes after transarterial chemoembolization (TACE). Easy albumin-bilirubin (EZ-ALBI), a simplified albumin-bilirubin (ALBI) score, has recently been proposed as a new prognostic score for HCC. This study aimed to validate the EZ-ALBI score and evaluate the impact of dynamic changes in patients with intermediate-stage HCC undergoing TACE.

Methods

All patients with HCC treated with TACE at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between January 2015 and December 2019 were prospectively enrolled. Intermediate-stage HCC was defined as Barcelona Clinic Liver Cancer (BCLC) stage B or unresectable single HCC with size > 5 cm in BCLC stage A. EZ-ALBI and ALBI scores were calculated and stratified into three different grades. Overall survival (OS) and prognostic factors were assessed using the Kaplan–Meier curve and Cox proportional hazard model. Decision analysis curves were used to evaluate the clinical utility of the predictive scores.

Results

Among 672 patients with HCC treated with TACE, 166 patients with intermediate-stage HCC who met the eligibility criteria were enrolled. The median OS of all patients in the cohort was 21 months. A good correlation between the EZ-ALBI and ALBI scores was observed (correlation coefficient 1.000, p < 0.001). The baseline EZ-ALBI grades 1, 2, and 3 were 24.5%, 70%, and 5.5%, respectively. EZ-ALBI grade can stratify patients with significantly different prognoses (p = 0.002). Baseline EZ-ALBI grade 2, 3, and serum alpha-fetoprotein > 20 ng/ml were significantly associated with OS [hazard ratio (HR) 2.20 (95% confidence interval [CI] 1.24–3.88, p = 0.007), 3.26 (95% CI 1.24–8.57, p = 0.016), and 1.77 (95% CI 1.10–2.84, p = 0.018), respectively]. Following TACE, 42 (29.6%) patients had a worsening EZ-ALBI grade. However, the EZ-ALBI grade migration was not significantly correlated with OS. EZ-ALBI and ALBI score provided improved discriminatory ability (Harrell’s concordance index 0.599 and 0.602, respectively) and better net benefit compared with Child-Turcotte-Pugh and Model for End-stage Liver Disease scores.

Conclusions

The baseline EZ-ALBI score demonstrated good predictive performance for survival and a strong correlation with conventional ALBI scores. Both the EZ-ALBI and ALBI scores outperformed other prognostic models in patients with intermediate-stage HCC receiving TACE. However, the dynamic change in the EZ-ALBI grade after TACE was not associated with postprocedural survival.
Comparative study of indocyanine green (ICG)-R15 and Albumin-Indocyanine Green Evaluation (ALICE) grading system in the prediction of posthepatectomy liver failure and postoperative mortality in patients with hepatic alveolar echinococcosis
Authors: Liang Yuxin , Zhang Zilong , Dai Zonglin , Cao Rui , Zhong Deyuan , Lai Chunyou , Yao Yutong , Feng Tianhang , Huang Xiaolun
Published: June 2022

Background

A precise evaluation of liver reserve function in patients with hepatic alveolar echinococcosis (HAE) prior to hepatectomy could substantially increase the success rate of the operation and reduce the incidence of postoperative complications. The present study aimed to investigate the significance of the indocyanine green retention test at 15 min (ICG-R15) and the Albumin-Indocyanine Green Evaluation (ALICE) grading system in predicting severe posthepatectomy liver failure (PHLF) and postoperative mortality in HAE patients undergoing liver resection.

Methods

A total of 105 HAE patients undergoing hepatectomy were enrolled in this study. The value of each variable in predicting severe PHLF was evaluated by univariate and multivariate logistic regression analyses. The area under the receiver operating characteristic (ROC) curves (AUC) were calculated to evaluate the predictive ability of the Child–Pugh grade, ICG-R15, and ALICE grading system. Also, patients were classified using the optimal cutoff value for ICG-R15 and different ALICE grades, and the incidence of severe PHLF and postoperative mortality were compared with the predicted values.

Results

Out of the 105 HAE patients enrolled in this study, 34 patients (32.4%) developed severe PHLF. The ALICE grade and operative time were identified as independent predictors of severe PHLF. According to ROC analysis, the AUCs of the Child–Pugh grade, ICG-R15, and ALICE grade for predicting severe PHLF were 0.733 (95% confidence interval (CI), 0.637–0.814), 0.823 (95% CI, 0.737–0.891), 0.834 (95% CI, 0.749–0.900). The incidence of severe PHLF and postoperative 90-day mortality in patients with ICG-R15 > 7.2% were significantly higher than those with ICG-R15 ≤ 7.2% (P < 0.001; P = 0.008). Likewise, the incidence of severe PHLF and postoperative 90-day mortality in patients with ALICE grade 2 were higher than those with ALICE grade 1 within the Child–Pugh grade A (P < 0.001; P = 0.083).

Conclusion

ICG-R15 and ALICE grading system are powerful predictors of severe PHLF and postoperative mortality among HAE patients undergoing hepatectomy. Furthermore, a combination of the preoperative Child–Pugh grade and ALICE grading system may provide an even more precise and objective guidance and facilitate surgical decision-making for HAE patients.
Clinical efficacy of osimertinib in EGFR-mutant non-small cell lung cancer with distant metastasis
Authors: Gen Soei , Tanaka Ichidai , Morise Masahiro , Koyama Junji , Kodama Yuta , Matsui Akira , Miyazawa Ayako , Hase Tetsunari , Hibino Yoshitaka , Yokoyama Toshihiko , Kimura Tomoki , Yoshida Norio , Sato Mitsuo , Hashimoto Naozumi
Published: June 2022

Background

Osimertinib—the third-generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI)—has been widely used as a first-line treatment for patients with metastatic EGFR-mutant non-small cell lung cancer (NSCLC). Osimertinib demonstrated central nervous system activity in patients with brain metastasis; however, its efficacy against other distant metastatic organs, including bone and liver, remains unclear. Therefore, we retrospectively analyzed the clinical efficacy of osimertinib in these patients in comparison to other EGFR-TKIs.

Methods

Clinical data of patients with advanced NSCLC receiving gefitinib/erlotinib (n = 183), afatinib (n = 55), or osimertinib (n = 150) at five medical institutions were retrospectively assessed for progression-free survival (PFS), overall survival (OS), and best overall response rate (ORR).

Results

In univariate and multivariate analyses, most distant metastases, including the brain and bone, were unrelated to the therapeutic efficacy of osimertinib, although liver metastasis and L858R mutation were independently associated with shorter PFS. PFS and OS in patients with liver metastases were significantly shorter than those in patients without liver metastases (PFS: 7.4 vs. 19.7 months, OS: 12.1 months vs. not reached, respectively). Osimertinib provided significantly longer PFS in patients with brain or bone metastasis and exon 19 deletion than the other EGFR-TKIs. The PFS of patients with liver metastases was not significantly different among the three EGFR-TKI groups. Furthermore, the ORR of osimertinib in patients with liver metastases was significantly attenuated, and the effectiveness was similar to 1st- or 2nd -generation EGFR-TKIs.

Conclusion

Osimertinib provided better clinical benefits than 1st- and 2nd-generation EGFR-TKIs for patients with EGFR-mutant NSCLC, particularly those with brain or bone metastases and exon 19 deletion; however, its efficacy against liver metastasis was remarkably attenuated. New therapeutic developments for patients with EGFR-mutant NSCLC with liver metastases are needed.
Accelerate the process of getting vaccinated: factors associated with consideration of and accessibility to COVID-19 vaccination in metropolises of China
Authors: Tan Yinliang , Xie Zhilan , Qian Ying , Gu Jie , Bai Yundan , Gu Xiaoqing , Ye Zheng , Feng Jianmin , Huang Jiaoling
Published: June 2022

Background

Rapid mutation of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus is sweeping the world and delaying the full reopening of society. Acceleration of the vaccination process may be the key element in winning the race against this virus. We examine factors associated with personal considerations of and accessibility to the corona virus disease 2019 (COVID-19) vaccination in metropolises of China.

Methods

This multi-center, cross-sectional research was conducted using online questionnaires from April 1 to June 1, 2021, in community health service centers of Shanghai, Chengdu and Fuzhou. 9,047 vaccinated participants were included and data for 8,990 individuals were eligible for analysis. Chi-square test was conducted to find potential predictors, which were included in the logistic regressions. The odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the influence of region, socio-economic status (SES), and attitudes on vaccination process.

Results

In consideration phase, participants in Fuzhou (OR:2.26, 95%CI: 1.90 to 2.68) and Chengdu (OR: 2.48, 95%CI: 2.17 to 2.83) were more likely than those in Shanghai to consider longer than one month. These odds increased for participants with master or above degree (reference: illiteracy and primary school), higher monthly household income (reference: < ¥5000), and greater vaccination hesitancy (reference: low hesitancy). Unemployed and household-based participants (OR: 3.37, 95%CI: 1.69 to 6.75, reference: farmer) and participants without brand preference (OR:1.13, 95%CI:1.02 to 1.26) may take longer time of consideration. In the accessibility phase, participants in Fuzhou (OR: 8.82, 95%CI: 7.28 to 10.68) and Chengdu (OR: 2.28, 95%CI: 1.98 to 2.63) were more likely to wait longer than one week. These odds decreased for participants with master or above degree (reference: illiteracy and primary school), monthly household income from ¥5000 to ¥10,000 (reference: < ¥5000), and teacher or student (reference: farmer). Participants without brand preference (OR: 0.86, 95%CI: 0.77 to 0.95) were likely to wait shorter after appointment, while participants with higher risk awareness of domestic epidemic (medium, OR: 1.24, 95%CI: 1.12 to 1.37, reference: low) may wait longer.

Conclusions

The influential factors changed over two phases of vaccination process. Regional disparity affected both consideration and accessibility phases. Expect that, SES, and hesitancy were major factors of the consideration phase, but had limited impact on accessibility phase.
The burden of premature mortality among older adults: a population-based study in Malaysia
Authors: Chan Yee Mang , Ganapathy Shubash Shander , Tan LeeAnn , Alias Nazirah , Nasaruddin Nur Hamizah , Khaw Wan-Fei
Published: June 2022

Background

The populations of many countries—including Malaysia—are rapidly growing older, causing a shift in leading causes of disease and death. In such rapidly ageing populations, it is critical to monitor trends in burden of disease and health of older adults by identifying the leading causes of premature mortality and measuring years of life lost (YLL) to these. The objective of this study, therefore, is to describe the burden (quantified by YLL) associated with major causes of premature mortality among older adults in Malaysia in 2019.

Methods

All deaths that occurred in older adults aged 60 and above in Malaysia in the year 2019 were included in this study. YLL was calculated by summing the number of deaths for the disease category at 5-year age intervals, multiplied by the remaining life expectancy for the specific age and sex group. Both life expectancy and mortality data were obtained from the Department of Statistics Malaysia.

Results

In 2019, older adults accounted for 67.4% of total deaths in Malaysia (117,102 out of 173,746). The total number of YLL among older adults in Malaysia in 2019 was estimated at 1.36 million YLL, accounting for 39.6% of the total YLL (3.44 million) lost to all premature deaths in that year. The major causes of premature mortality among older adults were ischaemic heart disease (29.5%) followed by cerebrovascular disease (stroke) (20.8%), lower respiratory infections (15.9%), diabetes mellitus (8.1%) and trachea, bronchus and lung cancers (5.0%).

Conclusions

Non-communicable diseases (NCD) remained the largest contributor to premature mortality among older adults in Malaysia. Implementation of population-level NCD health promotion programmes, screening programmes among high-risk groups and holistic intervention programmes among populations living with NCD are critical in reducing the overall burden of premature mortality.
Measuring sustainable employability: psychometric properties of the capability set for work questionnaire
Authors: Gürbüz Sait , Joosen Margot C. W. , Kooij Dorien T. A. M. , Bakker Arnold B. , van der Klink Jac J. L. , Brouwers Evelien P. M.
Published: June 2022

Background

The capability set for work questionnaire (CSWQ) is being used to measure the new model of sustainable employability building on the capability approach. However, previous studies on the psychometric properties of the instrument are limited and cross-sectional. This two-way study aimed to (1) evaluate the convergent validity of the CSWQ with the theoretically related constructs person-job fit, strengths use, and opportunity to craft and (2) test the predictive and incremental validity of the questionnaire for the well-established work outcomes, including work ability, work engagement, job satisfaction, and task performance.

Methods

A representative sample of 303 Dutch workers, chosen with probably random sampling, were surveyed using a one-month follow-up, cross-lagged design via the Longitudinal Internet Studies for the Social Sciences panel. The convergent validity was assessed by exploring the strength of associations between the capability set for work questionnaire and the theoretically related constructs using Pearson’s correlations. The predictive and incremental validity was evaluated by performing a series of linear hierarchical regression analyses.

Results

We found evidence of the convergent validity of the capability set score by moderate correlations with person-job fit, strengths use, and opportunity to craft (r = 0.51–0.52). A series of multiple regression analyses showed that Time 1 capability set score and its constituents (i.e., importance, ability, and enablement) generally had predictive and incremental validity for work ability, work engagement, job satisfaction, and task performance measured at Time 2. However, the incremental power of the CSWQ over and above conceptually related constructs was modest.

Conclusions

The findings support the convergent, predictive, and incremental validity of the capability set for work questionnaire with not previously investigated work constructs. This provided further evidence to support its utility for assessing a worker’s sustainable employability for future research and practical interventions.
The effect of medication on serum anti-müllerian hormone (AMH) levels in women of reproductive age: a meta-analysis
Authors: Yin Wei-Wei , Huang Chang-Chang , Chen Yi-Ru , Yu Dan-Qing , Jin Min , Feng Chun
Published: June 2022

Objective

The study aims to address whether serum anti-müllerian hormone (AMH) levels fluctuate in the short term after medication application, including oral contraceptives (OCs), metformin (MET), Gonadotropin-releasing hormone agonist (GnRH-a), dehydroepiandrosterone (DHEA), vitamin D (VD), clomiphene citrate (CC), and letrozole (LET).

Methods

Published literature from PubMed, Embase, and Cochrane central was retrieved up until 19 September 2021. A total of 51 self-control studies with an average Newcastle–Ottawa quality assessment scale (NOS) score of 6.90 were analyzed. The extracted data were entered into Stata software, and the weighted mean difference/standardized mean difference (WMD/SMD) and 95% confidence interval (CI) were used for data analysis.

Results

After OCs treatment the AMH level showed a significant decline in women with normal ovarian function, which was significant within 3 months (WMD = -1.43, 95% CI: -2.05 to -0.80, P < 0.00001). After MET treatment, the serum AMH decreased in polycystic ovary syndrome (PCOS) patients (WMD = -1.79, 95% CI: -2.32 to -1.26, P < 0.00001), in both obese and non-obese patients. GnRH-a treatment in endometriosis patients led to dynamic changes in the serum AMH levels, that is, ascent at 1 month (P = 0.05), and descent at 3 months (P = 0.02). After DHEA treatment the serum AMH increased in diminished ovarian reserve (DOR) / poor ovarian response (POR) patients (WMD = 0.18, 95% CI: 0.09 to 0.27, P < 0.0001). After VD treatment the serum AMH increased, and it was obvious in non-PCOS patients (WMD = 0.78, 95% CI: 0.34 to 1.21, P = 0.0004). After CC treatment the serum AMH decreased significantly in PCOS patients, specifically in non-obese patients (WMD = -1.24, 95% CI: -1.87 to -0.61, P = 0.0001).

Conclusions

Serum AMH levels may be affected in the short term after drug application. Specifically, OC, MET and CC lead to decreased AMH level, DHEA and VD lead to increased AMH level, and GnRH-a leads to dynamic variation, which is correlated with PCOS, obesity, age, and duration of medication. The impacts of these medications should be taken into consideration when AMH is used as a marker of ovarian reserve.
Process evaluation of a multi-disciplinary complex intervention to improve care for older patients with chronic conditions in rural areas (the HandinHand Study): study protocol
Authors: Seismann-Petersen Swantje , Köpke Sascha , Inkrot Simone
Published: June 2022

Background

To improve health care in rural areas, especially for increasing numbers of people with chronic diseases, academically qualified nurses could take over expanded roles to meet the challenges of an ageing society and a decreasing number of General Practitioners (GPs). In the project “HandinHand” (HiH), qualified nurses (Expert nurses, ENs) will carry out home visits to older people with chronic diseases over a period of six months. ENs will prepare a care plan in cooperation with GPs to stabilise the care situation and avoid unplanned hospital admissions and GP visits. The process evaluation aims to provide an in-depth analysis of the implementation process and gather important information on barriers and facilitators to the implementation of ENs as a complementary health care structure in primary care, taking into account several context factors.

Methods

Based on the Medical Research Council (MRC) Framework for complex interventions, a logic model was developed and applied as the basis for data collection. Qualitative and quantitative data will be collected during the study. A mixed methods approach should allow to gain important insights from participants (e.g. ENs, GPs, patients) involved in the study as well as relevant stakeholders. Semi-structured interviews and surveys will be conducted. Data analysis will be based on the logical model, combining qualitative and quantitative data. Qualitative data will be analysed inductively-deductively using qualitative thematic framework analysis.

Discussion

The process evaluation will provide guidance and conclusions on further development and transferability. Of particular interest is the expanded role of ENs in primary care, which has barely been implemented in Germany and can be seen as a precursor to the development of an Advanced Practice Nursing (APN) role in primary care.
Vaccine equity in low and middle income countries: a systematic review and meta-analysis
Authors: Ali Huda Ahmed , Hartner Anna-Maria , Echeverria-Londono Susy , Roth Jeremy , Li Xiang , Abbas Kaja , Portnoy Allison , Vynnycky Emilia , Woodruff Kim , Ferguson Neil M , Toor Jaspreet , Gaythorpe Katy AM
Published: June 2022

Background

Evidence to date has shown that inequality in health, and vaccination coverage in particular, can have ramifications to wider society. However, whilst individual studies have sought to characterise these heterogeneities in immunisation coverage at national level, few have taken a broad and quantitative view of the contributing factors to heterogeneity in immunisation coverage and impact, i.e. the number of cases, deaths, and disability-adjusted life years averted. This systematic review aims to highlight these geographic, demographic, and sociodemographic characteristics through a qualitative and quantitative approach, vital to prioritise and optimise vaccination policies.

Methods

A systematic review of two databases (PubMed and Web of Science) was undertaken using search terms and keywords to identify studies examining factors on immunisation inequality and heterogeneity in vaccination coverage. Inclusion criteria were applied independently by two researchers. Studies including data on key characteristics of interest were further analysed through a meta-analysis to produce a pooled estimate of the risk ratio using a random effects model for that characteristic.

Results

One hundred and eight studies were included in this review. We found that inequalities in wealth, education, and geographic access can affect vaccine impact and vaccination dropout. We estimated those living in rural areas were not significantly different in terms of full vaccination status compared to urban areas but noted considerable heterogeneity between countries. We found that females were 3% (95%CI[1%, 5%]) less likely to be fully vaccinated than males. Additionally, we estimated that children whose mothers had no formal education were 27% (95%CI[16%,36%]) less likely to be fully vaccinated than those whose mother had primary level, or above, education. Finally, we found that individuals in the poorest wealth quintile were 27% (95%CI [16%,37%]) less likely to be fully vaccinated than those in the richest.

Conclusions

We found a nuanced picture of inequality in vaccination coverage and access with wealth disparity dominating, and likely driving, other disparities. This review highlights the complex landscape of inequity and further need to design vaccination strategies targeting missed subgroups to improve and recover vaccination coverage following the COVID-19 pandemic.

Trial registration

Prospero, CRD42021261927
The effect of temperature on physical activity: an aggregated timeseries analysis of smartphone users in five major Chinese cities
Authors: Ho Janice Y. , Goggins William B. , Mo Phoenix K. H. , Chan Emily Y. Y.
Published: June 2022

Background

Physical activity is an important factor in premature mortality reduction, non-communicable disease prevention, and well-being protection. Climate change will alter temperatures globally, with impacts already found on mortality and morbidity. While uncomfortable temperature is often perceived as a barrier to physical activity, the actual impact of temperature on physical activity has been less well studied, particularly in China. This study examined the associations between temperature and objectively measured physical activity among adult populations in five major Chinese cities.

Methods

Aggregated anonymized step count data was obtained between December 2017-2018 for five major Chinese cities: Beijing, Shanghai, Chongqing, Shenzhen, and Hong Kong. The associations of temperature with daily aggregated mean step count were assessed using Generalized Additive Models (GAMs), adjusted for meteorological, air pollution, and time-related variables.

Results

Significant decreases in step counts during periods of high temperatures were found for cold or temperate climate cities (Beijing, Shanghai, and Chongqing), with maximum physical activity occurring between 16 and 19.3 °C. High temperatures were associated with decreases of 800-1500 daily steps compared to optimal temperatures. For cities in subtropical climates (Shenzhen and Hong Kong), non-significant declines were found with high temperatures. Overall, females and the elderly demonstrated lower optimal temperatures for physical activity and larger decreases of step count in warmer temperatures.

Conclusions

As minor reductions in physical activity could consequentially affect health, an increased awareness of temperature’s impact on physical activity is necessary. City-wide adaptations and physical activity interventions should seek ways to sustain physical activity levels in the face of shifting temperatures from climate change.
A rare case of highly differentiated follicular carcinoma in ovary with FGFR4 Gly388Arg polymorphism: a case report and literature review
Authors: Bao Yi-Ting , Wang Chao , Huang Wu , Yao Liang-Qing , Yuan Lei
Published: June 2022

Background

Highly differentiated follicular carcinoma (HDFCO) is a rare form of struma-derived thyroid-type carcinoma in ovary, defined as ovarian struma spreading beyond ovary but consisting of benign thyroid tissues. No more than 30 cases of HDFCO have been reported since it was first recognized in 2008. The clinicopathologic and molecular features of HDFCO remain unclear up till now.

Case presentation

A 38-year-old, para 1 gravida 5 woman has a long history of recurrent right ovarian cysts. Histological evaluation showed the tumor progressed from ovarian mature cystic teratoma (OMCT) to highly differentiated follicular carcinoma (HDFCO) during three relapses. Whole-exome sequencing revealed the germline FGFR4 Gly388Arg polymorphism. Repeated operations were performed to remove lesions for the first two relapses. On the third recurrence, the patient received radical surgery with subsequent thyroidectomy and radioactive iodine ablation. No evidence of disease was observed by February 2022 (8 months).

Conclusions

The germline FGFR4 Gly388Arg polymorphism may accelerate the malignant transformation of HDFCO, probably by working as a second hit in the developing spectrum.