bluuebunny/crossref_metadata_2025 huggingface dataset:
Developments in systemic therapies for the management of lung cancer
Authors: Heynemann Sarah , Mitchell Paul
Published: December 2021

Lung cancer accounts for approximately 1 in 10 new cancer diagnoses annually and is responsible for the most cancer‐associated deaths in Australia. Despite such figures, there is reason for optimism with many practice‐changing developments to report for the management of patients with thoracic malignancies over the last few years. We outline such changes, including the emerging role of immunotherapy in the neoadjuvant and adjuvant setting for patients with localised non‐small‐cell lung cancer, as well as the established standard of consolidation immunotherapy following definitive chemoradiotherapy for those with locally advanced disease. In the metastatic setting, combination chemotherapy–immunotherapy approaches have become the new paradigm for most patients in the absence of a recognised driver mutation. A range of novel targeted therapies now exist and are Pharmaceutical Benefits Scheme (PBS)‐subsidised for targets such as EGFR, ALK and ROS1, with many others, such as KRAS G12C, NTRK, MET, RET and HER2, also with therapies rapidly being developed. Even among patients with small‐cell lung cancer, who account for the worst prognoses and until recently have received a chemotherapy regimen that has remained unchanged in over 20 years, there is a new standard‐of‐care in combination chemotherapy–immunotherapy. Furthermore, immunotherapy and potentially anti‐vascular endothelial growth factor agents now also play a role in mesothelioma treatment. Last, given recent developments in immunotherapy, targeted therapy and combination approaches in the non‐small‐cell lung cancer space, there is an increasing recognition of the diversity of lived experience for such patients and need for survivorship programmes to acknowledge such nuances.
Feasibility of collecting wound fluid during ongoing negative pressure wound therapy by the use of an additional container – A prospective observational study
Authors: Wolfsberger Christina Helene , Maitz Emanuel , Schmachtl Philipp , Winkler Sonja , Luschnig Daniel , Sigl Eva , Heinzle Andrea , Gamerith Clemens , Tuca Alexandru‐Cristian , Schintler Michael V.
Published: December 2021

Negative‐pressure‐wound‐therapy is commonly used in clinical routine for wound management. Aim of the present study was to assess the feasibility and safety of using an additional container to collect wound fluid during ongoing negative‐pressure‐wound‐therapy. In this present prospective observational study, patients with negative‐pressure‐wound‐therapy were included. An additional container was inserted in the connecting tube between the wound and the vacuum generating device. The following 3 days, the container was changed daily and replaced by a new one. Further safety outcome parameters were assessed. A questionnaire was answered by the responsible surgeon. Twenty‐two patients with negative‐pressure‐wound‐therapy with a median (IQR) age of 58.5 (53.0‐70.0) years were included in the present study. In median, the duration of negative‐pressure‐wound‐therapy was 5.0 (4.6‐5.5) days. In mean ± SD the collected volume of the wound fluid in millilitres (mL) was on day one 7 ± 4 on day two 8 ± 7 and 10 ± 11 on day three. In one patient, there was <0.1 mL of clear water in the additional container. No safety concerns due to the additional container were observed. This study demonstrates that collecting wound fluid during ongoing negative‐pressure‐wound‐therapy over a time period of 3 days is feasible and safe. No safety concerns were observed.
Justice Principles, Empirical Beliefs, and Cognitive Biases: Reply to Buchanan's ‘When Knowing What Is Just and Being Committed to Achieving it Is Not Enough’
Authors: Moore Margaret
Published: December 2021

This article raises three concerns about Buchanan's argument related to the individualist description of ideology and psychological description of the obstacles to justice, as well as the way in which he separates empirical and normative beliefs, which, the article argues, are much more closely connected in all the examples that he raises. In the end, however, it agrees with Buchanan's central contention concerning the cognitive biases that interfere with progress towards justice, but, it argues, these operate at a more sub‐conscious level than described by Buchanan.
Dead Ends and Blind Spots in the European Semester: The Epistemological Foundation of the Crisis in Social Reproduction
Authors: Cavaghan Rosalind , Elomäki Anna
Published: December 2021

This article provides new perspectives on the persistent hierarchy between ‘social’ and ‘economic’ goals in European Union's (EU) economic governance. We operationalize insights from feminist economics and political economy to analyse the agenda‐setting documents of the European Semester – the Annual Growth Surveys (AGS) – showing how the much‐debated integration of social goals into the European Semester is fundamentally constrained by mainstream economic epistemologies. These epistemologies misrepresent interrelationships between the productive economy and the reproductive labour needed to maintain it. Using interpretive policy analysis, we show how multiple concepts and measurements used to conceptualize policy goals and impacts within the AGSs, coalesce to systematically misrepresent reproductive labour as a ‘social’ activity, an irrelevance, or a cost, rather than a macroeconomic input. This restricts the possibilities of enhancing the social dimension of the European Semester, in ways conspicuously ignored by the existing literature, which are of heightened salience in the wake of Covid‐19.
Puerto Rican adolescents’ visits to the island, familial ethnic socialization, and cultural orientation
Authors: Villalobos Solís Myriam
Published: December 2021

Familial ethnic socialization is an important way in which Latino youth in the United States become oriented toward their culture. Although many Latino adolescents have contact with their familial homelands outside the United States, which may also promote their cultural orientation, extant research has focused on familial ethnic socialization within the U.S. The present study examined visits to the familial homeland as an ethnic socialization process among 105 stateside Puerto Rican adolescents (M = 15.96 years, SD = 1.41; 52% girls). Factor analyses suggested that visits to Puerto Rico and familial ethnic socialization were not part of the same construct. Moreover, path analyses showed that visits to Puerto Rico and familial ethnic socialization were associated with different aspects of Puerto Rican youths’ cultural orientation. Consistent with previous work, increased familial ethnic socialization was associated with greater ethnic identity and overall endorsement of the Latino values of family obligations and respeto. In contrast, more frequent visits to Puerto Rico were associated with greater expected endorsement of family obligations and respeto in challenging daily life situations.
Coming full circle: Past, present, and future research on ethnic‐racial socialization
Authors: Niwa Erika Y. , Hughes Diane L. , Ruck Martin D.
Published: December 2021

When this special issue was first proposed in 2019, we endeavored to push forward scholarship about the various ways in which individuals, interactions, and settings communicate messages to children and youth about ethnicity and race. In particular, we aimed to broaden the scope of our current understanding of ethnic‐racial socialization through the inclusion of theory and research that took a more expansive approach. We sought papers focused on multiple agents of socialization, including settings, that also (a) featured diverse ethnic‐racial groups and national contexts, (b) covered a wide swath of development, from early childhood through emerging adulthood, (c) employed varied methodological approaches, and (d) centered intersectional perspectives. As the world continues to change shape in the face of the ongoing Covid‐19 pandemic and broad‐based racial justice movements, this special issue feels ever more urgent and pressing. The articles presented in this special issue are diverse and expansive in their focus, approach, content, and findings. Yet, despite their breadth, they offer critical insight into three key questions facing the study of ethnic‐racial socialization: Where are we coming from? Where are we now? And where are we headed?
Attentional progress by conceptual engineering
Authors: Kitsik Eve
Published: December 2021

Does conceptual engineering as a philosophical method deserve all the attention that it has been getting recently? The important philosophical questions, one might say, are about the world, not about what our concepts are or should be like. This paper fleshes out one way in which conceptual engineering can contribute to philosophical progress. The suspicion that conceptual engineering is getting too much attention presupposes that it is important to distribute our philosophical attention well (for example, conceptual engineering should not get more than its fair share). The paper’s defense of conceptual engineering builds on that assumption. Conceptual engineering, it argues, is a way of configuring philosophers’ patterns of attention for the better: it serves attentional progress in philosophy.
Arabidopsis ACYL‐ACTIVATING ENZYME 9 (AAE9) encoding an isobutyl‐CoA synthetase is a key factor connecting branched‐chain amino acid catabolism with iso‐branched wax biosynthesis
Authors: Li Shipeng , Yang Xianpeng , Huang Haodong , Qiao Rong , Jenks Matthew A. , Zhao Huayan , Lü Shiyou
Published: December 2021

Iso‐branched wax compounds are well known in plants, but their biosynthetic pathways are still mostly unknown. It has been speculated that branched waxes are derived from branched‐chain amino acid (BCAA) catabolism, but the evidence for this is very limited.

Gas chromatography‐flame ionisation detection (GC‐FID) analysis revealed that mutations in two subunits of the branched‐chain ketoacid dehydrogenase (BCKDH) complex, a key enzyme complex in the degradation of BCAAs, significantly decreased the amounts of branched wax compounds, indicating that BCAA degradation may be integral to the synthesis of iso‐branched wax. Substrate feeding studies further revealed that the metabolic precursor of iso‐branched wax compounds is isobutyric acid (iBA), which is derived from valine degradation in Arabidopsis.

We also isolated a novel mutant and found that its branched wax deficient phenotype could not be rescued by iBA. Map‐based cloning together with complementation analysis revealed that mutation in ACYL‐ACTIVATING ENZYME 9 (AAE9) is responsible for this phenotype.

Genetic and enzyme activity analysis demonstrated that AAE9 is located downstream of the BCAA degradation pathway, and that it activates iBA to isobutyryl‐CoA for use on branched wax synthesis. Taken together, our study demonstrates that AAE9 is a key factor connecting BCAA catabolism with branched wax biosynthesis.
Top–down effects override climate forcing on reproductive success in a declining sea duck
Authors: Öst Markus , Lehikoinen Aleksi , Jaatinen Kim
Published: December 2021

Population performance is predicted to be more strongly influenced by detrimental species interactions such as predation under benign climatic conditions, and by climate forcing under harsh conditions, reflected in geographical gradients in biotic interaction strength. Less appreciated is the potential for site‐specific changes in drivers with the advent of anthropogenic alteration of predator–prey relationships, including apex predator restoration and spread of invasive predators. Particularly interesting is the relative impact of climate and biotic interactions on population performance when these conflict. In this 31‐year study (1990–2020), we revisit a common eiderSomateria mollissimapopulation from SW Finland, Baltic Sea, fifteen years on from an earlier study showing that climate warming positively affected reproductive parameters and performance. However, the population is simultaneously exposed to increasing predation by the rapidly recovering native apex predator and invasive mammals. Based on the current population trend, we predicted 1) a weakening of the previously documented positive effects of a warming climate on vital rates, 2) intensified predation and 3) increasing top–down control of vital rates and accompanying population decline. Five out of seven breeding parameters (annual spread in female body condition, breeding phenology and synchrony, interval between arrival and breeding, fledgling production) were best explained by predation indices, whereas climate signals (winter NAO, Baltic Sea maximum ice cover) on breeding parameters have weakened. Particularly intriguing is that the previous positive association between mild ice winters and subsequent reproductive output has disappeared during the past 15 years, highlighting the non‐linear nature of climate change responses. Indirect predation effects (selective disappearance, changed reproductive strategies, nest‐site selection and population age distribution) can potentially explain also the remaining breeding parameters (annual mean body condition and clutch size). The observed regime shift in predation risk appears to prevent this now endangered population from reaping the potential benefits of a warming climate.
Longitudinal Spinous‐Splitting Laminoplasty with Coral Bone for the Treatment of Cervical Adjacent Segment Degenerative Disease: A 5‐Year Follow‐up Study
Authors: He Wei , He Da , Wang Qi‐long , Tian Wei , Liu Bo , Liu Ya‐jun , Sun Yu‐qing , Xing Yong‐gang , Yuan Ning , Yuan Qiang , Xiao Bin , Han Bing , Wang Yu‐mei , Ma Teng‐fei , Liu Ming‐ming
Published: December 2021

This study was designed to analyze the causes of cervical adjacent segment degenerative disease (ASDis), evaluate the surgical outcomes of longitudinal spinous‐splitting laminoplasty with coral bone (SLAC) during cervical reoperation, and accumulate data on reoperation with SLAC in a primary hospital. Based on the inclusion and exclusion criteria, we conducted a retrospective study involving 52 patients who underwent cervical reoperation for ASDis using SLAC at the spinal surgery department of the Beijing Jishuitan Hospital from 1998 to 2014. Among them, 39 were treated with anterior cervical fusion and internal fixation during the first operation (anterior cervical corpectomy with fusion [ACCF], n = 24; anterior cervical discectomy and fusion [ACDF], n = 11; and cervical disc arthroplasty [CDA], n = 4). Outcomes were the Japanese Orthopaedic Association (JOA) score, neck disability index (NDI) score, upper limb/neck and shoulder evaluated using a visual analogue scale (VAS), and rates of ASDis. In patients who underwent an anterior cervical approach in the first instance, the incidence of ASDis was significantly higher in the C3/4 gap than in the other gaps. In the ACCF group, the lateral radiograph of the cervical spine revealed that the distance between the anterior cervical plate and the adjacent segment disc was <5 mm in 15 (62.5%) cases and five (12.8%) cases, respectively, the internal fixation screws broke into the annulus of the adjacent segment. After the first SLAC, ASDis developed at C2/3 and C3/4 in four (30.8%) and eight (61.5%) cases, respectively. After reoperation, all cases were followed up for >5 (average, 6.2) years. The pre‐reoperation and last follow‐up values were as follows: mean Japanese Orthopaedic Association score, 10.2 ± 1.5 vs 15.5 ± 0.7 (P = 0.03); neck disability index, 26.2 vs 13.6 points (P = 0.01); upper‐limb visual analog scale (VAS) score, 6.1 vs 2.6 points (P = 0.04); and neck and shoulder VAS score, 6.6 vs 2.1 points (P = 0.03). SLAC is a simple technique in which the local anatomy is clearly visible and satisfactory clinical outcomes are obtained.
Statistical Inference of the Value Function for Reinforcement Learning in Infinite-Horizon Settings
Authors: Shi Chengchun , Zhang Sheng , Lu Wenbin , Song Rui
Published: December 2021

Reinforcement learning is a general technique that allows an agent to learn an optimal policy and interact with an environment in sequential decision-making problems. The goodness of a policy is measured by its value function starting from some initial state. The focus of this paper was to construct confidence intervals (CIs) for a policy’s value in infinite horizon settings where the number of decision points diverges to infinity. We propose to model the action-value state function (Q-function) associated with a policy based on series/sieve method to derive its confidence interval. When the target policy depends on the observed data as well, we propose a SequentiAl Value Evaluation (SAVE) method to recursively update the estimated policy and its value estimator. As long as either the number of trajectories or the number of decision points diverges to infinity, we show that the proposed CI achieves nominal coverage even in cases where the optimal policy is not unique. Simulation studies are conducted to back up our theoretical findings. We apply the proposed method to a dataset from mobile health studies and find that reinforcement learning algorithms could help improve patient’s health status. A Python implementation of the proposed procedure is available at https://github.com/shengzhang37/SAVE.
Real-Time Prediction of Severe Influenza Epidemics Using Extreme Value Statistics
Authors: Thomas Maud , Rootzén Holger
Published: December 2021

Each year, seasonal influenza epidemics cause hundreds of thousands of deaths worldwide and put high loads on health care systems. A main concern for resource planning is the risk of exceptionally severe epidemics. Taking advantage of recent results on multivariate Generalized Pareto models in extreme value statistics we develop methods for real-time prediction of the risk that an ongoing influenza epidemic will be exceptionally severe and for real-time detection of anomalous epidemics and use them for prediction and detection of anomalies for influenza epidemics in France. Quality of predictions is assessed on observed and simulated data.
The best of both worlds – entering the nursing profession with support of a transition programme
Authors: Berglund Mia , Kjellsdotter Anna , Wills Joanne , Johansson Anita
Published: December 2021

Background

Transition into clinical practice for newly graduated nurses is a difficult time, with high stress levels defined by a demanding period of personal and professional acclimatisation. Transitions are complicated and multi‐dimensional, and to understand this process, it is crucial to identify the factors that facilitate or stand in the way of a healthy transition.

Aim

The phenomenological study aimed to describe newly graduated nurses’ expectations of transitioning into the nursing profession at the start of a clinical nursing introduction programme, including education, supervision, and critical reflection with peers.

Method

The study was based on seven group interviews with newly graduated nurses. The interviews utilised open‐ended and follow‐up questions and were carried out as a dialogue to enable reflection on the phenomenon of interest. This was explored and illuminated using the reflective lifeworld research approach, based on phenomenological epistemology.

Findings

“Expectations of transition into the nursing profession via the Clinical Nursing Introduction Programme” is signified by an oscillating movement between uncertainty, security, challenge, and growth on the threshold of a new identity. The phenomenon is constituted by the courage to grow, responsibility and fear, belonging and vulnerability, and support and challenge.

Conclusion

Transitioning into the nursing profession via the Clinical Nursing Introduction Programme means having the best of both worlds. Newly graduated nurses have the opportunity to receive education and structured support at the same time as they work independently in clinical practice.
How Intrusive Are Accelerometers for Measuring Nonlinear Vibrations? A Case Study on a Compressor Blade Subjected to Vibro-Impact Dynamics
Authors: Woiwode Lukas , Müller Florian , Groß Johann , Scheel Maren , Krack Malte
Published: December 2021

A characteristic feature of nonlinear vibrations is the energy transfer among different parts or modes of a mechanical system. Moreover, nonlinear vibrations are often non-periodic, even at steady state. To analyze these phenomena experimentally, the vibration response must be measured at multiple locations in a time-synchronous way. For this task, piezoelectric accelerometers are by far the most popular technology. While the effect of attached sensors on linear vibration properties is well-known (mass loading in particular), the purpose of the present work is to assess their intrusiveness on nonlinear vibrations. To this end, we consider a compressor blade that undergoes impacts near the tip for sufficiently large vibrations. We consider two configurations, one in which five triaxial piezoelectric accelerometers are glued to the blade surface and one without sensors attached. In both configurations, the vibration response is measured using a multi-point laser Doppler vibrometer. In the linear case without impacts, the lowest-frequency bending mode merely sees the expected slight frequency shift due to mass loading. In the nonlinear vibro-impact case, unexpectedly, the near-resonant response to harmonic base excitation changes severely both quantitatively and qualitatively. In particular, pronounced strongly modulated responses and period doubling are observed only in the case without attached sensors. We conjecture that this is due to a considerable increase of damping, caused by the sensor cables, affecting mainly the higher-frequency modes.
Two Accelerating Clocks: A Relativistic Thought Experiment
Authors: Neat Adam
Published: December 2021

Gravity bends light. One can argue this by reasoning that a beam of light should travel in a curved path when viewed from within an accelerating frame of reference, and then invoking Einstein’s principle of equivalence, which asserts that the effects observed in an accelerating frame of reference are indistinguishable from the effects observed in a uniform gravitational field. If light bends in an accelerating reference frame, it must also bend in a gravitational field.
Distinguishing between non-abelian topological orders in a quantum Hall system
Authors: Dutta Bivas , Yang Wenmin , Melcer Ron , Kundu Hemanta Kumar , Heiblum Moty , Umansky Vladimir , Oreg Yuval , Stern Ady , Mross David
Published: December 2021

Teasing out the topological order

Quantum Hall states, which form in two-dimensional electron gases at low temperatures and in the presence of strong magnetic fields, have long been known to have nontrivial topological properties. Among the most intriguing is the state that arises at the Landau level filling factor of 5/2. Theoretical calculations suggest several possibilities for the 5/2 ground state and associated topological order but distinguishing among them experimentally is tricky. Dutta
et al
. developed a method for doing so by interfacing a region in the 5/2 state with a region at an integer filling, and the measurements provided support for the particle-hole Pfaffian order. The technique can be used for the investigation of other exotic states in the quantum Hall setting. —JS
Revisiting paleontology’s greatest hits
Dinopedia
Darren Naish
Princeton University Press, 2021. 216 pp.
Authors: Black Riley
Published: December 2021

An otherwise solid dinosaur primer does little to convey the changing face of the field
Early and fast rise of Mesozoic ocean giants
Authors: Delsett Lene Liebe , Pyenson Nicholas D.
Published: December 2021

A whale-sized ichthyosaur shows how fast these reptiles evolved
Fibrin sparks inflammation in the oral mucosa
Authors: Vicanolo Tommaso , Hidalgo Andrés
Published: December 2021

Fibrin deposits in the oral mucosa trigger neutrophil activation and bone destruction
Amazon delivery
Authors: Moutinho Sofia
Published: December 2021

A rainforest expedition brings COVID-19 vaccines to some of Brazil’s most remote and vulnerable groups
In Other Journals
Authors: Sugden Andrew M. , Scanlon Seth Thomas , Purnell Beverly A. , Alderton Gemma , Szuromi Phil , Suleymanov Yury , Yiu Yuen
Published: December 2021

Editors’ selections from the current scientific literature
2021 AAAS Kavli Science Journalism Awards announced
Authors: Lane Earl , Hughes Emily
Published: December 2021

Reports from the ongoing pandemic highlighted the entries
NIH’s Collins steps down: ‘I won’t miss the nasty politics’
Authors: Kaiser Jocelyn
Published: December 2021

Geneticist’s 12-year tenure marked by funding increases, new initiatives, and battling the COVID-19 pandemic
Early migration may have spread Celtic languages
Authors: Gibbons Ann
Published: December 2021

Ancient DNA reveals 3000-year-old influx of people from France to Britain
Volcano distribution and tectonics: A planetoidic perspective
Authors: Cañón-Tapia* Edgardo
Published: December 2021

Volcanic activity is ultimately controlled by processes that take place many kilometers beneath the surface of a planet. The deeper processes are unlikely to reach the surface without some degree of modification at shallower levels. Nevertheless, traces of those deeper processes may still be found when examining the final products at the surface. In this work, it is shown that it is possible to gain insights concerning the integrated contribution of deep structures through the study of the spatial distribution of volcanic vents at the surface. The method here described relies on the systematic use of increasing smoothing factors in Gaussian kernel estimations. The sequences of probability density functions thus generated are equivalent to images obtained with an increasing wavelength, which therefore have the power to penetrate deeper below the surface. Although the resolution of this method is much smaller than the resolution provided by seismic or other geophysical surveys, it has the advantages of ease of implementation, extremely low cost, and remote application. Thus, the reported method has great value as a first-order exploration tool to investigate the deep structure of a planet, and it can make important contributions to our understanding of the volcano-tectonic relationship, not only on Earth, but also across the various bodies of the solar system where volcanic activity has been documented.
Quantifying the growth of continental crust through crustal thickness and zircon Hf-O isotopic signatures: A case study from the southern Central Asian Orogenic Belt
Authors: Wang Yujian , Zhu Dicheng , Lin Chengfa , Hu Fangyang , Liu Jingao
Published: December 2021

Accretionary orogens function as major sites for the generation of continental crust, but the growth model of continental crust remains poorly constrained. The Central Asian Orogenic Belt, as one of the most important Phanerozoic accretionary orogens on Earth, has been the focus of debates regarding the proportion of juvenile crust present. Using published geochemical and zircon Hf-O isotopic data sets for three belts in the Eastern Tianshan terrane of the southern Central Asian Orogenic Belt, we first explore the variations in crustal thickness and isotopic composition in response to tectono-magmatic activity over time. Steady progression to radiogenic zircon Hf isotopic signatures associated with syn-collisional crustal thickening indicates enhanced input of mantle-derived material, which greatly contributes to the growth of the continental crust. Using the surface areas and relative increases in crustal thickness as the proxies for magma volumes, in conjunction with the calculated mantle fraction of the mixing flux, we then are able to determine that a volume of ~14–22% of juvenile crust formed in the southern Central Asian Orogenic Belt during the Phanerozoic. This study highlights the validity of using crustal thickness and zircon isotopic signatures of magmatic rocks to quantify the volume of juvenile crust in complex accretionary orogens. With reference to the crustal growth pattern in other accretionary orogens and the Nd-Hf isotopic record at the global scale, our work reconciles the rapid crustal growth in the accretionary orogens with its episodic generation pattern in the formation of global continental crust.
Case–control study on clinical characteristics of child and adolescent psychiatric outpatients with child-to-parent violence
Authors: Sasaki Yoshinori , Usami Masahide , Sasaki Shoko , Sunakawa Hikaru , Toguchi Yusuke , Tanese Shuichi , Saito Kiyoshi , Shinohara Rena , Kurokouchi Toshinari , Sugimoto Kaori , Hakoshima Yuki , Inazaki Kumi , Yoshimura Yuta , Mizumoto Yuki , Okada Takayuki
Published: December 2021

Objectives

To the best of our knowledge, no case–control study on child and adolescent psychiatric outpatients has investigated the clinical characteristics of patients with child-to-parent violence (CPV). The current study aimed to evaluate the clinical characteristics of child and adolescent psychiatric patients with CPV.

Setting and participants

This research included child and adolescent psychiatric patients who were aged 10–15 years during their initial consultation. The participants were allocated to one of two groups: children with CPV (CPV group, n=109) and without CPV (non-CPV group, n=713).

Outcome measures

This study analysed data including age, sex, diagnostic classification of the primary diagnosis, antisocial behaviour, suicidal attempt or self-harm and refusal to attend school. Moreover, a history of abuse by parents was investigated. Psychological rating scales such as the Spence Children’s Anxiety Scale, Depression Self-Rating Scale for Children, Tokyo Autistic Behavior Scale, Attention-deficit/Hyperactivity Disorder-Rating Scale and Oppositional Defiant Behavior Inventory were used.

Results

Of 822 patients who sought consultation in our department, 109 (13.26%) were included in the CPV group during the first consultation. Compared with the non-CPV group, the CPV group had significantly higher proportions of patients who experienced physical abuse, psychological abuse and who witnessed violence between parents. Meanwhile, the proportion of patients with neurodevelopmental disorders was significantly higher in the CPV group than in the non-CPV group. Regarding developmental characteristics, impulsivity might be correlated with CPV. Moreover, violence and behavioural problems outside of home were associated with CPV.

Conclusions

In patients with CPV who sought consultation, the findings of the current study should be considered to understand invisible side and to facilitate the use of appropriate treatment approaches. However, a prospective study should be performed to investigate the causality between CPV and clinical characteristics.
What do people with lung cancer and stroke expect from patient navigation? A qualitative study in Germany
Authors: Fügemann Hella , Goerling Ute , Gödde Kathrin , Desch Anke Kristin , Müller-Nordhorn Jacqueline , Mauckisch Verena , Siegerink Bob , Rieckmann Nina , Holmberg Christine
Published: December 2021

Objective

This qualitative study investigated patients’ needs and wishes in relation to patient navigation.

Design

A qualitative interview study was conducted. Participants were invited to take part in three in-depth interviews over a period of 6–12 months. Thematic analysis was used.

Setting

Interviewees were sought in the Berlin metropolitan area of Germany in academic university hospitals, in rehabilitation clinics and through self-help organisations.

Participants

The sample consisted of individuals diagnosed with lung cancer (n=20) or stroke (n=20).

Results

From the perspective of interviewees, patient navigators should function as consistent contact persons, present during the whole care trajectory. Their role would be to guide patients through an often confusing healthcare landscape, offering practical, advisory and emotional assistance corresponding to patients’ needs. The study shows that—independent of the disease—participants had similar expectations and needs regarding support from navigators.

Conclusion

For chronic and complex diseases—as is the case with lung cancer and stroke—it appears less important for navigators to fulfil disease-specific tasks. Rather, they should ensure that patients’ more general needs, in relation to social, practical and emotional support, are met in a way that suits their individual wishes. Following these results, patient navigation programmes might be designed to include generic elements, which should then be adapted to the infrastructure in a particular healthcare region and to the particularities of a specific healthcare system.
Development and external validation of a dynamic nomogram for delayed cerebral ischaemia after aneurysmal subarachnoid hemorrhage: a study protocol for a multicentre retrospective cohort study
Authors: Hu Ping , Li Yuntao , Zhang Hongbo , Su Zhongzhou , Xu Shancai , Li Xuesong , Gao Xu , Liu Yangfan , Deng Gang , Xu Yang , Ye Liguo , Chen Qianxue
Published: December 2021

Introduction

Delayed cerebral ischaemia (DCI) caused by aneurysmal subarachnoid haemorrhage (aSAH) is the most frequent complication and typically contributes to poor neurological outcome or deterioration of patients’ condition. Therefore, early accurate and effective prediction of DCI is urgently needed. This study aims to construct a dynamic nomogram for precisely calculating the risk of DCI in patients with aSAH. Internal validation of this tool is conducted using the training cohort, and independent external validation is completed by using other medical centre datasets.

Methods and analysis

This study is a multicentre, retrospective, observational cohort study using data from patients with aSAH. The participants include all adult patients who received surgical treatment in neurosurgery of multiple medical centres from 1 September 2019 to 1 April 2021, including Renmin Hospital of Wuhan University, Huzhou Central Hospital, First Affiliated Hospital of Harbin Medical University, General Hospital of Northern Theatre Command and Affiliated Hospital of Panzhihua University. Clinical information is collected via the electronic medical record system, including demographic data, clinical state on admission and serum laboratory tests. Modified Fisher grade at admission, admission subarachnoid clot and cerebral oedema density, and residual postoperative subarachnoid clot density are determined using the electronic imagine record software. The primary outcome is DCI.

Ethics and dissemination

This study protocol was reviewed and approved by the Medical Ethics Committee of Renmin Hospital of Wuhan University, which is the principal affiliation of this study (approval number: WDRM2021-K022). The other Ethics Committees, including Huzhou Central Hospital (approval number: 202108005–01), First Affiliated Hospital of Harbin Medical University (approval number: H202156), General Hospital of Northern Theater Command (approval number: Y2021060) and Affiliated Hospital of Panzhihua University (approval number: 202105002), also approved the protocol. The results of this research will be published in a peer-reviewed medical journal.

Trial registration number

ChiCTR2100044448.
Exploring two distinct gentamicin prescribing protocols in UK hospitals: a mixed-methods realist evaluation
Authors: Dyar Nadine , Mattick Karen , Bethune Rob
Published: December 2021

Objectives

Gentamicin is the aminoglycoside antibiotic of choice in the UK. It has a narrow therapeutic index: underdosing results in inefficacy while overdosing is characterised by nephrotoxicity and ototoxicity. To improve patient safety, hospitals have protocols for the prescription of gentamicin, which vary in complexity and approach. This study aimed to explore two distinct protocols for prescribing gentamicin in hospital settings, in order to understand the mechanisms they trigger and the outcomes they achieve.

Setting

A mixed-methods realist evaluation explored gentamicin prescribing protocols in two hospital surgical admissions units in South West England between January and August 2018. Site 1 had a traditional, complex protocol, while site 2 took a simplified protocol.

Participants

Testing the initial programme theory (IPT) involved semi-structured audio-recorded interviews of a volunteer sample of healthcare professionals (HCPs) involved in the prescribing and administering process, alongside a clinical audit reviewing accuracy of gentamicin prescribing.

Outcome measures

Three sequential phases were used to identify factors in a successful protocol: IPT generation; testing; refinement of the IPT. The IPT was generated by literature search and analysis of existing protocols of sites 1 and 2. Refinement of the IPT synthesised the results of the quantitative and qualitative research to identify the key characteristics of a successful protocol.

Results

One hundred gentamicin prescriptions were reviewed, with a mean accuracy of gentamicin prescribing at site 1 of 65.67% and at site 2 of 78.79% (p<0.01). Thirty HCPs were interviewed. Key contexts were identified including prescriptiveness, experience and availability of patient information. These triggered hidden mechanisms including uncertainty, fear, confidence and frustration leading to both intended outcomes but also unintended outcomes such as deviation from protocol and unnecessary gentamicin levels.

Conclusions

A simplified prescribing protocol for gentamicin is better accepted by prescribers, leading to better adherence to protocol and more accurate prescribing.
Evidence-based recommendations for economic evaluations in spine surgery: study protocol for a Delphi consensus
Authors: Droeghaag Ruud , Schuermans Valérie N E , Hermans Sem M M , Smeets Anouk Y J M , Caelers Inge J M H , Hiligsmann Mickaël , van Hemert Wouter L W , Evers Silvia , van Santbrink Henk
Published: December 2021

Introduction

Considering the rising global healthcare expenses, economic evaluations are more important than ever. Even though the number of studies regarding costs and cost-effectiveness is increasing, the quality of these studies remains relatively low. This is mainly caused by abundant heterogeneity in methods used for determining, calculating and reporting cost data, despite current general guidelines for the conduct of economic evaluations. Disease-specific recommendations for the conduct of economic evaluations in the field of spine surgery, as complement to existing general guidelines, will ameliorate overall research quality, comparability and interpretability and thus, the overall quality. We aim to provide expert-based recommendations for the design, conduct, and reporting of economic evaluations in spine surgery.

Methods and analysis

A modified Delphi study will be conducted to formulate expert-based recommendations. The following steps will be taken:

(1) The conduct of a systematic review to identify relevant publications and identify relevant authors. Formation of an expert group and a Delphi-panel. (2) Drafting of statements based on articles included in the systematic literature review. Validation of drafted statements by the expert group. Step 2 can be repeated up to three times, statements can be discarded and adjusted in these rounds. Statements with more than 75% agreement will be accepted as consensus statements. (3) Validation of statements by the Delphi-panel. (4) Final recommendations.

Ethics and dissemination

The underlying work is based on existing literature and published data and does not include participation of patients, and thus does not require ethical review approval. The final recommendations are intended for (clinical) researchers in the field of cost-effectiveness in spine surgery. The Delphi method ensures that the final output reflects the opinions of international participants and gives insight in the adherence level to the recommendations. The aim is to reach uniformity in design, conduct and reporting of these studies, as is currently lacking. This will provide a solid basis to determine cost-effectiveness of spine surgeries and consequently aid to limit the rising healthcare costs. The findings of this study and the final recommendations will be disseminated in conferences and seminars and will be published in an international peer-reviewed journal.
Effectiveness of digital primary prevention interventions targeting physical activity, motor skills and nutrition in children aged 3–10 years in the setting of day care and primary school: protocol for a systematic review
Authors: Timpel Patrick , Herrmann Sandra , Flößel Philipp , Beck Heidrun , Schwarz Peter EH
Published: December 2021

Introduction

Available evidence points to an association of increased screen time and the availability of digital tools during childhood with negative health outcomes in later life. For many years, public discourse focused on restricting access and use of digital technologies below certain ages. However, little is known about the specific benefit of a responsible use of digital primary prevention in the setting of (early) childhood education. The objective of this evidence synthesis is to investigate the effectiveness of digital primary prevention interventions targeting physical activity, motor skills and/or nutrition in children aged 3–10 years in day-care facilities and (pre-) schools.

Methods and analysis

We present the rationale and methodological steps of a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures. Automated searches will be conducted by applying a pretested search strategy to the databases MEDLINE/PubMed, EMBASE and PsycInfo to identify relevant interventional (randomised controlled trials, controlled trials, crossover trials and pilot and feasibility) and observational (case–control, cohort) studies in English or German, with no date restrictions. The overall search will be complemented by backward, forward and additional hand searches. Two researchers will independently screen titles/abstracts and assess full texts by applying predefined eligibility criteria. Data extraction will be conducted by using a pretested data extraction sheet. The assessment of methodological quality will be performed independently by two review authors using the Critical Appraisals Skills Programme relevant to the study design applied in the given study. Additionally, qualitative content analysis will be conducted to analyse priorities for future research extracted from the discussion sections and conclusions of included studies.

PROSPERO registration number

CRD42020207682.
Visual outcomes and treatment adherence of patients with macular pathology using a mobile hyperacuity home-monitoring app: a matched-pair analysis
Authors: Gross Nico , Bachmann Lucas M , Islam Meriam , Faes Livia , Schmid Martin K , Thiel Michael A , Schimel Andrew , Sim Dawn A
Published: December 2021

Objective

We compared patients with neovascular age-related macular degeneration (nvAMD), diabetic macular oedema (DMO) and other macular pathologies testing their vision with the hyperacuity home-monitoring app Alleye to patients not performing home-monitoring regarding clinical outcomes and clinical management.

Design

Matched-pair analysis.

Setting

Retina Referral Centre, Switzerland.

Participants

For each eye using Alleye, we matched 2–4 controls not using home-monitoring based on age, gender, number of previous intravitreal injections (IVI), best corrected visual acuity (BCVA) (Early Treatment Diabetic Retinopathy Study letters), central macular thickness (CRT) and time point of enrolment, using the Mahalanobis distance matching algorithm. We included 514 eyes (288 patients); 107 eyes with nvAMD using home monitoring and 218 controls not using home monitoring, 25 eyes with DMO (n=52 controls) and 40 eyes with miscellaneous conditions (n=72 controls). 173 eyes (33.7%) received no IVI during follow-up.

Main outcome measures

Improvement of ≥5 letters, number of injection visits and treatment retention after correcting for differences in baseline characteristics with multivariate analyses.

Results

The mean follow-up duration was 809 days (range 147–1353) and the mean number of IVI/year among treated eyes was 6.7 (SD 3.1). Mean age at baseline was 70.4 years (SD 10.9), BCVA was 77.6 letters (SD 11.6) and CRT was 263.6 µm (SD 86.7) and was similar between patients using and not using home monitoring. In multivariate analyses, patients using home monitoring had a higher chance to improve visual acuity by ≥5 letters (OR 1.67 (95% CI 1.01 to 2.76; p=0.044)) than controls. Treated eyes using home monitoring had less injection visits/year (−0.99 (95% CI −1.59 to −0.40; p=0.001)) and a longer treatment retention +69.2 days (95% CI 2.4 to 136.0; p=0.042). These effects were similar across retinal pathologies.

Conclusions

This data suggest that patients capable of performing mobile hyperacuity home monitoring benefit in terms of visual acuity and discontinue treatment less often than patients not using home monitoring.
Users’ evaluation of Japan’s cancer information services: process, outcomes, satisfaction and independence
Authors: Yamaki Chikako , Takayama Tomoko , Hayakawa Masayo , Wakao Fumihiko
Published: December 2021

Background

Cancer information service (CIS) programmes are becoming increasingly important because patients need to obtain appropriate information and take an active role in their treatment decisions. Programme evaluation is required to determine the level of satisfaction and quality of experiences of users. The purpose of this study is (1) to identify users’ evaluation of CIS programmes by both satisfaction and outcomes that reflect the quality of experience and impact of using the CIS, (2) to examine the related factors of these evaluation outcomes and (3) to analyse the differences of those relations between patients and families.

Method

The self-reported questionnaire was answered by 447 patients and 216 families of patients who used Cancer Information Support Centres (CISCs) at 16 designated cancer hospitals from January 2016 to April 2016. We developed 12 evaluation items, including satisfaction, experience and the impact of using CISC.

Results

Respondents evaluated the CISC highly, especially in terms of overall satisfaction, followed by the counselling process. Immediate access to CISC was the strongest factor affecting outcomes. Patients who wanted to consult about ‘disease or symptoms’ or ‘had no specific problem’ tended to provide high scores for some outcomes, but those who wanted to consult about a ‘financial problem’ or ‘discharge or care at home’ provided negative scores. These trends were also observed in families but to a more limited extent.

Conclusion

Users’ evaluation of CISCs was sufficiently high in terms of overall satisfaction, showing reasonable scores in outcome levels. Immediate access was the strongest factor affecting outcomes and topics of consultation more directly affected evaluation by patients than by families. The distribution of the scores of the measures and related factors was reasonable. The 12-item measurement tool employed in this study seems to be useful for quality monitoring of the CIS.
Codeine dispensing for privately insured children in the USA: a retrospective database study
Authors: Oliveira J e Silva Lucas , Anderson Jana L , Bellolio Fernanda , Campbell Ronna L , Jeffery Molly M
Published: December 2021

In this retrospective study using claims data from the OptumLabs Data Warehouse including 24 658 769 eligible person-years of coverage in the USA, there was substantial decline in codeine dispensing between 2010 and 2019. However, we also observed a persistence of codeine prescribing despite the FDA contraindication in 2018. In 2019, codeine was still being prescribed to children aged 12–17 years at 934 prescriptions per 100 000 person-years of coverage and 106 per 100 000 person-years of coverage in children aged<12 years.