bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurses' Utilization of Information Resources for Patient Care Tasks
Authors: Brown Rebecca J.L. , Michalowski Martin
Published: April 2022

Critical care nurses manage complex patient care interventions under dynamic, time-sensitive and constrained conditions, yet clinical decision support systems for nurses are limited compared with advanced practice healthcare providers. In this work, we study and analyze nurses' information-seeking behaviors to inform the development of a clinical decision support system that supports nurses. Nurses from an urban midwestern hospital were recruited to complete an online survey containing eight open-ended questions about resource utilization for various nursing tasks and open space for additional insights. Frequencies and percentages were calculated for resource type, bivariate analyses using Pearson's χ
2 test were conducted for differences in resources utilization by years of experience, and content analysis of free text was completed.

Forty-five nurses (response rate, 19.6%) identified 38 unique resources, which we organized into a resource taxonomy. Institutional applications were the most common type of resource used (35.6% of all responses) but accounted for only 15.4% of respondents' “go-to resources,” suggesting potential areas for improvement. Our findings highlight that knowing where to look for information, the existence of comprehensive information, and fast and easy retrieval of information are key resource seeking attributes that must be considered when designing a clinical decision support system.
Monitoring Simvastatin Adherence in Patients With Coronary Heart Disease: A Proof-of-Concept Study Based on Pharmacokinetic Measurements in Blood Plasma
Authors: Vethe Nils Tore , Husebye Einar , Andersen Anders M. , Bergan Stein , Kristiansen Oscar , Fagerland Morten W. , Munkhaugen John
Published: April 2022

Background:

Poor statin adherence remains a public health concern associated with adverse outcomes. We evaluated the use of pharmacokinetic measurements to monitor adherence to simvastatin in patients with coronary heart disease (CHD).

Methods:

Eighteen patients with CHD taking an evening dose of simvastatin 20 mg (n = 7), 40 mg (n = 5), or 80 mg (n = 6) were examined at steady-state pharmacokinetics. Ten patients were instructed to interrupt simvastatin dosing and return for blood sampling for the subsequent 3 days. Dose-normalized plasma concentrations of simvastatin lactone and simvastatin acid and the sum of the 2 were evaluated to discriminate between adherent dosing and dose omission. Bioanalytical quantification was performed using liquid chromatography–tandem mass spectrometry.

Results:

A simvastatin acid cutoff of 1.0 × 10−2 nmol−1·L−1·mg−1 identified 100% of those omitting 2 doses and 60% of those omitting a single dose. Simvastatin acid showed superior ability to discriminate dose omission, as well as the best agreement between samples handled at ambient and cool temperatures (median deviation 3.5%; interquartile range −2.5% to 13%). The cutoff for a morning dose schedule, with a similar ability to discriminate, was estimated at 2.0 × 10−3 nmol−1·L−1·mg−1.

Conclusions:

The present method discriminated between adherence and reduced adherence to simvastatin therapy in patients with CHD. Sample handling is feasible for routine practice, and the assessment of adherence can be performed by direct measurement of simvastatin acid in a blood sample, according to defined cutoff values. Further studies validating the cutoff value and utility for clinical application are encouraged.
Sex Differences in Patient-Reported Outcomes in the Immediate Recovery Period After Resuscitation: Findings From the Cross-sectional DenHeart Survey
Authors: Wagner Mette Kirstine , Christensen Anne Vinggaard , Hassager Christian , Stenbæk Dea Siggaard , Ekholm Ola , Borregaard Britt , Thrysoee Lars , Rasmussen Trine Bernholdt , Thorup Charlotte Brun , Mols Rikke Elmose , Juel Knud , Berg Selina Kikkenborg
Published: April 2022

Background

A paucity of resuscitation studies have examined sex differences in patient-reported outcomes upon hospital discharge. It remains unclear whether male and female patients differ in health outcomes in their immediate responses to trauma and treatment after resuscitation.

Objectives

The aim of this study was to examine sex differences in patient-reported outcomes in the immediate recovery period after resuscitation.

Methods

In a national cross-sectional survey, patient-reported outcomes were measured by 5 instruments: symptoms of anxiety and depression (Hospital Anxiety and Depression Scale), illness perception (Brief Illness Perception Questionnaire [B-IPQ]), symptom burden (Edmonton Symptom Assessment Scale [ESAS]), quality of life (Heart Quality of Life Questionnaire), and perceived health status (12-Item Short Form Survey).

Results

Of 491 eligible survivors of cardiac arrest, 176 (80% male) participated. Compared with male, resuscitated female reported worse symptoms of anxiety (Hospital Anxiety and Depression Scale–Anxiety score ≥8) (43% vs 23%; P = .04), emotional responses (B-IPQ) (mean [SD], 4.9 [3.12] vs 3.7 [2.99]; P = .05), identity (B-IPQ) (mean [SD], 4.3 [3.10] vs 4.0 [2.85]; P = .04), fatigue (ESAS) (mean [SD], 5.26 [2.48] vs 3.92 [2.93]; P = .01), and depressive symptoms (ESAS) (mean [SD], 2.60 [2.68] vs 1.67 [2.19]; P = .05).

Conclusions

Between sexes, female survivors of cardiac arrest reported worse psychological distress and illness perception and higher symptom burden in the immediate recovery period after resuscitation. Attention should focus on early symptom screening at hospital discharge to identify those in need of targeted psychological support and rehabilitation.
Value of Diffusion-Weighted Imaging and Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Prediction of Treatment Outcomes in Nasopharyngeal Carcinoma
Authors: Paprad Tunchanok , Lertbutsayanukul Chawalit , Jittapiromsak Nutchawan
Published: April 2022

Objective

Magnetic resonance imaging (MRI) parameters that reflect the tumor microenvironment of nasopharyngeal carcinoma (NPC) may predict treatment response and facilitate treatment planning. This study aimed to evaluate the diffusion-weighted imaging and dynamic contrast-enhanced MRI (DCE-MRI) values for predicting the treatment outcomes in NPC patients.

Methods

Eighty-three patients with NPC underwent pretreatment MRI simulation with diffusion-weighted imaging and dynamic contrast-enhanced MRI. Average values of the apparent diffusion coefficient (ADC), Ktrans, Kep, Ve, Vp, and tumor volume of the primary tumors were measured. Other potential clinical characteristics (age, sex, staging, pathology, pretreatment Epstein-Barr virus level, and treatment type) were analyzed. Patients underwent follow-up imaging 6 months after treatment initiation. Treatment responses were assigned according to the Response Evaluation Criteria in Solid Tumors guideline (version 1.1).

Results

Fifty-one patients showed complete response (CR), whereas 32 patients did not (non-CR). Univariable logistic regression with variables dichotomized by optimal cutoff values showed that ADC ≥1.45 × 10−3 mm2/s, Vp ≥0.14, tumor volume of ≥14.05 mL, high stage (stages III and IV), and Epstein-Barr virus level of ≥2300 copies/mL were predictors of non-CR (P = 0.008, 0.05, 0.01, 0.009, and 0.04, respectively). The final multivariable model, consisting of a combination of ADC ≥1.45 × 10−3 mm2/s, Vp ≥0.14, and high stage, could predict non-CR with a good discrimination ability (area under the receiver operating characteristic curve, 0.76 [95% confidence interval, 0.66–0.87]; sensitivity, 62.50%; specificity, 80.39%; and accuracy 73.49%).

Conclusions

A multivariable prediction model using a combination of ADC ≥1.45 × 10−3 mm2/s, Vp ≥0.14, and high stage can be effective for treatment response prediction in NPC patients.
The Advantages of Applying a 5-mm Endoscope in the Transoral Endoscopic Thyroidectomy Vestibular Approach
Authors: Chen Hang , Deng Lijuan , Gong Zhixian , Zhu Xiaoping
Published: April 2022

Objective:

We sought to compare the effect of applying a 5-mm endoscope and a 10-mm endoscope in the transoral endoscopic thyroidectomy vestibular approach (TOETVA) and to clarify the advantages of using a 5-mm endoscope.

Materials and Methods:

A retrospective analysis of the clinical data of 135 patients who were diagnosed with papillary thyroid carcinoma and who had undergone TOETVA in the thyroid disease center of The First Affiliated Hospital of Nanchang University between January 2019 and May 2020 was performed. Among the included patients, a 10-mm endoscope was used in 50 cases (the 10-mm endoscope group) and a 5-mm endoscope was used in 85 cases (the 5-mm endoscope group), respectively. Operative trauma, operative parameters, postoperative complications, and postoperative mandibular sensation score were compared and analyzed.

Results:

Compared with the 10-mm endoscope group, the 5-mm endoscope group had less surgical trauma, less injury to the mandibular muscles (orbicularis oris, depressor labii inferioris, and mentalis muscle), shorter operative times (107.7±8.1 vs. 121.3±11.6 min, P<0.01), less intraoperative bleeding (14.3±4.8 vs. 17.9±5.3 mL, P<0.01), no obvious postoperative complications, lower mandibular sensation score values (5.7±0.6 vs. 6.0±0.4 points, P<0.01), and shorter mandibular recovery times (9.4±2.5 vs. 12.3±3.6 d, P<0.01).

Conclusion:

The application of a 5-mm endoscope not only improves the cosmetic effect of TOETVA but also reduces the degree of surgical trauma, saves the surgical space, improves the surgical efficiency, and reduces postoperative discomfort, with a promising application prospect.
Pendular Seesaw Nystagmus: Disappearance With Monocular Occlusion
Authors: Liu Xuefei , Wu Yunqing , Jiang Hanqiu , Wang Jiawei , Cui Shilei
Published: April 2022

We report a case of pendular seesaw nystagmus caused by bitemporal hemianopia; the nystagmus disappeared while in darkness as previously described, but it also disappeared with monocular occlusion, which indicates the pivotal role of binocular vision in the pathogenesis.
An Exploratory Study to Investigate the Utility of Clinical Screening for Neurodegenerative Disease in Age-Related Eye Disease Research
Authors: Pelak Victoria S. , Paez Yosbelkys Martin , Patnaik Jennifer L. , Holden Samantha K. , Subramanian Prem S. , Mathias Marc T. , Mandava Naresh , Lynch Anne M.
Published: April 2022

Background:

Unrecognized neurodegenerative diseases (NDD) in age-related eye disease research studies have the potential to confound vision-specific quality of life and retinal optical coherence tomography (OCT) outcome measures. The aim of this exploratory study was to investigate relationships between NDD screening tools and visual outcome measures in a small cohort of controls from the Colorado Age-Related Macular Degeneration Registry (CO-AMD), to consider the utility of future studies.

Methods:

Twenty-nine controls from the CO-AMD were screened using the Montreal Cognitive Assessment (MoCA), a Colorado Parkinsonian Checklist, and the Lewy Body Composite Risk Score. Univariate and multivariable linear regression modeling was used to assess associations between screening tools and the National Eye Institute Visual Function Questionnaire-25 (VFQ-25) and macular OCT outcome measures, and t tests were used to evaluate outcome measure differences between those with normal vs abnormal MoCA scores.

Results:

One patient withdrew. The average age was 72.8 years, and 68% were female patients. Ten participants (36%) had abnormal MoCA scores, and their VFQ-25 scores were only 1 point less and not statistically different than those with normal MoCA scores. Macular OCT volumes and thicknesses for retinal nerve fiber layer (RNFL) and retinal ganglion cell layer were consistently and moderately lower for those with abnormal MoCA scores, and a positive association between MoCA and macular RNFL volume was observed, although differences and regression were not significant. Parkinson screening tests were abnormal for only 4 participants and were not associated with OCT or VFQ-25 measures by regression modeling.

Conclusions:

Given the degree and direction of observed differences, further investigation is warranted regarding the relationship between cognitive screening tools and macular OCT measures in age-related eye disease research, but future investigations regarding the relationship between NDD screening tools and VFQ-25 seem unwarranted.
Early Retinal Microcirculation in Nonfunctioning Pituitary Adenomas Without Visual Field Defects Using Optical Coherence Tomography Angiography
Authors: Chou Yuyu , Wang Xuqian , Wang Ye , Gan Linyang , Xing Bing , You Hui , Ma Jin , Zhong Yong
Published: April 2022

Background:

For patients with nonfunctioning pituitary adenoma (NFPA) without manifesting visual acuity impairment or visual field defect (VFD), more sensitive and objective assessment methods will allow earlier detection before irreversible damage to the visual system. This study aimed to evaluate retinal vessel densities (VDs) alterations in these patients using optical coherence tomography angiography and to determine its diagnostic abilities.

Methods:

Between patients with NFPA without VFDs and age-matched, sex-matched healthy control individuals, comparisons of visual field metrics, retinal structural thickness, and microcirculation were conducted after adjusting for axial length (AL) and signal index of scans. Receiver operating characteristic (ROC) curves were further depicted to assess the diagnostic performance of significant parameters. To explore the impact of symptom duration, tumor size, and axial length on the significant parameters, multivariate regression analysis was conducted.

Results:

This cross-sectional study reviewed 107 patients with NFPA. Twenty-seven eyes of patients with NFPA without VFDs and 27 eyes of healthy controls were enrolled. Compared with healthy controls, patients with NFPA without VFDs had similar foveal avascular zone areas and perimeters, macular ganglion cell complex (mGCC) and peripapillary retinal nerve fiber layer thicknesses, and macular VDs. Only the VD in the radial peripapillary capillary (RPC) segment of the inferior temporal (IT) sector was much lower in the patient group. The 2 largest area under the ROC curves were the focal loss volume (FLV) of the mGCC and the VD in the RPC of the IT sector, both of which were significantly related to symptom duration and tumor size.

Conclusions:

At the early stage of NFPA before VFD and retinal thickness thinning, fundus microcirculation impairments may occur initially in the microvascular density of the RPC segment of the IT sector. The FLV and the VD of RPC at the IT sector may provide a basis for the early diagnosis of NFPA without VFD in clinical practice.
Exploring U.S. food system workers’ intentions to work while ill during the early COVID-19 pandemic: a national survey
Authors: Ceryes Caitlin A. , Agnew Jacqueline , Wirtz Andrea L. , Barnett Daniel J. , Neff Roni A.
Published: April 2022

Background

While “stay at home” orders were in effect during early phases of the COVID-19 pandemic, many U.S. food workers attended in-person work, charged with maintaining operation of the national food supply chain. Anecdotal evidence suggests that many U.S. food system workers encountered barriers to staying home despite symptomatic COVID-19 illness.

Methods

We conducted a national, cross-sectional, online survey between July 31 to October 2, 2020, among 2,535 respondents. We used multivariable regression and free-text analyses to explore factors associated with U.S. food system workers’ intentions to attend work while ill (i.e., presenteeism intentions) during the first four to six months of the COVID-19 pandemic.

Results

Overall, 8.8% of workers surveyed reported intentions to attend work while symptomatic with COVID-19 disease. Almost half of respondents (41.1%) reported low or very low household food security. Workers reporting a high workplace safety climate score were half as likely to report presenteeism intentions (adjusted odds ratio [aOR] 0.52, 95% confidence interval (CI) 0.37, 0.75) relative to those reporting low scores. Workers reporting low (aOR 2.06, 95% CI 1.35, 3.13) or very low (aOR 2.31, 95% CI 1.50, 3.13) levels of household food security had twice the odds of reporting presenteeism intentions relative to those reporting high/marginal food security.

Conclusions

Our findings suggest that workplace culture and safety climate could enable employees to feel like they can take leave when sick during a pandemic, which is critical to individual health and prevention of workplace disease transmission. However, the pressure experienced by food workers to work when ill, especially by those experiencing food insecurity, themselves, underscores the need for strategies which address these vulnerabilities and empower food workers to make health-protective decisions.
Comprehensive assessment of Age-Specific Mortality Rate and its incremental changes using a composite measure: A sub-national analysis of rural Indian women
Authors: Sharma Divya , Kiran Tanvi , Junaid KP , Rajagopal Vineeth , Sharma Saraswati
Published: April 2022

Background

Diverse socio-economic and cultural issues contribute to adverse health outcomes and increased mortality rates among rural Indian women across different age categories. The present study aims to comprehensively assess age-specific mortality rates and their temporal trends using a composite measure at the sub-national level for rural Indian females to capture cross-state differences.

Methods

A total of 19 states were included in the study to construct a composite age-specific mortality index for 2011 (base year) and 2018 (reference year) and examine the incremental changes in the index values across these years at the sub-national level in India. Sub-index values were calculated for each component age group and were subsequently used to compute the composite ASMR index using the geometric mean method. Based on the incremental changes, the performance of states was categorized into four different typologies.

Results

Improvement in mortality index scores in the 0-4 years age group was documented for all states. The mortality rates for the 60+ age group were recorded to be high for all states. Kerela emerged as the overall top performer in terms of mortality index scores, while Bihar and Jharkhand were at the bottom of the mortality index table. The overall mortality composite score has shown minor improvement from base year to reference year at all India level.

Conclusions

An overall reduction in the mortality rates of rural Indian women has been observed over the years in India. The success of public health interventions to reduce the under-five mortality rate is evident as the female rural mortality rates have reduced sizably for all states. Nevertheless, there is still sizable scope for reducing mortality rates for other component age groups. Additionally, there is a need to divert attention toward the female geriatric (60+ years) population as the mortality rates are still high.
WHEN SEX MATTERS: A COMPARATIVE GENERALISED STRUCTURAL EQUATION MODEL (GSEM) FOR THE DETERMINANTS OF STUNTING AMONGST UNDER-FIVES IN UGANDA
Authors: Vallence Ngabo M , Atuhaire Leonard , Rutayisire Peter Clever
Published: April 2022

The main aim of this study was to establish the differences in both the determinants of stunting and the causal mechanism through which the identified determinants influence stunting amongst male and female under-fives in Uganda. Literature shows that male children below the age of five years are at a higher risk of being stunted than their female counterparts. Specifically, studies in Uganda indicate that being a male child is positively associated with stunting while being a female is negatively associated with stunting.

Data for 904 male and 829 female under-fives was extracted form UDHS-2016 survey dataset. Key variables for this study were identified and used in generating relevant models and paths. Structural equation modeling techniques was used in its generalized form (GSEM). The generalized nature necessitated specifying both the family and link functions for each response variables in the system of the model. Sex of the child (b4) was used as a grouping factor and the height for age (HAZ) scores were used to construct the status for stunting of under-fives.

The estimated models and path clearly indicated that the set of underlying factors that influence male and female under-fives respectively were different and the path through which they influence stunting were different. However, some of the determinants that influenced stunting amongst male under-fives also influenced stunting amongst the female under-fives.

To reduce the stunting problem to the desirable state, it is important to consider the multifaceted and complex nature of the risk factors that influence stunting amongst the under-fives but more importantly consider the different sex specific factors and their causal mechanism or paths through which they influence stunting.
Postural control telerehabilitation with a low-cost virtual reality protocol for children with cerebral palsy: Protocol for a clinical trial
Authors: Gatica-Rojas Valeska , Cartes-Velásquez Ricardo , Soto-Poblete Alex , Cofré Lizama Luis Eduardo
Published: April 2022

Objective

To establish the feasibility and effectiveness of a rehabilitation programme using low-cost virtual reality aimed at improving postural control in children with cerebral type palsy spastic hemiplegia. It also seeks to compare low-cost virtual reality under two delivery modalities, telerehabilitation (TR) and face-to-face (FtF).

Methods

Randomized controlled clinical trial from the ACTRN platform ACTRN12621000117819. Eighteen sessions of low-cost virtual reality therapy will be provided through both, FtF and TR modalities using a Nintendo Wii balance board. Each programme will last for 6 weeks and will consist of 3 sessions per week of 25 minutes each. The participants will include 40 patients diagnosed with cerebral palsy type spastic hemiplegia. Twenty participants for each group. Participants will be assessed at baseline, by the end of weeks 2, 4, and 6, and at weeks 8 and 10 (post-intervention follow-ups). Clinical measures include the Modified-Modified Ashworth Scale for lower limbs, Modified Ashworth Scale for upper limbs, timed up-and-go tests, the timed one-leg standing and 6-minute walk test. Posturographic measures, including sway area and velocity, under six conditions will be used: 2 statics and 4 dynamic conditions, which include voluntary sway in the mediolateral direction following a metronome set at 30Hz and 60Hz, and sway while playing 2 different videogames.

Results

This study provides an assessment of the feasibility and effectiveness of an affordable rehabilitation programme using low-cost virtual reality aimed at improving postural control in children with cerebral palsy.

Conclusion

Rehabilitation programme using low-cost virtual reality will improve postural control in children with cerebral palsy type spastic hemiplegia and this programme delivered using TR will be as effective as a FtF modality. The TR programme has be designed to expand the coverage of physiotherapy services for children with cerebral palsy in low-resource settings and in remote areas.
Design and implementation of a global site assessment survey among HIV clinics participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) research consortium
Authors: Brazier Ellen , Maruri Fernanda , Wester C. William , Musick Beverly , Freeman Aimee , Parcesepe Angela , Hossmann Stefanie , Christ Benedikt , Kimmel April , Humphrey John , Freeman Esther , Enane Leslie A. , Lancaster Kathryn E. , Ballif Marie , Golub Jonathan E. , Nash Denis , Duda Stephany N.
Published: April 2022

Introduction

Timely descriptions of HIV service characteristics and their evolution over time across diverse settings are important for monitoring the scale-up of evidence-based program strategies, understanding the implementation landscape, and examining service delivery factors that influence HIV care outcomes.

Methods

The International epidemiology Databases to Evaluate AIDS (IeDEA) consortium undertakes periodic cross-sectional surveys on service availability and care at participating HIV treatment sites to characterize trends and inform the scientific agenda for HIV care and implementation science communities. IeDEA’s 2020 general site assessment survey was developed through a consultative, 18-month process that engaged diverse researchers in identifying content from previous surveys that should be retained for longitudinal analyses and in developing expanded and new content to address gaps in the literature. An iterative review process was undertaken to standardize the format of new survey questions and align them with best practices in survey design and measurement and lessons learned through prior IeDEA site assessment surveys.

Results

The survey questionnaire developed through this process included eight content domains covered in prior surveys (patient population, staffing and community linkages, HIV testing and diagnosis, new patient care, treatment monitoring and retention, routine HIV care and screening, pharmacy, record-keeping and patient tracing), along with expanded content related to antiretroviral therapy (differentiated service delivery and roll-out of dolutegravir-based regimens); mental health and substance use disorders; care for pregnant/postpartum women and HIV-exposed infants; tuberculosis preventive therapy; and pediatric/adolescent tuberculosis care; and new content related to Kaposi’s sarcoma diagnostics, the impact of COVID-19 on service delivery, and structural barriers to HIV care. The survey was distributed to 238 HIV treatment sites in late 2020, with a 95% response rate.

Conclusion

IeDEA’s approach for site survey development approach has broad relevance for HIV research networks and other priority health conditions.
Characteristics of health-related quality of life and related factors in patients with brain tumors treated with rehabilitation therapy
Authors: Watanabe Takahiro , Noto Shinichi , Natsumeda Manabu , Kimura Shinji , Tabata Satoshi , Ikarashi Fumie , Takano Mayuko , Tsukamoto Yoshihiro , Oishi Makoto
Published: April 2022

Background

Rehabilitation therapy during hospitalization is effective in improving activities of daily living (ADL) and physical function in patients with brain tumors. However, there are few studies on the effect of rehabilitation therapy on health-related quality of life (HRQOL) in patients with brain tumors. Additionally, the EuroQol-5Dimension-5Level (EQ-5D-5L) index score has not been reported as an outcome. This study aimed to investigate the HRQOL of patients with brain tumors who underwent rehabilitation therapy and investigated the factors affecting the EQ-5D-5L index score from various perspectives, including various brain tumor types, treatment methods, and recurrence. In addition, we examined the relationship between the EQ-5D-5L index score, disease-specific HRQOL scale, and ADL.

Methods

Patients with brain tumors who underwent treatment and rehabilitation at Niigata University Medical & Dental Hospital were included in this cross-sectional study. We used the EQ-5D-5L, European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire core 30, and EORTC quality of life questionnaire brain cancer module to evaluate HRQOL. ADL were assessed using the functional independence measure (FIM). The relationship between each HRQOL assessment score and the FIM was analyzed, and the influence of related factors was assessed by multiple regression analysis.

Results

This study included 76 patients. The EQ-5D-5L index score was 0.689 for all patients with brain tumors and 0.574 for those with glioblastomas, which was the lowest value. There was a strong correlation between the EQ-5D-5L index score and FIM (r = 0.627, p<0.001). In addition, the EQ-5D-5L index score was significantly correlated with most of the items of the disease-specific HRQOL scale. Multiple regression analysis revealed that glioblastoma histology (coefficient: -0.570, p = 0.024) and surgery (coefficient: 0.376, p = 0.030) were independent factors affecting the EQ-5D-5L index score.

Conclusions

Patients with glioblastoma undergoing rehabilitation may have reduced HRQOL, which was influenced by glioblastoma histology and surgery.
The regulation of circadian rhythm by insulin signaling in Drosophila
Authors: Yamaguchi Sho T , Tomita Jun , Kume Kazuhiko
Published: April 2022

Circadian rhythm is well conserved across species and relates to numerous biological functions. Circadian misalignment impairs metabolic function. Insulin signaling is a key modulator of metabolism in the fruit fly as well as mammals and its defects cause metabolic disease. Daily diet timing affects both circadian rhythmicities of behavior and metabolism. However, the relationship between circadian clock and insulin signaling is still elusive. Here, we report that insulin signaling regulates circadian rhythm in Drosophila melanogaster. We found the insulin receptor substrate mutant, chico1, showed a shorter free-running circadian period. The knockdown of insulin receptor (InR), or another signaling molecule downstream of InR, dp110, or the expression of a dominant-negative form of InR resulted in the shortening of the circadian period and diminished its amplitude. The impairment of insulin signaling both in all neurons and restricted circadian clock neurons altered circadian period length, indicating the insulin signaling plays a role in the regulation of circadian rhythm in clock cells. Among 3 insulin-like ligands expressed in the brain, dilp5 showed the largest effect on circadian phenotype when deleted. These results suggested that insulin signaling contributes to the robustness of the circadian oscillation and coordinates metabolism and behavior.

Highlights

Insulin receptor substrate mutant, chico1, displayed circadian rhythm phenotype.

Pan-neuronal inhibition of insulin receptor signaling shortened circadian cycle.

Inhibition of insulin signaling only in clock neurons altered circadian cycle.

Dilp5 is a major insulin receptor ligand for circadian effects.
Prostate cancer androgen receptor activity dictates efficacy of Bipolar Androgen Therapy
Authors: Sena Laura A , Kumar Rajendra , Sanin David E , Thompson Elizabeth A , Rosen D Marc , Dalrymple Susan L , Antony Lizamma , Yang Yuhan , Gomes-Alexandre Carolina , Hicks Jessica L , Jones Tracy , Bowers Kiara A. , Eskra Jillian N , Meyers Jennifer , Gupta Anuj , Skaist Alyza , Yegnasubramanian Srinivasan , Luo Jun , Brennen W Nathaniel , Kachhap Sushant K , Antonarakis Emmanuel S , De Marzo Angelo M , Isaacs John T , Markowski Mark C , Denmeade Samuel R
Published: April 2022

Testosterone is the canonical growth factor of prostate cancer but can paradoxically suppress its growth when present at supraphysiological levels. We have previously demonstrated that the cyclical administration of supraphysiological androgen (SPA), entitled Bipolar Androgen Therapy (BAT), can result in tumor regression and clinical benefit for patients with castration-resistant prostate cancer [1–5]. However, predictors and mechanisms of response and resistance have been ill-defined. Here we show that growth inhibition of prostate cancer models by SPA requires high androgen receptor (AR) abundance and activity and is driven in part by downregulation of MYC. Using matched sequential patient biopsies, we show that high pre-treatment AR activity predicts downregulation of MYC, clinical response, and prolonged progression-free and overall survival for patients on BAT. BAT induced strong downregulation of AR in all patients, which is shown to be a primary mechanism of acquired resistance to SPA. Acquired resistance can be overcome by alternating SPA with the AR inhibitor enzalutamide, which induces adaptive upregulation of AR and re-sensitizes prostate cancer to SPA. This work identifies a predictive biomarker of response to BAT and supports a new treatment paradigm for prostate cancer involving alternating between AR inhibition and activation.
AI-VDT can Help in Detecting Primary Lung Cancer
Authors: Suzuki Kazuhiro , Otsuka Yujiro , Imashimizu Kota , Hata Kazunori , Suzuki Kenji
Published: April 2022

The current study shows that measuring volume doubling time could accelerate the detection of primary lung cancer in chest CT imaging. Thirty tumors were selected from surgical cases of primary lung cancer at a university hospital in Japan, and the CT scan data and radiology reports were extracted retrospectively. The CT scan data were processed by a commercial pulmonary nodule AI and volume doubling time was calculated for each historical study time point. 43% of the 30 tumors had an VDT below 400 days in earlier study than the tumor was reported as a nodule on the radiology report. The average days of earlier detection was 299 days. Interpolation of the detailed mortality reduction data from the NELSON study predicted a 5.6% reduction in 10-year mortality from lung cancer.
Non-inferiority of essential medicines for caries arrest and prevention in a school-based program: Results from the CariedAway pragmatic clinical trial
Authors: Ruff Ryan Richard , Barry-Godin Tamarinda , Niederman Richard
Published: April 2022

Background

Dental caries is the most common global childhood disease. To control caries, the Centers for Disease Control and Prevention recommends school-based caries prevention, and the World Health Organization lists glass ionomer cement and silver diamine fluoride as essential dental medicines. The CariedAway trial tested the comparative effectiveness of these essential medicines when used in a school-based dental care program.

Methods

This cluster-randomized non-inferiority pragmatic trial was conducted in children from 2018 to 2022. Subjects were randomized at the school level to receive either silver diamine fluoride (”simple care”) or an active comparator of glass ionomer sealants and atraumatic restorations (”complex care”). All subjects received tooth brushes, fluoride toothpaste, and fluoride varnish. We assessed caries arrest and incidence at two years using mixed-effects multilevel models and two-sample proportion tests with clustering adjustment.

Results

1398 subjects received treatment and completed follow-up observations after two years. The proportion of subjects with arrested caries in simple and complex groups was 0.56 and 0.46, respectively (difference = -0.11, 95% CI = -0.22, 0.01). Prevention rates for no new caries were 0.81 and 0.82 (difference = 0.01, 95% CI = -0.04, 0.06).

Conclusions

Over a two-year, non-intervention period, simple care was non-inferior to complex care for both caries arrest and prevention. Results support the utilization of silver diamine fluoride as an arresting and preventive agent in school-based oral health programs and questions the periodicity of current caries prevention recommendations.
Mobile Primary Healthcare for post-COVID Patients in Rural Areas: a Proof-of-Concept Study
Authors: Stallmach Andreas , Katzer Katrin , Besteher Bianca , Finke Kathrin , Giszas Benjamin , Gremme Yvonne , Hamdan Rami Abou , Lehmann-Pohl Katja , Legen Maximilian , Lewejohann Jan Christoph , Machnik Marlene , Alsabbagh Majd Moshmosh , Nardini Luisa , Puta Christian , Stallmach Zoe , Reuken Philipp A.
Published: April 2022

Introduction

Post-COVID syndrome is increasingly recognized as a new clinical entity after SARS-CoV-2 infection. Patients living in rural areas may have to travel long with subjectively great effort to be examined using all necessary interdisciplinary tools. This problem could be addressed with mobile outpatient clinics.

Methods

In this prospective observational study, we investigated physical fitness, fatigue, depression, cognitive dysfunction and dyspnea in patients with post-COVID syndrome in a mobile interdisciplinary post-COVID outpatient clinic. Upon referral from their primary care physician, patients were offered an appointment at a mobile post-COVID outpatient clinic close to their home.

Results

We studied 125 patients (female, n=79; 63.2%) in our mobile unit. All patients reported symptoms lasting for more than 12 weeks after acute infection. 88.3% and 64.1% of patients reported significant impairment in physical and mental quality of life. Patients reported a median of three symptoms. The most frequently reported symptoms were fatigue (86.4%), cognitive dysfunction (85.6%), and dyspnea (37.6%). 56.0% of patients performed at <2.5thpercentile at the 1 min sit-to-stand test compared to age and sex-matched healthy controls and 25 patients (20.0%) exhibited a drop in oxygen saturation. A questionnaire given to each patient regarding the mobile unit revealed a very high level of patient satisfaction.

Conclusion

There is an increasing need for high-quality and locally available care for patients with post-COVID syndrome. A mobile post-COVID outpatient clinic is a new concept that may be particularly suitable for use in rural regions. Patients’ satisfaction following visits in such units is very high.
Using Explainable-AI to Find Geospatial Environmental and Sociodemographic Predictors of Suicide Attempts
Authors: Pavicic Mirko , Walker Angelica M. , Sullivan Kyle A. , Lagergren John , Cliff Ashley , Romero Jonathon , Streich Jared , Garvin Michael R. ,   MVP Suicide Exemplar Workgroup,   the Million Veteran Program, Pestian John , McMahon Benjamin , Oslin David W. , Beckham Jean C. , Kimbrel Nathan A. , Jacobson Daniel A.
Published: April 2022

Despite a global decrease in suicide rates in recent years, death by suicide has increased in the United States. It is therefore imperative to identify the risk factors associated with suicide attempts in order to combat this growing epidemic. In this study, we use an explainable-artificial intelligence method, iterative Random Forest, to predict suicide attempts using data from the Million Veteran Program. Our predictive model incorporates multiple environmental variables (e.g., elevation, light wavelength absorbance, temperature, humidity, etc) at ZIP code-level geospatial resolution. We additionally consider demographic variables from the American Community Survey as well as the number of firearms and alcohol vendors per 10,000 people in order to assess the contributions of proximal environment, access to means, and restraint decrease to suicide attempts. Our results show that geographic areas with higher concentrations of married males living with spouses are predictive of lower rates of suicide attempts, whereas geographic areas where males are more likely to live alone and to rent housing are predictive of higher rates of suicide attempts. We also identified climatic features that were associated with suicide attempt risk by age group. Additionally, we observed that firearms and alcohol vendors were associated with increased risk for suicide attempts irrespective of the age group examined, but that their effects were small in comparison to the top features. Taken together, our findings highlight the importance of social determinants and environmental factors in understanding suicide risk among veterans.
New ligand-binding sites identified in the crystal structures of β-lactoglobulin complexes with desipramine
Authors: Loch Joanna I. , Barciszewski Jakub , Śliwiak Joanna , Bonarek Piotr , Wróbel Paulina , Pokrywka Kinga , Shabalin Ivan G. , Minor Wladek , Jaskolski Mariusz , Lewiński Krzysztof
Published: April 2022

The homodimeric β-lactoglobulin belongs to the lipocalin family of proteins that transport a wide range of hydrophobic molecules and can be modified by mutagenesis to develop specificity for novel groups of ligands. In this work, new lactoglobulin variants, FAF (I56F/L39A/M107F) and FAW (I56F/L39A/M107W), were produced and their interactions with the tricyclic drug desipramine (DSM) were studied using X-ray crystallography, calorimetry (ITC) and circular dichroism (CD). The ITC and CD data showed micromolar affinity of the mutants for DSM and interactions according to the classical one-site binding model. However, the crystal structures unambiguously showed that the FAF and FAW dimers are capable of binding DSM not only inside the β-barrel as expected, but also at the dimer interface and at the entrance to the binding pocket. The presented high-resolution crystal structures therefore provide important evidence of the existence of alternative ligand-binding sites in the β-lactoglobulin molecule. Analysis of the crystal structures highlighted the importance of shape complementarity for ligand recognition and selectivity. The binding sites identified in the crystal structures of the FAF–DSM and FAW–DSM complexes together with data from the existing literature are used to establish a systematic classification of the ligand-binding sites in the β-lactoglobulin molecule.
Crystal structure and photoluminescent properties of a new EuIII–phthalate–acetate coordination polymer
Authors: Jittipiboonwat Prakottakarn , Chuasaard Thammanoon , Rujiwatra Apinpus
Published: April 2022

A new coordination polymer, poly[(acetato)aqua(μ3-phthalato)europium(III)], [Eu(C8H4O4)(CH3O2)(H2O)]
n
or [EuIII(phth)(OAc)(H2O)] (phth2− = phthalate and OAc− = acetate) was synthesized and characterized, revealing it to be a supramolecular assembly of one-dimensional [EuIII(phth)(OAc)(H2O)] chains. Each chain is built up of edge-sharing distorted tricapped trigonal–prismatic TPRS-{EuIIIO9} building motifs and assembled in a regular fashion through hydrogen-bonding and aromatic π–π interactions. The fully deprotonated phth2− ligand was shown to be an effective sensitizer, promoting the characteristic 5
D
0→7
FJ
(J = 1–4) emissions of EuIII even in the presence of the non-sensitizing OAc− group.
Crystal structure and Hirshfeld surface analysis of (E)-1-[2,2-dibromo-1-(4-nitrophenyl)ethenyl]-2-(4-fluorophenyl)diazene
Authors: Atioğlu Zeliha , Akkurt Mehmet , Shikhaliyev Namiq Q. , Mammadova Naila A. , Babayeva Gulnara V. , Khrustalev Victor N. , Bhattarai Ajaya
Published: April 2022

In the title compound, C14H8Br2FN3O2, the 4-fluorophenyl ring and the nitro-substituted phenyl ring form a dihedral angle of 64.37 (10)°. Molecules in the crystal are connected by C—H...O and C—H...F hydrogen bonds into layers parallel to (011). The crystal packing is consolidated by C—Br...π and C—F...π interactions, as well as by π–π stacking interactions. According to a Hirshfeld surface analysis of the crystal structure, the most significant contributions to the crystal packing are from O...H/H...O (15.0%), H...H (14.3%), Br...H/H...Br (14.2%), C...H/H...C (10.1%), F...H/H...F (7.9%), Br...Br (7.2%) and Br...C/C...Br (5.8%) contacts.
Organizational career management: a review and future prospect
Authors: Zhao Qinglin , Cai Zijun , Zhou Wenxia , Zang Ledi
Published: April 2022

Purpose

The purpose of this study is to review the research about organizational career management (OCM) and provide an integrated understanding of OCM research.

Design/methodology/approach

In this paper, the authors systematically review 85 OCM-related papers published in highly influential journals over the past four decades (1978–2021). This paper reviews the definitions, measurements, antecedents, outcomes, mediators and moderators of OCM.

Findings

Diverse definitions of OCM exist, with three key common factors: what should be included in OCM, who is responsible for OCM and the goal of OCM. Scholars use different OCM measures, which might be due to different nations, industries, groups and scale development methods. More than 20 papers demonstrated the positive influences of OCM, providing convincing evidence of the necessity of OCM. About 90% of the current papers we reviewed (27 out of 30 papers) dominantly examined the influence of OCM on individuals’ attitudes or work behavior. The influence of OCM on organizational outcomes was less addressed.

Originality/value

First, the authors review the existing OCM measurements and distinguish two ways of measuring OCM: OCMP (organizational level, rated by HR managers or HR vice president or CEO, capturing the real practices) and POCM (Perceived OCM, individual level, rated by employees, capturing subjective perception of practices). This distinction reduces the ambiguity in existing measurements. Second, we summarize the empirical findings of OCM, including the antecedents, outcomes, mediators and moderators. These findings uncover the benefits/risks of OCM and the factors that may influence its effectiveness. Third, the review provides several practical implications as the findings can help managers improve their career development programs.
Gender, family background, cynicism and ethical sensitivity of future procurement professionals in a developing country context: evidence from Ugandan universities
Authors: Tukamuhabwa Benjamin R. , Mbago Musa , Mutebi Henry , Kyoshabire Mercy
Published: April 2022

Purpose

Some scholars argue that ethical awareness increases alongside work experience,whereas others agree that ethics education shapes ethical awareness and that cheating in college predicts unethical behaviour in subsequent professional environment. The purpose of this paper is therefore to investigate the level and antecedents of ethical sensitivity of future procurement professionals.

Design/methodology/approach

An exploratory descriptive survey of a sample of 303 final year procurement students from the two largest public Universities in Uganda was conducted. Using Statistical Package for (SPSS) and Amos Version 27, data were analysed by using means, standard deviations, exploratory and confirmatory factor analyses and correlation analysis.

Findings

The study revealed that future procurement professionals exhibit low levels of ethical sensitivity. However, contrary to the general observations from the extant literature, gender and family background of students do not determine both ethical sensitivity and cynicism. Moreover, this study establishes that cynicism is positively associated with instances that depict low ethical sensitivity.

Research limitations/implications

This paper contributes to providing an empirical understanding of the derivation of unethical behaviour in procurement practice. Grounded in Aristotle’s organic theory of state and moral habituation, this argues that future procurement professionals posses natural proclivities that trigger their social instincts and membership to multiple associations in actualising their innate potential for ethical behaviour. This supports the notion that humans are potentially virtuous, whereby morality is learned, imitated, emerges and perfects through repetitive actions and is therefore incremental.

Practical implications

The findings mirror what prevails in practice in Uganda, where procurement practitioners have been implicated in unethical practices regardless of their gender and family background. This signals that managers should not recruit or deploy procurement personnel based on gender or family background.

Originality/value

While research on ethical sensitivity of students has been focussed on other disciplines such as accounting, nursing and other business studies, this paper focusses on ethical sensitivity of procurement students aspiring to join a professional environment that is severely marred with unethical practices. Further, Aristotle’s moral habituation and organic theory of state invoked in this study underline the synergies of both nature and nurturing in inculcating ethicality in procurement professionals.