bluuebunny/crossref_metadata_2025 huggingface dataset:
Shaping Circular Service Ecosystems
Authors: Fehrer Julia A. , Kemper Joya A. , Baker Jonathan J.
Published: July 2023

The circular economy (CE) presents an alternative perspective to the linear take-make-use-dispose model prevalent in industrial value chains. CE envisions economies operating like natural ecosystems—restorative and waste-free, underpinned by principles such as reuse, repair, share, and pay-for-use. Surprisingly, although these principles align with the fundamentals of service management, there is limited scholarly exploration of CE within service research. Leveraging service-dominant logic, this study introduces the concept of circular service ecosystems as ideal types of service ecosystems, regenerative, and embedded within nature, where (material, intellectual, digital and financial) resources flow seamlessly within and between nested systems without creating any waste or leakage. By analyzing 3,178 blogs penned by CE experts over 7 years and conducting in-depth interviews with industry specialists, this study offers two significant contributions. Firstly, it presents a process framework elucidating the transition towards circular service ecosystems. This framework explains the emergence of novel circular solutions and service ecosystem properties through processes of de- and re-institutionalization. Secondly, the study identifies six shaping strategies that actors can apply to drive circular service ecosystem transitions. The study concludes by emphasizing the importance of circular service ecosystems and CE as promising areas for future service research, providing a comprehensive research agenda to explore these areas in depth.
Trust in modernity: The case of Adam Smith
Authors: Barbalet Jack
Published: July 2023

Recent examination of Adam Smith’s mention of trust and his understanding of the role of trust in interpersonal relations add to his standing as a theorist of modernity. Smith’s development of the notion of trust is confined to an account of trustworthiness, which is consistent with his theory of moral agency based on the principle of the impartial spectator. In addition, it is demonstrated that the predominance of trustworthiness in Smith’s understanding relates to the significant presence of cottage industry in a globalised commercial economy, through which reliance on others is foregrounded. At the same time Smith was unable to grasp the disposition and agency of a trustor, a person giving trust, and their confidence in choosing to balance the risk of depending on strangers with the advantage such dependence might provide. In this way both Smith’s understanding of trust and the nature of trust itself are explicated.
‘Neither work nor leisure’: Motivations of microworkers in the United Kingdom on three digital platforms
Authors: Muldoon James , Apostolidis Paul
Published: July 2023

This article examines the experience of microworkers living in the United Kingdom. Based on a survey of 1189 microworkers and 17 in-depth interviews, the article explores the experiences of UK-based microworkers on three digital platforms: Prolific, Clickworker and Amazon Mechanical Turk. The article draws on the theoretical framework of self-determination theory to analyse workers’ motivations for performing microwork. It reveals that workers’ relatively high satisfaction with otherwise low-paying and low-status work was possible because workers conceptualised their activity as occupying an ambiguous space and time in their lives, blurring traditional distinctions between work and leisure. These findings contribute to our understanding of how microworkers experience their relationship to work in the United Kingdom.
Knowledge coproduction at the periphery of the urban and academia: Insights from Acapulco’s metropolitan area
Authors: Becerril Hector
Published: July 2023

In this paper I focus on the Coyuca Resilient to Climate project which was based on a coproduction process initiated by academics in Acapulco’s Metropolitan Area. Using Actor-Network Theory (ANT), I trace project’s implementation, considering the implications and complications of the process for the research team, and the role of coproduction for planning just cities. I argue that it is vital to consider the specific situation with regards to the urban and knowledge production systems from which researchers operate, connecting coproduction to broader political and academic contexts. I also argue that it is crucial to consider the multi-layered structure of power, specifically regarding academics situated at the periphery of the urban and academia, as it is from this double structure (‘potestas’ and ‘potentia’), that they engage in coproduction and planning just cities. Lastly, I argue that knowledge coproduction relates to long-term processes that require nurturing capacities and alliances for building not only just cities and but also a more just knowledge system.
Multiple UAVs on a shared tether: Use cases, modeling, and probabilistic path planning
Authors: Humann James , Equi Michael , Link Natalie , Latorre-Suarez Perla
Published: July 2023

We analyze the concept of multiple unmanned aerial vehicles (UAVs) on a shared tether (MUST), where the UAVs act as control nodes for the shape of the tether, enabling the system to maneuver around obstacles without tangling or colliding for increased flexibility compared with single-tethered UAVs. MUST use cases are gathered from stakeholders in the military, public safety, and commercial domains. We present a model for the tether shape to use in collision checking and a model for the interactions among tether weight, size, and power, which we exercise to determine the maximum tether segment sizes. We apply three probabilistic path-planning algorithms from the literature to MUSTs, using a novel local planner and constraint set. In simulation, we show that probabilistic planners are a feasible approach to path planning for MUSTs with curved tether segments. We also show the first manual piloting modality of MUSTs.
Challenges in the diagnosis and management of IBD: a sub-Saharan African perspective
Authors: Watermeyer Gill , Katsidzira Leolin , Nsokolo Bright , Isaac Alatise Olusegun , Duduyemi Babatunde M. , Kassianides Chris , Hodges Phoebe
Published: July 2023

With the exception of South Africa, inflammatory bowel disease (IBD) has long been considered uncommon in sub-Saharan Africa (SSA) with a dearth of peer-reviewed publications from the subcontinent. This most likely reflects underreporting as some cases may be missed due to the high burden of infectious diseases which may closely mimic IBD. In addition, many countries in SSA have limited endoscopic capacity, inadequate access to diagnostic imaging and a notable scarcity of histopathologists, radiologists and gastroenterologists. Beyond these obstacles, which significantly impact patient care, there are many other challenges in SSA, particularly the unavailability of key IBD therapies. In this review, we discuss barriers in diagnosing and managing IBD in SSA, as well as some of the initiatives currently in place to address these short comings.
Development and Validation of Binary Classifiers to Predict Nocturnal Hypoglycemia in Adults With Type 1 Diabetes
Authors: Afentakis Ioannis , Unsworth Rebecca , Herrero Pau , Oliver Nick , Reddy Monika , Georgiou Pantelis
Published: July 2023

Background:

One of the biggest challenges for people with type 1 diabetes (T1D) using multiple daily injections (MDIs) is nocturnal hypoglycemia (NH). Recurrent NH can lead to serious complications; hence, prevention is of high importance. In this work, we develop and externally validate, device-agnostic Machine Learning (ML) models to provide bedtime decision support to people with T1D and minimize the risk of NH.

Methods:

We present the design and development of binary classifiers to predict NH (blood glucose levels occurring below 70 mg/dL). Using data collected from a 6-month study of 37 adult participants with T1D under free-living conditions, we extract daytime features from continuous glucose monitor (CGM) sensors, administered insulin, meal, and physical activity information. We use these features to train and test the performance of two ML algorithms: Random Forests (RF) and Support Vector Machines (SVMs). We further evaluate our model in an external population of 20 adults with T1D using MDI insulin therapy and wearing CGM and flash glucose monitoring sensors for two periods of eight weeks each.

Results:

At population-level, SVM outperforms RF algorithm with a receiver operating characteristic–area under curve (ROC-AUC) of 79.36% (95% CI: 76.86%, 81.86%). The proposed SVM model generalizes well in an unseen population (ROC-AUC = 77.06%), as well as between the two different glucose sensors (ROC-AUC = 77.74%).

Conclusions:

Our model shows state-of-the-art performance, generalizability, and robustness in sensor devices from different manufacturers. We believe it is a potential viable approach to inform people with T1D about their risk of NH before it occurs.
Navigating the Maze: Caregivers Perception on Design Elements to Improve Wayfinding for Older Adults With Dementia in Long-Term Care Facilities
Authors: Alam Silvia , Kim Daejin
Published: July 2023

Aim:

The main purpose of this research is to understand the wayfinding experience of older adults with dementia in long-term care facilities and identifying environmental design elements that support older adults’ spatial abilities.

Background:

Wayfinding problems are the earliest symptoms of dementia, and older adults with cognitive impairment are more likely to get lost in the community and consequences cause psychological responses such as insecurity, agitation, and falling in their environment.

Method:

The research used data collected from 30 caregivers of two long-term care facilities in the Midwest through a survey and interview on their perceptions of wayfinding design elements.

Results:

The research findings highlighted on caregivers’ perception on wayfinding experience of older adults with dementia. The findings show a significant difference between importance and satisfaction on floor pattern and visibility in the facilities. Study indicated that glass partitions in the middle of the hall and corridor can create visual obstruction for older adults and barrier for staff as well to keep visual track on them. The qualitative study revealed that different colored doors for individual patient room in a memory care enhance older adults’ wayfinding abilities. In addition, in case of multisensory stimuli, noise and smell can improve their wayfinding abilities as well.

Conclusion:

The conclusion of the study highlights the importance of understanding the design elements that can be effective in creating a safer environment for older adults with dementia.
The controllability of the Technosphere, an impossible question
Authors: Picot Pauline , Guillaume Bertrand
Published: July 2023

The notion of ‘technosphere’ has been proposed to refer to the whole of technological infrastructures, stressing the importance of technology in the Anthropocene. Peter K Haff introduced it in the field of Earth System Science a decade ago. His argument entangles the claim of the technosphere’s uncontrollability with an attempt to overcome anthropocentrism. We develop a critical analysis of this proposal, enriched by a literature review. The idea of a ‘technosphere’ has been present in the scientific literature for at least 50 years. We provide an analysis of the evolution of the uses of the ‘technosphere’ before Haff’s publications. Then, we discuss in which ways Haff’s contribution is in continuity or rupture with these older views. Finally, we argue that the technosphere has little relevance when addressing the question of technology controllability and for overcoming anthropocentrism. This leads us to introduce an alternative proposal to the technosphere: ‘technodiversity’.
Billboard 200: The Lessons of Musical Success in the U.S.
Authors: Gourévitch Boris
Published: July 2023

There has been little quantitative analysis of the successful careers of music artists in the literature given the importance of music in world culture. The Billboard 200 database in the U.S. (BB200, 200 best-selling weekly albums) is freely available for the period 1963–2019, a long period encompassing the entire careers of many musicians. An analysis of this database enabled us to establish some rules of musical success for artists, which are examined in this article. Our results show that the time distribution of success for artists reaching high chart positions follows a Frechet-like distribution, with a decline principally due to the progressively shorter lifespan of successive charted albums from the same artist. We then show that the surmised difficulty of the second album exists. Our findings also confirm that success is more diverse than it was a few decades ago, in the sense that more artists reach the charts every year. Finally, we analyze and model the lifespan of albums in the charts, facilitating the isolation of the contribution of marketing to success and failure and comparisons between albums. The BB200 database provides an interesting point of entry to music data science, music marketing, but also to the more complex related notions of musical quality and creativity.
Nasopharyngeal Carriage Rate of Streptococcus pneumoniae, Related Risk Factors, and Antibiotic Susceptibility Among Inmates in Hawassa Central Prison Institute: Hawassa, Sidama National Region, Ethiopia
Authors: Reta Oute , Daka Deresse
Published: July 2023

Background

The bacterium Streptococcus pneumoniae commonly causes severe bacterial illnesses in both children and adults. S. pneumoniae is the most fatal bacterial pathogen, causing 50% of the deaths from lower respiratory infections in people of all ages.

Objectives

This study was aimed to determine a nasopharyngeal carriage rate of S. pneumoniae, related risk factors, and antibiotic susceptibility among prisoners in Hawassa Central Prison Institute Hawassa, Ethiopia

Methods

From July to August 2021, a cross-sectional investigation was carried out in Hawassa prison. All randomly chosen adult volunteers were a part of the study. In this study, about 330 different people were included. Within 3 h of collection, the swab specimen was inoculated onto 5% sheep blood agar; the inoculated medium was then incubated for 18-24 h at 35-37 °C in a CO2-enriched environment. Following incubation, the S. pneumoniae colonies were suspected, but the usual colony shape, alpha-hemolysis, Gram staining, optochin susceptibility, and bile solubility test allowed for confirmation. Antimicrobial susceptibility testing was carried out in accordance with the Clinical and Laboratory Standards Institute's guidelines.

Results

Overall carriage rate of S. pneumoniae among adult individuals were 41 (12.7%). The carriage rate of S. pneumoniae was affected by age classes that 39-48 years (OR = 4.82, 95%CI = 1.49-15.56, p = .009), 49-58 years (OR = 5.27, 95%CI = 1.27-21.89, p = .022), and greater than 58 years (OR = 4.36, 95%CI = 1.13-16.90, p = .033); cigarette smoking (OR = 3.41, 95%CI = 1.16-10.01, p = .026); and sharing beds (OR = 3.91, 95%CI = 1.27-12.07, p = .018). The majority of the isolates are susceptible for clindamycin (87.8%) and resistant for chloramphenicol (56%). Multidrug resistance was observed in 36.7%.

Conclusions

The overall carriage rate of S. pneumoniae was 12.7%. Age, cigarette smoking, and sharing beds in the same prison room had a substantial impact on this nasopharyngeal carriage rate. Chloramphenicol (56%), erythromycin (41.5%), tetracycline (39%), and co-trimoxazole (34.1%) resistance were seen in the majority of S. pneumoniae isolates. Early detection, hygiene maintenance, and appropriate treatment are necessary.
Dynamic Data Visualizations to Enhance Insight and Communication Across the Life Cycle of a Scientific Project
Authors: Wiebels Kristina , Moreau David
Published: July 2023

In scientific communication, figures are typically rendered as static displays. This often prevents active exploration of the underlying data, for example, to gauge the influence of particular data points or of particular analytic choices. Yet modern data-visualization tools, from animated plots to interactive notebooks and reactive web applications, allow psychologists to share and present their findings in dynamic and transparent ways. In this tutorial, we present a number of recent developments to build interactivity and animations into scientific communication and publications using examples and illustrations in the R language (basic knowledge of R is assumed). In particular, we discuss when and how to build dynamic figures, with step-by-step reproducible code that can easily be extended to the reader’s own projects. We illustrate how interactivity and animations can facilitate insight and communication across a project life cycle—from initial exchanges and discussions in a team to peer review and final publication—and provide a number of recommendations to use dynamic visualizations effectively. We close with a reflection on how the scientific-publishing model is currently evolving and consider the challenges and opportunities this shift might bring for data visualization.
The Organization and Function of the Phagophore-ER Membrane Contact Sites
Authors: Vargas Duarte Prado , Reggiori Fulvio
Published: July 2023

Macroautophagy is characterized by the de novo formation of double-membrane vesicles termed autophagosomes. The precursor structure of autophagosomes is a membrane cistern called phagophore, which elongates through a massive acquisition of lipids until closure. The phagophore establishes membrane-contact sites (MCSs) with the endoplasmic reticulum (ER), where conserved ATG proteins belonging to the ATG9 lipid scramblase, ATG2 lipid transfer and Atg18/WIPI4 β-propeller families concentrate. Several recent in vivo and in vitro studies have uncovered the relevance of these proteins and MCSs in the lipid supply required for autophagosome formation. Although important conceptual advances have been reached, the functional interrelationship between ATG9, ATG2 and Atg18/WIPI4 proteins at the phagophore-ER MCSs and their role in the phagophore expansion are not completely understood. In this review, we describe the current knowledge about the structure, interactions, localizations, and molecular functions of these proteins, with a particular emphasis on the yeast Saccharomyces cerevisiae and mammalian systems.
E-Syt1 Regulates Neuronal Activity-Dependent Endoplasmic Reticulum–Plasma Membrane Junctions and Surface Expression of AMPA Receptors
Authors: Mao Ranran , Tong Chunfang , Liu Jia-Jia
Published: July 2023

Endoplasmic reticulum (ER)–plasma membrane (PM) contact sites/junctions play important roles in cell physiology including signal transduction, ion and lipid transfer, and membrane dynamics. However, little is known about the dynamic regulation and functional roles of ER–PM junctions in neurons. Using a split green fluorescent protein-based membrane contact probe, we find that the density of ER–PM contact sites changes dynamically in the dendrites of hippocampal neurons undergoing long-term synaptic potentiation (LTP). We show that the Ca2±-sensing membrane tethering protein Extended Synaptotagmin 1 (E-Syt1) mediates the formation of ER–PM contact sites during LTP. We also show that E-Syt1 is required for neuronal activity-dependent surface expression of the α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid-type glutamate receptors. These findings implicate ER–PM junctions in the regulation of neurotransmitter receptor trafficking and synaptic plasticity.
Health care experiences of people with Parkinson’s disease in Australia
Authors: Danoudis Mary , Soh Sze-Ee , Iansek Robert
Published: July 2023

Background

Little is known about the health care experiences of people with Parkinson’s disease (PwP) living in Australia. Exploring health care experiences can provide insight into service gaps which can then help direct quality improvement, such as improving communication between patients and health professionals.

Methods

This study aimed to examine the health care experiences of a sample of PwP living in Australia using the Patient-Centered Questionnaire for Parkinson’s disease (PCQ-PD). Participants were recruited from four sources located in Victoria, Australia: (1) a metropolitan Movement Disorders Program (Group 1); (2) metropolitan based movement disorder neurologists working as sole practitioners and not within multidisciplinary teams (Group 2); (3) a regional based multidisciplinary PD program (Group 3); and (4) PD support groups in regional and rural Victorian towns without PD specialist programs (Group 4). Scores derived from the PCQ-PD included the overall patient-centered score (OPS), six sub-scale experience scores (SES) and the quality improvement scores (QIS). Health care experiences were compared between Groups 1, 2, 3 and 4 and multivariate linear regression models were used to explore factors contributing to patient-centeredness.

Results

227 participants reported a mean (SD) OPS score of 1.8 (SD 0.5) with no significant differences between groups. The rating for the Tailored Information subscale was low, (mean 1.3, SD 0.5), with Group 2 having a significantly lower score, 1.1 (SD 0.5), compared to Group 1, 1.4 (SD 0.5) (p = 0.048). Experiences of Continuity of Care and Collaboration of Professionals were rated significantly lower by Group 2, 1.3 (SD 1.0) compared to Groups 1, 1.8 (SD 0.9) (p = 0.018) and 3, 2.1 (SD 0.8) (p = 0.002). Care aspects related to the Tailored Information subscale were prioritised for improvement by all groups. The main predictors of positive health care experiences were disease duration (coeff 0.02; 95% CI 0.00, 0.04) and living with another person (coeff 0.27: 95% CI 0.03, 0.51).

Conclusion

This sample of participants with PD had poor experiences of several aspects of care known to be important in the provision of quality PD care. They prioritised the improvement of personalised health care information and better continuity of care and collaboration between health professionals.
Relationships of work stress and interpersonal needs with industrial workers’ mental health: a moderated mediation model
Authors: Wang Rongxi , Liu Yujie , Liu Shangbin , Chen Hui , Yu Xiaoyue , Xu Chen , Chen Yingjie , Xia Danni , Ge Xin , Wang Zhiqiang , Chang Ruijie , hu Fan , Shen Tian , Wang Ying , Wang Zixin , Cao Bolin , Zhang Kechun , Zou Huachun , Qin Jiade , Li Sisi , Cai Yong
Published: July 2023

Objectives

This study explores whether feelings of defeat (i.e., a sense of failed struggle and losing rank; referred to as defeat for simplicity) mediated the effect of work stress on depression/anxiety, the effect of interpersonal needs on depression/anxiety for Chinese industrial workers, and the possible moderating role of social support.

Method

A cross-sectional study was conducted in Shenzhen, China in 2019, in total, 2023 industrial workers (of 2700 invited; response rate = 75%) completed a self-administered survey consisted of Job Stress Scale, Interpersonal Needs Questionnaire, Defeat Scale, Centre for Epidemiological Studies Depression Scale, Generalized Anxiety Disorder Scale, two face-valid questions for social support, as well as sociodemographic information. Moderated mediation model was tested and loop plots were applied to probe into the conditional effects of work and interpersonal stress on depression and anxiety symptoms.

Result

Both the direct and indirect effect of work stress on depression and anxiety through defeat were significant (Work stress→ Depression: B = 0.035, p < .001, Work stress→ Defeat→ Depression: B = 0.034, p < .001; Work stress→ Anxiety: B = 0.038, p < .001, Work stress→ Defeat→ Anxiety: B = 0.045, p < .001). Meanwhile, defeat mediated the relationship of interpersonal needs with depression partially and the relationship of interpersonal needs with anxiety totally (Interpersonal needs→ Anxiety: B = 0.133, p < .001, Interpersonal needs→ Defeat→ Anxiety: B = 0.010, p = .537). Social support moderated the indirect path between interpersonal needs and depression/anxiety and buffered the effect.

Conclusion

The mediating role of defeat and the moderator role of social support in the relationship between stress and depression/anxiety were confirmed in industrial workers. Workers who reported more work and interpersonal stress would report more defeat feelings, and then exhibited more depression and anxiety symptoms; this mediation effect was stronger for those who had lower social support, respectively.
Misuse of Pregabalin: a qualitative study from a patient’s perspective
Authors: Servais Louise , Huberland Vincent , Richelle Lou
Published: July 2023

Introduction

The misuse of Pregabalin has been the subject of growing concern for several years. The effects sought are multiple and it is rarely taken as a single drug. It is most frequently used together with opioids, which may increase the risk of fatal overdose. In response to this emerging phenomenon, we seek to better understand the situation of misuse in Belgium and identify the people involved in it.

Methodology

A qualitative study using semi-structured interviews with 20 participants who misuse Pregabalin was conducted throughout the French-speaking region of Belgium between August 2021 and January 2022. Recruitment mostly took place in addictions centers, shelters for migrants and homeless persons and primary care centers. We then conducted a thematic analysis with the help of Nvivo software.

Results

A profile emerged, of young male users, immigrants, mainly first generation immigrants coming from North Africa. They had in common a challenging or even traumatic migration pathway and precarious living conditions in Belgian territory. Most of them had no stable income. They saw Pregabalin as enabling them to cope with their daily situation. All had psychiatric and/or somatic comorbidities for which they had apparently not recieved adequate medical care. This seemed to lead many of them to use Pregabalin as self-medication, for anxiety-depressive disorders and chronic pain, and it was sometimes initiated in their home country. Pregabalin was never used alone.

Conclusion

This study has highlighted a rare and insufficient documented profile of Pregabalin misuse: self-medication among a group of first generation immigrants, most of whom have no previous history of opioid-related disorders. Measures should be taken to improve access to health and social care for this population, considering all their biopsychosocial vulnerabilities.
A tool to assess fitness among adults in public health studies – Predictive validity of the FFB-Mot questionnaire
Authors: Woll Alexander , Cleven Laura , Jekauc Darko , Krell-Roesch Janina , Bös Klaus
Published: July 2023

Background

Fitness has important implications for physical activity behavior and is associated with various health-related outcomes. It can be assessed through a test battery or a self-reported questionnaire. One example is the FFB-Mot (Funktionsfragebogen Motorik; engl. functional fitness questionnaire) which consist of 28 items to assess four components of fitness in adults: cardiorespiratory fitness/ endurance, muscular strength, gross motor coordination, and flexibility. The aims of this manuscript were to (1) provide an English-version of the FFB-Mot questionnaire (developed from the German-version using translation and back-translation) to the international community of researchers in the areas of physical activity, fitness and health in adults, and (2) examine the predictive validity of the FFB-Mot questionnaire in a large sample of community-dwelling adults.

Methods

We used data from a longitudinal study in Germany with four measurement waves over a period of 18 years, with samples ranging between 310 and 437 participants (1572 adults in total, mean ages 46–58 years). To assess predictive validity, we calculated Pearson correlations between FFB-Mot data collected in 1997 and external health-related criteria (i.e., subjective health status, physician-rated health status, back pain, physical complaints and physical activity in minutes per week) collected in 2002, 2010, and 2015, and separately for males and females.

Results

We observed correlations between higher FFB-Mot scores with better subjective health status (in 2002: males, r = 0.25; females, r = 0.18; in 2010: males, r = 0.29; females, r = 0.28; in 2015: males, r = 0.40), and higher physical activity (in 2002: males, r = 0.24; females, r = 0.25; in 2010: males, r = 0.30; females, r = 0.38; in 2015: females, r = 0.27). Higher FFB-Mot scores were also correlated with lower back pain (in 2002: males, r = -0.23; females, r = -0.25; in 2010: females, r = -0.22), less physical complaints (in 2002: males, r = -0.36; females, r = -0.24), and better physician-rated health status (in 2002: males, r = -0.41; females, r = -0.29, 2010: males, r = -0.38; females, r = -0.44; in 2015: males, r = -0.47).

Conclusions

Our results suggest that the FFB-Mot to assess fitness in adults has predictive validity for health-related outcomes as indicated by significant correlations, albeit some effect sizes are small. The FFB-Mot may be used as one-time assessment of self-reported fitness, or for repeated testing to assess change of self-reported fitness over time and in different settings (e.g., public health research).
Future burden of non-communicable diseases attributable to overweight in Chile: a multistate life table modeling study
Authors: Fuentes Rodrigo , Nilson Eduardo , Rezende Leandro F. M. , Christofaro Diego Giulliano Destro , Silva Danilo R. , Ferrero-Hernández Paloma , Cristi-Montero Carlos , Marques Adilson , Farías-Valenzuela Claudio , Ferrari Gerson
Published: July 2023

Background

Previous studies have quantified the current burden of diseases attributable to overweight in Chile. However, no study has estimated the attributable burden of overweight in the future. Herein, we estimated the potential impact of different trajectories in the prevalence of overweight on the incidence and mortality from non-communicable diseases (NCDs) in Chilean adults from 2019 to 2030.

Methods

A multistate life table modelling was used to estimate the business-as-usual (BAU: if the current rate of increase in BMI persist through the next 11 years; i.e., 0.4% per year from 2003 to 2017) and three counterfactual scenarios (1: the increase rate of overweight is reduced by half; 2: maintanance of the current prevalence of overweight; 3: the prevalence of overweight is reduced by 6.7%) over a 11-year simulation period for burden of NCDs attributable to overweight in Chilean adults aged 20 to 80 years. The model inputs included nationally representative data of body mass index, national official demographic records, NCDs from the Global Burden of Disease study in 2019, and relative risks from a published meta-analysis.

Results

If the current trends of increase in overweight are maintained in Chile, approximately, 669 thousand cases and 117 thousand deaths from NCDs will occur from 2020 to 2030. In case the increase rate of overweight is reduced by half during this period, around 7 thousand cases and 1.4 thousand deaths from NCDs would be prevented, while achieving no increase in the prevalence of overweight would avert 10 thousand cases and 2 thousand deaths. In the optimistic scenario of reducing the prevalence of overweight by 6.7% until 2030, approximately 25 thousand cases and 5 thousand deaths from NCDs would be prevented.

Conclusion

We estimated that the number of NCDs cases and deaths that could be avoided by decreasing the prevalence of overweight in Chilean adults. Preventive programs aimed to reduce overweight may have a high impact on the future burden of NCDs in Chile.
A qualitative exploration of allied health providers’ perspectives on cultural humility in palliative and end-of-life care
Authors: Singh Hardeep , Haghayegh Arta Taghavi , Shah Riya , Cheung Lovisa , Wijekoon Sachindri , Reel Kevin , Sangrar Ruheena
Published: July 2023

Background

Cultural factors, including religious or cultural beliefs, shape patients’ death and dying experiences, including palliative and end-of-life (EOL) care preferences. Allied health providers must understand their patients’ cultural preferences to support them in palliative and EOL care effectively. Cultural humility is a practice which requires allied health providers to evaluate their own values, biases, and assumptions and be open to learning from others, which may enhance cross-cultural interactions by allowing providers to understand patients’ perceptions of and preferences for their health, illness, and dying. However, there is limited knowledge of how allied health providers apply cultural humility in palliative and EOL care within a Canadian context. Thus, this study describes Canadian allied health providers’ perspectives of cultural humility practice in palliative and EOL care settings, including how they understand the concept and practice of cultural humility, and navigate relationships with patients who are palliative or at EOL and from diverse cultural backgrounds.

Methods

In this qualitative interpretive description study, remote interviews were conducted with allied health providers who currently or recently practiced in a Canadian palliative or EOL care setting. Interviews were audio-recorded, transcribed, and analyzed using interpretive descriptive analysis techniques.

Results

Eleven allied health providers from the following disciplines participated: speech-language pathology, occupational therapy, physiotherapy, and dietetics. Three themes were identified: (1) Interpreting and understanding of cultural humility in palliative and EOL care (i.e., recognizing positionality, biases and preconceived notions and learning from patients); (2) Values, conflicts, and ethical uncertainties when practicing cultural humility at EOL between provider and patient and family, and within the team and constraints/biases within the system preventing culturally humble practices; (3) The ‘how to’ of cultural humility in palliative and EOL care (i.e., ethical decision-making in palliative and EOL care, complexities within the care team, and conflicts and challenges due to contextual/system-level factors).

Conclusions

Allied health providers used various strategies to manage relationships with patients and practice cultural humility, including intra- and inter-personal strategies, and contextual/health systems enablers. Conflicts and challenges they encountered related to cultural humility practices may be addressed through relational or health system strategies, including professional development and decision-making support.
Insulin growth factor axis and cardio-renal risk in diabetic kidney disease: an analysis from the CREDENCE trial
Authors: Mohebi Reza , Liu Yuxi , Hansen Michael K. , Yavin Yshai , Sattar Naveed , Pollock Carol A. , Butler Javed , Jardine Meg , Masson Serge , Heerspink Hiddo J. L. , Januzzi Jr James L.
Published: July 2023

Background

The insulin-like growth factors (IGF) play a crucial role in regulating cellular proliferation, apoptosis, and key metabolic pathways. The ratio of IGF-1 to IGF binding protein-3 (IGFBP-3) is an important factor in determining IGF-1 bioactivity. We sought to investigate the association of IGF-1 and IGFBP-3 with cardio-renal outcomes among persons with type 2 diabetes.

Methods

Samples were available from 2627 individuals with type 2 diabetes and chronic kidney disease that were randomized to receive canagliflozin or placebo and were followed up for incident cardio-renal events. Primary outcome was defined as a composite of end-stage kidney disease, doubling of the serum creatinine level, or renal/cardiovascular death. IGF-1 and IGFBP-3 were measured at baseline, Year-1 and Year-3. Elevated IGF-1 level was defined according to age-specific cutoffs. Cox proportional hazard regression was used to investigate the association between IGF-1 level, IGFBP-3, and the ratio of IGF-1/IGFBP-3 with clinical outcomes.

Results

Elevated IGF-1 was associated with lower glomerular filtration rate at baseline. Treatment with canagliflozin did not significantly change IGF-1 and IGFBP-3 concentrations by 3 years (p-value > 0.05). In multivariable models, elevated IGF-1 (above vs below age-specific cutoffs) was associated with the primary composite outcome (incidence rate:17.8% vs. 12.7% with a hazard ratio [HR]: 1.52; 95% confidence interval CI 1.09–2.13;P: 0.01), renal composite outcome (HR: 1.65; 95% CI 1.14–2.41; P: 0.01), and all-cause mortality (HR: 1.52; 95% CI 1.00–2.32; P; 0.05). Elevations in log IGFBP-3 did not associate with any clinical outcomes. Increase in log IGF-1/IGFBP-3 ratio was also associated with a higher risk of the primary composite outcome (HR per unit increase: 1.57; 95% CI 1.09–2.26; P; 0.01).

Conclusions

These results further suggest potential importance of IGF biology in the risk for cardio-renal outcomes in type 2 diabetes. SGLT2 inhibition has no impact on the biology of IGF despite its significant influence on outcomes.

Trial registration: CREDENCE; ClinicalTrials.gov Identifier: NCT02065791.
Hypoxia-cleavable and specific targeted nanomedicine delivers epigenetic drugs for enhanced treatment of breast cancer and bone metastasis
Authors: Li Zhaofeng , Liu Peixin , Chen Wei , Liu Xueying , Tong Fan , Sun Junhui , Zhou Yang , Lei Ting , Yang Wenqin , Ma Dong , Gao Huile , Qin Yi
Published: July 2023

Breast cancer bone metastasis has become a common cancer type that still lacks an effective treatment method. Although epigenetic drugs have demonstrated promise in cancer therapy, their nontargeted accumulation and drug resistance remain nonnegligible limiting factors. Herein, we first found that icaritin had a strong synergistic effect with an epigenetic drug (JQ1) in the suppression of breast cancer, which could help to relieve drug resistance to JQ1. To improve tumor-targeted efficacy, we developed a hypoxia-cleavable, RGD peptide-modified poly(D,L-lactide-co-glycolide) (PLGA) nanoparticle (termed ARNP) for the targeted delivery of JQ1 and icaritin. The decoration of long cleavable PEG chains can shield RGD peptides during blood circulation and reduce cellular uptake at nonspecific sites. ARNP actively targets breast cancer cells via an RGD-αvβ3 integrin interaction after PEG chain cleavage by responding to hypoxic tumor microenvironment. In vitro and in vivo assays revealed that ARNP exhibited good biodistribution and effectively suppressed primary tumor and bone metastasis. Meanwhile, ARNP could alleviate bone erosion to a certain extent. Furthermore, ARNP significantly inhibited pulmonary metastasis secondary to bone metastasis. The present study suggests that ARNP has great promise in the treatment of breast cancer and bone metastasis due to its simple and practical potential.
The motives and methods of methamphetamine and ‘heroin’ co-use in West Virginia
Authors: Ondocsin Jeff , Holm Nicole , Mars Sarah G. , Ciccarone Daniel
Published: July 2023

Background

Opioid and methamphetamine co-use is increasing across the USA with overdoses involving these drugs also rising. West Virginia (WV) has led the US in opioid overdose death rates since at least 2013 and rising co-use of methamphetamine with opioids has played a greater role in deaths over the last 5 years.

Methods

This study used rapid ethnography to examine methods and motivations behind opioids and methamphetamine co-use from the viewpoint of their consumers. Participants (n = 30) were people who injected heroin/fentanyl also using methamphetamine who participated in semi-structured interviews.

Results

We found multiple methods of co-using opioids and methamphetamine, whether alternately or simultaneously and in varying order. Most prioritized opioids, with motives for using methamphetamine forming three thematic categories: ‘intrinsic use’, encompassing both inherent pleasure of combined use greater than using both drugs separately or for self-medication of particular conditions; ‘opioid assisting use’ in which methamphetamine helped people manage their existing heroin/fentanyl use; and ‘reluctant or indifferent use’ for social participation, reflecting methamphetamine’s low cost and easy availability.

Conclusions

Methamphetamine serves multiple functions among people using opioids in WV. Beliefs persist that methamphetamine can play a role in preventing and reversing opioid overdose, including some arguments for sequential use being protective of overdose. ‘Reluctant’ uptake attests to methamphetamine’s social use and the influence of supply. The impact on overdose risk of the many varied co-use patterns needs further investigation.
Efficacy of chemotherapy versus surgery as initial treatment for gastric cancer with positive peritoneal cytology
Authors: Li Bailong , Miao Rulin , Shan Fei , Li Shuangxi , Jia Yongning , Xue Kan , Li Zhemin , Ying Xiangji , Pang Fei , Zhang Yan , Ji Jiafu , Li Ziyu
Published: July 2023

Background

The prognosis of gastric cancer (GC) patients with positive peritoneal cytology (CY1) without other distant metastasis is poor, and there are no standard treatment strategies. Our study aimed to compare the survival outcomes of CY1 GC patients receiving chemotherapy or surgery as initial treatment.

Methods

From February 2017 to January 2020, clinical and pathological data of patients diagnosed with CY1 GC without other distant metastasis in the Peking University Cancer Hospital was reviewed. Patients were divided into two groups: chemotherapy-initial group and surgery-initial group. In chemotherapy-initial group, patients received preoperative chemotherapy initially. According to the treatment response, the patients were divided into three subgroups: conversion gastrectomy group, palliative gastrectomy group, and further systematic chemotherapy group. In surgery-initial group, patients underwent gastrectomy followed by postoperative chemotherapy.

Results

A total of 96 CY1 GC patients were included with 48 patients in each group. In chemotherapy-initial group, preoperative chemotherapy yielded an objective response rate of 20.8% and disease control rate of 87.5%. Conversion to CY0 after preoperative chemotherapy was obtained in 24 (50%) patients. The median overall survival was 36.1 months in chemotherapy-initial group and 29.7 months in surgery-initial group (p = 0.367). The median progression-free survival was 18.1 months in chemotherapy-initial group and 16.1 months in surgery-initial group (p = 0.861). The 3-year overall survival rates were 50.0% and 47.9%, respectively. In chemotherapy-initial group, twenty-four patients who converted to CY0 by preoperative chemotherapy and received surgery obtained a significantly better prognosis. The median overall survival was still not reached in these patients.

Conclusion

There was no significant difference in survival outcomes between chemotherapy-initial group and surgery-initial group. CY1 GC patients who converted to CY0 by preoperative chemotherapy and received radical surgery could obtain a favorable long-term prognosis. Further investigation should focus on preoperative chemotherapy to eliminate peritoneal cancer cell.

Trial registration

This study is retrospectively registered.
Elevated CHCHD4 orchestrates mitochondrial oxidative phosphorylation to disturb hypoxic pulmonary hypertension
Authors: Wang Yu , Zeng Zhenyu , Zeng Zhaoxiang , Chu Guojun , Shan Xinghua
Published: July 2023

Background

Pulmonary arterial hypertension (PAH) is a highly prevalent cardiopulmonary disorder characterized by vascular remodeling and increased resistance in pulmonary artery. Mitochondrial coiled–coil–helix–coiled–coil–helix domain (CHCHD)-containing proteins have various important pathophysiological roles. However, the functional roles of CHCHD proteins in hypoxic PAH is still ambiguous. Here, we aimed to investigate the role of CHCHD4 in hypoxic PAH and provide new insight into the mechanism driving the development of PAH.

Methods

Serotype 1 adeno‐associated viral vector (AAV) carrying Chchd4 was intratracheally injected to overexpress CHCHD4 in Sprague Dawley (SD) rats. The Normoxia groups of animals were housed at 21% O2. Hypoxia groups were housed at 10% O2, for 8 h/day for 4 consecutive weeks. Hemodynamic and histological characteristics are investigated in PAH. Primary pulmonary artery smooth muscle cells of rats (PASMCs) are used to assess how CHCHD4 affects proliferation and migration.

Results

We found CHCHD4 was significantly downregulated among CHCHD proteins in hypoxic PASMCs and lung tissues from hypoxic PAH rats. AAV1-induced CHCHD4 elevation conspicuously alleviates vascular remodeling and pulmonary artery resistance, and orchestrates mitochondrial oxidative phosphorylation in PASMCs. Moreover, we found overexpression of CHCHD4 impeded proliferation and migration of PASMCs. Mechanistically, through lung tissues bulk RNA-sequencing (RNA-seq), we further identified CHCHD4 modulated mitochondrial dynamics by directly interacting with SAM50, a barrel protein on mitochondrial outer membrane surface. Furthermore, knockdown of SAM50 reversed the biological effects of CHCHD4 overexpression in isolated PASMCs.

Conclusions

Collectively, our data demonstrated that CHCHD4 elevation orchestrates mitochondrial oxidative phosphorylation and antagonizes aberrant PASMC cell growth and migration, thereby disturbing hypoxic PAH, which could serve as a promising therapeutic target for PAH treatment.

Graphical Abstract
Can a passive unilateral hip exosuit diminish walking asymmetry? A randomized trial
Authors: Kowalczyk Kayla , Mukherjee Mukul , Malcolm Philippe
Published: July 2023

Background

Asymmetric walking gait impairs activities of daily living in neurological patient populations, increases their fall risk, and leads to comorbidities. Accessible, long-term rehabilitation methods are needed to help neurological patients restore symmetrical walking patterns. This study aimed to determine if a passive unilateral hip exosuit can modify an induced asymmetric walking gait pattern. We hypothesized that a passive hip exosuit would diminish initial- and post-split-belt treadmill walking after-effects in healthy young adults.

Methods

We divided 15 healthy young adults evenly between three experimental groups that each completed a baseline trial, an adaptation period with different interventions for each group, and a post-adaptation trial. To isolate the contribution of the exosuit we compared a group adapting to the exosuit and split-belt treadmill (Exo-Sb) to groups adapting to exosuit-only (Exo-only) and split-belt only (Sb-only) conditions. The independent variables step length, stance time, and swing time symmetry were analyzed across five timepoints (baseline, early- and late adaptation, and early- and late post-adaptation) using a 3 × 5 mixed ANOVA.

Results

We found significant interaction and time effects on step length, stance time and swing time symmetry. Sb-only produced increased step length asymmetry at early adaptation compared to baseline (p < 0.0001) and an after-effect with increased asymmetry at early post-adaptation compared to baseline (p < 0.0001). Exo-only increased step length asymmetry (in the opposite direction as Sb-only) at early adaptation compared to baseline (p = 0.0392) but did not influence the participants sufficiently to result in a post-effect. Exo-Sb produced similar changes in step length asymmetry in the same direction as Sb-only (p = 0.0014). However, in contrast to Sb-only there was no significant after-effect between early post-adaptation and baseline (p = 0.0885).

Conclusion

The passive exosuit successfully diminished asymmetrical step length after-effects induced by the split-belt treadmill in Exo-Sb. These results support the passive exosuit’s ability to alter walking gait patterns.