bluuebunny/crossref_metadata_2025 huggingface dataset:
HIV‐1 integrase inhibitor raltegravir promotes DNA damage‐induced apoptosis in multiple myeloma
Authors: Akcora‐Yildiz Dilara , Gonulkirmaz Nurbanu , Ozkan Tulin , Beksac Meral , Sunguroglu Asuman
Published: April 2023

Raltegravir, the first integrase inhibitor approved for the treatment of HIV infection, has been implicated as a promising potential in cancer treatment. Therefore, the present study aimed to investigate the repurposing of raltegravir as an anticancer agent and its mechanism of action in multiple myeloma (MM). Human MM cell lines (RPMI‐8226, NCI H929, and U266) and normal peripheral blood mononuclear cells (PBMCs) were cultured with different concentrations of raltegravir for 48 and 72 h. Cell viability and apoptosis were then measured by MTT and Annexin V/PI assays, respectively. Protein levels of cleaved PARP, Bcl‐2, Beclin‐1, and phosphorylation of histone H2AX were detected by Western blotting. In addition, the mRNA levels of V(D)J recombination and DNA repair genes were analyzed using qPCR. Raltegravir treatment for 72 h significantly decreased cell viability, increased apoptosis, and DNA damage in MM cells while having minimum toxicity on cell viability of normal PBMCs approximately from 200 nM (0.2 μM; p < .01 for U66 and p < .0001 for NCI H929 and RPMI 8226 cells). Furthermore, raltegravir treatment altered the mRNA levels of V(D)J recombination and DNA repair genes. We report for the first time that treatment with raltegravir is associated with decreased cell viability, apoptosis induction, DNA damage accumulation, and alteration of mRNA expression of genes involved in V(D)J recombination and DNA repair in MM cell lines, all of which show its potential for anti‐myeloma effects. Hence, raltegravir may significantly impact the treatment of MM, and further studies are required to confirm its efficacy and mechanism of action in more detail in patient‐derived myeloma cells and in‐vivo models.
The effectiveness of a school mindfulness‐based intervention on the neural correlates of inhibitory control in children at risk: A randomized control trial
Authors: Andreu Catherine I. , García‐Rubio Carlos , Melcón María , Schonert‐Reichl Kimberly A. , Albert Jacobo
Published: April 2023

Interest in the applications of mindfulness practice in education is growing in the scientific community. Recent research has shown that mindfulness practice in schools may be beneficial for executive functions (EFs) which are abilities crucial for healthy development. The study of the effects of mindfulness practices on children's neural correlates of EFs, particularly inhibitory control, may provide relevant information about the impact and mechanisms of mindfulness‐based interventions (MBIs) in children. The aim of the present study was to investigate the effects of a MBI in elementary school children on the neural correlates of inhibitory control via a randomized controlled trial. Children from two 4th grade classrooms and two 5th grade classrooms located in a school identified as having low socioeconomic status in Santiago de Chile were randomly assigned to either receive a MBI or serve as active controls and receive a social skills program. Both before and after the interventions, electroencephalographic activity was recorded during a modified version of the Go/Nogo task in a subsample of children in each group. Additionally, teachers completed questionnaires of students’ EFs and students completed self‐report measures. Results revealed increases in EFs assessed by questionnaires together with improved P3 amplitude associated with successful response inhibition in children who received the MBI compared to active controls. These results contribute to the understanding of the ways in which mindfulness practices can promote the development of inhibitory control together with EF improvement, factors identified as critical for children's social and emotional development and positive mental health.

Research Highlights

This study investigated the effects of a mindfulness‐based intervention in children from a low socioeconomic status school on neural correlates of EFs.

Children performed a Go/Nogo task while electroencephalographic activity was recorded and completed questionnaires before and after a MBI or an active control program.

Improvements in EFs assessed by questionnaires together with an increased Nogo‐P3 activity associated with successful inhibition in children who received the MBI were found.

The results could contribute to understand how mindfulness practice can promote the development of inhibitory control in children from vulnerable populations.
Demographic resilience may sustain significant coral populations in a 2°C‐warmer world
Authors: Mason Robert A. B. , Bozec Yves‐Marie , Mumby Peter J.
Published: April 2023

Projections of coral reefs under climate change have important policy implications, but most analyses have focused on the intensification of climate‐related physical stress rather than explicitly modelling how coral populations respond to stressors. Here, we analyse the future of the Great Barrier Reef (GBR) under multiple, spatially realistic drivers which allows less impacted sites to facilitate recovery. Under a Representative Concentration Pathway (RCP) 2.6 CMIP5 climate ensemble, where warming is capped at ~2°C, GBR mean coral cover declined mid‐century but approached present‐day levels towards 2100. This is considerably more optimistic than most analyses. However, under RCP4.5, mean coral cover declined by >80% by late‐century, and reached near zero under RCP ≥6.0. While these models do not allow for adaptation, they significantly extend past studies by revealing demographic resilience of coral populations to low levels of additional warming, though more pessimistic outcomes might be expected under CMIP6. Substantive coral populations under RCP2.6 would facilitate long‐term genetic adaptation, adding value to ambitious greenhouse emissions mitigation.
Response to comments by Vauhkonen
Authors: Soimakallio Sampo , Böttcher Hannes , Niemi Jari , Mosley Fredric , Turunen Sara , Hennenberg Klaus Josef , Reise Judith , Fehrenbach Horst
Published: April 2023

Vauhkonen (2023) raised concerns regarding the applicability of the carbon balance indicator (CBI) applied in our paper (Soimakallio et al. 2022) to characterize the results in various contexts, the way the scenario pairs were compared, and the way the results were filtered. Here we respond to each of the above‐mentioned concerns Vauhkonen raised and finally to the conclusions that he drew.
Environmental impact of the production process of washing, assorting and packaging fresh potatoes and measures to mitigate it
Authors: Sáenz Mercedes , Latorre‐Biel Juan Ignacio , Martínez Eduardo , Jiménez Emilio , Longo Francesco , Blanco Julio
Published: April 2023

Potato is a tuber that, due to its great variety, is available in the markets all year round. Moreover, it is a widely consumed product worldwide on the account of its affordability and versatility. Therefore, studying it in depth is significant from not only a nutritional or economic point of view, but also for considering its potential environmental impact. In this paper, a Life Cycle Assessment (LCA) model is developed to assess the environmental impact of a model 5 kg bag of fresh washed potatoes. It considers all phases of potato processing, from the time the potato enters the facility until it leaves the gate (gate‐to‐gate LCA). The phase of the process with the greatest environmental impact is the cleaning and classification phase, mainly due to the significant consumption of water used in the cleaning process. The general consumption and storage phases are also relevant environmental impact phases to consider. In the case of these phases, the electricity consumption resulting from the operation of the facilities and product cooling is particularly noteworthy. After establishing the critical points, based on the environmental impact perspective, this paper proposes three measures to reduce the environmental impact of the process. The application of these three measures would reduce the environmental impact by 40% in environmental impact categories such as acidification or by 32% in the global warming category.
Fatty acid and triglyceride molecular species of milk fat fractionated by short‐path molecular distillation
Authors: Zhu Huiquan , Wang Xiaodan , Zhang Wenyuan , Zhang Yumeng , Gao Xixi , Wang Yunna , Gao Peng , Pang Xiaoyang , Zhang Shuwen , Lv Jiaping
Published: April 2023

Fractionation is important for the application of milk fat (MF). In this study, the contents of fatty acid (FA) and triglyceride (TAG) of MF and its fractions distilled by short‐path molecular distillation (SPMD) were detected. The results showed that a total of 19 FAs and 109 TAG molecular species were detected. Moreover, the short‐chain saturated FA, medium‐chain saturated FA, low‐molecular‐weight TAG, medium‐molecular‐weight TAG, S3 (TAG molecular species with three saturated FAs) and L2S (TAG molecular species with two long‐chain FAs and one short‐chain FA) were easily accumulated in the distillate, and the percentage of these components all increased first and then decreased during the whole distilling process. Compared with the distillate, polyunsaturated FA (PUFA) and high‐molecular‐weight TAG (HMW‐TAG, with the carbon numbers: 41–54 and molecular weight: 704–888) were enriched in the residue, and the increasing ratio of PUFA and HMW‐TAG was 393.75% and 8.58% respectively. Further analysis showed that the 16:0/4:0/16:0, 16:0/4:0/14:0, 16:0/12:0/4:0, etc. were the discrepant TAG molecular species during SPMD. Therefore, these results demonstrated that different fractions of MF could be obtained by adjusting the fractionation temperature, and it also would provide more important theoretical guidance for regulating MF fractionation, enriching the nutritional information of MF fractions.
Regulation of CD8 T‐cell signaling, metabolism, and cytotoxic activity by extracellular lysophosphatidic acid
Authors: Torres Raul M. , Turner Jacqueline A. , D'Antonio Marc , Pelanda Roberta , Kremer Kimberly N.
Published: April 2023

Lysophosphatidic acid (LPA) is an endogenous bioactive lipid that is produced extracellularly and signals to cells via cognate LPA receptors, which are G‐protein coupled receptors (GPCRs). Mature lymphocytes in mice and humans express three LPA receptors, LPA2, LPA5, and LPA6, and work from our group has determined that LPA5 signaling by T lymphocytes inhibits specific antigen‐receptor signaling pathways that ultimately impair lymphocyte activation, proliferation, and function. In this review, we discuss previous and ongoing work characterizing the ability of an LPA‐LPA5 axis to serve as a peripheral immunological tolerance mechanism that restrains adaptive immunity but is subverted during settings of chronic inflammation. Specifically, LPA‐LPA5 signaling is found to regulate effector cytotoxic CD8 T cells by (at least) two mechanisms: (i) regulating the actin‐microtubule cytoskeleton in a manner that impairs immunological synapse formation between an effector CD8 T cell and antigen‐specific target cell, thus directly impairing cytotoxic activity, and (ii) shifting T‐cell metabolism to depend on fatty‐acid oxidation for mitochondrial respiration and reducing metabolic efficiency. The in vivo outcome of LPA5 inhibitory activity impairs CD8 T‐cell killing and tumor immunity in mouse models providing impetus to consider LPA5 antagonism for the treatment of malignancies and chronic infections.
Alcohol, the gut microbiome, and liver disease
Authors: Jew Michael H , Hsu Cynthia L
Published: April 2023

The microorganisms inhabiting our gastrointestinal tract are critical for human health. Chronic heavy alcohol use can modulate the composition and function of the gut microbiota, thereby exacerbating end‐organ damage via the gut–brain axis and the gut–liver axis. In this review, we summarize the bacterial, fungal, and viral gut microbial compositional changes associated with alcohol use and alcohol‐associated liver disease and discuss the mechanisms of action by which gut dysbiosis reinforces alcohol use behavior and liver inflammation and injury. We also highlight important pre‐clinical and clinical trials that target gut microbial‐specific mechanisms for the treatment of alcohol use disorder and alcohol‐associated liver disease.
Coffee Shop Owners as Unexpected Tourist Guides in İstanbul's Fener, Balat, and Ayvansaray Neighbourhoods
Authors: Karakılıç İlhan Zeynep , Narlı Ayşe Nilüfer
Published: April 2023

This study aims to understand how the durability of the past may be visible in a place whose past is constantly reinterpreted and unintentionally remade by coffee shop owners in their conversations with their customers in the framework of ongoing economic transformations while they weave their own identities into that of the neighbourhood. In the absence of any readily available information about the history of the area, the coffee shop owners of the Fener, Balat, and Ayvansaray neighbourhoods of İstanbul interpret the cosmopolitan past of the area within the limitations of the materiality of these neighbourhoods under the influence of economic conditions. In this respect, while this article shows how social memory is commodified and tamed for daily usage, it also argues that it is a process that includes different actors and their interpretations, and that this process is bounded by the materiality and durability of the past.
Cancer disparities in Appalachian Kentucky
Authors: Hudson Lauren , Burus Todd , Park Lee , Huang Bin , Hull Pamela C. , Vanderford Nathan L.
Published: April 2023

Purpose

Cancer is the second leading cause of death in the United States, and the disease burden is elevated in Appalachian Kentucky, due in part to health behaviors and inequities in social determinants of health. This study's goal was to evaluate Appalachian Kentucky's cancer burden compared to non‐Appalachian Kentucky, and Kentucky compared to the United States (excluding Kentucky).

Methods

The following data were analyzed: annual all‐cause and all‐site cancer mortality rates from 1968 to 2018; 5‐year all‐site and site‐specific cancer incidence and mortality rates from 2014 to 2018; aggregated screening and risk factor data from 2016 to 2018 for the United States (excluding Kentucky), Kentucky, non‐Appalachian Kentucky, and Appalachian Kentucky; and human papilloma virus vaccination prevalence by sex from 2018 for the United States and Kentucky.

Findings

Since 1968, the United States has experienced a large decrease in all‐cause and cancer mortality, but the reduction in Kentucky has been smaller and slower, driven by even smaller and slower reductions within Appalachian Kentucky. Appalachian Kentucky has higher overall cancer incidence and mortality rates and higher rates for several site‐specific cancers compared to non‐Appalachian Kentucky. Contributing factors include screening rate disparities and increased rates of obesity and smoking.

Conclusions

Appalachian Kentucky has experienced persistent cancer disparities, including elevated all‐cause and cancer mortality rates for 50+ years, widening the gap between this region and the rest of the country. In addition to addressing social determinants of health, increased efforts aimed at improving health behaviors and increased access to health care resources could help reduce this disparity.
Gray matter reserve determines glymphatic system function in young‐onset Alzheimer's disease: Evidenced by DTI‐ALPS and compared with age‐matched controls
Authors: Chang Hsin‐I , Huang Chi‐Wei , Hsu Shih‐Wei , Huang Shu‐Hua , Lin Kun‐Ju , Ho Tsung‐Ying , Ma Mi‐Chia , Hsiao Wen‐Chiu , Chang Chiung‐Chih
Published: April 2023

Background

The diffusion tensor imaging analysis along the perivascular space (ALPS)‐index can be used to model the glymphatic system in vivo.

Aim

This study explores putative mechanisms between prediction of ALPS‐index and cognitive outcomes in young‐onset Alzheimer's disease (YOAD) and age‐matched controls (CTLs) and analyzes whether the link was mediated by the integrity of ALPS‐index‐anchored cerebral gray matter (GM).

Methods

We enrolled 130 patients with YOAD and 137 CTLs. All participants underwent three‐dimensional T1‐weighted MRI, diffusion tensor imaging and cognitive tests. We constructed GM regions correlated with the ALPS‐index in the YOAD and CTL groups. For the GM regions significantly correlated with the ALPS‐index and cognitive measures, we extracted a 4‐mm radius sphere. In the YOAD and CTL groups, we used mediator analysis to explore the ALPS‐index as predictor, GM partitions as mediators, and significant cognitive test scores as outcomes.

Results

Patient group had significantly lower ALPS‐index. The ALPS‐index was associated with GM volume in the cerebellar gray, dorsolateral prefrontal, thalamus, superior frontal, amygdala and hippocampus, and these coherent regions coincided with those showing GM atrophy in the YOAD group. Mediation analysis of the YOAD group suggested that the relationships between the ALPS‐index and cognitive performance were fully mediated by the integrity of ALPS‐index coherent GM areas.

Discussion

Reserved GM mediates the link between the glymphatic system and cognition. Our findings suggest that GM integrity rather than the glymphatic system could serve as a direct cognitive test scores predictor in patients with YOAD.
The politics of animal welfare: A scoping review of farm animal welfare governance
Authors: Hårstad Renate Marie Butli
Published: April 2023

The lack of research in farm animal welfare governance is noticeable given how political science traditionally describes the agricultural field as politicized, i.e., subject to private and public regulations and governance. This paper shows how this issue is making its way into social and political science by using a scoping review methodology to map and analyze what exists in the research literature on farm animal welfare governance from 2000 to 2021. In evaluating drivers in farm animal governance, the literature points to increasing public concern. This is not necessarily because it changes the public's actions, but rather give legitimacy to actors to drive change in other domains such as research and the market. This review identifies retailers and animal welfare organizations as key actors in private farm animal welfare governance. Public government and political parties are perceived as “slower drivers,” thus leaving room for private governance.
The role of employee assistance programs under COVID‐19‐induced work–family conflict: Effects on service employees' work engagement and burnout
Authors: Tsai Hung‐Yu
Published: April 2023

The COVID‐19 pandemic places substantial stress on service employees’ work and home lives. Little research has explored the negative effects of perceived stress from COVID‐19 on work and home domains in terms of employees’ attitudes toward work. We adopt a job demands–resources perspective to examine how perceived stress from COVID‐19 affects employees' work (i.e., work engagement and burnout) and home life (i.e., work–family conflict and family–work conflict). In particular, we address whether organizational employee assistance programs can buffer these negative effects. We sampled service employees (n = 248), and results show that perceived stress from COVID‐19 increases work engagement and burnout through work–family conflict and family–work conflict. Furthermore, employee assistance programs mean that employees are less likely to experience work–family conflict and family–work conflict when faced with perceived stress from COVID‐19. We discuss the theoretical and practical implications of these findings and propose directions for future research.
La articulación urbana de conjuntos cerrados. Estudio de caso en la localidad de Suba, Bogotá
Authors: Arango De Vengoechea Irene
Published: April 2023

En la actualidad más de un tercio de los hogares de Bogotá vive en conjuntos cerrados. Desde el año 2000, esta es la forma predominante de construcción de vivienda formal en la ciudad. El nuevo patrón urbano tiende a segregar las poblaciones, privatizar la seguridad y transformar negativamente el espacio público. La proliferación del modelo de ciudad de conjuntos cerrados y centros comerciales genera, además, una desarticulación urbana que evidencia un creciente problema de planificación. En este artículo se proponen lineamientos y estrategias para enfrentar esta problemática a partir del análisis histórico, planimétrico y normativo de un área objeto de estudio en la ciudad de Bogotá. El estudio se desarrolla en la localidad de Suba, por ser esta una de las zonas con mayor aglomeración de conjuntos cerrados en la ciudad, lo que la convierte en un caso ideal para investigar y proponer soluciones al fenómeno urbano global
Espacios públicos resilientes, una aproximación desde el diseño participativo con niños
Authors: López Valencia Adriana Patricia , Villa Velasco Crhistian Camilo , López Bernal Oswaldo
Published: April 2023

Este artículo presenta una reflexión sobre el desarrollo de ejercicios de diseño participativo para la intervención resiliente del espacio público, desde el aporte de los niños como actores principales del proceso y con un enfoque “de abajo hacia arriba” para la reducción de la vulnerabilidad frente a inundaciones. El texto analiza los aportes en el campo del diseño urbano de las apuestas creativas desarrolladas por los niños, a partir del diálogo y trabajo colaborativo alrededor del concepto de resiliencia, presentando como principales resultados intervenciones urbanas que permiten alcanzar tres objetivos: i) técnico, al cumplir una función de mitigación; ii) educativo, al servir de escenario interactivo para el aprendizaje de conceptos ambientales; y iii) recreativo, al consolidarse como espacios públicos para el disfrute de la comunidad. Así, se establece una relación directa para la apropiación de los proyectos de diseño urbano cuando el proceso de planificación y construcción se desarrolla de manera incluyente.
Christotopia: Spaces of Christ
Authors: Guerra Danilo Dourado
Published: April 2023

In this article, driven by the hermeneutics of the phenomenon and specialties, I propose the structuring of a theoretical-theological framework capable of identifying the categories and elements inherent to the antagonism between good and evil present in the order of created things, substantially in the human ontology. In this epistemological path, by the methodological option, I will go through the syntagmatic itinerary of evil, in its nuances and territorial thanatopic demarcations to antagonistically demonstrate the elements and traits that constitute the good that orbits the entire divine cosmogenesis. These elements that involve the positive response of humanity seen from the ethical and moral evaluative praxis to the paradigm of human faith shown in the lives of individuals and societies, the framing of the spatial specter of opposition to chaos in the midst of it. These spaces of axiological opposition and cosmic redemption are generated from the (in)carnational ontological-territorial phenomenon of the manifestation of the (trans)forming presence of Christ and his Basileia, through which the Christophanic theophany in its immanent transcendence reveals to us the heterotopic molds what I call Christotopia, the spaces of Christ.They are theotopic spaces from outside, but substantially, biotopic spaces from inside. They are spaces of life and meaning in which christophany is established in a diametrically opposed way to spaces of death and non-meaning which are installed throughout time and society in all its spheres. In the light of Foucault’s heterotopic metaphor, the Christotopias focus on human existence and can be seen as boats launched into the infinite sea of the thanatopic cosmos. The Christotopias are places without a place; places of re-signification and survival; spaces of faith and decision, life and salvation, palpable spaces of overlapping deviation from death, closed, but at the same time open, spaces of art, poetry and melody amidst the noises of this world, real places where utopias become realizable, palpable, and dreams in Jesus Christ become possible.
Cross-Lagged Associations Between Physical Activity, Self-Rated Health, and Psychological Resilience Among Older American Adults: A 3-Wave Study
Authors: Lee Sunwoo
Published: April 2023

The current study examined the reciprocal association between psychological resilience, physical activity, and self-rated health in older America adults. A 3-wave cross-lagged panel design was employed using data sampled from the Health and Retirement Study 2010, 2014, and 2018. In total, 8380 older adults, age ranged between 56 and 95 years at the baseline (mean age = 68.06, SD = 7.77), were analyzed. Using structural equation modeling, standardized path coefficients were estimated to determine the relationship between physical activity, self-rated health, and psychological resilience across 2 follow-up points. Cross-lagged analysis revealed that higher levels of physical activity at T1 and T2 were significantly associated with higher levels of self-rated health at T2 and T3, respectively. Self-rated health at T1 and T2 were significantly associated with physical activity at T2 and T3, respectively. Self-rated health and psychological resilience were positively related to one another at each time point. However, relationship between physical activity and psychological resilience was complex across time. Study findings support reciprocal prospective relationship between physical activity and self-rated health and the relationship between self-rated health and psychological resilience.
Promoting Science Literacy and Awareness across the Globe: the Role of Scientists as Science Ambassadors
Authors: Tuttle Matthew J. , Cejas Daniela , Kang Donghoon , Muchaamba Francis , Goncarovs Britta , Ozakman Yaprak , Aziz Fatima , Orelle Arnaud
Published: April 2023

Science literacy has many personal and societal benefits that allows for better informed decision-making. Although the importance of science literacy is recognized globally, there are many challenges associated with its promotion.
A Structure-Guided Genetic Modification Strategy: Developing Seneca Valley Virus Therapy against Nonsensitive Nonsmall Cell Lung Carcinoma
Authors: Zhao Zekai , Cao Lin , Sun Zixian , Liu Wenqiang , Li Xiangmin , Fang Kui , Shang Xianfei , Hu Junjie , Chen Huanchun , Lou Zhiyong , Qian Ping
Published: April 2023

Nonsmall cell lung cancer (NSCLC) accounts for approximately 85% of lung cancer cases (more than 1.85 million cases with 1.48 million deaths in 2020). In the present study, two novel oncolytic SVV mutants modified based on structural biology and reverse genetics (viral receptor-associated mutant SVV-S177A and viral antigenic peptide-related mutant SVV-S177A/P60S) with increased infectivity or lower immunogenicity significantly (
P
< 0.001) prolonged the mOS from 11 days in the control cohort to 23 days in the SVV-S177A cohort and the SVV-S177A/P60S cohort in the NSCLC-bearing athymic mouse model, which may provide the direction for modifying SVV to improve the effect of oncolysis.
The TexNet-CISR collaboration and steps toward understanding induced seismicity in Texas
Authors: Hennings Peter H. , Young Michael H.
Published: April 2023

Diverse seismicity-prone geologic systems are located in Texas, USA. These systems include areas of tectonically natural earthquakes and areas with induced seismicity stemming from multiple factors. Some systems are geologically and operationally simple, such as the Fort Worth Basin, where multiple lines of peer-reviewed evidence indicate that earthquakes have been induced by injection of oil-field wastewater above the geologic basement, and the Eagle Ford region, where earthquakes have been induced principally by hydraulic fracturing activities. Other systems are far more complex, such as the Texas Panhandle, where natural seismicity and induced seismicity coexist, and the Delaware Basin, where wastewater disposal both above and below shale targets and hydraulic fracturing coexist with induced seismic events. Although cases of induced seismicity were documented in Texas as early as the 1980s, the public’s attention and formal regulatory actions occurred after substantial increases in seismicity were observed proximal to unconventional hydrocarbon reservoir development in the Dallas–Fort Worth metropolitan area. These actions, intended to mitigate induced seismicity, included creation of the Texas-funded TexNet Earthquake Monitoring Program in 2015 and the formation of the industry-sponsored Center for Integrated Seismicity Research in 2016, implementing policy changes by the Railroad Commission of Texas, and altering field activities by the petroleum industry. A public-private partnership was established in Texas for monitoring earthquakes, conducting research on causation and evolving risk, and developing approaches for mitigation. This partnership between stakeholders represents a major concerted effort to address the evolving environmental hazards of induced seismicity. Even with these actions, however, the total number of earthquakes with ML ≥ 2.0 cataloged in Texas reached a record high of 2601 in 2022, representing more than double the number of earthquakes that occurred in 2020 and more than eight times the number that occurred in 2017. This chapter provides a recent history of seismicity in specific areas of Texas and the monitoring, research, and regulatory actions taken to mitigate induced seismicity.
Improving prehospital traumatic shock care: implementation and clinical effectiveness of a pragmatic, quasi-experimental trial in a resource-constrained South African setting
Authors: Mould-Millman Nee-Kofi , Dixon Julia , Beaty Brenda L , Suresh Krithika , de Vries Shaheem , Bester Beatrix , Moreira Fabio , Cunningham Charmaine , Moodley Kubendhren , Cermak Radomir , Schauer Steven G , Maddry Joseph K , Bills Corey B , Havranek Edward P , Bebarta Vikhyat S , Ginde Adit A
Published: April 2023

Objectives

This project seeks to improve providers’ practices and patient outcomes from prehospital (ie, ambulance-based) trauma care in a middle-income country using a novel implementation strategy to introduce a bundled clinical intervention.

Design

We conduct a two-arm, controlled, mixed-methods, hybrid type II study.

Setting

This study was conducted in the Western Cape Government Emergency Medical Services (EMS) system of South Africa.

Interventions

We pragmatically implemented a simplified prehospital bundle of trauma care (with five core elements) using a novel workplace-based, peer-to-peer, rapid training format. We assigned the intervention and control sites.

Outcome measures

We assessed implementation effectiveness among EMS providers and stakeholders, using the RE-AIM framework. Clinical effectiveness was assessed at the patient level, using changes in Shock Index x Age (SIxAge). Indices and cut-offs were established a priori. We performed a difference-in-differences (D-I-D) analysis with a multivariable mixed effects model.

Results

198 of 240 (82.5%) EMS providers participated, 93 (47%) intervention and 105 (53%) control, with similar baseline characteristics. The overall implementation effectiveness was excellent (80.6%): reach was good (65%), effectiveness was excellent (87%), implementation fidelity was good (72%) and adoption was excellent (87%). Participants and stakeholders generally reported very high satisfaction with the implementation strategy citing that it was a strong operational fit and effective educational model for their organisation. A total of 770 patients were included: 329 (42.7%) interventions and 441 (57.3%) controls, with no baseline differences. Intervention arm patients had more improved SIxAge compared with control at 4 months, which was not statistically significant (−1.4 D-I-D; p=0.35). There was no significant difference in change of SIxAge over time between the groups for any of the other time intervals (p=0.99).

Conclusions

In this quasi-experimental trial of bundled care using the novel workplace rapid training approach, we found overall excellent implementation effectiveness but no overall statistically significant clinical effectiveness.
Doctors’ experiences of referring and admitting patients to the intensive care unit: a qualitative study of doctors’ practices at two tertiary hospitals in Malawi
Authors: Gundo Rodwell , Kayambankadzanja, Raphael Kazidule , Chipeta Deliwe , Gundo Beatrice , Chikumbanje Singatiya Stella , Baker Tim
Published: April 2023

Objective

To explore doctors’ experiences of referring and admitting patients to the intensive care unit (ICU) at two tertiary hospitals in Malawi.

Design

This was a qualitative study that used face-to-face interviews. The interviews were audiotaped and transcribed verbatim into English. The data were analysed manually through conventional content analysis.

Setting

Two public tertiary hospitals in the central and southern regions of Malawi. Interviews were conducted from January to June 2021.

Participants

Sixteen doctors who were involved in the referral and admission of patients to the ICU.

Results

Four themes were identified namely, lack of clear admission criteria, ICU admission requires a complex chain of consultations, shortage of ICU resources, and lack of an ethical and legal framework for discontinuing treatment of critically ill patients who were too sick to benefit from ICU.

Conclusion

Despite the acute disease burden and increased demand for ICU care, the two hospitals lack clear processes for referring and admitting patients to the ICU. Given the limited bed space in ICUs, hospitals in low-income countries, including Malawi, need to improve or develop admission criteria, severity scoring systems, ongoing professional development activities, and legislation for discontinuing intensive care treatments and end-of-life care.
How do the older adults in nursing homes live with dignity? A protocol for a meta-synthesis of qualitative research
Authors: Sunzi Kejimu , Li Yadi , Lei Cheng , Zhou Xin
Published: April 2023

Introduction

As the population continuous to age and family sizes decrease, residing in nursing homes has emerged as a crucial option for older adults’ care. Ensuring a dignified life for older adults in nursing homes is critical for enhancing their overall quality of life. The primary objective of this study is to synthesise the evidence of qualitative research on the feelings and experiences of dignity among older adults living in nursing homes. This will enable a better understanding of the factors influencing the perception of dignity and its preservation, ultimately assisting older adults in achieving a more comfortable and fulfilling experience in nursing homes.

Methods and analysis

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses will guide this meta-synthesis. We conducted an initial search on 1 June 2022, for studies published between the inception of each database and 2022, using the population exposure-outcome nomenclature. We searched the Embase, Web of Science, CINAHL, Cochrane Library and PubMed databases for relevant studies. For data synthesis, we will employ the Ritchie and Spencer framework, and the Supporting the Use of Research Evidence Framework will be used for data analysis. To minimise the risk of bias, we will critically appraise the selected studies using the Qualitative Assessment and Review Instrument.

Ethics and dissemination

This review does not involve human participants and, therefore, does not necessitate ethical approval. We plan to disseminate the protocol and findings through relevant channels, including publication in pertinent journals, presentations at conferences and symposia, and engagement with local and international health stakeholders.

PROSPERO registration number

CRD42022343983.

Conclusion

This study aims to offer comprehensive evidence to guide nursing staff in providing dignity-focused interventions for older adult residents in nursing homes.
Moral distress among intensive care unit professions in the UK: a mixed-methods study
Authors: Boulton Adam Jonathan , Slowther Anne-Marie , Yeung Joyce , Bassford Christopher
Published: April 2023

Objective

To assess the experience of moral distress among intensive care unit (ICU) professionals in the UK.

Design

Mixed methods: validated quantitative measure of moral distress followed by purposive sample of respondents who underwent semistructured interviews.

Setting

Four ICUs of varying sizes and specialty facilities.

Participants

Healthcare professionals working in ICU.

Results

227 questionnaires were returned and 15 interviews performed. Moral distress occurred across all ICUs and professional demographics. It was most commonly related to providing care perceived as futile or against the patient’s wishes/interests, followed by resource constraints compromising care. Moral distress score was independently influenced by profession (p=0.02) (nurses 117.0 vs doctors 78.0). A lack of agency was central to moral distress and its negative experience could lead to withdrawal from engaging with patients/families. One-third indicated their intention to leave their current post due to moral distress and this was greater among nurses than doctors (37.0% vs 15.0%). Moral distress was independently associated with an intention to leave their current post (p<0.0001) and a previous post (p=0.001). Participants described a range of individualised coping strategies tailored to the situations faced. The most common and highly valued strategies were informal and relied on working within a supportive environment along with a close-knit team, although participants acknowledged there was a role for structured and formalised intervention.

Conclusions

Moral distress is widespread among UK ICU professionals and can have an important negative impact on patient care, professional wellbeing and staff retention, a particularly concerning finding as this study was performed prior to the COVID-19 pandemic. Moral distress due to resource-related issues is more severe than comparable studies in North America. Interventions to support professionals should recognise the individualistic nature of coping with moral distress. The value of close-knit teams and supportive environments has implications for how intensive care services are organised.
Barriers and enablers to healthcare system uptake of direct oral anticoagulants for stroke prevention in atrial fibrillation: a qualitative interview study with healthcare professionals and policy makers in England
Authors: Medlinskiene Kristina , Richardson Susan , Petty Duncan , Stirling Katherine , Fylan Beth
Published: April 2023

Objective

To better understand the factors influencing the uptake of direct oral anticoagulants (DOACs) across different health economies in National Health Service England from the perspective of health professionals and other health economy stakeholders.

Design

Qualitative interview study using a critical realism perspective and informed by the Diffusion of Innovations in Service Organisations model.

Setting

Three health economies in the North of England, United Kingdom.

Participants

Healthcare professionals involved in the management of patients requiring oral anticoagulants, stakeholders involved in the implementation of DOACs and representatives of pharmaceutical industry companies and patient support groups.

Intervention

Semistructured interviews (face-to-face or telephone) were conducted with 46 participants. Interviews were analysed using the Framework method.

Results

Identified factors having an impact on the uptake of DOACs were grouped into four themes: perceived value of the innovation, clinician practice environment, local health economy readiness for change, and the external health service context. Together, these factors influenced what therapy options were offered and prescribed to patients with atrial fibrillation. The interviews also highlighted strategies used to improve or restrict the uptake of DOACs and tensions between providing patient-centred care and managing financial implications for commissioners.

Conclusions

The findings contribute to the wider literature by providing a new and in-depth understanding on the uptake of DOACs. The findings may be applicable to other new medicines used in chronic health conditions.
Diabetes mellitus monitoring and control among adults in Australian general practice: a national retrospective cohort study
Authors: Zheng Mingyue , Bernardo Carla , Stocks Nigel , Hu Peng , Gonzalez-Chica David
Published: April 2023

Objectives

This study investigated whether the monitoring and control of clinical parameters are better among patients with newly compared with past recorded diabetes diagnosis.

Design

Retrospective cohort study.

Setting

MedicineInsight, a national general practice database in Australia.

Participants

101 875 ‘regular’ adults aged 18+ years with past recorded (2015–2016) and 9236 with newly recorded (2017) diabetes diagnosis.

Main outcome measures

Two different groups of outcomes were assessed in 2018. The first group of outcomes was the proportion of patients with clinical parameters (ie, glycated haemoglobin A1c (HbA1c), blood pressure (BP), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, triglycerides, estimated glomerular filtration rate and albumin-to-creatinine ratio) monitored at least once in 2018. The second group of outcomes were those related to diabetes control in 2018 (HbA1c ≤7.0%, (BP) ≤140/90 mm Hg, total cholesterol <4.0 mmol/L and LDL-C <2.0 mmol/L). Adjusted ORs (ORadj) and adjusted probabilities (%) were obtained based on logistic regression models adjusted for practice variables and patients’ socio-demographic and clinical characteristics.

Results

The study included 111 111 patients (51.7% men; mean age 65.3±15.0 years) with recorded diabetes diagnosis (11.0% of all 1 007 714 adults in the database). HbA1c was monitored in 39.2% (95% CI 36.9% to 41.6%) of patients with newly recorded and 45.2% (95% CI 42.6% to 47.8%) with past recorded diabetes (ORadj0.78, 95% CI 0.73 to 0.82). HbA1c control was achieved by 78.4% (95% CI 76.7% to 80.0%) and 54.4% (95% CI 53.4% to 55.4%) of monitored patients with newly or past recorded diabetes, respectively (ORadj3.11, 95% CI 2.82 to 3.39). Less than 20% of patients with newly or past recorded diabetes had their HbA1c, BP and total cholesterol levels controlled (ORadj1.08, 95% CI 0.97 to 1.21).

Conclusions

The monitoring of clinical parameters was lower among patients with newly than past recorded diabetes. However, diabetes control was similarly low in both groups, with only one in five monitored patients achieving control of all clinical parameters.
Encouragement of patients’ self-management in primary care for the prevention of cardiovascular diseases (DECADE): protocol for a cluster randomised controlled trial
Authors: Tinsel Iris , Schmoor Claudia , Börger Maja , Kamp Melanie , Kaier Klaus , Hardt Hanna , Kloppe Thomas , Rakebrandt Anja , Scherer Martin , Bergmann Antje , Görbing Tina , Kutter Susanne , Riemenschneider Henna , Maun Andy
Published: April 2023

Introduction

Cardiovascular diseases are the most common cause of death in Germany and among the most frequent reasons for encounters in primary care. Most patients with cardiovascular risks (CVRs) have difficulties implementing health-promoting behavioural changes. In this study, a complex intervention containing evidence-based patient materials and structured follow-up consultations are intended to strengthen patients’ self-management to improve health behaviour.

Methods and analysis

In this cluster randomised controlled trial, we investigate the effects of the intervention "Decision aid, action planning and follow-up support for patients to reduce the 10-year risk of cardiovascular diseases" (DECADE) using a 2×2 design. All patients, including the control group (CG), receive a CVR calculation. Three intervention groups (IGs) receive one or both of two different components of the DECADE intervention: IG1 (patient materials), IG2 (follow-up consultations) and IG3 (patient materials and follow-up consultations). The study was planned to be conducted with 77 general practitioners in 3 German regions and a target sample size of 924 patients. The observation period for each patient amounts to 12 months with three patient surveys: baseline (t0), after 6 and 12 months (t1 and t2). The primary outcome is patient activation (Patient Activation Measure 13 (PAM13-D)) at t1. Secondary outcomes include PAM13-D at t2 and further patient-reported and clinical outcomes at t1 and t2. We will also analyse the cost-effectiveness of the intervention, the degree of usage and satisfaction with the intervention.

Ethics and dissemination

The study was first approved by the lead ethics committee of the University of Freiburg on 15 April 2021 (vote number: 21-1078) and subsequently by the other ethics committees in the study regions (Ethics committee of medical association Baden-Württemberg (B-F-2021-078), Ethics Committee of the Technische Universität Dresden, Dresden (BO-EK-251052021), Ethics Committee of the State Chamber of Physicians of Saxony (EK-BR-92/21-1), Ethics Committee of the Hamburg Medical Association (2021-200013-BO-bet)). Informed consent is required for patients to participate in the study. The results of this study will be published in peer-reviewed journals and presented at congresses by the DECADE team. The DECADE lead management will communicate the results to the funder of this study.

Trial registration number

German Clinical Trials Register, DRKS00025401 (registration date: 21 June 2021); International Clinical Trials Registry Platform, DRKS00025401.
Comprehensive workplace intervention for cancer prevention in China (WECAN): protocol for a stepped-wedge, cluster-randomised controlled trial
Authors: Li Yuan , Sun Kaige , Wang Baohua , Wang Ning , Luo Rong , Wang Changqiong , Liu Yu , Duffy Stephen , MacGregor Graham A , Wu Jing , He Feng J , Zhang Puhong
Published: April 2023

Introduction

Cancer is the second leading cause of death across the globe with the majority of deaths occurring in low-income and middle-income countries. Evidence has shown that the cancer burden can be substantially reduced by avoiding behavioural risk factors through comprehensive intervention strategies, including workplace health promotion, which has shown to be cost-effective in developed countries while rarely conducted in developing countries. This study aims to explore a feasible and sustainable approach to the prevention and control of cancer in China by developing an evidence-based comprehensive workplace health model equipped with a smartphone application for implementation.

Methods and analysis

This study is designed as a stepped-wedge, cluster-randomised controlled trial. We will recruit 15 workplaces from three cities in China. A total of 750 employees will be randomly selected for evaluation that includes five rounds of survey conducted every 6 months. After the second evaluation, workplaces will be randomly allocated to start the intervention sequentially every 6 months in three steps with five workplaces per step. A mobile application ‘Healthy Workplace’ will be developed to support the intervention. On-line and off-line health-related activities will be carried out among employees. Employers will provide supportive policies, environment and benefits to facilitate the adoption of healthy behaviours. The primary outcome is the change of Healthy Lifestyle Index Score, which consists of five components including smoking, alcohol drinking, physical activity, diet and body mass index.

Ethics and dissemination

The study has been approved by Queen Mary University of London Ethics of Research Committee (QMERC22.257) and Chinese Centre for Disease Control and Prevention Institutional Review Board (202210). Written informed consent is required from all participants. Results will be disseminated through presentations, publications and social media.

Trial registration number

ChiCTR2200058680.