bluuebunny/crossref_metadata_2025 huggingface dataset:
Free agents seeking for career support: exploring the expectations of skilled contingent workers vis-à-vis labour market intermediaries
Authors: Sulbout Jérôme , Pichault François
Published: August 2022

Purpose

Recent studies on contingent workers highlight their boundaryless and protean nature, and depict them as free agents who reject organisational forms of career support. Going beyond such current view, this paper aims to shed light on the career support provided by labour market intermediaries (LMIs) to skilled contingent workers (SCWs), the latter known as freelancers and consulting firms' employees.

Design/methodology/approach

Using a qualitative stance and an inductive approach, the authors draw on 33 interviews to grasp SCWs' discourses on the career support offered by LMIs, and their account managers. The thematic analysis reveals two main themes: the career support delivered by LMIs to SCWs, and the expectations of SCWs regarding potential additional forms of career support from LMIs.

Findings

The authors show that SCWs are supported by LMIs in their career via a number of career management practices and operational support, and account managers a likely to play a key role in the careers of SCWs by providing transactional and relational career support. Moreover, the authors stress that SCWs are free agents, yet seeking for forms of support from LMIs.

Originality/value

The present paper addresses the roles of LMIs regarding non-standard population of workers through the lens of SCWs, what has barely been undertaken in recent research. This paper also enriches current debates on the organisational support SCWs are willing to accept and benefit from, despite the idiosyncratic nature of their careers.
Service quality and students’ academic achievement
Authors: Peña-Lang María Begoña , Barrutia Jose M. , Echebarria Carmen
Published: August 2022

Purpose

This paper aims to propose and examine the relationship between students’ perception of service quality and dimensions and their academic achievement.

Design/methodology/approach

Based on the resource-based view, a conceptual relationship between service quality and dimensions and academic achievement is proposed and tested with a sample of 380 STEM university students who attended secondary schools in a region of Spain.

Findings

Service quality and four of its dimensions (i.e. empathy, reliability, responsiveness and assurance/confidence) could contribute to students’ academic achievement. The expected effect of tangible elements on academic achievement was not supported by the data. Results were controlled for student’s personal factors that have proven important in explaining academic achievement in previous studies (i.e. need for cognition, need for emotion and self-efficacy).

Originality/value

Previous research has extensively studied factors affecting students’ academic achievement. However, the direct relationship between service quality and student’s academic achievement has been rarely proposed and examined. Service quality has been mostly viewed as a precursor of student satisfaction and loyalty. This research views service quality as a school higher-order capability that supplements students’ capabilities.
The development of a radial based integrated network for the modelling of 3D fused deposition
Authors: AlAlaween Wafa' , Abueed Omar , Gharaibeh Belal , Alalawin Abdallah , Mahfouf Mahdi , Alsoussi Ahmad , Albashabsheh Nibal
Published: August 2022

Purpose

The purpose of this research paper is to investigate and model the fused deposition modelling (FDM) process to predict the mechanical attributes of 3D printed specimens.

Design/methodology/approach

By exploiting the main effect plots, a Taguchi L18 orthogonal array is used to investigate the effects of such parameters on three mechanical attributes of the 3D printed specimens. A radial-based integrated network is then developed to map the eight FDM parameters to the three mechanical attributes for both PEEK and PEKK. Such an integrated network maps and predicts the mechanical attributes through two consecutive phases that consist of several radial basis functions (RBFs).

Findings

Validated on a set of further experiments, the integrated network was successful in predicting the mechanical attributes of the 3D printed specimens. It also outperformed the well-known RBF network with an overall improvement of 24% in the coefficient of determination. The integrated network is also further validated by predicting the mechanical attributes of a medical-surgical implant (i.e. the MidFace Rim) as an application.

Originality/value

The main aim of this paper is to accurately predict the mechanical properties of parts produced using the FDM process. Such an aim requires modelling a highly dimensional space to represent highly nonlinear relationships. Therefore, a radial-based integrated network based on the combination of composition and superposition of radial functions is developed to model FDM using a limited number of data points.
Effects of chemical warfare agent decontaminants on trace survival: Impact on fingermarks deposited on glass
Authors: Radgen‐Morvant Isabelle , Kummer Natalie , Curty Christophe , Delémont Olivier
Published: August 2022

Following a chemical incident involving chemical warfare agents or more broadly, chemical weapons, there are two possible approaches in dealing with the traditional forensic analysis of contaminated exhibits. The first is to analyze the contaminated items under safe conditions (i.e. in laboratories dedicated to the handling of such substances), while the second relies on item decontamination prior to processing them in traditional forensic laboratories. One of the main limitations of the latter is the possible degradation or destruction of traces caused by the decontamination process. Hence, it is crucial to have as much information as possible on the impact of different decontamination agents and procedures on traces. This research presents experimental results on the recovery of fingermarks on glass after the application of decontaminants typically used in case of chemical incidents. The impact of 11 decontaminants on fingermarks deposited on glass and on the subsequent enhancement with cyanoacrylate and Small Particle Reagent (SPR) was evaluated (by visual examination) by four evaluators. The results of the study demonstrated that the persistence of fingermarks on glass is highly dependent on the type of decontaminant used. Decontamination agents based on the principle of nucleophilic substitution to neutralize toxic chemicals allowed good subsequent development of fingermarks with SPR. Powdered decontaminants did not show any indication of alteration of fingermarks, whereas decontamination with oxidants leads to variable results.
Dietary acid load and esophageal cancer risk: A case‐control study
Authors: Ronco Alvaro Luis , Martínez‐López Wilner , Calderón Juan M. , Storz Maximilian Andreas
Published: August 2022

Background

A high dietary acid load (DAL) can produce metabolic acidosis, which is linked to cancer development through mechanisms of inflammation and cell transformation. There is limited epidemiological evidence linking DAL and cancer risk; however, none of the published studies focused on DAL and esophageal cancer (EC) risk in particular. Therefore, we sought to explore this association in the present study.

Methods

A case‐control study was performed in 1295 male patients (185 squamous cell EC cases and 1110 age‐frequency and urban/rural residence matched controls) through a multitopic inquiry, including a food frequency questionnaire. Food‐derived nutrients were calculated from available databases. The DAL was calculated based on two validated measures: Potential renal acid load (PRAL) score and net endogenous acid production (NEAP) score. Odds ratios (OR) and their 95% confidence intervals (95% CI) were estimated by unconditional logistic regression, adjusting for confounders.

Results

We found direct, significant associations between dietary acid load and EC risk: (OR = 2.28, 95% CI: 1.44–3.61, ptrend <0.0001) and (OR = 2.17, 95% CI: 1.38–3.41, ptrend <0.0001) for highest PRAL and NEAP tertiles, respectively. Our data raise the possibility that a high DAL may contribute to EC development. Both acid load scores were directly associated with animal‐based foods (mainly meat) and inversely associated with the intake of plant‐based foods.

Conclusion

To the best of our knowledge, this is the first epidemiological case–control study analyzing associations of DAL and squamous cell EC risk. Further research is warranted to confirm our findings.
Metabolomic and transcriptomic signatures of influenza vaccine response in healthy young and older adults
Authors: Chou Chih‐Hung , Mohanty Subhasis , Kang Heather A. , Kong Lingjia , Avila‐Pacheco Julian , Joshi Samit R. , Ueda Ikuyo , Devine Lesley , Raddassi Khadir , Pierce Kerry , Jeanfavre Sarah , Bullock Kevin , Meng Hailong , Clish Clary , Santori Fabio R. , Shaw Albert C. , Xavier Ramnik J.
Published: August 2022

Seasonal influenza causes mild to severe respiratory infections and significant morbidity, especially in older adults. Transcriptomic analysis in populations across multiple flu seasons has provided insights into the molecular determinants of vaccine response. Still, the metabolic changes that underlie the immune response to influenza vaccination remain poorly characterized. We performed untargeted metabolomics to analyze plasma metabolites in a cohort of younger and older subjects before and after influenza vaccination to identify vaccine‐induced molecular signatures. Metabolomic and transcriptomic data were combined to define networks of gene and metabolic signatures indicative of high and low antibody response in these individuals. We observed age‐related differences in metabolic baselines and signatures of antibody response to influenza vaccination and the abundance of α‐linolenic and linoleic acids, sterol esters, fatty‐acylcarnitines, and triacylglycerol metabolism. We identified a metabolomic signature associated with age‐dependent vaccine response, finding increased tryptophan and decreased polyunsaturated fatty acids (PUFAs) in young high responders (HRs), while fatty acid synthesis and cholesteryl esters accumulated in older HRs. Integrated metabolomic and transcriptomic analysis shows that depletion of PUFAs, which are building blocks for prostaglandins and other lipid immunomodulators, in young HR subjects at Day 28 is related to a robust immune response to influenza vaccination. Increased glycerophospholipid levels were associated with an inflammatory response in older HRs to flu vaccination. This multi‐omics approach uncovered age‐related molecular markers associated with influenza vaccine response and provides insight into vaccine‐induced metabolic responses that may help guide development of more effective influenza vaccines.
Demographic drivers of the growth of the number of Aboriginal and Torres Strait Islander people living with dementia, 2016–2051
Authors: Temple Jeromey , Wilson Tom , Radford Kylie , LoGiudice Dina , Utomo Ariane , Anstey Kaarin J. , Eades Sandra
Published: August 2022

Objective

To examine the demographic drivers that contribute to the future growth in the population of Aboriginal and Torres Strait Islander peoples living with dementia in Australia.

Methods

Design: Multistate, Indigenous status, cohort component, population projection model. Setting: National‐level, Aboriginal and Torres Strait Islander population. Data: Data prepared by the Australian Bureau of Statistics on births, deaths, migration and identification change. Australian Institute of Health and Welfare estimates of dementia prevalence alongside estimates from several studies. Major outcome measures: Number of older people living with dementia alongside a decomposition of demographic drivers of growth.

Results

By 2051, the relative growth in the number of Aboriginal and Torres Strait Islander peoples aged 50+ with dementia ranges from 4½ to 5½ times (under three prevalence scenarios) its 2016 estimate. Cohort flow (the gradual movement of younger cohorts into the 50+ age group, and the depletion of older cohorts from death, over time) is a key driver of the growth in the number of older people living with dementia.

Conclusions

High growth in the number of people living with dementia poses implications for culturally appropriate care, health‐care access and support for Aboriginal and Torres Strait Islander families, carers and their communities.
What Do We Learn about Voter Preferences from Conjoint Experiments?
Authors: Abramson Scott F. , Kocak Korhan , Magazinnik Asya
Published: August 2022

Political scientists frequently interpret the results of conjoint experiments as reflective of majority preferences. In this article, we show that the target estimand of conjoint experiments, the average marginal component effect (AMCE), is not well defined in these terms. Even with individually rational experimental subjects, the AMCE can indicate the opposite of the true preference of the majority. To show this, we characterize the preference aggregation rule implied by the AMCE and demonstrate its several undesirable properties. With this result, we provide a method for placing bounds on the proportion of experimental subjects who prefer a given candidate feature. We describe conditions under which the AMCE corresponds in sign with the majority preference. Finally, we offer a structural interpretation of the AMCE and highlight that the problem we describe persists even when a model of voting is imposed.
Editorial: tripartite motif 26 inhibits hepatitis B virus replication and its genetic polymorphism predicts response to interferon treatment—towards a better understanding of interferon responsiveness in chronic hepatitis B
Authors: Peng Cheng‐Yuan
Published: August 2022

LINKED CONTENT

This article is linked to Luo et al papers. To view these articles, visit https://doi.org/10.1111/apt.17124 and https://doi.org/10.1111/apt.17181
Natural history and impact of irritable bowel syndrome‐type symptoms in inflammatory bowel disease during 6 years of longitudinal follow‐up
Authors: Fairbrass Keeley M. , Hamlin P. John , Gracie David J. , Ford Alexander C.
Published: August 2022

Background

The long‐term natural history and impact of irritable bowel syndrome (IBS)‐type symptoms on outcomes in inflammatory bowel disease (IBD) are uncertain.

Aim

To assess this in a longitudinal follow‐up study of patients in secondary care

Methods

We assessed the natural history of IBS‐type symptoms in IBD via Rome III criteria applied at baseline, and 2 and 6 years. We defined longitudinal disease activity as the need for glucocorticosteroids or flare, escalation, hospitalisation or intestinal resection. To assess healthcare utilisation, we recorded the number of outpatient clinic attendances and investigations. We also collected anxiety, depression and somatoform symptom scores and quality of life scores during follow‐up.

Results

Among 125 individuals with Rome III data at all three time points, only 41 (32.8%) never reported IBS‐type symptoms. Fifteen patients (12.0%) had IBS‐type symptoms at baseline that resolved, 19 (15.2%) had fluctuating symptoms, 35 (28.0%) had new‐onset symptoms, and 15 (12.0%) had persistent symptoms. Among more than 300 patients with IBD activity data, IBS‐type symptoms were not associated with an increased likelihood of the need for glucocorticosteroids or flare, escalation, hospitalisation or intestinal resection. However, the mean numbers of outpatient appointments and endoscopic investigations were significantly higher among those with IBS‐type symptoms. Anxiety, depression and somatoform symptom scores were significantly higher, and quality of life scores were significantly lower, in those reporting IBS‐type symptoms at least once during the study.

Conclusions

IBS‐type symptoms affected more than two‐thirds of patients with IBD during >6 years of follow‐up and were associated with increased healthcare utilisation, and worse anxiety, depression, somatoform symptom and quality of life scores, but not adverse disease activity outcomes.
The evolving role of checkpoint inhibitors in the treatment of urothelial carcinoma
Authors: Tang Guyu , Liu Jing , Qi Lin , Li Yuan
Published: August 2022

The most prevalent pathological subtype of bladder and upper urinary tract malignancy is urothelial carcinoma (UC). Traditional therapies mainly include surgical resection, chemotherapy and radiotherapy. Checkpoint inhibitors, which are monoclonal antibodies developed to specifically target immune checkpoint molecules, have recently emerged as potential treatment options for UC patients, especially those targeting the programmed cell death protein 1 (PD‐1) and its ligand (PD‐L1). However, anti‐PD‐1/PD‐L1 therapy does not work for a considerable number of UC patients. Current antitumour immunotherapy research hotspots include seeking biomarkers that might predict therapeutic effects and exploring novel immune checkpoint molecules crucial for the antitumour immune response. Hence, we will recapitulate the latest preclinical and clinical trials of 5 PD‐1/PD‐L1 inhibitors, 1 cytotoxic T‐lymphocyte‐associated protein 4 inhibitor and combination therapies for UC treatment, including combined immunotherapy and immunotherapy with chemotherapy or radiotherapy. We will also summarize other potential immune checkpoint molecules found in ongoing UC studies. Moreover, we will highlight the role of biomarkers linked with the oncological efficacy of anti‐PD‐1/PD‐L1 immunotherapy and address the mechanisms of immunotherapy drug resistance in UC, with the hope of providing more systematic guidance for its application and development.
Generalized Propensity Score Approach to Causal Inference with Spatial Interference
Authors: Giffin A. , Reich B. J. , Yang S. , Rappold A. G.
Published: August 2022

Many spatial phenomena exhibit interference, where exposures at one location may affect the response at other locations. Because interference violates the stable unit treatment value assumption, standard methods for causal inference do not apply. We propose a new causal framework to recover direct and spill-over effects in the presence of spatial interference, taking into account that exposures at nearby locations are more influential than exposures at locations further apart. Under the no unmeasured confounding assumption, we show that a generalized propensity score is sufficient to remove all measured confounding. To reduce dimensionality issues, we propose a Bayesian spline-based regression model accounting for a sufficient set of variables for the generalized propensity score. A simulation study demonstrates the accuracy and coverage properties. We apply the method to estimate the causal effect of wildland fires on air pollution in the Western United States over 2005–2018.
Modulation of keratin deposition and pathogenesis of hidradenitis suppurativa: evidence coming from pachyonychia congenita
Authors: Giamarellos-Bourboulis Evangelos J.
Published: August 2022

Linked Article: Pavlovsky et al. Br J Dermatol 2022; 187:392–400.
Anti-interleukin-17A for pityriasis rubra pilaris: catching the psoriasis biologic wave
Authors: Balak Deepak M.W. , Rissmann Robert
Published: August 2022

Linked Article: Boudreaux et al. Br J Dermatol 2022; 187:650–658.
Roles of socioeconomic status, ethnicity and teacher beliefs in academic grading
Authors: Doyle Lewis , Easterbrook Matthew J. , Harris Peter R.
Published: August 2022

Background

Educational outcomes in the United Kingdom vary as a function of students' family background, with those of lower socioeconomic status (SES) and certain ethnic minority groups among the worst affected.

Aims

This pre‐registered study investigates: (i) whether knowledge about students' socioeconomic and ethnic background influences teachers' judgements about the quality of their work and potential for the future, and (ii) the role of teachers' beliefs—most notably about meritocracy—in their practices.

Sample

Our findings are based on the responses of 416 in‐service (88%) and trainee (12%) teachers who successfully passed several stringent exclusion criteria.

Methods

As part of a 2 × 2 independent measures design, teachers were randomly assigned to assess an identical piece of work ostensibly written by a student who varied by SES (higher vs. lower) and ethnicity (White British vs. Black Caribbean). Following this, they responded to several measures assessing their beliefs about education.

Results

Teachers judged students of lower SES to be inferior to students of higher SES across a range of indicators. By contrast, we found no evidence of racial bias in teachers' judgements, though potential reasons for this are discussed. Teachers who believed that schooling is meritocratic were significantly less likely to support equity‐enhancing teaching practices and initiatives.

Conclusions

Unconscious teacher biases and beliefs may be contributing to the relative underperformance of students from poorer backgrounds. These findings provide a mandate for educational institutions to help teachers reflect upon, and develop the skills required to mitigate potentially harmful biases.
Incidence of significant prostate cancer after negative MRI and systematic biopsy in the FUTURE trial
Authors: Exterkate Leonie , Wegelin Olivier , Barentsz Jelle O. , van der Leest Marloes G. , Kummer J. Alain , Vreuls Willem , de Bruin Peter C. , Witjes J. Alfred , van Melick Harm H.E. , Somford Diederik M.
Published: August 2022

Objectives

To assess the proportion of clinically significant (cs) prostate cancer (PCa) found during follow‐up in patients with negative systematic biopsy (SB) followed by non‐suspicious multiparametric magnetic resonance imaging (mpMRI) and persistent clinical suspicion of PCa compared to the general population.

Patients and Methods

A prospective study in a subgroup of patients from a multicentre randomized controlled trial was conducted between 2014 and 2017, including 665 men with prior negative SB with a persistent elevated prostate‐specific antigen and/or suspicious digital rectal examination undergoing mpMRI. All patients with negative SB and Prostate Imaging‐Reporting and Data System (PI‐RADS) ≤2 on mpMRI entered biochemical follow‐up. Follow‐up data until December 2021 were collected by reviewing institutional hospital records and the Dutch Pathology Registry (PALGA). The primary outcome was the observed number of csPCa (Gleason ≥3 + 4/International Society of Urological Pathology grade group ≥2) cases during follow‐up compared to the expected number in the general population (standardized incidence ratio [SIR]).

Results

In total, 431 patients had non‐suspicious mpMRI and entered biochemical follow‐up. After a median (interquartile range) follow‐up of 41 (23–57) months, 38 patients were diagnosed with PCa, of whom 13 (3.0%) had csPCa. The SIR for csPCa was 4.3 (95% confidence interval 2.3–7.4; total excess of eight cases). A higher risk of a positive biopsy for (cs)PCa based on the European Randomized Study of Screening for Prostate Cancer risk calculator and a suspicious repeat MRI (PI‐RADS ≥3) were significant predictive factors for csPCa.

Conclusion

After negative prior biopsy and non‐suspicious mpMRI the risk of csPCa is low. However, compared to the general population, the risk of csPCa is increased despite the high negative predictive value of mpMRI. More research focusing on biochemical and image‐guided risk‐adapted diagnostic surveillance strategies is warranted.
Bat responses to climate change: a systematic review
Authors: Festa Francesca , Ancillotto Leonardo , Santini Luca , Pacifici Michela , Rocha Ricardo , Toshkova Nia , Amorim Francisco , Benítez‐López Ana , Domer Adi , Hamidović Daniela , Kramer‐Schadt Stephanie , Mathews Fiona , Radchuk Viktoriia , Rebelo Hugo , Ruczynski Ireneusz , Solem Estelle , Tsoar Asaf , Russo Danilo , Razgour Orly
Published: August 2022

Understanding how species respond to climate change is key to informing vulnerability assessments and designing effective conservation strategies, yet research efforts on wildlife responses to climate change fail to deliver a representative overview due to inherent biases. Bats are a species‐rich, globally distributed group of organisms that are thought to be particularly sensitive to the effects of climate change because of their high surface‐to‐volume ratios and low reproductive rates. We systematically reviewed the literature on bat responses to climate change to provide an overview of the current state of knowledge, identify research gaps and biases and highlight future research needs. We found that studies are geographically biased towards Europe, North America and Australia, and temperate and Mediterranean biomes, thus missing a substantial proportion of bat diversity and thermal responses. Less than half of the published studies provide concrete evidence for bat responses to climate change. For over a third of studied bat species, response evidence is only based on predictive species distribution models. Consequently, the most frequently reported responses involve range shifts (57% of species) and changes in patterns of species diversity (26%). Bats showed a variety of responses, including both positive (e.g. range expansion and population increase) and negative responses (range contraction and population decrease), although responses to extreme events were always negative or neutral. Spatial responses varied in their outcome and across families, with almost all taxonomic groups featuring both range expansions and contractions, while demographic responses were strongly biased towards negative outcomes, particularly among Pteropodidae and Molossidae. The commonly used correlative modelling approaches can be applied to many species, but do not provide mechanistic insight into behavioural, physiological, phenological or genetic responses. There was a paucity of experimental studies (26%), and only a small proportion of the 396 bat species covered in the examined studies were studied using long‐term and/or experimental approaches (11%), even though they are more informative about the effects of climate change. We emphasise the need for more empirical studies to unravel the multifaceted nature of bats' responses to climate change and the need for standardised study designs that will enable synthesis and meta‐analysis of the literature. Finally, we stress the importance of overcoming geographic and taxonomic disparities through strengthening research capacity in the Global South to provide a more comprehensive view of terrestrial biodiversity responses to climate change.
Immune‐related adverse events in urothelial cancer patients: Adjustment for immortal time bias
Authors: Otsuka Hikari , Kita Yuki , Ito Katsuhiro , Sano Takeshi , Inokuchi Junichi , Tomida Ryotaro , Takahashi Atsushi , Matsumoto Kazumasa , Kurahashi Ryoma , Ozaki Yu , Uegaki Masayuki , Maruyama Satoru , Mukai Shoichiro , Tsutsumi Masakazu , Kawahara Takashi , Segawa Takehiko , Kitamura Hiroshi , Morita Satoshi , Kobayashi Takashi
Published: August 2022

To investigate the association between the onset, severity, and type of immune‐related adverse events (irAEs) and the efficacy of pembrolizumab in patients with platinum‐pretreated advanced urothelial carcinoma (UC), we retrospectively collected clinical datasets of 755 patients and conducted landmark analysis. Patients who survived for fewer than 3 months were excluded from the evaluation to reduce the immortal time bias. In total, 620 patients were evaluated, of whom 220 patients (35.5%) experienced grade ≥2 irAEs, including 134 patients with grade 2 irAEs and 86 with grade ≥3 irAEs. Propensity score matching extracted 198 patients with and without grade ≥2 irAEs. The onset of grade ≥2 irAEs was associated with longer median progression‐free survival (PFS) (8.3 months vs. 4.5 months, p = 0.003) and overall survival (OS) (20.4 months vs. 14.3 months, p = 0.031) and a higher objective response rate (ORR) (44.8% vs. 30.2%, p = 0.004). Patients with grade 2 irAEs had significantly better oncological outcomes (PFS, OS, and ORR) than grade ≤1 and ≥3 irAEs. Patients with grade ≥3 irAEs had worse outcomes than grade 2 irAEs. Endocrine and skin irAEs were related with better survival outcomes, and the rate of severities was lower in these categories. In conclusion, the occurrence of irAEs, particularly low‐grade irAEs, was predictive of pembrolizumab efficacy in patients with platinum‐pretreated advanced UC.
Participation in physical activity of adolescents with congenital heart disease
Authors: Lavenant Pauline , Cacioppo Marine , Ansquer Hélène , Guillaumont Sophie , Houx Laetitia , Brochard Sylvain , Amedro Pascal , Pons Christelle
Published: August 2022

Background

Participation in physical activity improves health in individuals with congenital heart disease. However, most do not sufficiently engage in physical activity. The aim of this study was to collect information regarding the experiences of adolescents with congenital heart disease who practiced physical activities.

Methods

French adolescents aged 13–18 years, diagnosed with congenital heart disease, class I or II dyspnoea on the NYHA scale and authorized physical activity were interviewed individually about their physical activity experiences using a semi‐structured format. The qualitative interview transcript data were analysed using a phenomenological approach; data analysis was performed independently by three researchers and merged at each step until saturation.

Results

Eleven adolescents with congenital heart disease participated. Three main themes emerged: ‘own representation’, ‘physical activity (PA) set‐up’ and ‘environment’. Adolescents had a generally positive view of physical activity, which was associated with positive experiences. However, they reported that their physical condition limited PA, and they wished for adapted activities. The results revealed the importance of environmental factors, for example, within the social and school environments. The participants indicated that they appreciated the social interactions that PA afforded, but that integration into a group could be difficult, especially in school, with some participants describing feelings such as anxiety, frustration or guilt when they could not participate fully. PA facilitators included familial support. However, participants noted a lack of clear medical guidance to help them choose suitable activities based on their circumstances and personal preferences. They wished for the public to be better informed about congenital heart disease to reduce stigmatism.

Conclusions

This study provides valuable information for clinicians, physical educators and policy makers to help them promote physical activity and support adolescents and their families in understanding their own condition, maximizing their potential and in their choice of activities.
Physical activity interventions for the mental health of children: A systematic review
Authors: Hale Gabrielle E. , Colquhoun Luke , Lancastle Deborah , Lewis Nicky , Tyson Philip J.
Published: August 2022

Objective

This systematic review explored the effectiveness of using physical activity (PA) interventions to enhance psychological well‐being and reduce psychological ill‐being (e.g., anxiety and depression) in children aged six to 11 years old from the general population.

Methods

Electronic databases were searched for studies published between January 2005 and June 2020: Web of Science, ProQuest Psychology Journals, PsycINFO, Pub Med, ASSIA, CINHAL PLUS, SPORTDiscus, EMBASE and Wiley Online Library. Search terms included ‘physical activity intervention’, ‘psychological well‐being’ and ‘child*’. After removing duplicates, 11 390 studies were independently screened by two authors based on inclusion/exclusion criteria and assessed for risk of bias.

Results

A total of 23 studies were narratively synthesized and categorized into four domains: Quality of Life (QOL), body image, self‐esteem and psychological ill‐being. Evidence was provided for the impact of PA interventions in improving QOL, body image and self‐esteem. Despite the positive effect on psychological well‐being, evidence for a reduction in the frequency and severity of symptoms associated with psychological ill‐being in children is less clear.

Conclusions

Reviewed studies support the use of PA interventions in enhancing the psychological well‐being of children in school and community settings. More research is warranted to understand the impact of PA interventions on reducing psychological ill‐being in children from the general population.
Adnexal iceberg: pruritic papule on top of a nodule on the back
Authors: Dowdle Travis S. , Holder Katherine G. , Hope Landon , Maldonado Dylan , Billings Steven , Tarbox Michelle
Published: August 2022

Basal cell carcinoma (BCC), one of the most common malignancies, is rarely associated with follicular and apocrine differentiation patterns. This case presents a case of BCC with atypical gross presentation and features of aberrant differentiation. Clinicians should maintain a high level of clinical suspicion for BCC in atypical lesions.

Click here for the corresponding questions to this CME article.
“Others' children are expendable.” Comparing childcare sector with health and long‐term sectors in Taiwan
Authors: Yeh Ming‐Jui , Liu Feng‐Yi
Published: August 2022

This article aims to untangle the puzzle of why the childcare sector often allocates the least of responsibility for care to the state in societies with Confucian social ethos compared with the healthcare and long‐term care sector. Using Taiwan as an illustrative case, the article offers an overview of the three care sectors and an in‐depth analysis of the development of the childcare sector. We argue that due to the diminished bureaucratic authority after the democratization process and the application of elder culture, the childcare sector is much less well‐developed than the other two sectors in Taiwan.
Immune response to third SARS‐CoV‐2 vaccination in seronegative kidney transplant recipients: Possible improvement by mycophenolate mofetil reduction
Authors: Kantauskaite Marta , Müller Lisa , Hillebrandt Jonas , Lamberti Joshua , Fischer Svenja , Kolb Thilo , Ivens Katrin , Koch Michael , Andree Marcel , Lübke Nadine , Schmitz Michael , Luedde Tom , Orth Hans Martin , Feldt Torsten , Schaal Heiner , Adams Ortwin , Schmidt Claudia , Kittel Margarethe , Königshausen Eva , Rump Lars C. , Timm Jörg , Stegbauer Johannes
Published: August 2022

Modification of vaccination strategies is necessary to improve the immune response to SARS‐CoV‐2 vaccination in kidney transplant recipients (KTRs). This multicenter observational study analyzed the effects of the third SARS‐CoV‐2 vaccination in previously seronegative KTRs with the focus on temporary mycophenolate mofetil (MMF) dose reduction within propensity matched KTRs. 56 out of 174 (32%) previously seronegative KTRs became seropositive after the third vaccination with only three KTRs developing neutralizing antibodies against the omicron variant. Multivariate logistic regression revealed that initial antibody levels, graft function, time after transplantation and MMF trough levels had an influence on seroconversion (P < .05). After controlling for confounders, the effect of MMF dose reduction before the third vaccination was calculated using propensity score matching. KTRs with a dose reduction of ≥33% showed a significant decrease in MMF trough levels to 1.8 (1.2–2.5) μg/ml and were more likely to seroconvert than matched controls (P = .02). Therefore, a MMF dose reduction of 33% or more before vaccination is a promising approach to improve success of SARS‐CoV‐2 vaccination in KTRs.
Acute injection‐related infections requiring hospitalisation among people who inject drugs: Clinical features, microbiology and management
Authors: Langham Freya J. , Curtis Stephanie J. , Tang Mei Jie , Jomon Bismi , Doyle Joseph S. , Vujovic Olga , Stewardson Andrew J.
Published: August 2022

Introduction

People who inject drugs are at risk of hospitalisation with injection‐related infections (IRI). We audited the clinical features, microbiology and management of IRI at a tertiary service in Melbourne to describe the burden and identify quality improvement opportunities.

Methods

We performed retrospective review of IRI admissions from January 2017 to April 2019. We extracted admissions where ICD‐10 codes or triage text suggested injecting drug use, and the diagnosis suggested IRI. We reviewed these for eligibility and extracted data using a standardised form. We performed mixed‐effects logistic regression to determine predictors of unplanned discharge.

Results

From 574 extracted candidate admissions, 226 were eligible, representing 178 patients. Median age was 41 years (interquartile range 36–47), 66% (117/178) male and 49% (111/226) had unstable housing. Over 50% (96/178) had a psychiatric diagnosis and 35% (62/178) were on opioid agonist therapy (OAT) on admission. Skin and soft tissue infection was the most common IRI (119/205, 58%), followed by bacteraemia (36/205, 18%) and endocarditis (26/205, 13%). Management included addictions review (143/226, 63%), blood‐borne virus screening (115/226, 51%), surgery (77/226, 34%) and OAT commencement (68/226, 30%). Aggression events (54/226, 15%) and unplanned discharge (69/226, 30%) complicated some admissions. Opioid use without OAT was associated with almost 3‐fold increased odds of unplanned discharge compared to no opioid use (odds ratio 2.90, 95% confidence interval 1.23, 6.85, p = 0.015).

Discussion and Conclusion

Comorbidities associated with IRI may be amenable to opportunistic intervention during hospitalisation. Further research is needed to develop optimal models of care for this vulnerable patient group.
Suturing techniques with endoscopic clips and special devices after endoscopic resection
Authors: Nomura Tatsuma , Sugimoto Shinya , Temma Taishi , Oyamada Jun , Ito Keichi , Kamei Akira
Published: August 2022

Endoscopic submucosal dissection is an established method for complete resection of large and early gastrointestinal tumors. However, methods to reduce bleeding, perforation, and other adverse events after endoscopic resection (ER) have not yet been defined. Mucosal defect closure is often performed endoscopically with a clip. Recently, reopenable clips and large‐teeth clips have also been developed. The over‐the‐scope clip enables complete defect closure by withdrawing the endoscope once and attaching the clip. Other methods involve attaching the clip‐line or a ring with an anchor to appose the edges of the mucosal defect, followed by the use of an additional clip for defect closure. Since clips are limited by their grasping force and size, other methods, such as endoloop closure, endoscopic ligation with O‐ring closure, and the reopenable clip over‐the‐line method, have been developed. In recent years, techniques often utilized for full‐thickness ER of submucosal tumors have been widely used in full‐thickness defect closure. Specialized devices and techniques for defect closure have also been developed, including the curved needle and line, stitches, and an endoscopic tack and suture device. These clips and suture devices are applied for defect closure in emergency endoscopy, accidental perforations, and acute and chronic fistulas. Although endoscopic defect closure with clips has a high success rate, endoscopists need to simplify and promote endoscopic closure techniques to prevent adverse events after ER.
Characteristics and care of young people with type 2 diabetes included in the national diabetes audit datasets for England
Authors: Misra Shivani , Holman Naomi , Barron Emma , Knighton Peter , Warner Justin , Kar Partha , Young Bob , Valabhji Jonathan
Published: August 2022

Introduction

We report contemporary age‐related prevalence, characteristics and care of children and young people with type 2 diabetes in England.

Methods

Individuals with a recorded diagnosis of type 2 diabetes between January 2019 and March 2020 were identified from a whole population register. Age, sex, ethnicity, deprivation quintile, weight, HbA1cand receipt of the nine National Institute for Health & Care Excellence (NICE) recommended annual care processes were extracted from electronic clinical records and analysed by pre‐specified age bands.

Results

In total, 122,780 (4.6%) of 2,642,435 individuals in England with type 2 diabetes were aged under 40 years, comprising; 650 (0.5%) under 16 years, 910 (0.7%) aged 16–18 years, 8245 (6.7%) aged 19–25 and 112,975 (92%) aged 26–39 years. Compared to people with type 2 diabetes aged above 40 years, young people were significantly more likely to be from minority ethnic groups: 51% under 16 years, 41% 16–18 years, 38% 19–25 years, 38% 26–39 years, 27% 40–59 years and 15% 60–79 years were of Black or Asian ethnicity. In addition, those aged under 40 years were more likely to be obese, women, to live in the most‐deprived socioeconomic areas and less likely to receive the NICE recommended annual care processes or achieve target HbA1c.

Interpretation

The substantial number of people under 40 years of age with type 2 diabetes, are more likely to have characteristics associated with inequalities and are less likely to achieve HbA1ctargets and receive recommended care processes. These findings highlight the need to consider novel approaches to service provision for this high‐risk group.
Improved patient‐reported outcomes with iGlarLixi versus premix BIAsp 30 in people with type 2 diabetes in the SoliMix trial
Authors: Polonsky William H. , Giorgino Francesco , Rosenstock Julio , Whitmire Katherine , Lew Elisheva , Coudert Mathieu , Alvarez Agustina , Nicholls Charlie , McCrimmon Rory J.
Published: August 2022

Aim

To assess patient‐reported outcomes (PROs) in the SoliMix trial, which compared the efficacy and safety of iGlarLixi versus BIAsp 30 in people with type 2 diabetes (T2D).

Materials and Methods

SoliMix (EudraCT: 2017‐003370‐13), a 26‐week, open‐label study, randomized (1:1) 887 adults with T2D and HbA1c ≥7.5%‐≤10.0% (≥58‐≤86 mmol/mol) on basal insulin plus oral antihyperglycaemic drugs (OADs) to once‐daily iGlarLixi or twice‐daily premix insulin, BIAsp 30. PROs were assessed using the Treatment‐Related Impact Measure Diabetes (TRIM‐D) and Global Treatment Effectiveness Evaluation (GTEE) questionnaires.

Results

Over 26 weeks, iGlarLixi showed greater improvement from baseline versus BIAsp 30 in total TRIM‐D score (least squares mean difference [95% confidence interval]: 5.08 [3.69, 6.47]; effect size: 0.32) and in each TRIM‐D domain, with the greatest differences seen in diabetes management (8.47 [6.11, 10.84]) and treatment burden (6.95 [4.83, 9.07]). GTEE scores showed a greater proportion of participants and physicians rated a complete or marked improvement of diabetes control with iGlarLixi (80.5%, 82.8%) versus BIAsp 30 (63.3%, 65.1%) at week 26. Post hoc analyses showed that after adjusting for HbA1c, body weight and hypoglycaemia outcomes, iGlarLixi continued to show greater improvements in TRIM‐D total scores versus BIAsp 30.

Conclusions

In addition to better glycaemic control, weight benefit and less hypoglycaemia, once‐daily iGlarLixi provided improved diabetes management, treatment burden and perceived effectiveness versus twice‐daily premix BIAsp 30, further supporting iGlarLixi as an advanced treatment option in people with suboptimally controlled T2D on basal insulin plus OADs.
Oral potentially malignant disorders – An assessment of knowledge and attitude to future education in undergraduate dental students
Authors: Brailo Vlaho , Freitas Marcio Diniz , Posse Jacobo Limeres , Monteiro Luis , Silva Luis Martins , Fricain Jean‐Cristophe , Catros Sylvain , Fénelon Mathilde , Lodi Giovanni , Ariyaratnam Raj , Murthy Vignesh , Keat Ross , Cook Richard James , Escudier Michael P. , Horvat Kristina , Lombardi Niccolò , Carey Barbara , Albuquerque Rui
Published: August 2022

Introduction

The aim of this study was to assess the knowledge and clinical experience of oral potentially malignant disorders (OPMDs) in undergraduate dental students in six European countries (Croatia, France, Italy, Portugal, Spain and United Kingdom) and assess student’s attitude and preference to future education on the topic. A secondary aim was to identify gaps in student’s knowledge and clinical practice. The study was a part of the Erasmus+ project “Oral Potentially Malignant Disorders: Healthcare Professionals Training“ (Grant No: 2020‐1‐UK01‐KA202‐078917).

Materials and Methods

An online questionnaire was distributed to all final‐year students in six partner universities. This consisted of four parts assessing: (1) knowledge on OPMDs, (2) clinical experience with this group of patients, (3) self‐rated competence in the management of OPMDs and (4) preferences with regard to future education.

Results

Two hundred and sixty final‐year dental students from six partner universities responded to the questionnaire. Response rates varied from 12% to 92% between partner universities. Significant differences in clinical experience and knowledge were found between students. Students with more clinical exposure to OPMDs rated their knowledge and competence in the management of OPMDs higher than students with less clinical experience. The majority of students were interested in future education on OPMDs, preferably via short educational videos.

Conclusion

The majority of students have received theoretical knowledge of OPMDs during their undergraduate studies, however, not all had clinical exposure to this group of patients. Students were open to further education on OPMDs. Important deficiencies in knowledge were identified that need to be addressed and it is anticipated that the e‐learning platform and e‐book that are in development by partner institutions will help to improve overall knowledge of OPMDs.
Institutional investors and corporate environmental and financial performance
Authors: Miller Steve M. , Qiu Bin , Wang Bin , Yang Tina
Published: August 2022

We propose a conceptual framework to illustrate that when three conditions hold, institutional investors moderate a positive relation between corporate financial performance and corporate environmental performance. We explore heterogeneities across institution types to demonstrate the importance of each condition. The moderating effect works through the channels of expert consulting and effective monitoring. Our results have important policy and practical implications given the global trend of ownership concentration in institutional investors and the projection that by 2025, one out of three dollars under professional management will be invested in corporate social responsibility assets.