bluuebunny/crossref_metadata_2025 huggingface dataset:
Health care professionals’ perceptions of factors influencing the process of identifying patients for serious illness conversations: A qualitative study
Authors: Morberg Jämterud Sofia , Sandgren Anna
Published: June 2022

Background:

The Serious Illness Care Programme enables patients to receive care that is in accordance with their priorities. However, despite clarity about palliative care needs, many barriers to and difficulties in identifying patients for serious illness conversations remain.

Aim:

To explore healthcare professionals’ perceptions about factors influencing the process of identifying patients for serious illness conversations.

Design:

Qualitative design. A thematic analysis of observations and semi-structured interviews was used.

Setting/participants:

Twelve observations at team meetings in which physicians and nurses discussed the process of identifying the patients for serious illness conversations were conducted at eight different clinics in two hospitals. Semi-structured interviews were conducted with three physicians and two nurses from five clinics.

Results:

Identifying the right patient and doing so at the right time were key to identifying patients for serious illness conversations. The continuity of relations and continuity over time could facilitate the identification process, while attitudes towards death and its relation to hope could hinder the process.

Conclusions:

The process of identifying patients for serious illness conversations is complex and may not be captured only by generic tools such as the surprise question. It is crucial to address existential and ethical obstacles that can hinder the identification of patients for serious illness conversations.
Exploring Characteristics of Homicide Offenders With Schizophrenia Spectrum Disorders Via Machine Learning
Authors: Sonnweber Martina , Lau Steffen , Kirchebner Johannes
Published: June 2022

The link between schizophrenia and homicide has long been the subject of research with significant impact on mental health policy, clinical practice, and public perception of people with psychiatric disorders. The present study investigates factors contributing to completed homicides committed by offenders diagnosed with schizophrenia referred to a Swiss forensic institution, using machine learning algorithms. Data were collected from 370 inpatients at the Centre for Inpatient Forensic Therapy at the Zurich University Hospital of Psychiatry. A total of 519 variables were explored to differentiate homicidal and other (violent and non-violent) offenders. The dataset was split employing variable filtering, model building, and selection embedded in a nested resampling approach. Ten factors regarding criminal and psychiatric history and clinical factors were identified to be influential in differentiating between homicidal and other offenders. Findings expand the research on influential factors for completed homicide in patients with schizophrenia. Limitations, clinical relevance, and future directions are discussed.
Political Economy of Expulsionary Urbanization: Subsumption and Estrangement of Spaces in Pakistan
Authors: Khan Danish
Published: June 2022

This article forwards the notion of “expulsionary urbanization” to explain processes of urban transformation in Pakistan against the backdrop of neoliberal regime of accumulation. The concept of expulsionary urbanization emphasizes that the production of new urban spaces is predicated on the theft of space, where one segment of the society appropriates space from another. On the one hand, expulsionary urbanization facilitates capital accumulation by creating new gated housing enclaves; on the other hand, it produces spatial estrangement for the marginalized groups. To delineate processes of spatial commodification, the article reintroduces the conceptual category of “subsumption of space” by capital, that is, capital’s drive to valorize itself by transforming land into a form of a fictitious capital.

JEL Classification: B51, B55, B50, B52, A14
Circuits of Social Reproduction: Nature, Labor, and Capitalism
Authors: Naidu Sirisha C.
Published: June 2022

This article offers a reformulation of social reproduction theory’s (SRT’s) circuit of social reproduction that is suitable for the Global South. Drawing from existing literature, the article argues that wage labor is not always central to social reproduction and that there exist multiple labors of social reproduction associated with capitalist production, noncapitalist commodity production, and subsistence production. These stylized interrelated labor processes, which are coconstituted with nature, represent the circuits of social reproduction. The circuits clarify how working people engage in social reproduction even when the wage economy is inadequate for survival. They also offer a basis for interrogating crises of social reproduction when the totality of work time does not guarantee socially determined necessary consumption. These reworked circuits present opportunities for identifying both potential sites of exploitation and sites of resistance in the Global South.

JEL Classification: B51, B54, Q56
Experiments in aerial firefighting with and without additives and its application to suppress wildfires near electrical transmission lines
Authors: Zhou Tejun , Lu Jiazheng , He Lifu , Wu Chuanping , Luo Jing
Published: June 2022

A comparison scheme is proposed to extinguish non-uniform fire scenes and continuously uniform fire scenes using a helicopter’s bucket fire-extinguishing device to spray extinguishing agent. Pure water, and Class AB, gel, and Class A extinguishing agents were added to the bucket fire-extinguishing device to spray 4-layer, 6-layer, and 12-layer wood crib fires. It was discovered that the depth (the distance from the top of the wood crib) of effective cooling and prevention of temperature recovery by extinguishing agents was 0.36 m and that the cooling performance of the extinguishing agents in sequence from high to low was Class A extinguishing agent > gel extinguishing agent > Class AB extinguishing agent > pure water. Their capacity to prevent temperature recovery in the wood crib fires in sequence from high to low was gel extinguishing agent > Class A extinguishing agent > Class AB extinguishing agent > pure water. A device has been developed that can add extinguishing agent to the helicopter bucket efficiently, and its application on-site during the 2020–2021 Spring Festival and other events showed that it can quickly extinguish small-area wildfires near electrical transmission lines to reduce line trips due to wildfire.
An asymmetric wettable PCL/chitosan composite scaffold loaded with IGF-2 for wound dressing
Authors: Yang Shuang , Lan Linhao , Gong Mingda , Yang Ke , Li Xiaoming
Published: June 2022

An effective dressing is essential for wound healing. In fact, the wettability performance is one of the most important factors of a wound dressing. The fundamental functions of a wound dressing involve the absorption of excess exudates and maintenance of optimal moisture at the wound by controlling water evaporation. Here, we designed a type of chitosan (CS) sponge and PCL nanofibrous membrane composite dressing with asymmetric wettability surfaces as wound healing materials for biomedical applications. The hydrophobic surfaces of the composite dressing were waterproof and could efficiently control the water vapor transmission rate, whereas the hydrophilic surface of the CS sponge had good cytocompatibility and water-absorbing capability. Insulin-like growth factor-2 (IGF-2) was added to the CS sponge, and exhibited a stimulatory effect on fibroblasts migration and proliferation. Therefore, the fabricated CS sponge and PCL membrane composite dressing had excellent cytocompatibility, vapor transmission rate, and liquid absorption and asymmetric wettability, suggesting its potential as a promising alternative to traditional wound dressing.
Australia – A Land for Young Women? Exploring Young Women's Positioning in Contemporary Australian Family Violence Discourses
Authors: Johnston Bianca , Flynn Catherine , Gordon Faith
Published: June 2022

Young women in Australia experience serious risks from intimate partner violence (IPV) as a form of family violence. However, there has been a lack of attention to the impact of this on young women and, as a result, these risks are not well understood. This article critically examines existing literature, policy and research and in doing so, specifically explores the ways in which young women aged between 10 and 20 years old are represented and positioned in contemporary family violence discourses. Framed by a review of socio-political and cultural history, the paper highlights the early colonial, patriarchal foundations of Australia, which have specific implications for the challenges that contemporary young women experience in situations of IPV. With a particular emphasis on the Australian context, this article employs both an intersectional and critical feminist lens, with a key focus on the dimensions of adolescent development and youth social geographies. Focusing specifically on these dimensions, including development, gender and age, highlights the important role that feminist social work perspectives and practices can contribute to uncovering, understanding and responding to young women's experiences of intimate partner violence through policy and advocacy.
The Association Between Type of Supplementation in the Newborn Nursery and Breastfeeding Outcomes at 2 and 6 Months of Age
Authors: Gray Karin , Ryan Stephanie , Churchill Martha , Harder Valerie S.
Published: June 2022

Background:

Supplementation in the newborn nursery has been associated with shorter breastfeeding duration. However, supplementation may at times be necessary.

Research Aim:

To determine the association between type of supplementation in the newborn nursery (mother’s own milk, formula, donor human milk) and breastfeeding outcomes at 2 and 6 months of age.

Methods:

This was a prospective, longitudinal, observational multi-group cohort study. In total, 2,343 surveys were sent to parents who, prior to delivery, indicated intent to exclusively breastfeed. Participants were grouped by type of nursery supplementation. Surveys asked about breastfeeding outcomes when infants were 2 and 6 months old. Our final analytic sample included data from 1,111 healthy newborns ≥ 35 weeks. We used multiple logistic regression to compare future breastfeeding outcomes for infants who were exclusively directly breastfed or who received supplementation during their birth hospitalization.

Results:

Both the donor human milk and formula groups had decreased breastfeeding at 2 and 6 months compared to the exclusively directly breastfed group. Notably, for infants who received formula compared to donor human milk, the odds of breastfeeding at 2 and 6 months were 74% and 58% lower, respectively ( OR = 0.26, 95% CI [0.12, 0.56] at 2 months; OR = 0.42, 95% CI [0.19, 0.94] at 6 months). The donor human milk group had lower odds of breastfeeding at both follow up times compared to the mother’s own milk group.

Conclusion:

Among those who intend to breastfeed, supplementation with donor human milk instead of formula in the newborn nursery may support longer breastfeeding.
Indigenous Rights of Children among Agropastoral Communities in Southern Ethiopia
Authors: Jirata Tadesse Jaleta
Published: June 2022

This article offers insights into the social and cultural rights that children are entitled to among agro-pastoral communities in Ethiopia. From an Indigenous, bottom-up perspective, children’s “unwritten rights” are not just part of the customary rights and cultural practices but also exemplify local epistemologies that subvert the universal conceptualization of rights. Based on ethnographic data from Guji in Ethiopia’s south, this article critically discusses the multiple rights and obligation that children have in communities that experience indigenous ways of life.
Polyethylene-oxide: NaI polymer electrolyte: Electrical, structural and photoelectrochemical studies
Authors: Singh Abhimanyu , Joshi Bhawana , Rawal Sangeeta , Singh Pramod K , Konwar Subhrajit , Madkhli Aysh Y , Noor IM , Aggarwal Daksh , Ibrahim Summayya Saleh
Published: June 2022

Conducting sodium iodide (NaI) doped polyethylene oxide (PEO) freestanding electrolyte films are prepared by solution cast technique. Electrical, Structural, and device performances are given in detail. Maximum conducting polymer electrolyte has been used to develop electric double-layer capacitors (EDLCs) as well as the dye-sensitized solar cell (DSSC) which shows that ion-conducting polymer electrolyte is a novel candidate for energy devices.
Energetic, exergetic analysis and machine learning of methane chlorination process for methyl chloride production
Authors: Gollangi Raju , Nagamalleswara Rao K
Published: June 2022

Nowadays, with the growing demand for energy and effective utilization of various available sources with the exorable techniques and approaches to maximize the efficiency of energy systems. This work has developed the synthesis of Methyl chloride (MC) from the methane chlorination process using the ASPEN HYSYS simulation tool. A Searchable analysis has been done on thermodynamic derivatives (likely Energy, Exergy) to probation on the entire process. This analysis calculates all process components’ energy loss, destruction and energy, and exergy efficiencies. A heavier energy loss has been found at Reactor (ERV) with 1785.5 kW and exergy destruction of 18.8% share. Heat Exchanger Network (HEN) has energy loss (960.32kW) & exergy destruction (791.29kW). The proposed new retrofit sustainable model recovered the waste heat from the HEN and achieved energy efficiency of 87.6% and exergy efficiency of 87.3% of the total MC process. Four Machine learning models were developed for the reactor (ERV) process to predict exergy destruction. The artificial Neural network (ANN) gave good testing predictions, followed by the Random Forest (RF) with a determination coefficient (R2) of 0.999957 and 0.999981.
An Exploration of the Impact of Electricity Consumption on Economic Growth in India using ARDL Cointegration Analysis
Authors: Dutta Ujjal Protim , Chakraborty Debasis
Published: June 2022

This study examines the connection between electricity consumption and economic growth of India from 1980 to 2017. Initially, the study conducted stationary test to study the stationarity properties of the variables. Autoregressive distributive lag (ARDL) model was used to estimate the long-run relationship among the variables. In addition to this, to estimate the causality between the variables, the study has employed Toda–Yamamoto Granger causality test. The long-run estimation of the ARDL model suggests that electricity consumption does not impact output per capita, while financial development and physical capital have positive and significant impact on output per capita. In line with the ARDL model, the Toda–Yamamoto Granger causality test also does not show any causal relationship among the variables. Based on the empirical outcomes, the study suggests few policy prescriptions.
“Always a Preemie”: Maternal Experiences Parenting a Very Preterm Infant into Toddlerhood
Authors: Quist Megan , Julian Megan M. , Meerkov Meera , Pesch Megan H.
Published: June 2022

This study sought to qualitatively describe themes in maternal narratives around parenting a former very or extremely preterm infant from the neonatal intensive care unit (NICU) into toddlerhood. Mothers (N = 14) of preterm infants ≤28 weeks gestation, now aged 2 to 4 years, completed a semi-structured interview; transcripts were qualitatively analyzed. Five themes of mothers’ experiences were identified: (a) anxiety and trauma related to birth and NICU stay; (b) the importance of clear communication with medical providers; (c) mothers’ need for and difficulty accessing self-care opportunities or services; (d) challenges of transitioning home; and (e) mothers, continued view of their toddlers as vulnerable and “always a preemie.” Most (11/14) mothers reported depressive symptoms in the clinically significant range. Results of this study highlight the potential hardships and lasting maternal mental health effects of raising a former very or extremely preterm infant, and the need for supports in the NICU, at discharge and longitudinally.
Associations of Handgrip Asymmetry With Impaired Health-Related Quality of Life Among Older Adults in South Korea: A Cross-Sectional Study Using National Survey Data
Authors: Baek Jihyun , Kim Yunmi , Kim Hyun-Young
Published: June 2022

This study aimed to examine the associations of handgrip strength (HGS) and asymmetry with health-related quality of life among South Korean older adults. We enrolled 7395 older adults from the Korea National Health and Nutrition Examination Survey. Health-related quality of life was measured using the EuroQol-5 Dimension. Weakness was defined as a HGS of <26 kg for men and <18 kg for women. Handgrip strength symmetry was defined as an HGS ratio of 0.9:1.1, and HGS asymmetry was defined as a ratio outside that range. Data were analyzed using the Rao-Scott χ2, F test, and multivariate logistic regression. Compared with those in the “symmetric HGS and not weak” group, those in the “asymmetric HGS and weak” group had impaired health-related quality of life for all variables among men (odds ratios [ORs] = 1.67-3.75). A greater risk of impaired self-care (SC; odds ratio [OR] = 2.33) and anxiety/depression (AD; OR = 1.40) was observed among women in the “asymmetric HGS and weak” group. Handgrip weakness and asymmetry are associated with impaired health-related quality of life. Handgrip asymmetry can be a clinical marker of health-related quality of life in older adults and must be measured alongside HGS.
Correspondence of Child Age and Gender Distribution in Child Sexual Exploitation Material and Other Child Content With Age and Gender of Child Sexual Assault Victims
Authors: Eke Angela W. , Seto Michael C.
Published: June 2022

Accessing child sexual exploitation material (CSEM; child pornography in legal statutes) can indicate sexual interest in children. It logically follows then that the age and gender of the depicted children may reflect specific interests in those age/gender groups, and if so, may correspond to age and gender of any known contact offending victims. We had data on CSEM characteristics and child victims for 71 men convicted of CSEM offenses who also had contact sexual offenses against children; some had also sexually solicited children online. Sixty-four men had 134 prior or concurrent child victims, and 14 men reoffended directly against 17 children during follow-up. There were significant, positive associations (with moderate to large effect sizes) between age and gender of children depicted in CSEM and age and gender of child contact or solicitation victims. Examining future offending, though with only 14 recidivists, all men who sexually reoffended against a girl had more girl CSEM content, and all men who sexually reoffended against a boy had more boy CSEM content. Our results suggest that CSEM characteristics can reflect child preferences. This information can be relevant in clinical settings, police investigations, and community risk management, though it does not rule out interest in, or offending against, victims of other ages or gender. We discuss these findings in the context of other evidence regarding victim cross-over, and suggest future research.
Encouraging openness in health care: Policy and practice implications of a mixed-methods study in the English National Health Service
Authors: Martin Graham , Chew Sarah , McCarthy Imelda , Dawson Jeremy , Dixon-Woods Mary
Published: June 2022

Objective

The National Health Service (NHS) in England has introduced a range of policy measures aimed at fostering greater openness, transparency and candour about quality and safety. We draw on the findings of an evaluation of the implementation of these policies in NHS organisations, with the aim of identifying key implications for policy and practice.

Methods

We undertook a mixed-methods policy evaluation, comprising four substudies: a longitudinal analysis of data from surveys of NHS staff and service users; interviews with senior stakeholders in NHS provider organisations and the wider system; a survey of board members of NHS provider organisations and organisational case studies across acute, community and mental health, and ambulance services.

Results

Our findings indicate a mixed picture of progress towards improving openness in NHS organisations, influenced by organisational history and memories of past efforts, and complicated by organisational heterogeneity. We identify four features that appear to be necessary conditions for sustained progress in improving openness: (1) authentic integration into organisational mission is crucial in making openness a day-to-day concern; (2) functional and effective administrative systems are vital; (3) these systems must be leavened by flexibility and sensitivity in implementation and (4) a spirit of continuous inquiry, learning and improvement is required to avoid the fallacy that advancing openness can be reduced to a time-limited project. We also identify four persistent challenges in consolidating and sustaining improvement: (1) a reliance on goodwill and discretionary effort; (2) caring for staff, patients and relatives who seek openness; (3) the limits of values-driven approaches on their own and (4) the continued marginality of patients, carers and families.

Conclusions

Variation in policy implementation offers important lessons on how organisations can better deliver openness, transparency and candour. These lessons highlight practical actions for policymakers, managers and senior clinicians.
Tracking control of moving flexible system by incorporation of feedback-based vibrational energy sink in model predictive control algorithm
Authors: Homaeinezhad M R , FotoohiNia F
Published: June 2022

This paper proposes a new approach towards the nonlinear problem of tracking control for mobile multivariable vibrational structure featuring an Euler-Bernoulli vibrational beam. The control scheme involves obtaining interactions between flexural and rigid motions of the multivariable continuum mechanics system with actuator force limitation both regarding domain and frequency bandwidth. To this end, the boundary control inputs are selected prioritizing two tasks, satisfying actuator limitations and obtaining minimum possible tracking error. The former is employed as hard constraint in model predictive control (MPC) scheme while the latter is considered as soft constraint. The control scheme is adjusted such that when actuator limits are exceeded, the soft constraints are relaxed to maintain stability. In order to provide smooth tracking, Euler-Bernoulli transverse vibration is attenuated by incorporating Feedback Vibrational Energy Sink (FVES) method in obtaining control law. Hence, actuators are manipulated such that total vibrational energy of flexible beam is damped without using passive or conventional active dampers. The accuracy of the proposed method has been verified via FEA-based simulations.
Punctuated or incremental? Macao’s budget change and governance before and after the handover
Authors: Li Qing , Ho Wai Hong , Shi Yu
Published: June 2022

As an export-oriented and developed micro-economy, Macao’s government budget has its own unique characteristics. Since 1999, Macao’s return to China represents a unique scenario of institutional and governance change from separation to unity of sovereignty and governance. This transition is different from the change of political regime, leadership turnover, and ruling party replacement on which the current literature focuses. By collecting budget expenditure data from 1976 to 2022, this study describes and compares Macao’s budgets, including total budget, operating budget, capital budget, and functional budget, to understand if different types of budgets have experienced incremental change or punctuated changes before and after the handover. The study finds that the total budget, capital budget, and most functional budgets show more incrementalism after the handover than before the handover, while the operating budget is more punctuated compared to the colonial administration budget.
E-participation in contemporary China: A comparison with conventional offline participation
Authors: Xu Ping , Johnson Kristin , Rundlett Ashlea
Published: June 2022

Drawing on the resource theory of political participation, we compare the determinants of Internet-based e-participation and conventional offline political participation in China by employing data from an original survey conducted in 2013. We find that e-government and other online platforms provide more equal participation opportunities to Chinese citizens traditionally lacking political resources. Although non-party members and non-elites are disadvantaged in conventional offline participation, they are not in e-participation, especially through using e-government systems. Internet/computer access and Internet skills push individuals away from conventional offline participation, and frequent social media users are more likely to engage in e-participation. Taken together, these results suggest that e-government and other online platforms offer the genuine potential to expand the scope of participation and empowers those traditionally disadvantaged in China.
A Microcurrent Dressing Reduces Cutibacterium Acnes Colonization in Patients Undergoing Shoulder Arthroplasty or Arthroscopy: A Prospective Case Series
Authors: Miller Bruce S. , Olszewski Adam M. , Bedi Asheesh
Published: June 2022

Background: Cutibacterium acnes infections in the shoulder remain a significant concern in the setting of shoulder arthroplasty. Purpose: We sought to evaluate the efficacy of a microcurrent dressing in reducing C. acnes skin colonization and thereby reducing the risk of periprosthetic joint infection of the shoulder. Methods: This study was designed as a prospective case series. From October 2017 to February 2019, patients undergoing elective shoulder arthroplasty or arthroscopic shoulder surgery at a major academic medical center were offered enrollment; they signed an informed consent to participate. Patients under the age of 18, scheduled for revision shoulder arthroplasty, or with sensitivity or allergy to silver, zinc, or latex were excluded. Subjects underwent skin culture swab of the shoulder in the mid-point of the planned deltopectoral incision. The JumpStart (Arthrex; Naples, FL) microcurrent dressing was then placed over the area of the planned incision, and a full-thickness skin biopsy was harvested from the incision at the initiation of the surgical procedure. All specimens were cultured for C. acnes by the hospital’s clinical microbiology laboratory with standard anaerobic technique. Results: Thirty-one subjects were enrolled in the study. Those who demonstrated no growth at baseline for the control specimen were excluded from further analysis (N = 11), given the absence of preoperative C. acnes colonization. Culture results from the 20 remaining subjects revealed significantly diminished C. acnes skin growth at the time of surgery compared to baseline. Sixty percent (12 of 20) of the subjects with positive skin swabs at baseline demonstrated no growth in the skin biopsy specimens at the time of surgery. There were no adverse events associated with the application of the microcurrent dressing. Conclusion: This prospective case series found that preoperative application of a microcurrent dressing resulted in significantly diminished C. acnes skin burden at the time of surgery in patients undergoing elective shoulder arthroplasty or arthroscopic shoulder surgery. Further study is warranted to investigate whether this preoperative intervention may contribute to a reduction in perioperative infections, including prosthetic joint infection.
Liver proteomic analysis reveals acute liver failure induced by lipopolysaccharide/D-galactosamine in rats involved in neutrophil extracellular trap formation
Authors: Wang Keyin , Zou Zhuolin , Zou Ting , Wei Dahai , Deng Min
Published: June 2022

Objectives

Acute liver failure (ALF) is a rare life-threatening condition that leads to rapid deterioration of liver function. Although global awareness of ALF consequences is increasing, the precise molecular mechanisms associated with its rapid progression remain unclear. In the present study, we established a rat model of ALF using Lipopolysaccharide (LPS)/D-galactosamine (D-Gal) and explored the potential molecular mechanism of ALF.

Methods

Multiplexed isobaric tandem mass tag labelling combined with liquid chromatography-mass spectrometry was used to thoroughly screen for differentially expressed proteins in liver samples from LPS/D-Gal-induced ALF rat models.

Results

We identified 175 proteins, whose expression was altered by at least 1.5-fold, between the liver samples of ALF and control groups. Of these, 14 dysregulated proteins mainly participated in the regulation of neutrophil extracellular trap (NET) formation. Furthermore, rats with severe ALF showed elevated levels of cathelicidin antimicrobial peptide, myeloperoxidase, and fibrinogen gamma chain, consistent with NET formation. These findings suggest that the NET formation pathway may have contributed to the regulation of the clinical features and progression of liver injury in ALF rats.

Conclusion

To our knowledge, this study is the first to report a global differential protein expression profile of liver samples from rats with LPS/D-Gal-induced ALF. Our TMT-based quantitative proteomic analysis revealed molecular differences involved in NET formation between the ALF and control rat groups, potential therapeutic targets for ALF treatment as well as fundamental information for further detailed experimental research.
The physical activity and health promotion activities of global university students: a review of reviews
Authors: Tafireyi Cecil Gabriel Simbarashe , Grace Jeanne Martin
Published: June 2022

University students globally are reportedly living unhealthy lifestyles, challenging universities to develop physical activity (PA) and health promotion (HP) intervention strategies. The current study aimed to review global universities’ physical activity and health promotion activities to inform the PA and HP guidelines for Eswatini university students in the Sub-Saharan region. An electronic search was performed for review articles published between 1996 and 2021, using Cochrane, Google Scholar, PubMed Central, Scopus, and Medline Web of Science databases. The documents reviewed showed that some global universities under investigation follow the health promoting university (HPU) concept influenced by the Ottawa charter (1986). The review articles further showed that implementing the healthy university concept differs due to cultural and contextual differences from one institution to another. The reviews showed the main item areas as smoking control/alcohol and drug abuse, mental health, sexual health, physical activities, healthy eating habits/diet categorized under health promotion. The main PA activities were pedometer activity tracking, measurement of PA using validated questionnaires, sports, games, among other intervention activities. The HPU concept is thus a good starting point that can be promoted and spread to all other universities globally with different charters’ guidance, including the Ottawa charter and the Okanagan charter.
Validation of a machine learning approach to estimate expanded disability status scale scores for multiple sclerosis
Authors: Alves Pedro , Green Eric , Leavy Michelle , Friedler Haley , Curhan Gary , Marci Carl , Boussios Costas
Published: June 2022

Background

Disability assessment using the Expanded Disability Status Scale (EDSS) is important to inform treatment decisions and monitor the progression of multiple sclerosis. Yet, EDSS scores are documented infrequently in electronic medical records.

Objective

To validate a machine learning model to estimate EDSS scores for multiple sclerosis patients using clinical notes from neurologists.

Methods

A machine learning model was developed to estimate EDSS scores on specific encounter dates using clinical notes from neurologist visits. The OM1 MS Registry data were used to create a training cohort of 2632 encounters and a separate validation cohort of 857 encounters, all with clinician-recorded EDSS scores. Model performance was assessed using the area under the receiver-operating-characteristic curve (AUC), positive predictive value (PPV), and negative predictive value (NPV), calculated using a binarized version of the outcome. The Spearman R and Pearson R values were calculated. The model was then applied to encounters without clinician-recorded EDSS scores in the MS Registry.

Results

The model had a PPV of 0.85, NPV of 0.85, and AUC of 0.91. The model had a Spearman R value of 0.75 and Pearson R value of 0.74 when evaluating performance using the continuous estimated EDSS and clinician-recorded EDSS scores. Application of the model to eligible encounters resulted in the generation of eEDSS scores for an additional 190,282 encounters from 13,249 patients.

Conclusion

EDSS scores can be estimated with very good performance using a machine learning model applied to clinical notes, thus increasing the utility of real-world data sources for research purposes.
Succinct Cancer Clinical Trial Consent Forms in Rural Patients With Cancer: A Secondary Analysis of a Randomized, Double-Blinded study
Authors: Wieland Jana , Satele Daniel , Almodallal Yahya , Novotny Paul , Pritzl Stephanie L. , Mandrekar Sumithra J. , Jatoi Aminah
Published: June 2022

Rural patients are often underrepresented in cancer clinical trials. This is a secondary analysis of a study that tested short (2000 word) versus long (6000 word) consent forms with a focus on rurality. Among 240 patients, 89 (37%) were rural. Seventy-one (80%) rural and 117 (77%) nonrural patients signed a consent form of any length ( P = .68). Forty-one of 47 (87%) rural patients signed a short consent form; in contrast, 30 of 42 (71%) signed a long form. These trends suggest rural patients are more likely to sign short consent forms. Further study is indicated.
Many kinds of oxidized proteins are present more in the urine of the elderly
Authors: Liu Yongtao , Pan Xuanzhen , Bao Yijin , Wei Lilong , Gao Youhe
Published: June 2022

Background

Many studies have shown an association between aging and oxidation. To our knowledge, there have been no studies exploring aging-related urine proteome modifications. The purpose of this study was to explore differences in global chemical modifications of urinary protein at different ages.

Methods

Discovery (n=38) cohort MS data including children, young and old groups were downloaded from three published studies, and this data was analyzed using open-pFind for identifying modifications. Verification cohort human samples (n=28) including young, middle-aged, and old groups, rat samples (n=7) at three-time points after birth, adulthood, and old age were collected and processed in the laboratory simultaneously based on label-free quantification combined with pFind.

Results

Discovery cohort: there were 28 kinds of differential oxidations in the old group that were higher than those in the young or children group in. Verification cohort: there were 17 kinds of differential oxidations of 49 oxidized proteins in the middle and old groups, which were significantly higher than those in the young group. Both oxidations and oxidized proteins distinguished different age groups well. There were also 15 kinds of differential oxidations in old age higher than others in the rat cohort. The results showed that the validation experiment was basically consistent with the results of the discovery experiment, showing that the level of oxidized proteins in urine increased significantly with age.

Conclusions

Our study is the first to show that oxidative proteins occur in urine and that oxidations are higher in older than younger ages. Perhaps improving the degree of excretion of oxidative protein in vivo through the kidney is helpful for maintaining the homeostasis of the body’s internal environment, delaying aging and the occurrence of senile diseases.
Abdominal aortic aneurysm rupture presenting with focal weakness and altered mental status: a case report
Authors: Garrity Brigid M. , Sugarman Eric , Pulley Stephen
Published: June 2022

Background

Abdominal aortic aneurysms (AAA) can present asymptomatically and may be found through routine screening or seen incidentally on imaging. Rupture due to weaking of the aortic wall is the main complication of an AAA and leads to approximately 200,000 deaths annually worldwide. Clinically, AAA rupture most frequently presents with abdominal and/or back pain, pulsatile abdominal mass, and hypotension. Here, we present an unusual presentation of embolic cerebrovascular accident associated with an AAA rupture.

Case presentation

A 58-year-old African American man transported to the emergency department via ambulance presents with altered mental status and unilateral extremity weakness. The initial presentation was concerning for acute cerebrovascular accident, acute kidney injury, severe sepsis, and urinary tract infection. Several hours after the initial presentation, the patient’s abdomen began to appear distended and he became hypotensive. An abdominal CT was ordered which showed a large AAA rupture with a retroperitoneal bleed. The patient was transferred to a higher-level medical center for surgical repair.

Conclusion

Abdominal aortic aneurysm rupture can rarely present due to an acute cerebrovascular accident with altered mental status and focal neurologic deficits.
Association of genetic polymorphisms of PCSK9 with type 2 diabetes in Uygur Chinese population
Authors: Wang Meng-Meng , Lu Chen-Fei , Yan Shi-qi , Wang Bao-Zhu , Yesitayi Gulinazi , Tian Yong-Liang , Xiang-Ma  , Ma Yi-Tong
Published: June 2022

Background

PCSK9 gene expression is associated with biological processes such as lipid metabolism, glucose metabolism, and inflammation. In the present study, our primary objective was to assess the association between the single-nucleotide polymorphisms in the PCSK9 gene and type 2 diabetes in Uygur subjects, in Xinjiang, China.

Methods

We designed a case–control study including 662 patients diagnosed with T2DM and 1220 control subjects. Four single-nucleotide polymorphisms (rs11583680, rs2483205, rs2495477 and rs562556) of PCSK9 gene were genotyped using the improved multiplex ligation detection reaction technique.

Results

For rs2483205, the distribution of genotypes, dominant model (CC vs CT + TT), overdominant model (CC + TT vs CT) showed significant differences between T2DM patients and the controls (P = 0.011 and P = 0.041 respectively). For rs2495477, the distribution of genotypes, the dominant model (AA vs GA + GG) showed significant differences between T2DM patients and the controls (P = 0.024). Logistic regression analysis suggested after adjustment of other confounders, the differences remained significant between the two groups [for rs2483205 CC vs CT + TT: odds ratio (OR) = 1.321, 95% confidence interval (CI) 1.078–1.617, P = 0.007; CC + TT vs CT: OR = 1.255, 95% CI 1.021–1.542, P = 0.03; for rs2495477 AA vs GA + GG: OR = 1.297, 95% CI 1.060–1.588, P = 0.012].

Conclusion

The present study indicated that CT + TT genotype and CT genotype of rs2483205, as well as GA + GG genotype of rs2495477 in PCSK9 gene were associated with an increased risk of type 2 diabetes in the Uygur population in Xinjiang.
Detection of antiviral drug resistance in patients with congenital cytomegalovirus infection using long-read sequencing: a retrospective observational study
Authors: Torii Yuka , Horiba Kazuhiro , Kawada Jun-ichi , Haruta Kazunori , Yamaguchi Makoto , Suzuki Takako , Uryu Hideko , Kashiwa Naoyuki , Goishi Keiji , Ogi Tomoo , Ito Yoshinori
Published: June 2022

Background

Congenital human cytomegalovirus (cCMV) infection can cause sensorineural hearing loss and neurodevelopmental disabilities in children. Ganciclovir and valganciclovir (GCV/VGCV) improve long-term audiologic and neurodevelopmental outcomes for patients with cCMV infection; however, antiviral drug resistance has been documented in some cases. Long-read sequencing can be used for the detection of drug resistance mutations. The objective of this study was to develop full-length analysis of UL97 and UL54, target genes with mutations that confer GCV/VGCV resistance using long-read sequencing, and investigate drug resistance mutation in patients with cCMV infection.

Methods

Drug resistance mutation analysis was retrospectively performed in 11 patients with cCMV infection treated with GCV/VGCV. UL97 and UL54 genes were amplified using blood DNA. The amplicons were sequenced using a long-read sequencer and aligned with the reference gene. Single nucleotide variants were detected and replaced with the reference sequence. The replaced sequence was submitted to a mutation resistance analyzer, which is an open platform for drug resistance mutations.

Results

Two drug resistance mutations (UL54 V823A and UL97 A594V) were found in one patient. Both mutations emerged after 6 months of therapy, where viral load increased. Mutation rates subsided after cessation of GCV/VGCV treatment.

Conclusions

Antiviral drug resistance can emerge in patients with cCMV receiving long-term therapy. Full-length analysis of UL97 and UL54 via long-read sequencing enabled the rapid and comprehensive detection of drug resistance mutations.
The efficacy of transdiagnostic cognitive behavioral therapy on migraine headache: a pilot, feasibility study
Authors: Soleimanian-Boroujeni Forouzandeh , Badihian Negin , Badihian Shervin , Shaygannejad Vahid , Gorji Yousef
Published: June 2022

Introduction

Psychological interventions are shown to be effective in migraine, but not utilized routinely yet. We aimed to evaluate the efficacy of transdiagnostic cognitive behavioral therapy (TCBT) on people with migraine (PwM).

Method

This study was conducted on 40 PwM aged 20–50 years. We randomly assigned participants to two groups of intervention, receiving 10 sessions of TCBT, and control, attending one session on relaxation and stress-management techniques. Days with headache, headache severity, migraine-related disability and effects on daily life, number of pain-relivers taken for headache, depression, and anxiety were assessed pre-intervention, post-intervention (three-month follow-up), and one-month after TCBT termination (four-month follow-up).

Results

Thirty-five participants suffering moderate to severe migraine completed the study (16 and 19 in TCBT and control groups, respectively). TCBT improved all measured items between study time-points (p < 0.05) in the intervention group, while such an improvement was not observed in the control group. Between group comparisons revealed superiority of TCBT group compared to the control group in most measured items at three- and four-month follow-ups (p < 0.05).

Conclusion

Ten sessions of TCBT improved migraine severity, associated disability, anxiety, and depression in PwM, with persistent effects after one month of therapy termination. However, the generalizability of these findings is limited due to the placebo effect in the intervention arm, given the more time each participant has spent with the therapist. TCBT could be an affordable, practical, and feasible intervention to be utilized for PwM and larger studies with equal number of sham therapy sessions are needed to further explore this.

Trial registration number: The study protocol was registered in clinicaltrial.gov (NCT03701477) prior to enrollment.
Exploring the potential mechanism of emetine against coronavirus disease 2019 combined with lung adenocarcinoma: bioinformatics and molecular simulation analyses
Authors: Zhang Kun , Wang Ke , Zhang Chaoguo , Teng Xiuli , Li Dan , Chen Mingwei
Published: June 2022

Background

Patients with lung adenocarcinoma (LUAD) may be more predisposed to coronavirus disease 2019 (COVID-19) and have a poorer prognosis. Currently, there is still a lack of effective anti-LUAD/COVID-19 drugs. Thus, this study aimed to screen for an effective anti-LUAD/COVID-19 drug and explore the potential mechanisms.

Methods

Firstly, we performed differentially expressed gene (DEG) analysis on LUAD transcriptome profiling data in The Cancer Genome Atlas (TCGA), where intersections with COVID-19-related genes were screened out. Then, we conducted Cox proportional hazards analyses on these LUAD/COVID-19 DEGs to construct a risk score. Next, LUAD/COVID-19 DEGs were uploaded on Connectivity Map to obtain drugs for anti-LUAD/COVID-19. Finally, we used network pharmacology, molecular docking, and molecular dynamics (MD) simulation to explore the drug’s therapeutic targets and potential mechanisms for anti-LUAD/COVID-19.

Results

We identified 230 LUAD/COVID-19 DEGs and constructed a risk score containing 7 genes (BTK,CCL20,FURIN,LDHA,TRPA1,ZIC5, andSDK1) that could classify LUAD patients into two risk groups. Then, we screened emetine as an effective drug for anti-LUAD/COVID-19. Network pharmacology analyses identified 6 potential targets (IL6,DPP4,MIF,PRF1,SERPING1, andSLC6A4) for emetine in anti-LUAD/COVID-19. Molecular docking and MD simulation analyses showed that emetine exhibited excellent binding capacities to DDP4 and the main protease (Mpro) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Conclusions

This study found that emetine may inhibit the entry and replication of SARS-CoV-2 and enhance tumor immunity by bounding to DDP4 and Mpro.
Is neonatal phototherapy associated with a greater risk of childhood cancers?
Authors: Sabzevari Fatemeh , Sinaei Reza , Bahmanbijari Bahareh , Dehghan Krooki Simin , Dehghani Azam
Published: June 2022

Background

Neonatal phototherapy (NNPT) has long been used as an effective and relatively safe method of treating neonatal hyperbilirubinemia. Considering the subsequent evidence of long-term impacts of NNPT such as malignancies, this study was conducted to evaluate the relationship between NNPT and childhood cancers.

Methods

This case-control study assessed 116 children up to 4 years old with every kind of cancer referred to the Oncology department of Afzalipour hospital, Kerman, Iran, from 2011 to 18. Moreover, 116 pediatric patients without cancer hospitalized at the same Center were included after sex and age matching as the control group. The history of phototherapy and its duration were evaluated in these two groups.

Results

We found no association between the NNPT and malignancies in children. However, high intensive phototherapy was higher historically among affected cancerous patients than in non-cancerous cases without any statistically significant difference (25% vs 19%; P = 0.26). Maternal educational level and history of maternal infection during pregnancy, which initially appeared to be two factors associated with malignancy in single variable regression analyses, were not significant based on the adjusted models.

Conclusions

The results did not show a positive correlation between NNPT and childhood cancers, which may partly be due to the relatively small sample size of the study. However, some other evidence is worrisome enough that NNPT should not be considered risk-free. Additional multi-centric studies should be undertaken to specify that phototherapy is really safe.