bluuebunny/crossref_metadata_2025 huggingface dataset:
Modelling of physicians’ clinical information-seeking behaviour in Iran: a grounded theory study
Authors: Daei Azra , Soleymani Mohammad Reza , Zargham‑Boroujeni Ali , Kelishadi Roya , Ashrafi-rizi Hasan
Published: April 2024

Objectives

Exploring clinical information-seeking behaviour (CISB) and its associated factors contributes to its theoretical advancement and offers a valuable framework for addressing physicians’ information needs. This study delved into the dimensions, interactions, strategies and determinants of CISB among physicians at the point of care.

Design

A grounded theory study was developed based on Strauss and Corbin’s approach. Data were collected by semistructured interviews and then analysed through open, axial and selective coding.

Setting

The study was conducted at academic centres affiliated with Isfahan University of Medical Sciences.

Participants

This investigation involved recruiting 21 specialists and subspecialists from the academic centres.

Results

The findings revealed that physicians’ CISB encompassed multiple dimensions when addressing clinical inquiries. Seven principal themes emerged from the analysis: ‘clinical information needs’, ‘clinical question characteristics’, ‘clinical information resources’, ‘information usability’, ‘factors influencing information seeking’, ‘action/interaction encountering clinical questions’ and ‘consequences of CISB’. The core category identified in this study was ‘focused attention’.

Conclusions

The theoretical explanation demonstrated that the CISB process was interactive and dynamic. Various stimuli, including causal, contextual and intervening conditions, guide physicians in adopting information-seeking strategies and focusing on resolving clinical challenges. However, insufficient stimuli may hinder physicians’ engagement in CISB. Understanding CISB helps managers, policy-makers, clinical librarians and information system designers optimally implement several interventions, such as suitable training methods, reviewing monitoring and evaluating information systems, improving clinical decision support systems, electronic medical records and electronic health records, as well as monitoring and evaluating these systems. Such measures facilitate focused attention on clinical issues and promote CISB among physicians.
Comparative analysis of antibodies to four major periodontal bacteria in respiratory diseases: a cohort study
Authors: Lund Håheim Anne Lise , Olsen Ingar , Thelle Dag S , Rønningen Kjersti S
Published: April 2024

Objectives

To make a descriptive comparison of antibodies to four major periodontal bacteria and their relation to the respiratory diseases asthma and bronchitis/emphysema, and to cancer incidence.

Methods

The serum of a random sample of men with no history of cancer incidence (n=621) was analysed by the ELISA method for antibody levels of four periodontal bacteria; the anaerobes of the so-called red complexTannerella forsythia(TF),Porphyromonas gingivalis(PG), andTreponema denticola(TD), and the facultative anaerobeAggregatibacter actinomycetemcomitans(AA). The antibody readings were divided into quartiles and the distribution of cases of the relevant diseases as compared with the non-cases. Comparisons of the quartile distributions were by the Pearson χ2test. Data and serum from the Oslo II study of Norwegian men from 2000 were used. The ELISA analyses were performed on thawed frozen serum. Cancer data from 17.5 years of follow-up were provided by the Norwegian Cancer Registry.

Results

In all, 52 men had reported asthma and 23 men had bronchitis/emphysema at the health screening. Results on cancer incidence are given for all respiratory cancers, n=23, and bronchi and lung cancers separately, n=18. Stratified analyses were performed for the four endpoints showing significant association with low levels of TD antibodies for bronchitis; p=0.035. Both TF and TD were significant for low levels of antibodies among daily smokers; p=0.030 for TF and p<0.001 for TD in the analysis of the full study sample. For PG and AA, no such associations were observed. An association with respiratory cancers was not observed.

Conclusion

A low level of TD was associated with bronchitis/emphysema compared with the rest of the cohort. In the total study sample, low levels of antibodies to both TF and TD were associated with daily smoking.
Characteristics of beta parapapillary atrophy in primary angle-closure suspect
Authors: Xiang Fei , Zhang Ye , Zhang Qing , Pan Xiaohua , Feng Hui , Zhang Meijuan , Li Caixia , Ji Qianqian , Li Zhi , Li Shuning
Published: April 2024

Objective

To investigate the characteristics of beta parapapillary atrophy (β-PPA) in patients with primary angle-closure suspect (PACS).

Methods and analysis

In total, 215 and 259 eyes with PACS and non-PACS (NPACS), respectively, were enrolled in this observational, cross-sectional study. Stereoscopic fundus and optical coherence tomography images were used to characterise β-PPA; the former was also used to measure the major β-PPA parameters. Univariate and multiple logistic regression analyses were used to identify the factors correlated with the presence of β-PPA and with β-PPA parameters.

Results

The β-PPA occurrence rates were 48.80% and 44.40% in the PACS and NPACS groups, respectively, with no significant difference between groups. Compared with that in the NPACS group, the β-PPA area was significantly larger (p=0.005) in the PACS group, but the angular extent and maximum radial length did not differ between groups (p=0.110 and 0.657, respectively) after adjusting for age and axial length. The presence of β-PPA was associated with older age (OR 1.057, 95% CI 1.028 to 1.088, p<0.001) and larger disc area (OR 1.716, 95% CI 1.170 to 2.517, p=0.006). A larger β-PPA area was associated with older age (p=0.014), greater vertical cup-to-disc ratio (p=0.028), larger disc area (p<0.001) and PACS diagnosis (p=0.035).

Conclusion

48.80% of participants with PACS had β-PPA, which is slightly larger than NPACS. The area of β-PPA was larger in PACS, while the angular extent and maximum radial length did not differ between groups.
Efficacy and safety of first-line or second-line selective laser trabeculoplasty for normal-tension glaucoma: a multicentre cohort study
Authors: Nitta Koji , Sugihara Kae , Narita Akiko , Naito Tomoko , Miki Takako , Katai Maki , Mizoue Shiro , Yoshikawa Keiji , Tanito Masaki , Sugiyama Kazuhisa
Published: April 2024

Background/aims

This study aimed to investigate and compare the efficacy and safety of first-line and second-line selective laser trabeculoplasty (SLT) in Japanese patients with normal-tension glaucoma (NTG).

Methods

100 patients with NTG were enrolled in this study. Patients were treated with SLT as a first-line or second-line treatment for NTG. Main outcome measures were intraocular pressure (IOP) reduction rate, outflow pressure improvement rate (ΔOP), success rate at 1 year and complications. Success was defined as ΔOP≥20% (criterion A) or an IOP reduction ≥20% (criterion B) without additional IOP-lowering eye-drops, repeat SLT or additional glaucoma surgeries. The incidence of transient IOP spike (>5 mm Hg from the pretreatment IOP), conjunctival hyperaemia, inflammation in the anterior chamber and visual impairment due to SLT were assessed.

Results

A total of 99 patients (99 eyes) were initially enrolled in this study, including 74 eyes assigned to the first-line SLT group and 25 eyes to the second-line SLT group. The mean IOP of 16.3±2.1 mm Hg before SLT decreased by 17.1%±9.5% to 13.4±1.9 mm Hg at 12 months after SLT in the first-line group (p<0.001), and the mean IOP of 15.4±1.5 mm Hg before SLT decreased by 12.7%±9.7% to 13.2±2.0 mm Hg at 12 months after SLT (p=0.005) in the second-line group. Both groups showed significant reductions in IOP. Higher pre-SLT IOP and thinner central corneal thickness were associated with greater IOP reduction. The success rate at 1 year was higher in the first-line compared with the second-line group, with lower pretreatment IOP and the use of IOP-lowering medication before SLT being associated with treatment failure. Most post-treatment complications were minor and transient.

Conclusions

SLT may be an effective and safe treatment option for NTG, as either a first-line or second-line treatment.

Trial registration number

The study was registered in the UMIN-CTR (UMIN Test ID: UMIN R000044059).
Health information technology tools to accelerate gastrointestinal evaluation in patients with iron deficiency anaemia: a cluster randomised controlled trial
Authors: Priyanath Gupta Aparna , Patel Dharmesh , Lee Ji Young , Volpentesta Michelle , Schachter Michael , Persell Stephen D
Published: April 2024

Objective

System-level safety measures do not exist to ensure that patients with iron deficiency anaemia (IDA) undergo proper diagnostic evaluations. We sought to determine if a set of EHR (electronic health record) tools and an expedited referral workflow increase short-term completion of bidirectional endoscopy in higher risk patients with IDA.

Materials and methods

We conducted a pragmatic, cluster-randomised trial randomised by primary care physician (PCP) that included 16 PCPs and 316 patients with IDA. Physicians were randomised to intervention or control groups. Intervention components included a patient registry visible within the EHR, point-of-care alert and expedited diagnostic evaluation workflow for IDA. Outcomes were assessed at 120 days. The primary outcome was completion of bidirectional endoscopy. Secondary outcomes were any endoscopy completed or scheduled, gastroenterology consultation completed, and gastroenterology referral or endoscopy ordered or completed.

Results

There were no differences in the primary or secondary outcomes. At 120 days, the primary outcome had occurred for 7 (4%) of the intervention group and 5 (3.5%) of the control group. For the three secondary outcomes, rates were 15 (8.6%), 12 (6.9%) and 39 (22.4%) for the immediate intervention group and 10 (7.0%), 9 (6.3%) and 25 (17.6%) for the control group, respectively, p>0.2. Lack of physician time to use the registry tools was identified as a barrier.

Discussion and conclusion

Providing PCPs with lists of patients with IDA and a pathway for expedited evaluation did not increase rates of completing endoscopic evaluation in the short term.

Trial registration number

NCT05365308.
PURCHASING TEAM INNOVATION CLIMATES AS ANTECEDENTS OF PURCHASING INVOLVEMENT IN OPEN INNOVATION
Authors: SERVAJEAN-HILST ROMARIC , SUURMOND ROBERT
Published: April 2024

This study aims to enhance our understanding of the relationship between team innovation climate within the purchasing team and the level of purchasing involvement in open innovation (OI) initiatives. Previous research in psychology and management has documented the impact of team climate on innovation capacity. Furthermore, the purchasing function has been recognised as a bridge between internal and external resources in OI. However, to date, research has not examined the link between the team innovation climate and the role of the purchasing function in OI initiatives. To address this gap, we studied a sample of 258 purchasing teams across industries in France based on a self-audit and questionnaire using established team innovation climate scales. From our analyses, four dimensions of the purchasing team climate towards innovation emerge: the team cohesiveness, the team creativity, the leader support for innovation and the institutional support for innovation. We subsequently conduct regression and necessary condition analysis. Our results show that institutional support is both necessary and positively related to involvement. Moreover, purchasing’s ability to contribute to inbound OI is constrained by each of the four dimensions of the team innovation climate, to various extents. Our work thereby elucidates the individual elements and the collective impact of the team innovation climate that enable the exploitation of the innovative potential of suppliers through purchasing’s bridge function between external and internal innovation actors providing new insights into the human side of OI at team level.

Managerial Highlights

• Team innovation climate plays an important role in the management of open innovation. • Team innovation climate influences the purchasing team’s involvement in open innovation projects of its firm i.e. the way its open innovation is managed. • There are four dimensions affecting the purchasing team innovation climate: institutional support, team leader support, team creativity and team cohesiveness. • High levels of involvement of the purchasing function do not occur without at least medium levels of these four dimensions. • Only institutional support is directly and positively related to the increasing level of involvement of purchasing in open innovation initiatives.
Bulging and contraction during nanoindentations on amorphous polymers
Authors: Bhattacharyya Arnab Sankar
Published: April 2024

In today's world, amorphous conducting polymers are extremely important in technology. Due to its lightweight, transparency, and long-lasting mechanical performance. They are finding applications in the aerospace, automotive, and military sectors, thus adequate precision-based research are required. The nanoindentation P-h plots of PPy were examined based on load fluctuations observed at specific depth intervals. The observations were used to explain polymeric chain motions and visco-elastic-plastic flow.
Subarachnoid Haemorrhage Incidence Pattern Analysis with Circular Statistics
Authors: Dravid Ashish , Sung Wen-Shan , Song Jeeuk , Dubey Arvind , Eftekhar Behzad
Published: April 2024

Knowledge about biological rhythms of diseases may not only help in understanding the pathophysiology of diseases but can also help health service policy makers and emergency department directors to allocate resources efficiently. Aneurysmal subarachnoid haemorrhage (SAH) has high rates of morbidity and mortality. The incidence of SAH has been attributed to patient-related factors such as characteristics of aneurysms, smoking, and hypertension. There are studies showing that the incidence of aneurysmal SAH appears to behave in periodic fashions over long time periods. However, there are inconsistencies in the literature regarding the impact of chronobiological factors such as circadian, seasonal, and lunar cycle factors on the occurrence of SAH. In this study, we focused on the analysis of a temporal pattern of SAH (infradian rhythms) with a novel approach using circular statistical methods. We aimed to see whether there is a circular pattern for the occurrence of SAH at all and if so, whether it can be related to known temporal patterns based on available literature. Our study did not support the notion that aneurysmal subarachnoid haemorrhages occur on any specific day in a cycle with specific lengths up to 365 days including specific weekdays, full moon, equinoxes, and solstices. Hence, we found no relationship between SAH incidence and timing. Study in larger populations using similar circular statistical methods is suggested.
Allelopathic Effects of Lantana camara L. Leaf Aqueous Extracts on Germination and Seedling Growth of Capsicum annuum L. and Daucus carota L.
Authors: Alemayehu Yiftusira , Chimdesa Meseret , Yusuf Zekeria
Published: April 2024

Allelopathy is the chemical interactions between plants that might lead to either stimulation or inhibition of growth, community structure, and plant invasions. Lantana camara L. is a noxious invasive weed that negatively affects seed germination, seedling growth, and increases the mortality of the crop plant. The objective of this work was to assess allelopathic effect of L. camara leaf aqueous extract on germination and seedling growth of Capsicum annuum (pepper) and Daucus carota (carrot). The aqueous extract of Lantana leaf samples was used as a source of allelopathic effects. Data were collected for germination and seedling growth parameters. The result indicated that the highest concentration of the allelopathic extract (20 mg/L) has demonstrated significantly the highest germination inhibition rate GIR (60.00%), germination speed V (2.54 U/day) for D. carota as GIR (70.00%), mean germination time MGT (0.36 days), and GI (0.67%) for C. annuum seeds. The highest concentration of the allelopathic extract (20 mg/L) has recorded the highest plumule inhibition rate PIR (59.63%) and radical inhibition rate RIR (48.95%) for D. carota seeds, as well as PIR (27.47%) and RLR (79.49%) for C. annuum. The largest negative allelopathic index (−60.00% or allelopathic intensity of 60.00%) was recorded for D. carota seeds, whilst (−63.43% or allelopathic intensity of 63.43%) was recorded for C. annuum seed germination. For D. carota seed germination, the first principal component (PC1) has got high positive loads from GI (0.36), RLR (0.31), GR (0.34), allelopathic index AI (0.34), relative length of plumule RLP (0.24), and V (0.30). By contrast, PC1 for D. carota seed germination has got the highest negative component loads recorded by GIR (−0.34), PIR (−0.24), MGT (−0.35), and RIR (−0.31). In allelopathic effect on C. annum seed germination, the first principal component (PC1) has got high positive scores from relative length of radical RLR (0.31), RLP (0.33), germination rate GR (0.33), V (0.33), and AI (0.33). Likewise, the high negative component loads were recorded by GIR (−0.33), PIR (−0.33), RIR (−0.31), and MGT (−0.32). The result of the present study demonstrated that GIR, PIR, and RIR were directly related to negative allelopathic activity.
Figure S3 from Proteasome Inhibition Reprograms Chromatin Landscape in Breast Cancer
Authors: Kinyamu H. Karimi , Bennett Brian D. , Ward James M. , Archer Trevor K.
Published: April 2024

Shows effects of proteasome inhibition on non-coding transcription.
FIGURE 5 from Proteasome Inhibition Reprograms Chromatin Landscape in Breast Cancer
Authors: Kinyamu H. Karimi , Bennett Brian D. , Ward James M. , Archer Trevor K.
Published: April 2024

DOCRs define important cis-regulatory regions specific to non-basal breast cancer tumors. A, Heat map showing chromatin accessibility signal (ATAC-seq) of TCGA breast cancer tumors (39) in DOCRs. Each row corresponds to a DOCR, and they are split by increase (GAIN) or decrease (LOST) in accessibility and by genomic category (PROMOTER, GENIC, INTERGENIC). N is the number of DOCRs in each category. Each column corresponds to a TCGA breast cancer tumor, split by non-basal (N = 57) and basal (N = 13) subtypes. Signal is z-score normalized by row, where red is high relative signal and blue is low relative signal. B, Venn diagram highlighting the number of SEs identified in Control only, 24H treated only, or shared between the samples. C, Heat map showing chromatin accessibility signal (ATAC-seq) of TCGA breast cancer tumors in SEs. Each row (N = 333) corresponds to a SE region, and they are split by cluster from hierarchical clustering. D, Circos plot showing chromosome coordinates of SEs, split by cluster. The outer ring shows reference chromosomes 1 through 22 in clockwise orientation. Inside rings correspond to clusters A–F from the heat map in C. The number of SE regions in each cluster per chromosome is indicated inset. Representative genes in SE regions in each cluster are shown. Color density indicates SE enrichment within each cluster and chromosome. E, Browser tracks showing the VMP1/MIR21 and SUMO1P1 SE regions. Tracks show read coverage of chromatin accessibility (ATAC), differential read coverage of accessibility (DIFF), H3K27ac read coverage, SE regions, and average ATAC read coverage for non-basal (brown) and basal (green) TCGA breast cancer tumors. Each track represents a control (0) light and 24H sample dark purple. F, Heat map showing ER ChIP-seq signal of MCF-7 cells treated with E2 (left) or Vehicle (right) in SE regions. Signal spans from 2 kb upstream of the SE, through the body of the SE, and to 2 kb downstream of the SE. Rows are split by cluster from the heat map in C. Signal is z-score normalized by row, where red is high relative signal and blue is low relative signal. G, Heat map showing ER ChIP-seq signal of breast tumor (left) or normal tissue (right) in SE regions. H, Heat maps showing differential signal for start RNA, accessibility (ATAC), RNAPII (Ser5P), K27ac and GRO-seq (E2) at non-genic TSSs that overlap GAIN (left) and LOST DOCRs (right). I, Browser tracks showing the SUMO1P1 SE region. Tracks show read coverage of chromatin accessibility (ATAC), differential accessibility (DIFF), SE regions, K27ac, RNAPII (SER5P), RNA-seq, and GRO-seq from cells treated with Veh and E2.
Does the Prevalence of Obesity in the Different Regions of Spain Influence the Attitudes, Perception, and Barriers to Its Treatment?
Authors: Vilarrasa Nuria , Salvador Javier , Poyato Francisco , Rubio-Herrera Miguel Ángel
Published: April 2024

Introduction: The differences in the prevalence of obesity between the various regions of Spain, partly attributed to socioeconomic differences, may influence the approach to this disease. The aim of this study was to compare differences in attitudes, perception, and barriers to the treatment of obesity between people with obesity (PwO) and health care professionals (HCPs), between the different regions of Spain. Methods: Sub-analysis of the ACTION-IO Spain study, which included 1,500 PwO and 306 HCP, was performed to identify differences in PwQ and HCPs belonging to regions with high prevalence of obesity (>16%, n = 9 regions, high prevalence of obesity [HPO] group) and low prevalence of obesity (<16%, n = 8 regions, low prevalence of obesity [LPO] group) (self-reported data), according to the 2017 National Health Survey of Spain. Statistics: comparison of proportions (χ2). Results: A total of 746 PwO belonged to HPO and 754 to LPO group. The PwO in HPO group were younger, had lower income, a lower level of higher education, higher unemployment rate, and fewer comorbidities. Obesity was considered a chronic disease to a higher extent in HPO compared to LPO group (62 vs. 56%), but this difference was not statistically significant. The PwO in HPO group discussed less with the HCPs about their excess weight (57 vs. 70%), did not feel motivated to lose weight in a higher percentage (26 vs. 18%), and felt less emotionally supported (16 vs. 24%). In HPO group, the preference for unhealthy food (51 vs. 36%), and the costs of healthy eating, anti-obesity drugs and bariatric surgery were perceived barriers to losing weight. A higher proportion of PwO in HPO group considered that exercise (58 vs. 40%) was more effective for achieving weight loss. In contrast, LPO group considered diet more effective (48 vs. 32%). HCPs in HPO group felt more motivated to treat obesity (83 vs. 68%) and a higher proportion (14 vs. 5%) identified the economic burden as one of the main reasons why PwO do not start conversations to lose weight. Conclusions: There is less concern and conversation about excess weight in PwO in regions with a higher prevalence of obesity, with socioeconomic limitations being one of the main perceived barriers to treatment.
Sleep Disorders and Sleep Disturbances in Persons with Multiple Sclerosis: A Population-Based Matched Case-Control Study in Denmark
Authors: Framke Elisabeth , Jennum Poul Jørgen , Thygesen Lau Caspar , Magyari Melinda
Published: April 2024

Introduction: Adverse sleep is common in multiple sclerosis (MS). Population-based studies including adequate control groups are lacking. We hypothesized that the prevalence of sleep disorders and other sleep disturbances would be higher in persons with MS than in controls. Methods: We conducted a population-based study linking individual-level data from the Danish MS Registry (n = 21,943 persons with MS) and the Danish Population Registry (n = 109,715 matched controls) with information on sleep disorders from the Danish National Patient Registry and other sleep disturbances assessed by dispensed prescription drugs from the Danish National Prescription Registry. Results: Prevalence of diagnosed sleep disorders in terms of central hypersomnia (0.15% vs. 0.06%), sleep disturbances (1.05% vs. 0.70%), and sleep movements (0.22% vs. 0.13%) and other sleep disturbances identified by dispensed central acting (10.73% vs. 1.10%) and hypnotic use (30.65% vs. 20.13%) medication was statistically significantly higher among persons with MS when compared to controls. We found no statistically significant difference in the prevalence of sleep apnea and parasomnia between groups. Stratified by sex and age at MS diagnosis, results for differences between persons with MS and controls were similar. Conclusion: In this registry-based study, we found that the prevalence of several diagnosed sleep disorders was higher in persons with MS than in controls, that is, those reflecting insomnia and daytime symptoms including hypersomnia. Other sleep disturbances identified by dispensed prescription medication were markedly higher in persons with MS than in controls.
Tick Bite Alopecia: A Report of Five Cases and Review of the Literature
Authors: Veraldi Stefano , Murgia Giulia , Nazzaro Gianluca , Barbareschi Mauro
Published: April 2024

Introduction: Although well-known, tick bite alopecia is rarely reported in the literature. Case Presentations: We present five cases of alopecia of the scalp caused by tick bites. All patients were Caucasians, 2 males and 3 females, with an age ranging from 4 to 9 years (mean age: 6.3 years). Discussion: The mechanisms by which ticks cause alopecia are unknown. The saliva of ticks contains anticoagulants (heparins, heparinoids, and coumarins). The release of these anticoagulants would induce an inflammatory reaction on the scalp, with alopecia as the final clinical result.
Current Fluid Management Practice in Critically Ill Adults on Continuous Renal Replacement Therapy: A Binational, Observational Study
Authors: White Kyle C. , Laupland Kevin B. , Ostermann Marlies , Neto Ary Serpa , Gatton Michelle L. , Hurford Rod , Clement Pierre , Sanderson Barnaby , Bellomo Rinaldo
Published: April 2024

Introduction: In critically ill patients undergoing continuous renal replacement therapy (CRRT), a positive fluid balance (FB) is associated with adverse outcomes. However, current FB management practices in CRRT patients are poorly understood. We aimed to study FB and its components in British and Australian CRRT patients to inform future trials. Methods: We obtained detailed electronic health record data on all fluid-related variables during CRRT and hourly FB for the first 7 days of treatment. Results: We studied 1,616 patients from three tertiary intensive care units (ICUs) in two countries. After the start of CRRT, the mean cumulative FB became negative at 31 h and remained negative over 7 days to a mean nadir of −4.1 L (95% confidence interval (CI) of −4.6 to −3.5). The net ultrafiltration (NUF) rate was the dominant fluid variable (−67.7 mL/h; standard deviation (SD): 75.7); however, residual urine output (−34.7 mL/h; SD: 54.5), crystalloid administration (48.1 mL/h; SD: 44.6), and nutritional input (36.4 mL/h; SD: 29.7) significantly contributed to FB. Patients with a positive FB after 72 h of CRRT were more severely ill, required high-dose vasopressors, and had high lactate concentrations (5.0 mmol/L; interquartile range: 2.3–10.5). A positive FB was independently associated with increased hospital mortality (odds ratio: 1.70; 95% CI; p = 0.004). Conclusion: In the study ICUs, most CRRT patients achieved a predominantly NUF-dependent negative FB. Patients with a positive FB at 72 h had greater illness severity and haemodynamic instability. Achieving equipoise for conducting trials that target a negative early FB in such patients may be difficult.
Primary Results of Patients with Genitourinary Malignancies Presented at a Molecular Tumor Board
Authors: Michaelis Jakob , Himmelsbach Ruth , Metzger Patrick , Lassmann Silke , Börries Melanie , Werner Martin , Miething Cornelius , Höfflin Rouven , Illert Anna L. , Duyster Justus , Becker Heiko , Sigle August , Gratzke Christian , Grabbert Markus
Published: April 2024

Introduction: Personalized medicine poses great opportunities and challenges. While the therapeutic landscape markedly expands, descriptions about status, clinical implementation and real-world benefits of precision oncology and molecular tumor boards (MTB) remain sparse, particularly in the field of genitourinary (GU) cancer. Hence, this study characterized urological MTB cases to better understand the potential role of MTB in uro-oncology. Methods: We analyzed patients with complete data sets being reviewed at an MTB from January 2019 to October 2022, focusing on results of molecular analysis and treatment recommendations. Results: We evaluated 102 patients with GU cancer with a mean patient age of 61.7 years. Prostate cancer (PCa) was the most frequent entity with 52.9% (54/102), followed by bladder cancer (18.6%, 19/102) and renal cell carcinoma (14.7%, 15/102). On average, case presentation at MTB took place 54.9 months after initial diagnosis and after 2.7 previous lines of therapy. During the study period, 49.0% (50/102) of patients deceased. Additional MTB-based treatment recommendations were achieved in a majority of 68.6% (70/102) of patients, with a recommendation for targeted therapy in 64.3% (45/70) of these patients. Only 6.7% (3/45) of patients – due to different reasons – received the recommended MTB-based therapy though, with 33% (1/3) of patients reaching disease control. Throughout the MTB study period, GU cancer case presentations and treatment recommendations increased, while the time interval between initial presentation and final therapy recommendation were decreasing over time. Conclusion: Presentation of uro-oncological patients at the MTB is a highly valuable measure for clinical decision-making. Prospectively, earlier presentation of patients at the MTB and changing legislative issues regarding comprehensive molecular testing and targeted treatment approval might further improve patients’ benefits from comprehensive molecular diagnostics.
“As mulheres são como as águas… crescem quando se encontram”: conhecendo o feminismo na Pan-Amazônia
Authors: Mestre Simone de Oliveira , Brasil Jamyle Vanessa Costa
Published: April 2024

Crystallized in the Brazilian social imagination, there is a nationalization of the Amazon as an exclusive area of Brazil, making invisible the fact that the forest is a Latin territory and neglecting its border and multicultural characteristics. Based on this conception, this article proposes a reflection on the importance of feminist movements that operate in the Pan-Amazon, seeking to address the counter-hegemonic Latin American feminisms existing in the territory and their relationship with the coloniality of power in the light of an approach that recognizes the existence of Afro-America in the Amazon. Furthermore, the impacts of colonialist actions and discourses, disguised as development, on the lives of women living in the Pan-Amazon and how they articulate their resistance are problematized.
Percursos na luta de coletivos culturais das periferias de São Paulo
Authors: Pacheco Tâmara
Published: April 2024

La principal bandera de denuncia del movimiento negro brasileño, desde finales de los años 1970, es el genocidio de la juventud negra. Este tema está vigente y cobra evidencia a través de nuevas formas de acción, debido a los avances en las políticas sociales de los regímenes democráticos, principalmente a partir de los años 1990 y los cambios paradigmáticos en el modo de producción capitalista. El más reciente proceso de democratización del país con la conquista de la Constitución ciudadana, iniciada en 1988, está marcado por las contradicciones, el avance del neoliberalismo, las amenazas a la democracia brasileña y el aumento de los índices de violencia, en los cuales el joven negro de la periferia se convierte en el “enemigo del Estado”. Utilizando el concepto de colonialidad del poder de Quijano y el concepto de necropolítica, defendido por Mbembe, buscamos comprender la praxis política por parte de colectivos culturales de la periferia de la ciudad de São Paulo que, al poner en tensión sobre las estructuras del Estado, basadas en alternativas de sociabilidad, proponen un nuevo significado a la esfera pública. Para comprender el protagonismo negro en la formación histórico-social de Brasil, es necesario ingresar al modo de producción esclavista, en el cual la cuestión racial ocurre con el colonialismo y los conflictos de clases entre esclavos y amos. Moura llama “quilombagem” a las estrategias de negación del sistema esclavista por parte de los esclavizados. Hoy esta práctica se actualiza con los colectivos periféricos.
A formação racializada de uma metrópole: São Paulo – um local determinado
Authors: Barbosa Eliete Edwiges
Published: April 2024

This article seeks to demonstrate how the metropolis of São Paulo builds a ghettoized city, with public political strategies for urban and economic development that used as a backdrop “the name of progress and urban development.” On the other hand, the occupation and dizzying growth of areas far away from the city, where the poor population had to live, gave rise to the peripheral areas of the city. These territories unify the urban space, where the insufficiency of public policies generates racialized access to citizenship rights.
Condições de saúde mental dos secundaristas em luta: os casos de Santiago e de São Paulo
Authors: Gregório Maria Eugênia Augusto
Published: April 2024

Este artículo busca identificar las estrategias de resistencia construidas por los estudiantes de la secundaria de Santiago y de São Paulo como formas de garantizar la representación de los estudiantes y que posibilitaron la salud mental de los jóvenes. Centrándonos en artículos científicos de la base de datos SciELO sobre el movimiento secundario en Chile y en Brasil, seguido de la realización de un Análisis de Contenido relacionado con nuestras referencias, analizamos la interfaz entre resistencia como poder y salud mental y opresión como productora de violaciones de derechos que produce enfermedad psíquica. Pudimos ver que la discusión presente en la literatura sobre las diferentes formas de resistencia contribuye a una revisión eurocéntrica del concepto de sujeto, así como a la comprensión de la salud, en que es posible entenderla en el campo ético-político como un poder para actuar a partir de la confrontación colectiva de la opresión manifestada por la producción cultural de los estudiantes de la secundaria.
Cardiac MRI-Enriched Phenomapping Classification and Differential Treatment Outcomes in Patients With Ischemic Cardiomyopathy
Authors: Kwon Deborah H. , Huang Shuaiqi , Turkmani Mustafa , Salam Donna , Al-Dieri Danah , Ming Wang Tom Kai , Kapadia Samir R. , Krishnaswamy Amar , Gillinov Marc , Svensson Lars G. , Grimm Richard A. , Tang W.H. Wilson , Chen David , Nguyen Christopher T. , Wang Xiaofeng
Published: April 2024

BACKGROUND:

Significant controversy continues to confound patient selection and referral for revascularization and mitral valve intervention in patients with ischemic cardiomyopathy (ICM). Cardiac magnetic resonance (CMR) enables comprehensive phenotyping with gold-standard tissue characterization and volumetric/functional measures. Therefore, we sought to determine the impact of CMR-enriched phenomapping patients with ICM to identify differential outcomes following surgical revascularization and surgical mitral valve intervention (sMVi).

METHODS:

Consecutive patients with ICM referred for CMR between 2002 and 2017 were evaluated. Latent class analysis was performed to identify phenotypes enriched by comprehensive CMR assessment. The primary end point was death, heart transplant, or left ventricular assist device implantation. A multivariable Cox survival model was developed to determine the association of phenogroups with overall survival. Subgroup analysis was performed to assess the presence of differential response to post-magnetic resonance imaging procedural interventions.

RESULTS:

A total of 787 patients were evaluated (63.0±11.2 years, 24.8% women), with 464 primary events. Subsequent surgical revascularization and sMVi occurred in 380 (48.3%) and 157 (19.9%) patients, respectively. Latent class analysis identified 3 distinct clusters of patients, which demonstrated significant differences in overall outcome (
P
<0.001). Latent class analysis identified differential survival benefit of revascularization in patients as well as patients who underwent revascularization with sMVi, based on phenogroup classification, with phenogroup 3 deriving the most survival benefit from revascularization and revascularization with sMVi (hazard ratio, 0.61 [0.43–0.88];
P
=0.0081).

CONCLUSIONS:

CMR-enriched unsupervised phenomapping identified distinct phenogroups, which were associated with significant differential survival benefit following surgical revascularization and sMVi in patients with ICM. Phenomapping provides a novel approach for patient selection, which may enable personalized therapeutic decision-making for patients with ICM.
Feasibility and Diagnostic Performance of Functional SYNTAX Score Derived From Dynamic CT Myocardial Perfusion Imaging
Authors: Dai Xu , Yu Lihua , Yu Yarong , Yang Wenli , Lan Ziting , Yuan Jiajun , Yang Wenyi , Zhang Jiayin
Published: April 2024

BACKGROUND:

Computed tomography (CT) fractional flow reserve (FFR)–derived functional SYNTAX score (FSS
CT-FFR
) is a valuable method for guiding treatment strategy in patients with multivessel coronary artery disease. Dynamic CT myocardial perfusion imaging (CT-MPI) demonstrates higher diagnostic accuracy than CT-FFR in identifying hemodynamically significant coronary artery disease. We aimed to evaluate the feasibility of CT-MPI–derived FSS (FSS
CT-MPI
) with reference to invasive FSS.

METHODS:

In this retrospective study, patients with multivessel coronary artery disease who underwent dynamic CT-MPI+ coronary CT angiography and invasive coronary angiography or FFR within 4 weeks were consecutively included. Invasive (FSS
invasive
) and noninvasive FSS (FSS
CT-MPI
and FSS
CT-FFR
) were calculated by an online calculator, which assigned points to lesions with hemodynamic significance (defined as FFR
invasive
≤0.80, invasive coronary angiography diameter stenosis ≥90%, CT-FFR ≤0.80, and myocardial ischemia on CT-MPI). Weighted κ value and net reclassification index were calculated to determine the consistency and incremental discriminatory power of FSS
CT-MPI
. Receiver operating characteristic curve analysis was used for the comparison of FSS
CT-MPI
and FSS
CT-FFR
in detecting intermediate- to high-risk patients.

RESULTS:

A total of 119 patients (96 men; 64.6±10.6 years) with 305 obstructive lesions were included. The average FSS
CT-MPI
, FSS
CT-FFR
, and FSS
invasive
were 15.58±13.03, 16.18±13.30, and 13.11±12.22, respectively. The agreement on risk classification based on the FSS
CT-MPI
tertiles was good (weighted κ, 0.808). With reference to FSS
invasive
, FSS
CT-MPI
correctly reclassified 27 (22.7%) patients from the intermediate- to high SYNTAX score group to the low-score group (net reclassification index, 0.30;
P
<0.001). In patients with severe calcification, FSS
CT-MPI
had better diagnostic value than FSS
CT-FFR
in detecting intermediate- to high-risk patients when compared with FSS
invasive
(area under the curve, 0.976 versus 0.884;
P
<0.001).

CONCLUSIONS:

Noninvasive FSS derived from CT-MPI is feasible and has strong concordance with FSS
invasive
. It allows accurate categorization of FSS in patients with multivessel coronary artery disease, in particular with severe calcification.
A survey on the practice of phlebotomy in Lithuania and adherence to the EFLM-COLABIOCLI recommendations
Authors: Stonys Ricardas , Vitkus Dalius
Published: April 2024

Graphical abstract
Highlights
• Venous blood sampling in Lithuania: noncompliance with EFLM-COLABIOCLI
• Inadequate continuous education is linked to poor phlebotomy practices
• Biomedical technicians, trained in phlebotomy, show higher compliance than nurses
• Harmonising blood collection practices across healthcare institutions is crucial
IntroductionThe aim of this study was to determine the level of compliance of venous blood sampling (VBS) in Lithuania with the joint recommendations of the European Federation of Clinical Chemistry and Laboratory Medicine and the Latin American Confederation of Clinical Biochemistry (EFLM-COLABIOCLI) and to analyse possible causes of errors. A survey was conducted between April and September 2022.
Materials and methodsA self-designed questionnaire was distributed to the Lithuanian National Societies. Error frequencies and compliance score were computed. Differences between groups were analysed using Pearson’s chi-square, Fisher’s exact criterion, Mann-Whitney U (for two groups), or Kruskal-Wallis (for more than two groups) for categorical and discrete indicators. The association between ordinal and discrete variables was assessed using Spearman’s rank correlation coefficient. Statistical significance was determined at P < 0.05.
ResultsA total of 272 respondents completed the questionnaire. Median error rate and compliance score were 31.5% and 13/19, respectively. Significant differences were found among professional titles, standard operating procedures availability, training recency, and tourniquet purpose opinions. A negative correlation was noted between compliance and time since training (rs = - 0.28, P < 0.001).
ConclusionsThe findings of this study indicate that there is a significant need for improvement in compliance with the EFLM-COLABIOCLI recommendations on VBS among specialists in Lithuania. Essential measures include prioritizing ongoing phlebotomy training and establishing national guidelines. Harmonisation of blood collection practices across healthcare institutions is crucial.
The European Union Climate Diplomacy: Evolving Practices in a Changing Geopolitical Context
Authors: Bremberg Niklas , Michalski Anna
Published: April 2024

The European Union (EU) has systematically promoted global climate change mitigation and adaptation efforts. Since the 1990s, despite varying success in international climate negotiations, it has sought to take a leadership role in global climate politics. Internal consolidation of environmental and climate policies has enhanced EU policy coherence and strengthened its ability to influence international efforts to mitigate climate change. Globally, however, the picture is marred by geopolitical competition, rendering the context of global climate politics less propitious for the EU’s climate leadership. This article examines how the EU’s climate diplomacy is adapting to an increasingly complex international context. It finds that while the EU climate action is still premised on the deep-seated beliefs of the EU’s ambitious approach to climate, the practices of EU climate diplomacy have adapted to a changing geopolitical context. This evolution is traced through a set of key diplomatic practices: narration, co-ordination, outreach and mainstreaming.
Phytoseiidae (Acari: Mesostigmata) of the subfamily Amblyseiinae from Brazil
Authors: LOFEGO ANTONIO CARLOS , BARBOSA MARINA FERRAZ DE CAMARGO , DEMITE PETERSON RODRIGO , MORAES GILBERTO JOSÉ DE
Published: April 2024

Phytoseiidae is composed of essentially predatory mites most commonly found on the aerial plant parts. Presently, it is considered to contain about 2,650 valid species, divided into nearly 102 genera of three subfamilies: Amblyseiinae, Phytoseiinae and Typhlodrominae. Approximately 250 of those have been reported from Brazil. Amblyseiinae is the largest subfamily, with about 65% of the described species. This publication summarises the morphologic, taxonomic and distributional information of the Amblyseiinae reported from Brazil, in support of future research on their conservation and practical use. A total of 195 valid species of 29 genera of Amblyseiinae is listed in this publication, 121 of which were described from this country, including seven species which are most certainly incorrect reports, based on the present state of knowledge. Two new combinations are proposed: one in Amblyseius, Amblyseius malvus (Denmark & Evans), and one in Transeius, Transeius piracicabae (Denmark & Muma). Six new synonyms are proposed (Chelaseius lativentris Karg, T. piracicabae, Euseius errabundus De Leon, Typhloromalus clavicus Denmark & Muma, Typhlodromips fordycei (De Leon) and Typhlodromips mangleae De Leon, as senior synonyms of Chelaseius brazilensis Denmark & Kolodochka, Transeius gervasioi Rocha, Silva & Ferla, Euseius plaudus Denmark & Muma, Typhlodromalus simus Denmark & Muma, Typhlodromips igapo Nuvoloni, Lofego, Rezende & Feres and Typhlodromips pederosus El-Banhawy, respectively). A key is provided to help in the separation of the species reported. So far, the most diverse genera in Brazil (followed by the number of species reported) are: Amblyseius Berlese (48), Neoseiulus Hughes (23), Typhlodromips De Leon (22), Iphiseiodes De Leon (14), Amblydromalus Chant & McMurtry (13) and Euseius Wainstein (12). The highest number of species is reported from the southeastern region (119 species), followed by the northeastern (82), the northern (68), the southern (65) and the midwestern (52). The states with highest numbers of registered species are São Paulo (109), Bahia (70), Rio Grande do Sul (62), Amazonas (47), Pernambuco (44) and Minas Gerais (43), while those with lowest numbers are Rio Grande do Norte (16), Sergipe (12), Pará (12), Rondônia (7) and Amapá (5). At least in part, those differences might be related to the dedicated searching effort.
Roles of Racial Ecologies on Black Adolescents’ Coping with Racism
Authors: Golden Chandler A. , Jones Shawn C.T. , Cage Jamie , Lozada Fantasy
Published: April 2024

Drawing from Spencer’s phenomenological variant of ecological systems theory (PVEST), this study examines how Black adolescents navigate racism-related stress, ethnic-racial socialization, and critical reflection as racial ecologies, and their association with coping strategies. Additionally, we explore critical action, a unique coping strategy related to critical consciousness. Using latent profile analysis, data from 200 Black adolescents (Mage = 14.2 years) were analyzed, with racism, ethnic-racial socialization, and critical reflection as indicators. Profile differences in coping were also investigated. Four distinct profiles of Black teen racial ecologies were identified: (a) Positively Racially Socialized, Less Discriminated ( n = 88); (b) Racially Socialized, Discriminated, and Aware ( n = 47); (c) Racially Discriminated and Negatively Socialized ( n = 37); and (d) Low Racially Salient ( n = 28). These profiles exhibited differences in coping strategy endorsement. The findings highlight the importance of Black youth's racial ecologies in shaping their coping mechanisms and have implications for research and clinical practices.
Middle Managers’ Role Overload, Workplace Anxiety, and Resistance to Change: The Moderating Effect of Emotion Regulation Strategies
Authors: Wang Qiao , Wu Zhouyue , Liu Jingjing , Zhang Yajun , Liu Liangcan
Published: April 2024

Middle managers play a pivotal role in organizational change. However, little is known about the antecedents of middle managers’ resistance to change. Drawing from the conservation of resource theory, this study examines the impact of middle managers’ role overload on their resistance to change. We collected time-lagged data from 242 middle managers in China. Our results show that middle managers’ role overload is positively related to resistance to change, and that this relationship is mediated by middle managers’ workplace anxiety. Furthermore, emotion regulation strategies moderate the effect of middle managers’ role overload on workplace anxiety as well as the indirect effect of middle managers’ role overload on resistance to change via workplace anxiety. These findings offer theoretical insights into how to effectively implement organizational change and manage middle managers’ resistance to change.