bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effects of Interpersonal Violence on Sleep Following the COVID-19 Stay-at-Home Order
Authors: Schober Daniel J. , Bruce Douglas , Lewis Taylor , Keller Allison , Lippert Julia F. , Singh Meha , Matzke Hannah , Prachand Nikhil
Published: September 2023

Purpose

Lack of sleep is a harm that can lead to chronic diseases ranging from diabetes to heart disease. We examined the exposure to interpersonal violence and its association with sleep, following the COVID-19 stay-at-home order.

Design

Cross-sectional.

Setting

Surveys were completed online and via paper-and-pencil in English and Spanish (N = 2049; RR = 68.4%).

Subjects

Respondents were 18+ and residing in Chicago.

Measures

The Chicago Department of Public Health’s “2022 Healthy Chicago Survey COVID-19 Social Impact Survey”.

Analysis

We developed two weighted models. Model 1 examined the effects of neighborhood violence on meeting the national sleep recommendation. Model 2 examined the effects of violence in the home among friends or family on meeting the sleep recommendation, incorporating additional predictors: victimization, stress, gender, race/ethnicity, household income, and general health. Odds ratios were estimated using multivariate logistic regression.

Results

Exposure to neighborhood violence and sleep was not significant, but knowing a friend or family member who experienced violence or mistreatment in their home affected the odds of meeting the sleep recommendation (OR = .61, 95% CI = .44-.84). Non-Hispanic Blacks had 52% lower odds of meeting sleep recommendations (OR = .48, 95% CI = .37-.63).

Conclusion

Addressing the harms to sleep that followed COVID-19 should engage diverse stakeholders in implementing culturally responsive interventions to promote adequate sleep and prevent chronic disease.
Building Consensus on Domains of Wellness Using Finnish and International Expert Panels: A Delphi-Method Study
Authors: Kauppi Krista , Roos Eira , Borg Patrik , Torkki Paulus
Published: September 2023

Purpose

The paper investigates whether we can build consensus on wellness domains and create a more universal conceptual framework for wellness.

Design

A modified ranking type of Delphi method.

Participants

Two separate panels consisting of 23 Finnish and 11 international experts.

Methods

Panels were asked to rate the importance of 61 systematic review-based wellness domains and to eventually form a wellness model in both panels. The similarities between the resulting models were investigated and a new conceptual framework for wellness was created.

Results

The Finnish model included 8 themes and 20 domains, and the international model 5 themes and eleven domains. Eight of the eleven domains were an exact match for the Finnish model (namely mental health, cognitive health, exercise, nutrition, community, life satisfaction, meaningfulness, work-life balance). There were also 2 similar domains that could be found in both models (namely self-care and lifestyle habits, social networks). A new conceptual framework for wellness was created based on these ten domains.

Conclusion

The lack of consensus on the wellness construct has made it difficult to find comparable measures that could assess and improve the level of wellness of individuals, organizations, and society. This study offers a conceptual framework that can be further validated and turned into a more universal measurement instrument.
Discussing ChatGPT’s implications for industry and higher education: The case for transdisciplinarity and digital humanities
Authors: Dianova Vera G. , Schultz Mario D.
Published: September 2023

This comment builds on the example of chat generative pretrained transformer (ChatGPT) to discuss the implications of generative AI on industry and higher education, underlining the need for more transdisciplinary digital literacy education. The release of ChatGPT has generated significant academic and professional interest and instigated a vibrant discussion on the opportunities offered and challenges posed by powerful and readily accessible generative AI reshaping teaching and learning at universities. ChatGPT has reignited an age-old debate on the impact of disruptive technologies on occupations and the labor market, but recent discussions have paid little attention to how university offerings may need to adapt. We strive to open this discussion arguing that while recent GPT technology has, indeed, made more conceivable the substitution of many tasks of white-collar and knowledge workers, and suggested an acceleration of the labor market shift towards technology-centric occupations, it has simultaneously made a stronger-than-ever case for transdisciplinary competences. Consequently, we emphasize the need to foster more transdisciplinary digital literacy in universities with curricula that provide breadth of knowledge and flexibility of mind, bridging humanities with STEM disciplines. Digital humanities education is in a unique position to promote the responsible use of generative AI, while encouraging critical reflection on its socio-cultural embeddedness.
The prevalence of sexually transmitted infections and their association with knowledge, attitudes, and practice in male street children in Indonesia
Authors: Nilasari Hanny , Indriatmi Wresti , Irawan Yudo , Budiono Santoso Edy , Silviana Andiati , Waworuntu Wiendra
Published: September 2023

Background

Street children’s level of knowledge, attitudes, and practice (KAP) regarding sexually transmitted infections (STIs) and HIV-related diseases remains a challenge since it is difficult to reach all key populations. This study aims to provide an overview of the findings of STI cases and their association with the KAP of street children in Jakarta and Banten.

Methods

We conducted a cross-sectional study on 259 male street children (aged 10 –21 years old). We collected the data through questionnaire interviews, history taking, physical examination, and specimen collection for STI and HIV testing.

Results

5.8% ( n = 15) STI cases were discovered, consisting of Hepatitis B ( n = 6), Hepatitis C ( n = 1), HIV ( n = 2), Chlamydia ( n = 3), Syphilis ( n = 1), and Gonorrhea ( n = 1). Buskers (44.4%) and other occupations like helping parents sell their wares, parking lot attendants, shoe shiners, or gathering (44.8%) dominated the sociodemographic characteristics. Condomless sex predominated risky sexual behavior, despite some subjects already having good knowledge.

Conclusion

Sociodemographic characteristics and the KAP of street children in Indonesia are varied. The association between the KAP level and STI cases in street children is challenging to describe. Further studies covering more areas in Indonesia are required.
Possibly mad? Marital murder in the early twentieth century: a matched-case gender analysis of forensic psychiatric investigations in Sweden
Authors: Karlén Malin Hildebrand , Nilsson Thomas
Published: September 2023

This study illustrates the impact on forensic psychiatric investigations (FPI) of time-specific scientific theories and moral normative considerations. A comparative historical perspective illustrates historical FPI procedures (i.e. methodology and focus), based on two matched FPI case reports from the 1930s: a man and a woman who had shot their respective spouses. First, in the analysis, a comparison was made between the two cases regarding assessment procedure and focus, applying a gender perspective, and second, stability and change in FPI praxis between the 1930s and the 2020s were identified. Similarities and differences were discussed based on changes in FPI praxis and influence of explanatory models within psychiatry. This can aid understanding of historical bias and indicate current bias and its risks to FPI reliability.
Response of diatom communities to climate and human disturbance: A 4200-year record from Costa Rica
Authors: Bitting Madeleine , Johanson Erik N , Haberyan Kurt A , Horn Sally P
Published: September 2023

This study integrates diatom analysis with existing records of pollen, charcoal, elemental composition, and stable light isotopes to expand upon the 4200-year history of human activity and climate change from Laguna Los Mangos in southern Pacific Costa Rica. We counted diatoms in peroxide-treated samples and analyzed community composition using cluster analysis, revealing four distinct assemblage zones with diatom variability most closely correlated with phosphorus, titanium, and organic content. The earliest assemblage (Zone D, 4150–3430 cal yr BP) was dominated by Encyonema silesiacum and Nitzschia incognita and aligned with a period of deforestation, erosion, and abundant macrophytes. Gomphonema affine proliferated in Zone C (3430–2450 cal yr BP), reflecting increased pH and productivity likely caused by agriculture-induced nutrient loading. We attributed the preservation gap from 3290 to 2970 cal yr BP in Zone C to silica depletion and erosional deposition that induced decline in diatom abundance by diluting valve concentrations in lake sediments. Nitzschia incognita and G. affine became the dominant taxa in Zone B (2450–1400 cal yr BP), likely reflecting eutrophy, increasing conductivity, and drying climate. Dominance of Diadesmis confervacea indicated reduced lake level in Zone A (1400 cal yr BP–modern) at the onset of the Terminal Classic Drought (TCD). A hiatus in the record indicates lake desiccation from 950 to 450 cal yr BP. During the Little Ice Age (LIA), diatoms reflect conditions similar to Zone B indicating increased lake level, circumneutral pH, and eutrophy. Refilling of the lake indicates increased precipitation during the LIA despite evidence of severe regional drought reported at other sites. Variable precipitation during this period likely resulted from the combined effects of Spanish contact, agricultural collapse, forest recovery, and shifts in Atlantic and Pacific climate forcing mechanisms. Overall, the Los Mangos diatom record reflects shallow, slightly alkaline, eutrophic conditions influenced by nutrient enrichment, erosion, and deforestation associated with maize agriculture.
Outcome of critically ill patients with systemic lupus erythematosus from a medical intensive care unit in Southern India
Authors: Bhargav Arvind , Ramanathan Venkateswaran , Ramadoss Ramu , Kavadichanda Chengappa , Mariaselvam Christina M , Negi Vir S , Thabah Molly M
Published: September 2023

Objective

Systemic lupus erythematosus (SLE) has become the most prevalent autoimmune condition requiring admission in the intensive care units (ICU) in the last two decades. Here we analysed the clinical outcomes of SLE patients admitted to our ICU between 2011 and 2021, and studied the prognostic role of high-density lipoprotein (HDL) and procalcitonin in those enrolled after August 2019.

Methods

Systemic lupus erythematosus (ACR/SLICC 2012) were enrolled, 72 retrospectively and 30 prospectively. Data on indications for ICU admission, complications, infections, and disease activity were recorded. Outcome was mortality at 90 days (prospective) whereas in the retrospective analysis outcome was hospital discharge or death in hospital. Serum HDL and procalcitonin (PCT) was estimated in the prospectively enrolled 30 patients and compared with 30 non ICU-SLE patients.

Results

Indications for ICU admissions were respiratory causes in 78/102 (76.5%) patients; for haemodynamic monitoring and for invasive procedures in the remaining. Pneumonia was the primary reason for mechanical ventilation, followed by diffuse alveolar haemorrhage (DAH). Eighty-three (81.3%) patients died; infections ( n = 54) and SLE related causes ( n = 29). APACHE-II >16 ( p = .026), lymphopenia ( p = .021), infection ( p = .002), creatinine >1.3 mg/dL ( p = .023), and hypotension requiring vasopressor support ( p = .006) emerged as significant predictors of non-survival on multivariable analysis. HDL (mg/dL) day 1 was significantly lower in SLE-ICU patients compared to non ICU-SLE (31.8 ± 14.3 vs 38.8 ± 11.4 mg/dl); p = .045. On day 1, PCT (ng/mL) in SLE-ICU was significantly higher when compared to non-ICU SLE; median (IQR): 0.53 (0.26–5.27) versus 0.13 (0.05–0.47), p < .001), respectively. It was also significantly higher on day 5 in SLE-ICU than non-ICU SLE (median (IQR): 4.18 (0.20–14.67) versus 0.10 (0.08–0.46), p = .004.

Conclusion

The mortality of SLE patients admitted to the ICU in this study is high, and infections were the principal reason for death. Baseline low HDL and higher procalcitonin are potential biomarkers to identify critically ill SLE patients.
Identification of monocyte-associated biomarkers in systemic lupus erythematosus and their pan-cancer analysis
Authors: Chen Huiting , He Jinxuan , Wang Linwei , Lin Yanbin , Mou Zhixiang , Huang Xiaoxuan , Chen Lan
Published: September 2023

Immune dysregulation is not only a pathogenic mechanism in systemic lupus erythematosus (SLE) but also a potential cause of the link between SLE and cancer. The current understanding of SLE monocyte-associated biomarkers is limited, and the precise mechanism behind the link between SLE and cancer is uncertain. By using WGCNA and immune infiltration to analyze the GSE72326 dataset, we determined the most pertinent modules for monocytes and discovered eight candidate hub genes from them. The limma software was used to find genes that were differently expressed in SLE. The genes that overlapped between the two were chosen using a Venn diagram as the essential genes related to monocytes in SLE, and the essential genes were verified by several datasets. Correlation analysis and GSEA analysis were used to examine the probable immunological pathways connected to key genes. We examined the expression of hub genes in cancer and their interaction with monocytes using the GEPIA and TIMER databases to understand the significance of essential genes in tumorigenesis. In addition, we performed transcription factor identification. We discovered three biomarkers (IFI30, BLVRA, and RIN2) that are mostly involved in interferon-related signaling pathways and are associated with monocyte-mediated immune responses in SLE. The three important genes are also strongly expressed in a number of malignancies and have a relationship with monocytes. As a result, IFI30, BLVRA, and RIN2 may act as SLE-associated biomarkers of monocytes and as a bridge between SLE and tumors. We proposed that interferon-related signaling pathways might function as possible mediators of cancer risk in SLE.
Scutellarin Protects Myocardial Ischemia-Reperfusion Injury ERK1/2-CREB Regulated Mitophagy
Authors: Wang Wei-Wei , Liu Xiao-Lei , Ding Yu , Chen Ya-Di , Ma Dan , Bu Rui , Bao Tian-Hao
Published: September 2023

Objectives

Scutellarin, which is obtained from Erigeron breviscapus Hand-Mazz (EBHM), is a flavonoid that has demonstrated the ability to safeguard neural stem cells from hypoxia-induced damage and prevent cell apoptosis. The aim of this study was to investigate the beneficial impacts of Scutellarin on mitophagy in both in vivo and in vitro models of myocardial ischemia-reperfusion (I/R) injury.

Materials and Methods

Prior to inducing models of myocardial I/R injury, mice were administered either Scutellarin (50 mg/kg/day) or a vehicle for seven consecutive days. The mice underwent I/R injury (30 min of left anterior descending (LAD) coronary artery ligation followed by 120 min of reperfusion). Myocardial injury markers were assessed by the enzyme-linked immunosorbent assay (ELISA). The size of the myocardial infarction was measured via 2,3,5-triphenyl tetrazolium chloride triazole staining, and the protein expression of LC3 and caspase-3 was determined through Western blot analysis. In vitro experiments were conducted utilizing cultured H9C2 cells subjected to an oxygen-glucose deprivation/reoxygenation model to investigate the underlying mechanism(s) of Scutellarin’s positive effects (50 µM).

Results

It shows that Scutellarin treatment reduced the size of the myocardial infarctions and decreased the levels of myocardial injury markers. Western blot analysis showed that protein expression of caspase-3 was decreasing and the ratio of LC3Ⅱ to LC3Ⅰ was increasing in the Scutellarin group. In vitro, Scutellarin decreased oxidative stress markers, stabilized mitochondrial membrane potential (∇Ψm), decreased mitochondrial permeability transition pore (mPTP) opening rate, promoted mitochondrial fusion, inhibited mitochondrial fission, and increased adenosine triphosphate (ATP) production and cell viability. Scutellarin increased the commitment of mitophagy by regulating Pink and Parkin, while apoptosis decreased. cAMP-response element-binding protein (CREB) and extracellular signal-regulated kinases 1 and 2 (ERK1/2) phosphorylation were also modulated by Scutellarin.

Conclusion

The myocardial protective effect of Scutellarin may be associated with the phosphorylation of CREB and ERK1/2.
Enhancing Supports for Novice Workers in Child Welfare: A Study of Coaching for Child Welfare Interns
Authors: Smith Natasha L. , Smith Angela M. , Mott Amber , Smith Brenda D.
Published: September 2023

Coaching in child welfare settings shows promise as a supplement to traditional agency-based supervision. This study investigates the perceived benefits and challenges of an innovative coaching model for social work students with child welfare internships. Focus groups were conducted with student interns, former interns, and coaches. Focus group participants perceived coaching as helpful for professional development and influential in decisions to stay in child welfare. Participants also contrasted supervision experiences with coaching experiences, finding coaching to be more supportive. Findings point to the potential of coaching and/or strengths-based supervision for fostering commitment to child welfare.
Paradoxical Tensions as a Double-Edged Sword: Analysing the Development of Platform Cooperatives in the European Gig Economy
Authors: Bunders Damion J. , De Moor Tine
Published: September 2023

Platform cooperatives promise to provide an alternative organizational model of worker ownership and governance to heavily criticized investor-owned gig platforms, but have until now remained relatively rare. This study examines the development of platform co-ops to gain insight into the reasons and mechanisms behind their slow but steady growth in Europe. Using desk research on 48 platform co-ops and 16 in-depth interviews with founders of platform co-ops, we build on paradox theorizing to analyze how founders of platform co-ops manage competing demands during the start-up phase. Extending recent studies on interorganizational paradoxes, we show how systemic tensions in the gig economy motivate the creation of platform co-ops as a way of coping and that interactions between tensions on different levels during actual development can result in failed market entry. Hence, this study also addresses the counter-intuitiveness to the establishment of organizations permeated with paradoxical tensions.
Sodium Lauryl Sulfoacetate
Authors: Burnett Christina L. , Bergfeld Wilma F. , Belsito Donald V. , Cohen David E. , Klaassen Curtis D. , Liebler Daniel C. , Rettie Allan E , Ross David , Slaga Thomas J. , Snyder Paul W. , Tilton Susan , Fiume Monice , Heldreth Bart
Published: September 2023

The Expert Panel for Cosmetic Ingredient Safety reviewed updated information that has become available since their original assessment from 1987, along with updated information regarding product types, and frequency and concentrations of use, and reaffirmed their original conclusion that Sodium Lauryl Sulfoacetate is safe as a cosmetic ingredient in the practices of use and concentration as described in this report.
Quaternium-26
Authors: Johnson Wilbur , Bergfeld Wilma F. , Belsito Donald V. , Hill Ronald A. , Klaassen Curtis D. , Liebler Daniel C. , Marks James G. , Shank Ronald C. , Slaga Thomas J. , Snyder Paul W. , Fiume Monice , Heldreth Bart
Published: September 2023

The Expert Panel for Cosmetic Ingredient Safety reviewed newly available studies since their original assessment in year 2000, along with updated information regarding product types and concentrations of use, and confirmed that sodium Quaternium-26 is safe as a cosmetic ingredient in the practices of use and concentration as described in this report.
Polyacrylamide
Authors: Raj Preethi S. , Bergfeld Wilma F. , Belsito Donald V. , Cohen David E. , Klaassen Curtis D. , Liebler Daniel C. , Rettie Allan E. , Ross David , Slaga Thomas J. , Snyder Paul W. , Tilton Susan , Fiume Monice , Heldreth Bart
Published: September 2023

The Expert Panel for Cosmetic Ingredient Safety reviewed updated information that has become available since their original assessment from 1991, along with updated information regarding product types, and frequency and concentrations of use, and reaffirmed their original conclusion that Polyacrylamide is safe as a cosmetic ingredient in the practices of use and concentration as described in this report.
Peripapillary retinal nerve fiber layer thickness as a diagnostic tool for pseudophakic cystoid macular edema
Authors: Rabina Gilad , Shtayer Chen , Shemesh Rachel , Mimouni Michael , Gal-Or Orly , Nemet Arie Y. , Geffen Noa , Segal Ori
Published: September 2023

Purpose

To investigate the effects of pseudophakic cystoid macular edema (PCME) on retinal nerve fiber layer (RNFL) thickness before and after treatment using optical coherence tomography (OCT).

methods

A retrospective, observational study of consecutive patients diagnosed with PCME after cataract surgery. Patients underwent macular and RNFL OCT imaging at time of diagnosis and during follow up. OCT was performed for both the study eye and the contralateral healthy eye which served as control. All patients were followed for a period of at least 6 months.

Results

Overall, 40 eyes of 40 patients with a mean age of 71.1 ± 8.1 years of which 45% (n = 18) were of male gender were included in this study. At presentation, the central thickness in the PCME eye was significantly higher than in the contralateral eye (515.7 ± 127.9μm versus 238.1 ± 41.8μm, p < 0.001). Similarly, all macular measurements were significantly higher in the PCME eye compared to the contralateral eye (p < 0.001 for all). In terms of RNFL measurements, the PCME eyes had greater global (p < 0.001), superonasal (p = 0.001) and superotemporal (p = 0.005) thickness values. PCME eyes demonstrated a significant decrease in thickness for all macular and RNFL parameters following resolution of CME (p < 0.05 for all).

Conclusions

PCME patients presents with greater global, superotemporal and superonasal RNFL thickness in comparison to the other healthy eye. After resolution of PCME, there is significant thinning of RNFL. Peripapillary RNFL thickness may serve as an additional parameter for diagnosis and follow-up of PCME.
The Patient as an Actor in His Care Pathway: Insights From the French Case
Authors: Aubert Isabelle , Kletz Frédéric , Sardas Jean-Claude
Published: September 2023

In France, patients’ right to take part in decisions regarding their health has been recognized by law since 2002. This legal recognition was the outcome of a long-standing call to allow all individuals to be “actors in their own health” and to co-develop their care pathway with the professionals involved. In practice, care pathways simultaneously intertwine both standardization and personalization dynamics, which involve different forms of professional-patient interaction. This article analyses the links between the organizational variables of care pathways, and the ways in which patients are involved in the management of their own pathway. To date, these links have received little attention in the management science and health literatures. We draw on material from a case study carried out in 2 French territories, combining the analysis of patient pathways with interviews conducted with professionals and carers. Building on this analysis, we propose a typology of patient profiles which distinguishes between their different forms of involvement in the development of their care pathway, based on its organizational characteristics.
Politicians Support (and Voters Reward) Intra-Party Reforms to Promote Transparency
Authors: Pereira Miguel M , Coroado Susana , de Sousa Luís , Magalhães Pedro C
Published: September 2023

Political parties increasingly rely on self-regulation to promote ethical standards in office. The adoption of ethics self-regulation and its ability to induce change is likely to be a function of the responses from politicians and voters. Without external enforcement mechanisms, compliance requires support from legislators. In turn, if voters perceive self-regulation as cheap talk, officials have fewer incentives to acquiesce. The extent to which such efforts are rewarded by voters and supported by elected officials remains an open question. We examine this question in a paired conjoint experiment with elected officials and voters in Portugal and Spain. The results show that politicians support (and voters reward) financial disclosures, lobbying registries, and sanctions for MPs involved in corruption cases. Voters also reward term limits, and the effects are not moderated by ideological agreement. The findings suggest that parties can benefit from promoting transparency reforms and are not penalized by experimentation.
Declining trends in telehealth utilization in the ongoing COVID-19 pandemic
Authors: Shilane David , Lu Ting’an Heidi
Published: September 2023

Introduction

Telehealth is an important complement to in-person healthcare, with opportunities to overcome barriers to healthcare and improve health equity. Telehealth utilization increased sharply at the onset of the COVID-19 pandemic. This study assessed trends in telehealth utilization for the years 2020 through 2022, both overall and in subgroups.

Methods

We gathered data from the 2020–2022 National Health Interview Survey. The rates of telehealth utilization were calculated overall and within subgroups based on demographic factors, health conditions, healthcare utilization, challenges of ability, and social needs. Adjusted multivariable logistic regression models of telehealth utilization assessed the yearly trends. We also analyzed the ratios of subgroup utilization relative to the overall rates.

Results

A total of 69,581 patients were identified with complete information. The overall rates of telehealth utilization were 36.2% for 2020, 38.9% for 2021, and 31.3% for 2022. The reduction in telehealth utilization for 2022 was large and statistically significant (OR: 0.64 (95% CI: 0.62–0.67), p < 0.001). Subgroup analyses showed corresponding reductions in 2022 for essentially all patient subgroups. Telehealth was utilized at higher rates by patients with chronic conditions, challenges of ability, and other kinds of medical utilization. Ratio analyses showed evidence of widening disparities for patients of older age, in rural areas, and by geographic region, limited education, and of low income.

Discussion

The study demonstrates declining rates of telehealth utilization are occurring with widening gaps among patient subgroups. Addressing these disparities may be critical to improving equity in telehealth and healthcare overall.
The Shame System Operates With High Precision
Authors: Leroux Alexie , Hétu Sébastien , Sznycer Daniel
Published: September 2023

Previous research indicates that the anticipatory shame an individual feels at the prospect of taking a disgraceful action closely tracks the degree to which local audiences, and even foreign audiences, devalue those individuals who take that action. This supports the proposition that the shame system (a) defends the individual against the threat of being devalued, and (b) balances the competing demands of operating effectively yet efficiently. The stimuli events used in previous research were highly variable in their perceived disgracefulness, ranging in rated shame and audience devaluation from low (e.g., missing the target in a throwing game) to high (e.g., being discovered cheating on one's spouse). But how precise is the tracking of audience devaluation by the shame system? Would shame track devaluation for events that are similarly low (or high) in disgracefulness? To answer this question, we conducted a study with participants from the United States and India. Participants were assigned, between-subjects, to one of two conditions: shame or audience devaluation. Within-subjects, participants rated three low-variation sets of 25 scenarios each, adapted from Mu, Kitayama, Han, & Gelfand (2015), which convey (a) appropriateness (e.g., yelling at a rock concert), (b) mild disgracefulness (e.g., yelling on the metro), and (c) disgracefulness (e.g., yelling in the library), all presented un-blocked, in random order. Consistent with previous research, shame tracked audience devaluation across the high-variation superset of 75 scenarios, both within and between cultures. Critically, shame tracked devaluation also within each of the three sets. The shame system operates with high precision.
Factors associated with radiographic progression in rheumatoid arthritis starting biological diseases modifying anti-rheumatic drugs (bDMARDs)
Authors: Adami Giovanni , Fassio Angelo , Pistillo Francesca , Benini Camilla , Viapiana Ombretta , Rossini Maurizio , Gatti Davide
Published: September 2023

Background:

Biological DMARDs (bDMARDs) have been proven to prevent joint damage and bone erosions. Nevertheless, approximately 15% of rheumatoid arthritis (RA) patients on bDMARDs will progress despite good control of joint inflammation.

Objectives:

The objective of our study is to investigate the factors associated with radiological progression of patients treated with bDMARDs.

Design:

We conducted a retrospective analysis of longitudinally collected data on RA patients starting bDMARDs.

Methods:

Presence or development of new erosions was assessed by a skilled rheumatologist at the time of the visit (baseline and 12 months thereafter). To determine the predictors of erosions, we employed multivariable logistic regression models. Discriminatory capacity for the prediction of new erosion development was assessed with receiver operating characteristic (ROC) curve, which was based on the logistic regression model.

Results:

A total of 578 RA patients starting bDMARDs were included in the study. Overall, 46 patients (approximately 10%) had radiographic progression (at least one new erosion) at 12 months of follow-up. The factors independently associated with higher risk of developing new erosions while on bDMARD were younger age, high disease activity at baseline, not being treated with cDMARDs, and presenting with erosions at baseline. In addition, we built a predictive model that can accurately foresee new erosions (AUC 0.846) in patients receiving bDMARDs

Conclusion:

We found that baseline erosive disease, higher disease activity during treatment, younger age, and monotherapy were the factors independently associated with the development of bone erosions. Our study may inform future targeted intervention in RA patients at risk of radiographic progression.
The Quality of Discharge Summaries After Acute Kidney Injury
Authors: Giles Cameron , Novakovic Milica , Hopman Wilma , Barreto Erin F. , Beaubien-Souligny William , Birks Peter , Neyra Javier A. , Wald Ron , Silver Samuel A.
Published: September 2023

Background:

Acute kidney injury (AKI) increases the risk of hospital readmission, chronic kidney disease, and death. Therefore, effective communication in discharge summaries is essential for safe transitions of care.

Objective:

The objectives of this study were to determine the quality of discharge summaries in AKI survivors and identify predictors of higher quality discharge summaries.

Design:

Retrospective chart review.

Setting:

Tertiary care academic center in Ontario, Canada.

Patients:

We examined the discharge summary quality of 300 randomly selected adult patients who survived a hospitalization with AKI at our tertiary care hospital, stratified by AKI severity. We included 150 patients each from 2015 to 2016 and 2018 to 2019, before and after introduction of a post-AKI clinic in 2017.

Measurements:

We reviewed charts for 9 elements of AKI care to create a composite score summarizing discharge summary quality.

Methods:

We used multivariable logistic regression to identify predictors of discharge summary quality.

Results:

The median discharge summary composite score was 4/9 (interquartile range, 2-6). The least frequently mentioned elements were baseline creatinine (n = 55, 18%), AKI-specific follow-up labs (n = 66, 22%), and medication recommendations (n = 80, 27%). The odds of having a higher quality discharge summary (composite score ≥4/9) was greater for every increase in baseline creatinine of 25 μmol/L (adjusted odds ratio [aOR]: 1.27; 95% confidence interval [CI]: 1.03, 1.56), intrarenal etiology (aOR: 2.32; 95% CI: 1.26, 4.27), and increased AKI severity (stage 2 aOR: 2.57; 95% CI: 1.35, 4.91 and stage 3 aOR: 3.36; 95% CI: 1.56, 7.22). There was no association between discharge summary quality and the years before and after introduction of a post-AKI clinic (aOR: 0.77; 95% CI: 0.46, 1.29).

Limitations:

The single-center study design limits generalizability.

Conclusions:

Most discharge summaries are missing key AKI elements, even in patients with severe AKI. These gaps suggest several opportunities exist to improve discharge summary communication following AKI.
Adherence to e-health interventions for substance use and the factors influencing it: Systematic Review, meta-analysis, and meta-regression
Authors: Shams Farhud , Tai Andy M.Y. , Kim Jane , Boyd Marisha , Meyer Maximilian , Kazemi Alireza , Krausz Reinhard Michael
Published: September 2023

Background

Substance use disorders affect 36 million people globally, but only a small proportion of them receive the necessary treatment. E-health interventions have been developed to address this issue by improving access to substance use treatment. However, concerns about participant engagement and adherence to these interventions remain. This review aimed to evaluate adherence to e-health interventions targeting substance use and identify hypothesized predictors of adherence.

Methods

A systematic review of literature published between 2009 and 2020 was conducted, and data on adherence measures and hypothesized predictors were extracted. Meta-analysis and meta-regression were used to analyze the data. The two adherence measures were (a) the mean proportion of modules completed across the intervention groups and (b) the proportion of participants that completed all modules. Four meta-regression models assessed each covariate including guidance, blended treatment, intervention duration and recruitment strategy.

Results

The overall pooled adherence rate was 0.60 (95%-CI: 0.52–0.67) for the mean proportion of modules completed across 30 intervention arms and 0.47 (95%-CI: 0.35–0.59) for the proportion of participants that completed all modules across 9 intervention arms. Guidance, blended treatment, and recruitment were significant predictors of adherence, while treatment duration was not.

Conclusion

The study suggests that more research is needed to identify predictors of adherence, in order to determine specific aspects that contribute to better exposure to intervention content. Reporting adherence and predictors in future studies can lead to improved meta-analyses and the development of more engaging interventions. Identifying predictors can aid in designing effective interventions for substance use disorders, with important implications for e-health interventions targeting substance use.
Exploring the impact of patient, physician and technology factors on patient video consultation satisfaction
Authors: Tenfelde Kim , Bol Nadine , Schoonman Guus G , Bunt Jan Erik H , Antheunis Marjolijn L
Published: September 2023

Objective

Video consultations (VCs) were made available to the general population during the COVID-19 pandemic to compensate for the cutback of face-to-face doctor–patient interactions. However, little is known about what patient-related (e.g. age), physician-related (e.g. patient–physician relationship) and technology-related (e.g. online privacy concerns) factors contribute to video consultation satisfaction among patients. This study aims to gain a better understanding of what makes patients satisfied with video consultations.

Methods

A total of 180 patients who recently engaged in a video consultation were invited to answer questions about patient-, physician- and technology-related variables and their satisfaction with the video consultation. To examine which factors predict patient video consultation satisfaction, a multiple hierarchical regression analysis was performed.

Results

Overall, patients were satisfied with their video consultation. The final hierarchical model, including all patient-related, physician-related and technology-related factors, significantly contributed to patient video consultation satisfaction. Predictors of higher patient video consultation satisfaction were experiencing less technical issues, having higher general positive attitudes towards online communication, reporting higher importance of less travel time and being more satisfied with physicians’ affective and instrumental communication.

Conclusions

Video consultations can be appropriate in a variety of situations, provided that technical issues can be minimized, patients have a positive attitude towards online communication and attach value to reduced travel time and online patient–physician interactions can be experienced as affective and instrumental. Findings from this study contribute to understanding how video consultations can be best utilized for effective patient–physician communication.
Feasibility study of using mobile application to support triage and diagnosis clinical decisions for pediatricians: User-centered design approach
Authors: Choosri Noppon , Kungsuwan Supakanya
Published: September 2023

Background

While there is some evidence in the literature demonstrating success in using a triage software application in ED, none of the solution was developed specifically to support a holistic decision of pediatricians in triage and diagnosis purposes to initiate the first treatment properly. To explore the usefulness and possibility of employing a digital-based solution to enhance clinician performance, the mobile application was developed and then assessed in different perspectives.

Objective

The primary objective of this study is to contribute implementation practice of an application to support pediatric triage and diagnoses. The secondary objective is to present the results of the preliminary evaluation of the application.

Methods

The application called Pedicmeter was developed. Formative tests with revisions were applied throughout the development phase. A number of summative extensive evaluations were also conducted to investigate the efficacy of the proposed method. The evaluation focused on measuring the ability of an application to support a pediatric staff’s decision to determine an overall severity level and disease diagnosis. Finally, the user’s (clinician's) satisfaction of using the application was measured.

Results

The application Pedicmeter enables clinicians to make more accurate decisions in determining emergency level of pediatric patients by 6.66%. The application accurately diagnosed a disease with 73.08% accuracy and 66.67% accuracy for respiratory and infectious diseases, respectively. The diagnostic information that the application suggested shows that it does have an influence on a clinician’s diagnosis. Using the app showed improvements in diagnostic accuracy for asthma, croup, sepsis, but it showed a decrease in the accuracy of a clinician's decision for pneumonia. The benefit of the application that satisfies the pediatricians the most is the helpfulness of the features of the application (86%), while the least satisfying factor was the required number of inputs (63%).

Conclusion

The developed application conceptually shows a promising opportunity to enhance clinicians’ decisions from the pilot study. However, the study also reveals further tweaks are required and unveils challenging issues and the concerns of clinician users when use the application. Further research will be conducted to investigate and determine the limiting factors and specific issues revealed by this study. Longitudinal data collection and analysis also need to be conducted to investigate the clinical implications.
Beyond Recording the Clinical Discussion: A Qualitative Study into Patient-Led Recordings in Hospital
Authors: Ryan Laura , Weir Kelly A , Maskell Jessica , Bevan Lily , Le Brocque Robyne
Published: September 2023

Patient-led recording occurs when a patient records a clinical encounter with their smart device. Understanding patient-led recording is important in ensuring a safe and patient-centered response to this behavior. This exploratory study provides insight into the patient perspective of patient-led recordings. We conducted 20 semistructured interviews with hospital and health service patients. The interview data was analyzed using thematic analysis. We identified three themes relating to patient-led recordings, including patient engagement, psychosocial, and health service. Findings suggest that health services move beyond querying the permissibility of recording and consider how to maximize the benefits of recording while reducing the risk of harm. Patients and clinicians need to be made aware of the potential broader psychosocial benefits of recording a clinical encounter during hospital admission. These results point to an urgent need for health services to develop policies and resources that support clinicians to work within a culture of recording.
Leveraging newspapers to understand urban issues: A longitudinal analysis of urban shrinkage in Detroit
Authors: Jiang Na , Crooks Andrew T , Kavak Hamdi , Wang Wenjing
Published: September 2023

Today we are awash with data, especially when it comes to studying cities from a diverse data ecosystem ranging from demographic to remotely sensed imagery and social media. This has led to the growth of urban analytics providing new ways to conduct quantitative research within cities. One area that has seen significant growth is using natural language processing techniques on text data from social media to explore various issues relating to urban morphology. However, we would argue that social media only provides limited insights when dealing with longer-term urban phenomena, such as the growth and shrinkage of cities. This relates to the fact that social media is a relatively recent phenomenon compared to longer-term urban problems that take decades to emerge. Concerning longer-term coverage, newspapers, which are increasingly becoming digitized, provide the possibility to overcome the limitations of social media and provide insights over a timeframe that social media does not. To demonstrate the utility of newspapers for urban analytics and to study longer-term urban issues, we utilize an advanced topic modeling technique (i.e., BERTopic) on a large number of newspaper articles from 1975 to 2021 to explore urban shrinkage in Detroit. Our topic modeling results reveal insights related to how Detroit shrinks. For example, side effects of 2007 to 2009 economic recessions on Detroit’s automobile industry, local employment status, and the housing market.
Allogenous Bone Grafting Technique for Staged Revision Anterior Cruciate Ligament Surgery
Authors: Vindfeld Søren , Lindanger Line , Inderhaug Eivind
Published: September 2023

Background:

Tunnel widening, slightly malplaced former tunnels or bone loss due to hardware removal might prevent a 1-stage anterior cruciate ligament (ACL) revision procedure due to tunnel convergence or challenging graft fixation. A range of graft sources and bone grafting techniques are described—all with their strengths and limitations. Common autograft techniques come with substantial donor site morbidity that might hinder postoperative rehabilitation.

Indications:

Graft tunnel issues might prompt the need for structural grafts and a 2-stage ACL revision approach. The use of the current dowel allograft technique gives a flexible approach where 1 or several cylindrical grafts can be placed in prepared sockets for reliable bony ingrowth.

Technique Description:

Using femoral head allografts and cannulated coring reamers, multiple bone dowels (up to 6) can give a flexible and adaptable bone grafting situation. The intra-articular tunnels are dilated, and dowels are produced to allow a press-fit fixation that facilitates good bone healing. Removal of sclerotic bone and microfracture is key to allow optimal bone-to-bone healing. Use of cannulas inserted through the arthroscopic portals and tamps plug advancement will give a reliable graft deployment without dowel breakage.

Results:

The current authors have used this uniform technique for 119 patients since 2014. All cases displayed good bony healing at 5 months after surgery on computed tomography and radiographs, and 115 out of 119 went on to have a stage 2 revision ACL surgery at 6 months spacing from the bone grafting. The most common reason for not going through the second-stage revision was improvement of symptoms due to graft removal and bone grafting during the first surgery.

Discussion/Conclusion:

The current allograft dowel bone grafting allows for a flexible bone grafting in cases where a 1-step ACL revision procedure is not feasible. Reliable bony ingrowth is seen in the current cohort allowing the final step of ACL revision at 6 months spacing from bone grafting.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Venous thromboembolism associated with severe dyspnoea and asthma in 102 792 adults
Authors: Nilausen Kristin Felicia , Landt Eskild Morten , Al-Shuweli Suzan , Nordestgaard Børge G. , Bødtger Uffe , Dahl Morten
Published: September 2023

Background

The most recent guideline on acute pulmonary embolism (PE) indicates possible long-term sequelae such as dyspnoea and chronic thromboembolic pulmonary hypertension after a PE event. However, effects on lung function or asthma risk have not been evaluated in the general population.

Methods

We tested whether individuals with a venous thromboembolism (VTE) encompassing PE and deep vein thrombosis (DVT) have reduced lung function, or greater risks of dyspnoea and asthma using data from 102 792 adults from the Copenhagen General Population Study. Diagnoses of PE, DVT and asthma were collected from the national Danish Patient Registry. Factor V Leiden and prothrombin G20210A gene variants were determined using TaqMan assays.

Results

Prevalences of PE, DVT and VTE were 2.2%, 3.6% and 5.2%, respectively. Individuals with VTE had forced expiratory volume in 1 s of 92% predicted compared with 96% pred in individuals without VTE (p<0.001). Individuals with VTEversusthose without had adjusted OR (95% CI) for light, moderate and severe dyspnoea of 1.4 (1.2–1.6), 1.6 (1.4–1.8) and 1.7 (1.5–1.9), respectively. Individuals with VTEversusthose without had an adjusted OR for asthma of 1.6 (95% CI 1.4–1.8). Factor V Leiden and prothrombin G20210A genotype also associated with increased risk of asthma (p for trend=0.002). Population-attributable fractions of severe dyspnoea and asthma due to VTE were 3.5% and 3.0%, respectively, in the population.

Conclusion

Individuals with VTE have worse lung function and higher risks of severe dyspnoea and asthma, and may account for 3.5% and 3.0% of people with severe dyspnoea and asthma, respectively, in the general population.