bluuebunny/crossref_metadata_2025 huggingface dataset:
Does misremembering drive false alarms for emotional lures? A diffusion model investigation
Authors: Yüvrük Elif , Starns Jeffrey , Kapucu Aycan
Published: October 2022

Previous evidence has shown that, in a recognition memory task, emotion leads participants to make more false alarms and decreases response times (RTs) for false alarm responses. This pattern could arise because participants adopt more liberal responding for emotional stimuli and/or because emotional lures are more likely than neutral lures to produce misleading memory retrieval. Recently, Starns et al. designed a new recognition memory paradigm and found that the speed of memory errors shows the influence of misleading information resulting in unavoidable memory errors. This study investigates the basis of false alarms to emotional lures by testing predictions of the diffusion model for a recognition paradigm similar to that by Starns et al. Participants studied lists of emotional words and then completed an old–new recognition memory test. After each old–new decision, participants were asked to make a forced-choice recognition decision that provided a chance to correct possible errors on the preceding old–new decision. Under the assumption that emotion promotes misremembering, the diffusion model predicts that forced-choice accuracy should be lower for pairs with emotional versus neutral lures and that faster old–new errors should be associated with lower forced-choice accuracy. This study tested these predictions, providing theoretical insights into how emotion affects memory retrieval and further developing a new methodology for measuring recognition performance.
A study on the discourse strategy of telecommunication fraud based on proximization theory
Authors: Ye Hong , Chen Kexin
Published: October 2022

Drawing on the proximization theory, this study investigated the characteristics and expected effects of proximization strategies in the discourse of telecommunication fraud through the textual analysis of samples selected among 2738 fraudulent texts. The results demonstrated a dominant use of spatial proximization strategy, which imitated the main features of institutional discourse to establish a community of interest with the recipients. Moreover, the use of various verb phrases made the recipients feel the imminence of threats or benefits. Additionally, the urgency and importance of the event created by the temporal proximization strategy also served to establish a cooperative relationship between the fraudsters and the recipients. The axiological proximization strategy served as a complementary tool to facilitate the realization of the above two strategies. This study could help with the identification of fraudulent content in texts and the creative production of the anti-fraud materials.
Cardiopulmonary function during exercise in heart failure with reduced ejection fraction following baroreflex activation therapy
Authors: Nottebohm Pia I. , Dumitrescu Daniel , Hamacher Stefanie , Hohmann Christopher , Madershahian Navid , Baldus Stephan , Reuter Hannes , Halbach Marcel
Published: October 2022

Purpose:

Baroreflex activation therapy has favorable effects in heart failure patients. We report the results of a single-center study of baroreflex activation therapy in heart failure with reduced ejection fraction including cardiopulmonary exercise testing for the first time to show the effect on exercise capacity.

Methods:

A total of 17 patients were treated with baroreflex activation therapy. Eligibility criteria were the New York Heart Association class ⩾III and ejection fraction ⩽35% on guideline-directed medical and device therapy. The New York Heart Association class, quality of life, and 6-min hall walk distance were assessed in all patients. Twelve patients underwent cardiopulmonary exercise testing before and 8.9 ± 6.4 months after initiation of baroreflex activation therapy.

Results:

The New York Heart Association class and 6-min hall walk distance improved after baroreflex activation therapy, while quality of life remained stable. Weight-adapted peak oxygen uptake increased significantly from 10.1 (8.2–12.9) ml/min/kg to 12.1 (10.4–14.6) ml/min/kg ( p = 0.041). Maximal heart rate was stable. Maximal oxygen pulse increased from 9.7 (5.5–11.3) to 9.9 (7.1–12.1) ml/heartbeat ( p = 0.047) in 10 patients with low maximal oxygen pulse at baseline (<16.5 ml/heartbeat). There was no significant change in maximal oxygen pulse in the whole cohort. Ventilatory efficiency remained stable.

Conclusion:

Weight-adapted peak oxygen uptake improved after baroreflex activation therapy, pointing to an enhanced exercise capacity. Ventilatory efficiency and heart rate did not change, while oxygen pulse increased in patients with low oxygen pulse at baseline, indicating an improvement in circulatory efficiency, that is, a beneficial effect on stroke volume and peripheral oxygen extraction.
Emerging perioperative therapeutic approaches in muscle invasive bladder cancer
Authors: Patil Goutham , Basu Arnab
Published: October 2022

Bladder cancer is a significant healthcare burden with more than 17,000 deaths in the United States in 2018. Patients who are diagnosed with muscle invasive bladder cancer (MIBC) have a high rate of micro-metastatic disease and have a much poorer prognosis compared with patients who have less advanced lesions. Historically, neoadjuvant administration of cisplatin-based therapy followed by surgery has been the mainstay of treatment. Unfortunately, of patients who come in with initially diagnosed MIBC, more than 50% are ineligible for traditional cisplatin-based therapy. Today, new modalities of treatment such as immune checkpoint inhibitors are beginning to radically improve outcomes in this population. The addition of immune checkpoint therapy to traditional chemotherapy appears to augment pathologic complete response rates in the bladder during surgery. Immunotherapy combinations also provide novel trimodality approaches with excellent outcomes in those pursuing non-surgical management. Pure immunotherapy approaches appear promising in the neoadjuvant and adjuvant setting, and the immune checkpoint inhibitor nivolumab is now approved in the adjuvant setting for high-risk patients. Antibody drug conjugates, such as enfortumab vedotin, and targeted therapies, such as infigratinib, are in trials in the perioperative setting. This review article summarizes the current evidence and likely future developments for the management of muscle invasive bladder cancer in 2022 and beyond.
Bone fragility: conceptual framework, therapeutic implications, and COVID-19-related issues
Authors: Iolascon Giovanni , Paoletta Marco , Liguori Sara , Gimigliano Francesca , Moretti Antimo
Published: October 2022

Bone fragility is the susceptibility to fracture even for common loads because of structural, architectural, or material alterations of bone tissue that result in poor bone strength. In osteoporosis, quantitative and qualitative changes in density, geometry, and micro-architecture modify the internal stress state predisposing to fragility fractures. Bone fragility substantially depends on the structural behavior related to the size and shape of the bone characterized by different responses in the load–deformation curve and on the material behavior that reflects the intrinsic material properties of the bone itself, such as yield and fatigue. From a clinical perspective, the measurement of bone density by DXA remains the gold standard for defining the risk of fragility fracture in all population groups. However, non-quantitative parameters, such as macro-architecture, geometry, tissue material properties, and microcracks accumulation can modify the bone’s mechanical strength. This review provides an overview of the role of different contributors to bone fragility and how these factors might be influenced by the use of anti-osteoporotic drugs and by the COVID-19 pandemic.
Exploring Molecular Targets and Mechanisms of Apigenin in the Treatment of Papillary Thyroid Carcinoma Based on Network Pharmacology and Molecular Docking Analysis
Authors: Li Dongyu , Wang Lei , Jing Yuchen , Jiang Bo , Zhao Lei , Miao Yuxi , Xin Shijie , Ge Chunlin
Published: October 2022

To explore potential therapeutic targets and underlying mechanisms of apigenin (API) for papillary thyroid carcinoma (PTC) treatment. Methods: In the present study, network pharmacological analysis combined with molecular docking was used to identify API-related therapeutic targets for PTC treatment. Firstly, potential API-interacting and PTC-related targets were obtained from online databases. Furthermore, we constructed drug-target-disease interaction networks followed by functional enrichment analysis, expression patterns and prognostic values of predicted core targets by using bioinformatic tools. Moreover, we performed molecular docking to validate binding activity of API to core pharmacological targets. Results: A total of 110 API-related therapeutic targets were found to be engaged in the treatment of PTC. Moreover, TP53, HSP90AA1, AKT1, EGFR, SRC, VEGFA, ACTB, JUN and ESR1 were identified as core pharmacological targets of API for treating PTC. The enrichment analysis suggested that API played a comprehensive role in regulating the apoptotic process, modulating cell proliferation, and that multiple pathways were involved in API-related PTC treatment. Further results indicated that the PI3k-Akt/p53 signaling pathway was the key signaling pathway. Moreover, JUN was found mostly correlated with survival and molecular docking results demonstrating strong affinities between API and these core targets. Conclusion: Our findings systematically demonstrated API-associated pharmacological targets and mechanisms for treating PTC and demonstrated that API could function against PTC by inducing apoptosis, cell death and immunological reactions. Our research gives valuable insights and a theoretical basis for API-related PTC treatment.
Fashioned Mucoperichondrial Flap Technique Versus Fishing Line Technique in the Repair of Septal Dislocation: A Prospective Comparative Study
Authors: Abo El Naga Heba A. , Hamdan Ahmad M.
Published: October 2022

Background

A nasal septal dislocation is a common form of septal deviation with many challenges and different surgical techniques for correction.

Objective

To assess the efficacy of fashioned mucoperichondrial flap technique versus fishing line technique in the repair of septal dislocation.

Methods

The study was a prospective comparative cohort study conducted on 88 patients aged above 18 years who have symptomatic mild to moderate caudal septal dislocation spanning the period from June 2021 to June 2022. Preoperatively, all patients were evaluated by the Nasal Obstruction and Septoplasty Effectiveness (NOSE) scale to assess the degree of nasal obstruction. Anterior rhinoscopy and endoscopic examination of the nose were done for every patient to assess the degree of obstruction, whether mild, moderate, or severe. Outcomes included an assessment of both techniques’ efficacy in managing nasal obstruction as expressed by the NOSE scale and comparing both techniques regarding the operative and postoperative details.

Results

The current study showed a highly significant improvement in the NOSE scale postoperatively in both groups ( P < .00001 for both groups). The mean operative duration for group I was significantly less than that for group II ( P < .00001). There was a nonsignificant difference between both groups regarding the postoperative NOSE scale, and postoperative degree of obstruction ( P = .066 and .56, respectively). Regarding postoperative complications, there was a nonsignificant difference between both groups except for patient discomfort as assessed 1 week postoperatively. Group II showed significantly more patient discomfort ( P = .02), which improved 4 weeks postoperatively.

Conclusion

Both techniques presented in this study effectively corrected mild and moderate caudal septal dislocation with significant improvement of nasal obstruction postoperatively. Both techniques produced good esthetic outcomes and were associated with few comparable complications in both groups.
Acute pancreatitis in SARS-CoV-2 infection: A case report from Tanzania
Authors: Suleiman Jamil , Sadiq Abid , Sanga Evans , Sadiq Adnan , Urasa Sarah , Msuya David , Chugulu Samwel , Lodhia Jay
Published: October 2022

The pandemic caused by the severe acute respiratory syndrome coronavirus 2 has mainly affected the respiratory system but has expanded to other systems, including the gastrointestinal system. We present an 80-year-old man with sharp epigastric pain and vomiting. Laboratory investigations revealed elevated pancreatic enzymes, and contrast-enhanced computed tomography of the abdomen suggested acute pancreatitis. He was undergoing treatment for acute pancreatitis when he developed respiratory compromise, leading to the use of oxygen. Computed tomography of the chest revealed bilateral pleural effusion. However, a positive nasopharyngeal swab suggested severe acute respiratory syndrome coronavirus 2 infection. He was treated for the viral infection with various medications until clinically stable before being self-isolated at home. His follow-up visits revealed a favorable outcome, with progressive resolve occurring 4 weeks after the onset. There is no specific conclusion regarding pancreatic involvement in severe acute respiratory syndrome coronavirus 2 infection. There are several confounding factors in the etiology of acute pancreatitis during concomitant severe acute respiratory syndrome coronavirus 2 infection. However, further research is warranted to evaluate whether pancreatic involvement is one of the clinical presentations or subsequent complications of severe acute respiratory syndrome coronavirus 2 infection.
Lamellar Bodies in Podocytes Associated With Compound Heterozygous Mutations for Niemann Pick Type C1 Mimicking Fabry Disease, a Case Report
Authors: Pintavorn Pairach , Munie Stephanie , Munagapati Sweta
Published: October 2022

Rationale:

Niemann-Pick type C (NPC) is an autosomal recessive lysosomal storage disease (LSD) caused by mutations in NPC1 or NPC2 genes. Mutations result in abnormal cholesterol trafficking, which is manifested by abnormal cholesterol and glycosphingolipid accumulation in lysosomes of various cells.

Presenting Concerns of the Patient:

The patient had a history of hyperlipidemia, hypertension, depression, and elevated alkaline phosphatase and initially presented for a workup regarding chronic kidney disease stage G3b/A3 with proteinuria of 1.9 g/day.

Diagnosis:

Kidney biopsy revealed numerous lamellar bodies (LB) in podocytes with differential diagnoses of Fabry disease (FD), nail-patella syndrome (which is associated with LMX1B gene mutations), and drug-induced phospholipidosis per pathology report. Her workup was negative for a galactosidase-alpha ( GLA) mutation with normal serum and leukocyte alpha-galactosidase A activity. She was serendipitously discovered to have compound heterozygous mutations in NPC1 genes (one pathogenic and the other a variant of uncertain significance) from the comprehensive lysosomal storage gene panel as part of her genetic workup for FD. Further studies were done to determine the significance of the NPC1 mutation and revealed elevated oxysterols. (The profile was consistent with NPC, with elevated cholestane-3beta,5alpha,6beta-triol and 7-ketocholesterol and normal lyso-sphingomyelin.) Sonogram revealed hepatosplenomegaly (liver measuring 20 cm and spleen 15.8 cm). These findings in conjunction with lysosomal lipid accumulation on kidney biopsy were consistent with NPC.

Interventions:

She was on 2 cationic amphiphilic agents (CAAs), fluoxetine and atorvastatin, both of which were stopped. There was no significant difference in proteinuria 2 months off CAAs. The treatment of NPC remained supportive care and avoiding medications that can induce seizures or excessive salivary secretion.

Novel Findings:

The presence of LB is classically described as a feature of FD which is an LSD. Niemann-Pick type C is another example of an LSD and is typically manifested by neurovisceral symptoms and varies by the age of onset. Renal diseases are typically not described as one of the manifestations of NPC. To our knowledge, there is only one report each for Niemann-Pick disease type A/B and NPC with LB on kidney biopsy. The finding reaffirms that the presence of LB indicates lysosomal lipid accumulation from a variety of etiologies and is not a pathognomonic finding of FD. Niemann-Pick type C should be included as one of the diseases capable of causing renal LB.
The Living Kidney Donor Safety Study: Protocol of a Prospective Cohort Study
Authors: Garg Amit X. , Arnold Jennifer B. , Cuerden Meaghan , Dipchand Christine , Feldman Liane S. , Gill John S. , Karpinski Martin , Klarenbach Scott , Knoll Greg A. , Lok Charmaine , Miller Matthew , Monroy-Cuadros Mauricio , Nguan Christopher , Prasad G. V. Ramesh , Sontrop Jessica M. , Storsley Leroy , Boudville Neil
Published: October 2022

Background:

Living kidney donation is considered generally safe in healthy individuals; however, there is a need to better understand the long-term effects of donation on blood pressure and kidney function.

Objectives:

To determine the risk of hypertension in healthy, normotensive adults who donate a kidney compared with healthy, normotensive non-donors with similar indicators of baseline health. We will also compare the 2 groups on the rate of decline in kidney function, the risk of albuminuria, and changes in health-related quality of life.

Design, Participants, and Setting:

Prospective cohort study of 1042 living kidney donors recruited before surgery from 17 transplant centers (12 in Canada and 5 in Australia) between 2004 and 2014. Non-donor participants (n = 396) included relatives or friends of the donor, or donor candidates who were ineligible to donate due to blood group or cross-match incompatibility. Follow-up will continue until 2021, and the main analysis will be performed in 2022. The anticipated median (25th, 75th percentile, maximum) follow-up time after donation is 7 years (6, 8, 15).

Measurements:

Donors and non-donors completed the same schedule of measurements at baseline and follow-up (non-donors were assigned a simulated nephrectomy date). Annual measurements were obtained for blood pressure, estimated glomerular filtration rate (eGFR), albuminuria, patient-reported health-related quality of life, and general health.

Outcomes:

Incident hypertension (a systolic/diastolic blood pressure ≥ 140/90 mm Hg or receipt of anti-hypertensive medication) will be adjudicated by a physician blinded to the participant’s donation status. We will assess the rate of change in eGFR starting from 12 months after the nephrectomy date and the proportion who develop an albumin-to-creatinine ratio ≥3 mg/mmol (≥30 mg/g) in follow-up. Health-related quality of life will be assessed using the 36-item RAND health survey and the Beck Anxiety and Depression inventories.

Limitations:

Donation-attributable hypertension may not manifest until decades after donation.

Conclusion:

This prospective cohort study will estimate the attributable risk of hypertension and other health outcomes after living kidney donation.
Refugees in host countries: A comparative study between Uyghurs in Turkey and Tibetans in India
Authors: Pandey Deeksha
Published: October 2022

The status of refugees in host nations may depend upon several factors, including the economic situation of the receiving state, political alignments, international commitments, ethnic affinities, the domestic refugee regime, security considerations and bilateral ties with the home country. The study aims to discern the role that bilateral ties and domestic considerations play in the refugee experience. Is there a pattern that can be drawn out from these two factors? The article uses neoclassical realist and critical theories to better understand the phenomena, while employing the case study method to make a comparative study. The study analyses how India and Turkey have dealt with refugees belonging to two ethnic minorities of the Republic of China: the Tibetans and the Uyghurs. The results show that the way the receiving states handle refugees depends greatly on domestic considerations. It becomes clear that even though bilateral ties between the host and the home nation are important, no simple deduction can be made on how this affects the treatment of refugees. Both cases provide varied response patterns; it is only through a blend of realpolitik and critical theory that the phenomena can be understood. Mapping refugees and their movements, as well as their status in the host countries, determines many of the policies created for their welfare. The article therefore attempts to provide a framework for a better understanding of the phenomena by considering bilateral ties and domestic considerations.
Dear Program Directors: There Are Numerous Entrustable Professional Activities on a Burns Rotation!
Authors: Rogers Alan D , Cartotto Robert
Published: October 2022

Background: Burn care has long been an integral part of the scope of plastic surgery, but the time allocated to exposure for plastic surgery residents is under threat due to the range of sub-specialities competing for their time. As part of the Competence by Design approach to plastic surgical training, residents are provided with a list of 52 “Entrustable professional activities’ (EPA's) to ensure that core skills and knowledge are acquired. Methods: This survey, distributed via email using a link to Survey MonkeyTM, sought to determine which EPA's were available for completion by plastic surgeons in training during the burn rotation at a major academic burn centre in Canada. Via investigator consensus, 26 of the 52 EPA's were included for assessment; the remaining 26 were not regarded as relevant to the burn centre rotation and therefore better acquired elsewhere. Results: Thirty two residents who underwent a burn rotation between 1 January 2015 and 31 December 2021 completed the anonymous survey. Seventeen of the 26 EPA's evaluated were judged by more than 75% of respondents as being readily amenable to completion during the burn rotation. Most of these EPA's relate to the comprehensive care of patients with acute burn injuries, the management of an in-patient plastic surgery service, and associated quality improvement processes. Residents who completed rotations less than three months in duration had less opportunity to complete a further 8 EPA's in comparison to those who had longer rotations, especially with respect to the care of patients undergoing complex wound care and burn reconstruction. Conclusions: In addition to threatening seamless service delivery at burn centres, reduced resident exposure to the burn rotation may compromise the delivery of burn care in the community. The results of this survey refute any argument that the burn service is a “low yield” rotation from an EPA acquisition perspective.
Book review: Complete Contract Law. Authored by André Naidoo
Authors: Todd Andrea
Published: October 2022

Complete Contract Law. Authored by André Naidoo, Oxford University Press, Oxford, 2021. pp. 692, £37.99. ISBN 9780198749868.
Dystopia, Purity and Segregation: A Study of Hindutvavad in Indian Nationalism from the Lens of Web Series: Leila
Authors: Chachra Manisha
Published: October 2022

‘Purity for all’ or ‘ Jai Aryavarta (land of the Aryans)!’1 (Bühler 1886, 5) are the slogans of the nation-state dominated by Hindus in the Netflix released web series, Leila. Based on the theoretical framework of Thomas Blom Hansen, ‘The Saffron Wave’, I have argued that secularism in India was unique to its circumstances and therefore, did not entail a separation between the state and the religion. In recent times, religious nationalism is called out for xenophobia against minorities and attacks against lower-caste communities (Hansen 1999, 134). This article attempts to examine the parallels between religious nationalism in Leila and Indian politics. Through qualitative research methodology and narrative analysis, the article compares the ideas of purity, segregation and dystopia from the series with the Indian politics. The core argument of the article is that although religious nationalism is determined by these ideas, it continues to be a multi-layered concept.
Frugal alignment-free identification of FLT3-internal tandem duplications with FiLT3r
Authors: Boudry Augustin , Darmon Sasha , Duployez Nicolas , Figeac Martin , Geffroy Sandrine , Bucci Maxime , Celli-Lebras Karine , Duchmann Matthieu , Joudinaud Romane , Fenwarth Laurène , Nibourel Olivier , Goursaud Laure , Itzykson Raphael , Dombret Hervé , Hunault Mathilde , Preudhomme Claude , Salson Mikaël
Published: October 2022

Background

Internal tandem duplications in the FLT3 gene, termed FLT3-ITDs, are useful molecular markers in acute myeloid leukemia (AML) for patient risk stratification and follow-up. FLT3-ITDs are increasingly screened through high-throughput sequencing (HTS) raising the need for robust and efficient algorithms. We developed a new algorithm, which performs no alignment and uses little resources, to identify and quantify FLT3-ITDs in HTS data.

Results

Our algorithm (FiLT3r) focuses on the k-mers from reads covering FLT3 exons 14 and 15. We show that those k-mers bring enough information to accurately detect, determine the length and quantify FLT3-ITD duplications. We compare the performances of FiLT3r to state-of-the-art alternatives and to fragment analysis, the gold standard method, on a cohort of 185 AML patients sequenced with capture-based HTS. On this dataset FiLT3r is more precise (no false positive nor false negative) than the other software evaluated. We also assess the software on public RNA-Seq data, which confirms the previous results and shows that FiLT3r requires little resources compared to other software.

Conclusion

FiLT3r is a free software available at https://gitlab.univ-lille.fr/filt3r/filt3r. The repository also contains a Snakefile to reproduce our experiments. We show that FiLT3r detects FLT3-ITDs better than other software while using less memory and time.
Safety and efficacy of interrupting dual antiplatelet therapy one month following percutaneous coronary intervention: a meta-analysis of randomized controlled trials
Authors: Parfrey Shane , Abdelrahman Amr , Blackman Daniel , Blaxill Jonathan M. , Cunnington Michael S. , Greenwood John P. , Malkin Christopher J. , Mozid Abdul M. , Rossington Jennifer A. , Veerasamy Murugapathy , Wassef Nancy , Wheatcroft Stephen B. , Bulluck Heerajnarain
Published: October 2022

Very short duration of dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI) has recently attracted a lot of attention with the introduction of newer generations stents. This is appealing, especially in patients at high bleeding risk. However, none of the trials were powered for the individual ischemic and bleeding endpoints. All randomised controlled trials (RCTs) investigating one-month versus routine duration of DAPT in patients undergoing PCI and reporting outcomes from the time of cessation of DAPT (1 month) to 1 year were eligible for inclusion in the meta-analysis. The pooled risk ratios (RR) with their 95% confidence interval (CI) were calculated with the random-effects model using the Mantel-Haenszel method. Four RCTs involving 26,576 patients were included in this meta-analysis. Cessation of DAPT after 1 month was associated with significantly less major bleeding [RR 0.70, 95%CI (0.51–0.95), P = 0.02, heterogeneity (I2) = 42%]. There was no statistically significant difference in all-cause mortality [RR 0.84 (95%CI 0.69–1.03), P = 0.10, I2 = 0%] and stroke [RR 0.71 (95%CI 0.45–1.13), P = 0.15, I2 = 42%] when compared to routine duration of DAPT. There was also no difference in myocardial infarction (MI) [RR 1.12 (95%CI 0.91–1.39), P = 0.28, I2 = 0%], and definite or probable stent thrombosis [RR 1.49 (95%CI 0.92–2.41), P = 0.11, I2 = 0%] with cessation of DAPT after 1 month. Cessation of DAPT 1 month after PCI was associated with significantly less major bleeding, but there was no difference in the rate of all-cause mortality, stroke, MI and stent thrombosis.
Evaluation of the factors affecting triage decision-making among emergency department nurses and emergency medical technicians in Iran: a study based on Benner’s theory
Authors: Soola Aghil Habibi , Mehri Saeid , Azizpour Islam
Published: October 2022

Introduction

Emergency department (ED) nurses and emergency medical technicians (EMTs) find themselves performing triage under time pressure and with limited information. Identifying an effective triage decision-making process can play a significant role in promoting patient safety. Experts are able to make faster and more effective decisions in emergencies than novices.

Objective

The current study aimed to identify the level of triage decision-making (TDM) and its’ predictors in ED nurses and EMTs based on self-reported levels of nursing proficiency in Benner’s theory from novice to expert.

Materials and methods

Out of 821 ED nurses and EMTs who met the inclusion criteria, 320 ED nurses and 152 EMTs were included in this descriptive-analytical research. Data were collected by a demographic information form and triage decision-making inventory (TDMI) and analyzed by SPSSv.22 software using descriptive statistics, Pearson correlation test, t-test, ANOVA, and multiple linear regression.

Results

The total score of TDMI in the ED nurses and EMTs was higher in the expert nurses than in the proficient, competent, advanced beginner and novices. Multiple linear regression analysis showed that self-reported levels of nursing proficiency, age, work experience, marital status and triage training course were predictors of TDM in ED nurses (P < .05), and self-reported levels of nursing proficiency, service location, work experience, and triage training course were predictors of TDM in EMTs (P < .05).

Conclusion

Understanding the predictors influencing TDM health professionals may facilitate the understanding of their training needs. The training needs of a novice and inexperienced person may be different from those of an expert person, it is recommended that the training methods be based on the experiences and professional levels of nurses so that the training provided is effective and quality. Moreover, to increase the TDM power and reduce TDM errors due to lack of experience, a system is suggested to be established to allow novice nurses in the first year to work with experienced nurses. Also it is suggested that the determining educational and training focus with regards to triage before entering the bedside be done based on predictors.
Community-acquired pneumonia – use of chest x-rays for diagnosis in family practice
Authors: Eilat-Tsanani Sophia , Kasher Carmel , Levine-Kremer Hana
Published: October 2022

Background

According to guidelines, the diagnosis of pneumonia should be confirmed by chest x-ray, ensuring appropriate management and wise use of antibiotics. Our study aimed to describe use of x-rays by family doctors and patients following diagnosis of pneumonia in primary care practices in the north of Israel.

Methods

This was a retrospective database study including adults diagnosed with pneumonia, assessing rates of referral and actual use of chest x-rays. We examined rates of referral for chest x-rays and rates of adherence to the referral, according to age, gender, smoking status, comorbidities and distance of residence from the radiology facility.

Results

During one year there were 4,230 diagnosed cases of pneumonia in the practice, of which 2,503 were referred for chest x-rays, and 1,920 adhered to the referral (45% of those diagnosed with pneumonia). The rate of referral was higher when the radiology facility was located in the same city as the family doctor compared to outside the city (69.7% and 53.2%, p < 0.001). Patients aged 40–64 were referred more than patients aged 18–39 or 65+ (61.5% vs. 56.5% and 58.3%, p = 0.03). Actual use of chest x-rays (considering both referral and adherence) was more likely when the radiology facility was in the same health centre or city than when it was outside the city [OR = 2.4; 95% CI: 2.1–2.8]; patients aged 65 + or 40–64 were more likely to adhere to the referral for x-ray than those aged 18–39 [OR = 1.3; 95% CI: 1.1–1.6, OR = 1.2; 95% CI: 1.0–1.4, respectively].

Conclusion

Accessibility of radiology facilities seems to be an important factor associated with both doctors’ decisions and patients’ adherence to the referral for chest x-rays.
The role of area level social deprivation on childhood and adolescent consultation rate in primary care: a population based, cohort study
Authors: Fonderson M. S. , Bindels P. J. E. , Bohnen A. M. , de Schepper E. I. T.
Published: October 2022

Background

Studies show that children and adolescents in the most socially deprived areas (SDA) consult their general practitioner (GP) more often than those in the least socially deprived areas (Non-SDA). Given that GPs see a wide range of diseases, it is important to know which clinical diagnoses are shaped by socioeconomic factors. The primary objective was to determine the association between area level social deprivation and consultation rates in a pediatric population. The secondary objective was to explore this association across a wide range of clinical diagnoses.

Methods

A cohort study using the Rijnmond Primary Care Database (RPCD) was conducted. Between 2013 and 2020, a total of 69,861 patients aged 0 to 17 years registered with a GP were analysed. A consultation was defined as patient contact and entry of a diagnosis using the International Classification of Primary Care (ICPC-1) code. Associations between consultation rates, ICPC-1 codes and area level social deprivation were explored using a Poisson regression model. The incidence risk ratio (IRR) and 95% confidence interval (CI) were reported.

Results

Over the 7-year study period the consultation rate of the study population was 3.8 per person-years. The top 5 reasons for children and adolescents to consult their GP was related to skin, respiratory, general unspecified, musculoskeletal and digestive symptoms or diagnoses. Consultation rate was higher in SDA group compared to Non-SDA group (IRR 1.20, 95% CI 1.19–1.20). Consultation rate for ICPC-1 code related to pregnancy and family planning was significantly lower in SDA group compared to Non-SDA group. Upon further exploration of this code, SDA group were less likely to consult for oral contraception and more likely to contact a GP for induced termination of pregnancy compared to Non-SDA group (IRR 0.36; 95% CI 0.33–0.44 and IRR 2.94; 95% CI 1.58–5.46 respectively).

Conclusions

Overall, SDA group had higher GP consultation rates for the majority of clinical diagnoses except for pregnancy and family planning. In this latter category, adolescent females in SDA consulted less frequently for oral contraception. This study illustrates the need to understand the underlying health seeking behaviors of children and adolescents at different development phases of their lives.
Interventions addressing functional abilities of older people in rural and remote areas: a scoping review of available evidence based on WHO functional ability domains
Authors: Zhao Ivy Yan , Montayre Jed , Leung Angela Y. M. , Foster Jann , Kong Ariana , Neville Stephen , Ludolph Ramona , Mikton Christopher , Officer Alana , Molassiotis Alex
Published: October 2022

Background

The World Health Organization (WHO) encourages healthy ageing strategies to help develop and maintain older people’s functional abilities in five domains: their ability to meet basic needs; learn, grow, and make decisions; be mobile; build and maintain relationships, and contribute to society. This scoping review reports the available evidence-based interventions that have been undertaken with people ≥ 50 years of age in rural and remote areas and the outcomes of those interventions relevant to enhancing functional ability.

Methods

The scoping review was undertaken following the JBI methodology. A literature search was carried out to identify published intervention studies for enhancing functional ability in older people living in rural and remote settings. The databases searched included CINAHL, Scopus, ProQuest Central, PubMed, EBSCOHost, APA PsycInfo, Carin.info, and the European Network for Rural Development Projects and Practice database. Gray literature sources included government reports, websites, policy papers, online newsletters, and studies from a bibliographic hand search of included studies.

Results

Literature published from January 2010 to March 9, 2021 were included for review. A total of 67 studies were identified, including quasi-experimental studies (n = 44), randomized controlled trials (n = 22), and a descriptive study. Five main types of interventions were conducted in rural and remote areas with older people: Community Services, Education and Training, Exercise and Physical Activity, Health Promotion Programmes, and Telehealth. Health Promotion Programmes (n = 28, 41.8%) were the most frequently reported interventions. These focused primarily on improving the ability to meet basic needs. About half (n = 35, 52.2%) of the included studies were linked to the ability to learn, grow, and make decisions, and 40% of studies (n = 27) were relevant to the ability to be mobile. Only a very limited number of intervention studies were geared towards outcomes such as maintaining relationships (n = 6) and contributing to society (n = 3).

Conclusion

Interventions for enhancing functional ability focused primarily on the ability to meet basic needs. We identified the need for health-related interventions in rural and remote areas to consider all five functional ability domains as outcomes, particularly to strengthen the psychosocial wellbeing of older people and enhance their sense of purpose through their contributions to society.
Oral health and depressive symptoms among older adults in urban China: a moderated mediation model analysis
Authors: Sun Qian , Wang Youwei , Chang Qingsong
Published: October 2022

Background

This study explored the association between oral health and depression occurs via daily dietary satisfaction as a mediator, and that body mass index could moderate the path between daily dietary satisfaction and depression.

Methods

Data for this research were derived from a community survey adopting quota sampling in the cities of Tianjin and Shijiazhuang in mainland China in 2020 (N = 781). The moderated mediation model was tested by using bootstrapping with resampling strategies, and the Johnson-Neyman technique was used to visualize the moderating effect of body mass index.

Results

A significant negative association between oral health and depression has been indicated (B = −0.22, SE = 0.11, 95%CI [− 0.44, − 0.01]), and dietary satisfaction partially mediated the relationship between oral health and depression (B = −0.04, SE = 0.02, 95%CI [− 0.09, − 0.002]). The path was moderated by body mass index, and the effect of dietary satisfaction on depression was much greater in people with relatively low body mass index.

Conclusions

This study present evidence for policymakers and researchers that strategies to enhance oral health and daily dietary satisfaction could be important for preventing depression in Chinese older adults, and especially for the relatively fitter older groups with lower body mass index.
E. coli bacteraemia and antimicrobial resistance following antimicrobial prescribing for urinary tract infection in the community
Authors: McCowan Colin , Bakhshi Andisheh , McConnachie Alex , Malcolm William , Barry Sarah JE , Santiago Virginia Hernandez , Leanord Alistair
Published: October 2022

Background

Urinary tract infections are one of the most common infections in primary and secondary care, with the majority of antimicrobial therapy initiated empirically before culture results are available. In some cases, however, over 40% of the bacteria that cause UTIs are resistant to some of the antimicrobials used, yet we do not know how the patient outcome is affected in terms of relapse, treatment failure, progression to more serious illness (bacteraemia) requiring hospitalization, and ultimately death. This study analyzed the current patterns of antimicrobial use for UTI in the community in Scotland, and factors for poor outcomes.

Objectives

To explore antimicrobial use for UTI in the community in Scotland, and the relationship with patient characteristics and antimicrobial resistance inE. colibloodstream infections and subsequent mortality.

Methods

We included all adult patients in Scotland with a positive blood culture withE. coligrowth, receiving at least one UTI-related antimicrobial (amoxicillin, amoxicillin/clavulanic acid, ciprofloxacin, trimethoprim, and nitrofurantoin) between 1st January 2009 and 31st December 2012. Univariate and multivariate logistic regression analysis was performed to understand the impact of age, gender, socioeconomic status, previous community antimicrobial exposure (including long-term use), prior treatment failure, and multi-morbidity, on the occurrence ofE. colibacteraemia, trimethoprim and nitrofurantoin resistance, and mortality.

Results

There were 1,093,227 patients aged 16 to 100 years old identified as receiving at least one prescription for the 5 UTI-related antimicrobials during the study period. Antimicrobial use was particularly prevalent in the female elderly population, and 10% study population was on long-term antimicrobials. The greatest predictor for trimethoprim resistance inE. colibacteraemia was increasing age (OR 7.18, 95% CI 5.70 to 9.04 for the 65 years old and over group), followed by multi-morbidity (OR 5.42, 95% CI 4.82 to 6.09 for Charlson Index 3+). Prior antimicrobial use, along with prior treatment failure, male gender, and higher deprivation were also associated with a greater likelihood of a resistantE. colibacteraemia. Mortality was significantly associated with both having anE. colibloodstream infection, and those with resistant growth.

Conclusion

Increasing age, increasing co-morbidity, lower socioeconomic status, and prior community antibiotic exposure were significantly associated with a resistantE. colibacteraemia, which leads to increased mortality.
Polygenic association of glomerular filtration rate decline in world trade center responders
Authors: Koraishy Farrukh M. , Mann Frank D. , Waszczuk Monika A. , Kuan Pei-Fen , Jonas Katherine , Yang Xiaohua , Docherty Anna , Shabalin Andrey , Clouston Sean , Kotov Roman , Luft Benjamin
Published: October 2022

Background

The factors associated with estimated glomerular filtrate rate (eGFR) decline in low risk adults remain relatively unknown. We hypothesized that a polygenic risk score (PRS) will be associated with eGFR decline.

Methods

We analyzed genetic data from 1,601 adult participants with European ancestry in the World Trade Center Health Program (baseline age 49.68 ± 8.79 years, 93% male, 23% hypertensive, 7% diabetic and 1% with cardiovascular disease) with ≥ three serial measures of serum creatinine. PRSs were calculated from an aggregation of single nucleotide polymorphisms (SNPs) from a recent, large-scale genome-wide association study (GWAS) of rapid eGFR decline. Generalized linear models were used to evaluate the association of PRS with renal outcomes: baseline eGFR and CKD stage, rate of change in eGFR, stable versus declining eGFR over a 3–5-year observation period. eGFR decline was defined in separate analyses as “clinical” (> -1.0 ml/min/1.73 m2/year) or “empirical” (lower most quartile of eGFR slopes).

Results

The mean baseline eGFR was ~ 86 ml/min/1.73 m2. Subjects with decline in eGFR were more likely to be diabetic. PRS was significantly associated with lower baseline eGFR (B = -0.96, p = 0.002), higher CKD stage (OR = 1.17, p = 0.010), decline in eGFR (OR = 1.14, p = 0.036) relative to stable eGFR, and the lower quartile of eGFR slopes (OR = 1.21, p = 0.008), after adjusting for established risk factors for CKD.

Conclusion

Common genetic variants are associated with eGFR decline in middle-aged adults with relatively low comorbidity burdens.
Quality of life and mental health of women who had cardiac disease in pregnancy and postpartum
Authors: Hutchens Jane , Frawley Jane , Sullivan Elizabeth A.
Published: October 2022

Purpose

Cardiac disease is a leading cause of maternal morbidity and mortality yet there is limited research on women’s experiences and quality of life (QoL) outcomes. The aim of this study is to explore the general and health-related QoL (HRQoL) and mental health outcomes for women who have experienced cardiac disease in pregnancy and the first 12 months postpartum (CDPP).

Methods

This exploratory descriptive study recruited 43 women with acquired, genetic and congenital CDPP. Patient reported outcomes measures (PROMs) used were: WHOQoL-Bref, a Kansas City Cardiac Questionnaire (KCCQ), the Depression, Anxiety and Stress Scales-21 (DASS-21), the Cardiac Anxiety Questionnaire (CAQ) plus newly developed questions.

Results

Women reported low health satisfaction (51.7/100), physical health (55.2/100) and low HRQoL (63.1/100). Women had clinically significant scores for depression (24%), anxiety (22%) and stress (19.5%) (DASS-21) and 44.5% scored at least moderate anxiety on the CAQ. Most women (83.7%) were advised to avoid pregnancy which 88.9% found “upsetting” to “devastating”; 10.0% were offered counselling. Most women were concerned about reduced longevity (88.1%), offspring developing a cardiac condition (73.8%), and the limitations on enjoyment of life (57.1%). Women missed medical appointments due to cost (25.03%) and difficulty arranging childcare (45.5%).

Conclusion

The majority of women reported inadequate information and counselling support, with women with CDPP having sustained impaired QoL and mental health outcomes. The new and modified questions relating to mothering and children reflected the primacy of mothering to women’s identity and needs.
Positive mental health in Canadian adults who have experienced childhood sexual abuse: exploring the role of social support
Authors: Foley Gillian , Fowler Ken , Button Pam
Published: October 2022

Purpose:

Childhood sexual abuse (CSA) is predictive of poorer mental health, greater psychiatric disorder risk, and lower positive mental health (PMH) during adulthood, outcomes potentially moderated by social support. The current study aimed to explore whether Canadian adults who have experienced CSA differ from those who have not in terms of PMH and social support. Within the CSA sample, it was further investigated whether gender differences exist with respect to PMH and social support, and if particular social support subscales predict PMH.

Method:

Using data from the 2012 Canadian Community Health Survey – Mental Health (CCHS-MH), 1,328 adults between 20 and 64 years reporting CSA were profiled and compared in terms of sociodemographic and socioeconomic factors, using an age, sex, and frequency matched sample of non-CSA adults. Social Provisions Scale (SPS), and the Mental Health Continuum – Short Form (MHC-SF) means were subsequently compared between the CSA and non-CSA samples, and Hierarchical regressions were conducted for CSA males and females separately to examine whether SPS subscales predicted PMH after controlling for age and income.

Results:

Canadian adults reporting CSA had significantly lower PMH and social support (overall and for particular subscales). For adult CSA females, guidance, social integration, and reassurance of worth predicted higher PMH, while attachment and reassurance of worth predicted higher PMH scores for CSA males.

Conclusion:

Adults who have experienced CSA are at risk for lower PMH and social support. Gender differences are also evident in social support subtypes that predict PMH which have important clinical implications.