bluuebunny/crossref_metadata_2025 huggingface dataset:
The post-migration experiences and mental wellbeing of Shan men in Thailand: a qualitative study
Authors: Cashmore Aaron , Bhatarasakoon Patraporn , Haswell Melissa , Jalaludin Bin , Ritchie Jan
Published: July 2022

Purpose

Hundreds of thousands of Shan people from Myanmar have crossed the Thai border seeking employment or refuge from war, with numbers increasing following the 2021 coup in Myanmar. Still, little is known about their post-migration experiences. This study explored the ways relocating to Thailand influenced the lives and mental wellbeing of Shan men, the factors affecting their engagement with Thai society and their responses to opportunities and challenges.

Design/methodology/approach

Given the lack of published research on this topic, this study used a qualitative approach. Semi-structured interviews were conducted with 14 purposively selected Shan men in Chiang Mai, Thailand. Data were examined using qualitative thematic analysis.

Findings

Five themes emerged: the strength of both push and pull factors; the importance of ethnicity, community and acting transnationally; experiencing discrimination and feeling “low”; coping by forgetting problems, hiding from trouble and studying; and wanting to return when conditions allow. The findings reveal how moving to Thailand can improve but also undermine the mental wellbeing of Shan men. Results also highlight the influence of ethnic identity, community and post-migration opportunities and stressors on how these men adapt to life in Thailand and on their attitudes towards return migration. Respondents used a mix of emotion- and problem-focused coping strategies.

Originality/value

To the best of the authors’ knowledge, this study is one of the first to explore post-migration experiences and mental wellbeing among the Shan in Thailand.
Earnings management in times of natural disasters
Authors: Rueangsuwan Sarayut , Jevasuwan Supavinee
Published: July 2022

Purpose

The main purpose of this study is to examine the determinants of firms’ earnings management (EM) activities during natural disasters, specifically the 2011 floods in Thailand. The motivation for conducting this study is that although disasters stem from natural processes, such events affect firms’ actions, resulting in adverse economic and social outcomes.

Design/methodology/approach

Based on data from listed companies in Thailand and using a sample of 5,786 firm-year observations from 2008 to 2013, this study uses the differences-in-differences method to estimate the relation between earnings quality (EQ) and floods. Additionally, this study uses the same research design to observe how fast firms engage in EM, as reflected by the trends in EQ following the floods.

Findings

This study finds that firms engage in EM to increase their earnings numbers and misrepresent their performance after experiencing the 2011 floods in Thailand. The evidence is consistent with the hypothesis that natural disasters are related to EQ. In addition, this study finds that firms’ responses are observed only in the year after the floods (2012).

Originality/value

This study contributes to the literature on EM and quality in two ways. First, this study provides new evidence that during crisis situations such as natural disasters, firms strive to signal good news to capital markets, consistent with the market expectation hypothesis. Second, this study shows that natural disasters are as useful and equal as other exogenous shocks such as financial crises for economic research.
Façades as product wrap: a typology to identify the consumers affected by product design
Authors: Aljukhadar Muhammad
Published: July 2022

Purpose

The elevation of a residential building, or façade, affords aesthetic and functional value to tenants. Façades embody the design of the core product, i.e. the building’s unit. When carefully executed, they contribute to the attractiveness, livability and sustainability of urban areas. The purpose of this study is to show how façades influence consumer decision, and to identify the consumers affected more by façades, i.e., product design.

Design/methodology/approach

Hinging on notions from product design and appearance, this research underscores the ways by which façades affect potential tenants. It also proposes that personality dimensions (i.e. concern with own physical appearance and view of achievement) identify the tenants affected more by façades. A study involving 1,091 consumers was performed to test the hypotheses.

Findings

Functional and aesthetic façades facilitated the tenant decision to buy or rent a living unit in three ways: attraction, convection and conversion. Two tenant segments (performers and egotists) were the most affected by façades. Hence, key consumer segments including self-actualizers would be less influenced by product design.

Practical implications

Construction companies should focus on delivering functional, aesthetic and well-maintained façades to boost satisfaction and sales. They should view the resources allocated to this purpose as an investment. Certain tenants are more affected by façades. Companies should identify the consumer segments more affected by design cues to better respond to their preferences. Policymakers are encouraged to set guidelines that foster well-executed façades in urban areas.

Originality/value

This research underscored the ways by which the façades of residential buildings shape consumer decision. In addition, it provided a typology to help pinpoint the tenants more affected by façades. Finally, it elaborated design theories in the context of residential building façades, which can be used by future researchers to understand the role of façade in fulfilling tenants’ needs and expectations.
CSR assurance practice and financial distress likelihood: evidence from India
Authors: Oware Kofi Mintah , Appiah Kingsley
Published: July 2022

Purpose

The purpose of this study is to examine the effect of corporate social responsibility assurance practice (CSRAP) on the financial distress likelihood of listed firms in India. It uses the signalling theory to interpret the relationship among the variables of the study.

Design/methodology/approach

The study used the Indian stock market as the testing grounds and applied probit and panel probit regression to examine the data set with 800 firm-year observations from 2010 to 2019.

Findings

The study’s first findings show that firms with an assurance service have a negative correlation and are less likely to stay in financial distress situations for an extended period. However, corporate social responsibility (CSR) assurance has a positive but weak correlation with insignificance with financial distress likelihood of firms in India. The authors also find that the engagement of CSR assurance and level of assurance (limited assurance) does not cause a change in a firm financially distress likelihood of firms in India. However, as assurance service providers, auditing firms are more likely to reduce a firm’s likelihood of financial distress. Finally, the study shows that CSRAP (CSR assurance, assurance service providers and level of assurance) does not moderate the association between CSR expenditure and financial distress likelihood of listed firms in India.

Originality/value

The study findings are the first to examine the level of assurance and financial distress of firms according to the authors’ knowledge. This study also adds new knowledge to the factors that cause or reduces the financial distress of listed firms, including CSRAPs.
An improved parallel five-level reinjection CSC for self-commutation of thyristor converter
Authors: Song Yumei , Hao Jianzhang , Dong Changhao , Guo Xizheng , Wang Li
Published: July 2022

Purpose

This paper aims to study a multi-level reinjection current source converter (MLR-CSC) that adds attracting properties such as the self-commutation and pulse multiplication to the thyristor converter, which is of great significance for increasing the device capacity and reducing current harmonics on the grid side. Particularly, designing advantageous driving methods of the reinjection circuit is a critical issue that impacts the harmonic reduction and operation reliability of the MLR-CSC.

Design/methodology/approach

To deal with the mentioned issue, this paper takes the five-level reinjection current source converter (FLR-CSC), which is a type of the MLR-CSC, as the research object. Then, a method that can fully use combinations of five-level reinjection switching functions based on the concept of decomposition and recombination is proposed. It is worthy to mention that the proposed method can be easily extended to other multi-level reinjection circuits. Moreover, the working principle of the three-phase bridge circuit based on semi-controlled thyristors in the FLR-CSC that can achieve the four-quadrant power conversion is analyzed in detail.

Findings

Finally, the simulation and experimental results of FLR-CSC verify the effectiveness of the proposed reinjection circuit driving method and the operating principle of four-quadrant power conversion in this paper.

Originality/value

The outstanding features of the proposed driving method for FLR-CSC in this paper include combinations of reinjection switching functions that are fully exploited through three simple steps and can be conveniently extended to other multi-level reinjection circuits.
Real‐world safety and effectiveness of pembrolizumab in Japanese patients with radically unresectable melanoma: An all‐case postmarketing surveillance in Japan
Authors: Yamazaki Naoya , Shimizu Akiko , Ozaki Masahiko , Hamada Masahiro , Takeuchi Noriko , Ito Yuichiro , Maekawa Shinichiroh
Published: July 2022

This all‐case postmarketing surveillance (PMS) survey (101 centers; February 15, 2017, to March 3, 2020) captured factors that impact the safety and effectiveness of newly initiated pembrolizumab monotherapy for the treatment of radically unresectable melanoma in Japan. Eligible patients were enrolled both retrospectively and prospectively, and followed up at 1, 3, 6, and 12 months. Safety assessments included treatment‐related adverse events (TRAEs), adverse events of special interest (AEOSIs) from the Japanese Risk Management Plan (J‐AEOSIs), and J‐AEOSIs related to pembrolizumab. Effectiveness assessments included objective response rate (ORR; complete response/partial response) and disease control rate (DCR) according to the RECIST criteria. Overall, 294 and 236 patients comprised the safety and effectiveness (RECIST) assessment sets, respectively. Median (range) age of the patients was 70 (22–94) years, and the majority (60.4%) received pembrolizumab as first‐line therapy. The most common type of melanoma was cutaneous (41.5%), followed by mucosal (29.3%), acral (24.8%), and unknown (4.4%). Overall, 45.2% and 24.8% of patients experienced TRAEs and AEOSIs, respectively. In total, 24.8% and 9.2% of patients experienced any‐grade and grade ≥3 pembrolizumab‐related AEOSIs, respectively. The most common grade ≥3 pembrolizumab‐related AEOSIs were endocrine disorders and liver dysfunction (2.4% each), followed by colitis/severe diarrhea (2.0%), interstitial lung disease (1%), and type 1 diabetes (0.7%). No grade 5 J‐AEOSIs were observed. ORR was 16.5% at the 1‐year follow‐up: mucosal melanoma (20%), acral melanoma (10%), and cutaneous melanoma (17.5%). ORR was higher among patients who did not receive versus those who did receive previous systemic therapy across all three melanoma types. DCR was 52.1% at the 1‐year follow‐up: cutaneous melanoma (57.3%), acral melanoma (51.7%), and mucosal melanoma (43.1%). This all‐case PMS survey confirmed the real‐world safety and effectiveness of pembrolizumab monotherapy for the treatment of radically unresectable melanoma in Japan.
Scaling effects of temperature on parasitism from individuals to populations
Authors: Kirk Devin , O'Connor Mary I. , Mordecai Erin A.
Published: July 2022

Parasitism is expected to change in a warmer future, but whether warming leads to substantial increases in parasitism remains unclear. Understanding how warming effects on parasitism in individual hosts (e.g. parasite load) translate to effects on population‐level parasitism (e.g. prevalence, R0) remains a major knowledge gap.

We conducted a literature review and identified 24 host–parasite systems that had information on the temperature dependence of parasitism at both individual host and host population levels: 13 vector‐borne systems and 11 environmentally transmitted systems.

We found a strong positive correlation between the thermal optima of individual‐ and population‐level parasitism, although several of the environmentally transmitted systems exhibited thermal optima >5°C apart between individual and population levels. Parasitism thermal optima were close to vector performance thermal optima in vector‐borne systems but not hosts in environmentally transmitted systems, suggesting these thermal mismatches may be more common in certain types of host–parasite systems.

We also adapted and simulated simple models for both types of transmission modes and found the same pattern across the two modes: thermal optima were more strongly correlated across scales when there were more traits linking individual‐ to population‐level processes.

Generally, our results suggest that information on the temperature dependence, and specifically the thermal optimum, at either the individual or population level should provide a useful—although not quantitatively exact—baseline for predicting temperature dependence at the other level, especially in vector‐borne parasite systems. Environmentally transmitted parasitism may operate by a different set of rules, in which temperature dependence is decoupled in some systems, requiring the need for trait‐based studies of temperature dependence at individual and population levels.
Floral biology, breeding system and pollination ecology of Justicia betonica L. (Acanthaceae): An assessment of its low reproductive success in West Bengal, India
Authors: Layek Ujjwal , Midday Mrinmoy , Bisui Sourabh , Kundu Arijit , Karmakar Prakash
Published: July 2022

Besides its importance as an ornamental plant, Justicia betonica L. is also used as a medicinal plant for the treatment of several human disorders. However, the population size and abundance of the plant species are very low in Indian states, including West Bengal. The breeding system and pollination ecology of J. betonica are still unclear. Therefore, some reproductive aspects were investigated in order to provide important information for the sustainability of the species. The flowering duration spanned from December to May, with its peak in February–March. Flower opening time was much earlier (5.00–8.00 a.m.) on a hot day (in April–May) than on a cold day (10.00 a.m.–12.00 p.m. in December–January). The time of anther dehiscence coincided with the flower opening time; however, the stigma became receptive later. The plant species is self‐compatible but dependent on pollinators for fruit and seed sets. Members of different insect groups like ants, bees, butterflies, flies, moths and wasps visit the flowers. Among them, Allorhynchium metallicum and Halictus acrocephalus are the primary pollinators (based on the “relative pollinator service”). The plant species showed a significant pollination deficit (coefficient of pollination deficit [D] = 0.32) in the open condition. Larvae of the florivorous moth Gatesclarkeana erotias significantly reduced reproductive success by eating their floral parts, ovules and immature seeds. In conclusion, combining the pollination deficit and the feeding activity of phytophagous insects (moth larvae) may reduce the reproductive fitness of J. betonica in the study regions.
Moth sex pheromones affect interspecific competition among sympatric species and possibly population distribution by modulating pre‐mating behavior
Authors: Cheng Jianjun , Chen Qinghua , Guo Qianshuang , Du Yongjun
Published: July 2022

Premating behaviors mediated by pheromones play pivotal roles in animal mating choices. In natural populations of the striped stem borer Chilo suppressalis and the rice leaf roller Cnaphalocrocis medinalis in the rice field habitat, we discovered that Z11‐16:Ald, a major component of the C. suppressalis pheromone, modulated the premating behavior of C. medinalis. Z11‐16:Ald evoked a strong olfactory response in male antennae and strongly inhibited the sex pheromone trapping of male C. medinalis in the field. The functions of three C. medinalis sex pheromone receptor genes (CmedPR1–3) were verified through heterologous expression in Xenopus oocytes. CmedPR1 responded to Z11‐18:OH and Z11‐18:Ald, as well as the interspecific pheromone compound Z11‐16:Ac of sympatric species; CmedPR2 responded to Z13‐18:OH and Z13‐18:Ald, as well as the sex pheromone compounds Z11‐16:Ald and Z9‐16:Ald of sympatric species; and CmedPR3 responded to Z11‐18:OH and Z13‐18:OH, as well as the interspecific pheromones Z11‐16:OH, Z9‐16:Ald, Z11‐16:Ac, and Z11‐16:Ald of sympatric species. Thus, CmedPR2 and CmedPR3 share the ligand Z11‐16:Ald, which is not a component of the C. medinalis sex pheromone. Therefore, the sex pheromones of interspecific species affected the input of neural signals by stimulating the sex pheromone receptors on the antennae of male C. medinalis moths, thereby inhibiting the olfactory responses of the male moths to the sex pheromones. Our results demonstrate chemical communication among sympatric species in the rice field habitat, the recognition of intra‐ and interspecific sex pheromones by olfactory receptors, and how insect premating behaviors are modulated to possibly affect resource partitioning.
miR‐128‐3p inhibits high‐glucose‐induced peritoneal mesothelial cells fibrosis via PAK2/SyK/TGF‐β1 axis
Authors: Zhang Yao , Xiao Wu‐Hao , Huang Yi‐Xiong , Yang Yi‐Ya , Ouyang Sha‐Xi , Liang Yu‐Mei , Liu Kang‐Han
Published: July 2022

Aim

To elucidate the mechanism of miR‐128‐3p in peritoneal fibrosis (PF).

Methods

Peritoneal mesothelial cells (PMCs) were dealt with high glucose (HG) for 3 days. The expressions of miR‐128‐3p, p21‐activated kinase 2 (PAK2), spleen tyrosine kinase (SyK), and transforming growth factor‐β1 (TGF‐β1) were detected with quantitative real‐time reverse transcription polymerase chain reaction. The levels of IL‐1β, TNF‐α, IL‐6, and monocyte chemotactic protein‐1 in supernatant were measured by ELISA. Proteins of TGF‐β1, SyK, PAK2, α‐SMA, collagen I, vimentin, ERK/AP‐1, and IκBα/NF‐κB pathway related proteins were measured by Western blot. The correlation between miR‐128‐3p and PAK2 was found by bioinformatics analysis and luciferase reporter gene analysis.

Results

miR‐128‐3p was decreased while PAK2, SyK, and TGF‐β1 were increased in HG‐induced PMCs. Moreover, miR‐128‐3p inhibited HG‐induced fibrosis and inflammation in PMCs by targeting PAK2. PAK2 activated SyK, which induced TGF‐β1 expression through ERK/AP‐1 and IκBα/NF‐κB pathways to promote HG‐induced fibrosis of PMCs.

Conclusion

miR‐128‐3p inhibited HG‐induced PMCs fibrosis via PAK2/SyK/TGF‐β1 axis.
Environmental DNA methylation of Lymnaea stagnalis varies with age and is hypermethylated compared to tissue DNA
Authors: Zhao Beilun , van Bodegom Peter M. , Trimbos Krijn B.
Published: July 2022

Environmental DNA (eDNA) approaches contributing to species identifications are quickly becoming the new norm in biomonitoring and ecosystem assessments. Yet, information such as age and health state of the population, which is vital to species biomonitoring, has not been accessible from eDNA. DNA methylation has the potential to provide such information on the state of a population. Here, we measured the methylation of eDNA along with tissue DNA (tDNA) of Lymnaea stagnalis at four life stages. We demonstrate that eDNA methylation varies with age and allows distinguishing among age classes. Moreover, eDNA was globally hypermethylated in comparison to tDNA. This difference was age‐specific and connected to a limited number of eDNA sites. This differential methylation pattern suggests that eDNA release with age is partially regulated through DNA methylation. Our findings help to understand mechanisms involved in eDNA release and shows the potential of eDNA methylation analysis to assess age classes. Such age class assessments will encourage future eDNA studies to assess fundamental processes of population dynamics and functioning in ecology, biodiversity conservation and impact assessments.
A novel form of precise segmentectomy—Triumphal arch‐like anatomical segmentectomy
Authors: Zheng Yixiong , Zhang Shuliang , Zeng Taidui , Chen Maohui , Huang Guanglei , Xu Chi , Xu Guobing , Zheng Wei , Chen Chun , Zheng Bin
Published: July 2022

The increasingly accurate sublobar anatomical resection is constantly being explored and practiced. Surgeons try to preserve as much viable lung tissue as possible. Sublobar resection of the target tissue is similar with a cone‐shaped structure which penetrates deeply into the pulmonary parenchyma and runs through the lobe at both ends. This has not previously been described. The remaining lung tissue resembles the Triumphal Arch in Paris, France. Here, we describe triumphal arch‐like sublobectomy in detail, aiming to provide clinicians with an idea to explore this novel sublobectomy under similar conditions.
A randomized controlled trial on virtual reality distraction during venous cannulation in young children
Authors: Thybo Kasper H. , Friis Susanne M. , Aagaard Gitte , Jensen Claus S. , Dyekjær Charlotte D. , Jørgensen Casper Haslund , Walther‐Larsen Søren
Published: July 2022

Background and Objectives

Pain management in children is often inadequate, and the single most common painful procedure in children who are hospitalized is needle procedures. Virtual reality (VR) has been shown to decrease anxiety and pain in children undergoing painful procedures primarily in children from the age of 7 years. Our aim for this study is to investigate patient satisfaction and pain reduction by using a three‐dimensional VR interactive game as a distraction in 4–7 years old children during venous cannulation.

Methods

In this randomized clinical trial, we enrolled 106 children aged 4–7 years who were scheduled for venous cannulation. Patients assigned to the control group were adherent to standard of care, including topical numbing cream, positioning, and distraction in this group by games of choice on a tablet/smartphone. In the study group, children were adherent to standard of care and were distracted by an interactive VR game. Primary outcomes were patient satisfaction and the procedural pain assessed by using Wong–Baker Faces Pain Rating Scale; secondary outcomes were the procedural time and any adverse events.

Results

We found an overall high level of patient satisfaction with our regime of topical numbing cream, positioning, and distraction. The primary outcome of pain during the procedure was median 20 mm (IQR 0–40) and 20 mm (IQR 0–55) (Wong–Baker 0–100 mm) in the VR group and the control group, respectively (difference: 0 mm, 95%CI: 0–20, p = .19). No significant difference was found in procedural times. The number of adverse effects was low, with no significant difference between the two groups.

Conclusions

VR distraction is an acceptable form of distraction for children 4–7 years old when combined with topical numbing cream and positioning during preoperative venous cannulation. No difference was found between VR‐ and smartphone/tablet distraction.
The clinical utility of ongoing sonographic cervix length surveillance in pregnancies prescribed vaginal progesterone therapy
Authors: Ninkov Tatiana , Nathan Elizabeth A. , Belcher Cathryn N. , White Scott W. , Newnham John P.
Published: July 2022

Background

Vaginal progesterone therapy significantly reduces preterm birth (PTB) rates in those high‐risk pregnancies with a sonographic short cervix (≤25 mm) and/or a history of spontaneous PTB. Cervical length (CL) is routinely measured at the midtrimester morphology scan; however, CL surveillance thereafter is not currently recommended. Progesterone's precise mechanism of action remains unknown, though if it indeed influences CL, shortening after treatment initiation could indicate therapeutic failure and risk of PTB.

Aims

The aim was to explore the utility of serial transvaginal ultrasound (TVU) measurement of CL at 16, 19 and 22 weeks for predicting PTB in high‐risk pregnancies prescribed progesterone therapy.

Methods

A retrospective cohort study was conducted involving women who attended the King Edward Memorial Hospital PTB Prevention Clinic from 2015 to 2019 and were prescribed progesterone therapy. CL was measured at 16, 19 and 22 weeks by TVU. CL change across three time points was assessed using linear mixed models; then relationships between CL change between 16–19 and 19–22 weeks and PTB were analysed using logistic regression models.

Results

Term birth was most likely when CL did not decrease across both time periods. The addition of 16–19 week decrease in CL to a model, including CL at 19 weeks alone, for predicting PTB increased sensitivity from 43.2 to 56.3%, specificity from 73.2 to 77.4%, and overall accuracy from 61.7 to 70.2%.

Conclusion

For high‐risk women prescribed vaginal progesterone therapy, serial measurement of the cervix at 16 and 19 weeks improves clinical ability to predict PTB from current recommendations of 19‐week measurement alone.
Multi‐centre randomised trial of invasive and less invasive surfactant delivery methods showed similar spirometry results at 5–9 years of age
Authors: Göpel Wolfgang , Kribs Angela , Roll Claudia , Wieg Christian , Teig Norbert , Hoehn Thomas , Welzing Lars , Vochem Matthias , Hoppenz Marc , Bührer Christoph , Mehler Katrin , Hubert Mechthild , Eichhorn Joachim , Schmidtke Susanne , Rausch Tanja Katrin , König Inke Regina , Härtel Christoph , Roth Bernd , Herting Egbert
Published: July 2022

Aim

We explored whether subnormal forced expiratory volume within 1 s (FEV1) at 5–9 years of age was lower in children born preterm who received less invasive surfactant administration (LISA) rather than surfactant via an endotracheal tube.

Methods

The multi‐centre, randomised Nonintubated Surfactant Application trial enrolled 211 preterm infants born at 23–26 weeks of gestation from 13 level III neonatal intensive care units from April 2009 to March 2012. They received surfactant via LISA (n = 107) or after conventional endotracheal intubation (n = 104). The follow‐up assessments were carried out by a single team blinded to the group assignments. The main outcome was FEV1 < 80% of predicted values.

Results

Spirometry was successful in 102/121 children. The other children died or were lost to follow‐up. Median FEV1 was 93% (interquartile range 80%–113%) of predicted values in the LISA group and 86% (interquartile range 77–102%) in the control group (p = 0.685). Rates of FEV1 < 80% were 11/57 (19%) and 15/45 (33%), respectively, which was an absolute risk reduction of 14% (95% confidence interval −3.1% to 31.2%, p = 0.235). There were no differences in other outcome measures.

Conclusion

The proportion of children aged 5–9 years with subnormal FEV1 was not significantly different between the groups.
Antenatal and neonatal risk factors in very preterm children were associated with language difficulties at 9 years of age
Authors: Taskila Hanna‐Leena , Heikkinen Minna , Yliherva Anneli , Välimaa Taina , Hallman Mikko , Kaukola Tuula , Kallankari Hanna
Published: July 2022

Aim

This Finnish study compared language and reading abilities between schoolchildren born at a very low gestational age (VLGA) of <32 weeks and at term and analysed any associations between antenatal and neonatal risk factors and language skills in the VLGA group.

Methods

We prospectively followed 76 children born at a VLGA and 50 children born at term when they reached a mean age of 9.0 (8.1–10.0) years. They attended mainstream schools and had no severe neurosensory disabilities. Receptive language ability, rapid naming and word reading were evaluated using standardised tests.

Results

Children in the VLGA group had lower scores for receptive language abilities (median 55.0 vs. 57.0, p = 0.01) and word reading (mean 4.4 vs. 5.1, p = 0.03) than the children in the term group. In the VLGA group, foetal growth restriction was associated with lower scores for rapid naming, early intraventricular haemorrhage was associated with poor word reading and respiratory distress syndrome was associated with poor rapid naming (p < 0.05).

Conclusion

Schoolchildren born at a VLGA had more difficulties with receptive language abilities and word reading than children born at term. Foetal growth restriction and early neonatal morbidities were associated with language difficulties.
How are policies implemented in children's services? Developing an initial programme theory to evaluate the implementation of the new Child Sexual Exploitation guidance in Wales
Authors: Usubillaga Juan , Diaz Clive , Forrester Donald
Published: July 2022

Although children's social care is an area rich in guidance, there is very little research looking at the implementation of new policies in the United Kingdom. In this article, we report on the first stage of a realist evaluation of the implementation of the new Safeguarding Children from Child Sexual Exploitation guidance in Wales. We discuss the development of an initial programme theory, for which we conducted semi‐structured interviews with practitioners and managers in three local authorities. We developed programme theories across three areas: policy nature and development, implementation plans and organizational context. Findings suggest that, for policies to produce a significant impact on practice, they need to be sufficiently different to social workers' current perceptions of practice. Second, we found that the coordination between national and local policies is critical for successful implementation as contradictions between them might lead to confusion in what local teams should prioritize. Finally, our findings highlight the importance of effective communication of policy changes, as well as a supportive organizational culture to strengthen implementation in local contexts. These findings illustrate the complexity of policy implementation and the need for policymakers to consider the meaningful involvement of local practitioners in national policy development.
Magnetic resonance imaging has a limited role in investigating odynophagia if examination is normal: A binary logistic regression analysis of 484 patients presenting to a tertiary head and neck clinic
Authors: Wright Oliver , Zhang Ting Ting , Gyimah Dominic Ayi , Davies‐Husband Cameron
Published: July 2022

Introduction

Investigation of head and neck cancers places a significant burden on the National Health Service and effective resource allocation is of perpetual importance. Existing risk calculators are designed to stratify the likelihood of underlying malignancy according to symptoms, but are less relevant in secondary care as they do not integrate clinical examination findings (e.g. naso‐endoscopy). We looked to evaluate the utility of magnetic resonance imaging (MRI) in investigating patients with unilateral odynophagia and a normal clinical examination.

Methods

A retrospective analysis was conducted over a 54‐month period; 484 consecutively‐recruited adult patients who underwent MRI of the neck for suspected malignancy were included. Imaging reports, case notes, and histopathology results were reviewed. Patients with previously diagnosed/treated malignancy, undergoing surveillance, or those with pathology of the salivary glands, oral cavity or thyroid gland, were excluded. A multivariate binary logistical regression model was performed to calculate the odds ratios and probabilities of malignancy for each presenting symptom, with and without negative nasoendoscopy findings.

Results

The overall incidence of malignancy within the cohort was 173/484 patients (35.7%; 95% CI 31.5%–40.2%) with no cases of malignancy in patients presenting with odynophagia and a normal nasoendoscopy (0/39). The presence of a neck lump was significantly associated with malignancy, (odds ratio [OR] 2.03, p = .001; 95% CI 1.59–2.58), as was dysphagia (OR 1.52, p = .009; 95% CI 1.11–2.11). Conversely, globus was found to have an inverse association (OR 0.41, p < .001; 95% CI 0.24–0.70).

New patients presenting with odynophagia alone and normal endoscopy or globus have a low likelihood of underlying malignancy, justifying reassurance and follow‐up in the event of persistent symptoms. Contrariwise, patients with a neck lump, dysphagia, odynophagia and multiple concurrent aerodigestive tract symptoms, or an abnormal endoscopy have a high likelihood of underlying malignancy and should be investigated accordingly.
Differential effects of metformin‐mediated BSEP repression on pravastatin and bile acid pharmacokinetics in humans: A randomized controlled trial
Authors: Metry Melissa , Krug Samuel A. , Karra Vijaya Kumari , Kane Maureen A. , Fink Jeffrey C. , Shu Yan , Wang Hongbing , Polli James E.
Published: July 2022

Metformin has been shown to repress transcription of the bile salt export pump (BSEP) in human primary hepatocytes. The primary objective of this study was to assess the effect of oral metformin on the human pharmacokinetics (PKs) of two BSEP probe substrates: pravastatin and chenodeoxycholic acid (CDCA; also known as chenodiol). Endogenous bile acid levels were assessed as a secondary measure of metformin impact. An open‐label, randomized, single‐dose, placebo‐controlled, fasted, crossover PK study was conducted in 12 healthy adult volunteers. Metformin (500 mg b.i.d.) or placebo (b.i.d.) was administered orally for 6 days. On day 7, a single dose of the BSEP substrates pravastatin (80 mg) and CDCA (250 mg) were administered orally. Plasma samples were quantified for pravastatin, CDCA, and endogenous bile acids. Compared to placebo, metformin increased pravastatin plasma exposure, did not impact CDCA plasma exposure, and reduced conjugated primary bile acid levels in the blood. These results are consistent with metformin repressing BSEP expression. This differential effect reflects the degree of enterohepatic recirculation of victim substrates.
Bringing pharmacomicrobiomics to the clinic through well‐designed studies
Authors: Steiner Heidi E. , Patterson Hayley K. , Giles Jason B. , Karnes Jason H.
Published: July 2022

Pharmacomicrobiomic studies investigate drug‐microbiome interactions, such as the effect of microbial variation on drug response and disposition. Studying and understanding the interactions between the gut microbiome and drugs is becoming increasingly relevant to clinical practice due to its potential for avoiding adverse drug reactions or predicting variability in drug response. The highly variable nature of the human microbiome presents significant challenges to assessing microbes’ influence. Studies aiming to explore drug‐microbiome interactions should be well‐designed to account for variation in the microbiome over time and collect data on confounders such as diet, disease, concomitant drugs, and other environmental factors. Here, we assemble a set of important considerations and recommendations for the methodological features required for performing a pharmacomicrobiomic study in humans with a focus on the gut microbiome. Consideration of these factors enable discovery, reproducibility, and more accurate characterization of the relationships between a given drug and the microbiome. Furthermore, appropriate interpretation and dissemination of results from well‐designed studies will push the field closer to clinical relevance and implementation.
Thinking about differences in the worldwide prevalence of cerebral palsy
Authors: Paneth Nigel , Yeargin‐Allsopp Marshalyn
Published: July 2022

This commentary is on the original article by McIntyre et al. on pages 1494–1506 of this issue.
‘Much more convenient, just as effective’: Experiences of starting continuous glucose monitoring remotely following Type 1 diabetes diagnosis
Authors: Tanenbaum Molly L. , Zaharieva Dessi P. , Addala Ananta , Prahalad Priya , Hooper Julie A. , Leverenz Brianna , Cortes Ana L. , Arrizon‐Ruiz Nora , Pang Erica , Bishop Franziska , Maahs David M.
Published: July 2022

Aim

Initiating continuous glucose monitoring (CGM) shortly after Type 1 diabetes diagnosis has glycaemic and quality of life benefits for youth with Type 1 diabetes and their families. The SARS‐CoV‐2 pandemic led to a rapid shift to virtual delivery of CGM initiation visits. We aimed to understand parents' experiences receiving virtual care to initiate CGM within 30 days of diagnosis.

Methods

We held focus groups and interviews using a semi‐structured interview guide with parents of youth who initiated CGM over telehealth within 30 days of diagnosis during the SARS‐CoV‐2 pandemic. Questions aimed to explore experiences of starting CGM virtually. Groups and interviews were audio‐recorded, transcribed and analysed using thematic analysis.

Results

Participants were 16 English‐speaking parents (age 43 ± 6 years; 63% female) of 15 youth (age 9 ± 4 years; 47% female; 47% non‐Hispanic White, 20% Hispanic, 13% Asian, 7% Black, 13% other). They described multiple benefits of the virtual visit including convenient access to high‐quality care; integrating Type 1 diabetes care into daily life; and being in the comfort of home. A minority experienced challenges with virtual care delivery; most preferred the virtual format. Participants expressed that clinics should offer a choice of virtual or in‐person to families initiating CGM in the future.

Conclusion

Most parents appreciated receiving CGM initiation education via telehealth and felt it should be an option offered to all families. Further efforts can continue to enhance CGM initiation teaching virtually to address identified barriers.
Developing services to support the delivery of care to people with early‐onset type 2 diabetes
Authors: Misra Shivani , Gable David , Khunti Kamlesh , Barron Emma , Young Bob , Kar Partha , Valabhji Jonathan
Published: July 2022

Early‐onset type 2 diabetes occurring in childhood or early adulthood carries a significant excess burden of microvascular diabetes complications, cardiovascular disease and premature death, compared to later onset type 2 diabetes along with adverse pregnancy outcomes in women of child‐bearing age. National audit data in England reveal that 122,780 individuals under the age of 40 years are currently living with type 2 diabetes, with an over‐representation of people from minority ethnicities and those in the most socioeconomically deprived quintiles. A diagnosis of type 2 diabetes earlier in life poses some unique challenges to healthcare providers that are not routinely encountered when type 2 diabetes presents later. These include; (1) the need to ensure correct diabetes classification in an age group that carries a higher probability of other types of diabetes, (2) overcoming difficulties in engaging with individuals who are of working age or in full‐time education, (3) appreciating and addressing the lower attainment of diabetes treatment targets and (4) proactively supporting women of child‐bearing age to optimise their future pregnancy outcomes through better preparation for pregnancy, including achieving optimum glycaemic control at the time of conception. Meanwhile, approaches to prevent type 2 diabetes in younger age groups are challenged by difficulties in identifying those at highest risk, by poorer attendance at lifestyle interventions to prevent or delay the onset of type 2 diabetes and by attenuation of associated weight loss in those that do attend. In this article, we discuss the importance of recognising and addressing the distinct challenges in delivering healthcare to those with early‐onset type 2 diabetes, the greater challenges in preventing type 2 diabetes at younger ages, and key components of strategies that might address these challenges to drive improvements in pregnancy outcomes, microvascular and cardiovascular outcomes.
The WISDOM self‐management intervention: A cost‐effectiveness analysis to support the transformation of type 2 diabetes care in England
Authors: Singh Surya , Price Hermione , Fayers Kate , Leal Jose , Donoghue Victoria , Hempenstall Julia , Lewis Paul , O'Halloran Paul , Tsiachristas Apostolos
Published: July 2022

Objectives

To assess the cost‐effectiveness of the WISDOM self‐management intervention for type 2 diabetes compared with care as usual.

Design

We performed a difference‐in‐differences analysis to estimate differences in risk factors for diabetes complications between people in the WISDOM group (n = 25, 276) and a control group (n = 15, 272) using GP records. A decision analytic model was then used to extrapolate differences in risk factors into costs and outcomes in the long term.

Setting

Participating GP practices in West Hampshire and Southampton, UK.

Participants

All people diagnosed with type 2 diabetes between January 1990 and March 2020 (n = 40,548).

Outcomes

Diabetes‐related complications, quality‐adjusted life years (QALYs) and costs to the English National Health Service at 5 years and lifetime.

Interventions

The WISDOM intervention included risk stratification, self‐management education programme to professionals and people with type 2 diabetes, and monitoring of key treatment targets.

Results

WISDOM was associated with less atrial fibrillation [p = 0.001], albuminuria [p = 0.002] and blood pressure [p = 0.098]. Among all people in the intervention group, WISDOM led to 51 [95%CI: 25; 76] QALYs gained and saved £278,036 [95%CI: −631,900; 176,392] in the first 5 years after its implementation compared with care as usual. During those people' lifetime, WISDOM led to 253 [95%CI: 75; 404] QALYs gained and cost saving of £126,380 [95%CI: −1,466,008; 1,339,628]. The gains in QALYs were a result of reduced diabetes‐related complications through improved management of the associated risk factors.

Conclusions

The WISDOM risk‐stratification and education intervention for type 2 diabetes appear to be cost‐effective compared to usual care by reducing diabetes complications.
Healthcare resource utilization in patients with myeloproliferative neoplasms: A Danish nationwide matched cohort study
Authors: Christensen Sarah Friis , Svingel Lise Skovgaard , Kjærsgaard Anders , Stenling Anna , Darvalics Bianka , Paulsson Björn , Andersen Christen Lykkegaard , Christiansen Christian Fynbo , Stentoft Jesper , Starklint Jørn , Severinsen Marianne Tang , Clausen Mette Borg , Hilsøe Morten Hagemann , Hasselbalch Hans Carl , Frederiksen Henrik , Mikkelsen Ellen Margrethe , Bak Marie
Published: July 2022

Few studies have assessed healthcare resource utilization (HRU) in patients with Philadelphia‐negative myeloproliferative neoplasms (MPN) using a matched cohort design. Further, no detailed assessment of HRU in the years preceding an MPN diagnosis exists. We conducted a registry‐based nationwide Danish cohort study, including patients with essential thrombocythemia, polycythemia vera, myelofibrosis, and unclassifiable MPN diagnosed between January 2010 and December 2016. HRU data were summarized annually from 2 years before MPN diagnosis until emigration, death, or end of study (December 2017). We included 3342 MPN patients and 32 737 comparisons without an MPN diagnosis, matched on sex, age, region of residence, and level of education. During the study period, the difference in HRU (rate ratio) between patients and matched comparisons ranged from 1.0 to 1.5 for general practitioner contacts, 0.9 to 2.2 for hospitalizations, 0.9 to 3.8 for inpatient days, 1.0 to 4.0 for outpatient visits, 1.3 to 2.1 for emergency department visits, and 1.0 to 4.1 for treatments/examinations. In conclusion, MPN patients had overall higher HRU than the matched comparisons throughout the follow‐up period (maximum 8 years). Further, MPN patients had substantially increased HRU in both the primary and secondary healthcare sector in the 2 years preceding the diagnosis.
Age‐specific impacts of nicotine and withdrawal on hippocampal neuregulin signalling
Authors: Keady Jack , Fisher Miranda , Anderson Erin , LeMalefant Rachel , Turner Jill
Published: July 2022

Smoking remains the leading cause of preventable death in the United States, with 87% of smokers starting before the age of 18. Age of initiation is a major predictive factor for smoking frequency and successful smoking cessation. People who initiate smoking during adolescences are 2.33 times more likely to become heavy smokers and half as likely to quit compared with smokers who started during adulthood. Additionally, schizophrenia, a disease state linked to altered neurodevelopment during adolescence, is a major predictive factor for smoking status. Smoking rates among people suffering from schizophrenia are between 60% and 90%. Interestingly, the Neuregulin Signalling Pathway (NSP), which plays an important role in neurodevelopment, is implicated in both schizophrenia and nicotine use disorder. Specifically, SNPS in neuregulin 3 (Nrg3) and Erb‐B2 Receptor Tyrosine Kinase 4 (ErbB4) have been associated with smoking cessation outcomes and schizophrenia. Here, we examine the effects of chronic nicotine (18 mg/kg/day) and 24‐h withdrawal on NSP gene expression in the hippocampus of adult (20‐week‐old) and adolescent (4‐week‐old) mice. We show that withdrawal from chronic nicotine decreased the expression of Erbb4 mRNA in the hippocampus of the adult mice but increased the expression of cytosolic Erbb4 protein in adolescent mice. Nrg3 mRNA and protein expression was not altered by chronic nicotine or withdrawal in the adult or adolescent cohorts, but Nrg3 mRNA and synaptosomal protein expression was lower in the adult withdrawal group when compared with their adolescent counterparts. These results highlight the age‐specific effects of nicotine withdrawal on the NSP and may contribute to the lower quit rate and higher cigarette consumption of smokers who initiation during adolescences.
Emerging biological archives can reveal ecological and climatic change in Antarctica
Authors: Strugnell Jan M. , McGregor Helen V. , Wilson Nerida G. , Meredith Karina T. , Chown Steven L. , Lau Sally C. Y. , Robinson Sharon A. , Saunders Krystyna M.
Published: July 2022

Anthropogenic climate change is causing observable changes in Antarctica and the Southern Ocean including increased air and ocean temperatures, glacial melt leading to sea‐level rise and a reduction in salinity, and changes to freshwater water availability on land. These changes impact local Antarctic ecosystems and the Earth's climate system. The Antarctic has experienced significant past environmental change, including cycles of glaciation over the Quaternary Period (the past ~2.6 million years). Understanding Antarctica's paleoecosystems, and the corresponding paleoenvironments and climates that have shaped them, provides insight into present day ecosystem change, and importantly, helps constrain model projections of future change. Biological archives such as extant moss beds and peat profiles, biological proxies in lake and marine sediments, vertebrate animal colonies, and extant terrestrial and benthic marine invertebrates, complement other Antarctic paleoclimate archives by recording the nature and rate of past ecological change, the paleoenvironmental drivers of that change, and constrain current ecosystem and climate models. These archives provide invaluable information about terrestrial ice‐free areas, a key location for Antarctic biodiversity, and the continental margin which is important for understanding ice sheet dynamics. Recent significant advances in analytical techniques (e.g., genomics, biogeochemical analyses) have led to new applications and greater power in elucidating the environmental records contained within biological archives. Paleoecological and paleoclimate discoveries derived from biological archives, and integration with existing data from other paleoclimate data sources, will significantly expand our understanding of past, present, and future ecological change, alongside climate change, in a unique, globally significant region.