bluuebunny/crossref_metadata_2025 huggingface dataset:
Peer community health workers improve HIV testing and ART linkage among key populations in Zambia: retrospective observational results from the Z‐CHECK project, 2019–2020
Authors: Lindsay Brianna R. , Mwango Linah , Toeque Mona‐Gekanju , Malupande Siphiwe Lucy , Nkhuwa Elizabeth , Moonga Clement Nchimunya , Chilambe Andrew , Sakala Henry , Kafunda Ina , Olowski Pawel , Olufunso Adebayo , Okuku Jackson , Kancheya Nzali , Mumba Daliso , Hachaambwa Lottie , Sheneberger Robb , Blanco Natalia , Lavoie Marie‐Claude , Claassen Cassidy W.
Published: November 2022

Introduction

Zambia has made tremendous progress towards HIV epidemic control; however, gaps remain among key populations (KPs), such as female sex workers (FSWs), men who have sex with men (MSM), people who inject drugs (PWID) and people in prisons and enclosed settings due to cultural, social and legal barriers. The University of Maryland, Baltimore Zambia Community HIV Epidemic Control for Key Populations (Z‐CHECK) project aimed to improve HIV case‐finding, linkage and treatment adherence at the community level for KPs in Zambia. We describe Z‐CHECK strategies and examine HIV positivity yield and antiretroviral therapy (ART) linkage among KPs to inform ongoing programme improvement.

Methods

Z‐CHECK recruited, trained and deployed peer community health workers (CHWs) for KP groups, with ongoing mentorship in community engagement. CHWs offered HIV testing in safe spaces and escorted newly HIV‐diagnosed clients for same‐day ART initiation. Z‐CHECK also reached out to KP community leaders and gatekeepers for KP mobilization and trained healthcare workers (HCWs) on KP services and sensitivity. We conducted a retrospective observational review of routinely collected aggregate data for KPs aged ≥15 years at high risk for HIV transmission across five districts in Zambia from January 2019 to December 2020.

Results

Z‐CHECK provided HIV testing for 9211 KPs, of whom 2227 were HIV positive (positivity yield, 24%). Among these, 1901 (85%) were linked to ART; linkage for MSM, FSW, PWID and people in prisons and enclosed settings was 95%, 89%, 86% and 65%, respectively. Programme strategies that contributed to high positivity yield and linkage included the use of peer KP CHWs, social network testing strategies and opportunities for same‐day ART initiation. Challenges to programme implementation included stigma and discrimination among HCWs, as well as KP CHW attrition, which may be explained by high mobility.

Conclusions

Peer CHWs were highly effective at reaching KP communities, identifying persons living with HIV and linking them to care. Engaging KP community gatekeepers resulted in high diffusion of health messages and increased access to health resources. The mobility of CHWs and HCWs is a challenge for programme implementation. Innovative interventions are needed to support PWID and people in prisons and enclosed settings.
Do rural clan‐based networks reduce the risk of a return to poverty? Evidence from China
Authors: Xu Fang , Zhang Xiaoru , Zhou Di
Published: November 2022

Avoidance of a return to poverty is a priority within postpoverty alleviation programmes in rural China. As traditional social networks, clan‐based networks have long played a pivotal role within rural society and governance. However, few studies have examined their influence on the return to poverty of rural families. Therefore, we used the China Family Panel Survey (CFPS) data from 2014 to explore how clan networks influence the risk of a return to poverty among rural households and its mechanisms. Our findings suggest that clan networks can reduce the risk of returning to poverty and that they have heterogeneous effects on families and regions with different characteristics. Their main function is to reduce the borrowing cost through an external support mechanism and to promote movements of the rural labour force to urban areas where they can earn higher nonagricultural stable incomes through an internal sharing mechanism. This study of the role of traditional clan‐based networks in poverty avoidance can contribute to their enhanced role in the new era, while also providing inputs for consolidating and expanding poverty alleviation, innovating existing follow‐up poverty alleviation guarantee mechanisms and promoting comprehensive rural revitalization.
Opting out of public sector employment: Gender and occupational aspirations among university graduates in Sierra Leone
Authors: Harris Jamelia
Published: November 2022

Using primary data from Sierra Leone, this article explores the relationship between gender and occupational aspirations. Descriptive findings suggest largely similar desired occupational roles across gender; however, regression results show that the odds of females aspiring for public sector employment are half that of males. Lower ambition for public sector employment among females is associated with less favourable perceptions of public sector employment in key areas that are deemed important to graduates such as salary, status from employment, the ability to contribute to society, training opportunities and career progression. Such ‘opting out’ by university‐educated women has implications for women's inclusion in national development.
正常腎機能患者のプレガバリン中毒に対する血液浄化療法の効果(Effects of blood purification therapy for pregabalin intoxication in patients with normal kidney function)
Authors: 歩 鶴岡 , 浩士 林下 , 智美 吉野 , 胤明 重光 , 和彦 木林 , 賢一朗 中尾
Published: November 2022

プレガバリンを過量服薬した正常腎機能患者に対してextracorporeal treatment（ECTR）を施行し，経過中の血中プレガバリン濃度を液体クロマトグラフィー質量分析法（LC–MS）で測定した2例を経験したため報告する。症例1は49歳の女性。プレガバリン5,750mg，ベニジピン160mgなどを過量服用し救急搬送された。来院時，舌根沈下あり気管挿管した。洞停止が頻回にみられ，循環不全進行のためノルアドレナリン，ドブタミンを開始した。来院後11時間より血液濾過透析（hemodiafiltration: HDF）を開始し5時間施行した。プレガバリンの半減期はHDF前22.8時間，HDF中2.3時間であった。症例2は41歳の女性。プレガバリン3,225mg，アムロジピン65mgなどを過量服薬し救急搬送された。ICU入室後に意識レベルが低下したため，気管挿管した。来院後5時間より血液透析（hemodialysis: HD）を開始し4時間施行した。HD終了後に意識レベルの改善がみられた。正常腎機能患者のプレガバリン中毒に対してECTRを導入したところ，血中プレガバリン濃度は速やかに低下し早期の意識レベル改善，循環動態改善の効果が得られた。昏睡状態や呼吸不全，循環不全を合併する重症プレガバリン中毒に対しては，正常腎機能であっても早期の状態改善にECTRが有効である可能性が示唆された。
日本版敗血症診療ガイドライン2020の使用状況と認知度に関するアンケート調査(Questionnaire survey on usage and awareness of the Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020)
Authors: 日本版敗血症診療ガイドライン2020特別委員会アンケート調査班
Published: November 2022

日本版敗血症診療ガイドライン（The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock: J–SSCG）2020特別委員会は，J–SSCG2020の使用状況と認知度，および，今後の改善点を検討するために，オンラインアンケートを実施した。J–SSCG2020を合同作成した日本集中治療医学会と日本救急医学会の2学会の会員には使用状況を調査するために最大22項目，J–SSCG2020を後援いただいた16学会の会員には認知度を調査するために最大10項目の質問を実施した。2学会会員を対象としたアンケートは450名より回答を得た。敗血症診療にJ–SSCG2020を参考にするとの回答は88%であった。敗血症患者の何%くらいでJ–SSCG2020に準じた診療が行われているかという質問には，75%程度であるとの回答が最多（54%）であった。J–SSCG2020で取り上げた22項目のうち特に遵守している項目に対する回答者数の割合は，3～62%と項目ごとに大きなばらつきがみられた。また，日本の敗血症診療におけるJ–SSCG2020の役割について，診療の標準化（87%），教育の向上（64%）の点で特に評価されていた。J–SSCG2016アンケート結果との比較では，J–SSCG2020の方がより広く敗血症診療に利用されていた。16学会会員対象のアンケートは764名より回答を得た。J–SSCG2020の認知度は72%であった。認知している回答者のうち81%が敗血症診療に利用し，うち95%は役に立つとの回答であった。一方，J–SSCG2020の問題点としては，内容が多すぎるという意見が最多であった。日本医療機能評価機構EBM普及推進事業（Minds）によるThe Appraisal of Guidelines for Research and Evaluation（AGREE II）を用いた評価では，J–SSCG2020の全体評価は88%であった。以上から，集中治療医や救急医のみならず，一般臨床家を対象として幅広く敗血症診療を支援するというJ–SSCG2020の主要な目的はある程度達成されていることが示唆された。一方，領域や臨床疑問（clinical question: CQ）数の見直しなど今後の改訂に向けた課題も明らかになった。
繰り返し実施したfinger testが陰性であったものの，筋膜の組織検査を追加することで診断することができた壊死性筋膜炎の1例(A case of necrotizing fasciitis diagnosed by histopathological examination of fascia after repeated negative finger tests)
Authors: 純一郎 飯尾 , 健太郎 尾崎 , 一実 宮島 , 諒吏 尾崎 , 美里 中山 , 潤一 前原
Published: November 2022

壊死性筋膜炎の診断法の一つとして，病変の皮膚を切開し，筋膜を触診し壊死を確認するfinger testがあり，比較的高い感度であることが報告されている。今回我々は，69歳男性，糖尿病，末期腎不全，ステロイド内服歴のある患者に生じた右下腿の壊死性筋膜炎の症例を経験した。初日に行ったfinger testは陰性であった。第3病日に病態が悪化した際に再度finger testを行ったが陰性であった。2回目のfinger testの際に筋膜の組織検査を追加したところ，筋膜結合組織内の好中球浸潤を認めた。この結果をもって壊死性筋膜炎と確定診断し，緊急手術を行う方針となった。finger testが陰性であっても臨床的に壊死性筋膜炎が疑わしい症例であれば，finger testの際に筋膜組織の病理学的検査を追加することで確定診断につながる可能性がある。
Characteristics of women seeking care at a vulvar clinic: A study of 600 patients during a 17‐year period
Authors: Rosendahl Karolina , Shayesteh Alexander , Nylander Elisabet
Published: November 2022

Background

Symptoms from the vulva and vagina affect about one‐third of all women and have a negative influence both on sexual health and psychosocial well‐being. Research regarding vulvar diseases is sparse and there is a need for a better understanding of women seeking care for vulvar diseases.

Objectives

The objectives of this descriptive study were to investigate symptoms, signs, and background characteristics of women attending our multidisciplinary vulvar clinic at the University Hospital, Umeå, Sweden between 2005 and 2021.

Methods

We conducted a prospective study by using a vulvar‐specific questionnaire and reviewed the medical records to collect supplementary data.

Results

A total of 600 women participated. The most common symptom among all participants was dyspareunia (67.6%). Pain diagnoses dominated in the younger population while inflammatory diseases were most common among patients 40 years of age or more. We found a significant association between dyspareunia and negative experiences of gynaecological examination (p < 0.001) as well as between pruritus and not having a regular contact with a psychologist (p < 0.05).

Conclusions

Women seeking care at our vulvar clinic exhibit a complicated and complex set of symptoms intertwined with many aspects of life. Increasing awareness among healthcare professionals, an experienced team at the clinic, and a multidisciplinary approach regarding the symptoms and needs of women with vulvar conditions are important to optimise care and treatment. Clinicians must be aware that vulvar diseases may have different symptomatology due to age. It is also important to highlight that the symptomatology presented by patients attending for vulvar diseases, has changed during the past decade.
Origins of harvested American black ducks: stable isotopes support the flyover hypothesis
Authors: Kusack Jackson W. , Tozer Douglas C. , Schummer Michael L. , Hobson Keith A.
Published: November 2022

Waterfowl management is more effective when based on detailed information on population connectivity between breeding, wintering, and stopover sites. For the American black duck (Anas rubripes), a species of conservation concern, estimates for the fall age ratio at harvest differed depending on whether harvest data were derived from Canada or the United States, suggesting regional differences. Within Canada, hunters in Atlantic Canada were more likely to harvest black ducks from nearby breeding locations compared to hunters in southern Ontario and Quebec, Canada, who were more likely to harvest individuals from the Boreal Softwood and Taiga Shield of eastern Canada. Black ducks harvested in the United States are thought to originate predominantly from northern portions of the breeding range, leading to the flyover hypothesis, which postulates that black ducks produced in the Boreal Softwood and Taiga Shield region are less susceptible to harvest by hunters in Atlantic Canada and northeastern United States. To test the flyover hypothesis, we examined regional and temporal differences in the origins of harvested black ducks using feathers from wings (n = 664) submitted by hunters to the species composition and parts collection surveys across 3 hunting seasons (2017–2018, 2018–2019, 2019–2020). We used a likelihood‐based assignment method that relied on feather stable‐hydrogen isotopes (δ2H) and stable‐carbon isotopes (δ13C) to determine the natal or molt origin of individuals harvested within eastern Canada and the United States. We also used a spatial clustering technique to group harvested individuals by area of origin withouta prioriknowledge of such regions. Adult female black ducks originated farther south compared to males and juveniles. All sexes and ages of black ducks harvested in Atlantic Canada showed predominantly southern origins, while those harvested in the United States and other Canadian provinces primarily originated farther north within the boreal, supporting the flyover hypothesis. By contrast, we found no relationship between timing of harvest or peaks of migration and individual origin. After combining band returns and stable isotopes, we inferred 2 distinct stocks: the Mississippi flyway stock and the Atlantic flyway stock. We recommend that regional demographic parameters, particularly for Atlantic Canada, be directly measured to promote more effective conservation of black ducks and optimize harvest opportunities in the United States and Canada.
Piping plover chick ecology following landscape‐level disturbance
Authors: Robinson Samantha G. , Walker Katie M. , Bellman Henrietta A. , Gibson Daniel , Catlin Daniel H. , Karpanty Sarah M. , Ritter Shannon J. , Fraser James D.
Published: November 2022

Population declines of disturbance‐dependent species due to suppression of natural disturbances are realized across ecosystems. The piping plover (Charadrius melodus; plover), a disturbance‐dependent and conservation‐reliant shorebird that nests on sandy beaches and barrier islands on the Atlantic Coast, was listed under the United States Endangered Species Act in 1986. In 2012, Hurricane Sandy landed on Fire and Westhampton islands, barrier island nesting sites for plovers in New York, USA. Hurricane Sandy was a natural disturbance in this system, creating abundant nesting habitat. The number of chicks produced by a pair, or a population, is a direct measure of reproductive output, and gaining a better understanding of productivity and chick behavior following large‐scale habitat creation may improve plover habitat management and potentially species persistence. We evaluated the effects of landscape features on habitat selection, behavior, and survival of plover broods using logistic regression, generalized linear mixed effects models, and survival models. Plover broods selected flatter sites with less dense vegetation than available at random. Chick foraging rates were highest in moist substrates and were lower in areas of higher nesting plover density. Chick survival was greater for broods that hatched earlier in the breeding season and increased as chicks aged. Generally, providing access to sites with flatter, moist substrates will likely result in higher quality brood rearing habitat on the landscape. Ultimately, vegetation removal and habitat management may be needed to reduce plover nesting density and ensure sufficient habitat, which may in turn improve plover chick survival. Moreover, sustaining natural landscape disturbances such as those resulting from storms, and not taking actions to prevent hurricane‐created overwash, will allow these landscape features to persist.
Bird carcass detection from integrated trials at multiple wind farms
Authors: Kitano Masato , Smallwood K. Shawn , Fukaya Keiichi
Published: November 2022

It is often necessary to estimate the number of wind turbine collision fatalities to assess impacts to birds following construction of wind farms. Detection of bird carcasses at wind turbines in the field is affected by carcass persistence and searcher detection rate. Integrated detection trials, which integrate carcass persistence and searcher detection trials into the periodic fatality search, have been proposed as an effective method for estimating these parameters. The purpose of our study was to test whether and how environmental factors affect integrated detection trial outcomes at multiple wind farms. We conducted this study at 10 wind farms in various environments of Japan. Binary data on trial outcomes in open versus forested areas served as our response variable in a generalized additive mixed model informed by days into trial, carcass body mass, season, whether snow covered the ground, and precipitation. For both ground cover types, days into trial and body mass were included in all the top models, suggesting that these factors most influenced bird carcass detection probability in integrated trials. The best model in open areas included days into trial, body mass, snow, and precipitation, and the best model in forested areas included days into trial, body mass, snow, precipitation, and season. Values of area under the curve indicated high accuracy of the best model for both ground cover types. The survey design needs to be appropriate to the size of the target species and to the environment in which the impacts will occur, such as the site's seasonality, its ground cover, and whether snow will cover the ground. Frequency of post‐construction fatality monitoring should also be set cautiously, especially at wind farms located on small‐bird migration routes, at wind farms in open areas, in areas with snow‐covered ground in winter, or in forested areas during spring and summer because detection probabilities decline fastest under such conditions.
Extent of Surgery for Follicular Thyroid Carcinoma
Authors: Kethidi Nikhit , Vedula Sudeepti , Shihora Dhvani , Patel Rushi , Park Richard C. W.
Published: November 2022

Objectives

To examine the association between the extent of surgery and overall survival in follicular thyroid cancer (FTC) patients.

Study Design

Retrospective analysis of the National Cancer Database (NCDB).

Methods

Patients who underwent surgical intervention for FTC from 2004 to 2015 were selected. Patients were >18 years old, with tumor size 1–4 cm, no other malignancies, and >0 follow up time. Patients were divided into two cohorts based on extent of surgery: lobectomy (≥1 lobe resected) and thyroidectomy (total or near total resection). Pearson's chi‐squared analysis was used to compare cohorts. Kaplan–Meier survival and Cox hazards models were utilized to determine overall survival between two cohorts with p < 0.05 used for significance.

Results

A total of 6871 patients were identified with FTC, of which 1507 patients underwent lobectomy and 5364 patients underwent total thyroidectomy. There were no significant differences in patient demographics, comorbidity index, local spread, or tumor grade. Patients undergoing lobectomy had mean survival of 12.94 versus 12.71 years for those undergoing thyroidectomy. Extent of surgery was not associated with a significant difference in survival (5 years OS = 96% in lobectomy and 95.5% in total thyroidectomy, p = 0.08). Stratification by tumor grade resulted in no significant difference in survival between lobectomy and thyroidectomy.

Conclusion

Survival time was not significantly different in patients with more extensive resection of FTC.

Level of Evidence

3 Laryngoscope, 133:993–999, 2023
Are Mobile Applications in Laryngology Designed for All Patients?
Authors: Odigie Eseosa , Andreadis Katerina , Chandra Iyra , Mocchetti Valentina , Rives Hal , Cox Steven , Rameau Anaïs
Published: November 2022

Objectives

Mobile applications (apps) are multiplying in laryngology, with little standardization of content, functionality, or accessibility. The purpose of this study is to evaluate the quality, functionality, health literacy, readability, accessibility, and inclusivity of laryngology mobile applications.

Methods

Of the 3230 apps identified from the Apple and Google Play stores, 28 patient‐facing apps met inclusion criteria. Apps were evaluated using validated scales assessing quality and functionality: the Mobile App Rating Scale (MARS) and the Institute for Healthcare Informatics App Functionality Scale. The Clear Communication Index (CDC) Institute of Medicine Strategies for Creating Health Literate Mobile Applications, and Patient Education Materials Assessment Tool (PEMAT) were used to evaluate apps health literacy level. Readability was assessed using established readability formulas. Apps were evaluated for language, accessibility features, and representation of a diverse population.

Results

Twenty‐six apps (92%) had adequate quality (MARS score > 3). The mean PEMAT score was 89% for actionability and 86% for understandability. On average, apps utilized 25/33 health literate strategies. Twenty‐two apps (79%) did not pass the CDC index threshold of 90% for health literacy. Twenty‐four app descriptions (86%) were above an 8th grade reading level. Only 4 apps (14%) showed diverse representation, 3 (11%) had non‐English language functions, and 2 (7%) offered subtitles. Inter‐rater reliability for MARS was adequate (CA‐ICC = 0.715).

Conclusion

While most apps scored well in quality and functionality, many laryngology apps did not meet standards for health literacy. Most apps were written at a reading level above the national average, lacked accessibility features, and did not represent diverse populations. Laryngoscope, 133:1540–1549, 2023
Longitudinal Clinical and Biological Characteristics in Juvenile‐Onset Huntington's Disease
Authors: Schultz Jordan L. , Langbehn Douglas R. , Al‐Kaylani Hend M. , van der Plas Ellen , Koscik Timothy R. , Epping Eric A. , Espe‐Pfeifer Patricia B. , Martin Erin P. , Moser David J. , Magnotta Vincent A. , Nopoulos Peggy C.
Published: November 2022

Background

Juvenile‐onset Huntington's disease (JOHD) is a rare form of Huntington's disease (HD) characterized by symptom onset before the age of 21 years. Observational data in this cohort is lacking.

Objectives

Quantify measures of disease progression for use in clinical trials of patients with JOHD.

Methods

Participants who received a motor diagnosis of HD before the age of 21 were included in the Kids‐JOHD study. The comparator group consisted of children and young adults who were at‐risk for inheriting the genetic mutation that causes HD, but who were found to have a CAG repeat in the non‐expanded range (gene non‐expanded [GNE]).

Results

Data were obtained between March 17, 2006, and February 13, 2020. There were 26 JOHD participants and 78 GNE participants who were comparable on age (16.03 vs. 14.43, respectively) and sex (53.8% female vs. 57.7% female, respectively). The mean annualized decrease in striatal volume in the JOHD group was −3.99% compared to −0.06% in the GNE (mean difference [MD], −3.93%; 95% confidence intervals [CI], [−4.98 to −2.80], FDR < 0.0001). The mean increase in the Unified Huntington's Disease Rating Scale Total Motor Score per year in the JOHD group was 7.29 points compared to a mean decrease of −0.21 point in the GNE (MD, 7.5; 95% CI, [5.71–9.28], FDR < 0·0001).

Conclusions

These findings demonstrate that structural brain imaging and clinical measures in JOHD may be potential biomarkers of disease progression for use in clinical trials. Collaborative efforts are required to validate these results in a larger cohort of patients with JOHD. © 2022 International Parkinson and Movement Disorder Society.
Validation of a modified bedside Pediatric Early Warning System score for detection of clinical deterioration in hospitalized pediatric oncology patients: A prospective cohort study
Authors: Soeteman Marijn , Kappen Teus H. , van Engelen Martine , Marcelis Maartje , Kilsdonk Ellen , van den Heuvel‐Eibrink Marry M. , Nieuwenhuis Edward E. S. , Tissing Wim J. E. , Fiocco Marta , van Asperen Roelie M. Wösten‐
Published: November 2022

Background

Hospitalized pediatric oncology patients are at risk of severe clinical deterioration. Yet Pediatric Early Warning System (PEWS) scores have not been prospectively validated in these patients. We aimed to determine the predictive performance of the modified BedsidePEWS score for unplanned pediatric intensive care unit (PICU) admission and cardiopulmonary resuscitation (CPR) in this patient population.

Methods

We performed a prospective cohort study in an 80‐bed pediatric oncology hospital in the Netherlands, where care has been nationally centralized. All hospitalized pediatric oncology patients aged 0–18 years were eligible for inclusion. A Cox proportional hazard model was estimated to study the association between BedsidePEWS score and unplanned PICU admissions or CPR. The predictive performance of the model was internally validated by bootstrapping.

Results

A total of 1137 patients were included. During the study, 103 patients experienced 127 unplanned PICU admissions and three CPRs. The hazard ratio for unplanned PICU admission or CPR was 1.65 (95% confidence interval [CI]: 1.59–1.72) for each point increase in the modified BedsidePEWS score. The discriminative ability was moderate (D‐index close to 0 and a C‐index of 0.83 [95% CI: 0.79–0.90]). Positive and negative predictive values of modified BedsidePEWS score at the widely used cutoff of 8, at which escalation of care is required, were 1.4% and 99.9%, respectively.

Conclusion

The modified BedsidePEWS score is significantly associated with requirement of PICU transfer or CPR. In pediatric oncology patients, this PEWS score may aid in clinical decision‐making for timing of PICU transfer.
A congenital CSF3R mutation in chronic neutropenia reveals a vital role for a cytokine receptor extracellular hinge motif in the response to granulocyte colony‐stimulating factor
Authors: Feyen Jacqueline , Ernst Martijn P. T. , van der Velden Vincent H. J. , Valk Peter J. M. , Broeders Lianne , Touw Ivo P. , Raaijmakers Marc H. G. P.
Published: November 2022

We describe a patient with congenital neutropenia (CN) with a homozygous germline mutation in the colony‐stimulating factor 3 receptor gene (CSF3R). The patient's bone marrow shows lagging neutrophil development with subtle left shift and unresponsiveness to CSF3 in in vitro colony assays. This patient illustrates that the di‐proline hinge motif in the extracellular cytokine receptor homology domain of CSF3R is critical for adequate neutrophil production, but dispensable for in vivo terminal neutrophil maturation. This report underscores that CN patients with inherited CSF3R mutations should be marked as a separate clinical entity, characterized by a failure to respond to CSF3.
Effects of COVID‐19 vaccination on platelet counts and bleeding in children, adolescents, and young adults with immune thrombocytopenia
Authors: Kaicker Shipra , Martinko Kirsten , Bussel James B.
Published: November 2022

Coronavirus disease 2019 (COVID‐19) vaccines rarely cause de novo immune thrombocytopenia (ITP) but may worsen preexisting ITP in adults. Whether severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccines impact platelet counts and bleeding in children, adolescents, and young adults (C‐AYA) with preexisting ITP is unknown. We report here the very limited effect of COVID‐19 vaccination on platelet counts and bleeding in a single‐center series of 2 C‐AYA with ITP. No patient experienced worsening bleeding and only one child had a significant decrease in platelet count which improved spontaneously to her baseline without intervention. SARS‐CoV2 vaccination was safe in C‐AYA with ITP in this small cohort.
Effect of a novel pilot support group on distress and quality of life in breast cancer patients in Nigeria
Authors: Asuzu Chioma C. , Akin‐Odanye Elizabeth O. , Asuzu Michael C. , Adedokun Tunde , Ntekem Atara , Ogundiran Temidayo , Henry Mellissa , Watson Maggie
Published: November 2022

Objective

To assess the effect of a new breast cancer support group (BCSG) on breast cancer patients' self‐reported distress and quality of life.

Methods

A single arm pre‐post trial providing an eight session healthcare provider led BCSG. Primary outcome variables were distress and quality of life assessed using the National Comprehensive Cancer Network Distress Thermometer (DT) and The Functional Assessment of Cancer Therapy ‐ Breast plus Arm Morbidity (FACT‐B+4), respectively. Topics in each session addressed a wide range of issues some of which were pre‐selected by the patients themselves.

Data analysis

Paired sample t‐test was used for data analysis on International Business Machine Statistical Package for the Social Sciences 21.

Results

The participants (N = 18) had a mean age of 51. Most had secondary school level education (54%), were traders (59%) and had stage 3 or 4 disease (67%). A larger proportion (78% or n = 14) of the patients lived in rural areas, while 4 (22%) of the patients lived in Ibadan. Out of the 8 sessions, 12 (67%) of the participants attended 1‐3 sessions while 6 (33%) attended 4‐8 sessions. There were, significant improvements in emotional wellbeing (t = −4.253; p < 0.05) and functional wellbeing (t = −2.191; p < 0.05) on the FACT‐B+4. There was a significant reduction in the DT score (t = 2.345; p < 0.05) but the number of items on the problem list were not significantly reduced (t = 1.191; p > 0.05). Majority (75%) of the patients rated the support group activities as satisfactory.

Conclusion

These data show that the support group can benefit breast cancer patients in terms of reduced distress levels along with satisfaction and improvement in the functional and emotional wellbeing indices of quality of life.
Use of group IIB metal ions as charge carriers for collision‐induced dissociation of glycopeptide and glycan
Authors: Wong H.‐T. Kitty , Chen Xiangfeng , Zhang Simin , Lui Tin‐Yi , Hu Danna , Chan T.‐W. Dominic
Published: November 2022

Rationale

Dissociation of biomolecules by tandem mass spectrometry (MS/MS) generates a variety of fragment ions which provide useful information for the structural characterization of biomolecules. Different fragmentation strategies result in different mass spectra for the same molecule and thus provide distinct features. Charge carriers play important roles in determining the dissociation pathways of the target precursor ions. The use of various transition metals ions as charge carriers of glycopeptide and glycan might provide additional structural information and needs to be investigated.

Methods

A 9.4 T SolariX FTICR mass spectrometer was used for collision‐induced dissociation (CID) of glycopeptide and glycan. Group IIB metal ions, including Zn2+, Cd2+ and Hg2+, were used as charge carriers. Glycopeptide NLTK‐M5G2 and glycan G1F were used as the model systems.

Results

For Zn2+‐ and Cd2+‐adducted species, cross‐ring cleavages, glycosidic cleavages and cleavages along the peptide backbone could be obtained. There is a high degree of similarity in their CID spectra with that of Mg2+ ion‐adducted glycopeptide species. For Hg2+‐adducted species, only glycosidic cleavages were observed in high abundance. The formation of doubly‐charged ions (M2+) and a series of [f−H]+ fragments indicated unique dissociation pathways for Hg2+‐adducted glycopeptide.

Conclusions

Zn2+ and Cd2+‐adducted glycopeptide species produced similar dissociation CID spectra, whereas Hg2+‐adducted species produced significantly different CID spectra. Similar CID dissociation features were also observed for Group IIB metal ions adducted glycan species. These results demonstrated that different metal ions might be used to tune the dissociation behaviors of glycopeptides and glycans.
Estimation and prediction of ecological footprint using tourism development indices top tourist destination countries
Authors: Roumiani Ahmad , Basir Arian Abdul , Mahmoodi Hamide , Shayan Hamid
Published: November 2022

During the last two decades, the ecological footprint (EF) has had various fluctuations and has been associated with an upward trend, which can be a concern. This research aims to statistically examine tourism development indices and their effect on the EF during the last two decades in eight top tourism countries (France, United States, China, Italy, Turkey, Mexico, Thailand, and Germany). For this purpose, indices (extracted from the World Bank and Global Footprint Network databases) were used. Also, repeatability models were used to check the time and place and penalized regression models were used for the fit and accuracy of tourism development indices. The research findings showed that the amount of EF in the countries of China, France, the United States of America, Mexico and Thailand had an upward trend. The predictive accuracy of the penalized regression models of Ridge, LASSO and Elastic Net were reported as 0.910, 0.908, and 0.908, respectively. The difference is that the LASSO model acted more strictly and provided a more economical model by selecting the variable. We believe that a deeper statistical look can effectively apply an efficient strategy in better management of the EF challenge.
Dynamic impairment classification through arrayed comparisons
Authors: Wang Zheng , Wang Zi , Lyu Lingyun , Cheng Yu , Seaberg Eric C. , Molsberry Samantha A. , Ragin Ann , Becker James T.
Published: November 2022

The multivariate normative comparison (MNC) method has been used for identifying cognitive impairment. When participants' cognitive brain domains are evaluated regularly, the longitudinal MNC (LMNC) has been introduced to correct for the intercorrelation among repeated assessments of multiple cognitive domains in the same participant. However, it may not be practical to wait until the end of study for diagnosis. For example, in participants of the Multicenter AIDS Cohort Study (MACS), cognitive functioning has been evaluated repeatedly for more than 35 years. Therefore, it is optimal to identify cognitive impairment at each assessment, while the family‐wise error rate (FWER) is controlled with unknown number of assessments in future. In this work, we propose to use the difference of consecutive LMNC test statistics to construct independent tests. Frequency modeling can help predict how many assessments each participant will have, so Bonferroni‐type correction can be easily adapted. A chi‐squared test is used under the assumption of multivariate normality, and permutation test is proposed where this assumption is violated. We showed through simulation and the MACS data that our method controlled FWER below a predetermined level.
Clinical utility of a new protocol of cardiac computed tomography in dogs
Authors: Kim Junyoung , Lee Siheon , Hwang Jeongyeon , Yoon Junghee
Published: November 2022

Objectives

The characteristics of non‐electrocardiography‐ and electrocardiography‐gated multidetector computed tomography have not been extensively studied in veterinary clinics but it can be useful for cardiac imaging. This study aimed to ascertain the differences between non‐electrocardiography and electrocardiography gating methods and to establish their clinical utility based on patient history.

Methods

Six client‐owned dogs (two with patent ductus arteriosus, two with heart base tumour, one with pericardial mesothelioma, and one with normal health) were included in this study. All the dogs were examined using a non‐electrocardiography‐gated scan, followed by a retrospective electrocardiography‐gated scan. Images were reviewed to determine the optimal scan timing and R–R interval in non‐electrocardiography‐ and electrocardiography‐gated images, respectively, for detailed coronary artery imaging, diagnostic quality of the best coronary artery visualisation in non‐electrocardiography‐ and electrocardiography‐gated images through visual assessment of the main coronary artery branches, and branching patterns of the left coronary artery. Further, we compared the size and margin demarcation of the heart or pericardial lesions in non‐electrocardiography‐ and electrocardiography‐gated images obtained from patients with heart or pericardial tumours.

Results

The optimal scan timing and R–R interval were the second‐scan timing and end‐diastole (70%–90%), respectively. Second‐scan non‐electrocardiography‐gated images allowed coronary artery evaluation, indicating high‐grade quality in visual assessment, except for the septal branch. Electrocardiography‐gated images, but not non‐ECG‐gated images, clearly revealed pericardial nodules in two dogs.

Clinical Significance

Our findings suggest the respective clinical utilities of non‐electrocardiography‐ or electrocardiography‐gated imaging using high‐slice cardiac computed tomography based on patient history.
Critical and transformative approaches in leadership evaluation and research
Authors: McKee Katherine E.
Published: November 2022

In this article, the author summarizes what critical and transformational theory is, along with its goals, and describes why such an approach is particularly relevant within the field of student leadership development. Application of a critical and transformational approach to conducting research and program evaluation efforts in leadership and community development using practical examples within postsecondary education is also shared.
Assessing leadership development in groups and organizations
Authors: Martin Jillian A. , Weng John , Kliewer Brandon W.
Published: November 2022

This article discusses considerations and methodologies for leadership educators to assess leadership development in groups and organizations using groups as the unit of analysis rather than aggregating individual scores.
Qualitative inquiry in leadership development: An overview for practitioner‐scholars
Authors: Kniffin Lori E. , Priest Kerry
Published: November 2022

This article serves as an overview of qualitative inquiry for leadership development practitioner‐scholars both new and experienced. It begins with a discussion of the need for the qualitative inquiry to create knowledge about leadership development. Then, it overviews design components and includes examples of both research and assessment. We conclude by discussing quality standards for qualitative inquiry and providing suggestions for future directions.
Don't be afraid to eat the whole whale! Using mixed methods to enhance what we learn in leadership research and assessment
Authors: Hastings Lindsay J.
Published: November 2022

The purpose of this article is to identify proper uses for mixed methods in leadership research and assessment. This article will highlight research and assessment questions that are best served by mixed methods and will offer practitioner‐friendly guides and examples for integrating quantitative and qualitative data to help eat the whole whale “one bite at a time.” Sound decision‐making in the design, execution, and presentation of mixed methods studies and outcomes assessments not only produces better outputs, but greatly increases the likelihood of (a) publication in reputable journals, (b) sound program evaluation decisions, and (c) public consumption of study or assessment results.
Phase information in cosmological collider signals
Authors: Qin Zhehan , Xianyu Zhong-Zhi
Published: November 2022

Abstract

Massive particles produced during the cosmic inflation can imprint in the primordial non-Gaussianities as characteristic oscillating functions of various momentum ratios, known as cosmological collider signals. We initiate a study of the phase of the oscillating signals which can be unambiguously defined and measured. The phase can provide useful new information about the spin and the couplings of the intermediate heavy particles that cannot be obtained from the signal frequency and angular dependences alone. We also present new analytical results for full nonlocal signals from two typical 1-loop processes, enabling precise determination of the signal phase away from the squeezed limit.
Small Extracellular Vesicles Loaded with Immunosuppressive miRNAs Leads to an Inhibition of Dendritic Cell Maturation
Authors: Czernek Liliana , Pęczek Łukasz , Düchler Markus
Published: November 2022

In particular conditions, inhibition of an immune response is required to prevent tissue damage. Among these conditions are diseases caused by an over-reactive immune response, such as autoimmune or allergic disorders, or imminent organ rejection after transplantation. To avoid tissue damage, drug-mediated systemic immune suppression is an option, but it comes with high costs in the form of susceptibility to viral and bacterial infections. Thus, the induction of antigen-specific tolerance is preferable. Extracellular vesicles (EVs) are capable of delivering antigen together with immunosuppressive signals and may be used to specifically induce antigen-specific tolerance. However, naturally occurring EVs are heterogeneous and not all of them show immunosuppressive character. In our trials to engineer cell culture derived EVs to increase their tolerogenic potential, we equipped them with immunosuppressive miRNA mimics. Small EVs (sEVs) were isolated and purified from the human monocytic THP-1 cell line or from healthy donor peripheral blood mononuclear cells, and electroporated with miR-494 and miR-146a mimics. The acquired immunosuppressive potential of the modified sEVs was demonstrated by their ability to alter the major histocompatibility complex molecules and co-stimulatory receptors present on dendritic cells (DCs). To avoid allogeneic responses, the same cells that produced the sEVs served also as recipient cells. In contrast to the treatment with unmodified sEVs, the tolerogenic sEVs impeded lipopolysaccharide-induced maturation and kept DCs in a more immature developmental stage. Our experiments show that simple manipulations of sEVs using immunosuppressive cargo can lead to the inhibition of DC maturation.
Adolescent Girls and Young Women’s Experiences of Living with HIV in the Context of Patriarchal Culture in Sub-Saharan Africa: A Scoping Review
Authors: Mhungu Alington , Sixsmith Judith , Burnett Emma
Published: November 2022

Adolescent girls and young women (AGYW) in sub-Saharan Africa are disproportionately affected by the human immunodeficiency virus (HIV) due to socio-cultural gender, power, and economic disparities. This scoping review examined the literature to explore what is known about AGYW’s everyday personal, relational, and social experiences of HIV to help shape future protective HIV policy and practice. Six databases were searched: Medline, CINAHL, Scopus, ASSIA, Google Scholar, and ProQuest, resulting in a total of 12,581 articles. Of these, 40 articles were included in the review. Key themes generated from the thematic analysis were relational and psychosocial challenges, inhibiting sexual expression, poverty, stigma, and discrimination; managing health in everyday life; agency and resilience; and personal space and social support. In conclusion, the review found a lack of understanding of AGYW’s everyday experiences of living with HIV from their own perspectives. There was also little consideration of the role of patriarchal culture and how this constrains AGYW’s ability to negotiate their relationships. Further research is needed to reveal AGYW’s perspectives on living with HIV in sub-Saharan Africa.
Interactions of Antiretroviral Drugs with Food, Beverages, Dietary Supplements, and Alcohol: A Systematic Review and Meta-analyses
Authors: Wiesner Agnieszka , Skrońska Magdalena , Gawlik Gabriela , Marcinkowska Monika , Zagrodzki Paweł , Paśko Paweł
Published: November 2022

Multiple factors may affect combined antiretroviral therapy (cART). We investigated the impact of food, beverages, dietary supplements, and alcohol on the pharmacokinetic and pharmacodynamic parameters of 33 antiretroviral drugs. Systematic review in adherence to PRISMA guidelines was performed, with 109 reports of 120 studies included. For each drug, meta-analyses or qualitative analyses were conducted. We have found clinically significant interactions with food for more than half of antiretroviral agents. The following drugs should be taken with or immediately after the meal: tenofovir disoproxil, etravirine, rilpivirine, dolutegravir, elvitegravir, atazanavir, darunavir, lopinavir, nelfinavir, ritonavir, saquinavir. Didanosine, zalcitabine, zidovudine, efavirenz, amprenavir, fosamprenavir, and indinavir should be taken on an empty stomach for maximum patient benefit. Antiretroviral agents not mentioned above can be administered regardless of food. There is insufficient evidence available to make recommendations about consuming juice or alcohol with antiretroviral drugs. Resolving drug-food interactions may contribute to maximized cART effectiveness and safety.
A Balancing Act: A Systematic Review and Metasynthesis of Family-Focused Practice in Adult Mental Health Services
Authors: Tuck M. , Wittkowski A. , Gregg L.
Published: November 2022

Parental mental illness is a major international public health concern given its implications for whole families, including children. Family-focused practice (FFP), an approach that emphasises a “whole-family” approach to care, provides an opportunity to mitigate the significant risks associated with parental mental health difficulties. The positive benefits associated with FFP have led to a shift in policy and practice towards prioritising FFP within adult mental health services. However, evidence suggests that FFP remains scarce and is not routine. Research has identified the important role of practitioners in facilitating FFP. The current review identified, synthesised and appraised the international qualitative literature examining adult mental health practitioners’ implementation experiences of FFP. It aimed to provide an evidence-informed account of practitioner experiences of FFP delivery and to identify key recommendations to enhance future FFP outcomes in AMHS. Ovid Medline, PsycInfo, CINAHL plus, EMBASE and Web of Science Core Collection were searched systematically, in line with PRISMA guidance, up to January 2022. The Critical Appraisal Skills Programme (CASP) was used to undertake the quality appraisal prior to a thematic synthesis being conducted. The review was registered on PROSPERO. Nineteen papers, spanning 17 years of research with 469 practitioners, were included. Three main themes and 14 subthemes were developed, representing different aspects of practitioner experiences of FFP delivery. Practitioners’ approach to FFP was variable and influenced by their beliefs about FFP, perceived roles and responsibilities, competence, service setting, and personal parenting status. Practitioners engaged in a balancing act to maintain a dual focus on their service-users and their children, to navigate powerful emotions, and consider multiple perspectives in a biomedical organisational structure that advocates individualised treatment. Although working together unified teams, a greater need for external interagency collaboration was identified. The use of strength-based approaches with clients and dedicated staff resources, within clear guidelines and frameworks, was reported to be necessary to maximise FFP delivery. This review proposes a complex FFP dynamic whereby practitioners engage in a constant balancing act between FFP stakeholders to achieve meaningful FFP outcomes for service-users and their families. Service recommendations are provided.
A Synthesis of the Dibble et al. Controlled Experiments into the Mechanics of Lithic Production
Authors: Li Li , Lin Sam C. , McPherron Shannon P. , Abdolahzadeh Aylar , Chan Annie , Dogandžić Tamara , Iovita Radu , Leader George M. , Magnani Matthew , Rezek Zeljko , Dibble Harold L.
Published: November 2022

Archaeologists have explored a wide range of topics regarding archaeological stone tools and their connection to past human lifeways through experimentation. Controlled experimentation systematically quantifies the empirical relationships among different flaking variables under a controlled and reproducible setting. This approach offers a platform to generate and test hypotheses about the technological decisions of past knappers from the perspective of basic flaking mechanics. Over the past decade, Harold Dibble and colleagues conducted a set of controlled flaking experiments to better understand flake variability using mechanical flaking apparatuses and standardized cores. Results of their studies underscore the dominant impact of exterior platform angle and platform depth on flake size and shape and have led to the synthesis of a flake formation model, namely the EPA-PD model. However, the results also illustrate the complexity of the flake formation process through the influence of other parameters such as core surface morphology and force application. Here we review the work of Dibble and colleagues on controlled flaking experiments by summarizing their findings to date. Our goal is to synthesize what was learned about flake variability from these controlled experiments to better understand the flake formation process. With this paper, we are including all of the data produced by these prior experiments and an explanation of the data in the Supplementary Information.