bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic accuracy of serum ascites albumin gradient (SAAG) in a contemporary unselected medical cohort
Authors: Subhani Mohsan , Sheth Abhishek , Palaniyappan Naaventhan , Sugathan Peuish , Wilkes Emilie A , Aithal Guruprasad P
Published: November 2022

Objectives

To describe the different aetiologies of ascites and test the validity of serum ascites albumin gradient (SAAG) and cytology in a contemporary unselected medical cohort.

Methods

All adult patients admitted to Nottingham University Hospitals, UK, between 1 May 2013 and 30 April 2018 with new-onset radiologically-confirmed ascites were included. Data were analysed to determine the distribution of different aetiologies of ascites and the diagnostic accuracy of SAAG in portal hypertension and cytology in malignancy as underlying causes of ascites.

Results

Over 5 years, 286 patients presented with new-onset ascites; 122 surgical cases were excluded. Most patients were men (n = 84, 51.2%) over 50 years of age (n = 142, 86.6%). Cirrhosis accounted for 54.9% (n = 90) of the cases of ascites followed by malignancy (n = 48, 29.3%) and cardiac failure (n = 10, 6.1%). SAAG ≥11 g/L had a sensitivity of 85.5% and specificity of 60.6% for diagnosing portal hypertension as a cause of ascites (diagnostic accuracy = 78.5%, 95% confidence interval (CI): 69.8–85.5; area under the curve (AUC) = 0.756, 95% CI: 0.652–0.860). Ascitic fluid cytology was positive in 50% of malignant cases and 66% of primary peritoneal carcinomatosis cases.

Conclusion

The underlying aetiology and the validity of available tests varied substantially compared with previous reports.
Motivational Conflict and Volitional Career Actions in Young Adults: Ego Depletion as an Explanatory Mechanism
Authors: Widyowati Arini , Creed Peter , Hood Michelle , Duffy Amanda
Published: November 2022

We assessed the underlying mechanisms through which career motivational conflict was related

to career volitional action in young adults. We tested a model in which career motivational conflict (parent-child career incongruence and career goal progress discrepancy) was related to reduced career volitional actions (career decision self-efficacy and career engagement) via self-regulatory failure (ego depletion in reference to talking to parents about their careers or thinking about their careers). Participants were 260 young adults (75.8% female; M age = 19.89 years) enrolled at a large, multi-campus university in South-East Queensland, Australia. We confirmed greater career-related motivational conflict, in both forms, was associated with lower volitional actions. Furthermore, self-referenced depletion explained the relationships between career goal progress discrepancy and poorer career decision self-efficacy and less career engagement. These findings have implications for how counsellors might assist young people to improve their career volitional actions by reducing the effects of career motivational conflict.
Healthcare Equity and Leadership: Implementation of Diversity, Equity, and Inclusion Training for Pharmacy Residents
Authors: Tillman Frank , Liu Ina , Lovince Judith , Mays Erin , Musick Kaitlin , Sato Jennifer , Rao Kamakshi V.
Published: November 2022

Background

Pharmacy training programs infrequently include formal training in the areas of diversity, equity, and inclusion (DEI). Hence, the purpose of this report is to offer perspectives gained from the delivery of a DEI curriculum within a pharmacy residency program aimed at expanding experiential learning focused on DEI and health equity. Program Implementation: Pharmacy residents at an academic medical center were invited to participate in a longitudinal DEI/equity seminar series that was thoughtfully and strategically developed by a team of residents and program leadership based on a six-step process. Residents were offered 9 individual seminars covering 4 major focus areas to facilitate enhanced awareness, learning, and vulnerability. Participants were invited to provide evaluations of each seminar and the overall series. Program Assessment: A total of 41 residents (100%) participated in at least one of the 9 seminars that were offered and approximately 50% completed the post-series survey. Resident-perceived benefit of each individual session was consistently favorable. Additionally, greater than 70% of participants responded favorably when asked about the impact of each session on their awareness, resources provided, and ability to apply the learnings to their practice. Conclusion: Our inaugural experience with the integration of a DEI seminar series into a pharmacy residency program suggests that there is a clear benefit to including DEI/health equity into pharmacy residency training. This data may suggest that adoption of DEI-focused experiential training may increase cultural awareness and the availability of resources to better equip pharmacy residents in applying concepts of DEI into their practice.
Process and parameters for laser assisted localised heat treatment in manufacturing applications
Authors: Pereira Rui Pedro , Peixinho Nuno , Carneiro Vítor , Cortez Sara , Costa Sérgio Luís , Blanco Vítor
Published: November 2022

This paper presents information and results relevant for the development of a laser heat treatment process suitable to improve manufacturing in high strength steel and high strength aluminium alloys. The challenges with manufacturing of such materials include springback effect and localised fracture. The study details heat cycle and their effect in metallurgical state and mechanical properties. Such laser induced heat treatment process is intended to improve the forming behaviour of metal parts in challenging metal forming conditions, in particular for the delay or avoidance of localised fracture. Results for strength, hardness and elongation properties are presented. It was concluded that it is possible to locally modify yield strength and hardness using process duration suitable for industrial applications. Suitable process temperature ranges and target heat cycles were identified. A positive effect of material softening was observed in both hardness and strength properties. However, in some cases a reduction of ductility is apparent which must be considered for targeted industrial applications. The dimension of the heat-affected zone was also considered as design variable for the industrial process development. Preliminary results were obtained in a development forming tool.
Hybrid optimisation of input process parameters of deep-drawn cylindrical cups from directional rolled copper strips
Authors: Sivam SP Sundar Singh , Rajendran R
Published: November 2022

Deep drawing is a method of producing sheet metal. It is extensively used in the automobile, packaging and home appliance industries. Incorrect parameter selection might induce defects in stamped components. Trial and error can improve product accuracy, but at the expense of execution and calculation. An optimisation approach and a response surface model are used to determine the optimal parametric parameter design. This study proposes a full and efficient optimisation approach, starting with modelling by RSM (Response Surface Methodology) and concluding with optimal process parameter identification. Based on this, a neural network was developed to improve cylindrical cup deep drawing. Three characteristics of fabricating the cups are clearance, punch radius and coefficient of friction. This parameter demonstrates the resultant tool force, spring back, maximum forming limiting curve and maximum thinning rate of cylinder cups. Initially, the three inputs are varied to measure the outcome using simulation software by Altair inspire form. Then, the equations for each output are designed using quadratic-based linear model fitting. The generated objective function is then used to establish the ideal process parameters for the cylindrical cups. The proposed method is compared to real-time physical experiments. The optimised parameter microstructure at the high-stress zone and the product quality are satisfactory without defects.
Multisectoral Nutrition Interventions and Their Impact on BMI and Thinness Levels Among Adolescent Girls: An Open Experiment in Two Remote Blocks of Karnataka, India
Authors: Rao Veena S. , Rajneesh Shalini , Degaonkar Chaya , Reddy Hanimi , Bharadwaj SVSRK
Published: November 2022

The Karnataka Multisectoral Nutrition Pilot Project (2015–2018) was implemented in Devadurga Block, Raichur District and Chincholi Block, Gulbarga District—two most backward Blocks in Karnataka. Special interventions for behaviour change and appropriate dietary supplementation for adolescent girls (11–18 years) were implemented through an inter-sectoral, intergenerational strategy. This article analyses real time data regarding thinness/severe thinness among 8,847 adolescent girls in the cross-sectional group and 1,545 adolescent girls in the cohort group. Both BMI-cut-offs method and BMI-for-age Z-score methods provide strong evidence of significant increase in percentage of ‘normal’ adolescent girls from baseline to endline; significant decrease in severe thinness; non-significant decrease/increase in moderate thinness. Data also indicates that while 68.2% of baseline moderately thin girls transitioned to normal category, 71.8% new moderately thin girls (44.3% from improved severely thin girls and 27.5% from normal girls), transitioned into the moderately thin category. Data provides strong evidence that thinness/severe thinness among adolescent girls reduced significantly through project interventions, which are simple to replicate. Tallest girls at baseline, and those gaining fastest height, transitioned to becoming/remaining moderately/severely thin, an area for further research. Further research is required regarding the ideal duration of interventions to improve moderate underweight/thinness to normal status.
Effects of systemic antibiotics in early onset ventilator-associated pneumonia in trauma patients: A single-centre retrospective cohort study
Authors: Wong Ching Yee , Ng Yau Tak , Ching Ka Chun , Ha Pui Kwan , Leung Chun Yu , Au Wing Kiu , Lui Chun Tat , Tsui Kwok Leung
Published: November 2022

Background:

Ventilator-associated pneumonia is one of the commonest complications encountered in intubated patients: its incidence ranges from 20% to 60%, with higher incidences seen in patients with polytrauma. Ventilator-associated pneumonia can result in poor neurological outcomes upon discharge, longer duration of mechanical ventilation and prolonged intensive care unit stays. The use of systemic antibiotics has been proposed as one method to reduce this complication. However, its effectiveness remains to be determined, and concerns about bacterial resistance hinder its use. This study aims to evaluate the effects of systemic antibiotics on early ventilator-associated pneumonia prevention.

Methods:

This is a single-centred retrospective cohort study, using data in the local trauma registry from 2015 to 2020. Patients aged ⩾18 years who suffered from injury to the head or trunk and were intubated within 12 h of hospitalization were evaluated for early ventilator-associated pneumonia to determine the effectiveness of systemic antibiotics on the incidence of ventilator-associated pneumonia and to identify other risk factors for ventilator-associated pneumonia in patients suffering from trauma.

Result:

A total of 250 patients were recruited; 59 of them met the criteria for early onset ventilator-associated pneumonia. Early use of broad-spectrum antibiotics with potent anaerobic coverage was found to be protective for early onset ventilator-associated pneumonia (adjusted odds ratio = 0.228, p = 0.044). Increasing age and severe thoracic or abdominal injury were also found to be strong non-modifiable predictors for the development of early onset ventilator-associated pneumonia.

Conclusion:

Use of systemic antibiotics with potent anaerobic coverage within 3 h of injury was found to prevent early onset ventilator-associated pneumonia in those intubated within 12 h of injury. However, a large-scale randomized control trial may be needed to further evaluate its benefit and its potential side effects, most notably the risk of antibiotic resistance.
He Knows, She Doesn’t? Epistemic Inequality in a Developmental Perspective
Authors: Silva Filho Waldomiro J. , Dazzani Maria Virginia M. , Tateo Luca , Gottschalk Sukerman Barreto Rodrigo , Marsico Giuseppina
Published: November 2022

This paper aims at establishing a dialogue between philosophy and psychology about the conditions and the process through which humans build epistemic relationships during ontogenetic development. By the latter term, we mean any form of interaction which is aimed at producing a belief about some relevant aspects of the world, present or absent, past or future and at assessing its degree of epistemic trustworthiness. The paper is built as a dialogue between a philosopher and a psychologist, who present different faces of the problem of epistemic legitimation respectively and discuss the possible ways in which the dialogue can lead to theoretical advancement in understanding the development of the human epistemic subject. The chapter is divided into four sections: in the first section, we outline how we develop ontogenetically as epistemic subjects, and the sense that our epistemic life depends on other people’s words or testimony; in the second section, we deal with the notion of epistemic injustice and epistemic silencing; in the third section, we discuss strategies to counter epistemic silencing and; in the fourth part, we try to elaborate a synthesis and suggest a new beginning.
Microbial Contamination of Herbal Preparations on the Ghanaian Market, Accra
Authors: Darkwah Samuel , Agbettor Doris , Codjoe Francis , Donkor Eric S
Published: November 2022

In developing countries, an estimated 80% of the population use traditional herbal medicines as part of their primary health care. As the market for herbal medicine expands in many African countries, partly due to their use in the treatment of COVID-19, there is the need to address all the associated safety issues. The aim of the study was to evaluate the microbial contamination of locally prepared, as well as imported foreign herbal products sold in Accra. Standard microbiological methods were employed in the enumeration of coliforms and the identification of pathogenic microbes in 60 herbal preparations that were sampled. A larger proportion (76.7%) of local herbal preparations was contaminated with bacteria as compared with imported ones (63.3%). Bacillus species and Pseudomonas aeruginosa were the predominant bacteria obtained from foreign and locally manufactured herbal preparations, respectively. A proportion of 36.7% (11) of the local samples were positive for coliform and the coliform counts ranged from 3.0 × 101 cfu/ml to 2.0 × 104 cfu/ml. Two foreign herbal samples (6.7%) were positive for coliforms; one had a count of 1.7 × 105 cfu/g while the other had 2 × 104 cfu/g. Herbal preparations sold in markets of Accra harbour several microbial pathogens; the risk is relatively higher for locally produced herbal preparations compared to imported herbal preparations. As a result, it is recommended that quality assurance in the production of local herbal preparations should be thoroughly monitored from the beginning of production to the final selling of the preparations. There is also the need to strengthen microbiological safety monitoring of imported herbal preparations.
Identification and Characterization of a Novel Dual Inhibitor of Indoleamine 2,3-dioxygenase 1 and Tryptophan 2,3-dioxygenase
Authors: Yoshioka Saeko , Ikeda Tomonori , Fukuchi Sogo , Kawai Yurika , Ohta Katsumi , Murakami Hisashi , Ogo Naohisa , Muraoka Daisuke , Takikawa Osamu , Asai Akira
Published: November 2022

Kynurenine (Kyn), a metabolite of tryptophan (Trp), is a key regulator of mammal immune responses such as cancer immune tolerance. Indoleamine-2,3-dioxygenase (IDO) and tryptophan-2,3-dioxygenase (TDO) are main enzymes regulating the first and rate-limiting step of the Kyn pathway. To identify new small molecule inhibitors of TDO, we selected A172 glioblastoma cell line constitutively expressed TDO. Characterization of this cell line using kinase inhibitor library resulted in identification of MEK/ERK pathway-dependent TDO expression. After knowing the properties for TDO expression, we further proceeded to screen chemical library for TDO inhibitors. We previously determined that S-benzylisothiourea derivatives are enzymatic inhibitors of indoleamine 2,3-dioxygenase 1 (IDO1) and suggested that the isothiourea moiety could be an important pharmacophore for binding to heme. Based on this premise, we screened an in-house library composed of various isothiourea derivatives and identified a bisisothiourea derivative, PVZB3001, as an inhibitor of TDO. Interestingly, PVZB3001 also inhibited the enzymatic activity of IDO1 in both cell-based and cell-free assays but did not inhibit other heme enzymes. Molecular docking studies suggested the importance of isothiourea moieties at the ortho position of the phenyl ring for the inhibition of catalytic activity. PVZB3001 showed competitive inhibition against TDO, and this was supported by the docking simulation. PVZB3001 recovered natural killer (NK) cell viability and functions by inhibiting Kyn accumulation in conditioned medium of both IDO1- and TDO-expressing cells. Furthermore, oral administration of IDO1-overexpressing tumor-bearing mice with PVZB3001 significantly inhibited tumor growth. Thus, we identified a novel selective dual inhibitor of IDO1 and TDO using the Kyn production assay with a glioblastoma cell line. This inhibitor could be a useful pharmacological tool for modulating the Kyn pathway in a variety of experimental systems.
External validation of a clinical prediction model in multiple sclerosis
Authors: Moradi Nahid , Sharmin Sifat , Malpas Charles B , Shaygannejad Vahid , Terzi Murat , Boz Cavit , Yamout Bassem , Khoury Samia J , Turkoglu Recai , Karabudak Rana , Shalaby Nevin , Soysal Aysun , Altıntaş Ayşe , Inshasi Jihad , Al-Harbi Talal , Alroughani Raed , Kalincik Tomas
Published: November 2022

Background:

Timely initiation of disease modifying therapy is crucial for managing multiple sclerosis (MS).

Objective:

We aimed to validate a previously published predictive model of individual treatment response using a non-overlapping cohort from the Middle East.

Methods:

We interrogated the MSBase registry for patients who were not included in the initial model development. These patients had relapsing MS or clinically isolated syndrome, a recorded date of disease onset, disability and dates of disease modifying therapy, with sufficient follow-up pre- and post-baseline. Baseline was the visit at which a new disease modifying therapy was initiated, and which served as the start of the predicted period. The original models were used to translate clinical information into three principal components and to predict probability of relapses, disability worsening or improvement, conversion to secondary progressive MS and treatment discontinuation as well as changes in the area under disability-time curve (ΔAUC). Prediction accuracy was assessed using the criteria published previously.

Results:

The models performed well for predicting the risk of disability worsening and improvement (accuracy: 81%–96%) and performed moderately well for predicting the risk of relapses (accuracy: 73%–91%). The predictions for ΔAUC and risk of treatment discontinuation were suboptimal (accuracy < 44%). Accuracy for predicting the risk of conversion to secondary progressive MS ranged from 50% to 98%.

Conclusion:

The previously published models are generalisable to patients with a broad range of baseline characteristics in different geographic regions.
Theory-Responsive Data Analysis: Searching for the Closest Fit
Authors: Jaeger Elizabeth L.
Published: November 2022

Qualitative researchers differ in their beliefs about the role of theory in data analysis. Some begin with theoretical constructs employed as codes in a deductive process while others hold theory at bay until late in an inductive process ( Gibbs, 2007 ). Still others toggle back and forth from theory to data to theory and so on. Researchers have offered comprehensive accounts of inductive coding (e.g., grounded theory; Charmaz, 2006 ) or general descriptions of the application of theory within data analysis ( Anfara & Mertz, 2006 ; Dressman, 2008 ). Absent from the literature, however, is a detailed description of a back-and-forth analysis practice. The current article fills this gap in the literature by presenting a specific procedure in which the researcher begins with an initial theoretical position and then examines the data to establish a key question raised by that data. The process continues as the researcher considers a variety of theories which address the question, selects the “best fit” theory, carefully applies that theory to the data and supporting literature, and finally reflects on ways in which study findings may enhance the theory. I exemplify this activity with data from a study of members of a writing group for adults with major mental illness.
Thruster fault identification using improved peak region energy and multiple model least square support vector data description for autonomous underwater vehicle
Authors: Yin Baoji , Zhang Mingjun , Zhou Jiahui , Tang Wenxian , Jin Zhikun
Published: November 2022

This article investigates a novel fault identification approach to determine the percentage of the thrust loss for autonomous underwater vehicle thrusters. The novel approach is developed from a combination of the peak region energy (PRE) and support vector data description (SVDD) by considering that PRE is able to acquire a primary feature in low dimensions from signals without any secondary process and that SVDD can establish a hypersphere boundary for a class of fault samples even in the case of a small number of training samples. Three improvements, namely removing the fusion, an energy leakage and a homomorphic transform are applied to the PRE. It forms an improved PRE to increase the area under the curve. Furthermore, another three new contents, namely the least square, a multiple model fusion and a dead zone are added to the SVDD. It constructs a multiple model least square SVDD to increase the overall identification accuracy. Experiments are performed on an experimental prototype autonomous underwater vehicle in a pool. The experimental results indicate the effectiveness of the proposed method.
Factors affecting hand cosmesis and the aesthetic impact of surgery on congenital hand differences in Finland
Authors: Nietosvaara Noora N. , Sommarhem Antti J. , Stenroos Antti , Nietosvaara Aarno Y. , Grahn Petra
Published: November 2022

We assessed the appearance and cosmetic impact of surgery in congenitally different hands in Finland. A questionnaire was sent to 1165 respondents (786 female) with a mean age of 33 years (range 3–84). Participants were shown nine image pairs and seven pairs of pre- and postoperative images twice in a random order and asked to choose the more cosmetically pleasing one. We found that the appearance and number of fingers had an important aesthetic role, with higher number and more normal appearing digits consistently scoring higher than its counterpart (range 59–99%). Postoperative appearances were perceived as better than preoperative ones in syndactyly (98%), thumb duplication (92%), cleft hand (93%) and radial dysplasia (99%). Toe transfer and pollicization had little impact on cosmesis. This study demonstrated that surgery could improve cosmesis in congenitally different hands and overall, most respondents prefer an appearance that is as close as possible to normality. Level of evidence: IV
Disrespect and abuse during focused antenatal care and associated factors among pregnant women who visited public health facilities in Awsi Rasu of Afar Region Northeast Ethiopia
Authors: Ibrahim Ibrahim Mohammed , Mohammed Osman Ahmed , Mare Kusse Urmale , Mohammed Mohammed Wagris , Aychiluhm Setognal Birara
Published: November 2022

Objectives:

Maternal disrespect and abuse are the top significant barriers to the use of maternal health services. However, poor attention has been given to the hospitality and suitability of care provided to women in the facilities where they have been moved to utilize health services. This study is aimed to assess the prevalence of maternal disrespect and abuse during focused antenatal care and its associated factors among pregnant women who visit public health facilities in Awsi Rasu of Afar Region Northeast Ethiopia.

Methods:

Institution-based cross-sectional study design was employed from March 1 to 30, 2022 in selected health facilities of the Awsi Rasu of Afar Region, Northeast Ethiopia. A total of 1278 mothers were included using consecutive sampling techniques. The data were entered into Epi-data version 3.1 and exported to SPSS version 23.0 for statistical analysis. Statistical significance is declared using adjusted odds ratio (AOR) with a corresponding 95% confidence interval (CI).

Results:

The overall prevalence of disrespect and the abusive experience was 56.7% (95% CI: 54–59.3%). A low average monthly income of less than or equal to 3000 Ethiopian birrs (AOR = 0.72; 95% CI: 0.55–0.94), Age (20–25) years (AOR = 2.33; 95% CI 1.72–3.2), having no formal education (AOR = 2.01; 95% CI: 1.35–3.15), and having unplanned pregnancy (AOR = 1.6; 95% CI: 1.21–2.01) were significantly associated with disrespect and abuse during focused antenatal care.

Conclusion:

The prevalence of disrespect and abusive experience during antenatal care in the study area was high relative to other studies. In the multivariable logistic regression model age of the mother (20–25 years), no formal education, low family income, and unplanned pregnancy are the predictors of disrespect and abusive care. Providing respectful health care during antenatal care with a suitable approach for all mothers irrespective of their age, unplanned pregnancies, and educational status is the most substantial to encourage maternal service use.
User Attitude Towards E-learning Platforms: An Insight Through the Expectation Confirmation Model and the Affordance Theory Lens
Authors: Dhiman Neeraj , Gupta Anil , Arora Neelika , George Babu
Published: November 2022

The present study aimed to determine the manifesting variables of continually using e-learning platforms. The present study synthesizes the expectation–confirmation model (ECM) and affordance theory to explain better the continuance use of e-learning and the benefits users perceive after initial use. We have adjoined these two theoretical models for the following reasons, and to the best of our knowledge, no studies have combined ECM with affordance theory. The study followed a survey method, and a total of 466 respondents were contacted. The model was tested using the structural equation modelling technique through the Partial Least square method. The research study highlights a model with three layers of relationships with affordances triggering the expectations about the utility and usability of e-learning technologies. Furthermore, the findings of this study has indicated that all the proposed hypotheses are supported. Specifically, this study has reported that perceived usefulness is found to be a key variable that plays an essential role in determining the success of online learning platforms. Subsequently, the study offers a theoretical narrative for user satisfaction and loyalty toward e-learning platforms in light of the ECM and the Affordance Theory. The findings of this study offer critical insights for content creators and app designers on user experience design for e-learning apps that would eventually help to devise better teaching-learning strategies in technology-mediated learning environments.
Public health approaches to youth involvement in violence: Examining stakeholders’ perspectives in Australia and the United Kingdom
Authors: Klose Hannah , Gordon Faith
Published: November 2022

Australia and the United Kingdom (UK) have each witnessed a ‘punitive turn’ in relation to youth justice responses. A lack of contextualisation, such as the impact of trauma and adverse childhood experiences on young people, is often overlooked by media outlets, governments and policymakers, in favour of individual pathologisation of young people. In direct contrast to these punitive responses, the public health approach (PHA) has emerged particularly in the UK; and it identifies experiences of trauma as one of the leading causes of violence within communities. Drawing on the perspectives of those working with children and young people, we critically explore whether the implementation of a PHA could be an effective approach to addressing the underlying causes of young people's involvement in violence. The paper focuses specifically on a case study of the youth justice system in Victoria, Australia and draws on domestic and global perspectives of key stakeholders, to consider whether the introduction of a PHA in Victoria, Australia, would position young people's diverse needs at the centre of policy change in youth justice and better outcomes for young people and communities.
Pulmonary aspergillosis: diagnosis and treatment
Authors: Lamoth Frederic , Calandra Thierry
Published: November 2022

Aspergillusspecies are the most frequent cause of fungal infections of the lungs with a broad spectrum of clinical presentations including invasive pulmonary aspergillosis (IPA) and chronic pulmonary aspergillosis (CPA). IPA affects immunocompromised populations, which are increasing in number and diversity with the advent of novel anti-cancer therapies. Moreover, IPA has emerged as a complication of severe influenza and coronavirus disease 2019 in apparently immunocompetent hosts. CPA mainly affects patients with pre-existing lung lesions and is recognised increasingly frequently among patients with long-term survival following cure of tuberculosis or lung cancer. The diagnosis of pulmonary aspergillosis is complex as it relies on the presence of clinical, radiological and microbiological criteria, which differ according to the type of pulmonary aspergillosis (IPA or CPA) and the type of patient population. The management of pulmonary aspergillosis is complicated by the limited number of treatment options, drug interactions, adverse events and the emergence of antifungal resistance.
Molecular logic of salt taste reception in special reference to transmembrane channel-like 4 (TMC4)
Authors: Kasahara Yoichi , Narukawa Masataka , Takeuchi Ayako , Tominaga Makoto , Abe Keiko , Asakura Tomiko
Published: November 2022

The taste is biologically of intrinsic importance. It almost momentarily perceives environmental stimuli for better survival. In the early 2000s, research into taste reception was greatly developed with discovery of the receptors. However, the mechanism of salt taste reception is not fully elucidated yet and many questions still remain. At present, next-generation sequencing and genome-editing technologies are available which would become pivotal tools to elucidate the remaining issues. Here we review current mechanisms of salt taste reception in particular and characterize the properties of transmembrane channel-like 4 as a novel salt taste-related molecule that we found using these sophisticated tools.
Tumor mutation burden-related long non-coding RNAs is predictor for prognosis and immune response in pancreatic cancer
Authors: Wang Chunjing , Wang Zhen , Zhao Yue , Jia Ruichun
Published: November 2022

Background

Pancreatic cancer is one of the most common malignant tumors with extremely poor prognosis. It is urgent to identify promising prognostic biomarkers for pancreatic cancer.

Methods

A total of 266 patients with pancreatic adenocarcinoma (PAAD) in the Cancer Genome Atlas (TCGA)-PAAD cohort and the PACA-AU cohort were enrolled in this study. Firstly, prognostic tumor mutation burden (TMB)-related long non-coding RNAs (lncRNAs) were identified by DESeq2 and univariate analysis in the TCGA-PAAD cohort. And then, the TCGA-PAAD cohort was randomized into the training set and the testing set. Least absolute shrinkage and selection operator (LASSO) was used to construct the model in the training set. The testing set, the TCGA-PAAD cohort and the PACA-AU cohort was used as validation. The model was evaluated by multiple methods. Finally, functional analysis and immune status analysis were applied to explore the potential mechanism of our model.

Results

A prognostic model based on fourteen TMB-related lncRNAs was established in PAAD. Patients with High risk score was associated with worse prognosis compared to those with low risk score in all four datasets. Besides, the model had great performance in the prediction of 5-year overall survival in four datasets. Multivariate analysis also indicated that the risk score based on our model was independent prognostic factor in PAAD. Additionally, our model had the best predictive efficiency in PAAD compared to typical features and other three published models. And then, our findings also showed that high risk score was also associated with high TMB, microsatellite instability (MSI) and homologous recombination deficiency (HRD) score. Finally, we indicated that high risk score was related to low immune score and less infiltration of immune cells in PAAD.

Conclusion

we established a 14 TMB-related lncRNAs prognostic model in PAAD and the model had excellent performance in the prediction of prognosis in PAAD. Our findings provided new strategy for risk stratification and new clues for precision treatment in PAAD.
Radiomics-based prediction of response to immune checkpoint inhibitor treatment for solid cancers using computed tomography: a real-world study of two centers
Authors: Yu Yang , Bai Yuping , Zheng Peng , Wang Na , Deng Xiaobo , Ma Huanhuan , Yu Rong , Ma Chenhui , Liu Peng , Xie Yijing , Wang Chen , Chen Hao
Published: November 2022

Background

Immune checkpoint inhibitors (ICIs) represent an approved treatment for various cancers; however, only a small proportion of the population is responsive to such treatment. We aimed to develop and validate a plain CT-based tool for predicting the response to ICI treatment among cancer patients.

Methods

Data for patients with solid cancers treated with ICIs at two centers from October 2019 to October 2021 were randomly divided into training and validation sets. Radiomic features were extracted from pretreatment CT images of the tumor of interest. After feature selection, a radiomics signature was constructed based on the least absolute shrinkage and selection operator regression model, and the signature and clinical factors were incorporated into a radiomics nomogram. Model performance was evaluated using the training and validation sets. The Kaplan–Meier method was used to visualize associations with survival.

Results

Data for 122 and 30 patients were included in the training and validation sets, respectively. Both the radiomics signature (radscore) and nomogram exhibited good discrimination of response status, with areas under the curve (AUC) of 0.790 and 0.814 for the training set and 0.831 and 0.847 for the validation set, respectively. The calibration evaluation indicated goodness-of-fit for both models, while the decision curves indicated that clinical application was favorable. Both models were associated with the overall survival of patients in the validation set.

Conclusions

We developed a radiomics model for early prediction of the response to ICI treatment. This model may aid in identifying the patients most likely to benefit from immunotherapy.
Acute retinal necrosis in a patient on immunosuppressive treatment for COVID-19 pneumonia: a case report
Authors: Nishiyama Takeyuki , Tsujinaka Hiroki , Mizusawa Yutaro , Ueda Tetsuo , Ogata Nahoko
Published: November 2022

Background

Patients with coronavirus disease 2019 (COVID-19) occasionally develop ocular complications. We report a case of acute retinal necrosis (ARN) caused by Epstein–Barr Virus (EBV) that developed in a patient who had severe acute respiratory syndrome due to SARS-CoV-2 infection.

Case presentation

A 68-year-old woman complained of floaters and blurred vision in her right eye as she was receiving systemic prednisolone for COVID-19 pneumonia under isolation in our hospital. The patient visited an ophthalmologist following her discharge from the hospital and after the 2 weeks of isolation had ended. At the initial examination, her best-corrected visual acuity (BCVA) was 20/100 in the right eye, and the eye showed moderate anterior segment inflammation and vitreous opacities. Treatment was initiated with topical 0.1% betamethasone and 1.5% levofloxacin. After 1 month, the inflammation in the right eye decreased and her BCVA improved to 20/40. However, on day 48 from her initial visit, the inflammation in her right eye worsened and her BCVA decreased to 20/2000 by day 80. Pars plana vitrectomy with silicone oil tamponade was performed to remove the vitreous opacities, and expanded white exudates peripherally and retinal vessels with white sheathing suggestive of acute retinal necrosis (ARN) were seen intraoperatively. Analysis of the vitreous sample revealed EBV positivity on polymerase chain reaction. The patient was diagnosed with EBV-associated ARN and treated with systemic steroids and valaciclovir. The ocular inflammation gradually decreased, and she was discharged from the hospital. However, a week later, the inflammation in the right eye markedly worsened. Despite another course of steroids, the inflammation worsened, resulting in total retinal detachment and absolute glaucoma. Because of the severe pain, the right eye was enucleated.

Conclusions

Clinicians should be aware that COVID-19 and immunosuppressive treatment can reactivate EBV in the eye.
Men’s conceptualization of gender-based violence directed to women in Alexandra Township, Johannesburg, South Africa
Authors: Zinyemba Kudakwashe Gracious , Hlongwana Khumbulani
Published: November 2022

Background

Gender-based violence (GBV) is a crucial global public health challenge disenfranchising women and girls from enjoying their fundamental human rights, thereby threatening their well-being. While the concept of GBV does not imply that violence is always unidirectional, literature shows that women and girls are the most common victims of this type of violence. One in three women, globally, have suffered physical or sexual violence by an intimate partner or non-partner. Evidence has shown that a number of women who experience GBV varies widely, with 37% being in Eastern Mediterranean, 37.7% in South-East Asia, 29.8% in America, 36.6% in Africa, 44% in sub-Saharan Africa (SSA) and 53% in South Africa.

Methods

Using a semi-structured face-to-face interview with fifteen conveniently sampled adult males, who met the selection criteria, this study explored men’s conceptualisation of GBV in Alexandra Township, using qualitative research methods.

Results

Socio-economic factors and evolving cultural dynamics were perceived to be among the key factors aggravating gender-based violence. Participants viewed poverty and substance abuse as the main causes of violence towards women, a phenomenon tied to the growing frustration emanating from men’s inability to provide for their families. Cultural factors related to the patriarchal system and diminishing value of respect between men and women were identified as root causes of GBV. The participants also blamed the government for what they considered to be “too many rights” for women, resulting in men exerting their authority through abuse. Participants also expressed concerns over feminisation of GBV, asserting that men fall prey to GBV too. Partner infidelity and insecurities also contributed to GBV.

Conclusion

The study results provided important insights on how men conceptualize GBV in Alexandra Township, South Africa. These results revealed that socio-economic conditions, alongside some gender stereotypes are pervasive and shape how men view GBV in Alexandra Township. This evidence is necessary for developing interventions aimed at curbing GBV and may also be suggestive of the need to redesign programmes targeting men, so that certain stereotypes can be uprooted.
Social integration and mental health of Somali refugees in the Netherlands: the role of perceived discrimination
Authors: Kuppens Emma , van den Broek Thijs
Published: November 2022

Background

We assess whether social integration is associated with mental health among Somali refugees in the Netherlands, and how this association is shaped by perceived discrimination.

Methods

We performed linear regression and formal mediation analyses on Survey Integration Minorities data (n = 417) to assess whether the effects of two facets of social integration – Dutch language proficiency and informal contacts with natives – on mental health were mediated or suppressed by perceived discrimination.

Results

Dutch language proficiency was positively associated with mental health, but also with perceived discrimination. Informal contact with natives was not significantly associated with mental health or perceived discrimination. There was marginally significant evidence (p < .1) that perceived discrimination suppressed the positive association between Dutch language proficiency and mental health.

Discussion

Greater Dutch language proficiency appears to be beneficial for Somali refugees’ mental health, but this effect may partly be cancelled by the associated stronger experiences of discrimination.
Intention of healthcare providers to use video-communication in terminal care: a cross-sectional study
Authors: Evering Richard M. H. , Postel Marloes G. , van Os-Medendorp Harmieke , Bults Marloes , den Ouden Marjolein E. M.
Published: November 2022

Background

Interdisciplinary collaboration between healthcare providers with regard to consultation, transfer and advice in terminal care is both important and challenging. The use of video communication in terminal care is low while in first-line healthcare it has the potential to improve quality of care, as it allows healthcare providers to assess the clinical situation in real time and determine collectively what care is needed. The aim of the present study is to explore the intention to use video communication by healthcare providers in interprofessional terminal care and predictors herein.

Methods

In this cross-sectional study, an online survey was used to explore the intention to use video communication. The survey was sent to first-line healthcare providers involved in terminal care (at home, in hospices and/ or nursing homes) and consisted of 39 questions regarding demographics, experience with video communication and constructs of intention to use (i.e. Outcome expectancy, Effort expectancy, Attitude, Social influence, Facilitating conditions, Anxiety, Self-efficacy and Personal innovativeness) based on the Unified Theory of Acceptance and Use of Technology and Diffusion of Innovation Theory. Descriptive statistics were used to analyze demographics and experiences with video communication. A multiple linear regression analysis was performed to give insight in the intention to use video communication and predictors herein.

Results

90 respondents were included in the analysis.65 (72%) respondents had experience with video communication within their profession, although only 15 respondents (17%) used it in terminal care. In general, healthcare providers intended to use video communication in terminal care (Mean (M) = 3.6; Standard Deviation (SD) = .88). The regression model was significant (F = 9.809, p-value<.001) and explained 44% of the variance in intention to use video communication, with ‘Outcome expectancy’ (beta .420, p < .001) and ‘Social influence’ (beta .266, p = .004) as significant predictors.

Conclusions

Healthcare providers have in general the intention to use video communication in interprofessional terminal care. However, their actual use in terminal care is low. ‘Outcome expectancy’ and ‘Social influence’ seem to be important predictors for intention to use video communication. This implicates the importance of informing healthcare providers, and their colleagues and significant others, about the usefulness and efficiency of video communication.
Sexual harassment from patient to medical student: a cross-sectional survey
Authors: Mahurin Heather M. , Garrett Jamie , Notaro Eliza , Pascoe Vanessa , Stevenson Philip A. , DeNiro Katherine L. , Shinohara Michi M.
Published: November 2022

Background

There is little existing research investigating SH/SA specifically from patients to students. This study aims to assess the prevalence and impact of SH and SA from patient to medical student.

Methods

A cross-sectional survey study was administered via electronic email list to all current medical students at the University of Washington School of Medicine (n = 1183) over a two-week period in 2019. The survey questions addressed respondents’ experiences with SH/SA from patients, frequency of reporting, and impact on feelings of burnout.

Results

Three hundred eleven responses were received for a response rate of 26%; 268 complete responses were included in the final analysis. Overall, 56% of respondents reported ever experiencing SH from a patient. SH from a patient was reported by significantly more of those who identify as female compared to male (66% vs 31%; p < .001). Similar frequency of experiencing SH within the last year were reported by females and males (90% vs 88%; p = .96). Clinical students were more likely to have ever experienced SH compared to preclinical students (61% vs 39%; p < .001). The majority (86%) of respondents who experienced SH/SA did not report it in an official capacity. Those who identify as female were more likely to report that SH from a patient contributed to feelings of burnout (21% vs 5% for male; p = .02). Behaviors consistent with SA were experienced by 16% of respondents, with similar frequency between females and males.

Conclusions

This study demonstrates that patient to medical student SH/SA is a common occurrence, particularly among students identifying as female. It also highlights the significant impact of SH/SA incidents on feelings of burnout.
How health systems facilitate patient-centered care and care coordination: a case series analysis to identify best practices
Authors: Simpson Kaitlyn , Nham Wilson , Thariath Josh , Schafer Hannah , Greenwood-Eriksen Margaret , Fetters Michael D. , Serlin David , Peterson Timothy , Abir Mahshid
Published: November 2022

Large- and small-scale transformation of healthcare delivery toward improved patient experience through promotion of patient-centered and coordinated care continues to be at the forefront of health system efforts in the United States. As part of a Quality Improvement (QI) project at a large, midwestern health system, a case series of high-performing organizations was explored with the goal of identifying best practices in patient-centered care and/or care coordination (PCC/CC). Identification of best practices was done through rapid realist review of peer-reviewed literature supporting three PCC/CC interventions per case. Mechanisms responsible for successful intervention outcomes and associated institutional-level facilitators were evaluated, and cross-case analysis produced high-level focus items for health system leadership, including (1) institutional values surrounding PCC/CC, (2) optimization of IT infrastructure to enhance performance and communication, (3) pay structures and employment models that enhance accountability, and (4) organizing bodies to support implementation efforts. Health systems may use this review to gain insight into how institutional-level factors may facilitate small-scale PCC/CC behaviors, or to conduct similar assessments in their own QI projects. Based on our analysis, we recommend health systems seeking to improve PCC/CC at any level or scale to evaluate how IT infrastructure affects provider-provider and provider-patient communication, and the extent to which institutional prioritization of PCC/CC is manifest and held accountable in performance feedback, incentivization, and values shared among departments and settings. Ideally, this evaluation work should be performed and/or supported by cross-department organizing bodies specifically devoted to PCC/CC implementation work.