bluuebunny/crossref_metadata_2025 huggingface dataset:
FAIR Equivalency in Indonesia's Digital Health Framework
Authors: Purnama Jati Putu Hadi
Published: August 2022

The objective of this study was to assess the regulatory framework for health data in Indonesia in order to understand the policy context and explore the possibility of expanding the adoption and implementation of the FAIR Guidelines, which state that data should be Findable, Accessible, Interoperable and Reusable (FAIR), in Indonesia. Although the FAIR Guidelines were not explicitly mentioned in any of the policy documents relevant to the Indonesian digital health sector, six out of the eight documents analysed contained FAIR Equivalent principles. In particular, Indonesia's Population Identification Number (NIK) has the potential, as a unique identifier, to support the integration and interoperability (findability) of data, which is crucial to all other aspects of the FAIR Guidelines. There is also a plan to build standards and protocols into the implementation of information systems in each ministry and government agency to improve data accessibility (accessibility), the integration of the various information systems is planned/ongoing (interoperability), and the need for a standardised arrangement for health information systems related to health data following the community standard is recognised (reusability). The documents at the core of Indonesia's digital health/eHealth policy have the highest FAIR Equivalency Score (FE-Score), showing some degree of alignment between the Indonesian digital health implementation vision and the FAIR Guidelines. This indicates that Indonesia's digital health sector is open to using the FAIR Guidelines.
FAIR Equivalency with Regulatory Framework for Digital Health in Ethiopia
Authors: Tadele Taye Getu , Yohannes Amare Samson , Gebremeskel G. Tesfit , Abrha Medhanyie Araya , Ayele Wondimu , Habtamu Tigist , van Reisen Mirjam
Published: August 2022

This paper investigates whether or not there is a policy window for making health data ‘Findable’, ‘Accessible’ (under well-defined conditions), ‘Interoperable’ and ‘Reusable’ (FAIR) in Ethiopia. The question is answered by studying the alignment of policies for health data in Ethiopia with the FAIR Guidelines or their ‘FAIR Equivalency’. Policy documents relating to the digitalisation of health systems in Ethiopia were examined to determine their FAIR Equivalency. Although the documents are fragmented and have no overarching governing framework, it was found that they aim to make the disparate health data systems in Ethiopia interoperable and boost the discoverability and (re)usability of data for research and better decision making. Hence, the FAIR Guidelines appear to be aligned with the regulatory frameworks for ICT and digital health in Ethiopia and, under the right conditions, a policy window could open for their adoption and implementation.
FAIR Versus Open Data: A Comparison of Objectives and Principles
Authors: Jati Putu Hadi Purnama , Lin Yi , Nodehi Sara , Cahyono Dwy Bagus , van Reisen Mirjam
Published: August 2022

This article assesses the difference between the concepts of ‘open data’ and ‘FAIR data’ in data management. FAIR data is understood as data that complies with the FAIR Guidelines—data that is Findable, Accessible, Interoperable and Reusable—while open data was born out of awareness of the need to democratise data by improving its accessibility, based on the idea that data should not have limitations that prevent people from using it. This study compared FAIR data with open data by analysing relevant documents using a coding analysis with conceptual labels based on Kingdon's theory of agenda setting. The study found that in relation to FAIR data the problem stream focuses on the complexity of data collected for research, while open data primarily emphasises giving the public access to non-confidential data. In the policy stream, the two concepts share common standpoints in terms of making data available and reusable, although different approaches are adopted in practice to accomplish these goals. In the politics stream, stakeholders with different objectives support FAIR data and from those who support open data.
FAIR Machine Learning Model Pipeline Implementation of COVID-19 Data
Authors: Folorunso Sakinat , Ogundepo Ezekiel , Basajja Mariam , Awotunde Joseph , Kawu Abdullahi , Oladipo Francisca , Ibrahim Abdullahi
Published: August 2022

Research and development are gradually becoming data-driven and the implementation of the FAIR Guidelines (that data should be Findable, Accessible, Interoperable, and Reusable) for scientific data administration and stewardship has the potential to remarkably enhance the framework for the reuse of research data. In this way, FAIR is aiding digital transformation. The ‘FAIRification’ of data increases the interoperability and (re)usability of data, so that new and robust analytical tools, such as machine learning (ML) models, can access the data to deduce meaningful insights, extract actionable information, and identify hidden patterns. This article aims to build a FAIR ML model pipeline using the generic FAIRification workflow to make the whole ML analytics process FAIR. Accordingly, FAIR input data was modelled using a FAIR ML model. The output data from the FAIR ML model was also made FAIR. For this, a hybrid hierarchical k-means (HHK) clustering ML algorithm was applied to group the data into homogeneous subgroups and ascertain the underlying structure of the data using a Nigerian-based FAIR dataset that contains data on economic factors, healthcare facilities, and coronavirus occurrences in all the 36 states of Nigeria. The model showed that research data and the ML pipeline can be FAIRified, shared, and reused by following the proposed FAIRification workflow and implementing technical architecture.
Curriculum Development for FAIR Data Stewardship
Authors: Oladipo Francisca , Folorunso Sakinat , Ogundepo Ezekiel , Osigwe Obinna , Akindele Akinyinka
Published: August 2022

The FAIR Guidelines attempts to make digital data Findable, Accessible, Interoperable, and Reusable (FAIR). To prepare FAIR data, a new data science discipline known as data stewardship is emerging and, as the FAIR Guidelines gain more acceptance, an increase in the demand for data stewards is expected. Consequently, there is a need to develop curricula to foster professional skills in data stewardship through effective knowledge communication. There have been a number of initiatives aimed at bridging the gap in FAIR data management training through both formal and informal programmes. This article describes the experience of developing a digital initiative for FAIR data management training under the Digital Innovations and Skills Hub (DISH) project. The FAIR Data Management course offers 6 short on-demand certificate modules over 12 weeks. The modules are divided into two sets: FAIR data and data science. The core subjects cover elementary topics in data science, regulatory frameworks, FAIR data management, intermediate to advanced topics in FAIR Data Point installation, and FAIR data in the management of healthcare and semantic data. Each week, participants are required to devote 7–8 hours of self-study to the modules, based on the resources provided. Once they have satisfied all requirements, students are certified as FAIR data scientists and qualified to serve as both FAIR data stewards and analysts. It is expected that in-depth and focused curricula development with diverse participants will build a core of FAIR data scientists for Data Competence Centres and encourage the rapid adoption of the FAIR Guidelines for research and development.
What Scholem Failed to See: Moses Dobruska as a Founder of Sociological Thought
Authors: Greco Silvana
Published: August 2022

After a brief outline of the biography of Moses Dobruska (1753–1794), this article wants to emphasize what most scholars, in particular Gershom Scholem, did not want to recognize about this Moravian Jew, coming from a sectarian Sabbatian environment, who later converted to Catholicism. He was not only a brilliant businessman, literate, a poet, and Freemason, but also a social philosopher, and, even more, a forgotten founding father of sociology. His work Philosophie sociale (Paris 1793) is a milestone in the development of a social discipline still in progress, which later took the name sociology. This study highlights the strong influence exerted by Dobruska on subsequent authors. In particular, it shows how Dobruska’s concept of ‘disorganization’ (the breaking of a political, cultural and social order) had a strong influence on the thought of Henry Saint-Simon (1760–1825) and his pupil Auguste Comte (1798–1857).
Partner Country Characteristics as Factors in Foreign Policy Behaviour: Germany’s Relations with Developing Countries
Authors: Höflinger Tim
Published: August 2022

This article seeks to identify partner country characteristics as potential explanatory factors for Germany’s foreign policy actions in its bilateral relations with developing countries. From this starting point, two different types of foreign policy actions have been considered: Diplomatic cooperation and development cooperation. Firstly, a comprehensive panel data set has been assembled, containing a set of indicators capturing the socio-economic, demographic, geographic and political characteristics of 101 developing countries from the 2000–2017 period as well as Germany’s foreign policy actions in these countries. Subsequently, a regression analysis was carried out to examine the impact of the country characteristics on Germany’s bilateral foreign policy actions. The analysis has shown that dyad partner characteristics influence Germany’s bilateral foreign policy behaviour with developing countries across both types of foreign policy actions. Based on the identified relationships, one can draw some informed inferences regarding Germany’s foreign policy conduct with developing countries.
Description of two new janirid isopods (Isopoda, Asellota, Janiridae) from Korean waters
Authors: KIM SUNG HOON , KIM JONG GUK , YOON SEONG MYEONG
Published: August 2022

Two janirid isopods, Caecijaera ciliata sp. nov. and Janiralata truncata sp. nov., are reported from Korean waters in this study. Caecijaera ciliata sp. nov. differs from its congeners by the following features: pereonites 4–7 with large simple setae on the midline of the posterior tergite margins; the pleotelson is angled proximolaterally; the antennula is six-articled; the basis of pereopod Ⅶ is serrated superiorly; and the appendix masculina is not coiled. Janiralata truncata sp. nov. can be distinguished from its related species by the following characteristics: the lateral margin of the cephalothorax has an acute projection anterolaterally; all coxal plates of the pereonites are visible dorsally; male pleopod Ⅰ has a pair of small rounded projections distally near the fusion line of the two first pleopods; the exopod of pleopod Ⅲ has two plumose setae on the distomedial margin.
One hundred new records, a new species, and the first pictures of Agonocryptus Cushman (Hymenoptera, Ichneumonidae, Cryptinae)
Authors: SUPELETO FERNANDA A. , AGUIAR ALEXANDRE P.
Published: August 2022

Updated distribution maps are provided for all known species of Agonocryptus, with 115 new distribution records for 16 species, an expansion from 166 to 281 unique coordinates, or nearly 70%, in relation to what was previously published. A new species is proposed, A. glaphyrus sp. nov., from Colombia. All taxa previously treated as subspecies are raised to the rank of species, as follows: A. chichimecus (Cresson, 1873) stat. nov., A. coxinota Gupta, 1982 stat. nov., A. discoidaloides (Viereck, 1905) stat. nov., A. flavosternum Gupta, 1982 stat. nov., A. nigrifemur Gupta, 1982 stat. nov., A. nigristernum Gupta, 1982 stat. nov., A. paulus Gupta, 1982 stat. nov., and A. tucumanus Gupta, 1982 stat. nov. New distribution data is provided for the following taxa, with new records for countries specified where applicable: A. adustus Gupta, 1982, new to Colombia; A. argentinus Gupta, 1982; A. brevicauda Kasparyan & Ruíz-Cancino, 2005, new to Brazil; A. chichimecus; A. discoidaloides; A. flavosternum; A. fumosus Gupta, 1982; A. heathi (Brues, 1912); A. lioneli Gupta, 1982; A. nigristernum; A. physocnemis (Brullé, 1846); A. rufithorax Gupta, 1982; A. rugifrons Gupta, 1982; A. russulus Gupta, 1982; A. tricolor Gupta, 1982; and A. varus (Brullé, 1846), new to Bolivia, Brazil, Colombia, French Guyana, Guyana, and Trinidad & Tobago. Images of the studied species are published for the first time, including the males of A. discoidaloides, A. physocnemis, and A. rugifrons, documenting both the typical morphology of each taxon and their morphological variation, which is also described and discussed. Specimens cited by Gupta (1982) as likely to represent a distinct subspecies of A. varus are identified as Digonocryptus zopherus Aguiar & Santos, 2012. Elevation data, both from the literature and original, is compiled and compared, revealing a range of preferences among different species.
A new Ryukyuan species of Edaphus Motschulsky (Coleoptera, Staphylinidae, Euaesthetinae)
Authors: JAŁOSZYŃSKI PAWEŁ , SAPIEJA MATEUSZ
Published: August 2022

Edaphus nagugushikuensis sp. n., a new Japanese rove beetle species of the subfamily Euaesthetinae is described and illustrated based on a male specimen collected in the northern region of Okinawa-jima, Okinawa Prefecture, Japan. It is the 56th species of Edaphus Motschulsky known to occur in Japan, and the sixth known to inhabit the largest Ryukyuan island. Puthz’s identification key to Edaphus species of the southwestern Japanese islands from 2010 is modified to include the new species.
Personality development in adolescence: Examining big five trait trajectories in differential learning environments
Authors: Tetzner Julia , Becker Michael , Bihler Lilly-Marlen
Published: August 2022

This study addresses two questions: Do Big Five traits change from early to middle adolescence? How do developmental trajectories differ between educational environments (i.e., secondary school tracks)? We used a representative random sample from Germany, following 6th graders (T1, N = 1662; age: M = 11.68; SD = 0.63; female = 47.4%; from N = 87 primary schools) to the end of compulsory secondary education over three measurement points (i.e., assessing students in 6th, 7th, and 9th grade). Results of latent change modeling indicated overall increases in mean levels for all personality traits from early to middle adolescence. Regarding selection effects, the results indicated that more conscientious, agreeable, extraverted, open, and emotionally stable sixth graders were more likely to transit into an academic rather than a non-academic secondary school track. Moreover, the results showed that these initial differences in personality traits seemed to diminish between 6th and 9th grade for all personality traits. Additionally, controlling for selection effects, a contextual effect was discernible for conscientiousness. This study highlighted the potential role of differential learning environments for modifying changes in personality traits during adolescence.
Potential anticancer effect of sodium caprate on human gastric cancer cells
Authors: Kim Nam-Hee , Park Jung Ho , Koo Dong-Hoe , Lee Taeheon , Yang Jeong-Yoon , Lee Hee-Young
Published: August 2022

The role of sodium caprate (C10) in enhancing drug absorption is well established; however, little information is available on its role as an anticancer drug. This study aimed to evaluate the anticancer effect of C10 in gastric cancer cells. The mechanism of cytotoxicity of C10 was evaluated by western blotting following treatment of the gastric cancer cells with various concentrations of C10. C10 cytotoxicity was measured via MTS (3-(4, 5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H tetrazolium), lactate dehydrogenase (LDH), cAMP, and ATP assays. Gastric cancer cells were observed by electron microscopy following treatment with C10. Then, xenograft mice that were inoculated with gastric cancer cells were treated with C10 for 4 weeks, after which the changes in tumor size were measured. C10 triggered apoptosis in the gastric cancer cells through the mitochondrial pathway at concentrations of more than 0.2 mM. However, 15 mM of C10 induced necrosis in gastric cancer cells by causing cellular swelling and the formation of holes in the cell membrane. Levels of cAMP and ATP decreased significantly following exposure to 15 mM C10 for 1 h. Additionally, the size of the xenograft tumors was significantly reduced by 24% after 4 weeks of C10 treatment ( p < 0.05). This study indicates that C10 induces apoptosis and necrosis in a concentration-dependent manner and has clear anticancer effects on gastric cancer cells.
Natural Resources and Ethnic Conflict: A Geo-strategic Understanding of the Rohingya Crisis in Myanmar
Authors: Debnath Kunal , Chatterjee Souvik , Afzal Afnan Bint
Published: August 2022

Since the enactment of the 1982 Burmese Citizenship Law, the Rohingya Muslims have been stateless, and they are attempting to become Burmese citizens. In Myanmar, ethnic identity continues to be the most politically significant marker stratified by government policy. Despite Myanmar’s official recognition of 135 minority groups, ethnic identities are fixed in exclusionary terms like Buddhist or non-Buddhist, Bamar or non-Bamar. Ethnicity and religion, therefore, have played a significant role in the formation of Myanmar’s national identity, that systematically excludes the Rohingyas. Hence, religion and ethnic identities are often contemplated as the major reason for the Rohingya crisis. However, contrary to the popular perception, this article argues that, along with the ethnic and religious aspects of the Rohingya conflict, the geo-strategic and economic aspects of the conflict must also be addressed with seriousness, as the conflict has occurred under a variety of political and economic conditions. It investigates the role of resource geo-economics of the Myanmar government and military forces in the recent conflict. Furthermore, this article examines China’s and India’s vested geo-strategic and economic interests in Rakhine. Findings from the research imply that the persecution and displacement of the Rohingyas may be linked to the resources and geo-strategic factors present in Rakhine.
There but for the grace of OGOD: Religion and diversity in South African public schools
Authors: Finn Meghan
Published: August 2022

South Africa’s doctrinal approach to religion in public schools allows for circumscribed space for religious observances, while protecting diverse and minority interests. In Organisasie vir Godsdientse-Onderrig en Demokrasie v Laerskool Randhart [2017] ZAGPJHC 160; 2017 (6) SA 129 (GJ), the High Court held that a public school cannot promote that it adheres to only one religion to the exclusion of others. The judgment placed weight on the value of diversity, which affirms inclusivity and difference in a pluralist society. While diversity is normatively significant, the court’s preference for it is consistent with an ongoing judicial trend that favours reliance on generalised norms over concrete provisions. This leaves open important questions as to how particular religious policies and observances at a school level should be tested within a local context, and the meaning to be given to constitutional requirements that religious observances at state or state-aided institutions be free, voluntary, and conducted on an equitable basis. Five years after that judgment was handed down, these debates are of renewed importance, with legislative amendments currently before Parliament that would require a public school’s code of conduct to take into account the diverse cultural beliefs and religious observances of learners.
Eliciting third person perspectives in social work case discussions: A device for reflective supervision?
Authors: Symonds Jon , Jorgensen Sabine , Webb Joseph , Mullins Eve , Wilkins David
Published: August 2022

Reflective supervision is widely recommended as an effective way to support social workers to think about their practice and to make better decisions. Although previous research has proposed methods of pursuing reflective supervision, little is known about how supervisors attempt this in actual supervision meetings. One proposed method for supervisors is to elicit third person perspectives so that social workers can consider a situation from different points of view. In this article, we examine this method by analysing audio recordings of 12 supervision meetings from one local authority Children and Families Social Work team. Using Conversation Analysis (CA), we explore supervisors’ attempts to elicit other people’s perspectives, focusing on how such requests were formed and how the social worker responded. We found 35 instances of supervisors attempting to elicit third person perspectives and identified four different ways that supervisors designed these enquiries. Supervisors oriented to two concerns, based on whether they enquired about a perspective that was currently established or projected into the future, and whether the information was verifiable through speech or actions, or imagined based on the other person’s thoughts or understanding. We draw on CA work on epistemics and stance to show how these different approaches have implications for what the social worker is expected to know and how both speakers orient to the accountability of the social worker. We conclude by considering the epistemic friction between the design of these enquiries, the relevance of professional accountability and the possibilities for pursuing reflective supervision in practice.
Lifestyle Medicine Core Competencies: 2022 Update
Authors: Lianov Liana S. , Adamson Karen , Kelly John H. , Matthews Simon , Palma Mechelle , Rea Brenda L.
Published: August 2022

The lifestyle medicine core competencies were developed by a committee of physicians from several medical specialties to provide guidance on the knowledge and skills needed for physicians to provide high quality lifestyle interventions that optimize chronic disease outcomes. These competencies were published in the Journal of the American Medical Association (JAMA) in 2010 and used as the foundation for the first lifestyle medicine course and for the lifestyle medicine board certification examination. In the ensuing years, interest in the field and application has expanded to a variety of health professionals. With evolution of the lifestyle medicine evidence-base, the competencies have been updated. This article sums up the changes in their organization and content. Regular updates are anticipated to align with the ongoing scientific studies and evolution of the field.
Walkie-Talkie Maps – A Novel Method to Conduct and Visualize Remote Ethnography
Authors: Yavo-Ayalon Sharon , Gong Cheng , Yu Harrison , Mandel Ilan , Ju Wendy
Published: August 2022

The COVID-19 pandemic, travel restrictions, and social distancing measures have made it difficult to observe, monitor, or manage urban life. To capture the experience of being in New York City during the first year of the COVID-19 pandemic, we used a novel method of remote ethnography to interview people who were walking the city. We developed the Walkie-Talkie Map to collect and present these interviews, enabling website visitors to see what the subject saw as they walked the route of their choice. Visitors can interactively scroll through the interview and have access to additional visualizations and imagery that contextualize the main narrative. Visitors are thus able to vicariously experience what it was like to be in New York City at the outset of the COVID-19 epidemic. This work provides a case study on how to perform observational research when geographic and bodily distance has become the norm. We discuss the advantages and limitations of our method and conclude with its contributions to the study of cities and for others looking to conduct remote observational research in different fields of knowledge. The Walkie-Talkie maps can be found on this url: https://www.socialdistancing.tech.cornell.edu/what-is-a-walike-talkie
Post-operative Scar Comparison With Supraorbital Eyebrow and Upper Blepharoplasty Approach in the Management of Zygomaticomaxillary Complex Fractures
Authors: Mirza Hamza H. , Ahmed Faheem , Rahber Murtaza , Rana Zahoor A.
Published: August 2022

Study Design

A prospective randomized comparative study was conducted to evaluate the postsurgical scar with Supraorbital Eyebrow (SE) Approach and Upper Blepharoplasty (UB) Approach used for open reduction and internal fixation (ORIF) of zygomaticomaxillary complex (ZMC) fractures.

Objective

To evaluate and compare the post-operative scar using Vancouver Scar Scale (VSS) following ORIF of ZMC fractures with SE and UB approaches.

Methods

In this study, 88 patients with ZMC fractures requiring ORIF and meeting the inclusion criteria were recruited between 2019 and 2020. Patients were randomly divided into SE and UB group, 44 patients in each. Clinical and radiological assessment was done preoperatively and post-operative scar evaluation was carried out at different intervals over a period of 6 months using VSS. A blinded observer rated the scar.

Results

The results showed that after 6 months of surgery, all the 44 (100%) patients in UB group had a mild scar (VSS score 1–5), while in the SE group 34 (77.3%) patients had a mild scar (VSS score 1–5) and 10 (22.7%) had a moderate scar (VSS score 6–10). The difference between the 2 groups was statistically significant ( P-value = .001).

Conclusions

The UB approach has been established to be superior to SE approach in terms of post-operative scar as the results were statistically significant. This study can be used to advocate more frequent use of UB approach as compared to the previously popular SE approach for the management of ZMC fractures.
Metastatic neuroendocrine tumor masquerading as orbital cysticercosis
Authors: Wirth Magdalena A , Khan Haaris M , Sabiq Farahna , Agoumi Mehdi , Neufeld Anastasia
Published: August 2022

Orbital metastases secondary to neuroendocrine tumors are exceedingly rare. We present a unique case of a 30-year-old female initially presenting with fever, chills, periorbital swelling, and painful proptosis. CT orbits revealed two ovoid-shaped ring-enhancing lesions in the right lateral and superior rectus muscles and clear sinuses, atypical for infectious post-septal cellulitis. Further work-up included serologic analysis, auto-immune panel, and MRI. Further imaging showed pseudocystic orbital lesions mimicking orbital cysticercosis. Additionally, given the bilateral nature of the lesions and patient’s country of origin, this parasitic process was highly suspected. A course of albendazole and steroids led to resolution of symptoms. With a presentation at age 30, this is by far the youngest case reported in literature to date.
Hyperphosphatemia: A Clue to Diagnosis
Authors: Gayathri C. , Keerthana B. , Jahnavi D. , Monika C.V. , Srilakshmi G. , Lakshmi B. Sangeetha , Aishwarya P. Lakshmi , Ram R. , Kumar V. Siva
Published: August 2022

Serum phosphate level reference range in adults is 2.5 mg/dL to 4.5 mg/dL and in children is 3 mg/dL to 6 mg/dL. The causes of hyperphosphatemia fall into four categories. These are decreased renal excretion of phosphorus, exogenous phosphorus administration, redistribution of phosphorus, and pseudohyperphosphatemia. We report a 69-year-old gentleman presented with the history of swelling of feet and facial puffiness of 1 month duration. He had renal failure with normal sized kidneys. Serum phosphorus was high. Advanced investigations revealed plasma cell proliferative disorder (clonal bone marrow plasma cells >10%) on bone marrow examination, presence of M band at the junction of beta-2 and gamma region, and elevated serum IgG and serum beta-2 microglobulin. Hyperphosphatemia in multiple myeloma may be true, or pseudohyperphosphatemia. Diligent history, examination, and investigations have yielded the possibility of pseudohyperphosphatemia owing to multiple myeloma in our patient. The interference with the phosphomolybdate ultraviolet assay for serum phosphorus estimation is one of the reasons of pseudohyperphosphatemia in multiple myeloma. The other mechanism of pseudohyperphosphatemia could be the direct binding of paraprotein to phosphorus.
A microfluidic-based analysis of 3D macrophage migration after stimulation by Mycobacterium, Salmonella and Escherichia
Authors: Pérez-Rodríguez Sandra , Borau Carlos , García-Aznar José Manuel , Gonzalo-Asensio Jesús
Published: August 2022

Macrophages play an essential role in the process of recognition and containment of microbial infections. These immune cells are recruited to infectious sites to reach and phagocytose pathogens. Specifically, in this article, bacteria from the genus Mycobacterium, Salmonella and Escherichia, were selected to study the directional macrophage movement towards different bacterial fractions. We recreated a three-dimensional environment in a microfluidic device, using a collagen-based hydrogel that simulates the mechanical microarchitecture associated to the Extra Cellular Matrix (ECM). First, we showed that macrophage migration is affected by the collagen concentration of their environment, migrating greater distances at higher velocities with decreasing collagen concentrations. To recreate the infectious microenvironment, macrophages were exposed to lateral gradients of bacterial fractions obtained from the intracellular pathogens M. tuberculosis and S. typhimurium. Our results showed that macrophages migrated directionally, and in a concentration-dependent manner, towards the sites where bacterial fractions are located, suggesting the presence of attractants molecules in all the samples. We confirmed that purified M. tuberculosis antigens, as ESAT-6 and CFP-10, stimulated macrophage recruitment in our device. Finally, we also observed that macrophages migrate towards fractions from non-pathogenic bacteria, such as M. smegmatis and Escherichia coli. In conclusion, our microfluidic device is a useful tool which opens new perspectives to study the recognition of specific antigens by innate immune cells.
Measuring and exploring mental health determinants: a closer look at co-residents’ effect using a multilevel structural equations model
Authors: Gabr Hend , Baragilly Mohammed , Willis Brian H.
Published: August 2022

Objective

Previous research has demonstrated that individual risk of mental illness is associated with individual, co-resident, and household risk factors. However, modelling the overall effect of these risk factors presents several methodological challenges. In this study we apply a multilevel structural equation model (MSEM) to address some of these challenges and the impact of the different determinants when measuring mental health risk.

Study design and setting

Two thousand, one hundred forty-three individuals aged 16 and over from 888 households were analysed based on the Household Survey for England-2014 dataset. We applied MSEM to simultaneously measure and identify psychiatric morbidity determinants while accounting for the dependency among individuals within the same household and the measurement errors.

Results

Younger age, female gender, non-working status, headship of the household, having no close relationship with other people, having history of mental illness and obesity were all significant (p < 0.01) individual risk factors for psychiatric morbidity. A previous history of mental illness in the co-residents, living in a deprived household, and a lack of closeness in relationships among residents were also significant predictors. Model fit indices showed a very good model specification (CFI = 0.987, TLI = 0.980, RMSEA = 0.023, GFI = 0.992).

Conclusion

Measuring and addressing mental health determinants should consider not only an individual’s characteristics but also the co-residents and the households in which they live.
Estimating effects of health policy interventions using interrupted time-series analyses: a simulation study
Authors: Jiang Huan , Feng Xinyang , Lange Shannon , Tran Alexander , Manthey Jakob , Rehm Jürgen
Published: August 2022

Background

A classic methodology used in evaluating the impact of health policy interventions is interrupted time-series (ITS) analysis, applying a quasi-experimental design that uses both pre- and post-policy data without randomization. In this paper, we took a simulation-based approach to estimating intervention effects under different assumptions.

Methods

Each of the simulated mortality rates contained a linear time trend, seasonality, autoregressive, and moving-average terms. The simulations of the policy effects involved three scenarios: 1) immediate-level change only, 2) immediate-level and slope change, and 3) lagged-level and slope change. The estimated effects and biases of these effects were examined via three matched generalized additive mixed models, each of which used two different approaches: 1) effects based on estimated coefficients (estimated approach), and 2) effects based on predictions from models (predicted approach). The robustness of these two approaches was further investigated assuming misspecification of the models.

Results

When one simulated dataset was analyzed with the matched model, the two analytical approaches produced similar estimates. However, when the models were misspecified, the number of deaths prevented, estimated using the predicted vs. estimated approaches, were very different, with the predicted approach yielding estimates closer to the real effect. The discrepancy was larger when the policy was applied early in the time-series.

Conclusion

Even when the sample size appears to be large enough, one should still be cautious when conducting ITS analyses, since the power also depends on when in the series the intervention occurs. In addition, the intervention lagged effect needs to be fully considered at the study design stage (i.e., when developing the models).
Detecting disabilities in everyday life: evidence from a geriatric assessment
Authors: Dzien Cornelius , Unterberger Petra , Hofmarcher Paul , Winner Hannes , Lechleitner Monika
Published: August 2022

Background

The activities of daily living (ADL) score is a widely used index to establish the degree of independence from any help in everyday life situations. Measuring ADL accurately is time-consuming and costly. This paper presents a framework to approximate ADL via variables usually collected in comprehensive geriatric assessments. We show that the selected variables serve as good indicators in explaining the physical disabilities of older patients.

Methods

Our sample included information from a geriatric assessment of 326 patients aged between 64 and 99 years in a hospital in Tyrol, Austria. In addition to ADL, 23 variables reflecting the physical and mental status of these patients were recorded during the assessment. We performed least absolute shrinkage and selection operator (LASSO) to determine which of these variables had the highest impact on explaining ADL. Then, we used receiver operating characteristic (ROC) analysis and logistic regression techniques to validate our model performance. Finally, we calculated cut-off points for each of the selected variables to show the values at which ADL fall below a certain threshold.

Results

Mobility, urinary incontinence, nutritional status and cognitive function were most closely related to ADL and, therefore, to geriatric patients’ functional limitations. Jointly, the selected variables were able to detect neediness with high accuracy (area under the ROC curve (AUC) = 0.89 and 0.91, respectively). If a patient had a limitation in one of these variables, the probability of everyday life disability increased with a statistically significant factor between 2.4 (nutritional status, 95%-CI 1.5–3.9) and 15.1 (urinary incontinence, 95%-CI 3.6–63.4).

Conclusions

Our study highlights the most important impairments of everyday life to facilitate more efficient use of clinical resources, which in turn allows for more targeted treatment of geriatric patients. At the patient level, our approach enables early detection of functional limitations and timely indications of a possible need for assistance in everyday life.
The effect of co-dependent (thinking in motion [TIM]) versus single-modality (CogniFit) interventions on cognition and gait among community-dwelling older adults with cognitive impairment: a randomized controlled study
Authors: Embon-Magal Shiri , Krasovsky Tal , Doron Israel , Asraf Kfir , Haimov Iris , Gil Efrat , Agmon Maayan
Published: August 2022

Background

Cognition and motor skills are interrelated throughout the aging process and often show simultaneous deterioration among older adults with cognitive impairment. Co-dependent training has the potential to ameliorate both domains; however, its effect on the gait and cognition of older adults with cognitive impairment has yet to be explored. The aim of this study is to compare the effects of the well-established single-modality cognitive computerized training program, CogniFit, with “Thinking in Motion (TIM),” a co-dependent group intervention, among community-dwelling older adults with cognitive impairment.

Methods

Employing a single-blind randomized control trial design, 47 community-dwelling older adults with cognitive impairment were randomly assigned to 8 weeks of thrice-weekly trainings of TIM or CogniFit. Pre- and post-intervention assessments included cognitive performance, evaluated by a CogniFit battery, as a primary outcome; and gait, under single- and dual-task conditions, as a secondary outcome.

Results

CogniFit total Z scores significantly improved from baseline to post-intervention for both groups. There was a significant main effect for time [F (1, 44) = 17.43, p < .001, ηp2 = .283] but not for group [F (1, 44) = 0.001, p = .970]. No time X group interaction [F (1, 44) = 1.29, p = .261] was found. No changes in gait performance under single and dual-task performance were observed in both groups.

Conclusions

The findings show that single-modality (CogniFit) and co-dependent (TIM) trainings improve cognition but not gait in older adults with cognitive impairment. Such investigations should be extended to include various populations and a broader set of outcome measurements.

Trial registration

ACTRN12616001543471. Date: 08/11/2016.
Prolonged increased neutrophil-to-lymphocyte ratio is associated with mortality after successful revascularization for treatment of acute ischemic stroke
Authors: Li Song , Hu Linghong , Wang Jian , Zou Feihui , Han Bin , Wang Yougang , Liu Kefeng
Published: August 2022

Background

To determine the association between dynamic neutrophil-to-lymphocyte ratio (NLR) during hospitalization and mortality 1 month after ischemia reperfusion in patients undergoing endovascular treatment (EVT) with successful revascularization for acute large vessel occlusion stroke.

Methods

This retrospective study included patients who had undergone successful EVT. Information was collected regarding patients’ clinical characteristics, imaging data, and mortality at 1 month. Univariate and multivariate logistic regression models were applied to assess the association between NLR and mortality. We used a generalized additive model and a generalized additive mixed model to compare trends in NLR over time between survivors and nonsurvivors.

Results

A total of 237 patients were included. During the 1-month follow-up, 42 of these patients (17.7%) died. The multivariate analysis demonstrated that NLR obtained within 12 to 24 hours (odds ratio [OR] = 1.18; 95% confidence interval [CI]: 1.04, 1.33; P = 0.008), 24 to 48 hours (OR = 1.16; 95% CI: 1.01, 1.35; P = 0.044), and 48 to 72 hours (OR = 1.23; 95% CI: 1.03, 1.47; P = 0.021) after EVT were independently associated with mortality at 1 month. In addition, there was a trend for NLR to decrease gradually over time for both survivors and nonsurvivors; however, NLR in survivors decreased by an average of 0.29 daily than in nonsurvivors.

Conclusions

Increased NLR in the early period after EVT was associated with an increased risk of mortality, and a continued trend toward higher NLR over time was also linked with a higher mortality risk.
Long-term results of trans-scaphoid perilunate fracture dislocations treated by open reduction and internal fixation
Authors: Yu Xiao-Jun , Wang Shan-Xi , Guo Xin-Zhen , Liu Qi-Kun , Wang Ying-Guang , Qu Yun-Kun , Kang Hao , Bao Yuan
Published: August 2022

Purpose

The paper holds the research purpose of confirming the long-term results of trans-scaphoid perilunate fracture dislocations (TSPFD) under the treatment of open reduction and internal fixation.

Methods

Anteroposterial-lateral radiographs of the patient's wrist were taken before and after surgery. We use a dorsal approach for all cases. Postoperative clinical and radiographic assessments were performed routinely. The scapholunate angle (SLA), estradiol angle (RLA), as well as lunotriquetral distance (LTD) assisted in the radiographic assessment. Clinical assessment was performed using the Krimmer score, modified Mayo wrist score (MWS), active flexion extension arc (FEA), radial deviation and ulnar deviation arc (RUDA) and grip strength. A visual analog scale (VAS) assisted in the pain evaluation, the VAS score ranges from 0 to 10.

Results

Twenty-two TSPFD patients due to the wrist trauma received operative treatment and we retrospectively analyzed the surgical results, together with evaluating their clinical and radiological follow-up. These patients held a mean age of 30 years old. Herzberg’s perilunate fracture-dislocation classification was taken into account to find that 19 males and 3 females suffered dorsal dislocation. The fellow-up time lasted 98.3 months on average. All cases obtained sufficient union after open reduction and internal fixation. The last follow-up found the median of grip strength was 20.00 (interquartile range, 20.00–21.25), which was 84.5% of the normal side. The modified Mayo wrist score evaluation scale considered 12 cases as excellent, and 10 good. The median of VAS and Krimmer scores at the final follow-up were 1.50 (interquartile range, 0.75–2.00) and 100.00 (interquartile range, 100.00–100.00), respectively, higher relative to the pre-operation (P < 0.001). No patients showed nerve damage preoperatively or postoperatively, or pin tract infection in any of the patient.

Conclusions

It is necessary to diagnose such complicated biomechanical damage in early stage and adopt the open reduction and stable fixation for treatment; appropriate treatment can contribute to a functionally adequate and anatomically integrated wrist.
Analyzing annual changes in network structures of a social media application-based information-sharing system in a Japanese community
Authors: Haruta Junji , Tsugawa Sho , Ogura Kazunari
Published: August 2022

Background

Understanding the evolution of social network services (SNSs) can provide insights into the functions of interprofessional information-sharing systems. Using social network analysis, we aimed to analyze annual changes in the network structure of SNS-based information sharing among healthcare professionals over a 3-year period in Japan.

Methods

We analyzed data on SNS-based information sharing networks with online message boards for healthcare professionals for 2018, 2019, and 2020 in a Japanese community.

These networks were created for each patient so that healthcare professionals could post and view messages on the web platform. In the social network analysis (SNA), healthcare professionals registered with a patient group were represented as nodes, and message posting and viewing relationships were represented as links. We investigated the structural characteristics of the networks using several measures for SNA, including reciprocity, assortativity and betweenness centrality, which reflect interrelational links, the prevalence of similar nodes with neighbors, and the mediating roles of other nodes, respectively. Next, to compare year-to-year trends in networks of patients overall, and between receiving nursing care levels 1–3 (lighter care requirement) and levels 4–5 (heavier care requirement), we described the annual structural differences and analyzed each measure for SNA using the Steel–Dwass test.

Results

Among 844, 940, and 1063 groups in each year, groups for analysis in care levels 1–3/4–5 were identified as 106/135, 79/89, and 57/57, respectively. The overall annual assessment showed a trend toward increased diameter and decreased density, but the differences were not significant. For those requiring care levels 1–3, assortativity decreased significantly, while for those requiring care levels 4–5, reciprocity decreased and betweenness centrality increased significantly. No significant differences were found in the other items.

Discussion

This study revealed that the network of patients with a lighter care requirement had more connections consisting of nodes with different links, whereas the network of patients with a heavier care requirement had more fixed intermediary roles and weaker interrelationships among healthcare professionals. Clarifying interprofessional collaborative mechanisms underlying development patterns among healthcare professionals can contribute to future clinical quality improvement.
Barriers and facilitators to the utilization of the intensive adherence counselling framework by healthcare providers in Uganda: a qualitative study
Authors: Musinguzi Pius , Najjuma Josephine Nambi , Arishaba Adellah , Ochen Eric , Ainembabazi Racheal , Keizirege Fred , Sabano Racheal Lillian , Wakida Edith K. , Obua Celestino
Published: August 2022

Background

Uganda Ministry of Health (UMOH) embraced the World Health Organization recommendation for people living with human immunodeficiency virus with a detectable viral load (VL) exceeding 1000 copies/mL to receive intensive adherence counselling (IAC). The IAC framework was developed as a step-by-step guide for healthcare providers to systematically support persons with non-suppressed VL to develop a comprehensive plan for adhering to treatment. The objective of this study was to explore the current practice of the healthcare providers when providing IAC, and identify the barriers and facilitators to the utilization of the UMOH IAC framework at two health centers IV level in rural Uganda.

Methods

This was a descriptive cross-sectional qualitative study that explored the current practices of the healthcare providers when providing IAC, and identified the barriers and facilitators to the utilization of the UMOH IAC framework. We used an interview guide with unstructured questions about what the participants did to support the clients with non-suppressed VL, and semi-structured questions following a checklist of categories of barriers and facilitators that affect ‘providers of care’ as provided by the Supporting the Use of Research Evidence for policy in African health systems (SURE) framework. Current practice as well as the categories of barriers and facilitators formed the a priori themes which guided data collection and analysis. In this study we only included healthcare providers (i.e., medical doctors, clinical officer, nurses, and counsellors) as ‘providers of care’ excluding family members because we were interested in the health system.

Results

A total of 19 healthcare providers took part in the interviews. The healthcare providers reported lack of sufficient knowledge on the UMOH IAC framework; most of them did not receive prior training or sensitization when it was first introduced. They indicated that they lacked counselling and communication skills to effectively utilize the IAC framework, and they were not motivated to utilize it because of the high workload at the clinics compounded by the limited workforce.

Conclusions

Although the UMOH IAC framework is a good step-by-step guide for the healthcare providers, there is need to understand their context and assess readiness to embrace the new behavior before expecting spontaneous uptake and utilization.