bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Ethics Committee in an Oncological Research Hospital: two-years Report
Authors: Perin Marta , De Panfilis Ludovica ,   on behalf of the Clinical Ethics Committee of the Azienda USL-IRCCS di Reggio Emilia
Published: June 2023

Research question and aim

Clinical Ethics Committees (CECs) aim to support healthcare professionals (HPs) and healthcare organizations to deal with the ethical issues of clinical practice. In 2020, a CEC was established in an Oncology Research Hospital in the North of Italy. This paper describes the development process and the activities performed 20 months from the CEC’s implementation, to increase knowledge about CEC’s implementation strategy.

Research design

We collected quantitative data related to number and characteristics of CEC activities carried out from October 2020 to June 2022 using the CEC internal database. Data were reported descriptively and compared with data from the literature to provide a complete overview of the CEC’s development and implementation process.

Participants and research context

The study has been conducted at the local health authority (LHA) of Reggio Emilia. It is a report of the activities provided by the CEC, where no HPs or patients were involved.

Ethical Considerations

The report is part of a larger study named EVAluating a Clinical Ethics Committee implementation process (EvaCEC), which has been approved by the Local Ethics Committee (AUSLRE Protocollo n° 2022/0026554 of 24/02/2022). EvaCEC is also the first author's PhD project.

Findings

In total, the CEC performed 7 ethics consultations (EC), published three policies related to particular ethical questions of clinical and organizational practice, provided one educational online course on ethics consultation targeting employed HPs, and promoted a specific dissemination process among the different departments of the LHA. According to our results, the CEC widely fulfilled the standard threefold set of clinical ethics support services tasks (namely, ethics consultation, ethics education, and policy development), but further investigations are needed to evaluate the CEC’s impact on clinical practice.

Conclusion

Our findings may increase knowledge regarding the composition, role, and tasks of a CEC in an Italian setting, informing future strategies and efforts to regulate these institutions officially.
Prescribers’ Compliance to Human Serum Albumin Usage Criteria and Its Implication on Cost Saving
Authors: Sukkha Sayamon , Sangroongruangsri Sermsiri , Malaphan Jaturon , Sodsee Pattira , Kongjaew Aumakorn , Sakdamnuson Waraporn , Ingsathit Atiporn , Bunupuradah Pakwan
Published: June 2023

Human serum albumin (HSA) is a commonly used product with high impact on healthcare expenditure. Little is known regarding the appropriateness of HSA use in healthcare system. This study aimed to assess prescriber’s compliance to the approved HSA criteria. Potential cost saving was also estimated. A cross-sectional study was performed in a tertiary care, university hospital in Bangkok in 2019. Prescriptions for HSA for all adult patients along with corresponding medical records were reviewed and assessed against the approved HSA criteria. Deviation from the criteria was used to estimate the potential cost saving. A total of 688 prescriptions were reviewed, 200 prescriptions met the inclusion criteria and were included in the analysis. Among six indications in the approved criteria for HSA, the rates of criteria compliance ranged from 48 to 90%. Hypoalbuminemia was found to be the main reason for inappropriate use. The estimated cost saving from inappropriate HSA use was €3,543 (€59 per prescription). Significant deviation from the approved criteria of HSA use was seen in a Thai hospital and significant cost saving can be made by increasing the compliance to the criteria. A practice improvement initiative to promote rational use of HSA is warranted.
Assessment of inter-observer agreement among experienced and inexperienced observers and an automated device for dipstick urinalysis in dogs and cats
Authors: Cervone Mario , Rossi Lydia , Cappelle Julien , Rannou Benoit , Hugonnard Marine
Published: June 2023

Standard visual urine dipstick analysis (UDA) is performed routinely in veterinary medicine; results can be influenced by both the operator and the method. We evaluated the agreement of results for canine and feline urine samples analyzed using a 10-patch dipstick (Multistix10SG; Siemens), both visually under double-anonymized conditions by students and a laboratory technician, and with an automated device (AD; Clinitek Status, Siemens). The mean concordance for semiquantitative urinalysis results between students and the technician and between students and the AD was fair (κ0.21–0.40) in dogs and cats; concordance was moderate between the technician and the AD (κ0.41–0.60) in dogs and good (κ0.61–0.80) in cats. For pH, the mean concordance between students and the technician and between the technician and the AD was good (ρ0.80–0.92) in dogs and cats; concordance was good between students and the AD (ρ0.80–0.92) in dogs and moderate (ρ0.59–0.79) in cats. Repeatability was higher ( p < 0.001) for the technician and the AD than for a student. We found good agreement between UDA performed by an experienced operator and an AD in dogs and cats but found low reproducibility and low repeatability for urinalysis performed by an inexperienced operator.
Parental Career Expectation Predicts Adolescent Career Development Through Career-Related Parenting Practice: Transactional Dynamics Across High School Years
Authors: Zhou Nan , Cao Hongjian , Wang Shaofan , Li Xiaomin , Liang Yue
Published: June 2023

The potential mediating role of career-related parenting practice in the association between parental career expectation and adolescents’ career development remains understudied, especially the likely transactional dynamics inherent within such links. This study utilized three-annual-wave data from 3196 Chinese adolescents across the high school years ( Mage = 15.55 years old, SD = .44; 52.8% girls at Wave 1) to address such gaps. Results of cross-lagged structural equational modeling analyses demonstrated reciprocal associations between parental career expectation and career adaptability consistently across three high school years; and career-related parental support served as a mediator in such associations, net of a series of covariates. However, no associations of career ambivalence with parental career expectation across the high school years emerged. Such findings highlighted the dynamic nature of the associations among parental career expectation, career-related parenting practice, and adolescents’ career developmental outcomes. Implications for future research and practice were discussed.
Evidence-Based Assessment of Substance Use Disorder
Authors: Boness Cassandra L. , Carlos Gonzalez Juan , Sleep Chelsea , Venner Kamilla L. , Witkiewitz Katie
Published: June 2023

The current review describes updated information on the evidence-based assessment of substance use disorder. We offer an overview of the state of the science for substance-related assessment targets, instruments (screening, diagnosis, outcome and treatment monitoring, and psychosocial functioning and wellbeing) and processes (relational and technical) as well as recommendations for each of these three components. We encourage assessors to reflect on their own biases, beliefs, and values, including how those relate to people that use substances, and to view the individual as a whole person. It is important to consider a person’s profile of symptoms and functioning inclusive of strengths, comorbidities, and social and cultural determinants. Collaborating with the patient to select the assessment target that best fits their goals and integration of assessment information in a holistic manner is critical. We conclude by providing recommendations for assessment targets, instruments, and processes as well as recommendations for comprehensive substance use disorder assessment, and describe future directions for research.
Infective complications in cancer patients treated with subcutaneous versus intravenous trastuzumab and rituximab: An individual patient data meta-analysis
Authors: Alexander Marliese , Jachno Kim , Phillips Kelly-Anne , Seymour John F , Slavin Monica A , Cheung Ada , Shen Vivian , Maarouf Dana , Wolfe Rory , Lingaratnam Senthil
Published: June 2023

Background

Investigation of infection risk with subcutaneous versus intravenous trastuzumab and rituximab administration in an individual patient data (IPD) and published data meta-analysis of randomised controlled trials (RCTs).

Methods

Databases were searched to September 2021. Primary outcomes were serious and high-grade infection. Relative-risk (RR) and 95% confidence intervals (95%CI) were calculated using random-effects models.

Results

IPD meta-analysis (6 RCTs, 2971 participants, 2320 infections) demonstrated higher infection incidence with subcutaneous versus intravenous administration, without reaching statistical significance (serious: 12.2% versus 9.3%, RR 1.28, 95%CI 0.93to1.77, P = 0.13; high-grade: 12.2% versus 9.9%, RR 1.32, 95%CI 0.98to1.77, P = 0.07). With exclusion of an outlying study in post-hoc analysis, increased risks were statistically significant (serious: 13.1% versus 8.4%, RR 1.53, 95%CI 1.14to2.06, P = 0.01; high-grade: 13.2% versus 9.3%, RR 1.56, 95%CI 1.16to2.11, P < 0.01). Published data meta-analysis (8 RCTs, 3745 participants, 648 infections) demonstrated higher incidence of serious (HR 1.31, 95%CI 1.02to1.68, P = 0.04) and high-grade (HR 1.52, 95%CI 1.17to1.98, P < 0.01) infection with subcutaneous versus intravenous administration.

Conclusions

Results suggest increased infection risk with subcutaneous versus intravenous administration, although IPD findings are sensitive to exclusion of one trial with inconsistent results and identified risk-of-bias. Ongoing trials may confirm findings. Clinical surveillance should be considered when switching to subcutaneous administration. PROSPERO registration CRD42020221866/CRD42020125376.
What’s wrong with creativity?
Authors: Schaefer Stephan M , Hallonsten Olof
Published: June 2023

In this essay we put forward a critique of the prevailing orthodoxy of creativity and innovation which are rarely fundamentally questioned neither in science nor in public discourse. We urge to reconsider contemporary purposes and consequences of what we call instrumental and humanist conceptions of creativity and innovation. Based on our critique we speak out to transcend reified notions of creativity and innovation by engaging in disciplined imagination of desirable alternative futures using the example of craft as a timeless form of work. Craft, we argue, prefigures a type of creativity and innovation that addresses the social and ecological challenges of contemporary economy and society and may thus serve as a source for inspiration to radically re-think current, ingrained notions of creativity and innovation.
The neoliberal perils of yoga and self-care on apps and platforms
Authors: Gidaris Constantine
Published: June 2023

This article situates the digital self-care industry within a neoliberal framework in which I critically analyze the effects of modern postural yoga through platforms and apps. In specific, I argue that the neoliberalization of digitally mediated self-care through Instagram, YouTube, Calm and Yoga-Go not only place the onus of health and wellbeing on individuals, they also endanger the physical health, mental health and digital privacy of their users. In turn, the consequences of economic and political systems that have created many of the social conditions that push people to seek ways in which they themselves can alleviate the pressures and stresses of everyday life continue to be ignored.
Stereotypes in media representations of boy bands and their fans
Authors: Coleman Renita , Lyons Annie
Published: June 2023

Boy bands have long been disparaged in music journalism, in part because of their association with teenage and prepubescent girls who are their primary fans. This study uses media stereotypes of musicians and their fans to see how the interplay of age and gender among these two constituencies is associated with negative stereotyping in music journalism. This study fills a gap in scholarship with a quantitative comparison of how modern boy bands and their fans are stereotypically portrayed compared to non-boy bands and their fanbases in a generalizable way. A content analysis of UK and U.S. music journalism from 2010 to 2015 finds that young women music fans continue to be stereotyped, and that boy bands are diminished through stereotypes that are gendered feminine, most prominently about their age and youth, authenticity of the music, and innocent sexuality. However, the boy bands were not diminished through feminine tropes more closely aligned with women fans, such as with the use of emotional language. Being young and male does not automatically mean marginalization and stereotyping, however – the young men in the non-boy bands were consistently referred to in non-stereotypical ways.
Visual analytics for monitoring credit scoring models
Authors: Baldo Daiane Rodrigues , Regio Murilo Santos , Manssour Isabel Harb
Published: June 2023

Financial institutions use credit Scoring models to predict the default of their customers and assist in decision-making about the granting of credit. As a large volume of credit transactions is generated daily alongside a potential increase in this information with the advent of Open Finance, it is challenging to monitor this information quickly so we can act in case these models lose performance. Considering this context, our research aims to provide a Visual Analytics approach to assist in monitoring credit models. For this, initially, we carried out a systematic review of the literature on the subject and conducted semi-structured interviews with 13 domain experts. Considering the needs raised with this study, we created a prototype called Visual Analytics for monitoring Credit Scoring models (VACS). The main contributions of this work are twofold: The requirements gathered through interviews with specialists, which allowed the analysis of how the models are monitored within financial institutions, something that is not disclosed and that can help in the standardization of the monitoring process; and VACS, which was evaluated by four domain experts who considered it a very complete and easy-to-use tool.
Stiffness identification of fixing device in CRTS II slab track based on long-term monitoring data
Authors: Wang Dedao , Li Shunlong , Lin Chao , Wang Senrong
Published: June 2023

The fixing device is an important component in the China Railway Track System (CRTS) II slab track, through which the longitudinal force of the track can be transferred to bridges and piers. The stiffness of the fixing device significantly affects the mechanical properties of the track. However, it is difficult to evaluate stiffness using conventional detection methods, because the fixing device is located under the base plate. In this study, the fixing-device stiffness of simply supported bridges was identified using long-term monitoring data and finite element (FE) analysis. First, a monitoring scheme was proposed based on the principle of track–bridge interaction. The strain in the base plate on both sides of the fixing device, as well as the temperature of the base plate and bridge, were obtained from 2015 to 2018. Then, the stiffness of the fixing device was proved to be closely related to the strain difference of the base plate on both sides of the fixing device, and the corresponding nonlinear mapping relationship was established through FE analysis. Finally, the fixing-device stiffness over 4 years was identified using long-term monitoring data and the established mapping function, and the influence of the stiffness degradation on the mechanical property of the track was discussed. This study can provide a reference for the design and maintenance of CRTS II slab tracks on multi-span simply supported bridges.
Multi-fault classification of rotor systems based on phase feature of axis trajectory in noisy environments
Authors: Hua Chunrong , Xiong Libo , Lv Lumei , Dong Dawei , Ouyang Huajiang
Published: June 2023

As it is difficult to distinguish multiple rotor faults with similar dynamic phenomena in noisy environments, a multi-fault classification method is proposed by combining the extracted trajectory phase feature, a parameter-optimized variational mode decomposition (VMD) method and a light gradient boosting machine (LightGBM) model. The trajectory phase feature is extracted from an axis trajectory by fusing the frequency, amplitude, and phase information related to rotor motion and can comprehensively describe the dynamic characteristics induced by different rotor faults. First, the vibration displacement signals in two orthogonal directions are collected to construct the axis trajectories with 12 rotor states including healthy, unbalance, misalignment, single crack, multiple cracks, and a mixture of them. Second, the trajectory phase feature is extracted from the vectorized axis trajectories, and the frequency spectra of trajectory phase angles under different rotor faults are analyzed through Fourier transform. Finally, a parameter-optimized VMD method combined with a LightGBM model is applied to classify multiple faults of rotor systems in different noisy environments based on the extracted trajectory phase feature. The 12 rotor states can be classified into nine categories based on the harmonic information of 1X–7X components (X is the rotating frequency of a rotor system) and other components with smaller amplitudes in the frequency spectra of trajectory phase angles. The average classification accuracy of the 12 rotor states exceeds 93.0%, and the recognition rate for each kind of fault is greater than 77.5% in noisy environments. The simulated and experimental results demonstrate the effectiveness and adaptability of the proposed multi-fault classification method. This work can provide a reference for the condition monitoring and fault diagnosis of rotor systems in engineering.
Globalisation and education equity: The impact of neoliberalism on universities’ mission
Authors: Sarpong Joshua , Adelekan Temitope
Published: June 2023

In his writing in the mid-nineteenth century – The Idea of a University, John Henry Newman argues that the university provides a platform for human advancement through teaching and research. Over a century later, our public university now hedged on several social, political, ecological and economic factors that bully its traditional mission daily. More recently, neoliberalism – a key feature of globalisation, knowledge economy, environmental crises and other economic logic – continues to significantly shift universities’ missions in another direction by creating winners and losers. Drawing on a range of theoretical perspectives, such as the glonacal agency heuristic, global economic and social forces, and empirical data, this paper examines the implications of these changes for equity in education, highlighting how global and national market-oriented policies, practices and outcomes continue to add to the stratification of higher education. Although the benefits of this global phenomenon are enormous, we maintain that the disbenefits are dire and could contribute to the narrowing of universities’ traditional missions, increased academic managerialism, the death of academic collegiality, and uneven development and unhealthy competition among universities locally and globally if not carefully considered. We admit that competition will continue to transform universities because the pressures of globalisation, as seen in recent times, increasingly influence higher education systems. However, since universities still operate mainly in their national context, we believe national educational policies can focus on reducing competition with other universities and promoting equity. To cement this way of thinking in universities both nationally and globally, we must understand the critical role of leadership as well as get it right.
LHPP Inhibits the Viability, Migration, and Proliferation of PDAC Cells and Significantly Affects the Expression of SDC1 and S100p
Authors: Xia Zhaozhi , Zhao Shuchao , Gao Xin , Sun Hongrui , Yang Faji , Zhu Huaqiang , Gao Hengjun , Lu Jun , Zhou Xu
Published: June 2023

Introduction

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy with a poor response to chemotherapy and an extremely poor prognosis. Recent studies have revealed that phospholysine phosphohistidine inorganic pyrophosphate phosphatase (LHPP) can inhibit the growth of various cancers. Therefore, the current study was conducted to investigate the antitumor effects of LHPP in PDAC and to explore its mechanism using proteomics analysis.

Methods and Results

Immunohistochemical analysis of clinical samples demonstrated that LHPP expression levels were lower in tumor tissues compared to adjacent nontumor tissues. Moreover, multivariate COX regression analysis showed that LHPP expression level was an independent prognostic factor for the patients with PDAC. Patients with high LHPP expression had a better prognosis. The lentiviral vectors for normal control (NC), LHPP knockdown (KD), and LHPP overexpression (OE) were infected with BxPC-3 and PANC-1 cell lines. Cell counting kit-8 assay, Transwell assay, and flow cytometry analyses showed that LHPP overexpression significantly inhibited the cell viability, migration, and proliferation of BxPC-3 and PANC-1 cells. Moreover, xenograft tumor model demonstrated that LHPP overexpression inhibited xenograft tumor growth in vivo. Subsequently, proteins with significantly altered expression in BxPC-3 cells after lentivirus infection were detected using proteomics analyses. Interestingly, compared to the NC group, the expression of Syndecan 1 (SDC1) was significantly upregulated in the KD group, while that of S100P was significantly downregulated in the OE group.

Conclusion

LHPP might emerge as an important target for delaying the advancement of PDAC, thereby providing a novel therapeutic approach for the treatment of PDAC.
Components of a Successful Classroom: A Factor Analysis for Initial Validation of a Measure Assessing Tier 1 Classroom Management
Authors: Maldonado Anniette F. , Fischer Aaron J. , Wright Hannah Michael , Jensen Rylee L. , Coombs Ashley N. , Mathis Sara N. , Lundy Keely , Funn Alyson , Hawken Leanne , Radley Keith , Perez Lauren
Published: June 2023

The literature has identified the use of data-based, problem-solving as an essential element in the promotion of positive behavior interventions and supports (PBIS) within the classroom. The Components of a Successful Classroom (CSC) tool is an instrument which has undergone initial validation to support its use for measuring critical features of Tier 1. This study provides initial support for the validation of this classroom management observation tool as part of a problem-solving consultation framework by examining the extent to which items on the CSC tool sample the constructs of interest in classroom management. Behavioral consultants utilized the tool to evaluate Tier 1 behavior management strategies implemented by teachers in the classroom. An exploratory factor analysis (EFA) was conducted to determine factor structure of the classroom management observation tool. Findings of the EFA supported a unidimensional construct best measured with three factors (i.e., preventive supports, feedback provision and engagement, and expectations and consequences). Currently, this tool may be useful to practitioners by guiding general education consultation after identifying main concerns in teacher’s implementation of Tier 1 supports and supporting implementation of PBIS practices in the classroom.
Extracellular to Intracellular Water Ratio Determined by Bioimpedance is Associated with Mortality in Patients Admitted for Diabetic Foot Ulcers
Authors: López-Valverde María Eugenia , Aragón-Sánchez Javier , Víquez-Molina Gerardo , Rodríguez Ortega Pilar
Published: June 2023

An increased extracellular water/intracellular water (ECW/ICW) ratio determined by bioimpedance has been related to mortality in patients undergoing hemodialysis. We aimed to evaluate the impact of body water distribution in patients with diabetes-related foot ulcers. Seventy-six patients were evaluated with bioimpedance, handgrip strength, and laboratory examinations. The ECW/ICW ratio is a prognostic factor for early mortality.
A review and journey in intrasaccular treatment of intracranial aneurysms
Authors: Islim Fathallah Ismail , Saleem Nayyar , Patankar Tufail
Published: June 2023

The invested effort and collaboration of clinicians and medical device companies to improve occlusion rates and clinical outcomes for patients with intracranial aneurysms treated via less invasive endovascular means led to the development of the concept of intrasaccular devices. Intrasaccular devices were introduced to offer simple treatment options, offering easier navigation through difficult anatomy, simpler and quicker deployment into large and wide-neck aneurysms. Additionally, they offer easier sizing, whilst offering a wide range of options suitable for aneurysms of different sizes. The concept of most intrasaccular devices is to occupy the aneurysm neck, however offering better stability than simple coiling, therefore increasing the chance of long-term aneurysm occlusion. This is achieved without a sizable metal content within the parent vessel, contrary to flow diverters, theoretically reducing the risk of thromboembolic events. This review aims to discuss the history and latest developments of intrasaccular intracranial devices, which offer an exciting and potentially successful option for treatment of complex intracranial aneurysms.
Elevating the Uses of Storytelling Methods Within Indigenous Health Research: A Critical, Participatory Scoping Review
Authors: Rieger Kendra L , Horton Mabel , Copenace Sherry , Bennett Marlyn , Buss Mandy , Chudyk Anna M , Cook Lillian , Hornan Bobbie , Horrill Tara , Linton Janice , McPherson Kim , Rattray Jennifer Moore , Murray Kealy , Phillips-Beck Wanda , Sinclair Rebecca , Slavutskiy Olga , Stewart Rebecca , Schultz Annette SH
Published: June 2023

There is a profoundly troubling history of research being done on Indigenous peoples without regard for their priorities and accompanying calls to decolonize health research. Storytelling methods can privilege Indigenous voices in research. Indigenous people’s knowledge systems have existed for millennium, where knowledge is produced and shared through stories. Our collaborative team of Indigenous and non-Indigenous researchers, and Indigenous Elders, patients, healthcare providers, and administrators, conducted a participatory, scoping review to examine how storytelling has been used as a method in Indigenous health research on Turtle Island (North America), Australia, and Aotearoa (New Zealand). We searched key databases and online sources for qualitative and mixed-methods studies that involved Indigenous participants and used storytelling as a method in health research. Reviewers screened abstracts/full texts to confirm eligibility. Narrative data were extracted and synthesized. An intensive collaboration was woven throughout and included gatherings incorporating Indigenous protocol, Elders’ teachings on storytelling, and sharing circles. We included 178 articles and found a diverse array of storytelling approaches and adaptations, along with exemplary practices and problematic omissions. Researchers honoured Indigenous ways of knowing, being, and doing through careful preparation and community engagement to do storywork, inclusion of Indigenous languages and protocols, and Indigenous initiation and governance. Storytelling centered Indigenous voices, was a culturally relevant and respectful method, involved a healing process, and reclaimed Indigenous stories. But it could result in several challenges when researchers did not meaningfully engage with Indigenous peoples. These findings can guide respectful storytelling research that bridges divergent Indigenous and Western knowledge systems, to decolonize health research.
Urinary incontinence in women 55 years and older: A scoping review to understand prevalence, incidence, and mortality of urinary incontinence during secondary care admission
Authors: McMillan Isobel , Hill Lyndsay , McCarthy Robyn , Haas-Eckersley Ruth , Russell Margaret , Wood Julie , Doxford-Hook Liz , Fu Yu , McGowan Linda , Iles-Smith Heather
Published: June 2023

Background:

Up to 40% of older women living in the community experience urinary incontinence. In community settings, urinary incontinence impacts the quality of life, morbidity, and mortality rates. However, little is known about urinary incontinence and its impact on older women admitted to hospitals.

Objectives:

This scoping review aims to establish the current knowledge of urinary incontinence during hospital admission for women (⩾ 55 years of age) with three key objectives: (a) What is the prevalence/incidence of urinary incontinence? (b) What health conditions are associated with urinary incontinence? (c) Is there an association between urinary incontinence and mortality?

Eligibility criteria:

Empirical studies were included in assessing the incidence/prevalence of urinary incontinence during hospital admissions and its related morbidities and mortality rates. Studies which only included men or younger women (< 55 years of age) were excluded. Only articles written in English and conducted between 2015 and 2021 were included.

Sources of evidence:

A search strategy was developed, and CINAHL, MEDLINE, and Cochrane databases were searched.

Charting methods:

Data from each article meeting the criteria were pulled into a table, including study design, study population, and setting, aims, methods, outcome measures, and significant findings. A second researcher then reviewed the populated data extraction table.

Results:

Overall, 383 papers were found: 7 met inclusion/exclusion criteria. Prevalence rates ranged from 22% to 80% depending on the study cohort. Several conditions were associated with urinary incontinence, including frailty, orthopaedics, stroke, palliative care, neurology, and cardiology. There was a potential positive association between mortality and urinary incontinence, although only two papers reviewed reported mortality.

Conclusion:

A dearth of literature determined the prevalence, incidence, and mortality rates for older women admitted to hospitals. Limited consensus on associated conditions was found. Further research is needed to fully explore urinary incontinence in older women during hospital admissions, particularly concerning prevalence/incidence and its association with mortality.
Identifying the characteristics, constraints, and enablers to creating value in applied performance analysis
Authors: Martin Denise , O’Donoghue Peter G. , Bradley Jonathan , Robertson Sam , McGrath Denise
Published: June 2023

While applied performance analysts (PAs) are a well-established applied sports science practitioner group, there is no clear definition of the purpose of an analyst, their key relationships, or the expertise required to execute the role successfully. This research sought to understand how PA practitioners and educators perceive their role as applied PA practitioners. Twenty-seven applied PAs and educators with applied PA experience participated in six online focus groups, completing an online survey in advance. Reflexive thematic analysis of transcripts and survey data generated an overarching theme: embedded applied PA practitioners have a value co-creation role within performance ecosystems which is inhibited by poor professional infrastructure and a lack conceptual clarity for the role. Five sub-themes are reported; the (a) why, (b) what, and (c) how of professional practice; d) the impact of stakeholder misunderstanding on PA practitioners; and (e) issues with professional recognition, development, and renumeration opportunities. This study demonstrates applied PAs’ role as curators, translators, influencers, and educators aiming to add value to the decision-making of a wide range of stakeholders. It highlights a potential deficit in applied practice in ‘value capture’ which may be perpetuating the problems practitioners reported with stakeholder misconceptions and undervaluing of their role. It is hoped this paper will inspire those invested in applied PA practice to create a shared understanding of how they can add value within the performance ecosystem so the profession can evolve and thrive.
A comparative study on the value of lower airway exhaled nitric oxide combined with small airway parameters for diagnosing cough-variant asthma
Authors: Bai Haodong , Shi Cuiqin , Yu Sue , Wen Siwan , Sha Bingxian , Xu Xianghuai , Yu Li
Published: June 2023

Background:

The diagnosis of cough-variant asthma (CVA) is based on bronchial provocation test, which is challenging to be conducted. Most CVA patients have type 2 airway inflammation and small airway dysfunction. FeNO200, reflecting small airway inflammation, may be used to diagnose CVA.

Objective:

This study aimed to explore and compare the value of lower airway exhaled nitric oxide (FeNO50, FeNO200, and CaNO) combined with small airway parameters for diagnosing CVA.

Methods:

Chronic cough patients who attended the clinic from September 2021 to August 2022 were enrolled and divided into CVA group ( n = 71) and non-CVA (NCVA) group ( n = 212). The diagnostic values of FeNO50, FeNO200, concentration of alveolar nitric oxide (CaNO), maximal mid-expiratory flow (MMEF), forced expiratory flow at 75% of forced vital capacity (FEF75%) and forced expiratory flow at 50% of forced vital capacity (FEF50%) for CVA were evaluated.

Results:

FeNO50 [39(39) ppb versus 17(12) parts per billion (ppb), p < 0.01], FeNO200 [17(14) ppb versus 8(5) ppb, p < 0.01] and CaNO [5.0(6.1) ppb versus 3.5(3.6) ppb, p < 0.01] in CVA group were significantly higher than those in NCVA group. The optimal cut-off values of FeNO50, FeNO200, and CaNO for diagnosis of CVA were 27.00 ppb [area under the curve (AUC) 0.88, sensitivity 78.87%, specificity 79.25%], 11.00 ppb (AUC 0.92, sensitivity 88.73%, specificity 81.60%) and 3.60 ppb (AUC 0.66, sensitivity 73.24%, specificity 52.36%), respectively. For diagnosing CVA, the value of FeNO200 was better than FeNO50 ( p = 0.04). The optimal cut-off values of MMEF, FEF75%, and FEF50% for the diagnosis of CVA were 63.80% (AUC 0.75, sensitivity 53.52%, specificity 86.32%), 77.9% (AUC 0.74, sensitivity 57.75%, specificity 83.49%) and 73.50% (AUC 0.75, sensitivity 60.56%, specificity 80.19%), respectively. The AUCs of FeNO50 combined with MMEF, FEF75%, and FEF50% for the diagnosis of CVA were all 0.89. The AUCs of FeNO200 combined with MMEF, FEF75%, and FEF50% for the diagnosis of CVA were all 0.93.

Conclusion:

FeNO200 > 11 ppb contributed strongly for differentiating CVA from chronic cough, especially in patients with small airway dysfunction.
How Mental Health Affects Injury Risk and Outcomes in Athletes
Authors: Rogers Davis L. , Tanaka Miho J. , Cosgarea Andrew J. , Ginsburg Richard D. , Dreher Geoffrey M.
Published: June 2023

Context:

The importance of mental health among athletes is becoming more recognized and valued. Athletes experience symptoms of depression, anxiety, and related mental health disorders at rates similar to those of the general population, but because athletes face unique cultural and environmental pressures, such disorders are exacerbated in the context of an injury. Furthermore, we review the less well-known evidence that mental health disorders in athletes are associated with an increased risk of injury. We discuss the increasing awareness of the deficiencies in mental health support for athletes, which has been especially highlighted during the COVID-19 pandemic as well as in prominent professional and Olympic athletes, and describe both internal and external barriers to appropriate care.

Evidence Acquisition:

We searched PubMed for pertinent peer-reviewed studies.

Study Design:

Clinical review.

Level of Evidence:

Level 5.

Results:

There is a known psychological response to injury that can prolong recovery from musculoskeletal injury; conversely, mental health disorders in athletes are not only associated with an increased injury risk but also portend poorer outcomes subsequently, including prolonged recovery times, increased rates of injury recurrence, decreased rates of return to sport, and reduced performance upon return. Because of inherent barriers to appropriate care of athletes, including identification, stigma, and resource availability, there are currently various ongoing efforts nationally to create and implement initiatives regarding athlete mental health screening, support systems, and directed interventions to address the inextricably linked physical and mental health of athletes.

Conclusion:

Athletic injury negatively impacts the mental health of athletes. Likewise, mental health can and does influence athletic performance and is also intimately tied to the risk of athletic injury, thus creating a complex cycle with inability to separate physical and mental health.
In-Game Workload Demands of Position Players in Major League Baseball
Authors: Freeston Jonathan , Soloff Lonnie , Schickendantz Mark , Genin Jason , Frangiamore Salvatore , Whiteley Rod
Published: June 2023

Background:

Athletes who are well prepared for the physical demands of competition are less susceptible to injury. Defining and then preparing athletes for these in-game demands is critical to athlete health and performance. The injury burden within Major League Baseball (MLB) is significant and differs by position. Despite its importance, the workload demands have not been described for position players in MLB.

Hypothesis:

That running demands would be significantly higher for outfielders, followed by infielders, and catchers, respectively, while batting and baserunning metrics would be similar across positions.

Study Design:

Cohort study.

Level of Evidence:

Level 3.

Methods:

Total and high-speed running distance (>75% Vmax), high-speed running count, hard accelerations (>2.78 m/s/s), defensive and baserunning minutes, total and hard throws (>75% max), and bat swing counts were calculated from Statcast data. Players with 100 games or more in the 2018 season ( n = 126) were included for analysis.

Results:

All offensive and baserunning metrics were similar across positions; however, significant positional differences were observed for defensive and overall workload metrics. High-speed running was highest among outfielders ( F1,7 = 27.1, P < 0.01), followed by infielders, then catchers. Hard accelerations ( F1,7 = 12.9, P < 0.01) were highest among first basemen, then outfielders, remaining infielders, and catchers. Total throws ( F1,7 = 17.7, P < 0.01) were highest among middle infielders. Hard throws ( P < 0.01) were highest among shortstops and third basemen.

Conclusion:

In-game workloads differ significantly by defensive position in MLB. These differences in running, throwing, and hitting volumes have significant implications for physical preparation and injury return-to-play progressions to optimize performance and minimize injury and reinjury risk for these athletes.

Clinical Relevance:

These data provide insight into how best to prepare athletes of different positions for the demands of the game both in terms of preseason preparation as well as return-to-play benchmarks following injury. These data should also serve as a platform for future research into the relationship between workload and injury among professional baseball players.
Subclavian steal syndrome in a right aortic arch with aberrant left subclavian artery atresia
Authors: Nakata Jonathan , Stahlfeld Kurt R , Simone Samuel T
Published: June 2023

Congenital aortic arch anomalies are an uncommon diagnosis resulting from embryologic malformations during the fourth to eighth week of gestation. Asymptomatic variants frequently are overlooked in the perinatal period and diagnosed incidentally during adulthood. Symptomatic variants can present with steal syndrome or dysphagia lusoria. The right aortic arch is a rare anomaly that is usually associated with other congenital anomalies but can occur in isolation. The most common types of right aortic arches are mirror image branching or an aberrant left subclavian artery. Aortic arch anomalies are important to recognize as they may have important implications in management. We present a 74-year-old female with a right aortic arch and aberrant left subclavian artery that was discovered after a fall. An extensive evaluation and work-up revealed symptoms consistent with subclavian steal syndrome that resolved following a carotid-axillary bypass. Subclavian steal secondary to a right aortic arch is extremely rare. This report reviews the current literature of a right aortic arch with an aberrant left subclavian artery presenting as a subclavian steal syndrome.
Prosthetic rehabilitation of a patient with hemimandibulectomy by a double occlusal table prosthesis
Authors: Adil Huda , Ahmed Naseer , Heboyan Artak
Published: June 2023

The objective of prosthetic rehabilitation of patients with hemimandibulectomy is to regain the masticatory function, comfort, esthetics, and self-esteem. This article presents a plan for the management of hemimandibulectomy with a removable maxillary double occlusal table prosthesis. A male patient, aged 43 years, was referred to Prosthodontic Out Patient Department with complaints of compromised aesthetics, difficulty in speaking, and lack of ability to chew. The patient underwent surgery 3 years ago in which hemimandibulectomy was performed due to oral squamous cell carcinoma. The patient had a Cantor and Curtis Type II defect. The mandible was resected distally from canine region on the right side of the arch. A prosthodontic device was planned with a double occlusal table, also known as twin occlusion prosthesis. The rehabilitation of hemimandibulectomy patients with a double occlusal table is of considerable importance. This report describes a simple prosthetic device that will help patients in regaining their functional and psychological well-being.
Chromium as a tool of logistical power: A material political economy of open-source
Authors: Zhang Bolun , Carpano Davide
Published: June 2023

Open-source software is used by almost all technology companies and has become an integral part of the technical infrastructure of digital capitalism. Generally, developers of open-source software have been viewed as a social movement at odds with the capitalist profit motive. This idealized view has been challenged as companies have made significant investments in open-source since the early 2000s. Current research frames corporate participation in open-source as fundamentally extractive in nature, failing to account for these sizable investments. Through a historical analysis of Google's Chromium browser project, we provide another way to understand corporate participation in open-source. This article takes a material political economic approach to argue that control of open-source projects can grant companies logistical power that enables them to influence standards and shape the Internet as an infrastructure for digital capitalism.
The Development of a Comprehensive Clinicopathologic Registry for Glomerular Diseases Using Natural Language Processing
Authors: Barr Bryce , Harasemiw Oksana , Gibson Ian W , Tremblay-Savard Olivier , Tangri Navdeep
Published: June 2023

Background:

Glomerulonephritis (GN) represents a common cause of chronic kidney disease, and treatment to slow or prevent progression of GN is associated with significant morbidity. Large patient registries have improved the understanding of risk stratification, treatment selection, and definitions of treatment response in GN, but can be resource-intensive, with incomplete patient capture.

Objective:

To describe the creation of a comprehensive clinicopathologic registry for all patients undergoing kidney biopsy in Manitoba, using natural language processing software for data extraction from pathology reports, as well as to describe cohort characteristics and outcomes.

Design:

Retrospective population-based cohort study.

Setting:

Tertiary care center in the province of Manitoba.

Patients:

All patients undergoing a kidney biopsy in the province of Manitoba from 2002 to 2019.

Measurements:

Descriptive statistics are presented for the most common glomerular diseases, along with outcomes of kidney failure and mortality for the individual diseases.

Methods:

Data from native kidney biopsy reports from January 2002 to December 2019 were extracted into a structured database using a natural language processing algorithm employing regular expressions. The pathology database was then linked with population-level clinical, laboratory, and medication data, creating a comprehensive clinicopathologic registry. Kaplan-Meier curves and Cox models were constructed to assess the relationship between type of GN and outcomes of kidney failure and mortality.

Results:

Of 2421 available biopsies, 2103 individuals were linked to administrative data, of which 1292 had a common glomerular disease. The incidence of yearly biopsies increased almost 3-fold over the study period. Among common glomerular diseases, immunoglobulin A (IgA) nephropathy was the most common (28.6%), whereas infection-related GN had the highest proportions of kidney failure (70.3%) and all-cause mortality (42.3%). Predictors of kidney failure included urine albumin-to-creatinine ratio at the time of biopsy (adjusted hazard ratio [HR] = 1.43, 95% confidence interval [CI] = 1.24-1.65), whereas predictors of mortality included age at the time of biopsy (adjusted HR = 1.05, 95% CI = 1.04-1.06) and infection-related GN (adjusted HR = 1.85, 95% CI = 1.14-2.99, compared with the reference category of IgA nephropathy).

Limitations:

Retrospective, single-center study with a relatively small number of biopsies.

Conclusions:

Creation of a comprehensive glomerular diseases registry is feasible and can be facilitated through the use of novel data extraction methods. This registry will facilitate further epidemiological research in GN.