bluuebunny/crossref_metadata_2025 huggingface dataset:
School collective efficacy and gambling: a multilevel study on 11th grade students in Stockholm
Authors: Olsson G , Brolin Låftman S , Modin B
Published: October 2021

Background

Earlier studies on risk factors of adolescent gambling and risk gambling have mainly focused on determinants at the individual or the family level. Yet, it is likely that also other social contexts in young people's lives affect their inclination to engage in gambling and in risk gambling. One such context is the school. The aim of the present study was to investigate the extent of between-school variation in gambling and in risk gambling, and to analyse the links between school collective efficacy and student gambling and risk gambling.

Methods

Data were derived from the Stockholm School Survey (SSS) and the Stockholm Teacher Survey (STS), conducted in 2016 among 5191 students and 1061 teachers in 46 upper secondary schools. School collective efficacy i.e. schools degree of social cohesion and informal control was assessed by teachers' responses to four items in the STS, which were added to an index and aggregated to the school level. Gambling and risk gambling were assessed by students' self-reports to four items in the SSS. Official register information on schools was also added to the data. Two-level binary logistic regression analyses were performed.

Results

Results show statistically significant between-school variation in both gambling (ICC=8.3%) and in risk gambling (ICC=18.1%). Compared with students attending schools with weak collective efficacy, those attending schools with strong collective efficacy were less likely to report both gambling (OR 0.58, 95% CI 9,40-0.82) and risk gambling (OR 0.40, 95% CI 0.22-0.71), even when adjusting for student- and school-level sociodemographic characteristics.

Conclusions

Students' inclination to engage in gambling and in risk gambling varies across schools. The findings suggest that a high level of school collective efficacy may contribute to counteract students' engagement in gambling and risk gambling.

Key messages

Students’ inclination to engage in gambling and in risk gambling varies across schools. The findings indicate that a strong school collective efficacy may contribute to reducing students’ inclination to engage in health risk behaviours.
A case-control study on physical activity of teenagers with adolescent idiopathic scoliosis
Authors: Marinov D , Valtcheva E
Published: October 2021

Background

Adolescent idiopathic scoliosis affects 2-3% of all teenagers. It is one of the most common chronic conditions in this age group, but studies on the physical activity (PA) of AIS patients are scarce. The available trials report conflicting findings when comparing the PA of children with AIS to healthy controls. Considering its possible role in the development of AIS and the potential benefits of PA, the topic should be further researched. This study aims to investigate the subject by comparing the physical activity of children with AIS to a group of healthy peers.

Methods

The study included 80 teenagers (aged 11-18 years) with AIS and 65 healthy age and gender-matched controls from Varna, Bulgaria. Data was collected after receiving informed consent from the parents. Children with chronic conditions (except AIS) were excluded. Information on AIS was taken from the available medical documentation. Data on PA during the last 7 days was collected via a standardized physical activity questionnaire for adolescents (PAQ-A). PAQ-A results vary from 1 (lowest PA) to 5 (highest PA). PAQ-A=2.75 has been found to correspond to the minimum recommended by WHO for this age group - 60mins of daily moderate to vigorous PA.

Results

None of the participants with AIS reported reduced PA due to impaired or restricted physical functions. The majority of children (78.8%) had mild scoliotic curvatures (Cobb angle 10°-20°). The mean PAQ-A score in AIS cases was 2.59 compared to 2.88 in controls. There was a statistically significant difference in PAQ-A score between the two groups (t = 2.722, p < 0.001). 59% of AIS had a PAQ-A score under 2.75, indicating that they do not meet the minimum PA recommendation by WHO, compared to 31% of the control group.

Conclusions

Patients with AIS have significantly lower PA than their healthy peers. The majority of children with AIS do not meet the minimum PA recommendations by the WHO.

Key messages

Our study reveals that children with AIS and mild curvatures have lower PA than their healthy peers despite not reporting impaired or restricted physical functions. Future prospective studies should investigate whether PA plays a role in the etiology of AIS.
Birth integrity through the lens of medicalization, risk, embodiment and intersectionality
Authors: Batram-Zantvoort S , Razum O , Miani C
Published: October 2021

Background

Women globally report suboptimal conditions during facility-based childbirth. Most approaches that capture abuse, violence or mistreatment in epidemiology do not reflect a theoretical perspective in their measurement. In order to contribute to a more valid consideration of the cultural drivers, institutional conditions, direct expressions and individual perceptions that violate or preserve what we define as “birth integrity”, we developed a new theory-informed approach and an accompanying multilevel framework.

Methods

We theoretically substantiated birth integrity, referring to medical anthropology, sociology, social epidemiology and a critical-feminist theory, in particular: risk and medicalization of childbirth, social embodiment and intersectionality. We then contextualized birth integrity within a multilevel framework to operationalize its potential for epidemiological research.

Results

We present a six-field theoretical framework to operationalise and measure birth integrity violations, from institutional discrimination, to gender norms structuring labour room interactions and restrictions on autonomy. It allows to measure birth integrity violations that women experience at the macro-to-micro level as implicit, invisible and normalized, or explicit, visible and societally accepted.

Conclusions

Our new multilevel framework, based on a theory-informed construct of birth integrity, allows to measure drivers of health inequality and gender-based violence in more dimensions than so far represented in epidemiological research.

Key messages

The birth integrity concept integrates theories of medicalization, risk, embodiment and intersectionality into a multilevel framework. Our birth integrity framework is useful in epidemiological approaches to explicitly acknowledge and integrate cultural drivers of gender-based violence and inequalities in maternity care research.
Experiences and views on SHS exposure prevention in Middle Eastern countries: a systematic review
Authors: Hassanein Z , Langley T , Bogdanovica I , Murray R , Leonardi-Bee J
Published: October 2021

Background

More than 50% of non-smoking women and children are exposed to second-hand smoke (SHS) in Middle Eastern countries. This review aims to synthesize the evidence on experiences and views of parents, children, and professionals towards SHS exposure prevention in Middle Eastern countries.

Methods

We included qualitative studies exploring experiences and views on prevention of SHS exposure among women and children in all settings in Middle Eastern countries. A systematic review was undertaken according to the Joanna Briggs Institute (JBI) guidelines for qualitative systematic reviews. Nine databases were searched from inception to January 2021. Meta-aggregation was used to synthesize the findings.

Results

Out of 5229 records identified, two qualitative studies reported in three publications met the eligibility criteria and were included. Using the JBI checklist for qualitative research, the critical appraisal scores of all papers were high. One study was conducted in Turkey and the other one in Israel, and study participants were parents of children. A total of 49 findings were extracted and aggregated into 8 categories, based on the similarity of meaning. Parents were aware that SHS is harmful, although the hazards of SHS exposure were not commonly discussed during pregnancy. However, there were conflicting views on ways of SHS exposure and approaches to minimise it. Parents implemented rules to decrease SHS exposure among children. While some parents were uncertain about the effectiveness of protective measures. Most common perceived barriers to reducing SHS exposure were beliefs about traditional values and personal psychological factors.

Conclusions

Parents in Middle Eastern countries knew that children's SHS exposure is harmful, though knowledge was not comprehensive and did not translate into actions to protect children. Health education program is essential to improve parental knowledge on hazards of SHS and effective preventive measures.

Key messages

Parents’ risk-awareness of SHS exposure is inadequate. Health education program is essential to improve parental knowledge on hazards of SHS and effective preventive measures in Middle Eastern countries.
A systematic review of mother-daughter interventions targeting physical activity
Authors: Brennan C , O' Donoghue G , Hall A , Keogh A , Matthews J
Published: October 2021

Background

Growing gender disparities in levels of physical inactivity put women and female youths at a greater risk of associated health problems. Mother-daughter interventions have been proposed as means to promote physical activity in this at-risk cohort. However, there is a lack of clarity as to if and why these types of interventions might be effective.

Methods

This systematic review examined the intervention characteristics, and behaviour change theory and techniques used in these interventions to promote physical activity for daughters and their mothers. PubMed, EMBASE, PsycINFO, CINAHL and Cochrane Library (Wiley) databases were searched for English language studies from inception to 13th May 2020. Interventions of any design that targeted daughters and mothers' physical activity were included in the review. Data was extracted using the Template for Intervention Description and Replication checklist, and the Behaviour Change Technique Taxonomy v1.

Results

4962 articles were screened and 11 unique studies met the inclusion criteria. Risk of bias was generally high. Narrative summary highlighted that many studies used social cognitive theory as a theoretical foundation, were based in the community and less than three months in duration with multiple sessions per week. Thirty-seven behaviour change techniques were identified across studies. Some techniques were deemed potentially effective including credible source, information on the health consequences of the behaviour and the self-regulatory related techniques of goal-setting, self-monitoring and problem-solving.

Conclusions

Future research should consider using checklists, frameworks and formative work with mothers and daughters to ensure interventions are rigorously designed, implemented, and evaluated, which can inform public policy to combat physical inactivity in this at-risk cohort.

Key messages

This is the first review to assess the intervention characteristics, and behaviour change theory and techniques of mother-daughter interventions targeting physical activity. This review advances the evidence base for future intervention development and more broadly can inform public policy to tackle physical inactivity in this at-risk cohort.
Learning lessons from the community response to COVID-19 in Wales
Authors: Grey CNB , Homolova L , Davies AR
Published: October 2021

Background

During the pandemic, community action sprang up in response to the health and social consequences of the virus. Communities were driven to support each other and those perceived as vulnerable. Community support and social capital are key for strengthening resilience, and an important contributor to population health. The aim was to explore what factors enabled community-led action in response to need amongst the most deprived areas in Wales during COVID-19.

Methods

Mixed-methods approach, with a strong focus on qualitative research with a systems-lens. Quantitative data was collected through a survey of 2500 adults >18 years; living, working or volunteering in Wales engaged in community action, and analysed descriptively. Outcomes were motivation, benefits, current and past activities, barriers, socio-economic characteristics [age, education, employment, postcode], digital volunteerism, resilience [RRC-ARM 12], and health and wellbeing [WEMWBS-14]. Qualitative data was collected in two communities in South Wales from 46 semi-structured interviews with recipients, volunteers, and strategic leads and analysed thematically. This explored determinants and experience of community-led action, levers and drivers, and integration with the wider system.

Results

Results are preliminary. They include individual-level factors underlying volunteerism and pro-social behaviour across different categories of volunteer (unstructured, informal, formal) and across national area-level deprivation indicators (WIMD), and perspectives across the system on community-led response and its role in community empowerment in supporting the vulnerable within communities.

Conclusions

Improved understanding of the role of community-led action as a protective factor against widening health inequalities during, and in recovery from COVID-19, was brought together to develop and coproduce a framework to empower community-led action and support sustainable integration with existing services.

Key messages

Understanding how community-led action sustained and be better supported and integrated into the health, third sector and social support system is important for building resilient communities. Understanding community-led action during COVID-19 will inform how this can best supported to help protect against the longer-term differences in the health, social and economic impact.
Internalized weight bias in the relationship between mental health and obesity in UK adolescents
Authors: Creese H , Saxena S , Nicholls D , Pascual-Sanchez A , Hargreaves D
Published: October 2021

Background

It is crucial to promote mental and physical health during adolescence to protect against lifetime risks of mental health problems and obesity. Internalized weight bias (self-directed stigmatizing attitudes about perceived weight status) and bullying are implicated as potential mechanisms in the relationship between mental health and obesity in adolescence. We examined internalized weight bias and bullying as potential mediators of the relationship between mental health and weight status across adolescence in the United Kingdom (UK).

Methods

We analysed data on 8,688 adolescents from the UK Millennium Cohort Study. Weight status was defined using sex and age specific International Obesity Taskforce cut points for body-mass index (not overweight/obese; overweight; obese) at 11 and 17 years. Mental health was defined using parental reported emotional (anxiety and depression), and externalizing (aggression and impulsivity) symptoms at 11 and 17 years (low; moderate; high). Self-reported measures of internalized weight bias captured via body-dissatisfaction and self-esteem and bullying at 14 years were tested as mediators. We used Generalized Structural Equation Models to examine longitudinal pathways between weight status and mental health across 11 and 17 years, whilst accounting for concurrent associations and potential confounders.

Results

Adolescents with high emotional (relative risk (RR) 1.98, 95% CI 1.28 to 3.07) or externalizing symptoms (RR 2.07, 95% CI 1.23 to 3.48) at 11 years were twice as likely to be obese at 17 years compared with those who had low symptoms. The impact of emotional and externalizing symptoms on weight status was found to be partially attributable to internalized weight bias, but not bullying, with significant mediation for body-dissatisfaction and low self-esteem.

Conclusions

Internalized weight bias partially explains the relationship between mental health and weight status across adolescence.

Key messages

There is a need for a holistic, early prevention strategy to focus on reducing weight stigma to encourage healthy mental and physical development of children. The relationship between mental health and weight status across adolescence is partly attributable to internalized weight bias.
Patients’ attitudes to and experience of the use of technology in mental health in Ireland
Authors: Finucane J
Published: October 2021

Mental health issues represent a significant proportion visits to GPs. It is estimated that 90% of mental health issues in Ireland are addressed in general practice, with an international trend towards making mental health services available in primary care. However, at present the mental health services, both locally in Ireland and internationally, are unable to meet the growing needs of those suffering mental ill health. Healthcare services internationally have examined novel and innovative ways of bridging with gap between patient needs and the available mental health services including e-mental health - “the use of information and communication technology to support and improve mental health”. The aim of this research was to explore patients' attitudes towards and experience of the use of technology and online resources with regard to mental health. Data was gathered by means of a patient survey. 8 point questionnaires were distributed and completed anonymously by 61 patients at the Carlton Clinic in Bray, Co. Wicklow. The objectives of the questionnaire were to ascertain patients' levels of awareness of the technology based resources available; whether they were using them; what patients' experience of using this technology was. The research showed low levels of awareness and usage with 39% of respondents aware of technology based resources and only 11% having ever used them. 15% of respondents reported that a GP had recommended digital resources to them. 72% of those surveyed reported they would find it useful if a GP recommended digital resources to them with regard to mental health issues.

Conclusions

Awareness and usage of digital resources in primary care population is low. However, the majority of patients were positive towards the option of digital resources and are willing to discuss them in mental health consultations.

Key messages

Readinzess of patients to embrace technology as means of delivering care and treatment for mental health problems in primary care in Ireland. Need for improved awareness of e-health options.
Mental health burden and self-efficacy among undergraduate students in the health sciences
Authors: Papadakaki M , Lioliou S , Kounali V , Liangou A , Chliaoutakis J
Published: October 2021

Perceived professional competence and self-efficacy are complex terms, which have been widely identified in concurrent literature as predictive criteria of future development and settlement of higher education students. The current study aimed at exploring factors affecting perceived professional competence and self-efficacy of Social Work and Nursing students of the Hellenic Mediterranean University. The study employed a sample of 313 students (171 Social Work, 142 Nursing). The questionnaire explored participants' sociodemographic and academic factors, perceived professional competence and self-efficacy (Nursing Competency Self Efficacy (NCSE) Scale for Outgoing Nursing Students), mental health symptoms during the past month (Symptom Checklist List, SCL 90-R) and life stressors during the past year (Life Stress Inventory, LSI). A total of 67.3% of the participants reported life stressors during the past year, with 17.6% reporting the highest burden. All the mental health scales of SCL-90 were found to have a negative linear relationship with perceived professional competence and self-efficacy but no relationship was detected with regard to life stressors. Participants' age, working status, subject and year of studies, as well as prior knowledge and high preference of the study subject, were shown to be significantly related with perceived professional competence and self-efficacy. The study has several implications for the educational and the health policy.

Key messages

Mental illness is a major public health concern with significant impact on students’ academic achievement. University-based mental health services could reach students in need and facilitate early intervention.
Why Talk Tough? Explaining Japanese Prime Ministers’ Proactiveness in National Defense Rhetoric
Authors: Liu Christine
Published: October 2021

What explains variations in the proactiveness of Japanese Prime Ministers (PMs) toward national defense? Although the Japanese Constitution renounces the use of force, leaders sometimes speak assertively over national security. Drawing on competing international relations and Japanese foreign policy theories, this study seeks to quantitatively model and analyze predictors of political rhetoric in PMs’ speeches and statements from 2009 to 2019. Each statement is coded into four sets of binary dependent variables through content analysis and tested against five competing hypotheses. The main finding reveals that leaders become more likely to advocate for specifically assertive national security policy when Chinese vessel intrusion increases, but not when North Korea missile tests and aircraft scrambles increase. Instead of a diversionary use of words, an emboldening effect is evident in rhetoric that evokes responsibility in international defense, moderated by ruling government strength. The findings advance academic understandings of Japanese national security policy messaging and highlight the effect of external threat perception on political rhetoric.
Glia maturation factor-γ is involved in S1P-induced marginal zone B-cell chemotaxis and optimal IgM production to type II T-independent antigen
Authors: Li Yingqian , Tang Yue , Liu Jun , Meng Xin , Wang Ying , Min Qing , Hong Rongjian , Tsubata Takeshi , Hase Koji , Wang Ji-Yang
Published: October 2021

Marginal zone B cells (MZBs) represent a unique B-cell sub-population that rapidly differentiate into IgM-secreting plasma cells in response to T-independent (T-I) antigen. Sphingosine 1-phosphate (S1P) promotes MZB localization to the marginal zone. However, intracellular molecules involved in MZB localization and migration remain largely unknown. Here, we show that MZBs lacking the glia maturation factor-γ (GMFG) are impaired in chemotaxis toward S1P under both in vitro and in vivo conditions, suggesting that GMFG is an effector downstream of S1P receptors. GMFG undergoes serine phosphorylation upon S1P stimulation and is required for S1P-induced desensitization of S1P receptor 1 (S1PR1). Compared with wild-type mice, Gmfg−/− mice produce elevated levels of 4-hydroxy-3-nitrophenyl-acetyl (NP)-specific IgM against a T-I type II antigen, NP–Ficoll, accompanied by dysregulated MZB localization. These results identify GMFG as a regulator of S1P-induced MZB chemotaxis and reveal a role for MZB localization in the marginal zone for optimal IgM production against a T-I antigen.
A novel conceptual approach to lean: value, psychological conditions for engagement with work and perceived organizational support in hospital care
Authors: Al-hakim Latif , Sevdalis Nick
Published: October 2021

Background

Lean thinking (LT) has emerged as a promising approach for reducing waste and improving efficiency. However, its applicability to and effectiveness within healthcare, particularly within hospital-based care, remains clouded by uncertainty. This paper attempts to answer the question ‘how lean thinking can best be applied to hospital-based care’.

Methods

Narrative review and conceptual synthesis

Results

We first review the principles of LT and how some of them are challenging to apply within hospital-based care. We then highlight that lean is an approach that was always meant as a combination of technical expertise and a focus on people—supported by a suite of human resource management supportive practices. We proceed to introduce evidence stemming from the literature studies on perceived organizational support and the psychological conditions for successful staff engagement with their work (namely, psychological meaningfulness, availability and safety as experienced by staff) and review how they may apply to hospital-based health workers. We finally advance a set of hypotheses regarding how different facets of value in a hospital care pathway may be correlated and these relationships mediated/moderated by perceived organizational support and the psychological conditions for engagement with work.

Conclusion

We conclude with a discussion of the limitations of our work and the aspiration that the conceptual analysis we have offered is a useful and actionable framework for hospital management to explore how best to support their staff—in a manner that ultimately achieves better quality and patient experience of care.
A 1% TBSA Chart Reduces Math Errors While Retaining Acceptable First-Estimate Accuracy
Authors: Ray William C , Rajab Adrian , Alexander Hope , Chmil Brianna , Rumpf Robert Wolfgang , Thakkar Rajan , Viswanathan Madhubalan , Fabia Renata
Published: October 2021

Life-threatening and treatment-altering errors occur in estimates of the percentage of total body surface area burned (%TBSA burned) with unacceptable frequency. In response, numerous attempts have been made to improve the charts commonly used for %TBSA-burned estimation. Recent research shows that the largest errors in %TBSA-burned estimates probably come from sources other than inaccurate values in the charts. Here, we develop a taxonomy of the possible sources of error and their impact on %TBSA-burned estimates. Also, we observe that different caregivers have different estimation needs: First-responders require a rapid estimate with sufficient accuracy to enable them to begin care and determine patient transport options, while burn surgeons ordering skin grafts desire accuracy to the square centimeter, and can afford considerable time to attain that accuracy. These competing needs suggest that a one-tool-fits-all-caregivers approach is suboptimal. We therefore present a validated, simplified burn chart that minimizes one of the largest sources of random errors in %TBSA-burned estimates—simple calculation errors—while also being quick and requiring little training. NCHart-1 also enables simple consensus estimates, as well as separation of estimation subtasks across caregivers, leading to several potential improvements in mass casualty situations. Our results demonstrate that NCHart-1 possesses the accuracy necessary for first responders, while reliably producing results in less than 2 minutes. Of 76 healthcare professionals surveyed, a large majority indicated a preference for NCHart-1 over their previous methods for ease of both use and training. For clinical or commercial use of NCHart-1, please contact: tech.commercialization@nationwidechildrens.org
US Supreme Court finds authority held by administrative patent judges to be unconstitutional and mandates procedural cure to give USPTO Director more control
Authors: Macedo Charles R , Goldberg David P , Sturm Chandler
Published: October 2021

United States v Arthrex, Inc., Nos. 19-1434, 19-1452, 19-1458, 594 US ____, slip opinion, United States Supreme Court, 21 June 2021 (Arthrex III)

Arthrex, Inc. v Smith & Nephew, Inc., 941 F3d 1320 (Federal Circuit 2019) (‘Arthrex I’), rehearing and rehearing en banc denied, 953 F3d 760 (Federal Circuit 2020) (‘Arthrex II’), petition for certiorari filed

On 21 June 2021, the United States Supreme Court issued a decision in United States v. Arthrex, Inc. finding that the authority of administrative patent judges (APJs) of the Patent Trial and Appeal Board to issue Final Written Decisions without review by a superior is inconsistent with their appointment as inferior officers under the Appointments Clause of the US Constitution. The Supreme Court sought to cure this constitutional violation by giving the Director of the United States Patent and Trademark Office more control over the rulings of APJs.
Assessing Repeated Oxalic Acid Vaporization in Honey Bee (Hymenoptera: Apidae) Colonies for Control of the Ectoparasitic Mite Varroa destructor
Authors: Berry Jennifer A , Bartlett Lewis J , Bruckner Selina , Baker Christian , Braman S Kris , Delaplane Keith S , Williams Geoffrey R
Published: October 2021

The American beekeeping industry continually experiences colony mortality with annual losses as high as 43%. A leading cause of this is the exotic, ectoparasitic mite, Varroa destructor Anderson & Trueman (Mesostigmata: Varroidae). Integrated Pest Management (IPM) options are used to keep mite populations from reaching lethal levels, however, due to resistance and/or the lack of suitable treatment options, novel controls for reducing mites are warranted. Oxalic acid for controlling V. destructor has become a popular treatment regimen among commercial and backyard beekeepers. Applying vaporized oxalic acid inside a honey bee hive is a legal application method in the U.S., and results in the death of exposed mites. However, if mites are in the reproductive stage and therefore under the protective wax capping, oxalic acid is ineffective. One popular method of applying oxalic is vaporizing multiple times over several weeks to try and circumvent the problem of mites hiding in brood cells. By comparing against control colonies, we tested oxalic acid vaporization in colonies treated with seven applications separated by 5 d (35 d total). We tested in apiaries in Georgia and Alabama during 2019 and 2020, totaling 99 colonies. We found that adult honey bees Linnaeus (Hymenoptera: Apidae), and developing brood experienced no adverse impacts from the oxalic vaporization regime. However, we did not find evidence that frequent periodic application of oxalic during brood-rearing periods is capable of bringing V. destructor populations below treatment thresholds.
A novel Lynch syndrome pedigree bearing germ-line MSH2 missense mutation c.1808A>T (Asp603Val)
Authors: Sekine Risako , Shimazu Kazuhiro , Nakano Daisuke , Yamaguchi Tatsuro , Suzuki Yusato , Fukuda Koji , Yoshida Taichi , Taguchi Daiki , Iijima Katsunori , Nanjyo Hiroshi , Shibata Hiroyuki
Published: October 2021

We report the first pedigree of Lynch syndrome bearing a germ-line MSH2 missense mutation c.1808A>T (Asp603Val). Until now, this missense mutation, in exon 12 of MSH2, was identified as a variant of unknown significance in the International Society for Gastrointestinal Hereditary Tumours database. In vitro induction mutagenesis experiments indicated that the MSH2 mutant protein (Asp603Val) is easily degraded in embryonic stem cells, albeit there is no clinical information concerning this mutant. Our pedigree includes four patients with Lynch syndrome-associated malignancies and clinically matches the Amsterdam II criteria. The proband, a female, first had an endometrial cancer at the age of 49 and then mantle cell lymphoma, colonic and gastric adenocarcinomas and neuroendocrine carcinoma, successively. Her mother also had Lynch syndrome-associated malignancies, including colonic, uterine and gastric cancers, and her elder son had rectal cancer. In the germline of the proband and her son, an MSH2 missense mutation c.1808A>T was discovered. Immunohistochemical analyses indicated that the expression of the MSH2 protein was decreased in the tumors, such as gastric cancer and neuroendocrine carcinoma, due to the missense mutation c.1808A>T. This study showed that the MSH2 missense mutation c.1808A>T (Asp603Val) is a likely pathogenic mutation and is responsible for typical Lynch syndrome-associated malignancies, including neuroendocrine carcinoma.
Study protocol for a national retrospective review of femoral periprosthetic fracture management. Is there variation in practice?
Authors: Nasser Ahmed A H , Chauhan Govind , Osman Khabab , Nandra Saroop , Nandra Rajpal , Mahmood Ansar
Published: October 2021

Introduction

The incidence of femoral periprosthetic fractures (PPFs) in the UK is on the rise. This rising incidence presents a clinical and an economic burden on the national health care services. There is also uncertainty about the most effective treatment modality for femoral PPFs, as well as a lack of evidence for a standardized management approach. We aimed to identify the true incidence and any variation in the management of femoral PPFs nationally.

Methods and analysis

This multicentre national collaborative study has been designed by a trainee led research network in collaboration with a well-established university research organization. Data will be collected from participating centres over a period of 10 years (2010–2019). All adults presenting with a femoral PPF will be identified, and the mode of treatment for each fracture subtype will be recorded. Other measures will evaluate patient and treatment variables, objective and subjective outcome measures. Univariate and multivariate regression analyses will be used, as well as the coefficient of determination (R) in an attempt to measure the degree to which the models could explain the variation in management.

Ethics and dissemination

This multicentre national project was approved by the local clinical governance department at each participating hospital site. The results of this study will be submitted to international peer reviewed journals and appropriate national and international conferences.
Prevalence of iliopsoas bursitis in patients with end-stage hip osteoarthritis
Authors: Dan Junpei , Okanoue Yusuke , Kitaoka Kenichi , Ikeuchi Masahiko
Published: October 2021

Objectives

Iliopsoas bursitis (IB) is a relatively rare condition that is associated with hip diseases. It can cause neurological symptoms and swelling of the lower extremities by compressing the femoral nerve and vessels. The aim of this study is to examine the prevalence of IB in patients with end-stage hip osteoarthritis.

Methods

A total of 544 patients underwent total hip arthroplasty between May 2010 and May 2019. All patients were examined using computed tomography (CT) to perform preoperative planning. We reviewed the CT images and examined the prevalence and size of IB. These lesions were divided into three types based on their shape (round type, oval type, and heart-shaped type).

Results

Of the 544 patients, IB was found in 37 patients. We observed the round type in 4 patients, the oval type in 31 patients, and the heart-shaped type in 2 patients. Two patients showed severe swelling in the legs and had a blood circulatory disorder of the legs. Both cases were heart-shaped bursitis.

Conclusion

Symptomatic IB was observed in two cases, both of which had a heart shape surrounding the iliopsoas tendon and femoral neurovascular bundle. Although symptomatic IB is a rare condition, special attention is required for heart-shaped IB.
Survival Outcomes following LINAC based Stereotactic Radiosurgery/Stereotactic Radiotherapy (SRST) treatment of brain metastases: The Wessex Experience
Authors: Noble Mark , Ching Jeng , Clarke Enrico
Published: October 2021

Aims

Since 2016, the University Hospital Southampton NHS Foundation Trust (UHSFT) has been commissioned by NHS England to deliver SRST to brain metastases. At UHSFT, all referrals are discussed at the Wessex Neurosciences multidisciplinary team meeting. Referrals that satisfy the criteria set by NHS England (estimated prognosis greater than 6 months, absence or controlled extracranial disease or potentially controllable extracranial disease with a Karnofsky Performance Status >70%) will be offered SRST. This retrospective study was performed to assess overall survival rates of patients with brain metastases treated with SRST with further tumour subtype analysis. We also benchmarked our results with other SRST centres.

Method

Retrospective data collection was performed for all the patients who have been treated with SRST. Patients who received SRST to a single metastasis, multiple metastases and/or to the resection cavity between 01/01/2017 to 30/09/2019 were included in this study. All treatment was delivered using a LINAC based SRST platform. Prescription doses ranged from 13.5 Gy to 21 Gy in a single fraction, 21 to 24 Gy in 3 fractions and 25 Gy in 5 fractions. Patients are treated using a stereotactic thermoplastic immobilisation shell and dynamic conformal arc therapy with ExacTrac TM and Cone Beam CT imaging. Dates of death were obtained from the NHS Digital Spine and survival analysis using median overall survival was performed using the Kaplan Meier Method.

Results

277 patients were treated between 01/01/17 and 30/9/2019. The median overall survival from the Kaplan Meier Method was shown to be 14.7 months and the 6-month overall survival was 71% for all patients.

Sub-group analysis of individual tumour sites showed: lung (n=110) median OS 12.1 months, melanoma (n=58) median OS 26.4 months, breast (n=46) median OS not reached (67% still alive) but 18 months survival was 70%, renal (n=22) median OS 15.4 months and colorectal (n=19) median OS 6 months. “Other” tumour sites (n=22) included patients with ovarian, neuroendocrine, sarcoma, testis, oesophagus, unknown primary and gallbladder which were grouped together due to small patient numbers. 41% of patients treated were alive at the time of analysis.

Conclusion

Patients with brain metastases treated with SRST at UHFST have similar outcomes compared to other SRST centres. These patients have a median overall survival of 14.7 months. However, 29% of patients analysed did not survive more than 6 months. Further collection and analysis of the data might improve patient selection and their outcomes.
Development of ‘Core Outcome Sets’ for meningioma in clinical studies: The COSMIC project
Authors: Millward Christopher , Keshwara Sumirat , Islim Abdurrahman , Srikandarajah Nisaharan , Marson Tony , Williamson Paula , Jenkinson Michael
Published: October 2021

Aims

To date, meningioma clinical trial activity has been limited, but a number of high-quality studies are underway, with more in development. There is heterogeneity in the outcomes reported in meningioma clinical trials. The COSMIC Project will develop two ‘Core Outcome Sets’ (COS) through comprehensive, transparent, consensus methodology; to ensure outcomes relevant to key stakeholders are reported within and across future meningioma clinical studies. The first will be for use in clinical effectiveness trials (COSMIC: Intervention), the second will be for use in clinical studies of incidental meningioma (COSMIC: Observation).

Method

Three systematic literature reviews will be performed to generate a long-list of outcomes potentially relevant to meningioma patients, healthcare professionals, researchers, and other stakeholder groups. The first systematic review will present the outcomes reported in published and ongoing meningioma clinical effectiveness trials. The second systematic review will present patient-reported outcomes (PRO) from the measurement tools utilised in meningioma PRO studies. The third systematic review will present the outcomes reported in published and ongoing clinical studies of untreated meningioma.

Outcomes will be deduplicated, unique outcomes categorised according to the taxonomy presented by COMET, and the lists combined. The long-list of outcomes will be prioritised through two, 2-round, modified eDelphi surveys including meningioma patients, healthcare professionals, researchers, and other stakeholder groups. Undecided outcomes from both eDelphi surveys will be ratified at two, one-day consensus meeting, with representation from all key stakeholder groups.

Results

We have formed a study advisory group with international representation from key organisations. The project already has confirmed support from the International Consortium on Meningioma (ICOM), the European Association of Neuro-Oncology (EANO), the Response Assessment in Neuro-Oncology Patient-Reported Outcome group (RANO-PRO), the Society for Neuro-Oncology (SNO), British Neuro-Oncology Society (BNOS), Society of British Neurological Surgeons (SBNS), The Brain Tumour Charity (TBTC), and Brainstrust.

Conclusion

Standardising minimum outcome reporting in meningioma clinical effectiveness trials and meningioma clinical studies, through the development of these two COS will ensure outcomes reported are relevant to key stakeholder groups, including patients, whilst reducing research waste for a disease with increasing clinical trial activity. We seek to raise awareness of this project and invite participation from a wide range of stakeholders to ensure that the final COS reflects the opinion of the neuro-oncology community. Registration will take place via the study website www.thecosmicproject.org between June-August 2021.
Definition and the Politics of Semantic Drift
Authors: Martin Craig
Published: October 2021

In this chapter Craig Martin and Susan Henking debate the merits of having a broad-based definition of religion. Martin argues that Henking’s original definition—including a gunshot, a haiku, and virtually everything in between—is so broad as to be unworkable. For Martin, this is tantamount to the vagueness that he sees as endemic to the academic study of religion. Henking, in turn, replies that definitions need not lead to clearer generalizations. The debate between these two sets out in stark opposition a tension inherent in the field and one, moreover, that weaves throughout the chapter.
The Circularity in Defining Religion
Authors: von Stuckrad Kocku
Published: October 2021

In this chapter Kocku von Stuckrad and Shaul Magid debate the utility of Magid’s initial definition that religion is, in many ways, a paradox, one that makes any definition of religion difficult to sustain. Von Stuckrad argues that such a definition risks reifying a certain form of religion and then assuming that its features are somehow general and universally applicable. He also argues that Magid’s definition attributes agency to religion when, in fact, religion does not actually do anything—social actors do. While agreeing to a certain extent, Magid counters with the claim that von Stuckrad does not place sufficient attention on issues of colonialism and imperialism.
Critical Voices, Public Debates
Authors: Patton Laurie L.
Published: October 2021

In this chapter Laurie L. Patton and Kocku von Stuckrad debate the utility of the term “religion.” In his original statement von Stuckrad argued that religion is whatever people want it to be, and while scholars should ideally avoid issues of normativity, they are often pulled into them. Patton responds that von Stuckrad dos not pay sufficient attention to the notion of economics, especially political economy, which, she argues, helps us to take into account the notion of secularization and the so-called nones. The public sphere, Patton argues, needs to be taken into account, especially since it is where religion is defined, often legally and without recourse to scholars of religion.
Introduction
Authors: Gordon Deborah
Published: October 2021

The introduction takes a first-hand look at the author’s experiences as a chemical engineer during the permitting of what is thought at the time to be the largest oil find in California history. This heavy oil and its location in Santa Barbara raise more questions than answers about the environmental and societal risks that accompany oil and gas. The introduction asks who should shoulder those risks. Six myths are surfaced to provide a reality check for readers. These preview the book’s chapters to follow: (1) oil and gas are physically abundant; (2) oil and gas resources are chemically diverse; (3) oil and gas have wide-ranging lifecycle climate impacts; (4) companies come and go, but oil and gas endure; (5) governments face conflicting incentives; and (6) civil society demonizes oil and gas but can’t stop using them either.
Curbing the Climate Footprints of Oil and Gas
Authors: Gordon Deborah
Published: October 2021

Chapter 4 lays out real-world solutions from the Oil Climate Index + Gas (OCI+). It argues that demand-side strategies, while necessary, have not been sufficient. An array of supply-side oil and gas strategies are needed to curb global warming. Numerous strategies that mitigate upstream, midstream, and downstream greenhouse gas (GHG) emissions are enumerated, including (1) eliminating routine flaring, (2) using renewable electricity, (3) using only manmade carbon dioxide for enhanced oil recovery, (4) reusing and pumping produced water more efficiently, (5) employing green hydrogen in refining, (6) locking up carbon in noncombustible end uses, (7) sequestering heavy residuals for reclamation and reuse, (8) reducing GHG emissions from liquefied natural gas, (9) decommissioning legacy assets with high GHGs, (10) minimizing fossil fuel inputs, (11) employing leak-free equipment, (12) operating permanent carbon capture, and (13) avoiding operating in sensitive ecosystems. The chapter concludes by presenting the cumulative mitigation potential of supply-side oil and gas strategies that are the responsibility of various actors.
Democratic Law
Authors: Shiffrin Seana Valentine
Published: October 2021

In this book, based on her 2017 Berkeley Tanner Lectures, the author offers an original, deontological account of democracy, law, and their interrelation. Her central thesis is that democracy and democratic law have intrinsically valuable, interconnected communicative functions. Democracy and democratic law together allow us to fulfill our fundamental duties to convey to each another messages of equal respect by fashioning the sorts of public joint commitments to act that a sincere message of equal respect requires. Law and democracy are essential to each other: the aspirations of democracy cannot be realized except through a legal system, and, conversely, law can fulfill its primary function only in a democratic context. After defending these theses, she explores two doctrinal examples to illustrate how a communicative conception of democratic law would yield concrete implications. First, articulating the special democratic character of judicially articulated common law, she resists instrumental, outcome-oriented conceptions of law and defends the essential importance of the common law duty of good faith in contracts. Second, appealing to the need for law to articulate a coherent set of moral commitments, she criticizes the US Supreme Court’s approach to constitutional balancing. In a set of commentaries, Niko Kolodny, Richard R. W. Brooks, and Anna Stilz offer illuminating and sometimes provocative discussion of both the philosophical and legal aspects of Shiffrin’s discussion. The author’s responses expand on themes concerning legal compliance, commitments, communication, dissent, political participation, and the permissible range of state interests.
Introduction
Authors: Ginsborg Hannah
Published: October 2021

This introduction offers a concise overview of the book. It outlines the three chapters of Seana Shiffrin’s core text; offers brief summaries of the three commentaries by Niko Kolodny, Richard R. W. Brooks, and Anna Stilz; and highlights some key points from Shiffrin’s extensive replies. It emphasizes two of the pretheoretical assumptions motivating Shiffrin’s argument for the communicative character of democratic law: that democracy is not defined in terms of elections and that both democracy and law must be conceived as a means for fulfilling moral obligations. It also emphasizes the Rawlsian background to Shiffrin’s argument, in particular the idea that justice requires that we realize for one another the social bases of self-respect. Finally, it underscores the timeliness of Shiffrin’s account in the light of widely recognized threats to democracy in the United States and elsewhere.