bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Quality and Safety of Venous Thromboembolism Prophylaxis Among Gastroenterology Inpatients at a Tertiary Hospital in Australia
Authors: van Oosterom Nameer , De Guzman Keshia R. , Winckel Karl , Johnson Anissa , Falconer Nazanin
Published: May 2023

Background and objective: Hospital acquired venous thromboembolisms (VTEs) are common and preventable. The Queensland Health VTE prophylaxis guidelines, developed in 2018, provide guidance for risk assessment, and prescribing of anticoagulation for prophylaxis and treatment of hospital inpatients. Currently, there are limited recommendations for gastroenterology patients. This study investigated the completion of VTE risk assessments, and the appropriateness of VTE prophylaxis regimens, in accordance with Queensland Health guidelines for gastroenterology patients. The quality and safety of VTE prophylaxis regimens was assessed based on their VTE risk and bleeding risk. Method: A retrospective study was conducted by obtaining a random sample of gastroenterology patients admitted to a tertiary Australian hospital, from 1st May 2019 and 1st May 2020, to determine the compliance of VTE risk assessment and thromboprophylaxis prescribing with state-wide VTE guidelines. The quality and safety of thromboprophylaxis was evaluated using the modified Caprini and HASBLED scores, and subsequent thromboprophylaxis-related complications. Results: Of the 94 patients reviewed, 68 did not have contraindications to thromboprophylaxis. Of these 68 patients, 32 (47%) had no VTE risk assessment recorded in their clinical records and were not prescribed any thromboprophylaxis during the hospitalization. There was no significant difference between thromboprophylaxis prescribing for patients with low VTE risk, compared to moderate to high VTE risk ( P = .075). There was a trend for decrease in thromboprophylaxis prescribing as HASBLED bleeding risk score increased, and patients with moderate-high bleed risk were less likely to be prescribed thromboprophylaxis ( P = .006). There were no thromboprophylaxis related complications identified. Conclusion: It is essential that all patients have a clearly documented risk assessment and are prescribed thromboprophylaxis according to best practice guidelines. The prescription of venous thromboembolism prophylaxis should continue to be individualized, with each patient assessed holistically.
The revolving door phenomenon in severe psychiatric disorders: A systematic review
Authors: Fonseca Barbosa Joana , Gama Marques João
Published: May 2023

Background:

The treatment of psychiatric patients has suffered a major change over the last decades, with long-term hospitalizations being replaced by short-term stays and appropriate aftercare in outpatient services. Some chronically ill patients exhibit a pattern of multiple hospitalizations, designated as the Revolving Door (RD) phenomenon.

Aims:

This review aims to analyse the existing literature regarding sociodemographic, clinical and other factors associated with multiple hospitalizations in psychiatric facilities.

Method:

The search performed in the PubMed database for the terms revolving[Title] AND (psyc*[Title] OR schizo*[Title] OR mental[Title]) presented 30 citations, 8 of which met the eligibility criteria. Four other studies found in references of these articles were also included in the review.

Results:

Albeit the use of different criteria to define the RD phenomenon, it is more likely to be associated with patients who are younger, single, with low educational level, unemployed, diagnosed with a psychotic disorder, particularly schizophrenia, and with alcohol and/or substance use. It is also associated with a younger age on disease onset, suicidality, noncompliance and voluntary type of admission.

Conclusion:

Recognizing patients with a RD pattern of admissions and prediction of rehospitalization can help the development of preventive intervention strategies and identify potential limitations in existing health care delivery systems.
Damage evolution of polymer matrix composites reinforced by nanoparticles modified under the three-point bending test by acoustic emission methods
Authors: Shayanfar Sina , Nikkhah Majid , Saber-Samandari Saeed , Salehi Manouchehr
Published: May 2023

This study aimed to investigate the behavior, and failure resistance of composite materials, and the effect of nanoparticles on their flexural properties. Nanoparticles with different weight percentages of nano-clay, and nano-silica were added to a plain weave C-glass fabric/epoxy/nano SiO2/nano-clay hybrid composite to analyze their effect. A three-point bending test was used to determine the findings. Initially, nano-clay and nano-silica were dispersed into epoxy resin at loadings of 0, 1, 3, and 5 weight percent for all hybrid composites using ultrasonic and mechanical stirring techniques. The test results show that the addition of both these nanoparticles up to 1 wt.% improved flexural strength, and flexural modulus by 12% and 26%, for nano-clay, 13% and 29%, for nano-silica, respectively. Then, during three-point bending tests, acoustic emission (AE) technique was used to detect damage mechanisms. Afterward, to classify damage mechanisms using AE features (peak amplitude and frequency), Gaussian Mixture Model (GMM) was used. Additionally, the evolution of damages in samples containing and without nanoparticles was investigated and studied using cumulative AE energy. The results show that the samples containing nanoparticles were more resistant to the growth of monotonous damage than those without nanoparticles.
Food Insecurity During the First Year of COVID-19: Employment and Sociodemographic Factors Among Participants in the CHASING COVID Cohort Study
Authors: Ng Yvette , Chang Mindy , Robertson McKaylee , Grov Christian , Maroko Andrew , Zimba Rebecca , Westmoreland Drew , Rane Madhura , Mirzayi Chloe , Parcesepe Angela M. , Kulkarni Sarah , Salgado-You William , Cohen Nevin , Nash Denis
Published: May 2023

Objective:

While much has been reported about the impact of the COVID-19 pandemic on food insecurity, longitudinal data and the variability experienced by people working in various industries are limited. This study aims to further characterize people experiencing food insecurity during the pandemic in terms of employment, sociodemographic characteristics, and degree of food insecurity.

Methods:

The study sample consisted of people enrolled in the Communities, Households and SARS-CoV-2 Epidemiology (CHASING) COVID Cohort Study from visit 1 (April–July 2020) through visit 7 (May–June 2021). We created weights to account for participants with incomplete or missing data. We used descriptive statistics and logistic regression models to determine employment and sociodemographic correlates of food insecurity. We also examined patterns of food insecurity and use of food support programs.

Results:

Of 6740 participants, 39.6% (n = 2670) were food insecure. Non-Hispanic Black and Hispanic (vs non-Hispanic White) participants, participants in households with children (vs no children), and participants with lower (vs higher) income and education levels had higher odds of food insecurity. By industry, people employed in construction, leisure and hospitality, and trade, transportation, and utilities industries had the highest prevalence of both food insecurity and income loss. Among participants reporting food insecurity, 42.0% (1122 of 2670) were persistently food insecure (≥4 consecutive visits) and 43.9% (1172 of 2670) did not use any food support programs.

Conclusions:

The pandemic resulted in widespread food insecurity in our cohort, much of which was persistent. In addition to addressing sociodemographic disparities, future policies should focus on the needs of those working in industries vulnerable to economic disruption and ensure those experiencing food insecurity can access food support programs for which they are eligible.
Could Intern Health Care Students Control Their Emotions and Make a Career Plan During the COVID-19 Pandemic?
Authors: Güngör Tavsanli Nurgül , Nehir Sevgi
Published: May 2023

The negative effects of the pandemic caused students to make changes in their career plans and their ability to manage their emotional states. Not only health students in our country, but also students in other countries of the world experienced fear, anxiety, and unwillingness to participate in professional practices and the provision of care for patients with COVID-19 during the COVID-19 pandemic. The study was conducted to determine factors influencing intern healthcare students’ career adaptability and their ability to manage emotions during the COVID-19 pandemic. The sample of this cross-sectional study consisted of 219 intern healthcare students studying at the Faculty of Health Sciences Undergraduate Program of a University in the fall semester of the 2020 to 2021 academic year. The study data were collected online using the Personal Information Form, Career Adapt-Ability Scale (CAAS), and Courtauld Emotional Control Scale (CECS). The data obtained were analyzed by using the independent samples t-test, Analysis of Variance (ANOVA), correlation tests, and the regression model to distinguish variables significantly. Two models explained more than 50% of the variance of CAAS and CECS regarding COVID-19, and 5.1% of the career planning regarding the period during the COVID-19 pandemic ( P < .05). As the students’ control over their careers decreased during the COVID-19, their feelings of anxiety and unhappiness increased ( P < .05). Of the variables, sex, department, future expectations, the position dreamed of being in after graduation, and attitudes toward patient care with COVID-19 affected their CAAS and CECS scores.
Comparing the Incomparable? Issues of Lacking Common Support, Functional-Form Misspecification, and Insufficient Sample Size in Decompositions
Authors: Hamjediers Maik , Sprengholz Maximilian
Published: May 2023

Decompositions make it possible to investigate whether gaps between groups in certain outcomes would remain if groups had comparable characteristics. In practice, however, such a counterfactual comparability is difficult to establish in the presence of lacking common support, functional-form misspecification, and insufficient sample size. In this article, the authors show how decompositions can be undermined by these three interrelated issues by comparing the results of a regression-based Kitagawa-Blinder-Oaxaca decomposition and matching decompositions applied to simulated and real-world data. The results show that matching decompositions are robust to issues of common support and functional-form misspecification but demand a large number of observations. Kitagawa-Blinder-Oaxaca decompositions provide consistent estimates also for smaller samples but require assumptions for model specification and, when common support is lacking, for model-based extrapolation. The authors recommend that any decomposition benefits from using a matching approach first to assess potential problems of common support and misspecification.
The role of D-dimer and fibrinogen testing in catheter-directed thrombolysis with urokinase for deep venous thrombosis
Authors: Liu Qiang , Chen Liang , Wang Zhengyu , Peng Zhiqing , Chen Wei , Pan Yucheng , Wang Yongli , Sha Yan
Published: May 2023

Background

During catheter-directed thrombolysis (CDT), D-dimer (D-D) are generated in large quantities and fibrinogen (FIB) is continuously consumed. Reduction of FIB increases the risk of bleeding. However, there are currently few studies on the relationship between D-D and FIB concentrations during CDT.

Objectives

To evaluate the relationship of D-D and FIB concentrations during CDT with urokinase for deep venous thrombosis (DVT).

Method

17 patients with lower limb DVT were enrolled and treated with CDT. The concentrations of plasma D-D and FIB were measured every 8 h during thrombolysis. The degree of thrombolysis was evaluated, the change rules of D-D and FIB concentrations were analyzed, and the change curve graphs were drawn. The “thrombus volume,” “thrombolysis time,” “thrombolysis ratio,” “D-D peak,” “D-D rising speed,” “FIB falling speed,” and “duration of D-D elevation” were calculated in each patient. The mixed model was used to simulate the time change trend of the plasma D-D and FIB concentrations. Pearson method and linear regression were used to analyze the correlation and linear relationship, respectively.

Results

The D-D concentration first increased rapidly and then decreased gradually, and the FIB concentration continued to decrease during thrombolysis. The rate of the decline of FIB varies with the urokinase dose. The thrombus volume is positively correlated with D-D rising speed, duration of D-D elevation, D-D peak, and FIB falling speed; the D-D rising speed is positively correlated with the D-D peak and FIB falling speed; and the D-D peak is positively correlated with the FIB falling speed. The correlation coefficients were all statistically significant ( p < 0.05). Efficacy reached level I–II in 76.5% patients. No major bleeding occurred in any of the patients.

Conclusion

During CDT with urokinase for DVT, the concentrations of D-D and FIB show specific changes, and there are some specific relationships between each other. Understanding these changes and relationships may be helpful to adjust the thrombolysis time and urokinase dose more rationally.
Toward certifiable optimal motion planning for medical steerable needles
Authors: Fu Mengyu , Solovey Kiril , Salzman Oren , Alterovitz Ron
Published: May 2023

Medical steerable needles can follow 3D curvilinear trajectories to avoid anatomical obstacles and reach clinically significant targets inside the human body. Automating steerable needle procedures can enable physicians and patients to harness the full potential of steerable needles by maximally leveraging their steerability to safely and accurately reach targets for medical procedures such as biopsies. For the automation of medical procedures to be clinically accepted, it is critical from a patient care, safety, and regulatory perspective to certify the correctness and effectiveness of the planning algorithms involved in procedure automation. In this paper, we take an important step toward creating a certifiable optimal planner for steerable needles. We present an efficient, resolution-complete motion planner for steerable needles based on a novel adaptation of multi-resolution planning. This is the first motion planner for steerable needles that guarantees to compute in finite time an obstacle-avoiding plan (or notify the user that no such plan exists), under clinically appropriate assumptions. Based on this planner, we then develop the first resolution-optimal motion planner for steerable needles that further provides theoretical guarantees on the quality of the computed motion plan, that is, global optimality, in finite time. Compared to state-of-the-art steerable needle motion planners, we demonstrate with clinically realistic simulations that our planners not only provide theoretical guarantees but also have higher success rates, have lower computation times, and result in higher quality plans.
How Do School Psychologists Address Issues of Effort, Motivation, and Honesty During Evaluations?
Authors: Lovett Benjamin J. , Schaberg Theresa , Nazmiyal Ara , Spenceley Laura M.
Published: May 2023

Data collected during psychoeducational evaluations can be compromised by response bias: clients not putting forth sufficient effort on tests, not being motivated to do well, or not being fully honest and careful when completing rating scales and contributing similar self-report data. Some of these problems apply to data from third-party informants as well. In the present study, we surveyed school psychologists about their approach to detecting, preventing, and reacting to apparent response bias. A sample of 297 school psychologists responded to at least one of four open-ended questions. We found that most participants only used informal techniques for detecting response bias (rather than specialized tests and embedded indices), relied on rewards or reinforcements to prevent response bias, and reacted to apparent response bias by noting it in their evaluation reports. However, a wide variety of other strategies were endorsed by smaller proportions of practitioners. We compare these results to results from similar surveys in neuropsychology, and discuss implications for applied practice as well as future research.
A viable strategy to recycle post-used carbon fiber thermoset composites as a multi-functional filler for PP composites
Authors: Montagna Larissa Stieven , De Almeida Fabio Augusto Passos , Batista Larissa Anne Pereira dos Santos , Dos Anjos Erick Gabriel Ribeiro , Brazil Tayra Rodrigues , Morgado Guilherme Ferreira de Melo , Baldan Mauricio Ribeiro , Passador Fabio Roberto
Published: May 2023

The correct destination of this post-used of carbon fiber (CF) reinforced epoxy composites, is considered noble since their manufacturing process involves high costs and advanced technologies. This work aimed to study the feasibility of mechanical recycling of CF/epoxy composites for nobler applications, such as non-structural internal components, antistatic packaging, or electronics housings. The CF/epoxy residues (CFRPres.) were collected from parts of the aerospace industry, selected, and ground, followed by granulometric separation. Then, the CFRPres. particles were incorporated as filler and/or partial reinforcement in a polypropylene (PP) matrix to obtain a new thermoplastic composite using double-screw extrusion processing, followed by hot compression molding to obtain standardized specimens. The quality of the composites obtained was evaluated through mechanical tests (tensile test, Izod impact strength, and Shore D hardness), thermal (differential scanning calorimetry), electric (impedance spectroscopy, electromagnetic), and morphological characterization (scanning electron microscopy). The addition of 30 wt% of CFRPres. in the PP matrix increases the electrical conductivity by seven orders of magnitude and exhibits semiconductor behavior, and increases 168% in the elastic modulus. As for the electromagnetic properties, increasing the content of residues in the composites also occurs a substantial increase in the relative permittivity. In addition, the development of composites from the incorporation of residues from the aerospace sector proved viable in applications where the impact strength, rigidity, and hardness are crucial, even for the high content of residues aggregate.
Embedding Cognition: Judgment and Choice in an Interdependent and Dynamic World
Authors: Weber Elke U. , Constantino Sara M. , Schlüter Maja
Published: May 2023

Society is facing pressing interrelated, multilevel, and systemic challenges. Human consumption patterns are driving biodiversity loss and climate change, with unevenly distributed impacts that exacerbate preexisting inequalities. Structural or systems-level solutions to these challenges depend on group- and individual-level change, and vice versa. Although cognitive psychology has advanced our understanding of individual and group-level decision-making, it rarely links these microlevel processes and behaviors to network- and systems-level structures, resulting in a fragmented theory of how individual and collective action can drive broader social change. For example, psychology has established that physical, social, and historical contexts shape perception, reasoning, and decision-making but has largely ignored the dynamic and interdependent relationship between behavior and contexts. In this review, we urge researchers to move beyond a focus on static contexts and individual and group-level cognition to incorporate deeper theorizing about the temporal dynamics and feedbacks between individuals and the broader contexts in which they are embedded. We review literature emphasizing the role of context in shaping psychological processes as well as emerging research that considers individuals as embedded in complex adaptive systems. Complex adaptive systems frameworks are well suited to study the dynamic and interdependent relationship among individuals and the broader systems and structures they inhabit. The integration of research in psychology with these perspectives may thus offer traction in identifying solution pathways to complex, multilevel challenges by pointing to theories and methods that integrate across levels of analysis and account for coupled nature-society systems.
Lie Detection: What Works?
Authors: Brennen Tim , Magnussen Svein
Published: May 2023

A reliable lie-detection method would be extremely useful in many situations but especially in forensic contexts. This review describes and evaluates the range of methods that have been studied. Humans are barely able to pick up lies on the basis of nonverbal cues; they do so more successfully with systematic methodologies that analyze verbal cues and with physiological and neuroscientific methods. However, the rates at which people are able to detect lies are still well below the legal standard of “beyond a reasonable doubt.” This means that the utmost caution must be exercised when such methods are employed. In investigations where independent evidence exists, there is emerging evidence that interviews based on a free account followed by the gradual introduction of the evidence by investigators can reveal inconsistencies in a guilty interviewee’s account. Automated machine-learning methods also hold some promise.
External validation of the Oakland score to assess safe hospital discharge among adult patients with acute lower gastrointestinal bleeding in an accident and emergency department in Hong Kong
Authors: Fong Ho Yin
Published: May 2023

Objective:

To externally validate the use of the Oakland score in identification of low-risk lower gastrointestinal bleeding patients who can be safely managed without hospitalisation in an accident and emergency department in Hong Kong.

Methods:

This single-centre retrospective cohort study included adult patients who attended the accident and emergency department for lower gastrointestinal bleeding and were subsequently admitted to hospital from 1 January 2020 to 31 December 2020. Safe discharge was defined as absence of all of the following adverse outcomes after hospital presentation: blood transfusion; therapeutic colonoscopy, mesenteric embolisation, or laparotomy for bleeding; in-hospital death (all causes); and readmission with subsequent lower gastrointestinal bleeding within 28 days. The sensitivities, specificities and area under the receiver-operating characteristic curve of the Oakland score were calculated.

Results:

Among 376 patients who were included in this study, 114 (30.3%) of them experienced one or more adverse outcomes. The area under the receiver-operating characteristic curve for safe discharge was 0.88 (95% confidence interval, 0.84–0.91). Using an Oakland score threshold of ⩽8 points as in the original derivation study can achieve 100% sensitivity (95% confidence interval, 96.8%–100%) and 7.3% specificity (95% confidence interval, 4.4%–11.1%) for safe discharge. When the Oakland score threshold was extended to ⩽11 points, a much greater proportion of low-risk patients could be identified, with 97.4% sensitivity (95% confidence interval, 92.5%–99.5%) and 32.8% specificity (95% confidence interval, 27.2%–38.9%) for safe discharge.

Conclusion:

The Oakland score performed well in identification of lower gastrointestinal bleeding patients who were at low risk of experiencing adverse outcomes and could thus be safely managed without hospitalisation. Extension of the Oakland score threshold to ⩽11 points can allow identification of a greater proportion of low-risk patients while sensitivity is reasonably maintained.
The Gift of Loss: A Rhizomatic Connection Journey
Authors: Cho Christine L.
Published: May 2023

In this piece, I explore how embodied reflexivity stop moments, juxtaposed with the photographic f-stop, inform the various stages of my creative process. Through deconstruction, fragmentation, and reconstruction of my images, I work to navigate and embrace loss to reconnect with myself as artist/daughter. Through the lens of my father’s camera, I engage in a form of relational consciousness: hearing his voice guide my composition and technical approach to my images and then freeing my consciousness to create on a more visceral level using the interdisciplinary approaches that are the foundation of my art making. I detail how my process became a form of conversation through the lens as well as a rhizomatic healing journey. Throughout, I question how dominant society regulates and controls how and what we grieve, who is grieved, and I advance the idea that grief and loss should be embraced as a gift.
Pushing Forward the Transition to a Circular Economy by Adopting an Actor Engagement Lens
Authors: Verleye Katrien , De Keyser Arne , Raassens Néomie , Alblas Alex A. , Lit Fernando C. , Huijben Josephina C. C. M.
Published: May 2023

Circular business models (CBMs), such as product-service systems, are rapidly gaining traction in light of a transition to a more circular and sustainable economy. The authors call for a new approach to inform and guide the development and adoption of these CBMs. The main reason is that different actors in the service ecosystems or networks linked to these business models—such as firms, customers, and governmental bodies—may be reluctant to join or even impede the transition to a circular economy. Based upon an abductive analysis of 133 CBM papers with the Motivation-Opportunity-Ability (MOA) framework as organizing structure, the authors theorize about how to achieve “circular economy engagement” ( i.e., an actor’s disposition to embrace CBMs). Specifically, they highlight and illustrate the role of (1) signaling and convincing as motivation-related practices, (2) matching and legitimizing as opportunity-related practices, and (3) supporting and empowering as ability-related practices. The authors provide illustrative cases for each of these practices along with a discussion of the theoretical and practical implications and the remaining challenges—all with the key aim to push the transition to a circular economy forward.
Prevalence of Iron Deficiency and its Association With Breast Cancer in Premenopausal Compared to Postmenopausal Women in Al Ahsa, Saudi Arabia
Authors: Al Khamees Mohammad , Alqurain Aymen A , Alsaleh Abdulmonem A , Alhashem Yousef A , AlSaffar Nida , Alibrahim Noura N , Aljunibi Fardus A , Alradwan Zaheda , Almohammade Nesreen , AlAlwan Bader
Published: May 2023

Iron is an essential cofactor needed for normal functions of various enzymes and its depletion lead to increase DNA damage, genomic instability, deteriorate innate, adaptive immunity, and promote tumor development. It is also linked to tumorigenesis of breast cancer cells through enhancing mammary tumor growth and metastasis. There is insufficient data describing this association in Saudi Arabia. This study aims to determine the prevalence of iron deficiency and its association with breast cancer among premenopausal and postmenopausal women referred for breast cancer screening center in Al Ahsa, Eastern Province of Saudi Arabia. Age, hemoglobin level, iron level, history of anemia, or iron deficiency were collected from patients’ medical records. The included participants were grouped based on their age into premenopausal (<50 years) or postmenopausal (⩾50 years). The definition of low Hb implemented (Hb below 12 g/dL) and low total serum Iron levels (below 8 μmol/L). Logistic regression test was used to compute the association between having a positive cancer screening test (radiological or histocytological) and participant’s lab results. The results are presented as odds ratios and 95% confidence intervals. Thrree hundred fifty-seven women were included, 77% (n = 274) of them were premenopausal. This group cases had more history of iron deficiency (149 [60%] vs 25 (30%), P = .001) compared to those in the postmenopausal group. The risk of having a positive radiological cancer screening test was associated with age (OR = 1.04, 95% CI 1.02-1.06), but negatively was associated with iron level (OR = 0.9, 95% CI 0.86-0.97) among the entire cohort. This study is the first to propose an association between iron deficiency and breast cancer among Saudi young females. This could suggest iron level as a new risk factor that may be used by clinicians to assess breast cancer risk.
Patient Identification and Tumor Identification Management: Quality Program in a Cancer Multicentric Clinical Data Warehouse
Authors: Pallier Karine , Prot Olivier , Naldi Simone , Silva Francisco , Denis Thierry , Giry Olivier , Leobon Sophie , Deluche Elise , Tubiana-Mathieu Nicole
Published: May 2023

Background:

The Regional Basis of Solid Tumor (RBST), a clinical data warehouse, centralizes information related to cancer patient care in 5 health establishments in 2 French departments.

Purpose:

To develop algorithms matching heterogeneous data to “real” patients and “real” tumors with respect to patient identification (PI) and tumor identification (TI).

Methods:

A graph database programed in java Neo4j was used to build the RBST with data from ~20 000 patients. The PI algorithm using the Levenshtein distance was based on the regulatory criteria identifying a patient. A TI algorithm was built on 6 characteristics: tumor location and laterality, date of diagnosis, histology, primary and metastatic status. Given the heterogeneous nature and semantics of the collected data, the creation of repositories (organ, synonym, and histology repositories) was required. The TI algorithm used the Dice coefficient to match tumors.

Results:

Patients matched if there was complete agreement of the given name, surname, sex, and date/month/year of birth. These parameters were assigned weights of 28%, 28%, 21%, and 23% (with 18% for year, 2.5% for month, and 2.5% for day), respectively. The algorithm had a sensitivity of 99.69% (95% confidence interval [CI] [98.89%, 99.96%]) and a specificity of 100% (95% CI [99.72%, 100%]). The TI algorithm used repositories, weights were assigned to the diagnosis date and associated organ (37.5% and 37.5%, respectively), laterality (16%) histology (5%), and metastatic status (4%). This algorithm had a sensitivity of 71% (95% CI [62.68%, 78.25%]) and a specificity of 100% (95% CI [94.31%, 100%]).

Conclusion:

The RBST encompasses 2 quality controls: PI and TI. It facilitates the implementation of transversal structuring and assessments of the performance of the provided care.
Indigenous innovation and organizational change towards equitable higher education systems: the Canadian experience
Authors: Tamtik Merli
Published: May 2023

Indigenous knowledges are largely absent from higher education institutions’ efforts to pursue excellence and innovation. Grounded in decolonization literature and institutional theory, this article examines how Indigenous peoples of Canada have engaged with innovation discourses in higher education. Through document analysis of 15 research-intensive Canadian universities and conversation with 13 Indigenous peoples, the article analyses political, functional, and normative pressures associated with Indigenous knowledges shaping Canadian universities. The article demonstrates how Indigenous groups have been able to push post-secondary institutions towards a normative shift in organizational structure. The article also shows how approaching innovation from decolonizing perspectives can provide a way forward for equitable higher education systems, advocating for re-imagining the dominant market economy, and focusing on learning from Indigenous worldviews that centre around reciprocity, ecological sustainability, and connection to land.
Critical Damage of Lung Parenchyma Complicated with Massive Pneumothorax in COVID-19 Pneumonia
Authors: Ghenu Maria Iuliana , Manea Maria Mirabela , Timofte Delia , Balcangiu-Stroescu Andra-Elena , Ionescu Dorin , Tulin Raluca , Ciornei Mariana Cătălina , Dragoş Dorin
Published: May 2023

It is already known that Coronavirus disease 2019 (COVID-19) may lead to various degrees and forms of lung parenchyma damage, but some cases take a strikingly severe course that is difficult to manage. We report the case of a 62-year old male, non-obese, non-smoker, and non-diabetic, who presented with fever, chills, and shortness of breath. The infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was diagnosed by real-time Polymerase Chain Reaction. Although the patient had been vaccinated with 2 doses of Pfizer-BioNTech COVID-19 vaccine 7 months earlier and had no risk factors for a severe outcome, serial computed tomography (CT) scan revealed lung involvement progressively extending from an initial 30% to 40% to almost 100% 2.5 months later. The spectrum of lung lesions included at first only ground-glass opacities and some tiny emphysema bullae, but later also bronchiectasis, pulmonary fibrosis, and large emphysema bullae as post-COVID-19 pulmonary sequelae. For fear of severe evolution of superimposed bacterial infection (Clostridoides difficile enterocolits and possibly bacterial pneumonia) the administration of corticosteroids was intermittent. Massive right pneumothorax secondary to bulla rupture, possibly favored by the indispensable high flow oxygen therapy, led to respiratory failure compounded by hemodynamic instability, and ultimately to the patient’s final demise. COVID-19 pneumonia may cause severe lung parenchyma damage which requires long-term supplemental oxygen therapy. Beneficial or even lifesaving as it might be, high flow oxygen therapy may nonetheless have deleterious effects too, including the development of bullae that may rupture engendering pneumothorax. Corticosteroid treatment should probably be pursued despite superimposed bacterial infection to limit the viral induced damage to lung parenchyma.
Populists in the shadow of great power competition: Duterte, Sukarno, and Sihanouk in comparative perspective
Authors: Nair Deepak
Published: May 2023

This article takes the study of populism beyond political parties and individual leaders and foregrounds coalitions in the making and unmaking of populist projects. It compares Rodrigo Duterte’s presidency in the Philippines with figures of an older vintage in postcolonial Southeast Asia—the Cold War neutralists President Sukarno of Indonesia and Prince Norodom Sihanouk of Cambodia, neither of whom fit neatly within dominant frameworks of populism in International Relations (IR). Drawing on Rogers Brubaker’s conceptualization of populism as a “discursive and stylistic repertoire,” I argue that the projects of Duterte, Sukarno, and Sihanouk embody populism in general and are suggestive of a distinct type vis-à-vis right- or left-wing party and individual populists. Specifically, these are populists who presided over ideologically diverse coalitions in contexts of intrusive Great Power competition. This comparison advances the study of populism in IR in three ways. First, rather than populist political parties and leaders, this article focuses on populists crafting coalitions in contexts of weak party milieus. Second, it draws on a capacious conceptualization of populism (as repertoire) which pushes beyond exclusively “ideological,” “strategic,” and “discursive” conceptions and better accounts for the empirical diversity of this phenomenon outside Euro-American shores. Third, this article highlights a novel pathway by which international politics shapes the fates of populism. The three cases show how a strident discourse of anti-colonialism glued populists’ diverse coalitions at home, while populists’ external alignment choices and efforts to steer “independent” foreign policies exacerbated coalitional fault lines, straining, if not unraveling, their projects.
Effectiveness of a telerehabilitation tablet app in combination with face-to-face physiotherapy for people with wrist, hand or finger injuries: A pragmatic multicentre clinical trial
Authors: Suero-Pineda Alejandro , Oliva-Pascual-Vaca Ángel , Durán Manuel Rodríguez-Piñero , Sánchez-Laulhé Pablo Rodríguez , García-Frasquet María Ángeles , Blanquero Jesús
Published: May 2023

Objective

To evaluate whether, in patients with trauma and soft tissue injuries of the wrist, hand and/or fingers, an exercise program performed on a touchscreen tablet-based app reduces the consumption of face-to-face resources and improves clinical recovery, compared to a conventional home exercise program prescribed on paper.

Design

Pragmatic, multicentre, parallel, two-group, controlled clinical trial with blinded assessor.

Participants and setting

Eighty-one patients with traumatic bone and/or soft tissue injuries of the hand, wrist and/or fingers recruited in four hospitals of the Andalusian Public Health System.

Interventions

The experimental group received a home exercise program using a touchscreen tablet application and the control group received a home exercise program on paper. Both groups received the same treatment of face-to-face physiotherapy.

Primary outcome

Number of physiotherapy sessions. Secondary outcomes were the duration of physiotherapy and clinical variables such as functional ability, grip strength, pain and manual dexterity.

Results

The experimental group required fewer physiotherapy sessions (MD −11,5 sessions; 95% CI −21.4 to −1.4), showed a shorter duration of physiotherapy (MD −3.8 weeks, 95% CI −7 to −1) and had better recovery of grip strength, pain and dexterity compared to the control group.

Conclusions

In patients with trauma and soft tissue injuries of the wrist, hand and/or fingers, an exercise program performed on a touchscreen tablet-based app in combination with face-to-face physiotherapy reduces the consumption of face-to-face resources and improves clinical recovery, compared to conventional home exercise program prescribed on paper.
Low body mass index and disease duration as factors associated with depressive symptoms of Chinese inpatients with chronic heart failure
Authors: Cheng Ling , Zhong Zhuqing , Ding Siqing , Duan Yinglong , Sun Na , Zheng Feng
Published: May 2023

Depression is common in patients with chronic heart failure (CHF), and is associated with an increased risk of adverse health outcomes. There is a paucity of data on this subject from the developing countries. The aim was to examine the prevalence and related factors of depressive symptoms among Chinese inpatients with CHF. A cross-sectional study was conducted. PHQ-9 questionnaire was used to assess depressive symptoms. The overall prevalence of depressive symptoms was 7.5%. Low BMI (OR = 4.837, CI = 1.278–18.301, p = 0.02), disease duration 3–5 years (OR = 5.033, CI = 1.248–20.292, p = 0.023) and 5–10 years (OR = 5.848, CI = 1.440–23.744, p = 0.013) were risk factors for depressive symptoms, while being married (OR = 0.304, CI = 0.123–0.753, p = 0.010) was protective factor. We should pay more attention to patients without a spouse, with low BMI and whose disease duration is between 3 and 10 years in Chinese inpatients with CHF.
Experiences of access to healthcare among newly arrived immigrants in Denmark: Examining the role of residence permit
Authors: Nielsen Maj R. , Jervelund Signe S.
Published: May 2023

Aims:

In Denmark, all residents regardless of nationality are ‘de jure’ entitled to a wide range of free-of-charge healthcare services. There is, however, only scarce quantitative knowledge on immigrants’ experiences of their ‘de facto’ access to healthcare and on how access relates to immigrants’ types of residence permits. The study aims to address these gaps.

Methods:

Survey data on access to healthcare, employment and housing were collected among adult, newly arrived immigrants in Denmark ( n=1711) at 26 publicly contracted Danish language schools in September–December 2021 by national cluster-random sampling stratified by region. Data were analysed using descriptive statistics and multivariate logistic regression.

Results:

In total, 21% reported general difficulties obtaining good healthcare. Commonly experienced barriers related to financial constraints (39%), communication (37%) and lack of knowledge about the healthcare system (37%). Refugees and their families had higher odds of reporting barriers related to finances (odds ratio (OR) 2.58; confidence interval (CI) 1.77–3.76), communication (OR 3.15; CI 2.39–4.14) and knowledge (OR 1.84; CI 1.16–2.90), while other family reunified immigrants had lower odds of reporting knowledge barriers (OR 0.71; CI 0.54–0.93) compared with immigrants with EU/EEA residence permits, adjusted for gender and residential region. These results remained significant when further adjusted for age, length of stay, education, income, rural/urban residence and household size.

Conclusions:

Difficulties accessing healthcare are experienced by a large share of newly arrived immigrants in Denmark and are dependent on residence permit type. The findings suggest strengthened efforts to reduce barriers related to finances, communication and knowledge, while focusing on the most vulnerable immigrants.
miR-1187 induces podocyte injury and diabetic nephropathy through autophagy
Authors: Chen Bin , He Qiang
Published: May 2023

MicroRNAs plays important roles in the progression of diabetic nephropathy (DN) and podocyte injury. This study aimed to investigate the role and regulation mechanism of miR-1187 during the development of DN and podocyte injury. The content of miR-1187 in podocytes was up-regulated under high glucose (HG) treatment and increased in kidney tissue of db/db mice (DN model mice) compared with control db/m mice. The administration of miR-1187 inhibitor could decrease podocyte apoptosis induced by HG and attenuate the decline in renal function and reduce proteinuria as well as glomerular apoptosis in db/db mice. Mechanistically, miR-1187 could inhibit the autophagy level in HG-exposed podocytes and glomerulus of DN mice. Moreover, miR-1187 inhibitor could reduce HG-stimulated podocyte injury and autophagy flux inhibition. The mechanism may depend on autophagy. In conclusion, targeting miR-1187 may be a new therapeutic target for improving the high glucose damage of podocytes and the progression of DN.
TyG-BMI and hypertension in Normoglycemia subjects in Japan: A cross-sectional study
Authors: Huang Xinming , He Jiacheng , Wu Guoxin , Peng Zishu , Yang Bin , Ye Langxi
Published: May 2023

Background

Insulin Resistance (IR) are associated with Hypertension (HTN). Triglyceride glucose-body mass index (TyG-BMI) is a readily available and clinically significant indicator of IR. This study aimed to investigate whether TyG-BMI is independently associated with HTN.

Methods

A total of 15,464 patients with normal blood glucose from 2004 to 2016 participated in this study. Participants were divided into four groups using the quartile method: TyG-BMI below 153.1, between 153.1 and 174.2, between 174.2 and 199.3, and over 199.3. The covariates included age, sex, BMI, WC, HDL-C, TC, TG, HbA1c, FPG, ALT, AST, GGT, SBP, DBP, smoking status, alcohol consumption, and exercise habits.

Results

The average age was 43.7 ± 8.9 years, and 45.4% were men. The prevalence of HTN was 6.2% (964/15464) of the population. TyG-BMI remained significantly associated with HTN after multivariate adjustment for TyG-BMI as a continuous variable (adjusted OR = 2.87, 95% CI: 1.90–4.34). Each 10-unit rise in TyG-BMI (continuous variable) was linked to a 31% increase in the prevalence of HTN (adjusted OR = 1.31, 95% CI: 1.25–1.37). In the subgroup analysis stratified by age, sex, waist circumference, and smoking status, the association between TyG-BMI and HTN were stable.

Conclusion

In this study, TyG-BMI was highly correlated with HTN, but more experiments and different populations are needed to verify this.
Partner Effects of Childhood Maltreatment: A Systematic Review and Meta-Analysis
Authors: Vaillancourt-Morel Marie-Pier , Bussières Ève-Line , Nolin Marie-Chloé , Daspe Marie-Ève
Published: May 2023

Although several studies have shown that childhood maltreatment (CM) is associated with a host of negative consequences including romantic relationship difficulties for victims in adulthood, most overlooked the potential effects on the romantic partner. This systematic review and meta-analysis aims to comprehensively synthesize the literature on the association between a person’s CM and their partner’s individual and couple outcomes. We searched PubMed, PsycNET, Medline, CINAHL, and Eric using search strings related to CM and partner. We identified 3,238 articles after removal of duplicates; 28 studies met the inclusion criteria and relied on independent sample. The studies reported associations between a person’s CM and a wide breadth of partner’s negative couple outcomes (e.g., communication, sexuality) as well as intra-individual psychological difficulties (e.g., psychological distress, emotion, and stress reactivity). Meta-analytic results showed significant, but trivial to small associations between a person’s CM and their partner’s lower relationship satisfaction ( r = −.09, 95% CI [−.14, −.04]), higher intimate partner violence ( r = .08, [.05, .12]), and higher psychological distress ( r = .11, [.06, .16]). These associations were similar for women and men and did not differ as a function of sample’s mean age, proportion of cultural diversity, and publication year. These findings suggest that a person’s CM is related to their partner’s outcomes including to the partner’s intra-individual outcomes. Prevention and intervention strategies should acknowledge that a person’s CM may also affect their romantic partner, considering the couple as a reciprocal system, and offer victims’ romantic partners specific services.
Classifying and evaluating fetuses with multicystic dysplastic kidney in etiologic studies
Authors: Cai Meiying , Guo Chong , Wang Xinrui , Lin Min , Xu Shiyi , Huang Hailong , Lin Na , Xu Liangpu
Published: May 2023

Multicystic dysplastic kidney (MCDK) is one of the most common fetal malformations, but its etiology remains unclear. Identification of the molecular etiology could provide a basis for prenatal diagnosis, consultation, and prognosis evaluation for MCDK fetuses. We used chromosome microarray analysis (CMA) and whole-exome sequencing (WES) to conduct genetic tests on MCDK fetuses and explore their genetic etiology. A total of 108 MCDK fetuses with or without other extrarenal abnormalities were selected. Karyotype analysis of 108 MCDK fetuses showed an abnormal karyotype in 4 (3.7%, 4/108) of the fetuses. However, CMA detected 15 abnormal copy number variations (CNVs) (14 pathogenic CNVs, and one variant of unknown significance [VUS] CNVs), in addition to four cases that were consistent with the results of karyotype analysis. Out of the 14 pathogenic CNVs cases, three were of 17q12 microdeletion, two of 22q11.21 microdeletion, 22q11.21 microduplication uniparental disomy (UPD), and one case of 4q31.3q32.2 microdeletion, 7q11.23 microduplication, 15q11.2 microdeletion, 16p11.2 microdeletion, and 17p12 microdeletion. Of the 89 MCDK fetuses with normal karyotype analysis and CMA, 15 were tested by WES. Two (13.3%, 2/15) fetuses were identified by WES as Bardet-Biedl syndrome (BBS) 1 and BBS2. Combined application of CMA-WES to detect MCDK fetuses can significantly improve the detection rate of genetic etiology, providing a basis for consultation, and prognosis evaluation.
“You Asked, I Answered, Now What?”: A White Principal’s Struggle to Confront Race(ism) and Address Black Teacher Retention
Authors: Coleman Stacy , Lowery Kendra
Published: May 2023

After viewing a video about Black teachers’ experiences, Vince Matthews, a White male middle school principal, invited Black teachers to a listening session to learn about their school experiences. He was certain that it would be a short, pleasant meeting because he believed he did not have a racist bone in his body. Instead, four teachers shared stories that revealed patterns of racism within the school. Furthermore, they said they considered leaving the school. Principal Matthews was challenged by how to shift from color evasiveness to centering race in decision-making, move beyond listening to implementing racial equity through policy and practice, and facilitate uncomfortable conversations with White faculty.