bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the impact of a decision support algorithm to improve clinicians’ chemotherapy-induced peripheral neuropathy assessment and management practices: a two-phase, longitudinal study
Authors: Knoerl Robert , Mazzola Emanuele , Hong Fangxin , Salehi Elahe , McCleary Nadine , Ligibel Jennifer , Reyes Kaitlen , Berry Donna L.
Published: March 2021

Background

Chemotherapy-induced peripheral neuropathy (CIPN) negatively affects physical function and chemotherapy dosing, yet, clinicians infrequently document CIPN assessment and/or adhere to evidence-based CIPN management in practice. The primary aims of this two-phase, pre-posttest study were to explore the impact of a CIPN clinician decision support algorithm on clinicians’ frequency of CIPN assessment documentation and adherence to evidence-based management.

Methods

One hundred sixty-two patients receiving neurotoxic chemotherapy (e.g., taxanes, platinums, or bortezomib) answered patient-reported outcome measures on CIPN severity and interference prior to three clinic visits at breast, gastrointestinal, or multiple myeloma outpatient clinics (n = 81 usual care phase [UCP],n = 81 algorithm phase [AP]). During the AP, study staff delivered a copy of the CIPN assessment and management algorithm to clinicians (N = 53) prior to each clinic visit. Changes in clinicians’ CIPN assessment documentation (i.e., index of numbness, tingling, and/or CIPN pain documentation) and adherence to evidence-based management at the third clinic visit were compared between the AP and UCP using Pearson’s chi-squared test.

Results

Clinicians’ frequency of adherence to evidence-based CIPN management was higher in the AP (29/52 [56%]) than the UCP (20/46 [43%]), but the change was not statistically significant (p = 0.31). There were no improvements in clinicians’ CIPN assessment frequency during the AP (assessment index = 0.5440) in comparison to during the UCP (assessment index = 0.6468).

Conclusions

Implementation of a clinician-decision support algorithm did not significantly improve clinicians’ CIPN assessment documentation or adherence to evidence-based management. Further research is needed to develop theory-based implementation interventions to bolster the frequency of CIPN assessment and use of evidence-based management strategies in practice.

Trial registration

ClinicalTrials.Gov,NCT03514680. Registered 21 April 2018.
Inhibition of ERAD synergizes with FTS to eradicate pancreatic cancer cells
Authors: Du Rong , Sullivan Delaney K. , Azizian Nancy G. , Liu Yuanhui , Li Yulin
Published: March 2021

Background

Pancreatic ductal adenocarcinoma (PDAC), one of the most lethal cancers, is driven by oncogenic KRAS mutations. Farnesyl thiosalicylic acid (FTS), also known as salirasib, is a RAS inhibitor that selectively dislodges active RAS proteins from cell membrane, inhibiting downstream signaling. FTS has demonstrated limited therapeutic efficacy in PDAC patients despite being well tolerated.

Methods

To improve the efficacy of FTS in PDAC, we performed a genome-wide CRISPR synthetic lethality screen to identify genetic targets that synergize with FTS treatment. Among the top candidates, multiple genes in the endoplasmic reticulum-associated protein degradation (ERAD) pathway were identified. The role of ERAD inhibition in enhancing the therapeutic efficacy of FTS was further investigated in pancreatic cancer cells using pharmaceutical and genetic approaches.

Results

In murine and human PDAC cells, FTS induced unfolded protein response (UPR), which was further augmented upon treatment with a chemical inhibitor of ERAD, Eeyarestatin I (EerI). Combined treatment with FTS and EerI significantly upregulated the expression of UPR marker genes and induced apoptosis in pancreatic cancer cells. Furthermore, CRISPR-based genetic ablation of the key ERAD components, HRD1 and SEL1L, sensitized PDAC cells to FTS treatment.

Conclusion

Our study reveals a critical role for ERAD in therapeutic response of FTS and points to the modulation of UPR as a novel approach to improve the efficacy of FTS in PDAC treatment.
First case of Phthirus pubis and Demodex co-infestation of the eyelids: a case report
Authors: Huo Yanan , Mo Yanping , Jin Xiuming , Huang Xiaodan , Chen Wei
Published: March 2021

Background

Phthirus pubis is an obligate parasite of human beings. Demodex spp. is a much more common parasite of human beings. However, P. pubis infestation accompanied by Demodex mite infestation in eye has not been reported.

Case presentation

We report the first case of Phthirus pubis and Demodex co-infestation on a 48-years-old woman. She presented to the hospital with itching and burning at her right eye for 2 weeks. Slit lamp examination revealed multiple nits and adults of P. pubis anchored to both upper and lower eyelashes. Eyelashes were trimmed, moxifloxacin eye ointment and fluorometholone eye drops were initiated daily. However, itching didn’t improve after 2 weeks of treatment. Light microscopy examination of eyelashes revealed infestation with Demodex. The patient was treated with lid scrubs with 25% tea tree oil daily for 4 weeks and was completely cured.

Conclusion

Our report shows the importance of an early and comprehensive diagnosis, because both phthiriasis palpebrarum and demodicosis can be confused with blepharitis.
BLEND-A: blending internet treatment into conventional face-to-face treatment for alcohol use disorder - a study protocol
Authors: Mellentin Angelina Isabella , Behrendt Silke , Bilberg Randi , Blankers Matthijs , Folker Marie Paldam , Tarp Kristine , Uffelmann Jakob , Nielsen Anette Søgaard
Published: March 2021

Background

A major challenge to psychological treatment for alcohol use disorder (AUD) is patient non-compliance. A promising new treatment approach that is hypothesized to increase patient compliance is blended treatment, consisting of face-to-face contact with a therapist combined with modules delivered over the internet within the same protocol. While this treatment concept has been developed and proven effective for a variety of mental disorders, it has not yet been examined for AUD.

Aims

The study described in this protocol aims to examine and evaluate patient compliance with blended AUD treatment as well as the clinical and cost effectiveness of such treatment compared to face-to-face treatment only.

Methods

The study design is a pragmatic, stepped-wedge cluster randomized controlled trial. The included outpatient institutions (planned number of patients: n = 1800) will be randomized in clusters to implement either blended AUD treatment or face-to-face treatment only, i.e. treatment as usual (TAU). Both treatment approaches consist of motivational interviewing and cognitive behavioral therapy. Data on sociodemographics, treatment (e.g. intensity, duration), type of treatment conclusion (compliance vs. dropout), alcohol consumption, addiction severity, consequences of drinking, and quality of life, will be collected at treatment entry, at treatment conclusion, and 6 months after treatment conclusion. The primary outcome is compliance at treatment conclusion, and the secondary outcomes include alcohol consumption and quality of life at six-months follow-up. Data will be analyzed with an Intention-to-treat approach by means of generalized linear mixed models with a random effect for cluster and fixed effect for each step. Also, analyses evaluating cost-effectiveness will be conducted.

Discussion

Blended treatment may increase treatment compliance and thus improve treatment outcomes due to increased flexibility of the treatment course. Since this study is conducted within an implementation framework it can easily be scaled up, and when successful, blended treatment has the potential to become an alternative offer in many outpatient clinics nationwide and internationally.

Trial registration

Clinicaltrials.gov.: NCT04535258, retrospectively registered 01.09.20.
Loneliness in early psychosis: a qualitative study exploring the views of mental health practitioners in early intervention services
Authors: Stefanidou Theodora , Wang Jingyi , Morant Nicola , Lloyd-Evans Brynmor , Johnson Sonia
Published: March 2021

Background

Loneliness is an important public health problem with established adverse effects on physical and mental health. Although people with psychosis often experience high levels of loneliness, relatively little is known about the relationship between loneliness and early psychosis. Potential interventions to address loneliness might be easier to implement early in the illness when social networks and social skills may be more intact than at a later stage. We investigated the views of mental health practitioners about the context and causes of loneliness in people with early psychosis, and about potential interventions.

Methods

Semi-structured face-to-face interviews were conducted with mental health practitioners (n = 20). Participants were purposively recruited from four early intervention services for first-episode psychosis in the UK. Interviews were transcribed verbatim and thematic analysis was conducted.

Results

Participants believed that the majority of service users with early psychosis experience feelings of loneliness. They often saw socially isolated and disconnected clients and believed them to be lonely, but rarely discussed loneliness explicitly in clinical interactions. A combination of symptoms, stigma and negative sense of self were believed to underpin loneliness. Participants could not identify any specific current interventions delivered by their services for tackling loneliness, but thought some routinely provided interventions, including social groups and psychological treatments, could be helpful. They favoured making a wider range of loneliness interventions available and believed that community agencies beyond mental health services should be involved to make these effective and feasible to deliver. They suggested social participation interventions without an explicit mental health focus as potentially promising and valued a co-produced approach to intervention development.

Conclusions

This study suggests that loneliness is not routinely discussed in early intervention services, and a targeted strategy for tackling it is lacking. Co-produced, individualised community approaches, and interventions that target symptoms, stigma and negative self-schemas might be beneficial in alleviating loneliness for people with early psychosis. Empirical research is needed to develop and test such interventions.
Trends, prevalence and factors associated with hypertension and diabetes among South African adults living with HIV, 2005–2017
Authors: Chiwandire Nicola , Zungu Nompumelelo , Mabaso Musawenkosi , Chasela Charles
Published: March 2021

Background

Many people are now living longer with HIV due to access to antiretroviral treatment. In turn, there has been an increase in the burden of hypertension and diabetes. The paucity of data on the burden of hypertension and diabetes in adults living with HIV in South Africa is a public health concern. The paper aimed to describe the prevalence and factors associated with hypertension and diabetes among adults living with HIV (ALHIV).

Methods

This was a secondary data analysis of the population based on the South African National HIV Prevalence, Incidence, Behaviour and Communication surveys for 2005, 2008 and 2017. Descriptive statistics were used to summarise the characteristics of the study sample. Bivariate and multivariate logistic regression analyses were used to determine factors associated with hypertension and diabetes.

Results

The total study population of ALHIV aged 25 years and older was 978, 1023 and 2483 for 2005, 2008 and 2017. The prevalence of hypertension showed an increasing trend at 11.8% in 2005, 9.5% in 2008 and 14.3% in 2017. The prevalence of diabetes was 3.3% in 2005, 2.8% in 2008 and 3.2% in 2017. Increased odds of hypertension among adults living with HIV were consistently associated with being female and the age group 45 years older across all the survey years, including pensioners and the sick, living in urban areas, high risk of hazardous alcohol consumption, diabetes and heart disease. Increased odds of diabetes were consistently associated with hypertension across all the survey years, including age group 45 years and older, and poor health. While having a secondary level of education and above was protective against diabetes.

Conclusion

The study showed that the prevalence of hypertension is high and has increased over time among adults living with HIV while the prevalence of diabetes has remained constant. Findings identified factors consistently associated with the prevalence of both diseases overtime, including contemporary risk factors that should be targeted in the integrated management of chronic disease and HIV care model.
The association of health-related factors with quality of life among the elderly population in the Jaffna district of Sri Lanka
Authors: Santhalingam Sathees , Sivagurunathan Sivayogan , Prathapan Shamini , Kanagasabai Sivapalan , Kamalarupan Luxmi
Published: March 2021

Background

The proportion of elderly individuals is increasing globally. They should be well cared for to enable them to enjoy their full lifespans. Good health is a vital component of one’s overall quality of life. Our study aimed to assess the association of health-related factors with quality of life among elderly individuals in the Jaffna District of Sri Lanka.

Methods

We conducted a community-based, cross-sectional study among 813 elderly individuals in the Jaffna district of Sri Lanka. Sociodemographic factors and the patterns of health conditions were recorded through an interviewer-administered questionnaire. Quality of life was measured through the World Health Organisation Quality of Life-Bref (WHOQOL-Bref) questionnaire.

Results

There were slightly more male respondents (53.5%) than females in the study. The median age of the participants was 70 (11) years. Approximately one-third of them had at least one chronic health condition. Musculoskeletal complaints were found to be the most common health condition, followed by diabetes, hypertension, vision problems, and asthma. Among the respondents, 20.1% were attending regular follow-up visits in a clinic, and 24% of them were meeting a doctor at least monthly. Among them, 6.8% had at least one limitation in their activities of daily living. However, the majority (58.6%) reported that they were satisfied with their health status. The following factors were found to be significantly associated with worse quality of life: the presence of health conditions, the presence of musculoskeletal conditions, hearing impairment, vision impairment, bronchial asthma, limitations in activities of daily living, and the use of addictive substances. Satisfaction with health, regular follow-up visits in a clinic, meeting a doctor at least monthly, and having diabetes were significantly associated with better quality of life.

Conclusion

Minimising the limitations of daily living, abstaining from using addictive substances, preventing diseases, and improving access to health services may enhance the quality of life of elderly individuals. Furthermore, these factors should be considered by policy makers seeking to improve the quality of life of elderly individuals.
Characterization of hyaluronan-coated extracellular vesicles in synovial fluid of patients with osteoarthritis and rheumatoid arthritis
Authors: Mustonen Anne-Mari , Capra Janne , Rilla Kirsi , Lehenkari Petri , Oikari Sanna , Kääriäinen Tommi , Joukainen Antti , Kröger Heikki , Paakkonen Tommi , Matilainen Johanna , Nieminen Petteri
Published: March 2021

Background

Hyaluronic acid (HA) is the major extracellular matrix glycosaminoglycan with a reduced synovial fluid (SF) concentration in arthropathies. Cell-derived extracellular vesicles (EV) have also been proposed to contribute to pathogenesis in joint diseases. It has recently been shown that human SF contains HA-coated EV (HA–EV), but their concentration and function in joint pathologies remain unknown.

Methods

The aim of the present study was to develop an applicable method based on confocal laser scanning microscopy (CLSM) and image analysis for the quantification of EV, HA-particles, and HA–EV in the SF of the human knee joint. Samples were collected during total knee replacement surgery from patients with end-stage rheumatoid arthritis (RA, n = 8) and osteoarthritis (OA, n = 8), or during diagnostic/therapeutic arthroscopy unrelated to OA/RA (control, n = 7). To characterize and quantify EV, HA-particles, and HA–EV, SF was double-stained with plasma membrane and HA probes and visualized by CLSM. Comparisons between the patient groups were performed with the Kruskal–Wallis analysis of variance.

Results

The size distribution of EV and HA-particles was mostly similar in the study groups. Approximately 66% of EV fluorescence was co-localized with HA verifying that a significant proportion of EV carry HA. The study groups were clearly separated by the discriminant analysis based on the CLSM data. The intensities of EV and HA-particle fluorescences were lower in the RA than in the control and OA groups.

Conclusions

CLSM analysis offers a useful tool to assess HA–EV in SF samples. The altered EV and HA intensities in the RA SF could have possible implications for diagnostics and therapy.
Development of a decision aid to support colorectal cancer screening: perspectives of Asians in an endemic urban community—a qualitative research study
Authors: Yuen Sok Wei Julia , Tay Tsang Yew , Gao Ning , Tho Nian Qin , Tan Ngiap Chuan
Published: March 2021

Background

Colorectal cancer (CRC) is a common malignancy worldwide. Despite being the most common cancer in Singapore, CRC screening rate remains low due to knowledge deficits, social reasons such as inconvenience and a lack of reminder or recommendation. A decision aid (DA) may facilitate an individual’s decision-making to undertake CRC screening by addressing misconceptions and barriers. We postulate that a more person-centred and culturally adapted DA will better serve the local population. The views of the target users are thus needed to develop such a DA. A CRC screening DA prototype has been adapted from an American DA to cater to the Asian users. This study aimed to explore user perspectives on an adapted CRC screening DA-prototype in terms of the design, content and perceived utility.

Methods

The study used in-depth interviews (IDIs) and focus group discussions (FGDs) to gather qualitative data from English-literate multi-ethnic Asian adults aged 50 years old and above. They had yet to screen for CRC before they were recruited from a public primary care clinic in Singapore. The interviews were audio-recorded, transcribed and analysed to identify emergent themes via thematic analysis.

Results

This study included 27 participants involved in 5 IDI and 5 FGDs. Participants found the DA easily comprehensible and of appropriate length. They appreciated information about the options and proposed having multi-lingual DAs. The design, in terms of the layout, size and font, was well-accepted but there were suggestions to digitalize the DA. Participants felt that the visuals were useful but there were concerns about modesty due to the realism of the illustration. They would use the DA for information-sharing with their family and for discussion with their doctor for decision making. They preferred the doctor’s recommendation for CRC screening and initiating the use of the DA.

Conclusions

Participants generally had favourable perceptions of the DA-prototype. A revised DA will be developed based on their feedback. Further input from doctors on the revised DA will be obtained before assessing its effectiveness to increase CRC screening rate in a randomized controlled trial.
The concept of justifiable healthcare and how big data can help us to achieve it
Authors: van Biesen Wim , Van Der Straeten Catherine , Sterckx Sigrid , Steen Johan , Diependaele Lisa , Decruyenaere Johan
Published: March 2021

Over the last decades, the face of health care has changed dramatically, with big improvements in what is technically feasible. However, there are indicators that the current approach to evaluating evidence in health care is not holistic and hence in the long run, health care will not be sustainable. New conceptual and normative frameworks for the evaluation of health care need to be developed and investigated. The current paper presents a novel framework of justifiable health care and explores how the use of artificial intelligence and big data can contribute to achieving the goals of this framework.
A qualitative study of organisational response to national quality standards for 7-day services in English hospitals
Authors: Sutton Elizabeth , Bion Julian , Mannion Russell , Willars Janet , Shaw Elizabeth , Tarrant Carolyn
Published: March 2021

Background

National standards are commonly used as an improvement strategy in healthcare, but organisations may respond in diverse and sometimes negative ways to external quality demands. This paper describes how a sample of NHS hospital trusts in England responded to the introduction of national standards for 7-day services (7DS), from an organisational behaviour perspective.

Methods

We conducted 43 semi-structured interviews with executive/director level and clinical staff, in eight NHS trusts that varied in size, location, and levels of specialist staffing at weekends. We explored approaches to implementing standards locally, and the impact of organisational culture and local context on organisational response.

Results

Senior staff in the majority of trusts described a focus on hitting targets and achieving compliance with the standards. Compliance-based responses were associated with a hierarchical organisational culture and focus on external performance. In a minority of trusts senior staff described mobilising commitment-based strategies. In these trusts senior staff reframed the external standards in terms of organisational values, and used co-operative strategies for achieving change. Trusts that took a commitment-based approach tended to be described as having a developmental organisational culture and a history of higher performance across the board. Audit data on 7DS showed improvement against standards for most trusts, but commitment-focused trusts were less likely to demonstrate improvements on the 7DS audit. The ability of trusts to respond to external standards was limited when they were under pressure due to a history of overall poor performance or resource limitations.

Conclusions

National standards and audit for service-level improvement generate different types of response in different local settings. Approaches to driving improvement nationally need to be accompanied by resources and tailored support for improvement, taking into account local context and organisational culture.
Hybrid mosquitoes? Evidence from rural Tanzania on how local communities conceptualize and respond to modified mosquitoes as a tool for malaria control
Authors: Finda Marceline F. , Okumu Fredros O. , Minja Elihaika , Njalambaha Rukiyah , Mponzi Winfrida , Tarimo Brian B. , Chaki Prosper , Lezaun Javier , Kelly Ann H. , Christofides Nicola
Published: March 2021

Background

Different forms of mosquito modifications are being considered as potential high-impact and low-cost tools for future malaria control in Africa. Although still under evaluation, the eventual success of these technologies will require high-level public acceptance. Understanding prevailing community perceptions of mosquito modification is, therefore, crucial for effective design and implementation of these interventions. This study investigated community perceptions regarding genetically-modified mosquitoes (GMMs) and their potential for malaria control in Tanzanian villages where no research or campaign for such technologies has yet been undertaken.

Methods

A mixed-methods design was used, involving: (i) focus group discussions (FGD) with community leaders to get insights on how they frame and would respond to GMMs, and (ii) structured questionnaires administered to 490 community members to assess awareness, perceptions and support for GMMs for malaria control. Descriptive statistics were used to summarize the findings and thematic content analysis was used to identify key concepts and interpret the findings.

Results

Nearly all survey respondents were unaware of mosquito modification technologies for malaria control (94.3%), and reported no knowledge of their specific characteristics (97.3%). However, community leaders participating in FGDs offered a set of distinctive interpretive frames to conceptualize interventions relying on GMMs for malaria control. The participants commonly referenced their experiences of cross-breeding for selecting preferred traits in domestic plants and animals. Preferred GMMs attributes included the expected reductions in insecticide use and human labour. Population suppression approaches, requiring as few releases as possible, were favoured. Common concerns included whether the GMMs would look or behave differently than wild mosquitoes, and how the technology would be integrated into current malaria control policies. The participants emphasised the importance and the challenge of educating and engaging communities during the technology development.

Conclusions

Understanding how communities perceive and interpret novel technologies is crucial to the design and effective implementation of new vector control programmes. This study offers vital clues on how communities with no prior experience of modified mosquitoes might conceptualize or respond to such technologies when deployed in the context of malaria control programmes. Drawing upon existing interpretive frames and locally-resonant analogies when deploying such technologies may provide a basis for more durable public support in the future.
A cost-analysis study of using adult red cell packs and Pedi-Packs in newborn intensive care units in Southern Iran
Authors: Haghpanah Sezaneh , Miladi Shima , Zamani Ali , Abadi Ali Mohammad Keshtvarz Hesam , Gholami Marjan , Gholami Maryam
Published: March 2021

Background and objective

Saving blood products is an important public health issue especially in developing countries with limited financial resources. We aimed to suggest a new hypothetical model to make a change in the current blood transfusion policy in the newborn intensive care unit (NICU) to reduce wastage of blood supplies as well as the risk of exposure to multiple donors.

Methods

In this cross-sectional study, all transfused neonates (n = 70) who were admitted to NICU of Nemazee Hospital, a tertiary referral hospital in Southern Iran, were evaluated between March and June 2019. Based on the information of neonates’ transfusion during this study period and determined transfusion indices, a specific pediatric pack was suggested and the related total costs per transfusion, as well as the donor-exposure rate of the hypothetical and the current transfusion method, were compared.

Results

Considering the mean number of transfusions per neonate: 4 and mean volume of transfused packed red cells: 20 ml per transfusion, the cost-analysis of pediatric and the adult pack was presented. Arithmetically, we proved a higher total cost per transfusion for using adult pack comparing to pediatric pack. Additionally, using a pediatric pack set leads to a 24% reduction in RBCs wastage per transfusion and a 68.13% reduction in donor-exposure rate.

Conclusions

The assignment of a dedicated pediatric pack for neonates will be able to improve the cost-effectiveness by a substantial reduction in donor-exposure rate and blood wastage. This finding should be taken into consideration to generate economic growth and make improvements in child health status.
Antibiotics-induced intestinal dysbacteriosis caused behavioral alternations and neuronal activation in different brain regions in mice
Authors: Wang Pan , Tu Ke , Cao Peng , Yang Yuefan , Zhang Hao , Qiu Xin-Tong , Zhang Ming-Ming , Wu Xiao-Jun , Yang Hui , Chen Tao
Published: March 2021

Antibiotics affect gut microbial composition, leading to Gut–Brain-Axis imbalance and neurobehavioral changes. However, the intestinal dysbacteriosis associated behavior changes are not consistently reported. It is not clear whether these changes are transient or permanent. The neuroprotective effect of probiotics against intestinal dysbacteriosis induced alternations needs to be determined either. In the present study, oral antibiotic mixture including Ampicillin, Streptomycin, and Clindamycin was utilized to induce intestinal dysbacteriosis in mice. Antibiotics application triggered mechanical allodynia in von frey test and spontaneous pain in open field test. It also resulted in increased anxiety and depressive-like behaviors and damaged spatial memory performance. After application of probiotics, the mechanical allodynia and spontaneous pain were alleviated significantly. The anxiety behaviors, depressive-like behaviors and recognitive performance were ameliorative as well. By using Fos protein as a marker, it is found that the sensory, emotion and memory related brain regions were activated in mice with intestinal dysbacteriosis. Our study is not only helpful for enriching our basic knowledge for understanding the changed pain responses and related brain disorders in antibiotics-induced dysbacteriosis mice, but also beneficial for providing a more comprehensive mechanistic explanation for the regulation of antibiotics and probiotics on gut microbiota and relevant alternations in animal neurological behaviors.
Targeting Bruton tyrosine kinase using non-covalent inhibitors in B cell malignancies
Authors: Gu Danling , Tang Hanning , Wu Jiazhu , Li Jianyong , Miao Yi
Published: March 2021

B cell receptor (BCR) signaling is involved in the pathogenesis of B cell malignancies. Activation of BCR signaling promotes the survival and proliferation of malignant B cells. Bruton tyrosine kinase (BTK) is a key component of BCR signaling, establishing BTK as an important therapeutic target. Several covalent BTK inhibitors have shown remarkable efficacy in the treatment of B cell malignancies, especially chronic lymphocytic leukemia. However, acquired resistance to covalent BTK inhibitors is not rare in B cell malignancies. A major mechanism for the acquired resistance is the emergence of BTK cysteine 481 (C481)  mutations, which disrupt the binding of covalent BTK inhibitors. Additionally, adverse events due to the off-target inhibition of kinases other than BTK by covalent inhibitors are common. Alternative therapeutic options are needed if acquired resistance or intolerable adverse events occur. Non-covalent BTK inhibitors do not bind to C481, therefore providing a potentially effective option to patients with B cell malignancies, including those who have developed resistance to covalent BTK inhibitors. Preliminary clinical studies have suggested that non-covalent BTK inhibitors are effective and well-tolerated. In this review, we discussed the rationale for the use of non-covalent BTK inhibitors and the preclinical and clinical studies of non-covalent BTK inhibitors in B cell malignancies.
The usability of Jordan stillbirths and neonatal deaths surveillance (JSANDS) system: results of focus group discussions
Authors: Khader Yousef S. , Shattnawi Khulood K. , Al-Sheyab Nihaya , Alyahya Mohammad , Batieha Anwar
Published: March 2021

Background

Jordan Stillbirths and Neonatal Deaths Surveillance system (JSANDS) is a newly developed system and is currently implemented in five large hospitals in Jordan. This study aimed at exploring the healthcare professionals’ perception about the usability of JSANDS.

Methods

A descriptive qualitative approach, using focus group discussions, was adopted. A total of 5 focus groups including 23 focal points were conducted in five participating hospitals in Jordan.

Results

Data analysis identified nine main issues related to the JSANDS system: the system usefulness, the system performance, data quality, the system limitations, human rights, female empowerment, nurses’ competencies strengthened, the sustainability of the JSANDS, and COVID-19 impact on the system. Users reported that JSANDS data were useful, the system was simple and easy to use, and the data were accurate and complete. However, some users reported that some technical issues need to be enhanced.

Conclusions

JSANDS was perceived positively by the current users. According to them, it provides a formative and comprehensive data on stillbirths and neonatal deaths and their causes, and therefore, was recommended to be adopted by its users and scaled up.
Psuedo static stability analysis of rock slope using patton’s shear criterion
Authors: Metya Subhadeep , Chaudhary Neeraj , Sharma Keshav Kumar
Published: March 2021

A deterministic model for the factor of safety of an idealized rock mass for planar mode of failure is developed adopting Limit Equilibrium Method (LEM) using Patton’s shear strength criterion and considering practically occurring conditions such as the effect of tension crack, water filled up in tension crack, horizontal and vertical seismic acceleration, rock bolt stabilizing force and surcharge. In the Pseudo-static analysis horizontal seismic acceleration is taken outward from the slope and vertical seismic acceleration is considered in both the direction i.e. towards the direction of gravity (downward) and opposite to the direction of gravity (upward). An expression of normal stresses as limiting criterion has been derived in order to compare the field normal stresses along the failure surface. A detailed parametric study has been presented to investigate the influence of vertical seismic coefficient for both the direction on the stability of rock slope using developed expression. For high normal stress along the failure plane, it is observed that the factor of safety decreases with increase in the value of vertical seismic coefficient towards the direction of gravity and increases linearly with increase in the value of vertical seismic coefficient against the direction of gravity and the opposite trend has been found for lower normal stress. The vertical seismic coefficient against the direction of gravity has predominant effect on factor of safety of rock slope as the rate of increase/decrease of factor of safety with vertical seismic coefficient is more against the direction of gravity. Hence in determining the critical factor of safety, effect of vertical seismic coefficient against the direction of gravity should be considered.
Self-efficacy and humanitarian aid workers
Authors: Turner Christine R. , Bosch Donald , Nolty Anne A. T.
Published: March 2021

As a result of frequent exposure to trauma, aid workers are at high risk for negative psychological symptoms. Training specifically geared at fostering critical incident self-efficacy in humanitarian aid workers may bolster critical incident self-efficacy as well as general self-efficacy as they relate to experiences of traumatic symptomatology and resilience. Sixty-three aid workers completed questionnaires regarding efficacy, resilience, coping, and posttraumatic stress symptomatology at baseline, and 46 aid workers completed the same measures after the training workshop. Multiple regression analysis indicated that higher levels of self-efficacy related to higher resilience levels. General self-efficacy and critical incident coping self-efficacy (CICSE) were stronger after the training, even when controlling for histories of trauma. Histories of trauma contributed significant variance to CICSE before the training but were insignificant after the training. These findings suggest that aid organizations can support their workers by providing training that promotes resilience through enhancing efficacies.
Experiences of patients who developed oral mucositis during solid neoplasms treatment: a Ugandan qualitative study
Authors: Kamulegeya Adriane , Nakanjako Damalie , Orem Jackson , Mayanja-Kizza Harriet
Published: March 2021

Background

Research on the management of complications of chemotherapy is important in facilitating the growing approaches to individualized patient management. Hence the need to document patient’s perspectives about chemotherapy-induced mucositis and the support they need from cancer care teams.

Methods

We carried out a qualitative study using in-depth interviews (IDI) and focus group discussions (FGD). We collected patient’s experiences on chemotherapy-induced mucositis by conducting 5 FGD and 13 IDIs.

Results

One glaring improvement that we need to make is the provision of information and counseling before, during, and after chemotherapy. Additionally, we need to explore inexpensive mucositis preventive strategies to aid our patients as they undergo treatment.

Conclusion

As a country, we must move away from taking cancer patients’ needs as those of common tropical diseases. This will allow us to provide that extra help needed outside the usual diagnosis and administration of medication.
Implementation of prostate cancer treatment decision aid in Michigan: a qualitative study
Authors: Paudel Roshan , Ferrante Stephanie , Woodford Jessica , Maitland Conrad , Stockall Eric , Maatman Thomas , Lane Giulia I. , Berry Donna L. , Sales Anne E. , Montie James E. ,   for the Michigan Urological Surgery Improvement Collaborative (MUSIC), Ann Arbor, Michigan, USA
Published: March 2021

Background

The American Urological Association White Paper on Implementation of Shared Decision Making (SDM) into Urological Practice suggested SDM represents the state of the art in counseling for patients who are faced with difficult or uncertain medical decisions. The Michigan Urological Surgery Improvement Collaborative (MUSIC) implemented a decision aid, Personal Patient Profile-Prostate (P3P), in 2018 to help newly diagnosed prostate cancer patients make shared decisions with their clinicians. We conducted a qualitative study to assess statewide implementation of P3P throughout MUSIC.

Methods

We recruited urologists and staff from 17 MUSIC practices (8 implementation and 9 comparator practices) to understand how practices engaged patients on treatment discussions and to assess facilitators and barriers to implementing P3P. Interview guides were developed based on the Tailored Interventions for Chronic Disease (TICD) Framework. Interviews were transcribed for analysis and coded independently by two investigators in NVivo, PRO 12. Additionally, quantitative program data were integrated into thematic analyses.

Results

We interviewed 15 urologists and 11 staff from 16 practices. Thematic analysis of interview transcripts indicated three key themes including the following: (i) P3P is compatible as a SDM tool as over 80% of implementation urologists asked patients to complete the P3P questionnaire routinely and used P3P reports during treatment discussions; (ii) patient receptivity was demonstrated by 370 (50%) of newly diagnosed patients (n = 737) from 8 practices enrolled in P3P with 78% completion rate, which accounts for 39% of all newly diagnosed patients in these practices; and (iii) urologists’ attitudes towards SDM varied. Over a third of urologists stated they did not rely on a decision aid. Comparator practices indicated habit, inertia, or concerns about clinic flow as reasons for not adopting P3P and some were unconvinced a decision aid is needed in their practice.

Conclusion

Urologists and staff affiliated with MUSIC implementation sites indicated that P3P focuses the treatment discussion on items that are important to patients. Experiences of implementation practices indicate that once initiated, there were no negative effects on clinic flow and urologists indicated P3P saves time during patient counseling, as patients were better prepared for focused discussions. Lack of awareness, personal habits, and inertia are reasons for not implementing P3P among the comparator practices.
Thyroid Hormones Regulate Goblet Cell Differentiation and Fgf19-Fgfr4 Signaling
Authors: Blitz Einat , Matsuda Hiroki , Guenther Stefan , Morikawa Takuto , Kubota Yukihiko , Zada David , Lerer-Goldshtein Tali , Stainier Didier Y R , Appelbaum Lior
Published: March 2021

Hypothyroidism is a common pathological condition characterized by insufficient activity of the thyroid hormones (THs), thyroxine (T4), and 3,5,3′-triiodothyronine (T3), in the whole body or in specific tissues. Hypothyroidism is associated with inadequate development of the intestine as well as gastrointestinal diseases. We used a zebrafish model of hypothyroidism to identify and characterize TH-modulated genes and cellular pathways controlling intestine development. In the intestine of hypothyroid juveniles and adults, the number of mucus-secreting goblet cells was reduced, and this phenotype could be rescued by T3 treatment. Transcriptome profiling revealed dozens of differentially expressed genes in the intestine of hypothyroid adults compared to controls. Notably, the expression of genes encoding to Fgf19 and its receptor Fgfr4 was markedly increased in the intestine of hypothyroid adults, and treatment with T3 normalized it. Blocking fibroblast growth factor (FGF) signaling, using an inducible dominant-negative Fgfr transgenic line, rescued the number of goblet cells in hypothyroid adults. These results show that THs inhibit the Fgf19-Fgfr4 signaling pathway, which is associated with inhibition of goblet cell differentiation in hypothyroidism. Both the TH and Fgf19-Fgfr4 signaling pathways can be pharmaceutical targets for the treatment of TH-related gastrointestinal diseases.
Experimental Study on Rheology of Animal Fats
Authors: RADULESCU Alexandru Valentin , RADULESCU Irina
Published: March 2021

In our days, there is a priority to diversify the sources of energy, in order to prevent the negative effects of human activity on the environment. One of the interestings solutions is to use the animal waste from the food industry. Turning animal fat into combustible would allow substituting it to oil in systems like boilers. But for using animal fat as energy in these systems, we should characterize it before by studying its rheological properties and especially the viscosity, in order to design the systems as well as possible. The purpose of the following study is to establish the main rheological properties of the pork fat, which is one of the most important waste source of animal fat from the food industry
Orbit Design and Trajectory Analysis of satellite in Low Earth Orbit
Authors: RAJA M. , ASTHANA Gaurav , SINGH Ajay , SINGHAL Ashna , LAKRA Pallavi LAKRA
Published: March 2021

An Attitude control system for a satellite in low earth orbit is designed in this project. As a reference, CARTOSAT-2 is selected to design the AOCS. CARTOSAT-2 is located in LEO so it suits the needs of the projects. It is mainly used for mapping of urban, rural areas and wetlands in India. To design a basic AOCS, a DC motor based model is considered. Transfer functions of DC motor and satellite dynamics model are calculated using Laplace transformation. Stability of the system is checked by plotting poles and zeroes of the systems. PID controller is used to improve the overall stability of the system by decreasing the errors in the output of the system. The systems are subjected to sine and step inputs and responses are plotted in the form of graphs. The plots are studied using SciLab as the tool to design the block diagram and the control system for the AOCS. Scilab along with FlightGear is used to visualize the response of the system.
Correlation between the anisotropy of an AA2021-T351 aluminium rolled thick plate and the occurrence of the stick-slip phenomenon
Authors: STOICA Nicolae-Alexandru , STOICA Alina-Maria , TUDOR Andrei , MANOLIU Victor , BOTAN Mihail , CRISTEA George Catalin
Published: March 2021

The stick-slip phenomenon is a dynamic instability that appears at the contact interface of two sliding surfaces. Its occurrence is influenced by the relative sliding speed, the contact pressure, and the system rigidity, but also by the state of contact between the two sliding surfaces. The present paper aims to study the influence of the anisotropy of an aluminium AA2021-T351 plate on the stick-slip phenomenon. For this, using the CETR UMT II tribometer, linear sliding tests have been performed on the aluminium alloy thick plate surface using a cylindrical pin made of ultra-high-molecular-weight polyethylene (UHMWPE) along three directions: a longitudinal one, corresponding to the rolling direction of the sample (0°), a transverse one, perpendicular to the rolling direction (90°), and a median direction (45°). Varying the sliding speed, the contact pressure, and the system rigidity, it was possible to observe the influence of the material anisotropy on the specific parameters of the stick-slip phenomenon.
Detection of trees features from a forestry area using airborne LiDAR data
Authors: VIZIREANU Ioana , CALCAN Andreea , GRIGORAS Georgiana , RADUCANU Dan
Published: March 2021

The impact of anthropogenic actions on the environment and climate has recently increased the need to map the afforested areas. In this context, the three-dimensional (3D) measurement of vegetation structures plays an important role in having an efficient forest inventory and management. Nowadays, the airborne LiDAR (Light Detection And Ranging) system offers high horizontal resolution as well as vertical dimension information, making it possible to estimate both three-dimensional characteristics of individual trees and to identify the distribution of forest resources in the region. This study aims to present a processing approach for the determination of each tree’s position (X and Y location, as well as tree height) and its dimensions (crown diameter, area and volume) using geometrically accurate 3D point clouds (data sets were collected in a forested area in Argeș County, Romania). To a better understanding of the forest features and to explore the potential of remote sensing for such analysis, it was further exploited Digital Terrain Model (DTM), Digital Surface Model (DSM), and Canopy Height Model (CHM) derivation.
Effects of the boundary layer control methods on stability and separation point
Authors: HOTHAZIE Mihai-Vladut , DANAILA Sterian
Published: March 2021

This paper concerns the benefits of the active boundary layer control methods. The main focus was studying the effectiveness of suction control for a laminar flow over an airfoil. However, injection normal to or along the wall was also approached using two numerical methods. For different values and distributions of the velocity control magnitude, a systematic comparison was done. Having the results of the laminar flow, a linear stability analysis based on the small disturbance theory was carried out obtaining both the neutral stability curves and the transition point. In the end, for each case, results were presented with the corresponding observations. Additionally, a study on the dependency of the separation point with respect to the injection velocity magnitude was done.
Concluding discussion: key themes in the (possible) move to co-production and co-creation in public management
Authors: Ferlie Ewan
Published: March 2021

The articles in this special issue add to a rapidly developing literature on co-creation in public services management. This final article focuses what might otherwise be a wide ranging discussion by addressing core themes proposed in the special issue’s introduction. We consider:

basic definitions of co-production and co-creation; the claim of a possible move from lower order co-production to higher level co-creation;

the link with different models of strategic management, why strategic management is important and which models are promising;

the potential role of digitalisation in the move to co-production and co-creation;

the possible link with co-creation informed innovation which contributes to the pursuit of public value outcomes.

We examine the potential role of strategic management along with the nature of any ‘metagovernance’ of associated policy networks. The conclusion makes general observations and considers future research direction.