bluuebunny/crossref_metadata_2025 huggingface dataset:
Scaling operator demodulation spectrum-based planetary gearbox fault diagnosis method under variable speed conditions
Authors: Zhao Dezun , Cui Lingli
Published: October 2022

It is a challenging task to detect planetary gearbox fault type under time-varying speeds. Firstly, under time-varying speeds, the fault-induced frequency harmonics of the planetary gearbox are time-varying and close-spaced, and the fault feature is difficult to detect from the spectrum or traditional time-frequency analysis (TFA) results. Secondly, the interference component in the vibration signal resulting from the complicated gearbox configuration is another obstacle for fault detection. As such, the scaling operator demodulation spectrum (SODS) technique with high readability is developed for planetary gearbox fault diagnosis under variable speed conditions. The developed technique consists of two terms: scaling demodulation operator term for transforming all time-varying fault-related frequency harmonics; and spectral selection criterion term for obtaining fault-related frequency harmonics and removing the other smeared frequency components. With the proposed technique, the time-varying and close-spaced fault-induced frequency harmonics can be quantitatively characterized by the spectral peaks. The performance of the SODS-based planetary gearbox fault diagnosis technique is validated by a simulated signal and two experimental signals collected from different test rigs. Furthermore, comparison results with the traditional TFA methods show that the proposed technique has much better ability to identify the fault-related frequency harmonics of the planetary gearbox.
(De)centralisation in fee-free policymaking process: Comparative review of Progressive Free Senior High and Free Senior High School policies in Ghana
Authors: Asante Gabriel , Nkansah Godfred Bonnah , Agbee David
Published: October 2022

The underlying ambition of fee-free education is to increase school access. This study reflects on decentralisation in the decision-making process and implementation of fee-free policies. We compare two policies at the high school level in Ghana to evaluate the differences and commonalities in how they responded to school access. We used interviews and secondary sources of data for qualitative content analysis. Haddad and Demsky’s rationality framework of education policymaking served as the analytical guide. The results show that Free Senior High School policy (FSHS) increased access to education by responding to the existing problem of low rate of transition from lower secondary to upper secondary education, unlike Progressive Free Senior High School policy (PFSHS). However, the desirability of access is over-prioritised in the current FSHS – unlike in the PFSHS, leaving gaps in administration, educational facilities and resources: challenges attributable to the concentration of centralised administrative decisions during policy formulation and implementation. We propose remedial measures to address these challenges.
Income Inequality, Race/Ethnicity, and Obesity in U.S. Men 20 Years and Older: 1999 to 2016
Authors: Zare Hossein , Gilmore Danielle R. , Meyerson Nicholas S. , Thorpe Roland J.
Published: October 2022

Obesity is a significant public health problem globally and within the United States. It varies by multiple factors, including but not limited to income. The literature indicates little evidence of the association between income and obesity. We examined the association between income and obesity in U.S. adult men ages 20 years and older and tested racial and ethnic differences. We used data from the 1999 to 2016 National Health and Nutrition Examination Surveys for analyses. Obesity was determined using body mass index ≥30 kg/m2. We used poverty income ratio (PIR) as a proxy for income and calculated the Gini coefficient (GC) to measure income inequality. We then categorized low-, medium-, and high PIR to examine the relationship between income inequality and obesity. We used Modified Poisson regression in a sample of 17,238 adult men, including 9,511 White Non-Hispanic White (NHW), 4,166 Non-Hispanic Black (NHB), and 3,561 Mexican Americans (MA). We controlled the models for age category, racial and ethnic groups, marital status, education, health behaviors, health insurance coverage, self-reported health, comorbidity, and household structure. Results of our adjusted models suggested a positive and significant association between PIR and obesity among NHWs and NHBs in medium and high PIR; this association was not significant in MAs. Results of our analyses using GC in obese men indicate that compared with NHWs (GC: 0.306, SE: 0.004), MAs (GC: 0.368, SE: 0.005), and NHBs (GC: 0.328, SE: 0.005) had experienced higher-income inequality. In treating obesity, policymakers should consider race/ethnicity strategies to reduce inequality in income.
A novel kinematic model and its compensation approach for structural parameter of rotating joints series robot
Authors: Xiang Ming , Sun Zhiwen , Feng Hao , Wang Wei , Huang Yuchen , Luo Xianhai
Published: October 2022

The pose accuracy is important performance index of industrial robot. In order to improve the pose accuracy, it is necessary to compensate the kinematic parameters of the robot. A novel approach for kinematic parameter compensation of robot based on the parameter solving of the ruled surface model is developed by establishing a model containing link error and kinematic pair error. The fitting axis of each joint is obtained by fitting the discrete points. Then, the fitting axes of the adjacent joints is used to identify the link errors and the link errors are compensated. This approach has been tested and verified on the LR7-710 robot. The test results show that the position error of the arc trajectory is reduced from 0.4580 to 0.0801 mm.
TNFRSF13B/TACI Mutations in Patients with Chronic Rhinosinusitis with Nasal Polyps
Authors: Tsiouma Georgia K. , Skoulakis Charalampos E. , Lachanas Vasileios A. , Sevdali Eirini G. , Tsinti Gerasimina N. , Florou Zoi A. , Petinaki Efthymia A. , Speletas Matthaios G.
Published: October 2022

Background

The pathogenesis of Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) remains still inconclusive. Recent studies identified an increased expression of BAFF (a B cell-activating factor) and its receptor TACI (Transmembrane Activator and cAML Interactor) in nasal polyp samples, while TNFRSF13B/TACI mutations have been found in patients with benign lymphoproliferative disorders and primary antibody deficiencies.

Objective

The aim of our study was to evaluate the possible contribution of TNFRSF13B/TACI mutations in CRSwNP pathogenesis.

Methods

Forty-four (44) patients with CRSwNP (male/female: 33/11, mean age: 52.5 years, range: 16-83) were analyzed for TNFRSF13B/TACI mutations by PCR-sequencing.

Results

No pathogenic TNFRSF13B/TACI mutations were identified in our cohort study of CRSwNP patients. We detected two common missense mutations (p.P251L and p.V220A), along with other common silent mutations and intronic polymorphisms in an identical prevalence to healthy control population.

Conclusion

TNFRSF13B/TACI mutations might not play a role in the pathogenesis of CRSwNP.
Visual Inspection for Lower Limb Malalignment Diagnosis Is Unreliable
Authors: Nguyen H. Chien , van Egmond Nienke , de Visser Huub M. , Weinans Harrie , Sakkers Ralph J.B. , Custers Roel J.H.
Published: October 2022

Objective

Visual inspection of the lower limb is often part of standard clinical practice during a physical examination at the outpatient clinic. This study aims to investigate how reliable visual inspections are in terms of detecting lower limb malalignments without additional tools and physical examinations.

Design

This study enrolled 50 patients. Each patient underwent a whole leg radiograph (WLR); in addition, a standardized digital photograph was taken of the lower limbs. Four persons (different experience levels) visually rated the digital photograph twice (unaware of the hip knee angle [HKA] on the WLR) and placed them in the category: severe valgus (>5°); moderate valgus (2°-5°); neutral, moderate varus (2°-5°); and severe varus (>5°). Visual ratings were compared with the measured HKA on WLRs for correlation using Spearman’s rho. Linear ordinal regression models with significance when P < 0.05 were used to test whether body mass index (BMI), age, gender, and HKA were possible risk factors for incorrect visual HKA assessment.

Results

Spearman’s rho between the visual assessment and measured HKA on the WLR was moderate with 0.478 ( P < 0.01). Women had an increased odds ratio of 3.7 ( P = 0.001) for incorrect visual assessment. Higher HKA also increased the odds ratio for erroneous visual assessment with 1.4 ( P = 0.003). BMI and age did not significantly increase the odds of erroneous visual leg axis assessments in this study.

Conclusions

Visual assessment of the lower limb alignment does not provide clinically relevant information. Lower limb malalignment diagnoses cannot be performed using only a visual inspection. Physical examination tests and radiographical assessments are advised.

Level of evidence:

Diagnostic level II
High-Anion-Gap Metabolic Acidosis During a Prolonged Hospitalization Following Perforated Diverticulitis: An Educational Case Report
Authors: Cecilia Farfan Ruiz Ana , Sriperumbuduri Sriram , Shaw Julie L V , Clark Edward G.
Published: October 2022

Rationale:

The metabolic acidoses are generally separated into 2 categories on the basis of an anion gap calculation: high-anion-gap and normal anion-gap metabolic acidosis. When a high-anion-gap metabolic acidosis (HAGMA) is not clearly explained by common etiologies and routine confirmatory testing, specialized testing can definitively establish rare diagnoses such as 5-oxoproline, d-lactate accumulation, or diethylene glycol toxicity.

Presenting Concerns of the Patient:

A 56-year-old woman had a prolonged hospital admission following perforated diverticulitis requiring sigmoid resection. Her hospitalization was complicated by feculent peritonitis and surgical wound dehiscence needing prolonged broad-spectrum antibiotics and wound debridements. She developed acute kidney injury and HAGMA in the hospital.

Diagnoses:

Chart review showed that she received a large cumulative dose of acetaminophen during her hospital stay. Laboratory studies showed markedly increased serum 5-oxoproline causing HAGMA.

Interventions (Including Prevention and Lifestyle):

Patient was admitted to the intensive care unit and treated with N-acetylcysteine and renal replacement therapy.

Outcomes:

After admission to the intensive care unit, the patient continued to require vasopressor and ventilatory support for septic shock and a ventilator-associated pneumonia. After an initial recovery and resolution of her HAGMA, she subsequently suffered recurrent aspirations which were fatal.

Teaching points:

1. The acronym GOLD MARK is useful when assessing patients with HAGMA and most causes of HAGMA can be established with routine testing. 2. When the etiology of HAGMA remains unclear, additional testing can be required to diagnose rare causes of HAGMA. 3. Rare causes of HAGMA are diethylene glycol, 5-oxoproline, and d-lactate accumulation. 4. Acidosis secondary to 5-oxoproline accumulation can occur even with “therapeutic” doses of acetaminophen in patients receiving it regularly for a prolonged period and who have depleted glutathione stores. 5. Risk factors for glutathione depletion include malnutrition, older age, sepsis, pregnancy, multiple chronic illnesses, and chronic kidney disease.
Neural network–based fully automated cardiac resting phase detection algorithm compared with manual detection in patients
Authors: Ogawa Ryo , Kido Tomoyuki , Shiraishi Yasuhiro , Yagi Yuri , Su Yoon Seung , Wetzl Jens , Schmidt Michaela , Kido Teruhito
Published: October 2022

Background

A cardiac resting phase is used when performing free-breathing cardiac magnetic resonance examinations.

Purpose

The purpose of this study was to test a cardiac resting phase detection system based on neural networks in clinical practice.

Material and Methods

Four chamber-view cine images were obtained from 32 patients and analyzed. The rest duration, start point, and end point were compared between that determined by the experts and general operators, and a similar comparison was done between that determined by the experts and neural networks: the normalized root-mean-square error (RMSE) was also calculated.

Results

Unlike manual detection, the neural network was able to determine the resting phase almost simultaneously as the image was obtained. The rest duration and start point were not significantly different between the neural network and expert ( p = .30, .90, respectively), whereas the end point was significantly different between the two groups ( p < .05). The start point was not significantly different between the general operator and expert ( p = .09), whereas the rest duration and end point were significantly different between the two groups ( p < .05). The normalized RMSEs of the rest duration, start point, and end point of the neural network were 0.88, 0.64, and 0.33 ms, respectively, which were lower than those of the general operator (normalized RMSE values were 0.98, 0.68, and 0.51 ms, respectively).

Conclusions

The neural network can determine the resting phase instantly with better accuracy than the manual detection of general operators.
The potential and pitfalls of co-producing urban knowledge: Rethinking spaces of engagement
Authors: Patel Zarina
Published: October 2022

Securing sustainable and just transition pathways in cities is recognised as key to addressing global environmental challenges. There is increasing acceptance that transformative change in cities must be shaped by the co-production of knowledge between diverse partners. The creation of spaces of collaboration, referred to in the literature as ‘third spaces’, is integral to such co-production of knowledge. However, evidence to support a direct relationship between third spaces of engagement and securing urban transformation is largely undocumented. This paper deepens and develops the idea of shared spaces for knowledge co-production by drawing on the experiences of City officials and PhD researchers in a City-University knowledge partnership in Cape Town. It uses the data to critique the third space for its limited engagement with how the relationship between individual knowledge brokers and their home institutions effects change. The findings of the paper show that, despite the benefits of boundary crossing between the academy and practice, such crossings also leave individuals peripheralised from their ‘home’ institutions. This disconnect and sense of ‘homelessness’ limits the potential of co-production to affect urban transformation. To address the conceptual lacunae of the third space, I develop the idea of the portal to reflect the dynamic exchange required between individuals and their home institutions for realising relevant change. The form of the portal is not spatially bound, but reflects dynamic processes of entering and exiting sites of knowledge exchange to secure a sense of belonging. By highlighting the need to include processes for anchoring institutional learning, the concept of portals for knowledge exchange offers additional scope for securing urban transformation.
Patient Perspectives on Home-Based Care and Remote Monitoring in Heart Failure: A Qualitative Study
Authors: Carter Jocelyn , Donelan Karen , Thorndike Anne N.
Published: October 2022

Introduction:

As individual interventions, home-based care and remote monitoring have been shown to help prevent hospitalizations for those with heart failure (HF) although both interventions have been limited by scalability and technical constraints, respectively. Few qualitative studies have explored patient perspectives, including acceptability, barriers, and facilitators of HF care inclusive of both interventions. The objective of this study is to explore patient perceptions on HF management at home, the use of home-based remote monitoring, and the value of home-based care.

Methods:

Qualitative interviews (N = 27) were conducted via phone (12/2020-3/2021) with adults with HF. A framework analysis was used to identify main themes along with verbatim transcription for coding and analyses. There were 5 key interview domains: general HF knowledge, perceptions of the value of home-based care, unmet needs related to the social determinants of health (SDOH), experience with healthcare technology and remote monitoring, and challenges in HF home management.

Results:

Five major themes emerged. Patients reported: (1) home-based care plan instructions are understood; (2) following medication, diet, and fluid management instructions are challenging due to difficult adherence to and implementation at home; (3) financial limitations serve as barriers to acquiring healthy food; (4) home-based support is a valuable component of managing medications, diet, and fluid; (5) despite limited use of technology, strong willingness to use remote monitoring is present amongst most.

Conclusions:

Participants reported understanding of care plan instructions and challenges adhering to care plans at home. Barriers included needing more home-based support for medications, diet, and fluid management and requiring additional assistance with financial barriers related to unmet social needs. A combined intervention inclusive of remote monitoring and home-based support has potential to improve home-based strategies and clinical outcomes for HF patients.
Ears on the Street: Practitioner Opinions on What Competencies Sales Executives Need and How to Develop Them
Authors: Boehm-Fischer Annina , Schmidt Joel T. , Nachtwei Jens
Published: October 2022

The goal of this in-depth interview study was to gain knowledge about important, needed and developed competencies of executives. Supplementary design factors and implementation barriers were examined as framework conditions for competency development. The study ( N = 66) gathers information from three different subject groups: executives ( n = 22), freelance trainers ( n = 23), and corporate HR professionals responsible for executive development ( n = 21). A total of 13 important competencies were extracted from the answers of all respondents. Groups agreed on five competencies (leading, communication, achievement motivation, organizing and strategy, social influence) which are therefore classified as needed. Design factors and implementation barriers were classified, ranked according to relevance and evaluated in general and on a group-specific basis. The two most important design factors mentioned by all subject groups are: 1) to ensure the practical relevance of development programs; and 2) to include time for discussion and reflection. The three most common barriers are daily business, conflicting old habits and lack of motivation. Results also show that other competencies are also developed, but are not classified as needed (e.g., openness for novelty, and self-reflection). These findings provide insight and guidance for creating training and development programs for sales executives that focus on the competencies that are needed and how these can be developed.
Assessment of Interventions in Primary Health Care for Improved Maternal, New-born and Child Health in Sub-Saharan Africa: A Systematic Review
Authors: Okonofua Friday E. , Ntoimo Lorretta F. C. , Adejumo Oluwadamilola A. , Imongan Wilson , Ogu Rosemary N. , Anjorin Seun O.
Published: October 2022

Primary health care (PHC) holds great potentials to improve maternal, newborn, and child health (MNCH) outcomes. However, there has been limited documentation of its effects on increasing universal access to maternal, newborn, and child health services in sub-Saharan Africa. Also, not adequately known are the most effective interventions to improve the delivery of PHC services in the region. The objective of this study was to conduct a systematic review of empirical evidence of interventions that improved access and quality of PHC services for maternal, newborn, and child health in sub-Saharan Africa. The protocol was registered on Prospero (Registration number CRD42019126029). Using terms related to primary health care and MNCH, we searched African Journals Online (AJOL), PubMed/Medline, Popline, ScienceDirect, Google Scholar, WHO Repository (IRIS), Directory of Open Access Journals (DOAJ), Cochrane Library, and reference lists for studies published in English between 2000 and 2019. Studies were included in the search if they reported interventions, and strategies implemented to improve quality and access to primary health care for maternal, newborn, and child health in sub-Saharan Africa. A total of 25 studies were included in the review. Effective interventions included financial incentives, task-shifting, community-directed engagements, training of providers, mobile health, cost-sharing, and supportive supervision among others. The result of this review contributes useful insight to guide the reformation, and development of new policies and programs for improving access and quality of primary health care delivery in sub-Saharan Africa, particularly to improve maternal and child health in the region. However, strategies to scale and sustain the successes need to be in place.
Conceptualizing Value Creation in the Platform Era
Authors: Wichmann Julian R.K. , Reinartz Werner , Venkatesan Rajkumar
Published: October 2022

Platforms have entered many industries and increasingly dominate markets. As such, they increasingly displace the traditional linear pipeline model of value creation with a web of value-creating interactions among three key players: the platform provider, platform consumers and platform suppliers. Existing conceptualizations of consumer value, however, are still based in the linear pipeline world which raises the need to update these frameworks to the platform era. In this article, we make first important strides towards an overarching platform-based valuation framework which can be applied to any type of platform. We build upon Kumar et al. (2010) by applying and extending the concept of customer engagement value to the platform context. In doing so, we delineate a variety of value components that (a) originate from a platform’s consumers as well as suppliers, (b) generate monetary and non-monetary value for the platform provider, and (c) generate direct and indirect value for the platform provider. Together, these value components holistically capture platform participants’ value creation and assist managers in evaluating the health and sustainability of their platforms.
Ultrasound-guided bilateral modified-thoracoabdominal nerve block through a perichondrial approach (M-TAPA) in patients undergoing laparoscopic cholecystectomy: a randomized double-blind controlled trial
Authors: Bilge Ayşegül , Başaran Betül , Et Tayfun , Korkusuz Muhammet , Yarımoğlu Rafet , Toprak Hatice , Kumru Nuh
Published: October 2022

Background

Modified thoracoabdominal nerve block through the perichondrial approach (M-TAPA) is a new technique that provides effective analgesia of the anterior and lateral thoracoabdominal walls by administering local anesthesia only to the underside of the perichondral surface. The primary purpose of the present study was to investigate the postoperative analgesic efficacy of M-TAPA block performed before surgery in patients undergoing laparoscopic cholecystectomy (LC).

Method

The present study was designed as a double-blind, randomized, controlled, prospective study. A total of 68 patients were included in the study. In group M-TAPA, M-TAPA block was performed bilaterally after the induction of general anesthesia. No block was performed on the group control. The postoperative pain scores, analgesic use in the first 24 h, antiemetic consumption, sedation, postoperative nausea and vomiting (PONV), and Quality of Recovery-40 (QoR-40) scores were recorded.

Results

Pain scores were significantly lower in group M-TAPA than in the group control, both during resting and motion at all times (p < 0.001 at each time point). The total amount of tramadol consumed in the first 24 h was lower in group M-TAPA [median 100 mg, min-max (0-200)] than in the group control (P < 0.001). Postoperative median QoR-40 scores were higher in group M-TAPA compared with the group control (P < 0.001). There were no differences between the groups in terms of other results.

Conclusion

After the LC surgery, ultrasound-guided M-TAPA block reduced postoperative pain scores and tramadol consumption effectively. It was observed that the quality of recovery was also higher because QoR-40 scores were higher.
Motion artefact reduction in coronary CT angiography images with a deep learning method
Authors: Ren Pengling , He Yi , Zhu Yi , Zhang Tingting , Cao Jiaxin , Wang Zhenchang , Yang Zhenghan
Published: October 2022

Background

The aim of this study was to investigate the ability of a pixel-to-pixel generative adversarial network (GAN) to remove motion artefacts in coronary CT angiography (CCTA) images.

Methods

Ninety-seven patients who underwent single-cardiac-cycle multiphase CCTA were retrospectively included in the study, and raw CCTA images and SnapShot Freeze (SSF) CCTA images were acquired. The right coronary artery (RCA) was investigated because its motion artefacts are the most prominent among the artefacts of all coronary arteries. The acquired data were divided into a training dataset of 40 patients, a verification dataset of 30 patients and a test dataset of 27 patients. A pixel-to-pixel GAN was trained to generate improved CCTA images from the raw CCTA imaging data using SSF CCTA images as targets. The GAN’s ability to remove motion artefacts was evaluated by the structural similarity (SSIM), Dice similarity coefficient (DSC) and circularity index. Furthermore, the image quality was visually assessed by two radiologists.

Results

The circularity was significantly higher for the GAN-generated images than for the raw images of the RCA (0.82 ± 0.07 vs. 0.74 ± 0.11, p < 0.001), and there was no significant difference between the GAN-generated images and SSF images (0.82 ± 0.07 vs. 0.82 ± 0.06, p = 0.96). Furthermore, the GAN-generated images achieved the SSIM of 0.87 ± 0.06, significantly better than those of the raw images 0.83 ± 0.08 (p < 0.001). The results for the DSC showed that the overlap between the GAN-generated and SSF images was significantly higher than the overlap between the GAN-generated and raw images (0.84 ± 0.08 vs. 0.78 ± 0.11, p < 0.001). The motion artefact scores of the GAN-generated CCTA images of the pRCA and mRCA were significantly higher than those of the raw CCTA images (3 [4–3] vs 4 [5–4], p = 0.022; 3 [3–2] vs 5[5–4], p < 0.001).

Conclusions

A GAN can significantly reduce the motion artefacts in CCTA images of the middle segment of the RCA and has the potential to act as a new method to remove motion artefacts in coronary CCTA images.
The role of optical coherence tomography angiography in distinguishing ischemic versus non-ischemic central retinal vein occlusion
Authors: An Weiting , Zhao Qi , Yu Rongguo , Han Jindong
Published: October 2022

Introduction:

To observe macular microvascular changes in patients with ischemic and non-ischemic central retinal vein occlusion (CRVO) by optical coherence tomography angiography (OCTA), and explore the value of OCTA in differentiating ischemic and non-ischemic CRVO.

Methods:

Cross sectional study. Fifty patients diagnosed as CRVO with macular edema were included. Macular edema in all patients were regressive after three consecutive anti-VEGF treatment. Patients were divided into ischemic and non-ischemic group according to ultra-wide-angle fundus fluorescein angiography (UWFFA). All patients underwent BCVA, IOP, color fundus photography, UWFFA and OCTA. The following parameters were measured: (1) Vessel density (VD): superficial and deep whole VD (SVD, DVD), superficial and deep central fovea VD (SFVD, DFVD), superficial and deep parafoveal VD (SPFVD, DPFVD); (2) Central foveal retinal thickness (CRT); (3) Area of foveal avascular zone (FAZ), perimeter of FAZ (PERIM), avascular index of FAZ (AI) and VD within a width of 300 microns around the FAZ region (FD-300). Comparison between ischemic and non-ischemic group was performed by two independent sample t-tests. Receiver operating characteristic (ROC) curve analysis was used to measure the area under the curve (AUC) of VD for predicting ischemic CRVO.

Results:

There were no significant differences in IOP, SFVD, DFVD and CRT between ischemic and non-ischemic group, and significant differences in age, BCVA, SVD, SPFVD, DVD, DPFVD, FAZ area, PERIM, AI and FD-300 between ischemic and non-ischemic group. ROC curve analysis showed AUC of DVD and DPFVD in predicting ischemic CRVO was highest (0.962). the threshold was 38.40%, and the sensitivity was 100%, but the specificity of DVD (92.3%) was significantly higher than that of DPFVD (84.6%). Therefore, DVD ≤ 38.40% can be used as the best threshold for determining ischemic CRVO.

Conclusion:

OCTA can quantitatively evaluate the macular microvascular structure of CRVO, which is helpful to distinguish ischemic from non-ischemic CRVO.
A retrospective study exploring how South African newspapers framed Schizophrenia and other psychotic disorders over an 11-year period (2004–2014)
Authors: Masinga Nombuso , Nyamaruze Patrick , Akintola Olagoke
Published: October 2022

Background:

The way schizophrenia is portrayed in the media contributes to the dissemination of misinformation about the symptoms, causes, and treatment of mental disorders and has the potential to perpetuate or mitigate the stigmatization of schizophrenia. While research on the news media’s role in exacerbating or mitigating the stigmatization of schizophrenia has been conducted widely in other contexts, our search did not yield any study on media framing of schizophrenia in South Africa. Therefore, this study used the framing theory to examine the media framing of schizophrenia following the enactment of two mental health policies in South Africa.

Methods:

We examined 216 news stories that covered the schizophrenia spectrum and other psychotic disorders from 20 South African newspapers retrieved from the SABINET – SA Media online archive over an 11-year period (2004–2014). Thematic analysis was used to analyse the news stories.

Results:

The findings show that most of the news stories had problems as their main frame. These were followed by stories framed to diagnose the causes of schizophrenia and other psychotic disorders; and stories that made moral judgements about issues around the schizophrenia spectrum and other psychotic disorders. Stories that were classified as suggesting remedies were relatively less frequent. A common thread in the news stories was the misperceptions about schizophrenia and other psychotic disorders. Media framing of the cultural interpretations of schizophrenia and other psychotic disorders tended to be derogatory and therefore stigmatising. Most news stories framed schizophrenia and other psychotic disorders as mainly caused by using psychoactive drugs/substance with Cannabis as the most frequently mentioned psychoactive drug.

Conclusion:

The study underscores the role of media analyses in framing schizophrenia and other psychotic disorders following the development of major mental health policies. The study showed that the media framing of schizophrenia could perpetuate stigmatisation, discrimination and social rejection of people with lived experiences of the condition. Our findings highlight the need for collaboration between researchers and the media to enhance opportunities for improved and more nuanced reporting of mental health issues.
Worldwide cancer statistics of adults over 75 years old in 2019: a systematic analysis of the global burden of disease study 2019
Authors: Xiang Danhong , Hu Shiwei , Mai Tianxiang , Zhang Xinlu , Zhang Lan , Wang Shengjie , Jin Keyi , Huang Jian
Published: October 2022

Background and purpose

Cancer has become one of the major killers of humanity due to the number of people over the age of 75 increasing with population ageing. The aim of this study was to analyse the incidence and mortality rates in people over 75 of 29 cancer types in 204 countries and regions, as well as the trends from 1990 to 2019.

Methods

Twenty-nine cancer types were collected from the Global Burden of Disease (GBD) 2019 database(https://vizhub.healthdata.org/gbd-results/). We collected global cancer data for 2019 in terms of sex, age, sociodemographic index (SDI), region, etc. The estimated annual percentage change (EAPC) was calculated to assess the trend of the cancer incidence and mortality rate from 1990 to 2019.

Results

In 2019, the number of new cancer cases and deaths among people 75 and older was almost 3 and 4.5 times that of 1990, respectively. From 1990 to 2019, there was a slow rise in incidence and a slight decline in mortality. There were significant differences in the cancer burden based on sex, age, region, and SDI. The cancer burden in men was higher than in women. In addition, the cancer burden varied from region to region. The highest cancer burden occurred in high-income North America. In addition, the higher the SDI was, the greater the burden of cancer. The incidence of cancer in high SDI was approximately seven times that of low SDI, and the trend of increase in high SDI was obvious. However, the trend of mortality in high SDI was decreasing, while it was increasing in low SDI.

Conclusions

The present study focused on the cancer burden in adults over 75 years old. The findings in the study could serve as the basis for an analysis of the types of cancers that are most prevalent in different regions. This is beneficial for strategies of prevention and treatment according to the characteristics of different countries and regions to reduce the burden of cancer in older adults.
Assessing trial representativeness using serious adverse events: an observational analysis using aggregate and individual-level data from clinical trials and routine healthcare data
Authors: Hanlon Peter , Butterly Elaine , Shah Anoop S. V. , Hannigan Laurie J. , Wild Sarah H. , Guthrie Bruce , Mair Frances S. , Dias Sofia , Welton Nicky J. , McAllister David A.
Published: October 2022

Background

The applicability of randomised controlled trials of pharmacological agents to older people with frailty/multimorbidity is often uncertain, due to concerns that trials are not representative. However, assessing trial representativeness is challenging and complex. We explore an approach assessing trial representativeness by comparing rates of trial serious adverse events (SAE) to rates of hospitalisation/death in routine care.

Methods

This was an observational analysis of individual (125 trials, n=122,069) and aggregate-level drug trial data (483 trials, n=636,267) for 21 index conditions compared to population-based routine healthcare data (routine care). Trials were identified from ClinicalTrials.gov. Routine care comparison from linked primary care and hospital data from Wales, UK (n=2.3M). Our outcome of interest was SAEs (routinely reported in trials). In routine care, SAEs were based on hospitalisations and deaths (which are SAEs by definition). We compared trial SAEs in trials to expected SAEs based on age/sex standardised routine care populations with the same index condition. Using IPD, we assessed the relationship between multimorbidity count and SAEs in both trials and routine care and assessed the impact on the observed/expected SAE ratio additionally accounting for multimorbidity.

Results

For 12/21 index conditions, the pooled observed/expected SAE ratio was <1, indicating fewer SAEs in trial participants than in routine care. A further 6/21 had point estimates <1 but the 95% CI included the null. The median pooled estimate of observed/expected SAE ratio was 0.60 (95% CI 0.55–0.64; COPD) and the interquartile range was 0.44 (0.34–0.55; Parkinson’s disease) to 0.87 (0.58–1.29; inflammatory bowel disease). Higher multimorbidity count was associated with SAEs across all index conditions in both routine care and trials. For most trials, the observed/expected SAE ratio moved closer to 1 after additionally accounting for multimorbidity count, but it nonetheless remained below 1 for most.

Conclusions

Trial participants experience fewer SAEs than expected based on age/sex/condition hospitalisation and death rates in routine care, confirming the predicted lack of representativeness. This difference is only partially explained by differences in multimorbidity. Assessing observed/expected SAE may help assess the applicability of trial findings to older populations in whom multimorbidity and frailty are common.
Are intentions to change, policy awareness, or health knowledge related to changes in dietary intake following a sugar-sweetened beverage tax in South Africa? A before-and-after study
Authors: Essman Michael , Zimmer Catherine , Carpentier Francesca Dillman , Swart Elizabeth C. , Taillie Lindsey Smith
Published: October 2022

Background

In April 2018, South Africa implemented the Health Promotion Levy (HPL), one of the first sugar-sweetened beverage (SSB) taxes to be based on each gram of sugar (beyond 4 g/100mL). The objectives of this study were to examine whether the psychological constructs tax awareness, SSB knowledge, SSB risk perception, and intentions to reduce SSB intake were associated with taxed beverage intake, whether they changed from pre- to post-tax, and whether they modified the effect of the HPL.

Methods

We collected single day 24-hour dietary recalls surveyed from repeat cross-sectional surveys of adults aged 18–39 years in Langa, South Africa. Participants were recruited in February-March 2018 (pre-tax, N = 2,481) and February-March 2019 (post-tax, N = 2,507) using door-to-door sampling. Surveys measured tax awareness, SSB knowledge, SSB risk perception, and intention to reduce SSB intake. SSB intake was estimated using a two-part model. To examine changes over time, logistic regression models were used for binary outcomes (tax awareness and intention to reduce SSB consumption) and linear regression models for continuous outcomes (SSB knowledge SSB risk perceptions). Effect modification was tested using interaction terms for each psychological construct with time.

Results

No constructs were associated with SSB intake at baseline. At post-tax, the predicted probability to consume taxed beverages was 33.5% (95% CI 28.5–38.5%) for those who expressed an intention to reduce SSB intake compared to 45.9% (95% CI 43.7–48.1%) for those who did not. Among consumers, intending to reduce SSB intake was associated with 55 (95% CI 28 to 82) kcal/capita/day less SSBs consumed. Tax awareness, SSB knowledge, and SSB risk perception increased by a small amount from pre- to post-tax. Intentions to reduce SSB intake was lower in the post-tax period. The tax effect on SSB intake was modified by SSB knowledge and intention to reduce SSB intake, with higher levels of each associated with lower SSB intake.

Conclusion

After the South African SSB tax was implemented, SSB knowledge and risk perception increased slightly, tax awareness remained low, and only SSB knowledge and behavioral intention to change were significantly associated with taxed beverage intake among participants recruited from a low-income South African township.
Impact of age on the cerebrospinal fluid spaces: high-convexity and medial subarachnoid spaces decrease with age
Authors: Hidaka Yosuke , Hashimoto Mamoru , Suehiro Takashi , Fukuhara Ryuji , Ishikawa Tomohisa , Tsunoda Naoko , Koyama Asuka , Honda Kazuki , Miyagawa Yusuke , Yoshiura Kazuhiro , Boku Shuken , Ishii Kazunari , Ikeda Manabu , Takebayashi Minoru
Published: October 2022

Background

Impaired cerebrospinal fluid (CSF) dynamics may contribute to the pathophysiology of neurodegenerative diseases, and play a crucial role in brain health in older people; nonetheless, such age-related changes have not been well elucidated. Disproportionately enlarged subarachnoid-space hydrocephalus (DESH) is a neuroimaging phenotype of idiopathic normal-pressure hydrocephalus, originating from impaired CSF dynamics, and closely associated with aging. This study aimed to investigate the pathophysiology of DESH and determine age-related changes in CSF dynamics.

Methods

Using magnetic resonance imaging, we investigated the pathophysiology of DESH by quantitatively evaluating the volumes of DESH-related regions (ventricles [VS], Sylvian fissure [SF], and subarachnoid spaces at high convexity and midline [SHM]) and brain parenchyma in community-dwelling individuals aged  ≥ 65 years. DESH-related regions were assessed using a visual rating scale, and volumes measured using voxel-based morphometry. Brain parenchyma volumes were measured using FreeSurfer software.

Results

Data from 1,356 individuals were analyzed, and 25 (1.8%) individuals had DESH. Regarding the relationships between the volume of each CSF space and age, VS and SF volumes increased with age, whereas SHM volume did not increase. VS and SF volumes increased as the whole brain volume decreased, whereas SHM volume did not increase even if the whole brain volume decreased; that is, SHM did not expand even if brain atrophy progressed. Moreover, lower Mini-Mental State Examination scores were significantly associated with lower SHM volume and higher VS volume. These associations remained significant even when individuals with DESH were excluded.

Conclusions

This study showed that the volume of high-convexity and medial subarachnoid spaces did not expand and tended to decrease with age; the human brain continuously progresses toward a “DESH-like” morphology with aging in community-dwelling older persons (i.e., DESH might be an “accelerated aging stage” rather than an “age-related disorder”). Our results indicated that brain atrophy may be associated with the development of “DESH-like” morphology. In addition, this morphological change, as well as brain atrophy, is an important condition associated with cognitive decline in older adults. Our findings highlight the importance of investigating the aging process of CSF dynamics in the human brain to preserve brain health in older people.
The effect of medial calcar support on proximal humeral fractures treated with locking plates
Authors: Hung Chun-Yu , Yeh Chia-Yi , Wen Po-Chong , Yeh Wen-Ling , Lin Shih-Jie
Published: October 2022

Background

Studies have reported mixed results on the importance of medial calcar support for the treatment of proximal humeral fractures. The purpose of this study was to compare radiographic and functional outcomes of patients who had displaced proximal humeral fractures with varying levels of medial support.

Methods

We performed a retrospective comparative cohort study. The study was conducted at a Level III trauma center in Taiwan. Seventy patients with proximal humeral fractures were collected retrospectively from 2015 to 2019. Only patients with two-, three-, or four-part types (Neer type I, II, or III) of displaced proximal humeral fractures were included in this study. However, patients with head-split fracture patterns, shoulder dislocation, prior shoulder trauma, and poor fracture reduction present in postoperative films were excluded. We assessed the radiographic outcomes, including the reduction score and amount of impaction in the humeral head. The functional outcome was evaluated based on the Constant score.

Results

Patients were grouped into the intact medial calcar group and the medial calcar deficiency group. In a subgroup analysis, the group with intact medial support had a significantly lower amount of impaction and a higher Constant score compared with the medial calcar deficiency group. Additionally, the groups with intact medial support had a nonsignificant difference in the Constant score between the affected side and the contralateral side.

Conclusion

The amount of impaction and the reduction score in the humeral head at the 12-month radiographic follow-up were significantly higher in the group with  medial support deficiency. However, the reduction score after surgery exhibited no difference. This implies that the inherent nature of medial comminution of proximal humeral fracture may lead to inferior radiographic outcomes.
Osteoblasts and osteoclasts: an important switch of tumour cell dormancy during bone metastasis
Authors: Dai Rongchen , Liu Mengfan , Xiang Xincheng , Xi Zhichao , Xu Hongxi
Published: October 2022

Bone metastasis occurs when tumour cells dissociate from primary tumours, enter the circulation (circulating tumour cells, CTCs), and colonize sites in bone (disseminated tumour cells, DTCs). The bone marrow seems to be a particularly dormancy-inducing environment for DTCs, yet the mechanisms of dormancy initiation, reactivation, and interaction within the bone marrow have to be elucidated. Intriguingly, some evidence has suggested that dormancy is a reversible state that is switched ‘on’ or ‘off’ depending on the presence of various bone marrow resident cells, particularly osteoclasts and osteoblasts. It has become clear that these two cells contribute to regulating dormant tumour cells in bone both directly (interaction) and indirectly (secreted factors). The involved mechanisms include TGFβ signalling, the Wnt signalling axis, the Notch2 pathway, etc. There is no detailed review that specifically focuses on ascertaining the dynamic interactions between tumour cell dormancy and bone remodelling. In addition, we highlighted the roles of inflammatory cytokines during this ‘cell-to-cell’ communication. We also discussed the potential clinical relevance of remodelling the bone marrow niche in controlling dormant tumour cells. Understanding the unique role of osteoclasts and osteoblasts in regulating tumour dormancy in bone marrow will provide new insight into preventing and treating tumour bone metastasis.