bluuebunny/crossref_metadata_2025 huggingface dataset:
Photovoltaic Panels and Solar Collectors in Cityscape of Bialystok (Poland) and Cordoba (Spain)
Authors: Gawryluk Dorota , Krawczyk Dorota Anna , Rodero Antonio
Published: April 2022

The technologies using of renewable sources energy like photovoltaic panels and solar collectors were used in Europe, mainly in southern countries (like Spain) until recently. EU policy of sustainable development and technological development impact on increase of popularity of those technologies in northern European countries like Poland. The research problem of the work is to determinate the appropriate conditions for the location of above-mentioned technology (panels) in the cityscape. The numerous examples of its destruction were noticed because panels were located using only energy efficiency conditions. The research methodology was based on “in situ” research (Bialystok-Poland, Cordoba – Spain) in order to determinate the categories of urban landscape in which panels are located. Technical, climatic, landscape and composition conditions were analysed in order to establish assessment of completed investments. The result of the science work are categories of the urban landscape views in Bialystok and Cordoba, ie architectural and landscape encloses (streets, squares, public gardens), city panoramas. The proposed methodology of assessment of cityscape impact are applicable to the planning, designing and investment process for Bialystok and Cordoba. They could be used to another cities also in necessary condition of taking into account the individual characteristic of cityscape. The proposed conclusions can be used in the planning, designing and investment process of another cities due to protection of their cityscape values.
The Impact of Urban Green-infrastructure Development on the Price of Surrounding Real Estate: A Case Study of Taichung City’s Central District
Authors: Hsu Kuo-Wei , Chao Jen-Chih
Published: April 2022

Amid increasingly common extreme climate events and urban heat-island effects, cities are at increased risk from a range of natural disasters. Green infrastructure emphasizes coordination and mutual benefit between, on the one hand, human construction and development, and the natural environment on the other, and can be adjusted to mitigate disaster risks. However, in addition to public-sector policies, urban green-infrastructure development requires incentives for private-sector implementation. This study examines the impact on the value of local real estate of three green-infrastructure projects in the Central District of Taichung City, Taiwan, both during and after their construction. Its findings show that green-infrastructure development can indeed drive-up urban real-estate prices, with slightly different rates of increase, according to type of real estate themselves. The knowledge of this dynamic provided by this study should make such development attractive to the private sector, and thus ultimately aid disaster prevention and improve the overall quality of the urban environment.
Impact of the mass isotope on plasma confinement and transport properties in the HL-2A tokamak
Authors: HE Yu , CHENG Jun , XU Yuhong , FANG Qian , LI Yucai , XU Jianqiang , WANG Weice , YAN Longwen , HUANG Zhihui , WU Na , JIANG Min , SHI Zhongbing , LIU Yi , ZHONG Wulyu , XU Min
Published: April 2022

The impact of the mass isotope on plasma confinement and transport properties has been investigated in Ohmically-heated hydrogen and deuterium plasmas in the HL-2A tokamak. Experimental results show that under similar discharge parameters the deuterium plasma has better confinement and lower turbulent transport than the hydrogen one, and concomitantly, it is found that the magnitude of geodesic acoustic mode zonal flows, the tilting angle of the Reynolds stress tensor and the turbulence correlation lengths are all larger in the edge region of the deuterium plasma. The results provide direct experimental evidence on the importance of the nonlinear energy coupling between ambient turbulence and zonal flows for governing the isotope effects in fusion plasmas.
A discrete choice experiment to identify patient preferences for the provision of NHS medicines helpline services
Authors: Ashby B S , Jones M D
Published: April 2022

Introduction

Medicines helplines for patients discharged from NHS hospitals can prevent medicines-related harm (1). They are an underused service, which is partly attributed to under-resourcing and consequent inability to meet NHS standards (2). There is no evidence to inform which elements of these standards should be prioritised to increase patient access.

Aim

To measure patient preferences for different attributes of the provision of medicines helpline services using a discrete choice experiment (DCE).

Methods

The International Society for Pharmacoeconomics and Outcomes Research good research practices were used to conduct a DCE. Adult members of the NHS ‘Research for the Future’ database who regularly take ≥1 prescribed medicine (or care for someone for does) completed an online survey. The survey presented ten pairs of helplines, each helpline described by seven attributes. Participants chose which helpline from each pair they would prefer to contact with a query following discharge. The attributes of each helpline were defined using standard descriptors (levels) selected with a D-efficient experimental design from two to four options. Twenty helpline pairs were blocked into two survey variants. Participants’ overall preferences for each attribute level were obtained using conditional logit regression and expressed as willingness for the NHS to pay (WTP).

Results

460 participants completed a survey (53% female, aged 20-91 years, mean number of regular medicines: 6.0). All attributes significantly affected patient preferences (p<0.001). Participants’ WTP for key characteristics are shown in the table.

Conclusion

Hospitals providing a medicines helpline should prioritise seven-day opening for extended hours with queries answered on the same day, as these attributes are valued most by potential patients. Other attributes, such as alternative means of contact or a locally based helpline are also valued, but to a lesser extent. Further analysis is required to determine the influence of participant characteristics on their preferences. Use of a DCE with experimental design and a large sample size has enabled patient preferences to be quantified with reasonable precision. However, findings are limited by the method of recruitment, as all participants had internet access and certain groups were over-represented in the sample (e.g. white ethnicity, university educated, higher income).

References

(1) Williams M, Jordan A, Scott J, Jones MD. A systematic review examining the effectiveness of medicines information services for patients and the general public. Int J Pharm Pract. 2020; 28(1): 26-40.

(2) Williams M, Jordan A, Scott J, Jones MD. Operating a patient medicines helpline: A survey study exploring current practice in England using the RE-AIM evaluation framework. BMC Health Serv Res. 2018; 18:868.
Determining patient knowledge of direct oral anticoagulants: a questionnaire study
Authors: Carey M , Silvari V , Crowley E , McCarthy S
Published: April 2022

Introduction

There has been a significant increase in the number of patients prescribed Direct Oral Anticoagulants (DOACs) (1). One of the advantages of DOACs is reduced need for monitoring compared to warfarin, however less frequent contact with healthcare professionals (HCPs) may contribute to poor patient knowledge leading to negative health consequences.

Aim

To determine patients’ knowledge on DOACs in the hospital and community pharmacy setting.

Methods

Participants were recruited from a university hospital and from a convenience sample of community pharmacies. Potential participants were identified by the pharmacist in that setting using the following criteria: age ≥18 years, adequate cognition, DOAC use ≥3 months. Following consent, the participant completed a questionnaire which consisted of participant demographics and questions from the KODOA (The Knowledge of Direct Oral Anticoagulants) questionnaire. Depending on participant preference, they either self-completed the questionnaire or provided oral answers which the researcher documented. Based on previous research (2), a target sample of 40 participants was set. Descriptive statistics were performed.

Results

40 participants were recruited; the mean (SD) age was 70.2 years (10.1), with 70% of participants reporting male gender. 62.5% of participants had an indication of atrial fibrillation. Mean (SD) duration of DOAC use was 5.6 years (3.6). Most patients rated their knowledge of their DOAC as moderate (50%) or good (27.5%). The results of the KODOA are presented in the table. The average score achieved by participant was 11.55/15 (± 1.88 SD). Participants scored high in areas such as DOAC indication, frequency of dosing, side-effects, drug interactions and when to seek further help. Areas of knowledge deficits included what to do when patients have forgotten a dose or have taken too much DOAC.

Conclusion

One limitation of the questionnaire is that the questions are presented in a multiple-choice format and it is possible that participants may have selected the correct answer due to chance. However, overall, participants demonstrated good levels of knowledge of their DOAC therapy. This study has identified areas of knowledge deficits which could be included in patient education when HCPs are counselling patients, when starting their DOAC and continually throughout treatment.

References

(1) Barry, Michael. Medicines Management Programme: Oral anticoagulants for stroke prevention in non-valvular atrial fibrillation [Internet]. 2019 [cited 2021 Jul 24]. Available from: https://www.hse.ie/eng/about/who/cspd/ncps/medicines-management/oral-anticoagulants/oral-anticoagulants-for-stroke-prevention-in-non-valvular-atrial-fibrillation-march-2019.pdf

(2) Metaxas C, Albert V, Stahl M, Hersberger KE, Arnet I. Development and validation of a questionnaire to self-assess patient knowledge of direct oral anticoagulants (KODOA-test). Drug Healthc Patient Saf. 2018 Jul 20;10:69–77.
Evaluation of the effect of adding a high-fidelity simulation to an existing didactic lecture to teach pharmacy undergraduates the management of sepsis in secondary care
Authors: Sunderland P , Fletcher W
Published: April 2022

Introduction

Sepsis is potentially life-threatening, requiring rapid identification and treatment. ‘Sepsis Six’ (1) has become the recognised treatment pathway and has traditionally been taught to our undergraduate pharmacy students in didactic fashion. Interactive teaching methods, such as simulation, are the most effective forms of education to improve patient safety (2). Such approaches might be beneficial in the teaching of sepsis management.

Aim

To evaluate the effect of adding simulation-based teaching to an existing didactic lecture on the management of sepsis.

Methods

Year 4 students at the University of Bath (n=92) attended a sepsis lecture given by a teacher practitioner with experience in managing sepsis in March 2020. Students completed an online survey that used Likert scales to evaluate understanding of sepsis and confidence in managing it (see table).

One week later, small groups of students completed a 30-minute simulation using a SimMan ALS ‘patient’ programmed to show physiological signs of sepsis. Simulations were facilitated by a teacher practitioner with experience of operating SimMan ALS. Each group had a brief outlining the required tasks: reviewing the patient; assessing sepsis risk; summarising a treatment plan and priority actions. After the simulation, students underwent de-brief and completed the same online survey a second time. Changes in students’ responses between surveys were analysed using Wilcoxon signed-rank tests in SPSS, therefore data from students who completed only one survey were not included.

Results

26 students completed both surveys (response rate: 28%). Likert scores for questions 1, 2, 4 and 5 were significantly higher following the simulation, indicating improved confidence and knowledge (see table).

Conclusion

Adding a high-fidelity simulation to an existing didactic lecture increased student confidence in identifying and managing sepsis. Self-reported knowledge of sepsis red flags also increased (indicated by the responses to Statement 1). This study should encourage future sepsis teaching to include a blend of didactic and simulated learning. Limitations include the low response rate, evaluation at only one university and reliance on student self-assessment of knowledge.

References

(1) Daniels, R, Nutbeam, T. et al (2019) The Sepsis Manual 5th Edition. UK Sepsis Trust. www.sepsistrust.org

(2) Yu A, Fontana G, Darzi A (2016). Evaluation of Education and Training Interventions for Patient Safety. A report by the Centre for Health Policy at Imperial College London, an academic partner to Health Education England and the Commission on Education and Training for Patient Safety. London.
An exploration of general practitioners’ and pharmacists’ views and experiences of integrating a pharmacist into general practice: a qualitative study
Authors: Hasan Ibrahim A S , Barry H E , Hughes C M
Published: April 2022

Introduction

Practice-based pharmacists (PBPs) have been introduced into general practice across the United Kingdom (UK) to relieve some of the pressures within primary care (1,2). However, there is little existing UK literature that has explored healthcare professionals’ (HCPs’) views about PBP integration and how this role has evolved.

Aim

To explore the views and experiences of general practitioners (GPs), PBPs, and community pharmacists (CPs) about PBPs’ integration into general practice and their impact on primary healthcare delivery.

Methods

Purposive and snowball sampling were used to recruit triads (a GP, a PBP, and a CP) from across five administrative healthcare areas in one region in the UK to participate in one-to-one semi-structured interviews. Sampling of practices to recruit GPs and PBPs commenced in August 2020. These HCPs identified the CPs who had most contact with the general practices in which the recruited GPs and PBPs were working. The interview topic guides were developed based on the published literature, and through discussion within the research team; they were piloted with two GPs, two PBPs, and two pharmacists. Due to the Covid-19 pandemic, interviews were conducted via telephone or Microsoft Teams platform. All interviews were recorded, transcribed verbatim, and analysed using inductive thematic analysis.

Results

Eleven triads were recruited from across the five administrative areas. Analysis of interview transcripts is ongoing. Findings to date have revealed four main themes in relation to PBPs’ integration into general practices (Table): evolution of the role, PBP attributes, collaboration and communication, and impact on care. A number of areas for development were identified such as patient awareness of the role and communication pathways between PBPs and CPs. Many saw PBPs as a ‘central hub-middleman’ between general practice and community pharmacies and between primary and secondary care.

Conclusion

Participants reported that PBPs had integrated well, and perceived a positive impact on primary health care delivery. Although recruitment was limited to one UK geographical region, the triad approach provided a more comprehensive overview of the working relationships between the three HCP groups. Further work is needed to increase patient awareness of the PBP role.

References

(1) Strategic Leadership Group for Pharmacy. Practice-based pharmacists’ statement. 2016. (Online) Available at: https://www.health-ni.gov.uk/sites/default/files/publications/health/practice-based-pharmacists.pdf (accessed 06 Oct 2021).

(2) NHS England. Clinical pharmacists in general practice. 2015. (Online) Available at: https://www.england.nhs.uk/gp/gpfv/workforce/building-the-general-practice-workforce/cp-gp/ (accessed 06 Oct 2021).
Who Owns a Deadly Virus? Viral Sovereignty, Global Health Emergencies, and the Matrix of the International
Authors: Elbe Stefan
Published: April 2022

This article investigates the global inequities imbricated in the international response to lethal viruses. It does so by developing a virographic approach to the study of international relations that builds upon the matrix methods pioneered within black feminist thought for unraveling particularly complex forms of interlocking oppression. Performing such a virography of international relations exposes the multifaceted economic, racial, and epistemological disparities embedded in the international management of emergent viruses. It further demonstrates how those multiple axes of international inequality intersect during viral outbreaks to form a deadly matrix of global subjugation—vital abandonment—that repeatedly deprives the world's majority population from equitable access to life-saving biomedical interventions. It finally also reveals how diplomatic assertions of viral sovereignty, that is, claiming legal ownership of pathogens, are directly enrolling lethal viruses now in the political strategies of countries seeking to resist their vital abandonment. Overall, a virography thus contributes to the broader study of international relations by foregrounding the global salience of epidemiological injustices and positionalities, by capturing the actant power of lethal viruses in contemporary world politics, and by intimating that the “international” can itself be studied as a continually reconfiguring matrix of interlocking and historically conditioned global inequities.
Unmastering Research: Positionality and Intercorporeal Vulnerability in International Studies
Authors: van Wingerden Enrike
Published: April 2022

This article argues that in order to understand how bodily impressions shape ways of knowing and being, researchers need to enhance claims of positionality through a language of intercorporeality. The notion of positionality is used to indicate the inherent situatedness and partiality of knowledge, but positionality statements also risk affirming a hierarchical narrative structure, leaving out how knowledge is indelibly and dynamically impressed by bodily others, thereby reinscribing researcher authority. Strengthening attempts to resist mastery in doing research, this article theorizes the intercorporeality of research practice on the basis of the bodily experiences of being there, being moved, and being vulnerable. These insights into the intercorporeality of research practice emerge from fieldwork across the West Bank, the Naqab desert, and alongside the Gaza fence. This article argues that intercorporeal vulnerability is at the core of cultivating knowledge, which emerges not only through willful action, but also through nonintentional rapport with objects and (non)human others. Understanding this vulnerability restores a sense of openness and uncertainty by appreciating research practice as always “in excess” of established categories and always just beyond the researcher's positional mastery.
Deprivation of Citizenship as Colonial Violence: Deracination and Dispossession in Assam
Authors: Shahid Rudabeh , Turner Joe
Published: April 2022

This article argues that deprivation of citizenship is an ongoing force of colonial violence. By exploring the case of citizenship stripping in India's northeastern state of Assam, the article proposes that the removal of citizenship rights is not merely an aberration of the “normal” rules of citizenship but bound up with ongoing forms of colonial dispossession informed by racial hierarchies, the regulation of belonging and mobility. Interdisciplinary scholarship on deprivation of citizenship remains largely Euro/Western-centric and fails to consider how deprivation works as part of broader patterns of colonial-modern dispossession. By drawing on Gurminder K. Bhambra's (2015) work on the colonial constitution of citizenship and Aurora Vergara-Figueroa's (2018) work on deracination, we treat deprivation of citizenship as a legacy of the colonial and racialized structure of citizenship itself. By using Assam as a case study, the article examines how practices of deprivations are tied to the histories of dispossession, extraction, and control, which underpinned the historical emergence of citizenship in (post)colonial India and beyond.
The importance of Arabidopsis PHOSPHOLIPID N-METHYLTRANSFERASE in glycerolipid metabolism and plant growth
Authors: Tan Yue-Rong , Nakamura Yuki
Published: April 2022

Phosphatidylcholine (PC) is a major class of phospholipids that are essential for post-embryonic growth in plants. In Arabidopsis, three copies of the phospho-base N-methyltransferase, PMT1, PMT2, and PMT3, are known to account for PC biosynthesis because the triple-knockout mutant is devoid of biosynthesis and shows lethality in post-embryonic but not embryonic growth. Arabidopsis also contains a distinct phospholipid N-methyltransferase (PLMT) that is homologous with yeast and animal PLMT that methylates phospholipids to produce PC. However, the knockout mutant of PLMT does not show morphological phenotypes or decreased PC content, so the role of PLMT remains unclear. Here, we show that PLMT is ubiquitously expressed in different organs and localized at the endoplasmic reticulum, where PC is produced. Overexpression of PLMT in planta increased the content of phospholipids including PC and affected vegetative but not reproductive growth. Although silique lengths were shorter, pollen remained viable and mature seeds were produced. Intriguingly, seed triacylglycerol content was increased with altered fatty acid composition. We conclude that PLMT might be a functional enzyme in PC biosynthesis and play an organ-specific role in developing seeds, where rapid accumulation of triacylglycerol dominates the entire glycerolipid metabolic flux.
NIHAO-LG: the uniqueness of Local Group dwarf galaxies
Authors: Arora Nikhil , Macciò Andrea V , Courteau Stéphane , Buck Tobias , Libeskind Noam I , Sorce Jenny G , Brook Chris B , Hoffman Yehuda , Yepes Gustavo , Carlesi Edoardo , Stone Connor
Published: April 2022

Recent observational and theoretical studies of the Local Group (LG) dwarf galaxies have highlighted their unique star-formation history, stellar metallicity, gas content, and kinematics. We investigate the commonality of these features by comparing constrained LG and field central dwarf halo simulations in the Numerical Investigation of a Hundred Astrophysical Objects (NIHAO) project. Our simulations, performed with NIHAO-like hydrodynamics which track the evolution of the Milky Way (MW) and M31 along with ∼100 dwarfs in the LG, reveal the total gas mass and stellar properties (velocity dispersion, evolution history, etc.) of present-day LG dwarfs to be similar to field systems. However, relative to field galaxies, LG dwarfs have more cold gas in their central parts and more metal-rich gas in the halo stemming from interactions with other dwarfs living in a high-density environment like the LG. Interestingly, the direct impact of massive MW/M31 analogues on the metallicity evolution of LG dwarfs is minimal; LG dwarfs accrete high-metallicity gas mostly from other dwarfs at late times. We have also tested for the impact of metal diffusion on the chemical evolution of LG dwarfs, and found that it does not affect the stellar or gaseous content of LG dwarfs. Our simulations suggest that the stellar components of LG dwarfs offer a unique and unbiased local laboratory for galaxy-formation tests and comparisons, especially against the overall dwarf population in the Universe.
Detection of F1 Hybrids from Single-genome Data Reveals Frequent Hybridization in Hymenoptera and Particularly Ants
Authors: Weyna Arthur , Bourouina Lucille , Galtier Nicolas , Romiguier Jonathan
Published: April 2022

Hybridization occupies a central role in many fundamental evolutionary processes, such as speciation or adaptation. Yet, despite its pivotal importance in evolution, little is known about the actual prevalence and distribution of current hybridization across the tree of life. Here we develop and implement a new statistical method enabling the detection of F1 hybrids from single-individual genome sequencing data. Using simulations and sequencing data from known hybrid systems, we first demonstrate the specificity of the method, and identify its statistical limits. Next, we showcase the method by applying it to available sequencing data from more than 1,500 species of Arthropods, including Hymenoptera, Hemiptera, Coleoptera, Diptera, and Archnida. Among these taxa, we find Hymenoptera, and especially ants, to display the highest number of candidate F1 hybrids, suggesting higher rates of recent hybridization between previously isolated gene pools in these groups. The prevalence of F1 hybrids was heterogeneously distributed across ants, with taxa including many candidates tending to harbor specific ecological and life-history traits. This work shows how large-scale genomic comparative studies of recent hybridization can be implemented, uncovering the determinants of first-generation hybridization across whole taxa.
The Best Gift You Could Give a Resident
Authors: Bamdad Michaela C. , Vitous C. Ann , Rivard Samantha J. , Anderson Maia , Lussiez Alisha , De Roo Ana C. , Englesbe Michael J. , Suwanabol Pasithorn A.
Published: April 2022

Background:

In recent years, there has been increasing focus on the well-being of resident physicians. Considering the persistent problem of burnout and attrition particularly among surgical trainees, this is a well-warranted and laudable area of focus. However, despite the widespread adoption of resources available to residents through individual institutions, there is little understanding of how and why these resources are engaged or not during particularly vulnerable moments, such as following an unwanted patient event including postoperative complications and deaths.

Methods:

This qualitative study explored access to and usage of resources to promote well-being following an unwanted patient outcome through semi-structured interviews of 28 general surgery residents from 14 residency programs across the United States, including community, academic, and hybrid programs. A qualitative descriptive approach was used to analyze transcripts.

Results:

Residents described 3 main types of institutional resources available to them to promote well-being, including counseling services, support from program leadership, and wellness committees. Residents also described important barriers to use for each of these resources, which limited their access and value of these resources. Finally, residents shared their recommendations for future initiatives, including additional protected time off during weekdays and regular usage of structured debrief sessions following adverse patient outcomes.

Conclusions:

While institutional resources are commonly available to surgery residents, there remain important limitations and barriers to use, which may limit their effectiveness in supporting resident well-being in times of need. These barriers should be addressed at the program level to improve services and accessibility for residents.
Oblique lateral interbody fusion combined with lateral plate fixation for the treatment of degenerative diseases of the lumbar spine
Authors: Li Hai-Dong , Zhong Li , Min Ji-Kang , Fang Xiang-Qian , Jiang Lei-Sheng
Published: April 2022

Oblique lateral interbody fusion (OLIF) is a minimally invasive decompression technique used in the treatment of lumbar degenerative diseases (LDDs). It is usually combined with posterior pedicle screw fixation to decrease perioperative complications. Few studies have reported the efficacy of OLIF combined with lateral plate instrumentation (OLIF-LP) for the treatment of LDDs.

The purpose of this retrospective study was to evaluate the clinical efficacy of OLIF combined with lateral plate instrumentation for the treatment of LDDs.

From May 2020 to September 2020, the clinical data of 52 patients who underwent OLIF-LP were analyzed. The operation time, blood loss, and complications were recorded. The radiological parameters, visual analog scale score, and Oswestry Disability Index were evaluated.

The average operation time, blood loss, and length of hospital stay were 75.41 ± 11.53 minutes, 39.57 ± 9.22 mL, and 7.22 ± 1.85 days, respectively. The visual analog scale score and Oswestry Disability Index both improved significantly after surgery (7.23 ± 1.26 vs 2.15 ± 0.87; 60.27 ± 7.91 vs 21.80 ± 6.32, P < .01). The postoperative disk height was 13.02 ± 8.83 mm, which was much greater than the preoperative value. The postoperative foraminal height improved significantly (16.18 ± 3.49 vs 21.54 ± 2.12 mm, P < .01), and the cross-sectional area improved from 88.95 ± 14.79 to 126.53 ± 8.83 mm2 (P < .001). The radiological fusion rate was 88% at the last follow-up. No major complications, such as ureteral injury, vascular injury, or vertebral body fracture, occurred.

Use of the OLIF-LP technique can help avoid lumbar posterior surgery and minimize the operative time and blood loss. OLIF-LP can achieve 1-stage intervertebral fusion and instrumentation through a single small incision.
Nonpharmaceutical therapy for autism spectrum disorder
Authors: Jiang Xin , Song Min , Qin Weixun , Xiao Jiang , Xu Xiaoqing , Yuan Qing
Published: April 2022

Background:

Autism spectrum disorder (ASD) is a widespread developmental disorder of the nervous system with an unclear etiology and pathogenesis. Its global incidence is currently increasing, and no effective drugs are available to improve its core symptoms. Nonpharmaceutical therapy can effectively relieve the core symptoms of autism, has fewer side effects than drugs, and is easily accepted by patients. This systematic and network meta-analysis aimed to evaluate the impact of non-pharmaceutical therapy on autism to explore preferable therapeutic options for autism.

Methods:

Online databases, including the China National Knowledge Infrastructure [CNKI], SinoMed, Wanfang Database [WF], China Science and Technology Journal Database [VIP], MEDLINE, Web of Science, EMBASE, and the Cochrane Library will be searched for randomized controlled trials of nonpharmacological interventions for autism published before October 2021. Two researchers will be independently responsible for the literature screening, data extraction, and quality assessment. Standard paired and Bayesian network meta-analyses will be performed using RevMan 5.3 Software and GEMTC 0.14.3, to compare the efficacy and safety of different nonpharmacological regimens.

Results:

The results of this systematic and network meta-analysis will be submitted to a peer-reviewed journal for publication.

Conclusion:

This study provides a comprehensive and reliable evidence-based reference for the efficacy and safety of different non-pharmacological interventions for autism.

PROSPERO registration number:

CRD 42021275571
Health and access to healthcare in homeless people
Authors: Bedmar Miguel A. , Bennasar-Veny Miquel , Artigas-Lelong Berta , Salvà-Mut Francesca , Pou Joan , Capitán-Moyano Laura , García-Toro Mauro , Yáñez Aina M.
Published: April 2022

Background:

Homelessness is a more complex problem than the simple lack of a place to live. Homeless people (HP) often suffer from poor health and premature death due to their limited access healthcare, and are also deprived of basic human and social rights. The study protocol described here aims to evaluate the complex relationship between homelessness and health, and identify the barriers and facilitators that impact access to healthcare by HP.

Methods:

This is a mixed-methods study that uses an explanatory sequential design. The first phase will consist of a cross-sectional study of 300 HP. Specific health questionnaires will be used to obtain information on health status, challenges during the COVID-19 pandemic, self-reported use of healthcare, diagnoses and pharmacologic treatments, substance abuse (DAST-10), diet quality (IASE), depression (PHQ-9), and human basic needs and social support (SSQ-6). The second phase will be a qualitative study of HP using the “life story” technique with purposive sampling. We will determine the effects of different personal, family, and structural factors on the life and health status of participants. The interviews will be structured and defined using Nussbaum's capability approach.

Discussion:

It is well-known that HP experience poor health and premature death, but more information is needed about the influence of the different specific social determinants of these outcomes and about the barriers and facilitators that affect the access of HP to healthcare. The results of this mixed methods study will help to develop global health strategies that improve the health and access to healthcare in HP.
Effects and safety of traditional Chinese medicine on the gut microbiota of an adult with chronic kidney disease
Authors: Huang Li , Luo Xin , Chen Ming
Published: April 2022

Background:

Studies have reported that changes in the abundance of gut microbiota may explain the medically helpful responses towards traditional Chinese medicine (TCM), an essential part of alternative and complementary medicine, in treating chronic kidney disease (CKD). This study aimed to illuminate the changes in the abundance of gut microbiota of TCM with CKD.

Methods:

The meta-analysis was performed in the PubMed, Web of Science, EMBASE CNKI, WanFang, VIP, and CBM databases, from its inception to October 2021 to discriminate randomized controlled trials and examine the effects of TCM on CKD. Two researchers independently performed literature selection, data extraction, and quality assessment. The risk of bias of the included studies was estimated by taking into consideration the characteristics including random sequence generation, allocation concealment, blinding of patients, blinding of outcome assessment, completeness of outcome data, selective reporting, and other bias using Cochrane Collaboration's tool for assessing the risk of bias.

Results and Conclusions:

From the perspective of intestinal flora, this study will provide high-quality evidence for the effectiveness and safety of TCM for CKD. It provides a new therapeutic approach for treating CKD with Chinese herbal medicine combined with Western medicine.

Inplasy registration number:

INPLASY2021100118.
Complementary and alternative therapies for stable angina pectoris of coronary heart disease
Authors: Wang Guanyu , Li Feiran , Hou Xu
Published: April 2022

Background:

Stable angina pectoris in patients with coronary heart disease is a clinical syndrome of rapid transient ischemia and hypoxia of myocardium due to the increase of myocardial load on the basis of fixed severe coronary artery stenosis. In recent years, the incidence rate of this disease has been rising steadily, which seriously threatens human life and health. When the disease occurs, its complementary and alternative therapy can relieve chest pain, improve cardiac function, and reduce adverse events. However, in retrospect of all the studies, we lack systematic analysis of the efficacy and safety of various complementary and alternative therapies. The curative effects were ranked. On the basis of these findings, we conducted a study of complementary and alternative therapy in patients with coronary heart disease, and proposed a network meta-analysis (NMA) protocol to explore the efficacy of different complementary and alternative therapies.

Methods:

We will comprehensively search the Chinese and English databases from the creation date to January 15, 2022. The randomized controlled trials of the supplementary and alternative treatment of stable angina pediatrics in patients with coronary heart disease and the relevant literature of the ongoing trials will be published. The 2 researchers will conduct literature screening and data extraction independently, using Cochrane system evaluator manual 5 3. The recommended bias risk assessment tool was used to evaluate the quality of the included study, Q-test was used and combined with heterogeneity analysis, and the analysis sensitivity was observed. The Review Manager 5.4 software provided by Cochrane Collaboration Network is used to statistically analyze the included literature, and the obtained results are made into forest map and funnel map for data analysis and processing. It is suggested that the evaluation will be used to formulate and evaluate the level, so as to classify the quality of NMA evidence.

Results:

Through analysis, we will get the efficacy and safety ranking of different complementary and alternative therapies in the treatment of stable angina pediatrics in patients with coronary heart disease, so as to provide further reference for the selection of clinical treatment methods.

Conclusion:

The complementary and alternative treatment of stable angina peptis in patients with coronary heart disease has a positive effect on improving its symptoms. This study can provide evidence support for clinicians and patients.

INPLASY registration number:

INPLASY202210066.
The association of clinical features and laboratory findings of COVID-19 infection with computed pneumonia volume
Authors: Zhang Xin , Zheng Jingjing , Qian Eryan , Xue Leyang , Liu Xingxiang
Published: April 2022

Coronavirus disease 2019 (COVID-19) was first detected in China in December 2019, and declared as a pandemic by the World Health Organization (WHO) on March 11, 2020.

To study the clinical features of patients with COVID-19, we analyzed the correlation between some inflammation-related indicators in patients’ serum and the severity of the disease, especially PV (pneumonia volume under CT scan) and pneumonia volume ratio (PVR).

Sixty-six COVID-19 patients in Huai’an, China were selected as the research subjects. We collected the clinical data, including general characteristics, clinical symptoms, serum test results and CT performance, explored the relationship between inflammation-related indexes, oxygenation index, PV, PVR, while indicators of mild to moderate patients and severe patients were compared.

The most prominent manifestations of COVID-19 patients were fever (47, 71.2%); cough (41, 62.1%), with or without respiratory and other systemic symptoms; There was no difference in gender (P = .567) and age (P = .865) between mild to moderate and severe groups. High sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), and interleukin-6 (IL-6) of overall patients were higher than the normal range (P < .001, respectively). hs-CRP was negatively correlated with oxygenation index (OI) (r = –0.55), whereas positively correlated with PV, PVR and ESR (r = 0.89; r = 0.87; r = 0.47, respectively); ESR was negatively correlated with OI (r = –0.45), meanwhile it was positively correlated with PV and PVR (r = 0.44; r = 0.46, respectively). OI was negatively correlated with PV and PVR (r = –0.6, respectively). PV had a clear correlation with PVR (r = 1). Severe patients’ hs-CRP, PV, PVR were higher than mild to moderate group (P = .006; P = .001; P < .001, respectively), but OI was lower (P < .001).

The clinical features of COVID-19 were similar to general viral pneumonia. hs-CRP, ESR showed a certain correlation with the PV and PVR, which might play a certain role in assessing the severity of COVID-19.
Problematic Internet use and daily difficulties among adolescents with school refusal behaviors
Authors: Fujita Junichi , Aoyama Kumi , Saigusa Yusuke , Miyazaki Hidehito , Aoki Yoshiko , Asanuma Kazuya , Takahashi Yuichi , Hishimoto Akitoyo
Published: April 2022

Problematic Internet use (PIU) is common and likely to coexist with mental health problems among adolescents with school refusal behavior. To date, no study has revealed to what extent PIU relates to the daily burden compared with other mental health problems. This study has examined the association between daily difficulties and PIU among adolescents with school refusal behaviors.

This cross-sectional study involved all first-visit patients, regardless of diagnosis, aged 10 to 18 years at 2 child/adolescent psychiatric outpatient clinics in Yokohama City, Japan, from April 2016 to March 2018. The Questionnaire-Children with Difficulties (QCD) were obtained from parents. Simultaneously, the severity of PIU was evaluated using the Internet Addiction Test and depressive and anxiety symptoms were evaluated using the Patient Health Questionnaire-9 and General Anxiety Disorder-7 scale in the 2 weeks before the first-visit. From 684 first-visit patients, 227 with school refusal behaviors were enrolled in the study.

PIU was observed in 40% of adolescents with school refusal behaviors. The QCD scores among patients with PIU were significantly lower than those in patients without PIU. Linear regression analysis revealed relationships between PIU and lower QCD scores throughout the day (except at night) and the total score of the day, after controlling for confounders such as depressive and anxiety symptoms.

In conclusion, among adolescents with school refusal behaviors, PIU may affect their parent-assessed daily difficulties particularly experienced throughout the day.
Nuclear medicine in the management of superficial skin abnormalities and institutional experience
Authors: Chhabra Anupriya , Pandey Somit , Rathore Yogesh , Kaur Gurvinder , Lakhanpal Tamanna , Singh Tanwar Karan , Kumaran M. Sendhil , De Dipankar , Shukla Jaya
Published: April 2022

Keloid, hypertrophic scars and basal cell carcinoma (BCC) falls under the category of non-melanoma skin cancer. Intralesional steroids, external beam radiation therapy, 5-Fluorouracil, cryotherapy, laser, etc are the available treatment options. However, recurrence has been reported with each type of treatment mode. In the present article, various treatment modes have been discussed and institutional experience of Rhenium-188 skin patches for the treatment of keloids and BCC has been discussed.
Is there an added value for whole body scan combined with stimulated thyroglobulin testing for follow-up of differentiated thyroid cancer patients?
Authors: Giveon Sharon , Levy Sigal , Rotman-Pikielny Pnina , Rosenblum Rachel Chava , Twito Orit
Published: April 2022

Background

Whole-body scan (WBS) is indicated for selected patients in the follow-up of differentiated thyroid cancer (DTC).

Aim

The aim of this study was to evaluate the incidence of positive WBS in patients with negative stimulated thyroglobulin (sTg), to define the clinical characteristics of this group, and the association with disease outcome.

Methods

DTC patients who underwent surveillance with simultaneous sTg and WBS were included.

Results

Two hundred seventy-two patients were included. Age at diagnosis was 46.5 ± 15.2 years, 79% were female. Mean duration of follow-up was 11.6 ± 6.8 years. Patients were categorised according to stimulation test results: sTg(−)/WBS(−) in 192/272 (70.6%); sTg(+) regardless of WBS results in 33/272 (12.1%); and sTg(−)/WBS(+) in 47/272 (17.3%) subjects. sTg > 10 mg/dl was considered positive. The three groups had similar demographic and pathologic characteristics. During follow-up, additional treatment was given in 77 patients (28.3%). Twelve (4.4%) developed distant metastases; 16 patients (5.8%) died. No deaths were disease-related. There was no difference in mortality rate between categories (P = 0.182). On multivariate analysis, additional treatment was associated with male gender (P = 0.046) and positive stimulation test results, either sTg (P < 0.001) or WBS (P < 0.001). Of the 47 WBS(+)/sTg(−) patients, 7(15%) were treated due to positive WBS results, including two who underwent additional surgery.

Conclusion

A substantial proportion of stimulation test results were discordant. There was a significant association between WBS results and administration of additional treatment. Routine WBS had additional value for a small proportion of patients with no other evidence for disease and no indication for WBS.
Outcome-based Validation of Confluent/Expansile Versus Infiltrative Pattern Assessment and Growth-based Grading in Ovarian Mucinous Carcinoma
Authors: Momeni-Boroujeni Amir , Song HyoChan , Irshaid Lina , Strickland Sarah , Parra-Herran Carlos , Busca Aurelia
Published: April 2022

The growth pattern (confluent/expansile versus infiltrative) in primary ovarian mucinous carcinoma (OMC) is prognostically important, and the International Collaboration on Cancer Reporting (ICCR) currently recommends recording the percentage of infiltrative growth in this tumor type. Histologic grading of OMC is controversial with no single approach widely accepted or currently recognized by the World Health Organization Classification of Tumours. Since ovarian carcinoma grade is often considered in clinical decision-making, previous literature has recommended incorporating clinically relevant tumor parameters such as growth pattern into the OMC grade. We herein validate this approach, termed Growth-Based Grade (GBG), in an independent, well-annotated cohort from 2 institutions. OMCs with available histologic material underwent review and grading by Silverberg, International Federation of Obstetrics and Gynecology (FIGO), and GBG schema. GBG categorizes OMCs as low-grade (GBG-LG, confluent/expansile growth, or ≤10% infiltrative invasion) or high-grade (GBG-HG, infiltrative growth in >10% of tumor). The cohort consisted of 74 OMCs, 53 designated as GBG-LG, and 21 as GBG-HG. Using Silverberg grading, the cohort had 42 (57%) grade 1, 28 (38%) grade 2, and 4 (5%) grade 3 OMCs. Using FIGO grading, 50 (68%) OMCs were grade 1, 23 (31%) grade 2, and 1 (1%) grade 3. Follow-up data was available in 68 patients, of which 15 (22%) had cancer recurrence. GBG-HG tumors were far more likely to recur compared with GBG-LG tumors (57% vs. 6%; χ2
P<0.0001). Silverberg and FIGO grading systems also correlated with progression-free survival in univariate analysis, but multivariate analysis showed only GBG to be significant (hazard ratio: 10.9; Cox proportional regression P=0.0004). Seven patients (10%) died of disease, all of whom had GBG-HG (log-rank P<0.0001). Multivariate analysis showed that the percentage of infiltrative growth was the only factor predictive of disease-specific survival (hazard ratio: 25.5, Cox P=0.02). Adding nuclear atypia to GBG categories did not improve prognostication. Our study validates the prognostic value of the GBG system for both disease-free survival and disease-specific survival in OMC, which outperformed Silverberg and FIGO grades in multivariate analysis. Thus, GBG should be the preferred method for tumor grading.