bluuebunny/crossref_metadata_2025 huggingface dataset:
Import and export of ideas: Georg Simmel in Chicago, George M. Beard in Berlin
Authors: Müller Julian
Published: July 2023

The influence of Georg Simmel on American sociology has been repeatedly pointed out. Robert E. Park and the Chicago School of Sociology in particular owe important impulses to Simmel. It is sometimes overlooked, however, that Simmel himself drew on imported knowledge in his famous essay ‘Die Großstädte und das Geistesleben’ when focusing on the nervousness of the city dweller. This article will therefore tell the brief story of a reciprocal transatlantic knowledge transfer between Berlin and Chicago. It looks at the mutual fascinations and influences, examining both the Americanisation of knowledge and the Europeanisation of experience.
Economics and dementia: Challenges and responses
Authors: Knapp Martin , Wong Gloria
Published: July 2023

Economics and dementia are interconnected in many ways. There is, for example, accumulating evidence of the ways in which dementia impacts on the economic status of individuals and families, on health and social care system budgets, and on national economies. An individual’s economic status can affect their risk of dementia and their ability to respond to it. Governments and other strategic decision-makers are aware of the (growing, indeed urgent) need to take action – whether that is prevention, treatment or care – but also very aware of the limited resources available to them and to the general population. Research evidence can potentially inform the difficult decisions that government and others need to take. We briefly summarise some economic evaluation studies in the dementia area as a basis for identifying the main challenges of moving from evidence to better policy and practice. We then discuss some possible responses (from a range of stakeholders) to these challenges, and how the STRiDE study has sought to contribute to this fast-moving field.
There Was a Queer Guy: A Performative Poetic Inquiry Into Heterosexism
Authors: Carless David
Published: July 2023

At a time when hate crimes related to sexuality and gender identity are increasing and Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) youth are disproportionately more likely to attempt suicide, this critical poetic inquiry revisits our shared history of heterosexism. Specifically, through the methodology of performance autoethnography, I explore some of the processes through which heterosexism, homophobia, and heteronormativity have operated within British culture across my own life course. I reimagine a well-known traditional rhyme with the aspiration that this accessible poem be used by others as a component of their activism and teaching on diversity and LGBTQ+ rights.
Treatment Satisfaction and Well-Being With Continuous Glucose Monitoring in People With Type 1 Diabetes: An Analysis Based on the GOLD Randomized Trial
Authors: Pylov Daniel , Polonsky William , Imberg Henrik , Holmer Helen , Hellman Jarl , Wijkman Magnus , Bolinder Jan , Heisse Tim , Dahlqvist Sofia , Nyström Thomas , Schwarz Erik , Hirsch Irl , Lind Marcus
Published: July 2023

Background:

The GOLD trial demonstrated that continuous glucose monitoring (CGM) in people with type 1 diabetes (T1D) managed with multiple daily insulin injections (MDI) improved not only glucose control but also overall well-being and treatment satisfaction. This analysis investigated which factors contributed to improved well-being and treatment satisfaction with CGM.

Methods:

The GOLD trial was a randomized crossover trial comparing CGM versus self-monitored blood glucose (SMBG) over 16 months. Endpoints included well-being measured by the World Health Organization–Five Well-Being Index (WHO-5) and treatment satisfaction by the Diabetes Treatment Satisfaction Questionnaire (DTSQ) as well as glucose metrics. Multivariable R2-decomposition was used to understand which variables contributed most to treatment satisfaction.

Results:

A total of 139 participants were included. Multivariable analyses revealed that increased convenience and flexibility contributed to 60% (95% confidence interval [CI] = 50%-69%) of the improvement in treatment satisfaction (Diabetes Treatment Satisfaction Questionnaire change version [DTSQ c]) observed with CGM, whereas perceived effects on hypoglycemia and hyperglycemia only contributed to 6% (95% CI = 2%-11%) of improvements. Significant improvements in well-being (WHO-5) by CGM were observed for the following: feeling cheerful ( P = .025), calm and relaxed ( P = .024), being active ( P = .046), and waking up fresh and rested ( P = .044). HbA1c reductions and increased time in range (TIR) were associated with increased treatment satisfaction, whereas glycemic variability was not. HbA1c reduction showed also an association with increased well-being and increased TIR with less diabetes-related distress.

Conclusions:

While CGM improves glucose control in people with T1D on MDI, increased convenience and flexibility through CGM is of even greater importance for treatment satisfaction and patient well-being. These CGM-mediated effects should be taken into account when considering CGM initiation.
For conjunctural geography: From method to counter-hegemonic practice
Authors: Cheng Han , Gonzalez-Vicente Ruben
Published: July 2023

Conjunctural analysis makes an important addition to the conceptual toolbox for understanding the contours of China's (capitalist) regional economies. In this commentary, we concur with Peck's suggestion that the conjunctural approach can animate economic geography's engagement with ‘thick’ theorization without foregoing context-rich inquiry. However, we also emphasize Stuart Hall's commitment to counter-hegemonic politics and his use of the conjunctural approach to explore – and ultimately facilitate – historical breaks in social structures of dominance. Through a brief exploration of ways of engaging the region in China area studies and Chinese geography, we discuss how the conjunctural approach can be mobilized to (re)politicize geographies of regional development.
Social reproduction, precarity, and the ‘new asset geographies’
Authors: Strauss Kendra
Published: July 2023

This commentary briefly develops Birch and Ward's argument that research on the ‘new asset geographies’ can make important contributions to understanding new and evolving geographies of social reproduction. I argue that processes and mechanisms of assetization connect not only to the making of markets but also of investor subjects, and are empirically and conceptually connected to multi-dimensional precarity in and beyond paid work. The latter signals the potential for more dialogue between researchers working to understand geographies of precarity and the new asset geographies.
Historicising the informal/formal dialectic: A reflection on the conceptualisation of informality versus the history of ‘informal’ economic activities
Authors: Potts Deborah
Published: July 2023

The relationship between the ‘formal’ and ‘informal’ sectors has long been a topic of academic inquiry. Brandon Finn's paper which focuses on a case study of Zambia argues for a deeper historicisation of the formal/informal inquiry. In my reflections on Finn's paper I suggest that Zambia's lack of a pre-colonial urban tradition may create some limitations on the historicisation of ‘informality’ and the discussion might usefully be pushed beyond the historical boundaries of European colonialism to consideration of urban economic activities in pre-colonial and pre-capitalist states and their urban centres.
Beauty and status: Matching and exchange within Chinese marriages
Authors: Xu Qi , Pan Xiuming
Published: July 2023

Status exchange in marriage refers to a marriage pattern in which one spouse compensates for his or her disadvantage in one status area relative to the other spouse with an advantage in another. Two prominent examples of marriage exchange discussed in the existing literature are race–status exchange and beauty–status exchange. Although the marriage exchange theory is well supported by early studies, in recent years, its applicability has been questioned by some scholars. Protracted debates on the topic in question were launched in two top sociological journals, the American Sociological Review and the American Journal of Sociology. This study reviews these debates and offers an in-depth theoretical investigation into the relationship between matching and exchange, and the premise of marriage exchange theory. In addition, we collect and analyze the data from the five waves of the China Family Panel Studies (2010–2018) on beauty–status exchanges and other forms of marriage exchanges in China. We found little evidence of beauty–status exchanges in Chinese marriages and even the well-assumed exchange of “woman's beauty for man's talent” lacks sound empirical support. However, there are ample evidences of exchanges among the four status factors of education, occupation, income, and family background. As indicators of socioeconomic status, these four variables are homogeneous in nature, and therefore can more easily substitute for one another. We argue that the validity of marriage exchange theory depends on the similarity or substitutability between the elements in exchange. Thus, we can neither completely accept nor reject the marriage exchange theory.
Please Remove Uncertainties! Otherwise, I Will Not Be Able to Do …! Intolerance to Uncertainty as a Threat to Personal Accomplishment: The Role of Work Ability and Thriving at Work
Authors: Kucuk Burcu Aydin
Published: July 2023

This study uses the Conservation of Resources Theory to understand whether intolerance of uncertainty leads to reduced personal accomplishment based on the work ability and thriving at work of employees. Besides intolerance of uncertainty directly affecting personal accomplishment, it also affects it through the mediating roles of employees’ work ability and thriving at work. The research model was tested using three-wave, time-lagged data from 278 employees. The findings confirm that intolerance of uncertainty leads to reduced personal accomplishment. Additionally, the results showed that work ability and thriving at work partially mediated this relationship. Further analysis suggests that both work ability and thriving at work act as parallel mediators in the relationship between intolerance of uncertainty and reduced personal accomplishment, and that there is no statistically significant difference between them. Therefore, intolerance of uncertainty presents a challenge to important issues that drive employees, such as ability, development, and success.
English Communication Skills in International Business: Industry Expectations Versus University Preparation
Authors: Roshid Mohammod Moninoor , Kankaanranta Anne
Published: July 2023

In the globalized labor market, skills gaps between industry expectations and university preparation are becoming more prevalent. English communication skills (ECS) are vital soft skills in all workplaces, particularly in international business, where English is commonly used as a lingua franca. This case study examined the nexus between academia and industry regarding the instruction of ECS and their applicability to meet the requirements of the globalized business landscape by collecting data from 43 personnel in the international ready-made garment (RMG) industry in Bangladesh. The research reveals that English courses in higher education do not adequately address the communication needs of the international RMG business, which requires practical experience in the workplace, trade-specific vocabulary, intelligibility, and clarity rather than a high level of fluency. The study recommends promoting the teaching of English for general business purposes in Bangladesh by integrating theoretical and practical learning in the classroom and workplace as part of the curriculum.
It Is Not Your Fault, Tell Someone: Case Studies of Young Women’s Experiences of Online Grooming in England
Authors: Smith Emily , Short Emma , Rai Roshan , Rajput Pinky , Wilson Amanda
Published: July 2023

This research study aimed to explore how young people experience cybercrime, with the study being inductive. Thus, the type of crime(s) emerged from the convenience sample and so happened to be online grooming of young women. Using the case study method, two semi-structured interviews were conducted with young women who were ages 12 and 16 (at the time of the study) with in-depth information provided for each case. The data were then triangulated between the research team and the Victim Service who co-created the study (including materials) and co-produced the manuscript. This method of triangulation also occurred to ensure the similarities and differences identified in the discussion. Similarities included that both young women had a trusted adult to tell and that they were not to blame. Differences occurred with the police involvement as well as contradictions in the advice of ‘just block them’. This study calls for better school-based interventions and police response using actual case studies for training and education. Suggestions for future research are further explored and include more tailored quantitative projects, further case studies and other qualitative methods, and a standardized curriculum for safety that can be devised with the Victim Service. Most importantly, if online grooming occurs, this is not because the individual has done something wrong or deserves it, rather they should tell an adult and seek help to end the behaviour.
Zooming into climatic conditions to understand cities: A review and perspective on studies of Chinese winter cities
Authors: Leng Hong , Zhao Jiaxuan , Yuan Qing , Zhao Jiaqi
Published: July 2023

Winter cities’ development faces numerous challenges, with one of the most fundamental being their harsh climatic conditions. Urban research plays a crucial role in guiding the healthy and systematic development of cities. It is tasked with addressing the challenges posed by harsh climate conditions, improving the living environment for humans, and promoting sustainable urban development. Firstly, we analyze the progress of planning research on winter cities in China and classify them into three main stages: starting attempt, stable growth, and rapid development. Secondly, studies are sorted out in terms of the optimization of the urban environment and the support for urban residents. The problems and challenges faced by urban planning research in winter cities are further condensed against the limitations of existing studies and the complexity of urban development. Finally, future research directions are proposed, including undertaking the requirements of national development strategies, strengthening the support of new technologies and methods, and building the multi-dimensional interaction mechanism. The review and outlook from this research will help promote theoretical development and application innovation in this field, which in turn better enhances the urban resilience of winter cities, promotes low-carbon construction, and facilitates the high-quality development of the human living environment.
Exploring the predictive value of combined ultrasound parameters for spinal anesthesia-induced hypotension in cesarean section: a prospective observational study
Authors: Feng Shimiao , Gu Juan , Yu Chao , Liu Jin , Ni Juan
Published: July 2023

Background

Prophylactic vasopressor infusion can effectively assist with fluid loading to prevent spinal anesthesia-induced hypotension. However, the ideal dose varies widely among individuals. We hypothesized that hypotension-susceptible patients requiring cesarean section (C-section) could be identified using combined ultrasound parameters to enable differentiated prophylactic medical interventions.

Methods

This prospective observational trial was carried out within a regional center hospital for women and children in Sichuan Province, China. Singleton pregnant women undergoing combined spinal-epidural anesthesia for elective C-sections were eligible. Women with contraindications to spinal anesthesia or medical comorbidities were excluded. Velocity time integral (VTI) and left ventricular end-diastolic area (LVEDA) in the supine and left lateral positions were measured on ultrasound before anesthesia. Stroke volume, cardiac output, and the percentage change (%) in each parameter between two positions were calculated. Vital signs and demographic data were recorded. Spinal anesthesia-induced hypotension was defined as a mean arterial pressure decrease of > 20% from baseline. The area under the receiver operating characteristic curve (AUROC) was used to analyze the associations of ultrasound measurements, vital signs, and demographic characteristics with spinal anesthesia-induced hypotension. This exploratory study did not have a predefined outcome; however, various parameter combinations were compared using the AUROC to determine which combined parameters had better predictive values.

Results

Patients were divided into the normotension (n = 31) and hypotension groups (n = 57). A combination of heart rate (HR), LVEDAs, and VTI% was significantly better at predicting hypotension than was HR (AUROC 0.827 vs. 0.707, P = 0.020) or LVEDAs (AUROC 0.827 vs. 0.711, P = 0.039) alone, but not significantly better than VTI% alone (AUROC 0.827 vs. 0.766, P = 0.098).

Conclusion

The combined parameters of HR and LVEDAs with VTI% may predict spinal anesthesia-induced hypotension more precisely than the single parameters. Future research is necessary to determine whether this knowledge improves maternal and neonatal outcomes.

Trial registration

ChiCTR1900025191.
Association between systemic inflammatory response index and left ventricular remodeling and systolic dysfunction in atrial fibrillation patients
Authors: Chi Runze , Shan Xiaoli , Guan ChunPing , Yang Hao , Wang Xiangkun , Li Bingong , Zhang Qing
Published: July 2023

Background

Cardiac remodeling and dysfunction can be caused by atrial fibrillation (AF). The aim of this research is to investigate the relationship between the systemic inflammatory response index (SIRI) and left ventricular (LV) remodeling and systolic function in individuals with AF.

Methods

416 patients with AF who were admitted to the Second Department of Cardiology in the East Ward of the Qingdao Municipal Hospital between January 2020 and May 2022 were included in the present retrospective research. The relationship between SIRI and various cardiac parameters was analyzed. The patients’ left atrial (LA) enlargement and left ventricular (LV) hypertrophy and systolic dysfunction were evaluated. SIRI was calculated by the formula: neutrophil × monocyte/lymphocyte.

Results

SIRI significantly correlated with LV end-diastolic diameter (LVDd), LV posterior wall thickness at end-diastole (LVPWTd), interventricular septal thickness at end-diastole (IVSTd), LV mass index (LVMI), LV ejection fraction (LVEF), LA diameter (LAD), C-reactive protein (CRP), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with AF. In multivariate linear regression analyses, SIRI was discovered to be significantly related to LVMI (ln-transformed) (p = 0.025), LVEF (ln-transformed) (p = 0.005), and LAD (ln-transformed) (p = 0.007). In multivariate logistic regression, the highest quartile of SIRI (SIRI > 1.62) was significantly associated with LV hypertrophy (p = 0.026), impaired LV systolic function (p = 0.002), and LA enlargement (p = 0.025).

Conclusions

SIRI was significantly associated with LV remodeling and systolic function impairment in patients with AF. SIRI may serve as a reliable and convenient inflammatory biomarker for detecting impaired cardiac structure and systolic function in patients with AF.
Volunteer-led online group exercise for community-dwelling older people: a feasibility and acceptability study
Authors: Lim S. E. R. , Meredith S. J. , Agnew S. , Clift E. , Ibrahim K. , Roberts H. C.
Published: July 2023

Background

Despite the clear benefits of physical activity in healthy ageing, engagement in regular physical activity among community-dwelling older adults remains low, with common barriers including exertional discomfort, concerns with falling, and access difficulties. The recent rise of the use of technology and the internet among older adults presents an opportunity to engage with older people online to promote increased physical activity. This study aims to determine the feasibility and acceptability of training volunteers to deliver online group exercises for older adults attending community social clubs.

Methods

This was a pre-post mixed-methods study. Older adults aged ≥ 65 years attending community social clubs who provided written consent and were not actively participating in exercise classes took part in the feasibility study. Older adults, volunteers, and staff were interviewed to determine the acceptability of the intervention. The intervention was a once weekly volunteer-led online group seated strength exercises using resistance bands. The duration of the intervention was 6 months. The primary outcome measures were the feasibility of the intervention (determined by the number of volunteers recruited, trained, and retained, participant recruitment and intervention adherence) and its acceptability to key stakeholders. Secondary outcome measures included physical activity levels (Community Health Model Activities Programme for Seniors (CHAMPS) questionnaire), modified Barthel Index, Health-related quality of life (EQ-5D-5L), frailty (PRISMA-7) and sarcopenia (SARC-F), at baseline and 6 months.

Results

Nineteen volunteers were recruited, 15 (78.9%) completed training and 9 (47.3%) were retained after 1 year (mean age 68 years). Thirty older adults (mean age 77 years, 27 female) participated, attending 54% (IQR 37–67) of exercise sessions. Participants had no significant changes in secondary outcome measures, with a trend towards improvement in physical activity levels (physical activity in minutes per week at baseline was 1770 min, and 1909 min at six months, p = 0.13). Twenty volunteers, older adults, and staff were interviewed and found the intervention acceptable. The seated exercises were perceived as safe, manageable, and enjoyable.

Conclusions

Trained volunteers can safely deliver online group exercise for community-dwelling older adults which was acceptable to older adults, volunteers, and club staff.

Trials registration

NCT04672200.
The magnetic resonance characteristics of sinonasal rhabdomyosarcoma in adults: analysis of 27 cases and comparison with pathological subtypes
Authors: Liu Jun-hua , Qi Meng , Huang Wen-hu , Sha Yan , Zhang Fang
Published: July 2023

Background

Sinonasal rhabdomyosarcoma (RMS) in adults is extremely rare, and early diagnosis and treatment are crucial to improve the patient’s prognosis. The purpose of this study was to evaluate the magnetic resonance imaging (MRI) findings of sinonasal RMS in adults and analyze the correlations between the imaging features and pathological subtypes.

Methods

We reviewed 27 patients with pathologically proven RMS of the nasal cavity and paranasal sinuses, including embryonal RMS (ERMS) in 14 patients, alveolar RMS (ARMS) in seven patients, and mixed-type RMS in six patients. Conventional MRI was performed in all 27 patients, and high-resolution diffusion-weighted imaging was conducted in 25 patients. The tumor location, size, morphological features, signal intensity, texture, contrast enhancement characteristics, lymph node metastases, apparent diffusion coefficients (ADCs), and involvement of local soft tissues were independently assessed by two authors.

Results

On MR imaging, sinonasal RMS appeared isointense on T1-weighted imaging in 21 cases (77.8%) and heterogeneously hyperintense on T2-weighted imaging in 18 patients (66.7%). After enhancement, the tumors were heterogeneously enhanced in 24 cases (88.9%). Botryoid enhancement with multiple small rings resembling bunches of grapes was found in 15 cases (55.6%). Mucosal invasion of the maxillary sinus was identified in 51.9% patients. Skull and orbit involvement were found in 55.6% and 81.5% patients, respectively. Lymph node metastasis was seen in 18 cases (66.7%). There were significant differences in botryoid enhancement (P = 0.044) and skull involvement (P = 0.044) among different histological subtypes. The mean ADC value of RMS was 0.73 ± 0.082 × 10–3 mm2/s, and there was no significant difference among different histological subtypes.

Conclusions

Some characteristic MRI findings such as botryoid enhancement in the ethmoid sinus, involvement of the orbit and skull, and a lower ADC value can provide important clues for preoperative diagnosis of sinonasal RMS in adults. Further, botryoid enhancement was more common in ERMS, while skull involvement was more common in ARMS.
How breast cancer therapies impact body image – real-world data from a prospective cohort study collecting patient-reported outcomes
Authors: Afshar-Bakshloo Melissa , Albers Sarah , Richter Chiara , Berninger Ottilia , Blohmer Jens-Uwe , Roehle Robert , Speiser Dorothee , Karsten Maria Margarete
Published: July 2023

Background

In breast cancer patients body image (BI) is a crucial aspect of quality of life (QoL). This study examined the postoperative impact of different surgical approaches on long-term BI analyzing real-world data to guide pre- and postoperative patient care and preserve QoL.

Methods

EORTC QLQ-BR23 BI scores were collected electronically in 325 breast cancer patients within routine clinical care for a duration of 41.5 months (11/17/2016 – 4/30/2020) at predefined time points preoperatively and repeatedly up to two years after breast-conserving surgery (BCS) (n = 212), mastectomy alone (M) (n = 27) or mastectomy with immediate breast reconstruction (MIBR) (n = 86). Higher scores indicated better BI. A linear mixed regression model was used to analyze the impact of BCS, M and MIBR, as well as non-surgical therapies on BI at treatment initiation and over time.

Results

BI scores deteriorated by 5 points (95%-confidence interval (CI) -8.94 to -1.57, p≈0.005) immediately after BCS, by 7 points (95%-CI -12.13 to -1.80, p≈0.008) after MIBR and by 19 points (95%-CI -27.34 to -10.34, p < 0.001) after M. The change over time after BCS (+ 0.10 points per week, 95%-CI -0.17 to 0.38), MIBR (-0.07 points per week, 95%-CI -0.35 to 0.20) and M (+ 0.14 points per week, 95%-CI -0.19 to 0.48) were not statistically significant (each p > 0.05). At treatment initiation chemotherapy was associated with a 22-point decline (95%-CI -25.39 to -17.87, p < 0.001) in BI score, while radiotherapy was associated with a 5-point increase (95%-CI 1.74 to 9.02, p≈0.004). However, over time chemotherapy was associated with a score recovery (+ 0.28 points per week, 95%-CI 0.19 to 0.37, p < 0.001), whereas for radiotherapy a trend towards BI deterioration was observed (-0.11 points per week, 95%-CI -0.23 to 0.02, p≈0.101).

Conclusions

Breast cancer surgery negatively affects BI. BCS and MIBR presumably harm BI less than M in the early postoperative period. Our data suggests BI to be deteriorating in the long term after MIBR while improving after BCS or M. Radiotherapy seems to have an additional negative long-term impact on BI. These findings should be confirmed in further studies to enable evidence-based patient information as part of preoperative shared decision-making and postoperative patient care.
The association of serum IL-33/ST2 expression with hepatocellular carcinoma
Authors: Pan Xiaolan , Liu Jinfeng , Li Meiqin , Liang Yihua , Liu Zhimin , Lao Ming , Fang Min
Published: July 2023

Background

IL-33 is a multifunctional cytokine with dual functions. However, the clinicopathological and prognostic significance of IL-33 in cancer patients, especially in patients with hepatocellular carcinoma (HCC), remains controversial. Therefore, we conducted a study of 565 patients with HCC and 561 healthy controls and performed a meta-analysis to quantitatively evaluate the above problems.

Methods

We collected blood from 565 patients with HCC and 561 healthy controls. ELISA was used to detect the concentrations of IL-33 and ST2 in the serum, and RT‒PCR was used to detect the levels of IL-33 and ST2 mRNA. Meanwhile, we collected comprehensive literature on IL-33 and the clinical characteristics of cancer patients retrieved from the PubMed, Web of Science and CNKI databases as of December 2022. An odds ratio (OR) with a 95% confidence interval (CI) was used to estimate the impact through overall and stratified analyses.

Results

Compared with the healthy control group, the levels of ST2 mRNA and serum in the peripheral blood of HCC patients increased (p < 0.05), while the levels of IL-33 mRNA and serum showed no significant difference between the two groups (p > 0.05). In the meta-analysis section, at the tissue level, the overall analysis showed that the expression of IL-33 was positively correlated with tumor stage, histological grade, distant metastasis, and tumor size. Compared with patients with low IL-33 expression, the 3-year overall survival (OS) rate (OR = 3.467, p < 0.001) and 5-year OS rate (OR = 2.784, p < 0.001) of patients with high IL-33 expression were lower. At the serum expression level, the overall analysis showed that the expression of IL-33 increased the risk of cancer, and the serum level of IL-33 was positively correlated with tumor stage and vascular invasion.

Conclusion

IL-33/ST2 is a useful predictive or prognostic biomarker in clinical evaluation and may be used as a potential therapeutic target, but much research is needed to verify this hypothesis.
Preoperative serum bilirubin is an independent prognostic factor for curatively resected esophageal squamous cell carcinoma
Authors: Huang Xiancong , Chen Yang , Yang Huan , Wang Ruting , Chen Zhongjian
Published: July 2023

Purpose

This study examines prognostic value of preoperative serum bilirubin, including unconjugated bilirubin (UCB), conjugated bilirubin (CB), and total bilirubin (TB), in esophageal squamous cell carcinoma (ESCC) patients who underwent curative resection.

Methods

Between May 2010 and December 2012, a total of 351 ESCC patients were retrospectively reviewed. All the patients underwent curative resection as their primary treatment. Clinicopathological features and overall survival (OS) rate were investigated. Kaplan-Meier curves were used to calculate the OS rate, and the prognostic factors were identified by Cox regression model. Besides, the potential inhibition effect of UCB on ESCC was investigated with both in vitro and in vivo models.

Results

The higher-level groups of UCB, CB, and TB demonstrated longer OS than their low counterparts, with hazard ratio (HR) values of 0.567 (95% CI: 0.424–0.759), 0.698 (95% CI: 0.522–0.933), and 0.602 (95% CI: 0.449–0.807), respectively. All three forms of bilirubin were identified as independent prognostic factors for patients with ESCC, and they were found to effectively stratify the survival risk of patients at TNM stage III. In vivo and in vitro models further confirmed the inhibitory effect of unconjugated bilirubin (UCB) on the proliferation of ESCC.

Conclusion

The findings of our study have shed new light on the prognostic value and biological functions of bilirubin in relation to ESCC. These results may contribute to a better understanding of the underlying mechanisms involved in ESCC tumorigenesis and provide potential therapeutic pathways for treating ESCC.
The role of neutrophils in corneal nerve regeneration
Authors: Zhao Xiaowen , Zhang Minghong , Li Fengjiao , Ma Cuiping , Wang Dianqiang , Wang Ye
Published: July 2023

Background

To investigate the role of neutrophils in corneal nerve regeneration.

Methods

A mouse model simulating corneal nerve injury was established and samples from corneal scraping with and without neutrophil closure were collected. These samples were used for corneal nerve staining, ribonucleic acid sequencing, and bioinformatics. Differential expression analysis was used to perform enrichment analysis to identify any significant differences between these two groups. The differential genes were then intersected with neutrophil-associated genes and a protein-protein interaction network was constructed using the intersected genes. The immune infiltration between the two groups was examined along with the immune cell variation between the high and low gene expression groups.

Results

Neutrophil removal delays corneal epithelial and nerve regeneration. A total of 546 differential genes and 980 neutrophil-associated genes, with 27 genes common to both sets were obtained. Molecular Complex Detection analysis yielded five key genes, namely integrin subunit beta 2 (ITGB2), matrix metallopeptidase 9 (MMP9), epidermal growth factor (EGF), serpin family E member 1 (SERPINE1), and plasminogen activator urokinase receptor (PLAUR). Among these genes, ITGB2, SERPINE1, and PLAUR exhibited increased expression in the neutrophil-confined group, while MMP9 and EGF showed decreased expression, with MMP9 and EGF displaying a more significant difference. Immune infiltration was also observed between the two groups, revealing significant differences in the infiltration of M0 macrophages, activated mast cells, and neutrophils. Moreover, the neutrophil levels were lower in the groups with low MMP9 and EGF expressions and higher in the high-expression group.

Conclusion

Neutrophil confinement might significantly affect the MMP9 and EGF expression levels. Strategies to inhibit MMP9 could potentially yield therapeutic benefits.
Trends in socioeconomic inequalities in behavioural non-communicable disease risk factors: analysis of repeated cross-sectional health surveys in England between 2003 and 2019
Authors: Ogunlayi Fatai , Coleman Paul C. , Fat Linda Ng , Mindell Jennifer S. , Oyebode Oyinlola
Published: July 2023

Background

Previous studies have shown that those in lower socioeconomic positions (SEPs) generally have higher levels of behavioural non-communicable disease (NCD) risk factors. However, there are limited studies examining recent trends in inequalities. This study examined trends in socioeconomic inequalities in NCD behavioural risk factors and their co-occurrence in England from 2003–19.

Methods

This time-trend analysis of repeated cross-sectional data from the Health Survey for England examined the relative index of inequalities (RII) and slope index of inequalities (SII) in four NCD behavioural risk factors: smoking; drinking above recommended limits; insufficient fruit and vegetables consumption; and physical inactivity.

Findings

Prevalence of risk factors has reduced over time, however, this has not been consistent across SEPs. Absolute and relative inequalities increased for physical inactivity; relative inequalities also increased for smoking; for insufficient fruit and vegetable consumption, the trends in inequalities depended on SEPs measure. Those in lower SEPs experienced persistent socioeconomic inequalities and clustering of behavioural risk factors. In contrast, those in higher SEPs had higher prevalence of excessive alcohol consumption; this inequality widened over the study period.

Interpretation

Inequalities in smoking and physical inactivity are persisting or widening. The pattern of higher drinking in higher SEPs obscure the fact that the greatest burden of alcohol-related harm falls on lower SEPs. Policy attention is required to tackle increasing inequalities in smoking prevalence, low fruit and vegetable consumption and physical inactivity, and to reduce alcohol harm.
The impact of COVID-19 and associated public health restrictions on trends in police-recorded violence in an English police force area
Authors: Lightowlers Carly , Coomber Kerri , Quigg Zara
Published: July 2023

Background

The COVID-19 pandemic, and associated public health measures, had a marked impact on a number of health and wellbeing outcomes, including alcohol use and violence. Current literature presents a mixed view of the impact of the pandemic on violence trends. The current study utilises police offence data from a region of northern England to examine the impact of lockdowns, and subsequent relaxation of restrictions, on trends in violent offences.

Methods

Time series analyses using seasonal auto-regressive integrated moving average (SARIMA) modelling was used to investigate the impacts of the COVID-19 public health measures on weekly offence trends from April 1 2018 to March 20 2021. Additionally, pre-pandemic data were used to forecast expected trends had the pandemic not occurred. These expected trends were then compared to actual data to determine if the average levels of violence were outside the forecasted expectations. Overall violence and six subtypes (violence with and without injury, sexual offences including rape, domestic violence, and alcohol-related violent offences) were examined.

Results

Overall, the observed trend in police recorded violent offences demonstrated fluctuating patterns in line with commencement and easing of public health restrictions. That is, offence numbers declined during lockdowns and increased after relaxation of restrictions. However, the majority of observed values fell within the expected range. This broad pattern was also found for subtypes of violent offences.

Conclusions

While violent crime trends demonstrated fluctuations with lockdowns, and subsequent easing of restrictions, these changes were not demonstrably larger than expected trends within this English region, suggesting that a sustained amplification in violence was not observed within this data. However, it is important to acknowledge the high levels of violence reported in this region across the study period, which should be used as a key driver for investing in long-term approaches to violence prevention. Given the extent of unreported violence generally, and that victims/survivors may come into contact with other support services (without reporting to the police), it is vital that policy and practice decisions take a holistic approach, considering a broad range of data sources.
Technology solutionism in paediatric intensive care: clinicians’ perspectives of bioethical considerations
Authors: Alexander Denise , Quirke Mary , Doyle Carmel , Hill Katie , Masterson Kate , Brenner Maria
Published: July 2023

Background

The use of long-term life-sustaining technology for children improves survival rates in paediatric intensive care units (PICUs), but it may also increase long-term morbidity. One example of this is children who are dependent on invasive long-term ventilation. Clinicians caring for these children navigate an increasing array of ethical complexities. This study looks at the meaning clinicians give to the bioethical considerations associated with the availability of increasingly sophisticated technology.

Methods

A hermeneutic phenomenological exploration of the experiences of clinicians in deciding whether to initiate invasive long-term ventilation in children took place, via unstructured interviews. Data were analysed to gain insight into the lived experiences of clinicians. Participants were from PICUs, or closely allied to the care of children in PICUs, in four countries.

Results

Three themes developed from the data that portray the experiences of the clinicians: forming and managing relationships with parents and other clinicians considering, or using, life sustaining technology; the responsibility for moral and professional integrity in the use of technology; and keeping up with technological developments, and the resulting ethical and moral considerations.

Discussion

There are many benefits of the availability of long-term life-sustaining technology for a child, however, clinicians must also consider increasingly complex ethical dilemmas. Bioethical norms are adapting to aid clinicians, but challenges remain.

Conclusion

During a time of technological solutionism, more needs to be understood about the influences on the initiation of invasive long-term ventilation for a child. Further research to better understand how clinicians, and bioethics services, support care delivery may positively impact this arena of health care.
Descriptive forest: experiments on a novel tree-structure-generalization method for describing cardiovascular diseases
Authors: Liewlom Peera
Published: July 2023

Background

A decision tree is a crucial tool for describing the factors related to cardiovascular disease (CVD) risk and for predicting and explaining it for patients. Notably, the decision tree must be simplified because patients may have different primary topics or factors related to the CVD risk. Many decision trees can describe the data collected from multiple environmental heart disease risk datasets or a forest, where each tree describes the CVD risk for each primary topic.

Methods

We demonstrate the presence of trees, or a forest, using an integrated CVD dataset obtained from multiple datasets. Moreover, we apply a novel method to an association-rule tree to discover each primary topic hidden within a dataset. To generalize the tree structure for descriptive tasks, each primary topic is a boundary node acting as a root node of a C4.5 tree with the least prodigality for the tree structure (PTS). All trees are assigned to a descriptive forest describing the CVD risks in a dataset. A descriptive forest is used to describe each CVD patient’s primary risk topics and related factors. We describe eight primary topics in a descriptive forest acquired from 918 records of a heart failure–prediction dataset with 11 features obtained from five datasets. We apply the proposed method to 253,680 records with 22 features from imbalanced classes of a heart disease health–indicators dataset.

Results

The usability of the descriptive forest is demonstrated by a comparative study (on qualitative and quantitative tasks of the CVD-risk explanation) with a C4.5 tree generated from the same dataset but with the least PTS. The qualitative descriptive task confirms that compared to a single C4.5 tree, the descriptive forest is more flexible and can better describe the CVD risk, whereas the quantitative descriptive task confirms that it achieved higher coverage (recall) and correctness (accuracy and precision) and provided more detailed explanations. Additionally, for these tasks, the descriptive forest still outperforms the C4.5 tree. To reduce the problem of imbalanced classes, the ratio of classes in each subdataset generating each tree is investigated.

Conclusion

The results provide confidence for using the descriptive forest.
Improved delineation model of a standard 12-lead electrocardiogram based on a deep learning algorithm
Authors: Darmawahyuni Annisa , Nurmaini Siti , Rachmatullah Muhammad Naufal , Avi Prazna Paramitha , Teguh Samuel Benedict Putra , Sapitri Ade Iriani , Tutuko Bambang , Firdaus Firdaus
Published: July 2023

Background

Signal delineation of a standard 12-lead electrocardiogram (ECG) is a decisive step for retrieving complete information and extracting signal characteristics for each lead in cardiology clinical practice. However, it is arduous to manually assess the leads, as a variety of signal morphological variations in each lead have potential defects in recording, noise, or irregular heart rhythm/beat.

Method

A computer-aided deep-learning algorithm is considered a state-of-the-art delineation model to classify ECG waveform and boundary in terms of the P-wave, QRS-complex, and T-wave and indicated the satisfactory result. This study implemented convolution layers as a part of convolutional neural networks for automated feature extraction and bidirectional long short-term memory as a classifier. For beat segmentation, we have experimented beat-based and patient-based approach.

Results

The empirical results using both beat segmentation approaches, with a total of 14,588 beats were showed that our proposed model performed excellently well. All performance metrics above 95% and 93%, for beat-based and patient-based segmentation, respectively.

Conclusions

This is a significant step towards the clinical pertinency of automated 12-lead ECG delineation using deep learning.
How can we meet the needs of patients, their families and their communities? A qualitative study including clinicians, consumer representatives, patients, and community members
Authors: Roberts Natasha , Jacmon Helene , Scanlon Brighid , Battersby Chrissy , Buttrum Peter , James Christine
Published: July 2023

Background

TheDiversity Working Groupwas formed in response to Australian Quality and Safety Health Care Standards that require organisations plan service delivery that incorporates information about the diversity of consumers, and those at higher risk of harm.

Methods

A qualitative gap analysis was conducted by a team from varied professional backgrounds including a clinician researcher, a nurse researcher with expertise in culturally and linguistically diverse care and a consumer representative with expertise in advocacy and carer representation. Qualitative questions were co-designed, using a person-centred care lens. Community organisation members, and clinicians and patients from both ambulatory and inpatient areas were approached. Responses were coded independently and synthesised using a Framework Methodology.

Results

In total 3 community organisation members, 40 clinicians and 30 patients consented to participate in the qualitative study over a period of three weeks. There were three key themes across responses, ‘What are diverse needs?’; ‘Assigning people to a group does not address a need’; ‘Unplanned care makes people feel vulnerable’. Those patients who are isolated, for any number of reasons, were identified as at greater risk of harm.

Conclusion

Taking a person-centred approach can potentially better understand the needs of patients and communities so that this information can be incorporated into health service delivery. Resources are needed to support patients and their families at times of transition care, particularly when care is unplanned.
Expanding hepatitis C virus test uptake using self-testing among men who have sex with men in China: two parallel randomized controlled trials
Authors: Wang Cheng , Zhao Peizhen , Weideman Ann Marie , Xu Wenqian , Ong Jason J. , Jamil Muhammad S. , Yang Bin , Tucker Joseph D.
Published: July 2023

Background

HCV self-testing (HCVST) may be an effective strategy to address low rates of HCV test uptake among men who have sex with men (MSM). We evaluated the effectiveness and cost of providing HCVST to increase HCV test uptake among MSM in China.

Methods

Two parallel, unmasked, individual-level randomized controlled trials were conducted. HIV-negative MSM and MSM living with HIV were enrolled from 22 cities in China. Men in both trials were randomly assigned (1:1) into standard-of-care (SOC) or HCVST arms. The primary outcome was the proportion of participants who tested for HCV during the trial period. Intervention effects were estimated using multiply imputed data in the main analysis. Costs were measured using a micro-costing approach.

Results

A total of 84 men who were HIV-negative (trial 1) and 84 men living with HIV were enrolled (trial 2). Overall, the proportion of individuals who underwent HCV testing during the trial period was higher in the HCVST arm compared to SOC in trial 1 (estimated risk difference (RD): 71.1%, 95% CI: 54.6 to 87.7%) and trial 2 (estimated RD: 62.9%, 95% CI: 45.7 to 80.1%). Over half (58.6%, 34/58) of HCV self-testers reported the self-test was their first HCV test. The cost per person tested in trial 1 was $654.52 for SOC and $49.83 for HCVST, and in trial 2 was $438.67 for SOC and $53.33 for HCVST.

Conclusions

Compared to the standard of care, providing HCVST significantly increased the proportion of MSM testing for HCV in China, and was cheaper per person tested.

Trial registration

Chinese Clinical Trial Registry. Registration number: ChiCTR2100048379.