bluuebunny/crossref_metadata_2025 huggingface dataset:
Service user experiences and views regarding telemental health during the COVID-19 pandemic: a co-produced framework analysis
Authors: Vera San Juan Norha , Shah Prisha , Schlief Merle , Appleton Rebecca , Nyikavaranda Patrick , Birken Mary , Foye Una , Lyons Natasha , Rains Luke Sheridan , Dedat Zainab , Lloyd-Evans Brynmor , Needle Justin J , Simpson Alan , Morant Nicola , Johnson Sonia
Published: February 2021

Background

The prominence of telemental health, including providing care by video call and telephone, has greatly increased during the COVID-19 pandemic. However, there are clear variations in uptake and acceptability, and concerns that digital exclusion may exacerbate previous inequalities in accessing good quality care. Greater understanding is needed of how service users experience telemental health, and what determines whether they engage and find it acceptable.

Methods

We conducted a collaborative framework analysis of data from semi-structured interviews with a sample of people already experiencing mental health problems prior to the pandemic. Data relevant to participants’ experiences and views regarding telemental health during the pandemic was identified and extracted. Data collection and analysis used a participatory, coproduction approach where lived experience researchers, clinical and academic researchers contributed to all stages of data collection, analysis and interpretation of findings.

Findings

Participants’ experiences and preferences regarding telemental health care were dynamic and varied across time, settings, and individuals. Participants’ preferences were shaped by the reason for contacting providers, their relationship with the care provider, and both parties’ access or acceptability to use remote technology. While face-to-face care tended to be the preferred option, participants identified benefits of remote care including making care more accessible for some populations and improved efficiency for functional appointments such as prescription reviews. Participants highlighted important new challenges around safety and privacy in online settings, and gave examples of good remote care strategies, including scheduling regular phone calls and developing guidelines about how to access remote care tools.

Discussion

Participants in our study and previous literature have highlighted advantages of telemental health care, as well as significant limitations which hinder mental health support and exacerbate inequalities in access to services. Some of these limitations are seen as potentially removable, for example through staff training or better digital access for staff or service users. Others indicate a need to maintain traditional face-to-face contact at least for some appointments. There is a clear need for care to be flexible and individualised to service user circumstances and preferences. Further research is needed on ways of minimising digital exclusion and to support staff in making effective and collaborative use of relevant technologies.
Assessing Age-Specific Vaccination Strategies and Post-Vaccination Reopening Policies for COVID-19 Control Using SEIR Modeling Approach
Authors: Wang Xia , Wu Hulin , Tang Sanyi
Published: February 2021

Background

As the availability of COVID-19 vaccines, it is badly needed to develop vaccination guidelines to prioritize the vaccination delivery in order to effectively stop COVID-19 epidemic and minimize the loss.

Methods

We evaluated the effect of age-specific vaccination strategies on the number of infections and deaths using an SEIR model, considering the age structure and social contact patterns for different age groups for each of different countries.

Results

In general, the vaccination priority should be given to those younger people who are active in social contacts to minimize the number of infections; while the vaccination priority should be given to the elderly to minimize the number of deaths. But this principle may not always apply when the interaction of age structure and age-specific social contact patterns is complicated. Partially reopening schools, workplaces or households, the vaccination priority may need to be adjusted accordingly.

Conclusions

Prematurely reopening social contacts could initiate a new outbreak or even a new pandemic out of control if the vaccination rate and the detection rate are not high enough. Our result suggests that it requires at least nine months of vaccination before fully reopening social contacts in order to avoid a new pandemic.
Theobroma cacaoimproves bone growth by modulating defective ciliogenesis in a mouse model of achondroplasia
Authors: Martin L. , Kaci N. , Benoist-Lasselin C. , Mondoloni M. , Decaudaveine S. , Estibals V. , Cornille M. , Loisay L. , Flipo J. , Demuynck B. , de la Luz Cádiz-Gurrea M. , Barbault F. , Fernández-Arroyo S. , Schibler L. , Segura-Carretero A. , Dambroise E. , Legeai-Mallet L.
Published: February 2021

A gain-of-function mutation in the fibroblast growth factor receptor 3 gene (FGFR3) results in achondroplasia (ACH), the most frequent form of dwarfism. The constitutive activation of FGFR3 impaired bone formation and elongation and many signaling transduction pathways. Identification of new and relevant compounds targeting the FGFR3 signaling pathway is of broad importance for the treatment of ACH. Natural plant compounds are the prime sources of drug candidates. Here, we found that the phenol compound (-)-epicatechin isolated fromTheobroma cacaoeffectively inhibits FGFR3’s downstream signaling pathways. Transcriptomic analysis inFgfr3mouse model showed that ciliary mRNA expression was modified and influenced significantly by the Indian hedgehog and PKA pathways. (-)-Epicatechin is able to rescue impairments in the expression of these mRNA that control both the structural organization of the primary cilium and ciliogenesis-related genes. In femurs isolated from a mouse model (Fgfr3Y367C/+) of ACH, we showed that (-)-epicatechin countered the bone growth impairment during 6 days ofex vivocultures. We confirmedin vivothat daily subcutaneous injections of (-)-epicatechin inFgfr3Y367C/+mice increased bone elongation and rescued the primary cilium defect observed in chondrocytes. This modification of the primary cilia promoted the typical columnar arrangement of flat proliferative chondrocytes and thus enhanced bone elongation. The results of the present proof-of-principle study illustrated (-)-epicatechin’s ability may facilitate the development of (-)-epicatechin as a treatment for patients with ACH.
Urban tourism performance index over the COVID-19 pandemic
Authors: Anguera-Torrell Oriol , Vives-Perez Jordi , Aznar-Alarcón Juan Pedro
Published: February 2021

Purpose

This study aims to propose and estimate the urban tourism performance index (UTPI), an index that can measure and track the month-by-month tourism performance on main tourism cities since the initial outbreak of the COVID-19 pandemic. The UTPI is estimated for the following urban destinations: Bangkok, Paris, London, Dubai, Singapore, Kuala Lumpur, New York, Istanbul, Tokyo, Seoul, Osaka, Phuket, Milan, Barcelona, Bali and Hong Kong.

Design/methodology/approach

Monthly based data measuring the tourism industry’s performance for these urban destinations has been collected. This data includes airlines’ and hotels’ performance, as well as potential tourists’ online searches. The obtained data has been combined using a principal component analysis, generating the UTPI.

Findings

The UTPI shows that all urban areas analyzed in this study experienced a devastating negative impact because of the COVID-19 pandemic outbreak. However, the tourism recovery evolution follows heterogeneous patterns.

Research limitations/implications

The proposed index can be estimated using additional variables. Moreover, the index is only estimated for 16 tourism cities. Future studies can reproduce the methodology by incorporating further variables and amplifying the geographical coverage.

Practical implications

The UTPI might be useful for researchers and policymakers interested in using a measure of tourism performance during the COVID-19 pandemic in some of the most important urban destinations. Likewise, the UTPI index may serve as a suitable aggregated measure of tourism performance in a post-COVID-19 era or to monitor tourism during future crises.

Originality/value

This study analyzes the tourism performance during the COVID-19 pandemic from an urban perspective.
Ude Jones Udeogu v FRN & Ors no SC. 622C/2019: its implication on fighting financial crime and the way forward
Authors: Yakubu Sirajo
Published: February 2021

Purpose

The purpose of this paper is to show how fighting financial crime suffered a setback in Nigeria as a result of the Supreme Court ruling in an appeal case – Ude Jones Udeogu v FRN and Ors no SC. 622C/2019.

Design/methodology/approach

This paper is a critical analysis of the implication of Supreme Courts’ ruling in Ude Udeogu Jones, its implication to law enforcement’s effort in fighting financial crime and the way to get around the ruling. The paper adopts qualitative methods. It is conducted through the analysis of the ruling and the relevant laws.

Findings

Due to the ruling in UdeUdeogu Jones, Section 396(7) of the Administration of Criminal Justice Act 2015 is no longer good law. Federal High Court judges elevated to the Court of Appeal no longer have special dispensation to conclude criminal cases they part heard. Furthermore, the ruling is a serious setback on the law enforcement’s efforts in fighting corruption. However, the drastic effect of the ruling can be mitigated by amending Section 396(7).

Research limitations/implications

Because the ruling is very recent, analysis is based on the relevant enactments and case laws including recent decisions of the Court of Appeal and the Supreme Court.

Originality/value

There is no comprehensive work on this ruling. Therefore, this paper adds value to knowledge as it makes clear the background of the appeal case, as well as the impact of the ruling of the Supreme Court on fighting financial crime in Nigeria and the way to get around the ruling.
Ethical behavior is the antidote to toxic culture
Authors: Meidav Neta
Published: February 2021

Purpose

In this paper, the author sought to explain why ethical behavior is the antidote to toxic workplace culture at a time where employees are forced to take their complaints through external channels when internal procedures fall short.

Design/methodology/approach

The author draws upon recent discussions around employer responsibilities in the wake of #MeToo and the Black Lives Matter movements, using relevant case studies to outline where employers have failed to offer adequate protection for their employees.

Findings

The author found that by promoting a healthy speak-up culture within the workplace, employees are more likely to feel that their concerns are heard, and the issues can be dealt with internally, to the benefit of both individuals and their organizations.

Originality/value

HR departments will be able to access the merits of shifting workplace culture to a more transparent model that bridges the trust gap between employees and their organizations.
Do dimethyl fumarate and nicotinic acid elicit common, potentially HCA2‐mediated adverse reactions? A combined epidemiological‐experimental approach
Authors: Dubrall Diana , Pflock René , Kosinska Joanna , Schmid Matthias , Bleich Markus , Himmerkus Nina , Offermanns Stefan , Schwaninger Markus , Sachs Bernhardt
Published: February 2021

Aim

Dimethyl fumarate and nicotinic acid activate the hydroxy‐carboxylic acid receptor 2 (HCA2) and induce flushing. It is not known whether HCA2 mediates other adverse drug reactions (ADRs) to these two substances. This study aims to compare ADRs associated with dimethyl fumarate and nicotinic acid, and to discuss whether they are HCA2‐mediated.

Methods

We identified spontaneous reports of suspected ADRs to dimethyl fumarate and nicotinic acid in the European Adverse Drug Reaction Database (EudraVigilance). These reports were analysed at different hierarchical levels of the Medical Dictionary for Regulatory Activities (MedDRA). In addition, we screened murine organs for HCA2 expression.

Results

Similarities in the ADR profile of dimethyl fumarate and nicotinic acid included “gastrointestinal signs and symptoms” (odds ratio [OR] 0.8 [0.6‐1.1]), “hepatobiliary investigations” (OR 1.3 [0.7‐2.5]) and “anxiety disorders and symptoms” (OR 0.9 [0.3‐2.2]) in High Level Group Terms; “diarrhoea (excluding infective)” (OR 1.2 [0.7‐1.8]) and “liver function analyses” (OR 1.3 [0.7‐2.6]) in High Level Terms; and “diarrhoea” (OR 1.2 [0.7‐2.0]) and “vomiting” (OR 0.9 [0.4‐1.7]) in Preferred Terms. In analogy, HCA2 was expressed in the gastrointestinal tract, liver and central nervous system (CNS) of murine organs. A discrepant ADR profile was seen for “lymphopenia” (n = 777) at the preferred term level (only reported for dimethyl fumarate) and “blood glucose increased” (more often reported for nicotinic acid; OR 0.1 [0.0‐0.5]).

Conclusion

The gastrointestinal ADRs common to both substances may be mediated by HCA2. Other ADRs not common to both substances are compound or indication‐specific reactions and likely do not involve HCA2.
‘Maturing Out’ as dilemmatic: Transitions towards relatively light drinking practices among UK University students
Authors: Conroy Dominic , Morton Charlotte , Griffin Christine
Published: February 2021

Objectives

University students in the UK engage in relatively high alcohol consumption levels, yet young adults, including students, now drink less than previously and abstain more. Against this cultural backdrop, our objective was to further understanding of ‘maturing out’ of excessive drinking practices among students by focusing on drinking transitions that had taken place during university years.

Design

A qualitative interview study.

Methods

Semi‐structured interviews were conducted with ten 18‐ to 27‐year‐old UK undergraduate university students who self‐identified as light or non‐drinkers. Interviews were audio‐recorded, and anonymized interview transcripts were subjected to an experience‐focused application of thematic analysis.

Results

Participants reported dilemmas involved in transitions from relatively high to low levels of alcohol consumption. One dilemma was characterized by managing to drink less (or nothing) without cutting off social options with university friends/peers. A second dilemma concerned not wishing to fully abandon the pleasures and increased social confidence that alcohol consumption could afford. Results also demonstrated that self‐reported drinking could contradict participants’ self‐defined ‘light drinker’ status.

Conclusions

This study reinforces the view that ‘maturing out’ involves more than simply having gained new responsibilities during young adulthood. Recognition of these dilemmatic features of drinking transitions could be drawn on in novel campus‐based interventions. Such interventions may help strengthen realistic and sustainable moderate drinking by guiding students to anticipate potential difficulties involved in planned reductions in personal drinking but may also help foster students’ ability to view drinking choices as in transition rather than as permanent and enduring.
Can moral convictions against gender inequality overpower system justification effects? Examining the interaction between moral conviction and system justification
Authors: De Cristofaro Valeria , Pellegrini Valerio , Giacomantonio Mauro , Livi Stefano , van Zomeren Martijn
Published: February 2021

It has been shown that disadvantaged groups who endorse system‐justifying beliefs tend to internalize their state of inferiority by expressing ingroup derogation and opposing collective action for change. In the present research, we recruited women – as disadvantaged group – from different countries (the United States, the United Kingdom, Italy) and examined whether their moral conviction against gender inequality, as an absolute stance that does not tolerate any violation, may interact with and overpower system‐justifying beliefs. Results from three studies provided support for our hypotheses. First, when women held strong moral conviction, they expressed higher identification with their disadvantaged ingroup and, in turn, higher collective action intentions, independent of system‐justifying beliefs. Second, when women held weak moral conviction, higher system‐justifying beliefs reduced women’s ingroup identification and, in turn, undermined their collective action intentions. This support is found across different contexts of gender inequality (the gender leadership gap, the gender pay gap, and the gender power imbalance), using different methodological approaches (online survey, online experiment, laboratory experiment). Implications, limits, and future directions are discussed.
Medical treatment of recurrent ischaemic priapism: a review of current molecular therapeutics and a new clinical management paradigm
Authors: Joice Gregory A. , Liu James L. , Burnett Arthur L.
Published: February 2021

Objectives

To examine the current molecular therapeutics in the medical treatment of recurrent ischemic priapism (RIP). To propose a stepwise clinical management paradigm for the treatment of RIP.

Methods

We performed a literature search using the PubMed database for the terms ‘recurrent ischemic priapism’ and ‘stuttering priapism’ up until December 2020. We assessed pre‐clinical and clinical studies regarding medical management of RIP and molecular pathophysiology. Case series and randomized trials were evaluated by study quality and patient outcomes to determine a potential clinical management scheme.

Results

Recent research has fostered an improved understanding of the underlying molecular pathophysiology of RIP that has paved the way forward for developing new therapeutic agents. Medications targeting neurovascular, hormonal and haematological mechanisms associated with RIP show great promise towards remedying this condition. A host of therapeutic agents operating across different mechanistic directions may be implemented according to a clinical management scheme to potentially optimize RIP outcomes.

Conclusion

RIP remains a medically neglected condition with current management focused on treating the acute condition rather than modulating the course of disease. Continued research into the molecular mechanisms of RIP and standardized clinical pathways can improve the quality of care for patients suffering from this condition.
Investigation of immune complexes formed by mitochondrial antigens containing a new lipoylated site in sera of primary biliary cholangitis patients
Authors: Aibara N , Ohyama K , Nakamura M , Nakamura H , Tamai M , Kishikawa N , Kawakami A , Tsukamoto K , Nakashima M , Kuroda N
Published: February 2021

Primary biliary cholangitis (PBC) is characterized by the presence of serum anti-mitochondrial autoantibodies (AMAs). To date, four antigens among the 2-oxo-acid dehydrogenase complex family, which commonly have lipoyl domains as an epitope, have been identified as AMA-corresponding antigens (AMA-antigens). It has recently been reported that AMAs react more strongly with certain chemically modified mimics than with the native lipoyl domains in AMA-antigens. Moreover, high concentrations of circulating immune complexes (ICs) in PBC patients have been reported. However, the existence of ICs formed by AMAs and their antigens has not been reported to date. We hypothesized that AMAs and their antigens formed ICs in PBC sera, and analyzed sera of PBC and four autoimmune diseases (Sjögren's syndrome, systemic lupus erythematosus, systemic scleroderma, and rheumatoid arthritis) using immune complexome analysis, in which ICs are separated from serum and are identified by nano-liquid chromatography-tandem mass spectrometry. To correctly assign MS/MS spectra to peptide sequences, we used a protein-search algorithm that including lipoylation and certain xenobiotic modifications. We found three AMA-antigens, the E2 subunit of the pyruvate dehydrogenase complex (PDC-E2), the E2 subunit of the 2-oxo-glutarate dehydrogenase complex (OGDC-E2) and dihydrolipoamide dehydrogenase binding protein (E3BP), by detecting peptides containing lipoylation and xenobiotic modifications from PBC sera. Although the lipoylated sites of these peptides were different from the well-known sites, abnormal lipoylation and xenobiotic modification may lead to production of AMAs and the formation ICs. Further investigation of the lipoylated sites, xenobiotic modifications, and IC formation will lead to deepen our understanding of PBC pathogenesis.
Atypical glandular cells in Papanicolaou test: Which is more important in the detection of malignancy, architectural or nuclear features?
Authors: Yucel Polat Aysegul , Tepeoglu Merih , Tunca Muzeyyen Zeynep , Ayva Ebru Sebnem , Ozen Ozlem
Published: February 2021

Objective

Atypical glandular cells (AGCs) in Pap (Papanicolaou) smears are uncommon but may represent various benign and malignant lesions. The aim of this study was to evaluate the AGC incidence in Pap smears, analyse the relationship between AGC and malignancy, and reveal the importance of architectural and nuclear features observed cytologically in malignancies.

Methods

Patients diagnosed with AGC on the basis of cervicovaginal cytology between May 2011 and July 2018 were included in this study. All slides were retrospectively reviewed and subclassified according to the Bethesda 2001 classification system. The cytomorphological features observed in the smears were recorded. Cytohistological correlations were evaluated, and the significant clinicopathological findings for malignancy were determined.

Results

Of 87 536 Pap smears, 195 (0.22%) had AGC results and 156 had tissue follow‐up. Among the 156 smears with AGC, 80 (51.3%) were diagnosed as AGC‐NOS (atypical glandular cells, not otherwise specified) and 76 (48.7%) as AGC‐FN (atypical glandular cells, favour neoplastic). Follow‐up biopsies revealed benign pathologies in 49 cases (31.4%) and malignant pathologies in 107 (68.6%). The rate of malignancy observed in AGC‐FN cases (89.5%) was higher than the rate of malignancy in AGC‐NOS cases (48.8%). Among the cytomorphological features, nuclear irregularity, presence of macronucleoli, feathering, loss of polarity, papillary pattern, and three‐dimensional formation were found to be significant indicators of malignancy.

Conclusion

As AGC in Pap smear was associated with a clinically significant diagnosis in 68.6% of the cases in our study, we suggest that all patients with AGC should undergo further clinical assessment.
DLBCL of bilateral submandibular glands and MALToma of thyroid—A rare coexistence
Authors: Kushwaha Pritika , Singh Meeta , Mandal Shramna , Dhingra Shruti , Jain Shyama
Published: February 2021

Involvement of the bilateral submandibular glands and thyroid by the same lymphoma simultaneously has been reported in the literature. However, two different types of lymphomas presenting simultaneously at different sites have never been reported. This case report highlights this rare occurrence. A 65‐year‐old female, a known case of Hashimoto’s thyroiditis with raised anti‐TPO antibodies, presented with thyroid swelling for 1 year and bilateral submandibular swelling for 3 years. FNAC and flow cytometry showed features of mucosa‐associated lymphoid tissue lymphoma in the thyroid gland, whereas the bilateral submandibular glands showed features of diffuse large B cell lymphoma. Histopathology and immunohistochemistry from the submandibular swelling led to similar diagnoses as the flow cytometry.
Cost‐effectiveness of rapid on‐site evaluation of endoscopic ultrasound fine needle aspiration in gastrointestinal lesions
Authors: Khoury Tawfik , Sbeit Wisam
Published: February 2021

Background and aim

Rapid on‐site evaluation (ROSE) can improve adequacy rates of fine needle aspiration (FNA) and thus save operational costs. Our aim was to assess the cost‐efficacy of ROSE performed during endoscopic ultrasound (EUS)‐FNA of gastrointestinal lesions.

Method

This was a retrospective cohort study of 156 patients who underwent EUS‐FNA for pancreatic, submucosal upper gastrointestinal, and adjacent lesions at Galilee Medical Center between 2012 and 2017. The patient cohort was divided into group A (62 patients, 39.7%) who underwent EUS‐FNA with ROSE, and group B (94 patients, 60.3%) without ROSE. Cost analysis was based on the additional expenditure of repeated EUS‐FNA sessions needed to reach accurate and final diagnosis in the two groups.

Results

The overall cost was significantly higher in group B ($121 422) as compared to group A ($72 861), including the ROSE cost. Additional EUS‐FNA sessions were needed in 11.3% and 23.4% in groups A and B, respectively. The additional cost to achieve final pathological diagnosis was $7203 and $24 696 in groups A and B, respectively (P = .02), yielding a savings of $252 per EUS‐FNA case by adding ROSE. Notably, adding ROSE to the EUS‐FNA exam for gastrointestinal non‐pancreatic lesions resulted in even higher savings per case ($682.40). Moreover, adding ROSE improved specimen adequacy to achieve final pathological diagnosis (odds ratio = 7.13, P = .0005).

Conclusions

EUS‐FNA with ROSE was cost‐effective. Incorporating ROSE into the clinical practice of EUS‐FNA saves costs and improves specimen adequacy.
Intraoperative consultation in the diagnosis of posterior fossa brain tumors following the 2016 WHO update
Authors: Gupta Kirti , Kapatia Gargi , Salunke Pravin , Ahuja Chirag K , Singh Vikram
Published: February 2021

Objective

Intraoperative crush/squash smear or frozen section consultation is routinely performed at several centers and offers rapid onsite assessment of tumor type and provides invaluable information to the neurosurgeons. The WHO classification of central nervous system neoplasms underwent a paradigm shift in 2016 with the incorporation of molecular data with the morphological features, such that several new entities came to be distinctly defined. With this paper, we present our experience at intraoperative consultation of brain tumors arising in posterior fossa and aim to apprise the pathologists with the spectrum of cytomorphologic appearances that can occur during such consultation and highlight the diagnostic dilemmas and pitfalls encountered in this setting.

Methods

This is a retrospective observational study illustrating the salient morphological features of commonly encountered brain tumors arising in the posterior fossa (prototype example of each type) reported at our institute over a period of seven years. Both squash smears and rapid snap frozen section were prepared and stained with Toluidine blue and rapid hematoxylin and eosin (H&E) stains.

Results and conclusions

While the majority of tumors at this location comprise of pilocytic astrocytoma, ependymoma, and medulloblastoma, some rare examples may also arise; common differentials must be considered and prudently excluded to arrive at the diagnosis which is crucial in guiding the neurosurgeon. Both squash smears and rapid frozen section should be prepared and complement each other for rapid on‐site evaluation.
The combination of ACR‐Thyroid Imaging Reporting and Data system and The Bethesda System for Reporting Thyroid Cytopathology in the evaluation of thyroid nodules—An institutional experience
Authors: Sakthisankari Shanmugasundaram , Vidhyalakshmi Sreenivasan , Shanthakumari Sivanandam , Devanand Balalakshmoji , Nagul Udayasankar
Published: February 2021

Background

The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is widely utilised by cytopathologists. The American College of Radiology (ACR) has also proposed a thyroid imaging reporting and data system (TIRADS) to classify thyroid nodules and guide their selection for fine needle aspiration (FNA). The current study aimed to analyse the usefulness of TBSRTC in thyroid cytology reporting, to examine its histological correlation with TIRADS, and to compare the management of lesions in each cytological category in our institute to the TBSRTC recommendations.

Materials and methods

A retrospective study was performed on all thyroid FNAs from a 2‐year period at a tertiary care centre. Histological correlations of TBSRTC and ACR TIRADS were examined for cases with surgical follow‐up, and the risk of malignancy in each TBSRTC category, and sensitivity and specificity of FNA and TIRADS, were calculated.

Results

A total of 337 thyroid FNAs were examined, with histological follow‐up in 99 cases. Risk of malignancy in categories I‐VI was 9.5%, 2.3%, 0.0, 8%, 87.5% and 100.0%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of FNA were 60.0%, 99.0%, 85.7%, and 97.5%, respectively, while those values for thyroid ultrasound were 90.3%, 72.2%, 92.9% and 65%, respectively.

Conclusion

The study substantiates the usefulness of TBSRTC in arriving at a more precise diagnosis. Hurthle cell lesions with atypia were the common cause of misdiagnosis. The combination of TIRADS and TBSRTC aids in better stratification of thyroid nodules and in decision making for management of lesions.
Ethical challenges in consent procedures involving pediatric cancer patients in Saudi Arabia: An exploratory survey
Authors: Alahmad Ghiath , AlSaqabi Muneera , Alkamli Hala , Aleidan Mona
Published: February 2021

Pediatric cancer is accompanied by many ethical challenges, particularly those related to respecting the child's opinion and parental responsibility and consent.

Questionnaires were collected from 400 participants, from four equal groups: doctors, nurses, parents and medical students, from three cities in Saudi Arabia, about three problematic issues which revolve around the mandatory consent of one or both parents, the extent of a child’s assent, and the acceptable form of consent and assent.

Despite the diversity of the participants' cultural backgrounds, most preferred both parents to give consent, followed by either parent without differentiation between parents, which reinforced a trend towards more gender equality. The majority of participants preferred that parental consent forms be detailed enough to obtain the maximum information, while others chose medium‐size consent forms; a large majority preferred that the form seeking to obtain the assent of the child with cancer be short, reflecting their desire not to increase the burden on the child, in addition to the fact that the final decision belongs to the parents rather than the child. Most participants preferred to rely on a child's level of maturity rather than having reached a certain age so that they could give assent, while the rest considered the age of 13‐14 as a suitable age.

These findings reflect an increasing ethical awareness regarding parental consent and child assent, and they can be formulated in a recommendation for a more ethical practice in the field of childhood cancer and pediatrics in general.
Applying REWIND cardiovascular disease criteria to SUSTAIN 6 and PIONEER 6: An exploratory analysis of cardiovascular outcomes with semaglutide
Authors: Verma Subodh , Fainberg Udi , Husain Mansoor , Rasmussen Søren , Rydén Lars , Ripa Maria Sejersten , Buse John B.
Published: February 2021

In the REWIND trial, dulaglutide reduced cardiovascular (CV) risk versus placebo in patients with type 2 diabetes in both the “established CV disease” (CVD) and “CV risk factor” subgroups. The SUSTAIN 6 and PIONEER 6 trials of semaglutide used different criteria for established CVD from those used in REWIND. The present post hoc analysis assessed the effect of semaglutide on major adverse CV events (MACE) in a pooled population of SUSTAIN 6 and PIONEER 6 patients, re‐categorized into CV risk subgroups using the REWIND CVD criteria. In the pooled analysis (n = 6480), a lower percentage of patients were in the established CVD subgroup, when using the REWIND CVD criteria, compared with the original trial CVD criteria (66.5% vs. 83.8%, respectively). After re‐categorization, the risk of MACE was significantly lower with semaglutide versus placebo in the established CVD subgroup (hazard ratio [HR] 0.74, 95% confidence interval [CI] 0.59, 0.92) and nonsignificantly lower in the CV risk factor subgroup (HR 0.84, 95% CI 0.55, 1.28) (P‐interaction = 0.60). These results suggest that the CV effects of semaglutide may extend to patients with type 2 diabetes across the CV risk continuum.
Insights into the molecular determinants of thermal stability in halohydrin dehalogenase HheD2
Authors: Wessel Julia , Petrillo Giovanna , Estevez‐Gay Miquel , Bosch Sandra , Seeger Margarita , Dijkman Willem P. , Iglesias‐Fernández Javier , Hidalgo Aurelio , Uson Isabel , Osuna Sílvia , Schallmey Anett
Published: February 2021

Halohydrin dehalogenases (HHDHs) are promising enzymes for application in biocatalysis due to their promiscuous epoxide ring‐opening activity with various anionic nucleophiles. So far, seven different HHDH subtypes A to G have been reported with subtype D containing the by far largest number of enzymes. Moreover, several characterized members of subtype D have been reported to display outstanding characteristics such as high catalytic activity, broad substrate spectra or remarkable thermal stability. Yet, no structure of a D‐type HHDH has been reported to date that could be used to investigate and understand those features on a molecular level. We therefore solved the crystal structure of HheD2 from gamma proteobacterium HTCC2207 at 1.6 Å resolution and used it as a starting point for targeted mutagenesis in combination with molecular dynamics (MD) simulation, in order to study the low thermal stability of HheD2 in comparison with other members of subtype D. This revealed a hydrogen bond between conserved residues Q160 and D198 to be connected with a high catalytic activity of this enzyme. Moreover, a flexible surface region containing two α‐helices was identified to impact thermal stability of HheD2. Exchange of this surface region by residues of HheD3 yielded a variant with 10 °C higher melting temperature and reaction temperature optimum. Overall, our results provide important insights into the structure–function relationship of HheD2 and presumably for other D‐type HHDHs.

Databases

Structural data are available in PDB database under the accession number 7B73.
A New Method for Determining Compound Specific Carbon Isotope of Chlorinated Solvents in Porewater
Authors: Herrero Jofre , Puigserver Diana , Parker Beth L. , Carmona José M.
Published: February 2021

A new method for the extraction of chlorinated solvents (CSs) from porewater with dimethylacetamide (DMA) used as a solvent and the determination of δ13C by gas chromatography‐isotope ratio mass spectrometry (GC‐IRMS) with solid‐phase microextraction (SPME) are presented. This method was used for the determination of δ13C of chloroethenes and chloromethanes. The extraction of the CSs from porewater with DMA led to a minimal loss of mass of solvent and chlorinated compounds. The accuracy of the method was verified with the analysis of the pure injected compounds using elemental analyzer—isotope ratio mass spectrometry (EA‐IRMS). It has been effectively applied in a study area in saturated soil samples of a pollutant source zone of perchloroethylene (PCE) and trichloroethylene (TCE). The limit of quantification of the new method was 0.034 μg/g for PCE and TCE for 10–20 g of soil sample. This new method allows for compound‐specific isotope analysis of CSs in porewater, which can be beneficial in sites where the identification of contamination sources and the behavior of the contaminants are not clear.
Perceptions of aquatic physiotherapy and health‐related quality of life among people with Parkinson’s disease
Authors: Terrens Aan Fleur , Soh Sze‐Ee , Morgan Prue
Published: February 2021

Background

Enablers for people with Parkinson's disease (PD) participating in aquatic physiotherapy have been identified, and exercise improves health‐related quality of life (HRQoL) but it is unclear whether all enablers and barriers for aquatic physiotherapy specific to the PD population have been explored.

Objective

To describe HRQoL in people with PD who have undertaken aquatic physiotherapy, and explore their perceptions and attitudes regarding the programme.

Methods

Twenty‐one participants who participated in a pilot trial on aquatic physiotherapy were included. Participants completed a survey regarding their experiences. The Parkinson's Disease Questionnaire‐39 (PDQ‐39) and Personal Well‐being Index‐Adult (PWI) were used to quantify HRQoL, whilst focus groups were conducted to explore their perceptions and attitudes. Descriptive statistics were used to summarize HRQoL scores. Focus group data were analysed using the deductive coding method.

Results

Most participants felt that the aquatic programme was worthwhile (n = 20/21, 95%). However, they had poor overall well‐being (mean 41.6, SD 13.5) and HRQoL (mean 31.0, SD 13.2) as measured by the PWI and PDQ‐39. Several barriers to aquatic therapy including safety when getting dressed, fatigue and transport were identified although many enablers were also identified, including an improvement in function, less falls and group socialization.

Conclusions

Aquatic physiotherapy was well‐accepted. Participants felt their function improved and felt safe in the water. HRQoL is lower in individuals with PD when compared to Australian norms; thus, interventions to optimize HRQoL need to be explored further.

Patient or Public Contribution

Patients participated in the aquatic intervention, survey and focus groups.
Effects of self‐management programs on blood pressure, self‐efficacy, medication adherence and body mass index in older adults with hypertension: Meta‐analysis of randomized controlled trials
Authors: Van Truong Pham , Wulan Apriliyasari Renny , Lin Mei‐Yu , Chiu Hsiao‐Yean , Tsai Pei‐Shan
Published: February 2021

Aim

To assess the effects of self‐management interventions on systolic blood pressure, diastolic blood pressure, self‐efficacy, medication adherence and body mass index in older adults with hypertension.

Background

Effective treatment of hypertension may require the practice of self‐management behaviours. However, evidence on effects of self‐management interventions on blood pressure, self‐efficacy, medication adherence and body mass index in older adults with hypertension is lacking.

Design

A systematic review and meta‐analysis.

Data sources

CINAHL, Cochrane Library, Embase, Ovid‐Medline, PubMed, Scopus, Web of Science and other sources were searched to October 2020.

Review methods

Data were analysed using Comprehensive Meta‐Analysis 2.0 and quality assessment was done using ROB 2.0. The pooled effect sizes were reported as Hedges' g values with corresponding 95% confidence intervals using a random‐effects model.

Results

Twelve randomized controlled trials met our inclusion criteria. The results revealed that self‐management interventions significantly decreased blood pressure and increased self‐efficacy and medication adherence in older adult patients with hypertension, with no significant effect on body mass index.

Conclusions

Self‐management interventions have considerable beneficial effects in older adults with hypertension. Health care providers should implement self‐management interventions to strengthen the patient's role in managing their health.
A novel approach for exploring the trade‐offs between several features of students’ well‐being
Authors: González‐Gallardo S. , Henriques C.O. , Marcenaro‐Gutierrez O.D. , Luque M.
Published: February 2021

We propose a novel approach to explore the trade‐offs between four features of students’ well‐being (anxiety, motivation, sense of belonging, and bullying). On the one hand, a multiobjective interval problem is formulated by considering these distinct components of well‐being as objective functions, being then instantiated with confidence intervals obtained from distinct econometric estimations. Then, the problem is solved through the use of a reference point approach that allows accounting for the decision maker's preferences by considering a set of weight vectors that can be used to express his/her preferences regarding the importance that should be given to each objective function. The results provide information on how the improvement of one objective might affect the remaining objectives. Furthermore, the student's profile corresponding to each scrutinized solution is also made available. Overall, the results claim that bullying is the most affected objective, highlighting the need to foster antibullying education policies in Spanish schools, according to PISA 2015 data. Finally, some educational polices are suggested in order to enhance students’ well‐being.
The implementation of correctional nursing practice—Caring behind bars: A grounded theory study
Authors: Dhaliwal Kirnvir K. , Hirst Sandra P. , King‐Shier Kathryn M. , Kent‐Wilkinson Arlene
Published: February 2021

Aim

To understand how registered nurses implement their nursing practice in correctional institutions with healthcare governance by a health authority (e.g. Ministry of Health).

Design

Straussian grounded theory.

Methods

Simultaneous data collection and analysis were undertaken using theoretical sampling, constant comparison and memo writing. Thirteen registered nurses engaged in semi‐structured telephone interviews about implementing their correctional nursing practice including, providing direct care to adult offenders. Data were collected (December 2018 to October 2019) until saturation occurred. Analytic coding (open, axial and final theoretical integration) was performed to identify the core category and subcategories around which the substantive theory was developed.

Results

The theory of Caring Behind Bars refers to the process of how registered nurses implemented their correctional nursing practice to care for offenders. The core category of Caring Behind Bars is comprised of five subcategories: tension between custody and caring, adaptability and advocacy, offender population, provision of care, and challenging and positive elements.

Conclusion

Caring Behind Bars required registered nurses to address tension between custody and caring by adapting and advocating to access offenders. The provision of care required registered nurses to use assessment skills and numerous resources to provide a variety of patient focused care to offenders. The consequences of Caring Behind Bars had challenging and positive elements.

Impact

The tension provides purposeful space to continue improving teamwork among correctional officers and registered nurses. More research is required about the impact of correctional healthcare governance models on professional practice and health outcomes. Frontline registered nurses can use the theory to make informed choices when providing care. Registered nurses practising in other domains of correctional nursing (i.e. administration, education and research) can also use this theory to advance and inform practice with the goal of promoting offender health.
The division and transfer of care responsibilities in paediatric type 1 diabetes: A qualitative study on parental perspectives
Authors: Aalders Jori , Hartman Esther , Pouwer Frans , Winterdijk Per , van Mil Edgar , Roeleveld‐Versteegh Angelique , Mommertz‐Mestrum Elke , Aanstoot Henk‐Jan , Nefs Giesje
Published: February 2021

Aim

To determine which factors other than child age play a role in the division and transfer of diabetes care responsibilities between parents and children with type 1 diabetes.

Design

Qualitative focus group study.

Methods

Across four sites in the Netherlands, 18 parents (13 mothers) of children (9–14 years) with type 1 diabetes participated in four focus groups in 2015–2016, as part of the research project 'Whose diabetes is it anyway?'. Qualitative content analysis and the constant comparison method were used to analyse the data.

Results

According to parents, the transfer process included both direct and indirect tasks, had different levels (remembering, deciding, performing), was at times a difficult and stressful process, and showed large variation between families. A large number of child, parent and context factors were identified that affected the division and transfer of diabetes care responsibilities according to parents. Both positive and negative consequences of the transfer process were described for parental and child health, behaviour and well‐being. Parental final evaluations of the division and transfer of diabetes care responsibilities appeared to be dependent on parenting values.

Conclusion

How families divide and transfer diabetes care tasks appeared to be affected by a complex interplay of child, parent and context characteristics, which had an impact on several parent and child domains.

Impact

Parents struggle with the right timing of transfer, which calls for more support from diabetes nurses. The identified factors can be used as input for integrating a more family‐based approach into current age‐based guidelines, to improve regular care.
The language of behaviour changes in dementia: A mixed methods survey exploring the perspectives of people with dementia
Authors: Wolverson Emma , Dunn Rosie , Moniz‐Cook Esme , Gove Dianne , Diaz‐Ponce Ana
Published: February 2021

Aims

The aim of this study was to explore the opinions of people with dementia, about the language used to describe changes in behaviour associated with dementia.

Design

This study adopted a human rights approach in a mixed methods convergent parallel synthesis design.

Methods

Online and paper‐based questionnaire data were collected between November 2019 and March 2020. A combination of convenience and purposive sampling was used to invite people with dementia to participate.

Results

In total, 54 people completed the survey. There was no clear consensus on a preferred term, but 28.3% preferred the term ‘unmet needs’ for describing changes in behaviour associated with dementia. Qualitative data revealed important nuances and challenges for researchers and practitioners in relation to terminology for this paradigm. Participants felt that the language we use to talk about changes in behaviour could influence how people with dementia are viewed and treated and how people feel about themselves.

Conclusion

The majority of participants were familiar with a range of terminology. There was no universal agreement on terminology, but there was an overall preference for terms that reflect the unmet needs likely to underlie perceived changes in behaviour.

Impact

People with dementia raised concerns about the language used to describe changes in behaviour that can occur in dementia. There is scope for improvements in the language used for this paradigm in both research and practice. Following a diagnosis of dementia, clinicians need to take the time to explore an individual's preferences and understandings. They can then share their own understanding about the potential for changed behaviour and if relevant, how any negative impact of this may be minimized.