bluuebunny/crossref_metadata_2025 huggingface dataset:
A systematic review of mood and depression measures in people with severe cognitive and communication impairments following acquired brain injury
Authors: Rose Alexandra E. , Cullen Breda , Crawford Sarah , Evans Jonathan J.
Published: November 2022

Aim

A systematic review to identify which mood and depression measures are valid for use with people with severe cognitive and communication impairments following severe acquired brain injury.

Method

A systematic search of Cochrane, Web of Science, Ovid, and EBSCOhost was performed in March 2020, July 2021, and September 2022. The search focused on self-report and observer-rated assessment tools used to assess mood, depression, and/or distress in those described as having a severe acquired brain injury. Psychometric properties were extracted using the Consensus-based standards for the selection of health measurement instruments (COSMIN) risk of bias checklist. Qualitative synthesis was performed on extracted patient data.

Results

Nineteen papers detailing the psychometric properties of 25 measures were included, involving 2,914 participants. Nine papers provided details confirming the severity of participants’ cognitive and communication impairments. The remaining papers described including severely injured participants but provided limited details so that precise level of severity could not be confirmed. Only one paper showed evidence of adequate psychometric properties and included those with severe cognitive impairments in a study of two observer-rated measures, the Stroke Aphasia Depression Questionnaire (10 items) and the Aphasia Depression Rating Scale.

Conclusions

Due to the exclusion of individuals with severe cognitive and communication consequences following brain injury, no studies using self-report measures showed adequate validity evidence to recommend their use in this population. A small study using two observer-rated scales included those with severe cognitive impairments and showed satisfactory evidence that these measures can be validly used with this population.
Effectiveness of vortioxetine in patients with major depressive disorder and co-morbid generalized anxiety disorder in routine clinical practice: A subgroup analysis of the RELIEVE study
Authors: Almeida Susana S , Christensen Michael Cronquist , Simonsen Kenneth , Adair Michael
Published: November 2022

Background:

Generalized anxiety disorder (GAD) is commonly co-morbid with major depressive disorder (MDD) and is associated with greater functional impairment and poorer treatment outcomes than MDD alone. However, studies on treatment with drugs for depression in patients with MDD and co-morbid GAD are limited.

Aims:

To examine the effectiveness of vortioxetine treatment in patients with MDD and co-morbid GAD in a subgroup analysis of the real-world RELIEVE study.

Methods:

The analysis included outpatients diagnosed with MDD and co-morbid GAD who initiated vortioxetine treatment at their physician’s discretion in the 24-week, observational RELIEVE study. Primary outcome was patient functioning (Sheehan Disability Scale (SDS)) after 12 and 24 weeks of vortioxetine treatment; secondary outcomes included depression severity (9-item Patient Health Questionnaire (PHQ-9)), cognitive symptoms (5-item Perceived Deficits Questionnaire – Depression (PDQ-D-5)) and cognitive performance (Digit Symbol Substitution Test (DSST)).

Results:

Overall, 180 patients with MDD and co-morbid GAD were included in the analysis. Following vortioxetine initiation, clinically significant improvements in patient functioning (SDS total score) were observed at week 12 (least-squares (LS) mean reduction from baseline, 7.5 points), sustained through week 24 (9.2 points) (both p < 0.0001). LS mean PHQ-9, PDQ-D-5 and DSST scores improved by 7.9, 4.8 and 7.4 points at week 24, respectively (all p < 0.0001 vs baseline). Adverse events were reported by 33.9% of patients (most commonly nausea, 13.3%).

Conclusions:

In routine clinical practice, vortioxetine was associated with clinically meaningful, sustained improvements in functioning, and depressive and cognitive symptoms, in patients with MDD and co-morbid GAD.

Clinical Trials Registry Name and Identifier:

Real-life Effectiveness of Vortioxetine in Depression (RELIEVE) (NCT03555136) https://clinicaltrials.gov/ct2/show/NCT03555136
Prediction of homologous recombination deficiency from cancer gene expression data
Authors: Kang Jun , Lee Jieun , Lee Ahwon , Lee Youn Soo
Published: November 2022

Objective

Homologous recombination deficiency (HRD) is the main mechanism of tumorigenesis in some cancers. HRD causes abnormal double-strand break repair, resulting in genomic scars. Some scoring HRD tests have been approved as companion diagnostics of polyadenosine diphosphate-ribose polymerase (PARP) inhibitor treatment. This study aimed to build an HRD prediction model using gene expression data from various cancer types.

Methods

The cancer genome atlas data were used for HRD prediction modeling. A total of 10,567 cases of 33 cancer types were included, and expression data from 5128 out of 20,502 genes were included as predictors. A penalized logistic regression model was chosen as a modeling technique.

Results

The area under the curve of the receiver operating characteristic curve of HRD status prediction was 0.98 for the training set and 0.93 for the test set. The accuracy of HRD status prediction was 0.93 for the training set and 0.88 for the test set.

Conclusions

Our study suggests that the HRD prediction model based on penalized logistic regression using gene expression data can be used to select patients for treatment with PARP inhibitors.
Taking groups to the ‘street’: The value of Pichon-Rivière’s notion of task
Authors: Castanho Pablo
Published: November 2022

This text aims at developing the importance of the notion of task in Pichon-Rivière in planning and conducting groups outside the consulting room. It is structured as a theoretical and practical reflection. After a preliminary general discussion on the statute of the task for both Pichon-Rivière and Foulkes, we propose and discuss three practical developments from Pichon-Rivière’s conception of task. The three developments are: 1) The task as a leader: its value in dealing with identity issues; 2) How centring on the task can moderate the transference towards the conductor; 3) Respecting narcissistic envelopes with tasked-centred interventions. It concludes by reaffirming that all three discussed elements are helpful when taking groups outside the consulting room—and yet that they also contribute to approach what Pichon-Rivière called the moment of a task as a potential moment in the sense of Donald Winnicott.
Environmental impact and waste recycling technologies for modern wind turbines: An overview
Authors: Rathore Neelam , Panwar N. L.
Published: November 2022

Wind power is rapidly expanding worldwide, and so is the installation of wind turbines. The concept of wind power as a clean-energy alternative will be questioned if the waste from these turbines is not and adequately controlled. The goal of this review paper is to evaluate the various approaches for end-of-life management of wind turbine blades emphasizing on fibre recovery. Different methods for recovering carbon and glass fibres are described, including thermal treatment and chemical treatments and their economic and environmental comparisons. Life cycle assessment and comparative analysis of different recycling processes are also presented. Natural composites, modified thermoset composites, and thermoplastic composites are also covered as alternative environmentally friendly blade materials.
Sensitivity analysis applied to the pyrolysis of charring and non-charring materials under a cone calorimeter
Authors: Fleurotte Manon , Authier Olivier , Bourbigot Serge , Fontaine Gaëlle , Debenest Gérald , Amokrane Abdenour
Published: November 2022

A sensitivity analysis is performed using the Morris method to prioritize the input parameters of a pyrolysis model according to their degree of influence on the heat release rate (HRR). Moreover, this sensitivity analysis aims determining possible interactions between the input parameters. Indeed, this important aspect is original and at our best knowledge has never been studied in the past. Two materials are studied under cone calorimeter: a non-charring (poly(methyl methacrylate) (PMMA)) and a charring one (polyvinyl chloride (PVC)). Different thicknesses and external heat fluxes are studied to determine their effects on the parameters influence. With regard to PMMA, the most influent parameters are the activation energy, the emissivity, the density and the heat capacity. For the PVC, the most influent parameters are the activation energies. For the PVC, this study showed the existence of interactions between input parameters. This result is original and shows the importance of considering this in sensitivity analysis studies.
Chronotype in Patients With Immune-Mediated Inflammatory Disease: A Systematic Review
Authors: Butler Thomas D. , Mohammed Ali Aala , Gibbs Julie E. , McLaughlin John T.
Published: November 2022

Immune-mediated inflammatory diseases (IMIDs) such as rheumatoid arthritis, inflammatory bowel disease, and asthma share common pathophysiological pathways characterized by chronic inflammation and subsequent tissue damage involving multiple body sites. Circadian rhythms are 24-h body cycles that regulate immune activity and control the magnitude of immune response based on time of day. Chronotype is a person’s individual circadian phase preference, ranging from morningness to eveningness, which is known to influence the risk of cardiometabolic and mental health disease. We systematically reviewed the literature to assess the association of questionnaire-based chronotype and patients with IMID. A comprehensive search of MEDLINE and Embase identified 12 studies meeting the inclusion criteria, conducted in 7 countries and covering 4 IMIDs to include 15,625 IMID patients and 410,783 healthy controls. Results showed that later chronotype may be a risk factor for worse quality of life and increased symptom burden in patients with IMIDs. In addition, chronotype may be a risk factor for IMID incidence, but the direction and magnitude of this effect were not consistent across individual IMIDs. Chronotype assessment could contribute to risk stratification in patients with IMIDs. Cross-disciplinary collaboration to understand the role of circadian rhythms and chronotype in driving common inflammatory pathways could help to improve outcomes for patients with IMIDs.
Tuberculin skin test versus QuantiFERON-TB gold in-tube for latent tuberculosis screening in people living with HIV in a resource-limited setting
Authors: José Raúl Nieto-Saucedo , Joshua Saldaña-Villanueva , Adriana Villafuerte-García , Eva Gutiérrez-Delgado , la Torre-Gutiérrez Hector De , Liz Jovanna Martínez-Navarro , Alejandro Ernesto Macías-Hernández , Juan Luis Mosqueda-Gómez
Published: November 2022

Objective

To compare QuantiFERON-TB Gold-in-Tube (QFT) and tuberculin skin test (TST) in the diagnosis of latent tuberculosis infection (LTBI) among people living with HIV (PLWHIV).

Methods

A cross-sectional study was carried out between 2017–2018. Tuberculin skin test and QFT were performed and their concordance was measured. The gold standard for LTBI was defined as positivity to any of the tests. A logistic regression model was carried out to predict the QFT result in patients with a negative TST.

Results

A total of 510 PLWHIV were included, with 409 (80.2%) being male. The mean age of the patients was 41.3 ± 11.8 years. The median time since HIV diagnosis was 5 years (IQR 2–10), with a median CD4+ count of 541 (IQR 340–757) cells/mm3. Overall, 20 patients had an isolated TST+, 22 an isolated QFT+ and 15 had both positive. Concordance between tests showed a kappa coefficient of .37. Overcrowding was the only predictor for a positive QFT after a negative TST ( p = .003).

Conclusion

There was fair agreement between tests in PLWHIV. In conditions of limited access to QTF, a TST-based strategy could be considered, with sequential use of QTF in high-risk patients with a negative result, especially those who live in overcrowded conditions.
Energy and environmental efficiency of China's regional electric power industry by considering renewable energy constraints
Authors: Chen Xifan , Zhu Qingyuan , Xu Chengzhen , Shen Zhiyang , Song Malin
Published: November 2022

The renewable electricity quota standard (RES) policy plays an important role in achieving sustainable and green development targets. Thus, it is essential to measure the sustainability of the electric power sectors in the context of RES. In terms of the energy and environmental efficiency (EEE) measurements, few studies divided energy inputs into renewable and non-renewable energy or explored the restricted problem of minimizing resource summation. To fill these gaps, we propose an improved fix-sum energy input data envelopment analysis (FSIDEA) model based on the adjustment strategy of weighted sum minimization of renewable energy inputs. The assurance region (AR) restriction and renewable energy input sum constraint (IC) are, respectively, imposed on the FSIDEA model to achieve the common equilibrium effective frontier (EEF). Finally, this study assesses the EEE of the electric power sectors in China's 30 main regions based on the common EEF. The result reveals that Beijing and Shanghai can be selected as benchmarks after efficiency comparison. In addition, our proposed model can compressively rank all decision-making units (DMUs) compared with traditional efficiency models.
A Gendered EU Settlement Scheme: Intersectional Oppression of Immigrant Women in a Post-Brexit Britain
Authors: Yong Adrienne
Published: November 2022

The EU Settlement Scheme (EUSS) is a transitory immigration regime rolled out by the Home Office as part of the measures for the UK withdrawing from the EU. More can be said about whether the EUSS can truly be hailed an overall “success”, as per official Government messaging, several years after its initial introduction. This paper evaluates this by considering two case studies of vulnerable immigrant women required to apply to the Scheme to successfully remain in the UK after the transition period: those at risk of or facing violence against women and girls (VAWG), and non-EU family members (NEFMs) of EU citizens. Using the theories of intersectionality and vulnerability, the paper outlines how gender and immigration status intersect to make women more vulnerable by virtue of the legal framework of the EUSS and its criteria, arguing that it entrenches intersectional oppression faced uniquely by these women.
Gendering strategic action fields in sports governance
Authors: Pape Madeleine , Schoch Lucie
Published: November 2022

How do meso-level field relations shape the ways that sports organizations act on gender equality? In this paper, we approach international sports governance as comprised of meso-level fields of strategic action in which male dominance and relations of masculinity are centrally at stake. We focus on the Union Cycliste Internationale (UCI), showing how the organization's efforts to address gender inequality are shaped by its relations with adjacent actors in the field. These actors jockey to form strategic coalitions as they struggle over the influence and resources to define the field configuration of international cycling, with challenges to the gendered status quo requiring careful management. Based on semi-structured interviews with individuals who held an elected or staff position within the UCI between 2005 and 2020, we show how field relations shaped the work of the UCI Women's Committee during this period as well as the experiences of women who succeeded in accessing decision-making roles. The UCI emerges in our analysis as a central governance unit via which the historical accumulation of advantage to men is preserved. We suggest that studying meso-level fields of strategic action can advance sociological research more broadly on how sports organizations are shaped by their contingent, dynamic, and (gender) unequal context.
Earnings differentials associated with sexual orientation in the Pakistan labour market
Authors: Wahid Abdul , Mantell Edmund H , Kowalewski Oskar
Published: November 2022

This study addresses the question of whether self-identified LGBT status has some power to explain differences between the earnings of male LGTB workers and their occupational counterpart non-LGBT male workers in the Pakistan labour market. The Pakistan labour market is known to be ‘traditional’ in the sense that its operations and the attitudes of participants reflect the confluence of various sociological, political, religious, cultural and patriarchal systems. However, the quantitative significance, if any, of overt sexual orientation and its correlation with earnings remains unclear. This study addresses that question. We find that employed male workers in our sample who are known to be (or thought by employers to be) members of the LGBT community experience significant earnings disadvantages relative to counterpart heterosexual workers.
The Unspoken Voice: Applying John Shotter’s Dialogic Lens to Qualitative Data from People Who have Communication Difficulties
Authors: Broomfield Katherine , Sage Karen , Jones Georgina L. , Judge Simon , James Deborah
Published: November 2022

As speech and language therapists, we explored theories of communication and voice that are familiar to our profession and found them an inadequate basis on which to generate deep and rich analysis of the qualitative data from people who have communication difficulties and who use augmentative and alternative communication. Expanding our conceptual toolkit to include the work of John Shotter allowed us to reconceptualise voice and where it is emergent in dialogue. Reimaging voice will inform clinical and research praxis with people who have communication difficulties as it allows practitioners to attend more closely to the complexity and nuance inherent in interactions with this population. Our proposition is exemplified with excerpts from a single participant who has communication difficulties to illustrate the value of dialogic theory in praxis. This article presents a provocation for the wider academy of qualitative health research; do we have the concepts and tools to develop meaning with people whose lived experiences may also be hard to voice in monologues?
JC Polyoma Virus as a Possible Risk Factor for Prostate Cancer Development - Immunofluorescence and Molecular Based Case Control Study
Authors: Gorish Babbiker M. T.
Published: November 2022

Background

In vitro studies have produced conflicting results about the significance of the JC Polyoma Virus (JCV) in the human cancers.

Objectives

Our study aims to detect the presence of JCV Large T antigen (LTag) together with viral load quantitation in the prostate tumor samples to assess if JCV harbors risk factor for prostate cancer (PCa).

Method

This was a case control-based study. A total of 110 patients participated in this study, including 55 patients with PCa and another 55 patients with benign prostatic hyperplasia (BPH) as cases and controls, respectively. Tissue, blood and urine samples were collected from each participant. Tissues samples were analyzed for the presence of JCV Ltag using a direct immunofluorescence assay (IF). Only positive IF tested samples were subjected to viral quantitation assay. Data were collected and managed using SPSS version 20.

Result

The JCV LTag in the cases group was 23.63% (13/55) which was higher than that of the controls group 5.45% (3/55) with a P. value of .006 and O.R of 5.76. The mean of viral load was significantly higher among cases tissue specimens 20156 ± 5450 copies/ml compared to controls group 6378 ± 2456copies/ml with P-value of .002. The virus was detected in 11/13 (84.6%) urine samples of cases with a mean viral load of 14068 ± 4590 copies/ml compared to 2/3 (66.6%) of controls viral load 2534 ± 1267 copies/ml.

Conclusion

In conclusion, a higher JCV LTag with more viral load were detected in cases group compared to controls. Our findings support a strong relationship between JCV infection and the probability of developing PCa.
A position-dependent acoustic model relevant for some active noise control applications
Authors: Boultifat Chaouki Nacer Eddine , Lohéac Jérôme , Yagoubi Mohamed , Chevrel Philippe
Published: November 2022

This paper focuses on acoustic modeling for active noise control applications. The desired model must be finite dimensional and efficient numerically to meet implementation requirements. It must also be parameterized by the position considered inside the cavity. This additional characteristic is desirable for addressing specific active noise control applications such as optimizing microphone placement, estimating acoustic pressure at different positions of the considered cavity, and finally attenuating noise level in a subarea of the cavity. The main contribution of this paper is to propose a finite-dimensional, low-order, and parameterized acoustic model of a cavity, suitable for active noise control applications. The resulting model is defined as a gray box that combines a one-dimensional analytical model of acoustic propagation, which handles the physical parameterization, and a black-box model that copes with actuator and sensor dynamics as well as modeling errors. The parameters of the proposed model are optimized in order to reproduce the frequency behavior of the real system (LS2N active noise control platform) in a frequency range. This model allows one to accurately reproduce the dynamics at any position in the considered cavity. The prediction performance of the proposed model was compared to a classical black-box model (usually used for active noise control applications) and validated experimentally using the LS2N active noise control platform. The analysis highlighted that the proposed gray-box model can predict the acoustic behavior in a great range of positions.
Experimental and numerical vibration analysis of surface mechanical attrition treatment
Authors: Yarar Eser , Ertürk A Tamer , Açıkgöz Çağatay , Karabay Sedat
Published: November 2022

The surface mechanical attrition treatment creates a nanocrystal layer with improved mechanical properties without changing the surface chemistry. Vibration produces residual stresses in a layer close to the surface by successive impacts on the material surface. Vibration treatments represent a “green” alternative to surface treatments without the use of chemicals and high temperatures. Depending on the operating frequency and amplitude of a particular vibration platform, the most decisive parameter to be controlled for the efficiency of the application is the velocity. Vibration platforms in the SMAT process are ultrasonic and mechanically based platforms. This work presents a vibration platform where velocity is below 1 m/s, which is the lowest operating speed defined in the SMAT process. This work includes both analytical and numerical solutions to the natural frequency values of the vibrating table. The operating conditions were determined by finding the natural frequency values. The amplitude, velocity, and acceleration relations of the vibrating table that will occur during the process were found using the frequency response analysis method. ANSYS and MATLAB were used for numerical and analytical solutions, respectively. Numerical and analytical results were in agreement with the experimental modal analysis.
Overview of the Most Commonly Identified Public Health Needs and Strategies in a Nationally Representative Sample of Nonprofit Hospitals
Authors: Franz Berkeley , Cronin Cory E. , Yeager Valerie A. , Burns Ashlyn , Singh Simone R.
Published: November 2022

Nonprofit hospitals have been required to conduct Community Health Needs Assessments and develop implementation strategies for almost a decade, yet little is known about this process on the national level. Using a nationally representative dataset of 2019 to 2021 nonprofit hospital community benefit reports, we assessed patterns in hospital identification of community health needs and investments in corresponding programs. The five most common needs identified by hospitals were mental health (identified by 87% of hospitals), substance use (76%), access (73%), social determinants of health (69%), and chronic disease (67%). The five most common needs addressed were: mental health (87%), access (81%), substance use (77%), chronic disease (72%), and obesity (71%). Institutional and community-level factors were associated with whether hospitals identified and addressed health needs. Hospitals often addressed needs that they did not identify, particularly related to the provision of medical services—which has important implications for population health improvement.
Do Sanctions Affect Undetected Sexual Offending?
Authors: Kelley Sharon M. , Kahn Rachel E. , Mundt James C. , Barahal Robert M.
Published: November 2022

Undetected sexual offending creates challenges for risk assessment since estimated sexual recidivism rates are based on documented charges or convictions. Courts and other stakeholders may be primarily interested in the true risk for sexual reoffense and not simply risk for detected sexual offenses. Attempts to study and quantify the rate of undetected sexual offending have resulted in a wide variety of estimates. In this study, we explore whether sanctions imposed for detected sexual offenses increase the detection rate of subsequent offenses, and thereby suppress undetected sexual offending in an exceptionally high-risk sample who were ultimately committed as Sexually Violent Persons. Results indicate the detection rate of sexual offenses increased following an initial sanction, subsequently decreasing the proportion of undetected to detected offending. This effect only occurred after the first sanction. Overall, the sample had a high detection rate and spent little time in the community before subsequent arrests. These results differ from other reports that high rates of sexual offenses go undetected.
Opioid Use Disorder Community Education Events: Rural Public Health Implications
Authors: Condie Alise Williams , Judd Hailey , Yaugher Ashley C.
Published: November 2022

The opioid overdose epidemic continues to disproportionately impact underserved rural areas throughout the nation, with many of these rural areas experiencing greater opioid-related mortality rates than their urban counterparts. With limited treatment infrastructure and resources, two rural communities in Southeast Utah utilized community-based participatory research collaboration principles to develop, implement, and evaluate a series of evidence-based community opioid education events. This practical and quantitative study surveying 123 participants describes the collaborative efforts of two rural communities in addressing the devastating impacts of the opioid overdose epidemic and reflects on the success of the events via descriptive analysis of summary data. These events increased participants’ reported perceptions of and knowledge in four main education areas: stigma reduction, prevention and treatment awareness, naloxone education and use, and resource location awareness. Post-event surveys further supported these results, revealing improved learning in each of these four areas, indicating increased knowledge toward opioid use disorder treatments and stigma reduction. In addition, participants identified key takeaways such as local resource awareness and dismantling stigma as effective strategies to reduce the negative effects of the opioid overdose epidemic. This model for rural community education supports previous research and serves as an effective strategy of public health practice to address the opioid overdose epidemic on a local level.
Evaluation of the effects of gabapentin on the physiologic and echocardiographic variables of healthy cats: a prospective, randomized and blinded study
Authors: Veronezi Tayná M , Lopes Daniela J , Zardo Izadora L , Ferronatto João VB , Trojan Marcelo M , Franck Kirian R , de Azevedo André F , Spiering Adriana G , Nunes Luciana N , Fadel Leandro , da Costa Fernanda VA
Published: November 2022

Objectives

The aim of this study was to evaluate, using echocardiography, the effects of oral administration of a single dose of gabapentin on the physiologic variables (heart rate [HR], respiratory rate [RR] and systolic blood pressure [SBP]) and systolic and diastolic cardiac function of healthy cats.

Methods

This was a prospective, randomized and blinded study with 40 healthy cats aged between 6 months and 2 years. The cats’ health status was assessed on the first appointment (T1) when they underwent a physical examination, complete blood count, biochemical profile, assessment of physiologic variables and echocardiogram. The echocardiogram was used to measure the left ventricle’s (LV) internal diameter during systole and diastole, isovolumic relaxation time, transmitral flow, E-wave deceleration time and HR. The cats were randomly divided into two groups: (1) a treatment group with 20 cats that received a single oral dose of gabapentin (100 mg/cat); and (2) a control group with 20 cats that received a single oral dose of placebo. All variables of the physiologic and echocardiographic variables were re-evaluated 1–3 weeks after T1 (T2), 90 mins after medication or placebo administration.

Results

There was no difference in the physiologic variables evaluated in both groups. The proportion of cats in the treatment group that had their ventricular filling waves fused on T1 but did not have them fused on T2 was significantly higher (45%) compared with cats in the control group (15%; P = 0.0384).

Conclusions and relevance

There was no difference between the groups in regard to SBP, HR, RR and echocardiographic variables. Gabapentin improved evaluation of diastolic function on echocardiogram because it reduced the fusion of ventricular filling waves during the evaluation of the diastolic function of the LV. Gabapentin did not cause adverse effects on the cardiovascular hemodynamics of young healthy cats.
Association of risk stratification score with dialysis vascular access stenosis
Authors: Kumbar Lalathaksha , Astor Brad C , Besarab Anatole , Provenzano Robert , Yee Jerry
Published: November 2022

Backgrounds:

Clinical monitoring is the recommended standard for identifying dialysis access dysfunction; however, clinical monitoring requires skill and training, which is challenging for understaffed clinics and overburdened healthcare personnel. A vascular access risk stratification score was recently proposed to assist in detecting dialysis access dysfunction.

Purpose:

Our objective was to evaluate the utility of using vascular access risk scores to assess venous stenosis in hemodialysis vascular accesses.

Methods:

We prospectively enrolled adult patients who were receiving hemodialysis through an arteriovenous access and who had a risk score ⩽3 (low-risk) or ⩾8 (high-risk). We compared the occurrence of access stenosis (>50% on ultrasonography or angiography) between low-risk and high-risk groups and assessed clinical monitoring results for each group.

Results:

Of the 38 patients analyzed (18 low-risk; 20 high-risk), 16 (42%) had significant stenosis. Clinical monitoring results were positive in 39% of the low-risk and 60% of the high-risk group ( p = 0.19). The high-risk group had significantly higher occurrence of stenosis than the low-risk group (65% vs 17%; p = 0.003). Sensitivity and specificity of a high score for identifying stenosis were 81% and 68%, respectively. The positive predictive value of a high-risk score was 65%, and the negative predictive value was 80%. Only 11 (58%) of 19 subjects with positive clinical monitoring had significant stenosis. In a multivariable model, the high-risk group had seven-fold higher odds of stenosis than the low-risk group (aOR = 7.38; 95% CI, 1.44–37.82; p = 0.02). Positive clinical monitoring results and previous stenotic history were not associated with stenosis. Every unit increase in the score was associated with 34% higher odds of stenosis (aOR = 1.34; 95% CI, 1.05–1.70; p = 0.02).

Conclusions:

A calculated risk score may help predict the development of hemodialysis vascular access stenosis and may provide a simple and reliable objective measure for risk stratification.
Distribution, Phylogeny and Evolution of Clinical and Environmental Vibrio vulnificus Antibiotic-Resistant Genes
Authors: Geng Nan , Sun Guojin , Liu Wen-Jia , Gao Bin-Cheng , Sun Cong , Xu Cundong , Hua Ertian , Xu Lin
Published: November 2022

Vibrio vulnificus is an emergent marine pathogen and is the cause of a deadly septicemia. However, the evolution mechanism of antibiotic-resistant genes (ARGs) is still unclear. Twenty-two high-quality complete genomes of V. vulnificus were obtained and grouped into 16 clinical isolates and 6 environmental isolates. Genomic annotations found 23 ARG orthologous genes, among which 14 ARGs were shared by V. vulnificus and other Vibrio members. Furthermore, those ARGs were located in their chromosomes, rather than in the plasmids. Phylogenomic reconstruction based on single-copy orthologous protein sequences and ARG protein sequences revealed that clinical and environmental V. vulnificus isolates were in a scattered distribution. The calculation of non-synonymous and synonymous substitutions indicated that most of ARGs evolved under purifying selection with the Ka/ Ks ratios lower than one, while h-ns, rsmA, and soxR in several clinical isolates evolved under the positive selection with Ka/ Ks ratios >1. Our result indicated that V. vulnificus antibiotic-resistant armory was not only confined to clinical isolates, but to environmental ones as well and clinical isolates inclined to accumulate beneficial non-synonymous substitutions that could be retained to improve competitiveness.
Predictors of Retention and Drug Use Among Patients With Opioid Use Disorder Transferred to a Specialty “Second Chance” Methadone Program
Authors: Moses Tabitha E , Rhodes Gary L , Tavakoli Emytis , Christensen Carl W , Amirsadri Alireza , Greenwald Mark K
Published: November 2022

Background:

Many patients in methadone treatment have difficulty achieving or maintaining drug abstinence, and many clinics have policies that lead to discharging these patients. We designed a pilot “Second Chance” (SC) program for patients scheduled to be discharged from other local methadone clinics to be transferred to our clinic.

Aim:

Determine whether SC patients’ retention and opioid use is related to physical or mental health conditions, non-opioid substance use, or treatment features.

Methods:

From December 2012 to December 2014, this program enrolled 70 patients who were discharged from other clinics in the area; we were their last remaining option for methadone treatment. Unlike the clinic’s standard policies, the treatment focus for SC patients was retention rather than abstinence. This program focused on connection to care (eg, psychiatric services) and enabled patients to continue receiving services despite ongoing substance use. Each patient was assessed at treatment entry and followed until June 2016 to evaluate outcomes.

Results:

SC patients receiving disability benefits (n = 37) vs. non-disabled (n = 33) had significantly ( P < .05) higher rates of current DSM-IV Axis I psychiatric diagnosis (97% vs 70%), prescriptions for opioids (84% vs 55%) and benzodiazepines (65% vs 27%), and higher methadone doses at admission (58 vs 46 mg) but did not differ significantly in rates of 6-month or 1-year retention (77% and 56%, respectively) or all-drug use (39% positive urine drug screens). Methadone doses >65 mg predicted significantly longer retention and less opioid use, but these effects were not moderated by baseline characteristics.

Conclusions:

Patients in methadone treatment struggling to achieve abstinence may benefit from retention-oriented harm-reduction programs. Higher methadone doses can improve retention and opioid abstinence despite psychiatric comorbidities. Further work is needed to improve program implementation and outcomes in this complex population.
Composite relations: Democratic firms balancing the general and the particular
Authors: Pohler Nina
Published: November 2022

This paper focuses on a central coordinative tension in alternative, democratic organizations: They need to maintain formal equality and democratic governance, but they also have to support their members in their autonomy and be sensitive toward their particularities. Based on an empirical study of two democratic-collectivist firms, this paper combines insights from Laurent Thévenot’s sociology of engagement, and Zelizer’s notion of relational work to analyze how firms can establish “composite relations” that enable to balance the general and the particular. The paper offers two main contributions to the literature on alternative organizations: First, it describes possibilities for compositions between particular, personal relations, which are often of high importance in alternative organizations, and general, standardized relations, which are centrally important for all modern organizations. Second, while influential work on alternative organization assumes, that the tension between social values and business is quasi-equal to a tension between informal and formalized coordination in organizations, this paper develops a more nuanced perspective on the interrelation between morality and coordination in alternative organizations.
Pivoting to online: The benefits, challenges and possibilities for international programme evaluations
Authors: Henley Lee John , Stanley-Clarke Nicky , Acharya Anuradha , Khadka Smriti , Olsson Asa
Published: November 2022

Global South non-government organizations rely on international funding and aid for continued service delivery. Service evaluation plays a significant role in ensuring compliance and ongoing service funding. Traditional service evaluation approaches could not take place during 2021 due to COVID-19, alternate mechanisms needed to be embraced. This article reports on the benefits and challenges of undertaking service evaluations online during the pandemic and the learnings and possibilities for a post-pandemic world. It emphasizes the importance of translating a relational approach to service evaluation to the online environment. Key learnings include that while some of the benefits of context and in-person connection are lost, taking a relational approach involving careful planning and reflexivity means the online evaluation process can be successful. Undertaking service evaluations online offers possibilities in a post-pandemic world as cost-effective alternatives to the expensive and time-consuming reality of in-person service evaluation across international borders and within development contexts.
‘Who is telling the truth?’ Migrants’ experiences with COVID-19 related information in Norway: a qualitative study
Authors: Czapka Elżbieta Anna , Herrero-Arias Raquel , Haj-Younes Jasmin , Hasha Wegdan , Madar Ahmed A. , Møen Kathy A. , Ortiz-Barreda Gaby , Diaz Esperanza
Published: November 2022

Aims:

The over-representation of migrants among those infected by COVID-19 in high-income countries has spurred questions about insufficient distribution of health information to society’s subgroups. Our study aimed to shed light on migrants’ experiences with information relating to COVID-19 in Norway.

Methods:

We conducted 55 semi-structured interviews with migrants from five different countries living in Norway: Somalia (10), Syria (15), Sri Lanka (10), Chile (10), and Poland (10). The interviews were performed by bilingual researchers with a migrant background, audio-recorded, transcribed and thematically analysed.

Results:

We identified the four key themes of multiple and contradictory information sources, language barriers, conspiracy theories/speculations, strategies for information provision and ways ahead. Participants accessed and combined several often transnational sources of information. Information was perceived as confusing and contradictory and there was a wish for more translated information.

Conclusions:

It is important to recognise the specific factors affecting migrants’ ability to receive, trust and use health-related information during pandemics and other health crises.
A matter of time? Institutional timescapes and gendered inequalities in the transition from education to employment in Australia
Authors: Craig Lyn , Ravn Signe , Churchill Brendan , Valenzuela Maria Rebecca
Published: November 2022

This article explores why women miss out in the transition from the educational system to the labour market. Using nationally representative longitudinal data (2001–18) from the Household Income and Labour Dynamics in Australia (HILDA) survey, we compare how long after graduation it takes men and women with tertiary qualifications (n = 2030) to achieve key labour market milestones: (1) getting a full-time job; (2) getting a permanent contract; (3) earning an average wage; (4) finding a job that matches their skill level. We find significant gender differences in reaching these milestones, confirming that time is a critical dimension for understanding gendered inequalities in the returns to education. We attribute findings to incompatible ‘timescapes’ across the institutions of education, family and employment. The more flexible timescape of education allows women to succeed, but the inflexible timescape of employment (particularly when combined with family responsibilities) impedes them from turning educational achievement into labour market progress.
Can a basic income help address homelessness? A Titmussian perspective
Authors: Clarke Andrew
Published: November 2022

Homelessness is a worsening problem across the developed world and existing policy responses are failing to have an impact. This article considers whether a basic income (BI) can play a role in radically overhauling prevailing homelessness policy and interventions. Drawing on Richard Titmuss’ classical arguments about the value of universalist welfare, I argue that a BI can play a role, but only as part of a suite of universalist measures that includes large-scale social housing investment and rent controls. I highlight how a BI can help address the ‘income side’ of the housing affordability problem driving homelessness, but must be coupled with other measures that address housing cost and supply. I also consider how a BI can reduce stigma arising from targeted homelessness measures. I conclude by arguing that addressing homelessness requires us to transform the logic of welfare provision and that a BI can help do this.
Bio-inspired 3D-printed lattice structures for energy absorption applications: A review
Authors: Ramakrishna Doodi , Bala Murali Gunji
Published: November 2022

The biomimetic approach rapidly evolves for designing novel lightweight structures and has been expanding in engineering design. Additive manufacturing or 3D printing permits three-dimensional parts to be fabricated with an intricacy and quality that might be tough or impossible to appreciate with the present traditional production techniques. With the probabilities and exactitude, 3D printing allows bio-inspired lattice structures from nature that are hypothetically advanced to ingest excellent energy absorption capacity with less material. The combination of additive manufacturing with cellular lattice architectures offers potential design options regarding material utilization, strength, cost, and component weight. A summary of recent advances in the improvement of bio-inspired structures is outlined in this review paper. Specifically, exciting highlights and remarkable mechanical properties of bio-inspired structures of bones, teeth, and dermal layers of creatures might be bio-mimicked to style economical energy absorbers. Researchers and engineers can use this information to create unique designs inspired biologically for the application of absorption energy.
Covariate-modulated rectangular latent Markov models with an unknown number of regime profiles
Authors: Russo Alfonso , Farcomeni Alessio , Pittau Maria Grazia , Zelli Roberto
Published: November 2022

We derive a multivariate latent Markov model with number of latent states that can possibly change at each time point. We model both the manifest and latent distributions conditionally on explanatory variables. Bayesian inference is based on a transdimensional Markov Chain Monte Carlo approach, where Reversible Jump is separately performed for each time occasion. In a simulation study, we show how our approach can recover the true underlying sequence of latent states with high probability, and that it has lower bias than competitors. We conclude with an analysis of the well-being of 100 nations, as expressed by the dimensions of the Human Development Index, for six-time points spanning a period of 22 years. R code with an implementation is available as supplementary material, together with files for reproducing the data analysis.
Working in a gray area—Healthcare staff experiences of receiving consent when caring for persons with dementia
Authors: Östlund Lena , Ernsth Bravell Marie , Johansson Linda
Published: November 2022

Background

Every person has the right to autonomy, and to be involved in decisions about their care. When persons with dementia have difficulties in expressing what they want, their autonomy is challenged. Staff should strive to involve the person in care decisions, to obtain consent and to avoid the use of coercion and restraints. However, care without consent exists and coercion and restraints are being used. In order to improve care, further knowledge is warranted.

Aims

The purpose of this study was to explore staff’s experiences of obtaining consent when caring for persons with dementia.

Methods

In total 14 focus group interviews were conducted with staff with experience of dementia care who work in either home care or residential care in Sweden. An inductive qualitative content analysis was used to analyze the collected data.

Results

Three categories were generated describing staff experiences of consent in dementia care: the person as the decision-maker, the staff as the decision-makers, and the viability of the consent. Overall, staff found it difficult to know if they really had consent from the individual. Even if the person verbally gave consent, it was challenging to know if the person really understood what they had consented to. Common to all three categories was the significance of the relationship between the person with dementia and staff: getting to know the person, recognizing the person’s response in terms of their facial expressions and body language as well as being able to explain and justify specific actions to the person.

Conclusion

Staff need better conditions in dementia care, including training and time to reflect on how to obtain consent. A person-centered approach can be one way to develop care and ensure that persons with dementia are allowed autonomy and to share in making decisions.