bluuebunny/crossref_metadata_2025 huggingface dataset:
When Covid‐19 meets conflict: politics of the pandemic response in fragile and conflict‐affected states
Authors: Hilhorst Dorothea , Mena Rodrigo
Published: September 2021

The Covid‐19 pandemic has magnified existing crises and vulnerabilities, but much remains unknown about how it has affected fragile and conflict‐affected settings. This paper builds on the theory that hazards become a disaster in interaction with vulnerability and response policies, yet often lead to renewed disaster risk creation. It is based on seven case studies of countries worldwide that experienced social conflict at the advent of the pandemic, covering the period from March–August 2020. The findings show that authorities instrumentalised Covid‐19 to strengthen their control and agendas. Responsibility was assumed for lockdowns, but this was not accompanied by care to mitigate their adverse effects. Social conflict shaped the response, as high levels of mistrust in authorities complicated the implementation of measures, while authorities did not support community‐based coping initiatives. Whether Covid‐19 will trigger or exacerbate conflict and vulnerabilities depends on pre‐existing, country‐specific conditions, and how a government and other actors frame the issue and respond.
Developmental programming by maternal obesity: Lessons from animal models
Authors: Schoonejans Josca Mariëtte , Ozanne Susan Elizabeth
Published: September 2021

The obesity epidemic has led to more women entering pregnancy overweight or obese. In addition to adverse short‐term outcomes, maternal obesity and/or gestational diabetes predispose offspring to developing obesity, type 2 diabetes and cardiovascular disease in adulthood through developmental programming. Human epidemiological studies, although vital in identifying associations, are often unable to address causality and mechanistic studies can be limited by the lack of accessibility of key metabolic tissues. Furthermore, multi‐generational studies take many years to complete. Integration of findings from human studies with those from animal models has therefore been critical in moving forward this field that has been termed the ‘Developmental Origins of Health and Disease’. This review summarises the evidence from animal models and highlights how animal models provide valuable insight into the maternal factors responsible for developmental programming, potential critical developmental windows, sexual dimorphism, molecular mechanisms and age‐related offspring outcomes throughout life. Moreover, we describe how animal models are vital to explore clinically relevant interventions to prevent adverse offspring outcomes in obese or glucose intolerant pregnancy, such as antioxidant supplementation, exercise and maternal metformin treatment.
Speckle tracking imaging combined with myocardial comprehensive index to evaluate left ventricular function changes in patients with systemic lupus erythematosus
Authors: Feng Jia , Zhai Zijing , Wang Zhen , Huang Lei , Dong Shanshan , Liu Kuichan , Shi Wenrong , Lu Guilin , Qin Wenjuan
Published: September 2021

Objective

To evaluate early changes in left ventricular systolic function in patients with systemic lupus erythematosus (SLE) using three‐dimensional speckle tracking imaging (3D‐STI).

Methods

A total of 30 SLE patients and 30 healthy people (control group) were selected, the patients were further divided into subgroups according to their Safety of Estrogens in Lupus Erythematosus National Assessment version of the SLE Disease Activity Index (SELENA‐SLEDAI) score: ≤ 12: mild‐to‐moderate group; > 12: severe group. All participants were examined using 3D‐STI, the 3D‐STI parameters were obtained. Receiver operating curves (ROC) were prepared for above parameters and analyzed to identify correlations among 3D‐STI parameters and high sensitivity‐TropT (hs‐TropT).

Results

Compared with the control group, the absolute values of left ventricular end‐diastolic volume (LVEDV), left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), global circumferential strain (GCS), left ventricular twist angle (LVtw), torsion (Tor) and myocardial comprehensive index (MCI) decreased, left ventricular end diastolic mass (LV EDmass), left ventricular end systolic mass (LV ESmass) and peak strain dispersion (PSD) increased in the mild‐to‐moderate and the severe groups (P2 < 0.05, P3 < 0.05). There was statistically significant difference in terms of 3D‐STI parameters between the mild‐to‐moderate group and the severe group (P1 < 0.05). The highest area under the ROC for MCI was 0.909, the highest sensitivity for MCI was 90.00%, and the highest specificity for Tor was 86.67%. Correlation analysis showed that there was a good correlation between the MCI and hs‐TropT (r = − 0.677).

Conclusion

3D‐STI technology may help detect early changes in left ventricular systolic function in patients with SLE.
Right ventricular free wall strain in acutely decompensated heart failure patients with ischemic and non‐ischemic cardiomyopathy
Authors: Miric Dino , Barac Ana , Capkun Vesna , Bakovic Darija
Published: September 2021

Aims

Right ventricular (RV) dysfunction is a predictor of adverse outcomes among patients with HF with reduced ejection fraction (HFrEF); however, differences in RV parameters in HFrEF patients with ischemic (ICM) and non‐ischemic cardiomyopathies (NICM) are not well understood. We investigated echocardiographic characteristics, including RV strain, in patients with acute decompensated heart failure (ADHF) and compared patients with ICM and NICM etiology.

Methods

Consecutive patients who presented with ADHF and NYHA class III‐IV were prospectively enrolled if they had LVEF < 40% and history of ICM or NICM. All patients underwent clinical exam, laboratory evaluation and 2‐D echocardiographic assessment of the left ventricular (LV) and RV function, LV and RV global longitudinal strain (LVGLS, RVGLS), and RV free wall strain (RVfwLS).

Results

Of 84 patients, 44 had ICM and 40 NICM. The groups had similar blood pressure, NT‐proBNP, and echocardiographic parameters of LV function including LVGLS. Absolute RVGLS values were lower than RVfwLS values in both groups. Patients with NICM had significantly lower RVfwLS, but not RVGLS, compared to patients with ICM (−13% to −17%,p = 0.006). Similar differences in RVfwLS were seen in patients in NYHA class III (NICM vs ICM: −13% and −17%, respectively, 95% CI: −8.5 to −.5) and NYHA class IV (NICM vs ICM: −13.8% and −17%, respectively, 95% CI: −6.4 to −.59).

Conclusion

Among patients hospitalized with ADHF, patients with nonischemic etiology compared with the patients with ICM, have more severe RV dysfunction measured by RVfwLS, despite similar extent of LV impairment and the same functional limitation class.
Behavioural change as a theme that integrates behavioural sciences in dental education
Authors: Perez Arnaldo , Green Jacqueline L. , Ball Geoff D. C. , Amin Maryam , Compton Sharon M. , Patterson Steven
Published: September 2021

The behavioural sciences curriculum in dental education is often fragmented and its clinical relevance is not always apparent to learners. Curriculum integration is vital to understand behavioural subjects that are interrelated but frequently delivered as separate issues in dental programmes. In this commentary, we discuss behavioural change as a curricular theme that can integrate behavioural sciences in dental programmes. Specifically, we discuss behavioural change in the context of dental education guidelines and describe four general phases of behavioural change (defining the target behaviour, identifying the behavioural determinants, applying appropriate behavioural change techniques and evaluating the behavioural intervention) to make the case for content that can be covered within this curricular theme, including its sequencing. This commentary is part of ongoing efforts to improve the behavioural sciences curriculum in dental education in order to ensure that dental students develop the behavioural competencies required for entry‐level general dentists.
IVQFIoT: An intelligent vulnerability quantification framework for scoring internet of things vulnerabilities
Authors: Anand Pooja , Singh Yashwant , Selwal Arvind , Singh Pradeep Kumar , Ghafoor Kayhan Zrar
Published: September 2021

With time smart services have become more domineering than ever before however, the pertinent security considerations fade to correspond with growing heterogeneity in the internet of things (IoT) devices and new technologies coupled with resource constraints, crafting IoT‐based systems more susceptible to cyber‐attacks. To ensure a secure IoT environment, pro‐active security mechanisms, like scanning vulnerabilities and prioritizing to remediate them timely, should be embedded in the system. Motivated by the facts, we in this paper, highlight the state of the art of several works trading with a common vulnerability scoring system (CVSS), its limitations, and the emendations recommended to conclude its maturity. CVSS is an industry standard that has been adopted worldwide to quantify the vulnerabilities in organizations for IT and IoT‐based systems. The vulnerabilities mathematical score coalesces with environmental knowledge for finding attack paths and apt score for prioritization. The specific functionality and exclusive dynamics of IoT and cyber‐physical systems in comparison to traditional computer networks, make the legacy cyber‐security exemplars unfit for these advanced networks. This paper studies the relevance of CVSS for smart systems and present an intelligent vulnerability quantification framework for IoT systems grounded on the CVSS v3.1 framework with threat intelligence and machine learning models. Further by applying blockchain technology in the proposed framework, the issues concerning security, lack of trust, and privacy possibly will resolve by hiring a smart contract.
Functional traits reveal the dominant drivers of long‐term community change across a North American Great Lake
Authors: Sinclair James S. , Fraker Michael E. , Hood James M. , Frank Kenneth T. , DuFour Mark R. , Gorman Ann Marie , Ludsin Stuart A.
Published: September 2021

Ecosystems worldwide have been impacted by multiple anthropogenic stressors, yet efforts to understand and manage these impacts have been hindered by difficulties in disentangling relative stressor effects. Theoretically, the actions of individual stressors can be delineated based on associated changes in functional traits and these relationships should be generalizable across communities comprised of different species. Thus, combining trait perspectives with community composition data could help to identify the relative influence of different stressors. We evaluated the utility of this combined approach by quantifying shifts in fish species and trait composition in Lake Erie during the past 50 years (1969–2018) in relation to human‐driven changes in nutrient inputs, climate warming, and biological invasions. Species and trait shifts were also compared between two Lake Erie basins, which differ in their environmental and biological characteristics, to identify trait responses that were generalizable across different ecosystems versus those that were context dependent. Our analyses revealed consistent species changes across basins, and shifts in feeding and thermal traits, that were primarily associated with altered nutrient inputs (oligotrophication followed by eutrophication). We found no or inconsistent trait‐based evidence for the effects of warming and two invasive fishes. Context‐dependent trait responses were also evident; nutrient inputs were related to shifts in species tolerant of turbidity in the shallow, eutrophic western basin, which contrasted to shifts between benthopelagic and benthic species in the deeper central basin. Our results reveal the dominant effects of specific stressors on a large freshwater lake and offer a framework for combining species‐based and trait‐based approaches to delineate the impacts of simultaneous stressors on communities of perturbed natural ecosystems.
Delivery of AAV‐based gene therapy through haemophilia centres—A need for re‐evaluation of infrastructure and comprehensive care: A Joint publication of EAHAD and EHC
Authors: Miesbach Wolfgang , Chowdary Pratima , Coppens Michiel , Hart Daniel P. , Jimenez‐Yuste Victor , Klamroth Robert , Makris Michael , Noone Declan , Peyvandi Flora
Published: September 2021

Introduction

Adeno‐associated virus (AAV)‐based gene therapy for haemophilia presents a challenge to the existing structure of haemophilia centres and requires a rethink of current collaboration and information exchange with the aim of ensuring a system that is fit‐for‐purpose for advanced therapies to maximise benefits and minimise risks. In Europe, a certification process based on the number of patients and facilities is offered to the haemophilia centres by European Haemophilia Network (EUHANET).

Aim and methods

This joint European Association for Haemophilia and Allied Disorders (EAHAD) and European Haemophilia Consortium (EHC) publication describes criteria for centres participating in gene therapy care that require a reassessment of the infrastructure of comprehensive care and provides an outlook on how these criteria can be implemented in the future work of haemophilia centres.

Results

The core definition of a haemophilia treatment centre remains, but additional roles could be implemented. A modifiable ‘hub‐and‐spoke’ model addresses all aspects associated with gene therapy, including preparation and administration of the gene therapy product, determination of coagulation and immunological parameters, joint score and function, and liver health. This will also include the strategy on how to follow‐up patients for a long‐term safety and efficacy surveillance.

Conclusion

We propose a modifiable, networked ‘hub and spoke’ model with a long term safety and efficacy surveillance system. This approach will be progressively developed with the goal of making haemophilia centres better qualified to deliver gene therapy and to make gene therapy accessible to all persons with haemophilia, irrespective of their country or centre of origin.
The geography of police killings utilising crowdsourced data
Authors: Weisheit Ralph , Harmon Mark G. , Ingram Jason , Cottle Clayton
Published: September 2021

Police have the legal authority to use deadly force, but its use has resulted in a backlash in some communities. This county‐level analysis of 2,200 civilian deaths by police in the United States from 2015 and 2016 considers whether deadly force is primarily in response to high levels of crime (a consensus approach) or is the result of police response in socially and economically disadvantaged communities (a conflict approach). The results indicate that factors associated with economic and structural disadvantage matter more than levels of crime in accounting for the presence and number of police‐involved deaths.
BSHI/BTS guidance on crossmatching before deceased donor kidney transplantation
Authors: Peacock S. , Briggs D. , Barnardo M. , Battle R. , Brookes P. , Callaghan C. , Clark B. , Collins C. , Day S. , Diaz Burlinson N. , Dunn P. , Fernando R. , Fuggle S. , Harmer A. , Kallon D. , Keegan D. , Key T. , Lawson E. , Lloyd S. , Martin J. , McCaughan J. , Middleton D. , Partheniou F. , Poles A. , Rees T. , Sage D. , Santos‐Nunez E. , Shaw O. , Willicombe M. , Worthington J.
Published: September 2021

All UK H&I laboratories and transplant units operate under a single national kidney offering policy, but there have been variations in approach regarding when to undertake the pre‐transplant crossmatch test. In order to minimize cold ischaemia times for deceased donor kidney transplantation we sought to find ways to be able to report a crossmatch result as early as possible in the donation process. A panel of experts in transplant surgery, nephrology, specialist nursing in organ donation and H&I (all relevant UK laboratories represented) assessed evidence and opinion concerning five factors that relate to the effectiveness of the crossmatch process, as follows: when the result should be ready for reporting; what level of donor HLA typing is needed; crossmatch sample type and availability; fairness and equity; risks and patient safety. Guidelines aimed at improving practice based on these issues are presented, and we expect that following these will allow H&I laboratories to contribute to reducing CIT in deceased donor kidney transplantation.
Association analysis of B7‐H3 and B7‐H4 gene single nucleotide polymorphisms in susceptibility to ankylosing spondylitis in eastern Chinese Han population
Authors: Chen Yuting , Yang Hui , Xu Shanshan , Shen Jiran , Xu Wei , Shao Ming , Pan Faming
Published: September 2021

This study was conducted to describe the association between the genetic variation of the recently identified immune checkpoint molecules B7‐H3 and B7‐H4, and the susceptibility to ankylosing spondylitis (AS). Two single nucleotide polymorphisms (SNPs) of B7‐H3 gene and three SNPs of B7‐H4 gene were genotyped in 649 AS patients and 646 age‐ and sex‐matched healthy controls. Allele, genotype frequencies and different inheritance models were performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs), and the demographic and clinical parameters of patients were recorded. Our data indicated that B7‐H4 rs10801935 and rs3738414 polymorphisms were correlated with AS susceptibility. In the stratification analyses, the minor A allele and GA genotype of B7‐H4 rs3738414 increased the risk of AS in male patients (OR = 1.244, 95%CI = 1.026–1.508; OR = 1.453, 95%CI = 1.120–1.886, respectively). However, the association did not reach statistical significance after Bonferroni correction. Furthermore, haplotype analysis revealed that B7‐H4 haplotype block TAG was a risk factor for the onset of AS (OR = 1.190, 95%CI = 1.020–1.389). These findings suggested that B7‐H4 gene polymorphism may contribute to AS susceptibility in eastern Chinese Han population.
Impacts of the COVID‐19 pandemic and unpaid care work on informal workers' livelihoods
Authors: OGANDO Ana Carolina , ROGAN Michael , MOUSSIÉ Rachel
Published: September 2021

The COVID‐19 pandemic triggered a health, economic and care crisis affecting all workers, including those in the informal economy. This article uses data from the first round of a mixed‐methods longitudinal study conducted in June/July 2020 by Women in Informal Employment: Globalizing and Organizing in partnership with informal workers' organizations in 12 cities. It assesses the impacts of the multidimensional crisis on care responsibilities and the resulting effects on livelihoods and food security. A gendered analysis of paid work and unpaid care work sheds light on the unique features of the impacts of the current “pandemic recession” on the world's informal labour force.
Rheumatoid arthritis is a preventable disease: 11 ways to reduce your patients' risk
Authors: Koller‐Smith Louise , Mehdi Ahmed M. , March Lyn , Tooth Leigh , Mishra Gita D. , Thomas Ranjeny
Published: September 2021

New evidence shows that up to 40% of rheumatoid arthritis (RA) cases are attributable to exposure to potentially modifiable factors. We can now identify people at higher risk of RA (pre‐RA) through their family history, risk factors, autoantibodies and symptoms. Counselling these patients to act to modify factors known to be associated with RA risk could prevent the development of RA, and evidence shows that informing individuals of their risk and of ways to reduce it leads to positive behavioural change and is not harmful. This consumer‐focussed narrative review is targeted at primary care providers and physicians to describe 11 changes that can be made, based on current evidence linking potentially modifiable factors to RA risk. These evidence‐based recommendations are: (i) cease smoking; (ii) reduce exposure to inhaled silica, dusts and occupational risks; (iii) maintain a healthy weight; (iv) increase leisure time physical activity; (v) maintain good dental hygiene; (vi) maximise breastfeeding if able; (vii) maximise dietary quality and avoid high‐salt diets; (viii) consume high levels of omega‐3 fatty acids and fish; (ix) reduce consumption of sugar‐sweetened soft drinks; (x) consume moderate levels of alcohol; and (xi) remain vitamin D replete.
Structure and microwave dielectric characteristics of Hf1‐xTixO2 ceramics
Authors: Ding Yi Han , Liu Lu , Yang Zi Jing , Li Lei , Chen Xiang Ming
Published: September 2021

Hf1‐xTixO2 dense ceramics were prepared by a standard solid‐state reaction process, and the microwave dielectric properties in a wide frequency range were determined together with structure evolution. With increasing x, the structure gradually changed from HfO2‐based solid solution (monoclinic in space group P21/c, x ≤ 0.05) to HfTiO4 (orthorhombic in space group Pbcn, x = 0.5), and the two phase regions were determined for 0.1 ≤x < 0.5 and x = 0.55. The microwave dielectric properties of HfO2 ceramics at 10 GHz were determined as εr = 14, Qf = 24 500 GHz, τf = –50 ppm/℃. With Ti‐substitution, the microwave dielectric characteristics, especially the Qf value, could be significantly improved, and the best combination of microwave dielectric characteristics was achieved at x = 0.05: εr = 17, Qf = 84 020 GHz (at 7.8 GHz) and 151 260 GHz (at 27.9 GHz), and τf = –47 ppm/℃. The smallest temperature coefficient of resonance frequency (τf = –4.8 ppm/℃) was obtained for x = 0.55 together with a Qf value of 52 370 GHz at 5.0 GHz and 60 390 GHz at 17.9 GHz, where the dielectric constant was 40. Moreover, Hf1‐xTixO2 microwave dielectric ceramics might be very competitive in the future of mobile communication technology due to their excellent compatibility with Si.
Impact of COVID‐19 and other infectious conditions requiring isolation on the provision of and adaptations to fundamental nursing care in hospital in terms of overall patient experience, care quality, functional ability, and treatment outcomes: systematic review
Authors: Whear Rebecca , Abbott Rebecca A. , Bethel Alison , Richards David A. , Garside Ruth , Cockcroft Emma , Iles‐Smith Heather , Logan Pip A. , Rafferty Ann Marie , Shepherd Maggie , Sugg Holly V. R. , Russell Anne Marie , Cruickshank Susanne , Tooze Susannah , Melendez‐Torres GJ , Thompson Coon Jo
Published: September 2021

Aim

This systematic review identifies, appraises and synthesizes the evidence on the provision of fundamental nursing care to hospitalized patients with a highly infectious virus and the effectiveness of adaptations to overcome barriers to care.

Design

Systematic review.

Data Sources

In July 2020, we searched Medline, PsycINFO (OvidSP), CINAHL (EBSCOhost), BNI (ProQuest), WHO COVID‐19 Database (https://search.bvsalud.org/) MedRxiv (https://www.medrxiv.org/), bioRxiv (https://www.biorxiv.org/) and also Google Scholar, TRIP database and NICE Evidence, forwards citation searching and reference checking of included papers, from 2016 onwards.

Review Methods

We included quantitative and qualitative research reporting (i) the views, perceptions and experiences of patients who have received fundamental nursing care whilst in hospital with COVID‐19, MERS, SARS, H1N1 or EVD or (ii) the views, perceptions and experiences of professional nurses and non‐professionally registered care workers who have provided that care. We included review articles, commentaries, protocols and guidance documents. One reviewer performed data extraction and quality appraisal and was checked by another person.

Results

Of 3086 references, we included 64 articles; 19 empirical research and 45 review articles, commentaries, protocols and guidance documents spanning five pandemics. Four main themes (and 11 sub‐themes) were identified. Barriers to delivering fundamental care were wearing personal protective equipment, adequate staffing, infection control procedures and emotional challenges of care. These barriers were addressed by multiple adaptations to communication, organization of care, staff support and leadership.

Conclusion

To prepare for continuation of the COVID‐19 pandemic and future pandemics, evaluative studies of adaptations to fundamental healthcare delivery must be prioritized to enable evidence‐based care to be provided in future.

Impact

Our review identifies the barriers nurses experience in providing fundamental care during a pandemic, highlights potential adaptations that address barriers and ensure positive healthcare experiences and draws attention to the need for evaluative research on fundamental care practices during pandemics.
A world without borders revisited: Impact of online sales tax collection on shopping and search
Authors: Hossain Mallick
Published: September 2021

For years, online retailers did not have to collect sales taxes at the time of sale. Over the past decade, states have passed laws to capture this lost revenue. I study the effect of closing the online sales tax loophole on online spending and search. Using online shopping data, sales taxes, and Amazon's staggered sales tax collection, I estimate that a household's tax elasticity is −1.9, implying a 13% decline in Amazon's revenues upon sales tax collection. After Amazon collects sales taxes, households increase their spending on Amazon's taxed competitors, but not its untaxed competitors. I find no evidence that households change their search behavior or shift their spending offline. Collecting sales taxes online will help governments recapture lost taxes and increase online competition, but will not shift customers back offline.
RHEMITT score: Predicting the risk of mid gastrointestinal rebleeding after small bowel capsule endoscopy: A prospective validation
Authors: de Sousa Magalhães Rui , Sousa‐Pinto Bernardo , Boal Carvalho Pedro , Rosa Bruno , Moreira Maria João , Cotter José
Published: September 2021

Background and Aim

The RHEMITT score (Renal disease; Heart failure; Endoscopic findings; Major bleeding; Incomplete SBCE; Tobacco; Treatment by enteroscopy) was the first score to accurately predict the individual risk of small bowel rebleeding after capsule endoscopy (SBCE). The aim of the study is on the prospective validation of the RHEMITT score.

Methods

Cohort of consecutive patients with mid‐gastrointestinal bleeding (MGIB) submitted to SBCE and followed prospectively, during at least 12 months, since 2017 until 2020. Rebleeding was defined as an overt bleeding event (melena or hematochezia) or a hemoglobin decrease of at least 2 g/dL. The RHEMITT score was calculated for each patient and the rebleeding rates compared. The performance of the score was tested by calculating the area under curve of the receiver operator characteristic curve. A rebleeding‐free survival was assessed, corresponding to the period between the date of SBCE and the date of the first post‐SBCE rebleeding event.

Results

We included 162 patients, 102 (62.9%) were female, with a mean age of 64 years old. The sensitivities and specificities of the score grades for predicting rebleeding were as following: for low‐risk patients, 0% (0–10%) and 28.8% (21.1–36.5%); for intermediate‐risk patients, 23.3% (8.2–38.4%) and 72% (64.3–79.7%); for high‐risk patients, 76.7% (61.6–91.8%) and 99.2% (97.7–100%), corresponding to an area under curve of the receiver operator characteristic of 0.988 (P < 0.001). Kaplan–Meyer plots were statistically different according to the attributed risk (log‐rank P value <0.001; Breslow–Wilcoxon P value <0.001).

Conclusion

The RHEMITT score performed with excellent discriminative power in predicting rebleeding risk, and we herewith propose a surveillance of MGIB patients guided by the RHEMITT score.
Proposal of a self‐assessment questionnaire for the diagnosis of sensitive skin
Authors: Corazza Monica , Guarneri Fabrizio , Montesi Leda , Toni Giulia , Donelli Irene , Borghi Alessandro
Published: September 2021

Background

Sensitive skin is very common and distressing. Its diagnosis may be difficult with the tools/methods available at the moment.

Aims

To assess the reliability of a self‐assessment questionnaire for the diagnosis of sensitive skin, using the results of lactic acid stinging test (LAST) as a reference for the identification of subjects suffering from this condition. A further objective was to identify the questionnaire cutoff score that better discriminates between subjects with or without sensitive skin.

Patients/methods

Among the adult volunteers included in this observational, cross‐sectional study, both LAST‐positive subjects, who were considered as having sensitive skin (“patients”), and negative ones (“controls”) completed the questionnaire. It consisted of a part for self‐assessing and quantifying (0–10) sensitive skin and another one that included 10 items, each referring to a specific, potentially triggering stimulus. A cumulative score (questionnaire‐based skin sensitivity score, 0–10) was calculated from the sum of all items considered capable of triggering unpleasant skin sensations in real‐life experience.

Results

One hundred and sixty‐two subjects were enrolled, 102 patients and 60 controls; 98 subjects thought they had sensitive skin. The mean questionnaire‐based skin sensitivity score was significantly higher among patients than controls and correlated with skin sensitivity self‐assessments. A cutoff value of 3 was set for the identification of LAST‐positive subjects, with 79% accuracy.

Conclusions

The study self‐assessment questionnaire seems to be a reliable tool for diagnosing sensitive skin in clinical practice. These results led us to identify a numerical cutoff for detecting propensity to experience sensitive skin.
Silence After Stops? Assessing Youth Disclosure of Police Encounters
Authors: Jackson Dylan B. , Semenza Daniel C. , Testa Alexander , Vaughn Michael G.
Published: September 2021

Youth–police encounters are common in the United States, with potentially serious mental health ramifications requiring social supports to cope. Still, no research has examined youth disclosure of these experiences to others. Using a national sample of youth stopped by police (N = 918; 56.09% Black, 20.48% Hispanic), we find that more than two‐thirds disclosed police encounters—most commonly to mothers. Even so, disclosure became less likely as perceptions of procedural injustice, social stigma, and legal cynicism increased. Among youth who disclosed stops but not to parents, disclosure to friends was common (61.18%), whereas disclosure to nonparent adults was not. Enhanced training for teachers, school counselors, and community leaders may improve youth outcomes by facilitating additional opportunities for disclosure and support.
LGBTQ Student Health: A Mixed‐Methods Study of Unmet Needs in Massachusetts Schools
Authors: Sava Lauren M. , Earnshaw Valerie A. , Menino David D. , Perrotti Jeff , Reisner Sari L.
Published: September 2021

BACKGROUND

Lesbian, gay, bisexual, transgender, and queer and questioning (LGBTQ) youth experience poor physical and mental health outcomes relative to their non‐LGBTQ peers. School health professionals (SHPs), such as school nurses, play a key role in addressing LGBTQ student health needs. However, few studies examine school health needs of LGBTQ students from both the youth and SHP perspective.

METHODS

From August 2017 to July 2018, 28 LGBTQ youth and 19 SHPs (N = 47) in Massachusetts participated in online focus groups and a brief survey on school health needs and experiences. Qualitative themes were coded using Rapid Qualitative Inquiry principles and NVIVO.

RESULTS

Both LGBTQ students and SHPs identified an urgent need for inclusive sexual education and mental health services. LGBTQ students raised access to safer bathrooms, information, and guidance on gender transitioning, and access to safe spaces as school‐based needs. Missing from SHPs' perspectives, students also discussed sexual violence/harassment of transgender students and racism impacting youth of color.

CONCLUSIONS

LGBTQ students, especially transgender students and LGBTQ youth of color, have unmet health needs that need to be addressed. Recognizing these needs is the first step towards inclusive health services and support for all students in schools. Next, interventions to increase the capacity of SHPs to address LGBTQ student health are necessary.
Liver stiffness measurement as a quantitative method for liver fibrosis in children with non‐alcoholic fatty liver disease: A meta‐analysis
Authors: Dong Bingtian , Chen Yuping , Lyu Guorong , Qin Ran
Published: September 2021

Aim

This study assessed the diagnostic performance of liver stiffness measurement (LSM) in detecting liver fibrosis in paediatric patients with non‐alcoholic fatty liver disease (NAFLD) through meta‐analysis.

Methods

Online database searches of PubMed, EMBASE, the Cochrane Library and the Web of Science were conducted for studies that evaluated the performance of LSM for diagnosing liver fibrosis in paediatric patients with NAFLD until 1 January 2021. The Quality Assessment of Diagnostic Accuracy Studies‐2 (QUADAS‐2) tool was used to assess the quality of the included studies. Three measures were used to assess the performance of LSM for detecting liver fibrosis in paediatric patients with NAFLD, including the summary sensitivities and specificities, the summary area under the receiver operating characteristic curves and the summary diagnostic odds ratios.

Results

Our final data included seven studies with a total of 436 paediatric patients with NAFLD for meta‐analysis. The overall prevalence of mild fibrosis, significant fibrosis, advanced fibrosis and cirrhosis was 66.3, 31.5, 14.9 and 1.2%, respectively. The summary sensitivity, specificity and area under the receiver operating characteristic values of LSM were 80, 92 and 0.94 for the prediction of mild fibrosis; 91, 97 and 0.98 for the prediction of significant fibrosis; and 89, 93 and 0.96 for the prediction of advanced fibrosis, respectively.

Conclusion

Liver stiffness measurement exhibited good diagnostic performance in predicting liver fibrosis and can be used as a non‐invasive tool in the management of paediatric patients with non‐alcoholic fatty liver disease.
Multi‐incident analysis of reviews of serious adverse clinical events in children with serious bacterial infection and/or sepsis in Queensland, Australia between 2012 and 2017
Authors: Coulthard Mark G , Osborne Jodie M , McCaffery Kevin , McAuley Sharon A , McEniery Julie A
Published: September 2021

Aim

To report on findings from a multi‐incident analysis of reviews of serious paediatric adverse clinical events related to serious bacterial infection and/or sepsis (hereafter referred to as sepsis for brevity) in Queensland, Australia, between 2012 and 2017.

Methods

The Queensland Paediatric Quality Council reviewed documentation from reviews of serious adverse events occurring in children (<18 years) with a diagnosis of sepsis at Queensland public hospitals between 2012 and 2017, including clinical details, coronial reports, autopsy reports and root cause analysis documents. A multi‐incident tool was designed and used by an expert panel to identify patient and facility demographics, contributing factors, and human and system factors associated with paediatric serious adverse events.

Results

There were 28 serious adverse clinical events reported related to paediatric sepsis, characterised by a high proportion of deaths (23) and a predominance of children aged under 4 years. Approximately half of all facilities were classified as rural and remote health services. Contributing factors included difficulty in recognising and responding to the deteriorating patient, inadequate management/treatment, diagnostic error (mainly diagnostic delay) and escalation delay/failure. Major system factors included communication issues, incorrect use of the early warning tool, inadequate coordination of care planning, policy/protocol/guideline failures and workforce problems.

Conclusion

Multi‐incident analysis is a useful tool for identifying themes that recur in similar events and presents opportunities for system‐wide improvement. Common themes and contributing factors were identified which may provide possibilities for earlier identification and intervention in childhood serious bacterial infection and/or sepsis.
Rural‐urban and within‐rural differences in COVID‐19 vaccination rates
Authors: Sun Yue , Monnat Shannon M.
Published: September 2021

Purpose

COVID‐19 mortality rates are higher in rural versus urban areas in the United States, threatening to exacerbate the existing rural mortality penalty. To save lives and facilitate economic recovery, we must achieve widespread vaccination coverage. This study compared adult COVID‐19 vaccination rates across the US rural‐urban continuum and across different types of rural counties.

Methods

We retrieved vaccination rates as of August 11, 2021, for adults aged 18+ for the 2,869 counties for which data were available from the CDC. We merged these with county‐level data on demographic and socioeconomic composition, health care infrastructure, 2020 Trump vote share, and USDA labor market type. We then used regression models to examine predictors of COVID‐19 vaccination rates across the USDA's 9‐category rural‐urban continuum codes and separately within rural counties by labor market type.

Findings

As of August 11, 45.8% of adults in rural counties had been fully vaccinated, compared to 59.8% in urban counties. In unadjusted regression models, average rates declined monotonically with increasing rurality. Lower rural rates are explained by a combination of lower educational attainment and higher Trump vote share. Within rural counties, rates are lowest in farming and mining‐dependent counties and highest in recreation‐dependent counties, with differences explained by a combination of educational attainment, health care infrastructure, and Trump vote share.

Conclusion

Lower vaccination rates in rural areas is concerning given higher rural COVID‐19 mortality rates and recent surges in cases. At this point, mandates may be the most effective strategy for increasing vaccination rates.
Configurational approaches to theory development in supply chain management: Leveraging underexplored opportunities
Authors: Ketchen David J. , Kaufmann Lutz , Carter Craig R.
Published: September 2021

In introducing the 2020 Emerging Discourse Incubator, Flynn et al. (2020, https://doi.org/10.1111/jscm.12227) urged supply chain scholars to leverage fresh approaches in order to develop supply chain‐specific theory, including approaches that are underutilized within the discipline. In response, we explain how more examination of configurations—meaningful sets of observations within a sample—can enhance theory development and, in particular, fuel the construction of supply chain‐specific theory. First, we describe the value of configurational theorizing while contrasting it with two more popular approaches: one that centers on linear relationships and one that spotlights the unique features of individual observations. Second, we explain the main configurational approaches available to scholars. Here, we pay special attention to qualitative comparative analysis (QCA)—an approach to configurational theorizing that is relatively new to organizational research. Third, we offer examples of how configurational theorizing via the use of QCA can be used to develop supply chain management theory. Although QCA is employed regularly in neighboring fields, QCA remains something of a conceptual curiosity within supply chain management research. This state of affairs represents an important opportunity because QCA's emphasis on causal complexity fits well with the fact that supply chain outcomes usually arise from an array of variables—often at different levels of analysis—and the interplay among them. Thus, better leveraging configurational theory development can facilitate the creation of novel conceptualizations and useful advice for practice.
Clinicopathological features of titinopathy from a Chinese neuromuscular center
Authors: Huang Kun , Duan Hui‐Qian , Li Qiu‐Xiang , Luo Yue‐Bei , Bi Fang‐Fang , Yang Huan
Published: September 2021

Titin, one of the largest proteins in humans, is a major component of muscle sarcomeres. Pathogenic variants in the titin gene (TTN) have been reported to cause a range of skeletal muscle diseases, collectively known as titinopathy. Titinopathy is a heterogeneous group of disabling diseases characterized by muscle weakness. In our study, we aimed to establish the clinicopathological‐genetic spectrum of titinopathy from a single neuromuscular center. Three patients were diagnosed as having definite titinopathy, and additional three patients were diagnosed as having possible titinopathy according to the diagnostic criteria. All the patients showed initial symptoms from age one to 40 years. Physical examination revealed that five patients had muscle weakness, and that one patient experienced behavioral changes. Muscle biopsy specimens obtained from all six patients demonstrated multiple myopathological changes, including increased fiber size variation, muscle fiber hypertrophy or atrophy, formation of centralized cell nuclei, necklace cytoplasmic bodies, and formation of rimmed vacuoles and cores. Genetic testing revealed 11 different TTN alterations, including missense (6/11), nonsense (2/11), frameshift (2/11), and splicing (1/11) mutations. Our study provides further evidence that TTN mutations are more likely to be responsible for an increasing proportion of various myopathies, such as hereditary myopathy with early respiratory failure (HMERF), core myopathy, and distal myopathy with rimmed vacuoles, than currently recognized mutations. Our findings expand the clinical, pathohistological and genetic spectrum of titinopathy.
The evolution of hypothermia for neuroprotection after cardiac arrest: a history in the making
Authors: Presciutti Alexander , Perman Sarah M.
Published: September 2021

While much has been observed regarding hypothermia by way of environmental exposure, it is modern day medicine that deployed hypothermia as a therapeutic. From the early 1930s, when Temple Fay deployed “refrigeration” to treat pain, to the work of Wilfred Bigelow and Charles Drew, who utilized hypothermia in open heart surgery—the opportunities seemed endless. However, questions arose surrounding appropriate temperatures to achieve best outcomes and how to minimize adverse events, such as coagulopathy and infection. In the 1980s, hypothermia underwent a resurgence through Peter Safar's critical studies in large animals, which quickly translated into feasibility studies and the landmark trials of 2002 that paved the way for postcardiac arrest care as we currently know it. Through clinical and observational trials, modern‐day targeted temperature management continues to adapt, striving to improve patient outcomes. While hypothermia has come a long way from the writings of Hippocrates, the ideal therapy has not yet been defined, and more work is needed. While the history is long, there is more to be written and advances to be achieved as we optimize the neuroprotective effects of hypothermia for comatose survivors of cardiac arrest.
Tree nut introduction in a peanut‐allergic child: To eat, to screen, or to avoid?
Authors: Abrams Elissa M. , Sicherer Scott H.
Published: September 2021

There is no defined standard of care around tree nut introduction in a peanut‐allergic child, and the role of screening prior to tree nut introduction is controversial. There is some evidence that peanut‐allergic children are at increased risk of tree nut allergy, with approximately 23–68% of children with co‐existent peanut/tree nut allergy. In some studies, it has been shown that tree nut allergy in children has the potential to be a severe allergy. However, this appears to be age‐specific as infant anaphylaxis in general tends to be milder, and there has been no fatality reported on the first ingestion of an allergen in infancy. Familial hesitancy has been identified as a possible condition for undertaking screening tests prior to allergen introduction. Indeed, there has been limited evidence that caregiver hesitancy may exist in peanut‐allergic families with tree nut introduction. However, pre‐emptive screening has the potential to overdiagnose tree nut allergy and delay introduction (which could paradoxically increase risk). As a result, the decision is best made in the context of shared decision‐making and patient preference‐sensitive care.
Accuracy of predictive equations in guiding tracheal intubation depth in children: A prospective study
Authors: Khanna Puneet , Garg Heena , Ray Bikash Ranjan , Singh Ajay , Kundu Riddhi , Sinha Renu
Published: September 2021

Background

Accurate insertion depth of endotracheal tube (ETT) in children has been predicted using the demographic variables, such as age, weight, and height. Middle finger length showed good correlation with ETT depth measurement in children aged 4–14 years.

Aims

The primary objective was to correlate the actual ETT insertion depth with the depth derived from middle finger length, age, weight, and height formulae in children aged 1–4 years. The secondary objective was to find the most accurate formula for prediction of ETT insertion depth.

Methods

This prospective parallel group study was done in 50 american society of anesthesiologists 1 or 2 children aged 1–4 years undergoing elective surgery under general anesthesia. Children with difficult airway, finger anomalies, or syndromic associations were excluded. Age, weight, height, and middle finger length of all children were measured. Depth of orally inserted uncuffed ETT and tracheal length was measured by fiberoptic bronchoscopy. The actual ETT depth was correlated with the depth calculated from different formulae.

Results

The mean middle finger length was 4.42 ± 0.50 cm, age was 2.64 ± 1.07 years, weight was 12.28 ± 2.84 kg, and height was 82.89 ± 16.23 cm. The mean tracheal length was 6.42 ± 0.96 cm. The mean depth of ETT was actual depth (12.89 ± 1.09 cm), middle finger depth (13.23 ± 1.53cm; p = .001; 95%CI 0.12–0.50), age‐based depth 1(3.31 ± 0.53 cm; 95%CI 0.37–1.44; p = .001), weight‐based depth (14.14 ± 1.42 cm; 95% CI 0.10–0.51; p = .004), and height‐based depth (13.73 ± 0.94 cm; 95% CI 0.15–0.77; p = .004). Middle finger length and age‐based formulae showed higher number of accurate placements (58% each). Weight‐ (74%) and height (64%)‐derived formulae gave a higher number of distal ETT placements.

Conclusion

Formulas based on the demographic variables and middle finger length showed good correlation with the actual ETT depth in children aged 1–4 years. The percentage of accurate ETT depth placements was higher with middle finger length and age‐based formulae.
Synergistic or Antagonist Effects of Different UV Ranges Analyzed by the Combination Index: Application to DNA Photoproducts†
Authors: Douki Thierry , Buhot Arnaud
Published: September 2021

Photobiological effects are known to greatly depend on the wavelength of the incident photons that define the nature of the activated chromophores. A growing number of experimental data show that considering the effect of complex light sources as a sum of the effects of monochromatic exposures can be misleading. Indeed, the combined exposure to several wavelength ranges may modulate photobiological responses or even induce novel processes. These observations are similar to a well‐known topic in chemical toxicology: the nonadditivity of effects in mixtures where either antagonism or synergy are often observed. In the present work, we investigated whether a data analysis tool first developed for studying nonadditivity in mixtures of drugs, the combination index, could be applied to photobiological processes. We chose to work on the formation of UV‐induced DNA photoproducts where additive, antagonist, and synergistic effects take place simultaneously. In addition to this application, we worked on the mathematical bases of the concept in order to broaden its applicability to phenomena exhibiting various dose–response patterns. We also addressed the question of the evaluation of the error on the determination of the combination index.