bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding parent experiences of end-of-life care for children: A systematic review and qualitative evidence synthesis
Authors: Barrett Laura , Fraser Lorna , Noyes Jane , Taylor Jo , Hackett Julia
Published: December 2022

Background:

An estimated 21 million children worldwide would benefit from palliative care input and over 7 million die each year. For parents of these children this is an intensely emotional and painful time through which they will need support. There is a lack of synthesised research about how parents experience the care delivered to their child at the end of life.

Aim:

To systematically identify and synthesise qualitative research on parents’ experiences of end-of-life care of their child.

Design:

A qualitative evidence synthesis was conducted. The review protocol was registered in PROSPERO (CRD42021242946).

Data sources:

MEDLINE, EMBASE, CINAHL, PsycINFO and Web of Science databases were searched for qualitative studies published post-2000 to April 2020. Studies were appraised for methodological quality and data richness. Confidence in findings was assessed by GRADE-CERQual.

Results:

About 95 studies met the eligibility criteria. A purposive sample of 25 studies was taken, of good-quality papers with rich data describing the experience of over 470 parents. There were two overarching themes: parents of children receiving end-of-life care experienced a profound need to fulfil the parental role; and care of the parent. Subthemes included establishing their role, maintaining identity, ultimate responsibility, reconstructing the parental role, and continuing parenting after death.

Conclusions:

Services delivering end-of-life care for children need to recognise the importance for parents of being able to fulfil their parental role and consider how they enable this. What the parental role consists of, and how it’s expressed, differs for individuals. Guidance should acknowledge the need to enable parents to parent at their child’s end of life.
Deific Figures and Human Bodies: Creating Hierarchies of Difference through the Incarnation of Moral Authority
Authors: Schnabel Elaine
Published: December 2022

Religious communities have long affirmed the agency of their sacred texts and their God/gods, providing a unique site of study for research on ventriloquizing authority, textual agency, and the power of incorporeal figures like values or principles. This paper uses PraiseMoves, an Evangelical  organization selling a “Christian alternative to yoga,” as a case study to develop the concept of deific agency. Deific agency is the agential power of incorporeal projections of moral authority. These projections mediate text-human relationships both in and beyond particular organizational contexts by imbuing visibly-privileged human bodies with moral authority. Deific figures can thus overwhelm textual agency by bonding with visibly-privileged bodies and thereafter organizing perceptions of moral authority in and beyond organizations in ways that disproportionately benefit physically-privileged human beings. This paper concludes by articulating the value of believing bodies for research and suggesting future avenues of inquiry.
Design and test of lateral interconnected hydro-pneumatic ISD suspension
Authors: Nie Jiamei , Zhao Yue , Zhang Xiaoliang , Zhang Tian
Published: December 2022

Aim to balance the ride comfort and handling stability of vehicles and improve suspension performance, this paper presents a novel lateral interconnected hydro-pneumatic “inerter-spring-damper” (ISD) suspension integrating a hydro-pneumatic suspension and a fluid inerter, which realizes the lateral connection of the suspension through the inerter. The equivalent mathematical model of the lateral interconnected ISD suspension is established; the 15-degree-of-freedom (DOF) model of the vehicle is built in AMESim, and the key parameters are optimized by genetic algorithm. The response characteristics of the novel hydro-pneumatic ISD suspension and traditional hydro-pneumatic suspension under pulse and random input are comparatively analyzed. The lateral interconnected hydro-pneumatic ISD suspension prototype is developed and tested on the bench. The simulation and test results prove that the proposed new suspension structure has a more effective shock absorption performance than the traditional hydro-pneumatic suspension. Overall, the novel hydro-pneumatic ISD suspension better consider to the ride comfort and handling stability, and the structure is simple, compact, and easy to deploy on practical vehicles.
Impediments to and readiness for Linked Data application in libraries: Pakistani information professionals’ perspective
Authors: Warraich Nosheen Fatima , Rorissa Abebe
Published: December 2022

Findings revealed that there is little evidence that exists of the implementation of LD technologies by libraries in developing countries. This study aims to examine the willingness of information professionals along with their perceived barriers to the implementation of LD technologies in Pakistani libraries. Data was collected from Pakistani librarians in an online questionnaire survey. There is broad interest and willingness to implement Linked Data technologies in Pakistani libraries while perceptions of the presence of barriers remain. Participants are willing to explore and learn more about LD technologies as well as advocate and promote the adoption of these technologies. They also want to attend events about LD technologies and their applications in libraries. Though they identified the existence of different potential barriers that have to do with themselves (e.g. lack of awareness of basic LD concepts), their institutions/libraries (e.g. they lack best practices regarding applications of LD in libraries), and the technology itself (e.g. new, complex, costly). These dynamics have implications for LD applications in libraries, especially those in developing countries. The current study is a valuable addition to the literature as no study has been conducted regarding the willingness to adopt LD in libraries and barriers to its implementation. Findings regarding barriers to implementation would helpful for policymakers and IT experts consider these challenges and work to minimize these challenges for the implementation of LD in Libraries.
Cardiovascular events and risk in patients with systemic lupus erythematosus: Systematic literature review and meta-analysis
Authors: Bello Natalia , Meyers Kristin J , Workman Jennifer , Hartley Louise , McMahon Maureen
Published: December 2022

Background

Systemic lupus erythematosus (SLE) is an autoimmune disease that typically affects women aged 16–55 years. Cardiovascular disease (CVD) is a well-recognized complication of SLE. This systematic literature review and meta-analysis evaluated the relative risk (RR; compared with non-SLE controls), absolute risk (AR; as incidence proportion, n/N), and incidence rate (IR) of CVD events (including stroke, myocardial infarction [MI], and CVD [composite or undefined]) in adult patients with SLE. The RR of CV risk factors (including hypertension, diabetes, and metabolic syndrome [MetS]) was also examined.

Methods

PubMed and Embase were searched on September 10, 2020. Observational studies published between January 2010 and September 2020 that reported RR, AR, and/or IR of CVD events, or RR of CV risk factors, were eligible. Pooled risk estimates were calculated using a random-effects model.

Results

Forty-six studies (16 cross-sectional, 15 retrospective cohort, 14 prospective cohort, and 1 case–control) were included in meta-analyses. Most studies were considered high quality (Critical Appraisal Skills Programme checklists). Compared with adults without SLE, patients with SLE had statistically significantly higher RRs (95% CIs) of stroke (2.51 [2.03–3.10]; 12 studies), MI (2.92 [2.45–3.48]; 11 studies), CVD (2.24 [1.94–2.59]; 8 studies), and hypertension (2.70 [1.48–4.92]; 7 studies). RRs of diabetes (1.24 [0.78–1.96]; 3 studies) and MetS (1.49 [0.95–2.33]; 7 studies) were elevated but not significant. RRs of stroke and MI were generally higher in younger versus older patients with SLE. In patients with SLE, the pooled estimate of AR (95% CI) was 0.03 (0.02–0.05), 0.01 (0.00–0.02), and 0.06 (0.03–0.10) for stroke (7 studies), MI (6 studies), and CVD (8 studies), respectively. The pooled estimate of IR per 1000 person-years (95% CI) was 4.72 (3.35–6.32), 2.81 (1.61–4.32), and 11.21 (8.48–14.32) for stroke (10 studies), MI (6 studies), and CVD (8 studies), respectively. Although heterogeneity (based on I2 value) was high in most analyses, sensitivity analyses confirmed the robustness of the pooled estimates.

Conclusions

This meta-analysis found an increased risk of stroke, MI, CVD, and hypertension in patients with SLE compared with the general population, despite substantial heterogeneity across the included studies.
Fracture-Related infection - the role of the surgeon and surgery in prevention and treatment
Authors: Valderrama-Molina Carlos Oliver , Pesántez Rodrigo
Published: December 2022

Fracture-related infection (FRI) is a complication that impacts care costs, quality of life, and patient function. Great strides have been made in the last decade to obtain a common language for definition and diagnosis with the contribution of the Fracture-Related Infection Consensus. Although FRI treatment requires the participation of clinical specialists in infectious diseases for the management of antibiotics, it is necessary to understand that this complication is an eminently surgical pathology. The orthopedic surgeon must play a leadership role in the prevention and treatment of this complex disease. In this review, the most relevant aspects of prevention are updated, and a strategy for a sequential and comprehensive approach to the patient with this complication is presented.
Design and control of a new electrostrictive polymer based continuum actuator for endoscopic robot
Authors: Jacquemin Q , Sun Q , Thuau D , Monteiro E , Tence-Girault S , Doizi S , Traxer O , Mechbal N
Published: December 2022

Minimally Invasive Surgery (MIS) consists of the insertion of a flexible endoscope into the patient body through natural orifices. Over the past few decades, the growing interest in microelectromechanical systems (MEMS) has paved the way for ubiquitous miniaturized integrated sensors and actuators in medical endoscopy. Nowadays, recent advances in materials have opened a promising way to fulfill the surgical requirements and size constraint for the development of smart continuum structures. Among smart materials, electroactive polymers (EAPs) exhibit exceptionally large, fast, repeatable, and reversible motions while perfectly meeting the requirements of micro-integration. However the high applied voltage required for the actuation is not compatible with in vivo medical application. To overcome these issues, a multilayered concept has been proposed. In this work a relaxor ferroelectric electrostrictive polymer is studied for its large electromechanical strain. A wide range of parameters involved in the active material has led us to the development of a finite element model on Abaqus to guide the experimental development. Then, to control this smart endoscopic robot a kinematic and a dynamic models have been built. To test and validate these models a Co-simulation procedure has been developed. This procedure coupled Abaqus and Matlab-Simulink allowing testing proposed control algorithms.
Computer-Based Simulations in Social Work Education: A Scoping Review
Authors: Egonsdotter Gunilla , Israelsson Magnus
Published: December 2022

Simulation-based learning is important in social work education. Most common is human-based simulations. In recent years, computer-based simulations have emerged as alternative. A question is if computer-based simulations differ from human-based, are similar abilities, that is, competence, trained when the simulation is computer-based? Purpose: Survey the international experiences of using computer-based simulations in social work education. Method: A five step scoping review. Databases focused on educational issues and social work was searched (Eric, Sociological Abstracts, Web of Science, Scopus). Sixteen publications were included. Results: Five different didactic categories of computer-based simulations were identified. The most common use of computer-based simulations is to practice student's procedural competence, and in lesser extent to enhance students’ meta-competence. Feedback and reflection are central for computer-based simulation, as for human-based simulations. Conclusion: The study shows a didactic field under development and that computer-based simulations provide opportunities to train self-reflection and critical thinking in social work education.
Sociodemographic Factors Associated with Do-Not-Resuscitate Order Utilization in the Surgical Intensive Care Unit: An Observational Study
Authors: Zhang Ziya , Weinberg Alan , Hackett Anna , Wells Celia , Shittu Atinuke , Chan Christy , Bass Kathryn , Philpotts Yoland , Gupta Rohit , Kohli-Seth Roopa
Published: December 2022

The use of a do-not-resuscitate (DNR) order is a powerful tool in outlining end-of-life care. This study explores sociodemographic factors associated with selection of a DNR order and assigning a healthcare proxy in the Surgical Intensive Care Unit (SICU). A retrospective chart review of 312 patients who expired in the SICU over a 7-year period was conducted. We analyzed the association of sociodemographic factors to selection of a DNR order and assignment of a healthcare proxy. Year of admission, age, religion, and proxy were independently associated with selection of DNR. In particular, the relative chance of a DNR selection in 2019 compared to 2012 was 3.538 (95% CL = 2.001–6.255, P < .01). There are significant sociodemographic factors that influence DNR utilization, highlighting the need to consider the social and religious backgrounds when engaging patients and their families in end-of-life care. Future studies will need to be conducted on whether these sociodemographic factors influence surviving patients as this study’s findings can only be applied to those who have expired.
Transmission of Trauma and Resilience in Multigenerational Families of Holocaust Survivors: Two Case Studies
Authors: Greenfeld Daliya , Reupert Andrea , Jacobs Nicky
Published: December 2022

This study explored the relevance of the Holocaust in the lives of Australian adults who grew up with at least one parent and grandparent who were Holocaust survivors. Two individual cases are highlighted with data analysed using a Phenomenological Interpretative Approach. Two themes are discussed: the relevance of the Holocaust in participants’ life and the familial communication patterns about the Holocaust. The findings demonstrate how past collective trauma continues to impact the lives of the survivors’ descendants decades after the historical events and how transmission of trauma and resilience from grandparents and parents to their offspring occurred verbally and non-verbally.
Cost comparison of filgrastim versus pegfilgrastim and pegfilgrastim biosimilars for inpatient prophylaxis of febrile neutropenia
Authors: Singer Kaeli , Forshay Charlotte M. , Kennerly-Shah Julie
Published: December 2022

Introduction

The Ohio State University Comprehensive Cancer Center (The James) uses daily subcutaneous filgrastim as the inpatient granulocyte colony-stimulating factor of choice. The coordination of care associated with filgrastim can often be a barrier to patient discharge. The purpose of this study was to compare the inpatient cost of daily filgrastim to single dose pegfilgrastim and biosimilars.

Methods

Adult patients admitted to The James who received at least one dose of filgrastim between June 1, 2021 and August 31, 2021 were retrospectively identified. This study compared the inpatient cost of filgrastim and biosimilars associated with one chemotherapy cycle to the potential inpatient cost of pegfilgrastim and biosimilars based on average sales price (ASP). Additionally, the number and duration of discharge prescriptions for filgrastim was determined.

Results

Of the 44 unique patient encounters that met inclusion criteria, 19 received 300-mcg doses of filgrastim and 25 received 480-mcg doses. The median number of doses administered per admission was eight. If each of these patients were to instead receive the most inexpensive biosimilar, pegfilgrastim reference product, the cost would be 216% higher than with filgrastim-sndz. At discharge, 15 patients (34%) received a prescription for filgrastim to be continued for a median duration of 6 days.

Conclusion

Based on ASP, pegfilgrastim was more costly than filgrastim. Potential rebates and negotiation power may alter the financial outlook of adding pegfilgrastim to inpatient formulary. Exploration of delays in discharge due to insurance coordination for filgrastim continuation in the outpatient setting may also impact formulary decisions.
Non-Human Primate Husbandry and Impact on Non-Human Primates Health: Outcomes From an IQ DruSafe/3RS Industrial Benchmark Survey
Authors: Salian-Mehta Smita , Poling Jerry , Birkebak Joanne , Rensing Susanne , Carosino Christopher , Santos Rosemary , West Wanda , Adams Khary , Orsted Kathy , Fillman-Holliday Denise , Burns Monika
Published: December 2022

The presence of health issues (diarrhea, poor body condition) in non-human primates can impact animal welfare, confound toxicity study data, and lead to animal exclusion from studies. A working group cosponsored by DruSafe and 3Rs Translational and Predictive Sciences Leadership Groups of the IQ Consortium conducted a survey to benchmark quarantine, pre-study screening, husbandry, and veterinary care practices and their impact on NHP health. Nineteen companies participated in the survey providing separate responses for studies conducted in-house and at Contract Research Organizations from 3 regions (North America (NA), Europe and Asia) for an aggregate of 33 responses. A majority of responding companies conducted studies at North America CROs (39%) or in-house (36%) using primarily Chinese (33%) or Cambodian (27%) and to a lesser extent Vietnam (18%) or Mauritian (15%) origin NHPs. Forty-Five percent of responses had pre-study health issues (fecal abnormalities, etc.) on ≥ 1 studies with the highest incidence observed in Vietnam origin NHPs (80%). The survey suggested variable pre-screening and quarantine practices across facilities. Husbandry practices including behavioral assessments, environmental enrichment and consistent diets were associated with a lower incidence of health issues. The survey also benchmarked approaches used to diagnose and manage abnormal feces in NHPs and has provided strategies to minimize impact on NHP health. The survey highlighted opportunities for harmonizing screening criteria across industry and for improving tracking and sharing of health screening results, leading to further refinement of NHP veterinary care practices, higher quality studies, and reduced NHP use.
Risk factors associated with corneal endothelial cell density in Posner-Schlossman syndrome
Authors: Wang Qian , Zeng Weijuan , Zeng Wen , Liu Yang , Ke Min
Published: December 2022

Purpose

To investigate the risk factors related to corneal endothelial cell density (ECD) in patients with Posner-Schlossman syndrome (PSS).

Patients and methods

It was an observational retrospective study. We reviewed the medical records of patients with PSS who attended the ophthalmology department at Wuhan University Zhongnan Hospital from January 2019 to December 2021. 42 eyes of 42 patients with PSS were included in the study. Demographic characteristics and clinical manifestations were recorded. The clinical characteristics of PSS patients with reduced ECD were compared with PSS patients with normal ECD. Simple and multiple linear regression analyses were carried out to identify the risk factors for ECD in PSS.

Results

The ECD-lowered group had a longer disease duration ( P = 0.000), higher rate of occurrence of corneal edema ( P = 0.039), higher cytomegalovirus (CMV) deoxyribonucleic acid (DNA) copy number ( P = 0.044), higher interleukin-10 (IL-10) level in the aqueous humor ( P = 0.044), and thinner average retinal nerve fiber layer (RNFL) thickness ( P = 0.016) than the control group. The results of multiple linear regression analysis indicated that disease duration (β =  − 0.287, P = 0.024) and level of IL-10 in the aqueous humor (β =  − 0.408, P = 0.001) were significantly negatively associated with ECD, while average RNFL thickness (β = 0.330, P =  0.007) was significantly positively related to ECD in PSS.

Conclusion

A longer disease duration, higher degree of glaucomatous damage and elevated level of IL-10 in the aqueous humor were associated with reduced ECD in PSS.
Experimental and numerical investigation on fuel/air mixing and macroscopic spray characteristics of free spray, convergent-divergent, and straight duct sprays under non-vaporizing conditions
Authors: Chen Tao , An Yanzhao , Hu Junnan , Shi Hao , Pei Yiqiang , Wang Kun
Published: December 2022

In this study, the convergent-divergent (CD) and straight (ST) duct sprays were conducted for comparison with free spray to investigate the diesel macroscopic spray characteristics and mixing process. The schlieren visualization system with a high-speed camera was performed with a 0.22 mm single-hole heavy-duty diesel injector. The injection pressure varied from 120 via 140 to 160 MPa, with the ambient pressure being set at 40 bar. The experimental result showed that CD and ST duct spray had much higher spray tip velocity compared to free spray during the early spray stage. CD duct spray presented a more dispersed and more distributed spray morphology along with larger-scale flow vortexes and gas entrainments, indicating the promoted fuel-air mixing process. Large-eddy simulations (LES) were conducted to analyze the pumping effect, the local separation of the boundary layer, and the air entrainment of different sprays. Compared with free spray, a much stronger pumping effect was generated for ST duct spray followed by CD duct spray; Less flow interaction with the spray body inside the ST duct, retaining more energy for spray development; A much stronger flow interaction was noted as the external gas was sucked into the expanding section of the CD duct, produce the local air vortexes in the narrow inner wall space of the CD duct, leading to the promoted spray diffusion and development with a wider spray cone angle. These phenomena from CD duct spray were beneficial for achieving a more sufficient fuel-air mixing process.
An Analysis of the Social Determinants of Health in South Carolina’s I-95 Corridor
Authors: Mandelbaum Jennifer , Almeda Jennifer , Blackwell Shanikque , Hopkins John W. , Myers Kristian , Hicks Shauna , Daguise Virginie G.
Published: December 2022

Background

One in four South Carolinians lives in a county along a nearly 200-mile stretch of Interstate 95 (I-95). Stretching from North Carolina to Georgia, this region is among the most rural, economically depressed, and racially/ethnically diverse in the state. Research is needed to identify social factors contributing to adverse health outcomes along the I-95 corridor, guide interventions, and establish a baseline for measuring progress. This study assessed social determinants of health in counties in South Carolina’s I-95 corridor relative to the rest of the state.

Method

Data for South Carolina’s 46 counties were extracted from the Centers for Disease Control and Prevention Minority Health Social Vulnerability Index (SVI), which grouped 34 census variables into six themes: socioeconomic status, household composition and disability, minority status and language, housing type and transportation, health care infrastructure, and medical vulnerability. Each theme was ranked from 0 (least vulnerable) to 1 (most vulnerable). Measures between regions were compared using the Wilcoxon–Mann–Whitney test.

Results

Compared with counties outside the I-95 corridor (n = 29), counties in the corridor (n = 17) scored higher on socioeconomic status vulnerability (.67 and .82, respectively) and medical vulnerability (.65 and .79, respectively). No statistically significant differences were found across other themes.

Conclusion

Identifying social determinants of health in South Carolina’s I-95 corridor is a crucial first step toward alleviating health disparities in this region. Interventions and policies should be developed in collaboration with local stakeholders to address distal social factors that create and reinforce health disparities.
Toward Epistemically-Just Research: A Methodologies Framework
Authors: McIntosh Shona , Wilder Rachel
Published: December 2022

This article interrogates the relationship between social science research and ways of doing, knowing and being that are dominant in Western universities. It traces a line from the colonial origins of dominant knowledge, through the creation of a rational scientist subject, in order to make visible the reproduction of epistemic inequality in modernity/coloniality. The link between epistemic injustice and neoliberal knowledge production practices in higher education is made clear through a particular focus on the role research methods play in this process, Finally, a reorientation is proposed along with a framework of methodologies for epistemically-just research.
l-Arginine supplementation regulates energy-substrate metabolism in skeletal muscle and adipose tissue of diet-induced obese rats
Authors: Jobgen Wenjuan S , Lee Mi-Jeong , Fried Susan K , Wu Guoyao
Published: December 2022

Dietary supplementation with l-arginine has been reported to reduce white fat mass in diet-induced obese rats and in obese humans. This study was conducted to test the hypothesis that the arginine treatment regulates glucose and fatty acid metabolism in insulin-sensitive tissues. Male Sprague–Dawley rats (4-week-old) were fed either low- or high-fat diets for 15 weeks ( n = 16/diet). Thereafter, lean or obese rats were fed their respective diets and received drinking water containing either 1.51% l-arginine-HCl or 2.55% alanine (isonitrogenous control) ( n = 8/treatment group). After 12 weeks of treatment, rats were euthanized and tissue samples were collected for biochemical assays. High-fat feeding increased the size of adipocytes isolated from retroperitoneal (RP) adipose tissue, while arginine treatment reduced their size. The total number of adipocytes in the adipose tissue did not differ among the four groups of rats. Glucose oxidation in extensor digitorum longus (EDL) muscle, soleus muscle, and RP adipose tissue were reduced in response to high-fat feeding. On the contrary, oleic acid oxidation in RP adipose tissue was enhanced in rats fed the high-fat diet. Arginine treatment stimulated both glucose and oleic acid oxidation in EDL and soleus muscles, while having no effect on glucose oxidation, oleic acid oxidation, or basal lipolysis per 106 adipocytes in RP adipose tissue. Collectively, these results indicate that oral supplementation with arginine to diet-induced obese rats promoted the oxidation of energy substrates in skeletal muscle, thereby reducing white fat in the body.
Improved maintenance strategy for the wind turbine system under operating and climatic conditions
Authors: Zied Hajej , Nidhal Rezg , Mohamed Ali Kammoun , Maryem Bouzouba
Published: December 2022

This paper studies and proposes a novel joint policy of production, imperfect and priority maintenance for a wind turbine system connected to battery storage and supply grid. The failure rate of wind farm is closely related to production rate and working time. The objective of this paper is to establish an economical energy production and imperfect maintenance plans minimizing the various costs incurred, taking into account the electricity demand variation, uncertainty of wind velocity, and the service level. The proposed maintenance strategy based on the priority and selective maintenance actions aims to choose the priority components for maintenance, while minimizing the total maintenance cost and ensuring a minimum reliability level for the wind turbine system. To achieve the latter goal, we formulate the reliability model of the wind turbine components by considering the influence of operating and environmental conditions. Numerical examples and sensitivity analyzes are presented to illustrate the significance and the effectiveness of the proposed methodology.
De-enemizing the enemy in the contemporary truce film
Authors: Sokołowska-Paryż Marzena
Published: December 2022

The author’s interest resides in war films which re-humanize the enemy so as to question the militaristic philosophy and politics of a given military conflict. Her discussion focuses on the truce film as a notable subgenre of the war film which, characteristically, transcends both historical and nationalistic paradigms. The analysis of Kya Dilli Kya Lahore and Camp X-Ray, as examples of two subvariants of the truce film, serve to underscore the narrative and cinematic strategies used to construct the effect of the interchangeability of the enemy protagonists, therefore ostentatiously undoing traditional state and army enforced forms of ‘distancing’ (see Grossman, On Killing: The Psychological Cost of Learning to Kill in War and Society, 1995). The questions to be posed include where, when and why truce films are produced, how do they correlate to the prevalent definitions of the war film genre and, finally, to what extent can they be seen as potentially constructing a ‘prosthetic memory’ (Alison Landsberg, ‘Memory, Empathy, and the Politics of Identification’, 2009)?
Consumers’ propensity to avoid seeking assistance: Conceptualization and scale development
Authors: Sangle-Ferriere Marion , Voyer Benjamin G.
Published: December 2022

Consumers are increasingly confronted with complex processes and technologies as part of their daily consumption. This difficulty, in turn, can hinder their experience and may have negative consequences in terms of satisfaction, word of mouth, and repurchase behaviors. Although companies often offer customer assistance, many consumers do not make the step to ask for help. In this research, we introduce a social psychological framework centered around the threats associated with help-seeking to better explain help-avoidant behaviors. Doing so, we introduce and develop the “propensity to avoid seeking assistance” construct to better understand what triggers and hinders customers’ assistance request behavior – or lack thereof. By offering and validating a new scale to measure such behavior, this research adds a methodological contribution to the literature. It also contributes to better explain the behavior of customers who would rather abandon using a product or service than ask for help.
Association between type of intervention center and outcomes after endovascular treatment for acute ischemic stroke: Results from the MR CLEAN Registry
Authors: Olthuis Susanne GH , Hinsenveld Wouter H , Pinckaers Florentina ME , Amini Marzyeh , Lingsma Hester F , Staals Julie , HCML Schreuder Tobien , Schonewille Wouter J , Yo Lonneke SF , BWEM Roos Yvo , Postma Alida A , Dippel Diederik WJ , van Zwam Wim H , van Oostenbrugge Robert J , de Ridder Inger R
Published: December 2022

Background:

Endovascular treatment (EVT) for acute ischemic stroke (AIS) is performed in intervention centers that provide the full range of neuro(endo)vascular care (level 1) and centers that only perform EVT for AIS (level 2). We compared outcomes between these center types and assessed whether differences in outcomes could be explained by center volume (CV).

Patients and methods:

We analyzed patients included in the MR CLEAN Registry (2014–2018), a registry of all EVT-treated patients in the Netherlands. Our primary outcome was the shift on the modified Rankin scale (mRS) after 90 days (ordinal regression). Secondary outcomes were the NIHSS 24–48 h post-EVT, door-to-groin time (DTGT), procedure time (linear regression), and recanalization (binary logistic regression). We compared outcomes between level 1 and 2 centers using multilevel regression models, with center as random intercept. We adjusted for relevant baseline factors, and in case of observed differences, we additionally adjusted for CV.

Results:

Of the 5144 patients 62% were treated in level 1 centers. We observed no significant differences between center types in mRS (adjusted(a)cOR: 0.79, 95% CI: 0.40 to 1.54), NIHSS (aβ: 0.31, 95% CI: −0.52 to 1.14), procedure duration (aβ: 0.88, 95% CI: −5.21 to 6.97), or DTGT (aβ: 4.24, 95% CI: −7.09 to 15.57). The probability for recanalization was higher in level 1 centers compared to level 2 centers (aOR 1.60, 95% CI: 1.10 to 2.33), and this difference probably depended on CV.

Conclusions:

We found no significant differences, that were independent of CV, in the outcomes of EVT for AIS between level 1 and level 2 intervention centers.
Monitoring metrics over time: Why clinical trialists need to systematically collect site performance metrics
Authors: Yorke-Edwards Victoria , Diaz-Montana Carlos , Murray Macey L , Sydes Matthew R , Love Sharon B
Published: December 2022

Background: Over the last decade, there has been an increasing interest in risk-based monitoring (RBM) in clinical trials, resulting in a number of guidelines from regulators and its inclusion in ICH GCP. However, there is a lack of detail on how to approach RBM from a practical perspective, and insufficient understanding of best practice.

Purpose: We present a method for clinical trials units to track their metrics within clinical trials using descriptive statistics and visualisations.

Research Design: We suggest descriptive statistics and visualisations within a SWAT methodology.

Study Sample: We illustrate this method using the metrics from TEMPER, a monitoring study carried out in three trials at the MRC Clinical Trials Unit at UCL.

Data Collection: The data collection for TEMPER is described in DOI: 10.1177/1740774518793379.

Results: We show the results and discuss a protocol for a Study-Within-A-Trial (SWAT 167) for those wishing to use the method.

Conclusions: The potential benefits metric tracking brings to clinical trials include enhanced assessment of sites for potential corrective action, improved evaluation and contextualisation of the influence of metrics and their thresholds, and the establishment of best practice in RBM. The standardisation of the collection of such monitoring data would benefit both individual trials and the clinical trials community.
Dupilumab increases aspirin tolerance in NSAID-exacerbated respiratory disease
Authors: Schneider Sven , Poglitsch Katharina , Morgenstern Christina , Quint Tamara , Gangl Katharina , Sinz Christoph , Bartosik Tina , Campion Nicholas James , Liu David Tianxiang , Landegger Lukas David , Tu Aldine , Stanek Victoria , Rocha-Hasler Marianne , Bangert Christine , Eckl-Dorna Julia
Published: December 2022

Background

Nonsteroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (N-ERD) comprises the triad of chronic rhinosinusitis with nasal polyps, asthma and intolerance to NSAIDs. Dupilumab treatment, targeting the interleukin-4 (IL-4) receptor α, significantly reduces polyp burden as well as asthma symptoms. Here we aimed to investigate the effect of dupilumab on aspirin intolerance, burden of disease and nasal cytokine profiles in patients with N-ERD.

Methods

In this open-label trial, adult patients with confirmed N-ERD were treated with dupilumab for 6 months. Clinical parameters (e.g.total polyp scores, quality of life questionnaires, smell test, spirometry), oral aspirin provocation testing and blood, nasal and urine sampling were monitored at regular intervals for up to 6 months after starting dupilumab therapy.

Results

Of the 31 patients included in the study, 30 completed both aspirin provocation tests. After 6 months of treatment with dupilumab, 23% of patients (n=7 of 30) developed complete aspirin tolerance and an additional 33% of patients (n=10 of 30) tolerated higher doses. Polyp burden was significantly reduced (total polyp score: −2.68±1.84, p<0.001), while pulmonary symptoms (asthma control test: +2.34±3.67, p<0.001) and olfactory performance improved (University of Pennsylvania Smell Identification Test: +11.16±9.54, p<0.001) in all patients after therapy. Patients with increased aspirin tolerance showed a significant decrease in urinary leukotriene E4 levels and their improvement in clinical parameters was associated with a reduction of eotaxin-1, C-C motif chemokine ligand 17, IL-5, IL-17A and IL-6.

Conclusion

In this study, 57% of N-ERD patients tolerated higher doses of aspirin under dupilumab therapy.
Construction and validation of a fatty acid metabolism risk signature for predicting prognosis in acute myeloid leukemia
Authors: Chen Miao , Tao Yuan , Yue Pengjie , Guo Feng , Yan Xiaojing
Published: December 2022

Background

Fatty acid metabolism has been reported to play important roles in the development of acute myeloid leukemia (AML), but there are no prognostic signatures composed of fatty acid metabolism-related genes. As the current prognostic evaluation system has limitations due to the heterogeneity of AML patients, it is necessary to develop a new signature based on fatty acid metabolism to better guide prognosis prediction and treatment selection.

Methods

We analyzed the RNA sequencing and clinical data of The Cancer Genome Atlas (TCGA) and Vizome cohorts. The analyses were performed with GraphPad 7, the R language and SPSS.

Results

We selected nine significant genes in the fatty acid metabolism gene set through univariate Cox analysis and the log-rank test. Then, a fatty acid metabolism signature was established based on these genes. We found that the signature was as an independent unfavourable prognostic factor and increased the precision of prediction when combined with classic factors in a nomogram. Gene Ontology (GO) and gene set enrichment analysis (GSEA) showed that the risk signature was closely associated with mitochondrial metabolism and that the high-risk group had an enhanced immune response.

Conclusion

The fatty acid metabolism signature is a new independent factor for predicting the clinical outcomes of AML patients.
Transcriptomic analysis reveals the formation mechanism of anemone-type flower in chrysanthemum
Authors: Fan Jiawei , Huang Jialu , Pu Ya , Niu Yajing , Zhang Mengmeng , Dai Silan , Huang He
Published: December 2022

Background

The ray and disc florets on the chrysanthemum capitulum are morphologically diverse and have remarkably abundant variant types, resulting in a rich variety of flower types. An anemone shape with pigmented and elongated disk florets is an important trait in flower shape breeding of chrysanthemums. The regulatory mechanism of their anemone-type disc floret formation was not clear, thus limiting the directional breeding of chrysanthemum flower types. In this study, we used morphological observation, transcriptomic analysis, and gene expression to investigate the morphogenetic processes and regulatory mechanisms of anemone-type chrysanthemum.

Result

Scanning electron microscopy (SEM) observation showed that morphological differences between non-anemone-type disc florets and anemone-type disc florets occurred mainly during the petal elongation period. The anemone-type disc florets elongated rapidly in the later stages of development. Longitudinal paraffin section analysis revealed that the anemone-type disc florets were formed by a great number of cells in the middle layer of the petals with vigorous division. We investigated the differentially expressed genes (DEGs) using ray and disc florets of two chrysanthemum cultivars, 082 and 068, for RNA-Seq and their expression patterns of non-anemone-type and anemone-type disc florets. The result suggested that the CYCLOIDEA2 (CYC2s), MADS-box genes, and phytohormone signal-related genes appeared significantly different in both types of disc florets and might have important effects on the formation of anemone-type disc florets. In addition, it is noteworthy that the auxin and jasmonate signaling pathways might play a vital role in developing anemone-type disc florets.

Conclusions

Based on our findings, we propose a regulatory network for forming non-anemone-type and anemone-type disc florets. The results of this study lead the way to further clarify the mechanism of the anemone-type chrysanthemum formation and lay the foundation for the directive breeding of chrysanthemum petal types.
Efficacy and safety of intranasal midazolam versus intranasal ketamine as sedative premedication in pediatric patients: a meta-analysis of randomized controlled trials
Authors: Lang Bingchen , Wang Huiqing , Fu Yuzhi , Zeng Linan , Huang Liang , Zhang Qianqian , Chen Shouming , Jia Zhi-jun , Zhang Lingli
Published: December 2022

Background

Intranasal midazolam and ketamine have been widely used as sedative premedication in children. It is difficult to determine which one yields better sedative effects for clinical practice. We conducted the present meta-analysis by summarizing the evidences to evaluate the efficacy and safety of intranasal midazolam versus intranasal ketamine as sedative premedication in pediatric patients.

Methods

We searched PubMed, Embase, and Cochrane Library from inception to April 2022. All randomized controlled trials (RCTs) used intranasal midazolam and ketamine as sedatives in children were enrolled. The risk of bias in RCTs was assessed by Cochrane risk of bias tool. Condition of parental separation, anesthesia induction or facemask acceptance, sedation level, different hemodynamic parameters and adverse events were considered as the outcomes in our study.

Results

A total of 16 studies with 1066 patients were enrolled. Compared with midazolam, administration of intranasal ketamine might be associated with severer changes in hemodynamics parameters including mean blood pressure (SMD = -0.53, with 95% CI [-0.93, -0.13]) and heart rate (HR) (SMD = -1.39, with 95% CI [-2.84, 0.06]). Meanwhile, administration of intranasal midazolam was associated with more satisfactory sedation level (61.76% vs 40.74%, RR = 1.53, with 95%CI [1.28, 1.83]), more rapid onset of sedation (SMD = -0.59, with 95%CI [-0.90, -0.28]) and more rapid recovery (SMD = -1.06, with 95%CI [-1.83, -0.28]). Current evidences also indicated that the differences of various adverse effects between two groups were not significant.

Conclusions

Given that administration of midazolam via intranasal route provides more satisfactory sedative level with less fluctuation of hemodynamics parameters and more rapid onset and recovery, it might be considered as the preferred sedative premedication for pediatric patients compared to ketamine. However, the widespread evidences with low or moderate quality indicated that superiority of intranasal midazolam in pediatric sedation needs to be confirmed by more studies with high quality and large sample size in future.

Trial registration

The protocol of present study was registered with PROSPERO (CRD42022321348).
Effectiveness and cost-effectiveness of a telemedicine programme for preventing unplanned hospitalisations of older adults living in nursing homes: the GERONTACCESS cluster randomized clinical trial
Authors: Gayot Caroline , Laubarie-Mouret Cécile , Zarca Kevin , Mimouni Maroua , Cardinaud Noelle , Luce Sandrine , Tovena Isabelle , Durand-Zaleski Isabelle , Laroche Marie-Laure , Preux Pierre-Marie , Tchalla Achille
Published: December 2022

Objective

The GERONTACCESS trial evaluated the utility and cost-effectiveness of a gerontological telemedicine (TLM) programme for preventing unplanned hospitalisation of residents living in nursing homes (NHs) in regions lacking medical facilities and/or qualified medical providers (“medical deserts”).

Design

GERONTACCESS was a 12-month, multicentre, prospective cluster-randomised trial conducted in NHs. The intervention group underwent TLM assessments every 3 months. The control group received the usual care. In both groups, comprehensive on-site assessments were conducted at baseline and the final visit. Care requirements were documented throughout the study.

Setting and participants

NH residents aged ≥ 60 years with multiple chronic diseases.

Methods

The study outcomes were the proportion of patients who experienced avoidable and unplanned hospitalisation, and the incremental cost savings per quality-adjusted life years from baseline to the 12-month follow-up.

Results

Of the 426 randomised participants (mean ± standard deviation age, 87.2 ± 7.6 years; 311 [73.0%] women), 23.4% in the intervention group and 32.5% in the control group experienced unplanned hospitalisation (odds ratio [OR] = 0.73, 95% confidence interval [CI] 0.43 to 0.97; p = 0.034). Each avoided hospitalisation in the intervention group saved $US 3,846.

Conclusions and implications

The results of GERONTACCESS revealed that our gerontological, preventative TLM program significantly reduced unplanned hospitalisations. This innovative intervention limited disease progression and promoted a healthy lifestyle among NH residents.

Trial registration

Clinicaltrials.gov, NCT02816177, registered June 28, 2016.
The unmet needs of older adults living in nursing homes in Mainland China: a nation-wide observational study
Authors: Huang Deqin , Zeng Tieying , Mao Jing , Zhao Meizhen , Wu Meiliyang
Published: December 2022

Background

The unmet needs of older adults in nursing homes could result in their poor health status physically and psychologically. The aim of this study was to understand the characteristics of unmet needs of older adults residing in nursing homes in China, and to probe into the contributing factors.

Methods

In this cross-sectional design, the demographic and health status questionnaire, Modified Barthel Index, the Numerical Rating Scale for pain assessment, Geriatric Depression Scale, Camberwell Assessment of Need for the elderly were employed to survey older adults living in 38 nursing homes in 13 cities in China from July 2017 to June 2018 through a multi-stage, stratified sampling scheme. The Short Portable Mental Status Questionnaire was adopted to exclude participants with severe cognitive impairment. Aside from descriptive analysis, a raft of hierarchical logistic regression models were run by sequentially controlling for the independent variables at 5 levels (demographic characteristics, health status, pain, ADL, and depression), aiming to identify the influencing factors of the unmet needs of the residents.

Results

The effective sample size involved 2063 older adults (63.4% female versus 36.6% male), with a response rate of 98.5%. The median and inter-quartile range of the total needs and unmet needs of the sample was 3(1, 4) and 0(0, 1) respectively, with 122 older participants having more than 3 unmet needs (high unmet need category) versus 1922 older ones having ≤ 3 unmet needs (low unmet need category). The unmet needs of older adults in nursing homes mainly fell into social domains. Gender, religion, educational background, marital status, living condition before admission, room type, incomes, staffing, number of diseases, pain, Barthel Index, and depression were contributive to unmet needs of older adults in long-term care facilities in the final model that was adjusted for all levels of variables (all p < 0.05).

Conclusion

Understanding the influencing factors of the unmet needs of older adults in long term care provides clues for healthcare professionals to offer better care for this population. System-level support to nursing homes and training of staff are highlighted. Plus, taking measures to beef up social connections for the older adults to meet their social needs was suggested.