bluuebunny/crossref_metadata_2025 huggingface dataset:
Multisite results from a practice-based self-assessment for oral anticancer agent (OAA) management.
Authors: Mackler Emily R. , Nachar Victoria , Curry Marjorie Adams , Kostoff Diana , Wood Angela , Mayfield Stephanie , Boring Brooke , Farris Karen B.
Published: October 2023

434

Background: The Hematology/Oncology Pharmacy Association (HOPA) supported a 6-month American Society of Clinical Oncology (ASCO) Quality Training Program (QTP) focused on oral anticancer agent (OAA) management. HOPA’s Oral Chemotherapy Collaborative, developed an OAA self-assessment tool to aid in identifying gaps in care regarding OAAs. The purpose of this study is to describe the results of the OAA baseline self-assessment completed by the participating teams. These results will provide insight into areas of future focus for OAA-based quality improvement. Methods: This multisite, retrospective analysis was conducted in September 2022, prior to the HOPA-ASCO QTP program launch. The OAA Self-Assessment was created by HOPA’s Oral Chemotherapy Collaborative utilizing Michigan Oncology Quality Consortium (MOQC’s) pre-existing OAA self-assessment as a guide. The final self-assessment included standards from MOQC, HOPA, and ASCO/ONS and took approximately 10 minutes to complete. Questions were categorized in the following 6 sections: Prescribing (n=25), Education (n=17), Dispensing/Distribution (n=5), Monitoring and Follow-Up (n=8), Practice Management (n=3), and Optimal-State Recommendations (n=4). Team leads from each of 9 participating sites focusing on OAA quality improvement were asked to share the anonymous assessment with team members at their sites who provide care to patients taking OAAs. All response choices were categorized as “never”, “sometimes”, or “always” for the degree to which the OAA standard is followed at the site. Frequency distributions are reported. Results: 105 clinicians (39 pharmacists, 34 nurses, 20 physicians, 10 NP/PAs, and 2 pharmacy technicians) completed the baseline self-assessment from 9 sites. Most standards had a response of “sometimes” or “always”. The area with the largest number of “always” was related to the completion of the OAA prescription. Of the 62 standards, 38 (61%) had at least 1 respondent select “never” and 4.5 respondents/standard (range 1 – 15) selected “never”. Standards that had the highest “never” responses were patient satisfaction monitoring (n=15), use of survivorship program for transition to primary care when appropriate (n=14), use of social determinants of health in OAA treatment decisions (n=13), documentation of treatment consent (n=12), use of therapeutics committee to determine place in therapy of OAAs (n=12), and use of collaborative practice agreements for pharmacists as part of the oncology care team (n=12). Conclusions: Adherence to OAA standards varied between the participating sites. A standardized baseline assessment evaluating current state is helpful in identifying gaps in care and targets for future quality improvement.
Real world US community urology adherence to prostate cancer guidelines.
Authors: Khilfeh Ibrahim , Shore Neal D. , Brown Gordon Andrew , Gaylis Franklin D. , Lowentritt Benjamin H. , O'Donnell Lorraine , Wilt Wanda , Burbage Sabree
Published: October 2023

449

Background: According to a 2010 Surveillance, Epidemiology, and End Results (SEER) Medicare analysis of prostate cancer (PCa) patients between 1992 and 2005, urologists accounted for more health services provided to PCa patients than any other specialty. Our study assessed the concordance of PCa care with two treatment-related Performance Indicators (PIs) derived from National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (NCCN Guidelines) in a real-world setting of community urologists. Methods: This retrospective analysis used PPS Analytics (Specialty Networks) Patient Population Health Management Platform, capturing 90 community urology practices with approximately 539,000 PCa patients treated between 7/1/2019-6/30/2022. Two PIs were identified from NCCN Guidelines through consultation with expert urologists to measure the quality of PCa care. PI-1 was defined as the proportion mCSPC patients who initiated an NCCN Category 1 preferred regimen for mCSPC. Guideline changes on 01/01/2020 created a need for two patient stratifications in PI-1. Patients in PI-1.1 had a mCSPC diagnosis between 05/2002 - 12/2019. Patients in PI-1.2 had a mCSPC diagnosis between 01/2020 - 06/2021. PI-2 was defined as the proportion of newly diagnosed intermediate-to-high risk localized PCa (Gleason score ≥ 7 or PSA ≥ 10) who received concurrent ADT with external beam radiation therapy (EBRT) based on the NCCN Guidelines recommendation for concurrent ADT in newly diagnosed intermediate-to-high risk localized PCa (LPC) receiving EBRT. Multi-level multi-variable regression was used to assess factors associated with concordance for each PI. Results: See table. Conclusions: Although changes in NCCN guidelines after 1/2020 led to improved systemic treatment in mCSPC, most patients still did not receive care concordant with recent NCCN recommendations. Our findings highlight opportunities for improving the quality of PCa care in a real-world community urology setting, notably for treatment in mCSPC. Future research should investigate reasons for deviating from NCCN preferred systemic regimens in mCSPC and intervene as appropriate.[Table: see text]
Positive feelings of daily accomplishment, role clarity, and academic balance may protect against stress and burnout in oncology.
Authors: Otukoya Eniola , Velazquez Manana Ana I. , Pandya Sankalp , Dandar Valerie M , Odei Bismarck , Chino Fumiko
Published: October 2023

53

Background: Burnout and stress have negative effects on physician well-being, workforce retention, and patient outcomes. Work overload, lack of control, and value mismatch are known drivers of burnout, but protective factors remain unclear. Methods: National data from the Association of American Medical Colleges (AAMC) StandPoint Faculty Engagement Survey, conducted 2020-2022 (overall response rate 58%) was analyzed. Job satisfaction questions assessed faculty autonomy (“I am satisfied with my autonomy at work”), accomplishment (“My day-to-day activities give me a sense of accomplishment”), clear roles (“My role here is clear to me”), institutional alignment (“I feel personally driven to help this medical school succeed”), and academic balance (“My effort assigned to service, teaching, and research, accurately reflects how my time is actually spent in the workplace”) with “agree”/“strongly agree” considered positive. Burnout measures included: “I enjoy my work”, “I am under stress”, or self-reported (at least) “one or more symptoms of burnout”. Faculty demographics included gender, race/ethnicity, sexual orientation, and rank. Multivariate analysis (MVA) identified factors associated with physician stress and burnout. Results: Of 1306 academic oncologists surveyed, most were male (56%), White (65%), and identified as heterosexual (96%); 7% were considered underrepresented in medicine by race or ethnicity. Of 814 (62% of sample) who self-assessed job satisfaction, most endorsed positive autonomy (82%), accomplishment (82%), clear roles (79%), institutional alignment (80%), and academic balance (59%). Of assessed demographics, women had slightly less institutional alignment (76% vs 83% men, p=0.026) and academic balance (55% vs 62% men, p=0.032). Of 751 (58% of sample) who self-assessed burnout, only 25% enjoyed their work; the rest were either under stress (46%) or had at least one symptom of burnout (29%). Of assessed demographics, women were more likely to report burnout (34% vs 25% men, p=0.0013). On MVA, women (OR=1.6, 95%CI 1.1-2.4) were more likely to be either under stress or endorse burnout. Any faculty (regardless of gender) who reported feelings of job accomplishment (OR=0.36, 95%CI 0.14-0.96), clear roles (OR=0.31, 95%CI 0.13-0.78), and academic balance (OR=0.32, 95%CI 0.20-0.51) were less likely to report stress or burnout. Conclusions: In a large mid-pandemic national survey of academic oncologists, the vast majority were either under stress or had symptoms of burnout, with women being at highest risk. Faculty who endorsed a sense of accomplishment, reported they had clear roles, and whose academic effort was aligned with their actual time at work had one-third the risk of stress and burnout as those who did not. Implementing programs to improve these vital aspects of academic work should be part of essential burnout mitigation efforts.
Care utilization and satisfaction among patients with cancer with neutropenic fever managed by a remote patient monitoring (RPM) program.
Authors: Pritchett Joshua , Paludo Jonas , Haemmerle Robert , Shi Qian , Khera Nandita , Yetmar Zachary , Wilson John W. , McCoy Rozalina , Leuenberger Angela , Phillips Sarah , Pahl Dominick , Kloft-Nelson Sara M. , Sangaralingham Lindsey R. , Ryu Alexander J. , Phelan David , Gangat Naseema , Molina Julian R. , Tilburt Jon Charles , Borah Bijan J. , Haddad Tufia C.
Published: October 2023

572

Background: The DEFeNDR (Decreasing the burden of Febrile Neutropenia through Dynamic RPM) program leverages in-home technology and centralized nurse monitoring to facilitate ambulatory management as an alternative to hospital-based care for cancer patients with neutropenic fever (NF). The objective of this study is to assess 30-day care utilization outcomes and patient satisfaction at 12 months after program implementation. Methods: Adult cancer patients hospitalized with NF were assessed daily for DEFeNDR program eligibility including MASCC score ≥21 (per ASCO guidelines) and no cellular therapy (CAR-T, BMT) in the prior 100 days. Patients agreeing to participate in the 30-day program received a cellular-enabled tablet with pre-connected devices for twice-daily vital signs and symptom assessments. Patient generated data were EHR-integrated in real-time. Embedded decision trees facilitated alerts for adverse trends. Virtual RPM nurses responded to alerts and utilized predefined care pathways. The primary endpoint was the mean proportion of evaluable days spent inpatient (mPEDI) within 30 days of eligibility comparing those who participated in the program (RPM) with those who declined (no RPM). Results: Of 85 eligible patients, 62 were offered DEFeNDR participation. Of those, 34 (54.8%) participated and 28 (45.2%) declined. Baseline characteristics and care utilization outcomes are summarized in Table 1. RPM patients experienced significantly lower mPEDI compared with unmonitored patients [5.1% (Standard Error [SE], 1.9%) vs 12.4% (SE, 2.1%); Wilcoxon Rank Sums p-value, 0.032]. RPM patients also experienced a trend toward fewer total hospital days and lower 30-day readmission rate, as well as shorter mean length of stay and lower rate of ICU utilization when readmitted. Non-visit care activities (EHR clinical communications, documentation, and patient messaging) were decreased from pre-hospital baseline for 58.8% of RPM patients versus 46.6% of those unmonitored. All RPM patients completing a patient satisfaction survey (n=9) indicated that they would recommend the program to patients with a similar condition. Conclusions: Cancer patients with NF participating in the DEFeNDR program experienced a significant reduction in mPEDI and care utilization compared with those who declined. Further studies are warranted to assess comparative effectiveness of this model vs usual care.[Table: see text]
PRO-SHOUT: Patient reported outcome supportive health in oncology utilizing technology.
Authors: McCollom Joseph William , Coupe Amanda , Cornet Victor , Tan Yi Rong , Lin Hung-Yeh , Flanagan Mindy , Daley Carly
Published: October 2023

578

Background: High levels of symptoms and distress in cancer patients are linked to negative outcomes related to treatment adherence, healthcare utilization, quality of life, and survival. As such, psychosocial distress screening is now mandated in the American College of Surgeons Commission on Cancer accreditation standards. A growing body of evidence supports usage of electronic patient-reported outcomes (ePROs) for screening, with ePRO added as a quality metric in CMS’s Oncology Care First Model. However, some concerns related to uptake, accessibility, and clinician buy-in remain. In 2020, our palliative oncology (PO) team’s provider-driven (PD) screening workflow transitioned from a qualitative to quantitative approach, using four research-validated tools to assess mental distress (PHQ-9, GAD-7), symptoms (ESAS), and spirituality (FICA). In 2021, we initiated an ePRO workflow in which patients were prompted to complete all tools via the EHR patient portal before each visit, defaulting to PD workflow when not utilized. The aim of this project was to uncover the team’s perception of this workflow evolution and assess ePRO utilization. Methods: We collected EHR data from July 2020 to January 2023 for encounters in our PO clinic within a community-based cancer institute in the Midwest United States. We included in-office and virtual encounters with 13 providers where at least one tool was used (ePRO or PD). We conducted 45-minute semi-structured interviews and 2 usability surveys with 7 of these providers to assess their perspectives of ePRO tools. The IRB determined this to be a quality improvement project. Results: A total of 16,923 encounters with 3,101 patients (54.4% male, 89.3% white, average age 64.8) were analyzed. Post-ePRO initiation, 30.4% of encounters (primarily virtual) utilized ePRO; as expected, most of these included all four questionnaires (96.1%). In contrast, providers often completed only the ESAS in the PD workflow, particularly for established patients. Clinicians rated the workflow positively on surveys and described advantages such as improved visit preparation, flow, and efficiency. Validated tools overall were credited with greater standardization and improved data tracking and usage. Disadvantages of our ePRO workflow included excessive repetition of tools compared to PD and concerns with accuracy and patient misinterpretation. Suggested solutions included reduced frequency of questionnaires and improved instructional aids. Conclusions: Identifying and treating symptoms and distress remains an important aspect of palliative oncology care. EHRs offer real-time engagement for patients through ePROs, although some challenges with uptake and utilization remain. Our providers viewed ePROs as favorable updates to their workflow and felt that challenges could be mitigated with further changes.
Exploring the perception of value in cancer care: A comparison of patients, providers, and payers.
Authors: Allen Casey Jackson , Knotts Chelsea , Snyder Rebecca A , Shen Chan , Bartlett David L.
Published: October 2023

60

Background: As the healthcare system moves towards value-based models, defining "value" is crucial. In the context of cancer care, there are multiple metrics essential to the aggregate of “value”, however their relative importance to the various stakeholders in value-based care are unknown. This study assesses the priorities of key stakeholders in value-based cancer care. Methods: A survey was administered to international cancer patients through online support groups and to healthcare providers and payers within a large regional health system. Respondents ranked the relative importance of treatment costs, longevity, treatment experience, functional and emotional well-being, and longevity (survival). Agreement among groups was analyzed using Kendall's coefficient of concordance (W). The priorities of each group were compared among stakeholders. Results: A total of 1,103 respondents including 782 patients, 216 healthcare providers, and 105 payers/policymakers participated. The majority of respondents were female (70%), white (89%), and had completed a four-year degree (63%). The patient cohort represented six continents and 20 cancer types. The most common cancer site was the pancreas (35%), followed by the esophagus (11%), bile duct (10%), and peritoneal surface malignancy (9%). Among providers, 29% were physicians, 21% nurses, 11% advanced practice providers, and 39% other providers. Among payers, 24% were administrators and 24% held were business analysts. Patients prioritized longevity and functional independence (W=39%, p<0.001), while providers prioritized patient emotional well-being over functional independence and experience (W=35%, p<0.001). Payers prioritized emotional well-being and patient longevity (W=26%, p<0.001). The overall ratings for each value metric among the three groups differed significantly (all p < 0.05). All groups ranked treatment costs as least important. Rankings were consistent across gender, education level, and time spent with patients within the cohorts. Conclusions: With general consistencies amongst the views of stakeholders, there are remains significant discordances in the perception of value. While the highest priority across stakeholder groups differed, costs of treatment consistently ranked as the least important value domain. These findings have important implications for the development of value-based cancer care models that account for the diverse perspectives of key stakeholders. Further research is needed to develop a generalizable measure of healthcare value.
Race/ethnicity and sex: Assessment of trends and disparities in palliative care utilization among patients with de novo metastatic breast cancer.
Authors: Freeman Jincong Q. , Li James L. , Akhiwu Ted
Published: October 2023

82

Background: Palliative care services (PCS) have been shown to improve the quality of life of patients (pts) with late-stage cancers; however, they remain underutilized. Further, national trends and racial/ethnic disparities in PCS use among metastatic breast cancer pts by sex are unclear. Methods: We analyzed data from pts with de novo metastatic breast cancer in the 2004-2019 National Cancer Database (NCDB), a joint project of the Commission on Cancer of the American College of Surgeons and American Cancer Society. Per NCDB, PCS, including surgery, radiotherapy, systemic therapy, and/or pain management, were performed to manage pain or symptoms/side effects; use was categorized as “yes/no.” Racial/ethnic groups included non-Hispanic (NH) Asian, NH Black, Hispanic, and NH White. Sex was reported as “female/male” per NCDB. Trends in PCS use were evaluated. Multivariable logistic regression models were fit to assess racial/ethnic disparities in PCS use by sex. Results: Of 134,943 pts (mean age 62 years [SD=14]), 98.6% were female. Most (74.1%) were NH White, followed by 17.2% NH Black, 5.9% Hispanic, and 2.7% NH Asian. Sociodemographic and clinicopathologic factors differed significantly across racial/ethnic groups. Overall, 20.3% used PCS, with a significant increase from 15.6% in 2004-2005 to 24.6% in 2018-2019 ( p trend <.001). The percentage of PCS use was 20.3% in female pts, with a significant increase from 15.7% in 2004-2005 to 24.6% in 2018-2019 ( p trend <.001). Similarly, 20.2% of male pts used PCS, with a significant increase from 12.7% in 2004-2005 to 24.1% in 2018-2019 ( p trend <.001). 21.0 % of NH White, 19.5% of NH Black, 17.1% of NH Asian, and 15.2% of Hispanic female pts used PCS; and 21.5% of NH White, 16.9% of NH Black, 15.4% of NH Asian, and 15.0% of Hispanic male pts did. In the adjusted regression models, NH Black (adjusted odds ratio [AOR]=0.88, 95% CI: 0.84-0.92, p<.001), NH Asian (AOR=0.74, 95% CI: 0.67-0.81, p<.001), and Hispanic (AOR=0.64, 95% CI: 0.59-0.69, p<.001) female pts were less likely to have used PCS than NH White female pts. NH Black male pts were less likely to have used PCS than their White male counterparts (AOR=0.57, 95% CI: 0.39-0.82, p=.002). Although Hispanic (AOR=0.67, 95% CI: 0.34-1.32, p=.246) and NH Asian (AOR=0.47, 95% CI: 0.16-1.36, p=.166) male pts were also less likely than NH White male pts to have used PCS, these differences were not statistically significant. Conclusions: The current study reports a low prevalence of PCS utilization, though with significant increases from 2004-2005 to 2018-2019, and highlights racial/ethnic disparities in utilization among pts with de novo metastatic breast cancer, regardless of sex. Equity-focused cancer supportive care programs should consider improving the utilization of, and equitable access to, PCS in this patient population, particularly in racial/ethnic minority communities.
Measurement of Psoas Major Correlating with Functional Performance in Asymptomatic Adults—An MRI and Ultrasound Study
Authors: Chu Yean , Chen Chao-Yin , Wang Chung-Li , Huang Min-Hsuan , Hsu Wei-Li , Lai Dar-Ming , Wang Shwu-Fen
Published: October 2023

Introduction/Purpose

Contraction of the psoas major (PM) stabilizes the lumbar–pelvic–hip region. Most studies use invasive radiology and expensive tools to determine the muscle width (MW) and cross-sectional area (CSA) or to activate the PM. Few studies use dynamic ultrasound imaging (USI). This study establishes the reliability and validity of dynamic USI for the measurement of MW and CSA of the PM, compares the results of three different lumbar–pelvic–hip stabilization tasks for resting and contraction, and determines the correlation with functional performance.

Methods

The muscle CSA (CSAMRI) and width (MWMRI) of the PM at the level of the third lumbar vertebra were measured in 19 asymptomatic adults using magnetic resonance imaging (MRI). USI was used for three tasks: pull-knee-approximate-hip, short lordosis, and active straight leg raise. The CSA (CSAUSI) and width (MWUSI) of the PM on the right side of body were measured using USI. On the same day, Timed Up and Go and five-repetition sit-to-stand (5R-STS) tests were used to determine functional performance.

Results

Reliability values for the MWUSI and CSAUSI were excellent for the three tasks. MWUSI and CSAUSI were significantly correlated with MWMRI and CSAMRI (r = 0.71–0.99). All tasks significantly increased the MWUSI and CSAUSI for PM contraction. In terms of the relationship between functional performance and changes in MWUSI or CSAUSI (ΔCSAUSI), only ΔCSAUSI was negatively correlated with the results for 5R-STS (r = −0.49, P < 0.05).

Conclusion

USI is a highly reliable method to measure the PM. The tasks for this study activated PM contraction, but there was no significant difference in contraction for the tasks. Measuring PM using USI gives real-time dynamic information during muscle contraction with functional performance.
Conflicting Associations among Bioelectrical Impedance and Cardiometabolic Health Parameters in Young White and Black Adults
Authors: GRAYBEAL AUSTIN J. , BRANDNER CALEB F. , STAVRES JON
Published: October 2023

Purpose

The purpose of this cross-sectional evaluation was to determine the associations between raw bioelectrical impedance and cardiometabolic health parameters in a sample of young non-Hispanic White and African American adults.

Methods

A total of 96 (female: 52, male: 44) non-Hispanic White (n = 45) and African American adults (n = 51) between the ages of 19 and 37 yr (22.7 ± 3.83 yr) completed several fasted assessments including resting systolic blood pressure (rSBP), blood glucose (FBG), blood lipids, and bioelectrical impedance spectroscopy. Bioelectrical impedance spectroscopy–derived measurements included phase angle, bioimpedance index (BI), impedance ratio (IR), reactance index (XCi), fat-free mass (FFM), FFM index (FFMi), and absolute (a) and relative (%) total body water (TBW) and extracellular (ECF) and intracellular fluid (ICF). All bioelectric variables were collected at 50 kHz other than IR (250 kHz/5 kHz). Multiple regressions were conducted and adjusted for sex, age, and body mass index.

Results

rSBP was positively, and HDL was inversely, associated with all bioelectrical impedance and absolute hydration variables (all P ≤ 0.050) other than XCi for rSBP and XCi and FFMi for HDL. rSBP (P < 0.001) was inversely, and HDL (P = 0.034) was positively, associated with IR. FBG was positively associated with BI, XCi, FFM, TBWa, and ECFa (all P < 0.050). Metabolic syndrome severity was positively associated with BI, FFM, TBWa, and ECFa for women (all P ≤ 0.050) and with ICFa for African American women (P = 0.016).

Conclusions

Given the rapid increase in the prevalence of cardiometabolic health risks among young adults and the broad use of bioelectrical impedance in practice, the conflicting associations we observed in this age group suggest that bioelectrical impedance parameters should be used with caution in the context of cardiometabolic health risks and age.
Κοινωνική και πολιτική τοποθέτηση του αποστράτου Έλληνα αξιωματικού από το μεσοπόλεμο έως τη μεταπολίτευση
Authors: Σακαγιάννης Γεώργιος
Published: October 2023

Ο ελληνικός εικοστός αιώνας αποτέλεσε πολεμικό και βετερανικό αιώνα. Αποτέλεσε αιώνα που εξέφρασε εθνικές στρατηγικές και εκφάνσεις αντίστοιχων ολοκληρώσεων, αλλά και εθνικούς διχασμούς, διωγμούς και καταρρεύσεις. Στον μακρό αυτό ελληνικό πολεμικό αιώνα, που προλογίστηκε από την ήττα του 1897, συνυπήρξαν ακήρυχτοι πόλεμοι, όπως με το Μακεδονικό Αγώνα, το Ποντιακό Αντάρτικο, τη Βόρεια Ήπειρο, την Κύπρο, μακρές πολεμικές περίοδοι, με προεξάρχουσες τις μακρές δεκαετίες1912-1922 και 1940-1949, ενώ η διαιώνιση μεταπολεμικών διχασμών, βετερανικών και προσφυγικών διεκδικήσεων και εκτάκτων μέτρων, ουσιαστικά διαιώνισε την εμπόλεμη κατάσταση σε ένα κλίμα φαινομενικά ανόρθωσης, ανοικοδόμησης, φαινομενικού εκδημοκρατισμού και νέων διεθνών συμμαχιών βαθιά μέσα στην ειρηνική περίοδο, ως την τελευταία ελληνική μεταπολίτευση. Ο κλειστός κύκλος των επαγγελματιών στρατιωτικών αποτέλεσε μόνο έναν στενότερο κύκλο του βετερανικού κινήματος. Προτείνονται ομόκεντροι ή ετερόκεντροι βετερανικοί κύκλοι, χωρίς τη βοήθεια των οποίων η κατανόηση της εκάστοτε μεταπολεμικής, βετερανικής ή προσφυγικής, συμπολιτευόμενης ή καθεστωτικής Ελλάδας, δεν μπορεί να επιτευχθεί. Οι βετερανικοί κύκλοι αποτέλεσαν επανειλημμένα αντικείμενο έρευνας από μελετητές, χωρίς να ορίζεται πολλές φορές η μίξη του πρώτου με τους επόμενους κύκλους και ενίοτε χωρίς διάκριση των «εκ μονίμων», «εξ εφέδρων», «εξεθελοντών», «κατ’ απονομήν», «επ’ανδραγαθία», αντιστασιακών ενόπλων, αόπλων ή πολεμοπαθών αναπήρων, αιχμαλώτων, προσφύγων ή λοιπών θυμάτων πολέμου. Περαιτέρω, σε επέκταση της διδακτορικής διατριβής του γράφοντος στην πολιτική και στρατιωτική ιστορία, που ψηλάφησε και συγκέντρωσε ερευνητικά τα κατωτέρω, η παρούσα προτείνει θεωρητικό και πρακτικό εργαλείο διαχείρισης των βετερανικών κύκλων,των συμβολισμών και της πολιτικής και κοινωνικής τους βαρύτητας. Μερικές εκατοντάδες συλλογικοτήτων, υπό τη μορφή πολεμικών ή μεταπολεμικών «συνδέσμων», «συλλόγων»,«ομοσπονδιών», «ενώσεων», «σωματείων», διαχειρίζονται το μεταπολεμικό κοινό στην ελληνική σύλληψη της κατά Antoine Prost εκδοχής, σύμφωνα με την οποία ο αποστρατευόμενος πολεμιστής, χωρίς την ένωσή του με ομοίους του, δεν είναι τίποτα.
Effects of non-contact electric fields on kidney and liver histology in tumour-induced rats
Authors: Alamsyah Firman , Firdausi Nisrina , Nugraheni Subekti Evi Dwi , Fadhlurrahman Ahmad Ghitha , Nurhidayat Luthfi , Pratiwi Rarastoeti , Taruno Warsito Purwo
Published: October 2023

Background: There were an estimated 2.1 million breast cancer diagnoses in 2018 worldwide, which is about 11.6% of the total cancer incidence. A novel modality of cancer treatment based on exposure to non-contact electric fields has been developed to reduce cancer incidence. However, the safety of the electric field exposure was not fully investigated. Therefore, the purpose of this study is to observe the safety of the electric field exposure on renal and liver structure. Methods: Female Sprague-Dawley rats were divided into one control group and three treatment groups. Animals were treated with 7,12-dimethylbenz[a]anthracene for mammary tumour induction and exposed to non-contact electric fields individually for 10 hours a day for three weeks. Fresh samples of the kidney and liver were collected for observing structural damage in both organs. The two organs were prepared for histopathological cross-sectioning using the paraffin method and Hematoxylin & Eosin staining followed by histological scoring using the post-examination masking method. Results: The damages found in the kidney were the following: thickening of Bowman capsule, karyolysis, karyorrexhis, pyknosis, cloudy swelling, epithelial sloughing, inflammation, haemorrhage, and congestion. The number of inflammation and haemorrhage in the kidney structure of the placebo group was the lowest and significantly different from the three other groups. All damages in the kidney were also found in the liver, but each showed different levels of damage. The damages in the kidney and liver caused by the exposure were not significant. Conclusions: The non-contact electric fields were not harmful to renal and liver structure in tumour-induced rats. Instead, it may increase the renal function in normal rats.
Broodstock development, induced spawning and larval rearing of the bilih, Mystacoleucus padangensis (Bleeker, 1852), a vulnerable species, and its potential as a new aquaculture candidate
Authors: Syandri Hafrijal , Azrita Azrita , Thamrin Rinold , Zen Deni , D. Roza Hendrik , Chandra Eduard Orah Jimmy , Abdurahman Maman , Yuza Alif , Irvan Irvan , Afriwan Afriwan
Published: October 2023

Background: Mystacoleucus padangensis living in Lake Singkarak, Indonesia, has high potential market demand but is threatened by overfishing and has not been successfully cultured. This study describes the first broodstock development, induced breeding, and larval rearing of M. padangensis. Methods: A total of 1,000 female and 1,000 male broodfish were collected from the wild and reared in two concrete ponds (128 m2) at the Centre for Biodiversity Conservation, P.T. Semen Padang, Indonesia. The broodfish were fed commercial feed to satiation at 09:00 and 17:00 h. The females (average weight 7.56 ± 0.85 g) and males (4.86 ± 1.20 g) were selected at a ratio of 1:4 (female:male), and gonad maturation was induced with a single dose of GnRH analogue (Ovaprim) of 0.1 ml/fish. At 16 h after hormone injection, eggs were collected individually into a plastic vessel. Spermatozoa were collected with sterile syringes. Eggs were fertilized using the "dry" method, and 0.5 ml samples (equal to 100 eggs) were taken. The eggs were incubated in a plastic strainer with a water volume of 1.57 litres and placed in a tarpaulin pond with a volume of 150.72 litres. Results: The overall hatching rate was 78.93 ± 4.13%. The newly hatched larvae were 3900.81 µm long, with a yolk sac of 82881.480 µm2. The mouth opened at 72 days post hatching (DPH) with a gape measuring approximately 61.880 µm. The protocol of larval feeding started with artificial feed, followed by Artemia nauplii up to 30 DPH. Weaning of larvae started at 4 DPH. Larvae started metamorphosis by 15 DPH and ended by 22 DPH when the larvae reached 7430.27 µm. Larval rearing resulted in an average survival rate of 28.4 ± 3.04%. Conclusions: Its successful spawning induction and high larval hatching and survival rates make M. padangensis an excellent aquaculture candidate.
The innovative dimension of the research training programmes under H2020-MSCA-ITN: a methodological approach to track, measure and analyse innovative aspects and provide policy-feedback conclusions.
Authors: Bitsios Ioannis , Martone Fabrizio , Ricci Riccardo , Arfi Audrey
Published: October 2023

Innovative research training programmes funded by the European Union are essential for the forging of highly skilled researchers to tackle, via breakthrough ideas and solutions, the challenges of our society. Being able to track, measure and analyse innovative aspects of the Marie Sklodowska-Curie Actions, Innovative Training Networks under the Horizon2020 funding scheme enables the impact assessment of such programmes, while filtering best practices and the generated knowledge that could ultimately breed and create further innovation. In parallel, it helps the identification of areas for improvement, the understanding of new needs to be accommodated and the co-design and implementation of EU funding policy activities to further promote innovation and excellence for researchers across Europe and beyond. In this study, a novel methodological approach is proposed for tracking and analysing innovation, using a representative sample of projects. Basic innovation indicators are examined and considered from the existing literature and from the applicable Multi-Annual Framework Programme Horizon2020. Additional ones are defined, complemented by questionnaires/surveys findings, to capture innovative aspects for which the standard indicators do not apply. Data mining and data visualization tools are used for the collection and processing of data. Innovation Radar 2 (IR) reports and HorizonResultsBooster 3 services are also engaged for the cross-validation of the identified innovative aspects. The study provides first-level input for policy-feedback activities, by identifying scientific domains and EU countries that may potentially require more attention for innovation generation. It highlights domains that are front-runners and can be used as examples or best practices for under-represented domains in terms of innovative outputs. Collaboration with organisations, defined as medium/high innovators, can increase innovation generation and success in future projects. Best practices are collected to serve as references for designing impactful future training programmes. The excellence of the H2020-MSCA-ITN actions is confirmed via the generated innovations.
Case Report: Effectiveness of physiotherapy rehabilitation in a patient with compound grade IIIC proximal third tibia fracture along with vascular injury
Authors: Somaiya Kamya , Samal Subrat , Boob Manali
Published: October 2023

The proximal metaphyseal region of the bone is thought to be the location of fractures of the proximal tibia. The surgical management of proximal tibial shaft fractures and high-energy bicondylar tibial plateau fractures is still challenging . Supra-cutaneous plating, also known as a locking compression plate, has been promoted as a crucial technique in the management of challenging reconstructive scenarios since it has shown to be adjustable, concealed, and well-accepted by patients. Physical therapy rehabilitation is critically necessary for a full recovery from a range of orthopaedic issues. Physical therapy rehabilitation is a vital step in the healing process for patients with lower limb fractures. In our study , we rehabilitated a patient with Compound grade IIIC proximal third tibia fracture right side managed with Closed reduction external fixator application and vascular repair along with proximal fibula fracture. Through this study, we developed a physiotherapy rehabilitation protocol that was very helpful for these patients, produced positive results, and served to enhance the patient's quality of life.
Mobile applications (apps) for tobacco cessation: Behaviour change potential and heuristic analysis using the Mobile Application Rating Scale (MARS)
Authors: Bhat Bhargav , Nayak Prajna Pramod , Vasthare Ramprasad , Singhal Deepak Kumar
Published: October 2023

Background Given the high prevalence of tobacco use, India presents a significant challenge in tobacco control. Yet, the support received for tobacco cessation is suboptimal. Hence, the aim was to identify and heuristically evaluate ‘high-quality’ and ‘engaging’ tobacco cessation mobile apps using the Mobile Application Rating Scale (MARS). Also, to categorize and analyse their features with respect to engagement, functionality, aesthetics, and information quality. Methods A systematic search of tobacco cessation apps was done within app stores of prominent smartphone platforms developed by Apple and Android. The following search terms: ‘quit smoking,’ ‘smoking cessation, ‘stop smoking,’ ‘smoking therapy,’ ‘quit tobacco,’ ‘cigarette cessation,’ ‘cold turkey,’ and ‘quit cigarette.’ Pearson’s correlations were used to analyse correlations between app scores (Total score app-quality/mean score) and downloads/ratings and number of downloads with the overall MARS score. A Chi-square test was performed to analyse any association between app focus and app release dates. Results Total MARS scores ranged from 3.1 to 4.9. Quitsure app (4.9), Craving to Quit! app (4.8) and Stop Tobacco Mobile Trainer: Quit Smoking App (4.74) were ranked the highest according to the MARS overall mean score. Older apps focussed more on mere goal setting or substance use, as compared to behaviour change; whereas, recently developed apps are now focussing more on behaviour change. Conclusions The content and functionality of behaviour change-focused apps were of higher quality than those of other app categories. These recently developed mHealth apps can effectively supersede the traditional smoking cessation methods.
A cross-sectional study on the prognostic value of the RAPID score in pleural infection in patients attending a tertiary care hospital in Central India
Authors: Annareddy Srinivasulareddy , Ghewade Babaji
Published: October 2023

Pleural infections pose a significant clinical challenge, with diverse outcomes that are often difficult to predict. The renal (urea), age, fluid purulence, infection source, dietary (albumin) (RAPID) score, a clinical tool designed to assess the risk of adverse outcomes in pleural infections, holds the potential as a prognostic indicator. This study aims to evaluate the prognostic value of the RAPID score in patients with pleural infections attending a tertiary care hospital in Central India. This hospital-based prospective cross-sectional observational study will span from July 2022 to June 2024, enrolling 50 adult patients aged 18 years and older admitted to the Department of Respiratory Medicine, a tertiary care hospital in central India. Data will be collected using a structured proforma, encompassing demographic data, clinical history, and comorbidities. Diagnostic investigations, including pleural fluid analysis, laboratory tests, sputum analysis, and radiological assessments, will be performed upon enrolment. RAPID scores will be calculated at admission, stratifying patients into low, medium, and high-risk categories. Treatment will follow established pleural infection protocols, with patients receiving empirical antibiotics and tailored treatment based on culture sensitivity results. Patients will be monitored for three months post-admission, and outcomes such as hospital stay duration, tube thoracostomy need, intercostal drainage tube duration, medical management success, surgical referral rates, surgical interventions, and 30-day and 90-day mortality rates will be assessed. This study aims to contribute valuable insights into the prognostic value of the RAPID score in pleural infections and factors influencing patient outcomes. The findings may facilitate more informed clinical decision-making and improve the management of pleural infections, ultimately enhancing patient care and outcomes.
Time to treat the climate and nature crisis as one indivisible global health emergency
Authors: Abbasi Kamran , Ali Parveen , Barbour Virginia , Benfield Thomas , Bibbins-Domingo Kirsten , Hancocks Stephen , Horton Richard , Laybourn-Langton Laurie , Mash Robert , Sahni Peush , Sharief Wadeia Mohammad , Yonga Paul , Zielinski Chris , Erhabor Gregory E.
Published: October 2023

Over 200 health journals call on the United Nations, political leaders, and health professionals to recognise that climate change and biodiversity loss are one indivisible crisis and must be tackled together to preserve health and avoid catastrophe. This overall environmental crisis is now so severe as to be a global health emergency.
Learner experiences of safety at public high schools in three South African townships: Baseline findings from the National School Safety Framework learner surveys
Authors: Kutywayo Alison , Mabetha Khuthala , Naidoo Nicolette P. , Mahuma Tshepo , Njobe Paseka , Hlongwane Ronelle , Mullick Saiqa
Published: October 2023

Background Despite progressive policies and frameworks on school safety by the Department of Basic Education, safety remains a concern in South African schools. Methods A cross-sectional descriptive design was employed using the National School Safety Framework (NSSF) 152-question learner survey, exploring perceptions and experiences pertaining to eight safety domains: dangerous objects, drugs and alcohol, bullying, verbal abuse, physical violence, discrimination, sexual violence, and journey to and from school. Grade 9-11 learners from 15 government-funded high schools in the Girls Achieve Power trial in Khayelitsha, Soweto, and Thembisa townships were surveyed (March 2018 - April 2019), sampling 10% of the school population. Data analysis included Principal Component Analysis (PCA), reducing correlated variables into fewer questions, then analysis on a scree plot by calculating eigenvalues; repeated PCA with those that had a minimum eigenvalue of 1 and Cronbach Alpha test for internal reliability. Eleven composite variables were included in the final analysis. Results In total, 1034 learners completed the NSSF learner survey; 52.9% were female and the mean age was 16 years (SD=1.36). Results show statistically significant associations between four of the 11 composite variables in relation to sex. Over half (55%) of males have experienced peer provocation and relational aggression (p<0.001). Fifty-eight percent of females reported feeling unsafe on their way to and from school (p<0.003). Over half of males reported that their school was not effective in enforcing discipline (p=0.002) while 58% of females noted they could comfortably report any form of experienced or witnessed violence at school, to their educators (p<0.000). Conclusions Violence continues to be a concern in South African schools. Interventions should work across the ecological model to effectively prevent and reduce violence at school and community levels. Strengthened NSSF implementation is critical to achieving this. We recommend NSSF learner survey adaptations to increase utility and implementation.
Demystifying physiologically based pharmacokinetic modelling among non-modelers towards model-informed medicine use in under-served populations.
Authors: Freriksen Jolien , Heijden Joyce van der , de Hoop-Sommen Marika , Johnson Trevor , Yeo Karen R , Kerwash Essam , Cole Susan , Nooney Janet , Greupink Rick , Zhao Ping , Wildt Saskia de
Published: October 2023

Physiologically based pharmacokinetic (PBPK) models represent computational technology to characterize drug behavior within the context of detailed human physiology.  Today, PBPK is routinely used in drug development and regulatory approval to support decisions on how a medicine can be used under certain clinical conditions.  As such, PBPK has the potential to enhance medicine use for populations that are often under-served globally in drug development and clinical care, namely pediatric patients, pregnant and lactating women. To facilitate broader applications of PBPK for these populations, we joined force and organized five hands-on workshops primarily to non-modelers on the principles of PBPK and its potential applications in pediatric and obstetric pharmacology in 2021 and 2022. In this open letter, we report learning objectives and content of such workshops and to highlight the significant value of these educational efforts.
The genome sequence of the July Highflyer, Hydriomena furcata (Thunberg, 1784)
Authors: Boyes Douglas , Holland Peter W. H. ,   University of Oxford and Wytham Woods Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life programme,   Wellcome Sanger Institute Scientific Operations: DNA Pipelines collective,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium
Published: October 2023

We present a genome assembly from an individual male Hydriomena furcata (the July Highflyer; Arthropoda; Insecta; Lepidoptera; Geometridae). The genome sequence is 423.3 megabases in span. Most of the assembly is scaffolded into 28 chromosomal pseudomolecules, including the Z sex chromosome. The mitochondrial genome has also been assembled and is 15.89 kilobases in length. Gene annotation of this assembly on Ensembl identified 17,324 protein coding genes.
The Past, Present and Future of CPoS
Authors: Willekens Frans , Schiefer Katrin , Sander Nikola , Spieß C. Katharina
Published: October 2023

In this editorial note, we reflect on the trajectory of Comparative Population Studies (CPoS) over the last decades, highlight major milestones along the road, and sketch our hopes and ideas for its future development. In 1975, the predecessor journal of CPoS named ZfB was established as the scientific journal of the newly founded German Federal Institute for Population Research (BiB). As the Institute grew its international collaborations and the journal transitioned from German to English language, ZfB became CPoS. Today, we are pleased that the journal has grown in statue and attracts high-quality submissions from scholars around the globe. Looking ahead, we envision CPoS as a unique open-access journal in the field of population studies where innovation, scientific rigor and attention to quality work hand-in-hand to advance population studies and respond to societal challenges.
The use of social networks in the professional development of pedagogical workers
Authors:   H. S. Skovoroda Kharkiv National Pedagogical University, Andriievska Vira , Halkina Tetiana ,   H. S. Skovoroda Kharkiv National Pedagogical University, Belevets Oleksandr ,   H. S. Skovoroda Kharkiv National Pedagogical University
Published: October 2023

The article shows that the pedagogical workers of the new generation need to create innovative conditions that meet the demands of the time for professional development and personal development. It was found that social networks provide the teacher with a number of new opportunities for improving professional skills and self-realization. The practical issues of using social networks in the professional development of pedagogical workers are revealed. The concept of “social network” in the perspective of the professional development of pedagogical workers has been clarified, namely: a social network is a tool for building an open informational and discussion space, within which specialists of various fields can exchange experience; accumulate ideas and identify problematic issues of science and education, find common ways to solve them; find or generate points of contact of their professional interests. The directions of using social networks in the professional development of pedagogical workers are highlighted: participation in online professional associations, communities of interest, groups; maintenance of online professional blogs, thematic pages, professional portfolio sites; creation and use of digital educational content. The practical issues of the use of social networks in the professional development of pedagogical workers in each of the highlighted areas are characterized, which will contribute to the formation of a complex of theoretical knowledge and practical skills for the productive use of social networks among specialists in various fields. Prospective areas of further scientific research are the preparation of pedagogical workers for the use of educational social networks in pedagogical practice.