bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of welding mode and filler metal on microstructure and mechanical properties of dissimilar joints of S900MC thermomechanical steel to St52 carbon steel welded by gas tungsten arc welding
Authors: Nassiri Navid , Abbasi Alireza , Ardestani Mohammad , Farnia Amirreza
Published: June 2022

In this research, S900MC thermomechanical steel was jointed to St52 carbon steel through a gas tungsten arc welding process in the continuous and pulsed modes. The welding was performed in two different weld designs of V-groove and close square, with and without using an ER70S filler metal, respectively. Furthermore, the microstructure, hardness, and tensile strength of the joints were investigated. A bainitic microstructure was observed in the weld metal of the samples jointed in the continuous mode. While the weld metal microstructure of the pulsed joints was changed from a ferritic microstructure to a tempered martensitic microstructure by implementing filler metal in the V-groove weld design. In all joints, the heat-affected zone was narrower at the S900M side and had a fine bainitic microstructure. Among all joints, the maximum hardness of 389 HV was achieved for the weld metal of V-groove joints welded in the pulsed mode. At a normal strain rate, there was no considerable contrast between the yield and tensile strength of all joints, however, the elongation of the continuous joints was better than that of the pulsed joints. Increasing the strain rate led to the drastic improvement of yield and tensile strength of the joint welded in the continuous mode without using filler metal.
Culture as Context: A Five-Country Study of Discretionary Green Workplace Behavior
Authors: Jiang Yuan , Jackson Susan E. , Shim Hanbo , Budhwar Pawan , Renwick Douglas W. S. , Jabbour Charbel Jose Chiappetta , Jabbour Ana Beatriz Lopes de Sousa , Tang Guiyao , Müller-Camen Michael , Wagner Marcus , Kim Andrea
Published: June 2022

To understand the conditions that support employee green behavior across cultures, we develop and test a conceptual model that describes how normative cues from work team leaders and peers in combination with country cultural norms shape discretionary green workplace behavior. Data from 1,605 employees in five countries indicate that power distance moderates the positive relationships observed between the discretionary green workplace behavior of leaders and their subordinates. In addition, an observed positive relationship between team green advocacy and individual discretionary green workplace behavior held across both collectivistic and individualistic cultures, contrary to our predictions. By taking macro-level cultural context into account and examining its interplay with lower-level work team norms, the study makes a significant contribution to understanding and intervening employees’ discretionary green behavior at work.
Mobile communication research in 15 top-tier journals, 2006–2020: An updated review of trends, advances, and characteristics
Authors: Wei Ran , Fan Jichen , Leo-Liu Jindong
Published: June 2022

Benefiting from the smartphone turn in wireless telecommunication, studies about mobile telephony have continued to grow in the 3/4G era. To explore the growth trends in the 3/4G era, and what and how mobile media are studied, the present study analyzes patterns and trends of mobile communication research in 512 articles published in 15 top-ranked communication journals from 2006 to 2020. Findings indicate that mobile communication research has grown into a distinctive subfield or sub-discipline, defined by four main characteristics. First, the scope of mobile communication research is broader than studies of mobile media alone. Second, mobile media as global technologies have attracted international authors, although global scholarship is uneven. Third, the boundary of mobile communication has expanded from social, economic, and cultural perspectives to those of health, education, and tourism. Fourth, although mobile communication research is increasingly theory-informed, building distinctive theories about mobile communication remains a challenge for future growth.
Resource scarcity and allocation criteria during the Covid-19 pandemic: Ethical issues
Authors: Delbon Paola , Maghin Francesca , Falconi Bruno , Conti Adelaide
Published: June 2022

The increase in cases of patients needing to be admitted to intensive care, due to Covid-19 infection, has led to a strong imbalance between available resources and healthcare requirements. Therefore, the determination of further criteria, in addition to those of clinical appropriateness and proportionality of care, to define the allocation of the limited resources available was necessary. For these reasons, in March 2020, the SIAARTI (Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care) published a document containing the “Clinical Ethics Recommendations for the Allocation of Intensive Care Treatments, in exceptional, resource-limited circumstances,” to relieve clinicians from a part of the responsibility in the decision-making process, which can be emotionally burdensome, carried out in individual cases and to make the allocation criteria for healthcare resources explicit in a condition of their own extraordinary scarcity.
Upregulation of CCT3 predicts poor prognosis and promotes cell proliferation via inhibition of ferroptosis and activation of AKT signaling in lung adenocarcinoma
Authors: Wang Kun , He Jian , Tu Changling , Xu Hui , Zhang Xugang , Lv Yongchang , Song Chao
Published: June 2022

Background

Chaperonin containing TCP1 subunit 3 (CCT3) acts as an oncogene in cancers, whereas its role and underlying mechanisms in lung adenocarcinoma (LUAD) are poorly understood. This study investigated the clinical relevance and function of CCT3 in LUAD.

Methods

Clinical relevance of CCT3 in LUAD and lung squamous cell carcinoma (LUSC) was analyzed based on TCGA database. qRT-PCR and Western blot were used to detect mRNA and protein expression, respectively. CCK8 and colony formation were performed to measure cell viability. PI and PI/Annexin V-FITC assay kit was used to determine cell cycle and cell death, respectively. Luciferase activity was performed to check whether CCT3 regulated slc7a11’s transcription activity. Ferroptosis was determined by incubating the cells with ferroptosis and apoptosis inducer, their inhibitor and autophagy inhibitor, followed by cell viability examination.

Results

We found that CCT3 was overexpressed in LUAD and LUSC tissues. Overexpression of CCT3 predicted the poor prognosis of LUAD patients. Loss-of-function and gain-of-function experiments demonstrated that CCT3 promoted the proliferation and colony formation of LUAD cells. In addition, CCT3 promoted cell cycle progression and suppressed slc7a11-mediated cell ferroptosis, but not apoptosis. We also found that CCT3 activated AKT. MK2206 significantly reduced the viability of CCT3 overexpressed LUAD cells, while had smaller inhibitory effect on the proliferation of control cells, suggesting that CCT3 dictates the sensitivity of LUAD cells to AKT inhibition.

Conclusion

Our study demonstrates that CCT3 contributes to the proliferation and growth of LUAD cells through inhibition of ferroptosis and activation of AKT.
CT enterography for evaluation of disease activity in patients with ileocolonic Crohn's disease
Authors: Tong Jinlu , Feng Qi , Zhang Chenpeng , Xu Xitao , Ran Zhihua
Published: June 2022

Background

CT enterography (CTE) is used routinely for assessment of activity and severity in Crohn's disease (CD), but there are few CTE scoring systems. The aim of this study was to develop a quantitative CTE scoring system for ileocolonic Crohn's disease activity.

Methods

Forty-nine CD patients with ileocolonic involvement were retrospectively included between March 2015 and May 2018. All patients underwent CTE and ileocolonoscopy. Mural hyperenhancement and mural thickening at CTE were scored quantitatively, while mural stratification, submucosal fat deposition, comb sign, perienteric fat hypertrophy and mesenteric fibrofatty proliferation were qualitative variables. A Tobit regression model was applied for assessing the association between Crohn's disease endoscopic index of severity (CDEIS) and CTE variables.

Results

A total of 280 intestinal segments were evaluated. Independent predictors for CDEIS were mural thickness (p < 0.001), mural stratification (p < 0.001) and comb sign (p = 0.002). In order to quantify disease activity based on CTE findings in each segment, a simplified CT enterography index of activity (CTEIA) was derived from logistic regression analysis. The formula was as follows: CTEIA (segment) = 2.1 mural thickness(mm) + 9.7 mural stratification + 5.2 comb sign. There was a high and significant correlation coefficient between CDEIS and CTEIA (r = 0.779, p < 0.001) for per-segment analysis. The model for the detection of ulcerative lesions in the colon and terminal ileum achieved an area under the receiver-operating curve of 0.901 using a cut-off point of 6.25.

Conclusions

CTEIA is a new qualitative tool for evaluation of ileocolonic Crohn’s disease, which need to be validated in further studies.
Risk of recurrent stillbirth and neonatal mortality: mother-specific random effects analysis using longitudinal panel data from Indonesia (2000 – 2014)
Authors: Dev Alka
Published: June 2022

Background

Despite significant government investments to improve birth outcomes in low and middle-income countries over the past several decades, stillbirth and neonatal mortality continue to be persistent public health problems. While they are different outcomes, there is little evidence regarding their shared and unique population-level risk factors over a mother’s reproductive lifespan. Data gaps and measurement challenges have left several areas in this field unexplored, especially assessing the risk of stillbirth or neonatal mortality over successive pregnancies to the same woman. This study aimed to assess the risk of stillbirth and neonatal mortality in Indonesia during 2000–2014, using maternal birth histories from the Indonesia Family Life Survey panel data.

Methods

Data from three panels were combined to create right-censored birth histories. There were 5,002 unique multiparous mothers with at least two singleton births in the sample. They reported 12,761 total births and 12,507 live births. Random effects (RE) models, which address the dependency of variance in births to the same mother, were fitted assuming births to the same mother shared unobserved risk factors unique to the mother.

Results

The main finding was that there having had a stillbirth increased the odds of another stillbirth nearly seven-fold and that of subsequent neonatal mortality by over two-fold. Having had a neonatal death was not associated with a future neonatal death. Mothers who were not educated and nullipara were much more likely to experience a neonatal death while mothers who had a prior neonatal death had no risk of another neonatal death due to unmeasured factors unique to the mother.

Conclusions

The results suggest that for stillbirths, maternal heterogeneity, as explained by a prior stillbirth, could capture underlying pathology while the relationship between observed risk factors and neonatal mortality could be much more dependent on context. Establishing previous adverse outcomes such as neonatal deaths and stillbirth could help identify high-risk pregnancies during prenatal care, inform interventions, and improve health policy.
Characteristic computed tomography features in mesenchymal-epithelial transition exon14 skipping-positive non-small cell lung cancer
Authors: Watari Naokazu , Yamaguchi Kakuhiro , Terada Hiroaki , Hamai Kosuke , Masuda Ken , Nishimura Yoshifumi , Sakamoto Shinjiro , Masuda Takeshi , Horimasu Yasushi , Miyamoto Shintaro , Nakashima Taku , Iwamoto Hiroshi , Shoda Hiroyasu , Ishikawa Nobuhisa , Fujitaka Kazunori , Miyazaki Kozue , Miyata Yoshihiro , Hamada Hironobu , Awai Kazuo , Hattori Noboru
Published: June 2022

Background

Mesenchymal-epithelial transition exon14 (METex14) skipping is one of the therapeutic driver oncogene mutations in non-small cell lung cancer (NSCLC), and can be treated with tepotinib and capmatinib. There is only one report on computed tomography (CT) findings of METex14 skipping-positive NSCLC, which shows that the primary tumor tends to have a large mass in the upper lobe, and extrathoracic metastases are common. This study examined the CT findings of METex14 skipping-positive NSCLC, focusing on the features of the margins and internal structures.

Methods

We consecutively included patients with METex14 skipping-positive NSCLC who were diagnosed between January 2018 and December 2020 at four independent institutions. We retrospectively reviewed the patient demographics and CT findings for tumor margins (invasion into surrounding tissue, lobulation, pleural indentation, spicula, and ground-glass opacity) and internal structures (air bronchograms, cavitation and internal low-density area).

Results

Fifteen patients with METex14 skipping-positive NSCLC were identified. Almost half of the patients were men (7/15; 46.7%), and their median age was 75.0 years. More than half were either current or former smokers (9/15; 60.0%). A vast majority of histological subtypes were adenocarcinoma (10/15; 66.7%), followed by pleomorphic carcinoma (3/15; 20.0%) and squamous cell carcinoma (2/15; 13.3%). With regard to CT findings, most primary tumors presented as masses larger than 30 mm (12/15; 80.0%) and were located in the upper lobes (12/15; 80.0%). Invasion into surrounding tissue and presence of internal low-density areas were observed in 60.0% (9/15) and 66.7% (10/15) of the primary tumors, respectively. Additionally, their frequencies increased to 72.7% (8/11) and 90.9% (10/11) in stage III/IV cases, respectively. In lymph node metastasis, internal low-density areas were observed in 8/10 cases (80.0%). Although these two CT features were rarely observed in distant metastases at diagnosis, they became apparent with progression of the metastatic tumor size.

Conclusions

METex14 skipping-positive NSCLC tumors tend to invade surrounding tissue and possess internal low-density areas. These CT findings might be characteristic of METex14 skipping-positive NSCLC.
Clinical predictors for nondiabetic kidney diseases in patients with type 2 diabetes mellitus: a retrospective study from 2017 to 2021
Authors: Zeng Yong-qin , Yang Yu-xing , Guan Cheng-jing , Guo Zi-wei , Li Bo , Yu Hai-yan , Chen Rui-xue , Tang Ying-qian , Yan Rui
Published: June 2022

Background

Nondiabetic kidney disease (NDKD), which is prevalent among patients with diabetes mellitus (DM), is considerably different from diabetic kidney disease (DKD) in terms of the pathological features, treatment strategy and prognosis. Although renal biopsy is the current gold-standard diagnostic method, it cannot be routinely performed due to a range of risks. The aim of this study was to explore the predictors for differentiating NDKD from DKD to meet the urgent medical needs of patients who cannot afford kidney biopsy.

Methods

This is a retrospective study conducted by reviewing the medical records of patients with type 2 DM who underwent percutaneous renal biopsy at the Affiliated Hospital of Guizhou Medical University between January 2017 and May 2021. The demographic data, clinical data, blood test results, and pathological examination results of the patients were obtained from their medical records. Multivariate regression analysis was performed to evaluate the predictive factors for NDKD.

Results

A total of 244 patients were analyzed. The median age at biopsy was 55 (46, 62) years. Patients diagnosed with true DKD, those diagnosed with NDKD and those diagnosed with NDKD superimposed DKD represented 48.36% (118/244), 45.9% (112/244) and 5.74% (14/244), respectively, of the patient population. Immunoglobulin A nephropathy was the most common type of lesion in those with NDKD (59, 52.68%) and NDKD superimposed DKD (10, 71.43%). Independent predictive indicators for diagnosing NDKD included a DM duration of less than 5 years (odds ratio [OR] = 4.476; 95% confidence interval [CI]: 2.257–8.877; P < 0.001), an absence of diabetic retinopathy (OR = 4.174; 95% CI: 2.049–8.502; P < 0.001), a high RBC count (OR = 1.901; 95% CI: 1.251–2.889; P = 0.003), and a negative of urinary glucose excretion test result (OR = 2.985; 95% CI: 1.474–6.044; P = 0.002)..

Conclusions

A DM duration less than 5 years, an absence of retinopathy, a high RBC count and an absence of urinary glucose excretion were independent indicators for the diagnosis of NDKD, suggesting that patients with NDKD may require a different treatment regimen than those with DKD.
Decision aids linked to the recommendations in clinical practice guidelines: results of the acceptability of a decision aid for patients with generalized anxiety disorder
Authors: Ramos-García Vanesa , Perestelo-Pérez Lilisbeth , Rivero-Santana Amado , Peñate-Castro Wenceslao , Duarte-Díaz Andrea , Álvarez-Pérez Yolanda , Trujillo-Martín María del Mar , del Cura-González María Isabel , Serrano-Aguilar Pedro
Published: June 2022

Background

Generalized anxiety disorder (GAD) is one of the most prevalent mental health problems. Patients with GAD have unmet needs related to the information received about their disorder, its treatments and their participation in the decision-making process. The aim of this study is to develop and assess the acceptability of a patient decision aid (PtDA) for patients with GAD.

Method

The PtDA was developed following the International Patient Decision Aid Standards. The recommendations of the Spanish clinical practice guideline (CPG) for patients with GAD were used as the basis. The first prototype was developed by an expert committee, further improvements were made with patients (n = 2), clinical experts (n = 13) and the project management group (n = 7). The acceptability of this second draft was assessed by patients non-involved in the previous phases (n = 11).

Results

The final PtDA version included a brief description of GAD and its treatments. Most participants agreed that the PtDA was easy to use, visually appealing and useful. At least half of the participants learned new things about treatments and adverse effects.

Conclusions

A PtDA was developed for patients with GAD based on recommendations from the Spanish CPG. It was improved and accepted by patients and clinical experts involved. An evaluation of its effectiveness on the shared decision-making process during the clinical encounter is planned.
Validation of a computerized decision support system to review pharmacotherapy treatment: scheduling guidelines
Authors: Zapelini Clávison Martinelli , Galato Dayani , Alano Graziela Modolon , de Carvalho Martins Karina Saviatto , Trauthman Silvana Cristina , Soares Alessandra , Schuelter-Trevisol Fabiana , Trevisol Daisson José
Published: June 2022

Background

The review of pharmacotherapy can be conceptualized as a service in which the drugs used by the patient are reviewed to control the risks as well as to improve the results of the drug therapy, detecting, solving, and preventing issues associated with the drug, readjusting the doses and times (schedule) so that the treatment is not incompatible or in duplicity.

Methods

The aim of the study was to validate an intelligent information system, which was developed to assist the scheduling activity in the pharmacotherapy review. The system used the concept of Genetic Algorithms. To validate the system, hypothetical cases were elaborated considering various aspects of pharmacotherapy such as underdose, overdose, drug interactions and contraindications. These cases were tested in the system and were also analyzed by pharmaceutical experts with clinical and research experience in the pharmacotherapy review process. The degree of agreement between the assessments of the appointments carried out by the pharmaceutical specialists and by the system were measured using the Kappa index with a 95% confidence interval.

Results

In detecting errors and make propositions, the system was able to identify 80% of errors, with pharmaceutical experts identifying between 20 and 70% of errors. In relation the results of kappa between the cases, the system had 87,3% of concordance, whereas the best pharmaceutical expert had 75,5% of concordance, considering the correct answer.

Conclusion

It can be concluded that with the methodology used, the investigation met the objectives and confirmed the system is effective for pharmaceutical review process. There are indications that the system can help in the Pharmacotherapy review process, being able to find prescription errors as well as to establish times for the use of medications according to the patient’s routine.
Perceptions and patient care needs among hepatitis B patients during COVID-19
Authors: Wallington Sherrie Flynt , Jeon Min Jeong , Nguyen T. Angeline , Byambaa Choosonjargal , Yang Y. Tony , Le Daisy
Published: June 2022

Background

The novel coronavirus of 2019 (COVID-19) has been and continues to be a rapidly developing public health crisis, that has also disrupted routine and maintenance health care for people living with chronic conditions. Some of these chronic conditions also put individuals at increased risk of COVID-19 complications, particularly if the condition is not under control. For these reasons, the exploratory study reported here examined the needs and preparedness of patients at a community health organization that specifically provides hepatitis B virus (HBV) care for high-risk groups that had previously tested positive for HBV.

Methods

Current study utilized exploratory analysis of qualitative COVID-19-related statements collected during calls to a total of 44 patients reached during April and May, 2020 in the Washington D.C. area. Researchers worked with a community based non-profit organization to reach current HBV + and HCV + patients to provide retention in care and assess patient needs in maintaining management of their condition adapted to include offering medication refills, telehealth, and other resources. We gathered emergent themes, using socio-ecological framework, regarding capacity and needs for managing their chronic condition in a vulnerable population during the initial, most interrupted, time period of a global public health crisis.

Results

From the notes of the calls, five thematic categories emerged: COVID-19 prevention awareness, assistance program access, medical resource access, access to knowledge and awareness about assistance programs, and needs and barriers. From these five themes, providers can develop strategies to better prepare their patients and provide care to patients with chronic conditions during major disruptions.

Conclusions

Future recommendations include increasing hepatitis and COVID-19 vaccine efforts, collaborating with community partners, and screening and understanding social determinants of health that affect racial and ethnic minorities.
Can diverse population characteristics be leveraged in a machine learning pipeline to predict resource intensive healthcare utilization among hospital service areas?
Authors: Ricket Iben M. , MacKenzie Todd A. , Emond Jennifer A. , Ailawadi Kusum L. , Brown Jeremiah R.
Published: June 2022

Background

Super-utilizers represent approximately 5% of the population in the United States (U.S.) and yet they are responsible for over 50% of healthcare expenditures. Using characteristics of hospital service areas (HSAs) to predict utilization of resource intensive healthcare (RIHC) may offer a novel and actionable tool for identifying super-utilizer segments in the population. Consumer expenditures may offer additional value in predicting RIHC beyond typical population characteristics alone.

Methods

Cross-sectional data from 2017 was extracted from 5 unique sources. The outcome was RIHC and included emergency room (ER) visits, inpatient days, and hospital expenditures, all expressed as log per capita. Candidate predictors from 4 broad groups were used, including demographics, adults and child health characteristics, community characteristics, and consumer expenditures. Candidate predictors were expressed as per capita or per capita percent and were aggregated from zip-codes to HSAs using weighed means. Machine learning approaches (Random Forrest, LASSO) selected important features from nearly 1,000 available candidate predictors and used them to generate 4 distinct models, including non-regularized and LASSO regression, random forest, and gradient boosting. Candidate predictors from the best performing models, for each outcome, were used as independent variables in multiple linear regression models. Relative contribution of variables from each candidate predictor group to regression model fit were calculated.

Results

The median ER visits per capita was 0.482 [IQR:0.351–0.646], the median inpatient days per capita was 0.395 [IQR:0.214–0.806], and the median hospital expenditures per capita was $2,302 [1$,544.70-$3,469.80]. Using 1,106 variables, the test-set coefficient of determination (R2) from the best performing models ranged between 0.184–0.782. The adjusted R2 values from multiple linear regression models ranged from 0.311–0.8293. Relative contribution of consumer expenditures to model fit ranged from 23.4–33.6%.

Discussion

Machine learning models predicted RIHC among HSAs using diverse population data, including novel consumer expenditures and provides an innovative tool to predict population-based healthcare utilization and expenditures. Geographic variation in utilization and spending were identified.
Identifying drivers of health care value: a scoping review of the literature
Authors: Landon Susan N. , Padikkala Jane , Horwitz Leora I.
Published: June 2022

Background

As health care spending reaches unsustainable levels, improving value has become an increasingly important policy priority. Relatively little research has explored factors driving value. As a first step towards filling this gap, we performed a scoping review of the literature to identify potential drivers of health care value.

Methods

Searches of PubMed, Embase, Google Scholar, Policy File, and SCOPUS were conducted between February and March 2020. Empirical studies that explored associations between any range of factors and value (loosely defined as quality or outcomes relative to cost) were eligible for inclusion. We created a template in Microsoft Excel for data extraction and evaluated the quality of included articles using the Critical Appraisal Skills Programme (CASP) quality appraisal tool. Data was synthesized using narrative methods.

Results

Twenty-two studies were included in analyses, of which 20 focused on low value service utilization. Independent variables represented a range of system-, hospital-, provider-, and patient-level characteristics. Although results were mixed, several consistent findings emerged. First, insurance incentive structures may affect value. For example, patients in Accountable Care Organizations had reduced rates of low value care utilization compared to patients in traditionally structured insurance plans. Second, higher intensity of care was associated with higher rates of low value care. Third, culture is likely to contribute to value. This was suggested by findings that recent medical school graduation and allopathic training were associated with reduced low value service utilization and that provider organizations had larger effects on value than did individual physicians.

Conclusions

System, hospital, provider, and community characteristics influence low value care provision. To improve health care value, strategies aiming to reduce utilization of low value services and promote high value care across various levels will be essential.
Surgical treatment on infective endocarditis: impact of diabetes on mortality
Authors: Kogan Alexander , Wieder-Finesod Anat , Frogel Jonathan , Peled-Potashnik Yael , Ram Eilon , Raanani Ehud , Sternik Leonid
Published: June 2022

Background

Type 2 diabetes mellitus (DM) is a frequent co-morbidity among patients suffering from infective endocarditis (IE). The aim of the study was to evaluate the impact of type 2 DM on the early-, intermediate- and long-term mortality of patients who underwent surgical treatment of endocarditis.

Methods

We performed an observational cohort study in the large tertiary center in Israel during 14 years. All data of patients who underwent surgical treatment of endocarditis, performed between 2006 and 2020 were extracted from the departmental database. Patients were divided into two groups: Group I (non-diabetic patients), and Group II (diabetic patients).

Results

The study population includes 420 patients. Group I (non-diabetic patients), comprise 326 patients, and Group II (diabetic patients), comprise 94 patients. Mean follow-up duration was 39.3 ± 28.1 months. Short-term, 30-day and in-hospital mortality, also intermediate-term mortality (1- and 3-year) was higher in the DM group compared with the non-DM group, but did not reach statistical significance: 11.7% vs. 7.7%. (p = 0.215); 12.8% vs. 8.3% (p = 0.285); 20.2% vs. 13.2% (p = 0.1) and 23.4% vs. 15.6% (p = 0.09) respectively. Long-term, 5-year mortality was significantly higher in the DM group, compared to the non-DM group: 30.9% vs. 16.6% (p = 0.003). Furthermore, predictors for long-term mortality included diabetes (CI 1.056–2.785, p = 0.029), as demonstrated by regression analysis.

Conclusions

Diabetic patients have trend to increasing mortality at the short- and intermediate period post-surgery for IE, but this is not statistically significant. Survival of diabetic patients deteriorates after more than three years follow surgery. Diabetes is an independent predictor for long-term, 5-year mortality after surgical treatment of endocarditis, regardless of the patients age and comorbidities.

Trial registration Ethical Committee of Sheba Medical Centre, Israel on 02.12. 2014, Protocol 4257
Systematic review of menstrual health and hygiene in Nepal employing a social ecological model
Authors: Sharma Aditi , McCall-Hosenfeld Jennifer S. , Cuffee Yendelela
Published: June 2022

Menstrual health and hygiene are a major public health and social issues in Nepal. Due to inadequate infrastructure to provide education, healthcare, and communication as well as religious teachings, women and girls are excluded from participation in many activities of daily living and community activities during menstruation. Evidence based research addressing menstrual health and hygiene in Nepal is scares. The objective of this paper is to review the current state of knowledge on menstrual health and hygiene in Nepal through a socio-ecological perspective. This systematic review identifies knowledge gaps and targets for future research and interventions. Studies from Nepal that examined factors contributing to menstrual health and hygiene were identified through searches across six databases (Medline, CINAHL, Web of Science, PsychInfo, Nepal Journals Online and Kathmandu University Medical Journal) in January 2019. The SEM is a public health framework that describes how health is impacted at multiple levels including the individual, interpersonal, community, organizational and policy levels. Key themes were identified, and factors contributing to menstrual health and hygiene were categorized as per the level of socio-ecological model (SEM). After a comprehensive literature review, twenty peer-reviewed publications, published between 2003 and January 2019 were included in this review. Eighteen studies were descriptive and two were interventional. The main outcomes reported were reproductive health concerns and menstrual hygiene practices. Nine studies focused on knowledge, attitude, and practices regarding menstruation, seven studies highlighted reproductive health issues, three studies focused on prevalence of culturally restrictive practices, and one on school absenteeism and intimate partner violence. Lack of awareness regarding menstrual health and hygiene, inadequate WASH facilities, no sex education and culturally restrictive practices makes menstruation a challenge for Nepali women. These challenges have negative implications on women and girls’ reproductive as well as mental health and school attendance among adolescent girls. There are gaps in the evidence for high quality interventions to improve menstrual health and hygiene in Nepal. Future research and interventions should address needs identified at all levels of the SEM.
Brain microvascular endothelial cell dysfunction in an isogenic juvenile iPSC model of Huntington’s disease
Authors: Linville Raleigh M. , Nerenberg Renée F. , Grifno Gabrielle , Arevalo Diego , Guo Zhaobin , Searson Peter C.
Published: June 2022

Huntington’s disease (HD) is an inherited neurodegenerative disease caused by expansion of cytosine–adenine–guanine (CAG) repeats in the huntingtin gene, which leads to neuronal loss and decline in cognitive and motor function. Increasing evidence suggests that blood–brain barrier (BBB) dysfunction may contribute to progression of the disease. Studies in animal models, in vitro models, and post-mortem tissue find that disease progression is associated with increased microvascular density, altered cerebral blood flow, and loss of paracellular and transcellular barrier function. Here, we report on changes in BBB phenotype due to expansion of CAG repeats using an isogenic pair of induced pluripotent stem cells (iPSCs) differentiated into brain microvascular endothelial-like cells (iBMECs). We show that CAG expansion associated with juvenile HD alters the trajectory of iBMEC differentiation, producing cells with ~ two-fold lower percentage of adherent endothelial cells. CAG expansion is associated with diminished transendothelial electrical resistance and reduced tight junction protein expression, but no significant changes in paracellular permeability. While mutant huntingtin protein (mHTT) aggregates were not observed in HD iBMECs, widespread transcriptional dysregulation was observed in iBMECs compared to iPSCs. In addition, CAG expansion in iBMECs results in distinct responses to pathological and therapeutic perturbations including angiogenic factors, oxidative stress, and osmotic stress. In a tissue-engineered BBB model, iBMECs show subtle changes in phenotype, including differences in cell turnover and immune cell adhesion. Our results further support that CAG expansion in BMECs contributes to BBB dysfunction during HD.
Effect of mobile-based cognitive behavior therapy (CBT) on lowering of blood lipid levels in atherosclerotic cardiovascular disease (ASCVD) patients: study protocol for a multicenter, prospective, randomized controlled trial
Authors: Hong Xu-Lin , Luan Yi , Liu Hong-Ying , Zhang Wen-Bin
Published: June 2022

Background

Atherosclerotic cardiovascular disease (ASCVD) remains a major source of mortality in China. Convincing evidence has demonstrated that the reduction of low-density lipoprotein cholesterol (LDL-C) is correlated with lowering ASCVD risk. The efficacy of lifestyle management in lipid levels reduction has been confirmed in numerous studies. However, considering that low compliance to lifestyle management has limited the benefits of lowering lipid levels, cognitive behavior therapy (CBT) is proposed as a solution to improve clinical outcomes. The objective of this trial is to compare the LDL-C outcome in ASCVD patients receiving mobile device-based CBT to a control group, with both groups under standard pharmacological treatments.

Methods

This trial is designed as a multicenter, prospective randomized controlled trial with a 6-month follow-up. Mean LDL-C level and the percentage of different LDL-C levels, coefficient of variation of LDL, General Self-Efficacy Scale (GSEs), quality of life index (QL-index), etc., between the two groups at baseline, 1, 3, and 6 months will be measured.

Discussion

This trial should demonstrate that the implementation of mobile-based CBT intervention will be potentially effective in lowering LDL-C levels in ASCVD patients.

Trial registration

Chinese Clinical Trial Registry (ChiCTR2100046775) [registered: 2021/5/28].
Analyzing the current English language teaching materials in line with the academic and professional needs and interests of diploma theology students
Authors: Deressa Wakgari , Tefera Yohannes , Alemu Adege
Published: June 2022

The study analyzed the current English language teaching/learning materials in line with the academic and professional needs and interests of diploma theology students. The study was a descriptive survey that made use of a mixed-method approach. Thus, the researcher employed convergent parallel mixed method design. The data were collected using a questionnaire, interview, and content analysis. The participants of the study were second and third-year diploma theology students, former theology students, and English as a Foriegn Language instructors. All the students(112) were chosen using comprehensive sampling technique, and five former theology students who were working as priests and evangelists were chosen using the snowball technique to fill out the questionnaire. EFL teachers were also chosen for the interview. Additionally, the skills of three units of the current English language teaching materials were evaluated using the checklist. The reliability of the questionnaire were checked using Cronbach Alpha, and the quantitative data were analyised using SPSS version 22. The study revealed that both students and EFL teachers perceived the teaching materials as they less assist the students in their academic and professional contexts. Finally, the researcher recommended that preparing teaching materials that fit the needs and interests of the students.
Commonly occurring adversities in families as risk factors for developing psychosocial and psychiatric morbidities: evidence from general practice
Authors: Tendolkar Indira , Polat Talip , Peters Hans , Akkermans Reinier , van de Laar Floris
Published: June 2022

Background

Childhood adversity may lead to mental and somatic complications throughout life. General practitioners are equipped to identify and manage adverse events in households. The relationship between adversities and psychiatric symptoms has not been studied in primary care.

Aims

We investigated the relationship of common adversities in families with respect to subsequent development of psychosocial and psychiatric problems in young children.

Method

We analysed data from seven general practices, including participants between 0 and 9 years of age. Adversity was defined as having a household member who was diagnosed with cancer, psychiatric disease or social problems. We compared these patients with controls matched for gender, age and general practice. The primary outcome was any new episode defined with a psychological and psychiatric label. Secondarily, the encounter rates at the general practices after adversity were analysed.

Results

Participants in both groups were followed for an average of 12 years, whereby patients with an adversity were more likely to develop psychiatric morbidities compared with matched references (odds ratio 1.38, 95% CI 1.12–1.68, P = 0.002), also revealing higher encounter rates at general practices. We found no statistically significant association between adversities in the family and increased psychosocial symptoms.

Conclusions

The short- and long-term consequences of exposure to negative events in childhood are of great public health importance. Our data suggest screening more proactively for consequences of commonly occurring adversities in families, as they are a risk factor for subsequent psychiatric symptoms. Enhanced consultation frequency at general practitioners following adversities should be differentiated in more detail.
Antidepressant prescribing patterns in Australia
Authors: Malhi Gin S. , Acar Mustafa , Kouhkamari Mahsa H. , Chien Tzu Hsiang , Juneja Prabhjot , Siva Sinthuja , Baune Bernhard T.
Published: June 2022

Background

The Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders (MDcpg2015 and MDcpg2020) provide evidence-based and consensus-based recommendations for managing mood disorders.

Aims

We examined Australian real-world prescribing habits to determine whether management in clinical practice aligned with MDcpg2015 recommendations.

Method

A retrospective analysis of a cohort of patients ≥16 years old who had been dispensed a Pharmaceutical Benefits Scheme (PBS)-listed antidepressant between July 2013 and June 2019 was conducted using Australian Commonwealth Department of Human Services PBS 10% sample data.

Results

Between July 2013 and June 2019, 239 944 patients in Australia commenced antidepressant treatment. Of these, 22% (52 694 patients) received a second treatment (a new class of treatment after a period of discontinuation or additional antipsychotic therapy) and 6% (15 741 patients) received a third treatment. Patients were initially prescribed primarily selective serotonin reuptake inhibitors (SSRIs; 52% of prescriptions) or tricyclic antidepressants (TCAs; 25%), even though TCAs are not recommended for first-line treatment. Fewer than one-quarter of patients were prescribed serotonin–noradrenaline reuptake inhibitors (13%) or other agents (10%). General practitioners (GPs) were more likely to initiate TCAs than psychiatrists (22% v. 7%).

Once initiated, the overall median time patients remained on treatment was 4.5 months; this was highest with SSRIs (5.8 months) and lowest with TCAs (0.9 months).

Conclusions

First-line prescribing broadly follows guidelines. GP and psychiatrist prescribing patterns differ, perhaps reflecting different patient groups and the need to tailor treatment to individuals. Future guidelines should aim to capture the different presentations and complexity of depression.
The Term Structure of Growth-at-Risk
Authors: Adrian Tobias , Grinberg Federico , Liang Nellie , Malik Sheheryar , Yu Jie
Published: June 2022

We show that the conditional distribution of forecasted GDP growth depends on financial conditions in a panel of 11 advanced economies. Financial conditions have a larger effect on the lower fifth percentile of conditional growth—which we call growth-at-risk (GaR)—than the median. In addition, the term structure of GaR reflects that when initial financial conditions are loose, downside risks are lower in the near term but increase in later quarters. This intertemporal tradeoff for loose financial conditions is amplified when credit-to-GDP growth is rapid. Using granular instrumental variables, we also provide evidence that the relationship from loose financial conditions to future downside risks is causal. Our results suggest that models of macrofinancial linkages should incorporate the endogeneity of higher-order moments to systematically account for downside risks to growth in the medium run. (JEL E23, E27, E32, E44)
Reputation, Bailouts, and Interest Rate Spread Dynamics
Authors: Dovis Alessandro , Kirpalani Rishabh
Published: June 2022

We propose a joint theory for interest rate dynamics and bailout decisions. Interest rate spreads are driven by time-varying fundamentals and expectations of future bailouts. Private agents are uncertain about the government's willingness to bail out and learn by observing its actions. The model provides an explanation for why we observe governments initially refusing to bail out borrowers at the beginning of a crisis even if they eventually end up providing a bailout after the crisis aggravates. The typical equilibrium outcome displays hump-shaped spreads and contagion as was the case in the US financial and European debt crises. (JEL E43, G01, G21, H63, H81)
INOVAÇÃO EM UM TABELIONATO DE NOTAS: UM ESTUDO DE CASO
Authors: Pagani Vitória Dal Ri , Todescat Marilda
Published: June 2022

Os notários, no Brasil, atuam na relevante função de prevenção de litígios. Em que pese a historicidade de suas funções, que por muitos é desconhecida, buscam adaptar-se ao contexto social em que estão inseridos. O objetivo deste artigo é analisar como ocorrem os processos de inovações de serviços e processos em um tabelionato de notas. Foi realizada pesquisa qualitativa com estratégia bibliográfica e estudo de caso, dentro da filosofia construtivista. O caso selecionado foi um tabelionato de notas da grande Florianópolis/SC. Os dados foram coletados por meio de entrevistas semiestruturadas e análise de documentos, os quais foram analisados por meio das técnicas de análise conteúdo. Encontrou-se que novas ideais surgem internamente no nível estratégico, por meio de um aprendizado mais formal em congressos e constatação de melhorias na prática do serviço, bem como no nível operacional, em um caráter mais informal, em vistas dos problemas averiguados. Externamente, pelo feedback dos usuários e benchmarking, essas ideias referem-se a novos produtos e arranjos organizacionais. No que concerne a serviços, em que pese novas ideias possam surgir no tabelionato, é necessário previsão legal. Foram identificadas três modalidades de inovação na serventia: serviço, processo e organizacional. O primeiro, oriundo de normas, possui relação com a desjudicialização. As inovações de processos e organizacional visam à desburocratização. O estudo da inovação neste tipo de organização contribui, academicamente, por tratar-se de uma lacuna teórica, e, na prática, para desconstruir a imagem burocrática dos tabelionatos de notas, supostamente alheios à inovação.
EDUCAÇÃO EM MARKETING: UMA ANÁLISE BIBLIOMÉTRICA ANCORADA NO SÉCULO XXI (2001 – 2020)
Authors: Carneiro Jailson Santana , Leal Janayna Souto , Vasconcelos Madiã Marcela Fernandes , Brandão Wanderberg Alves , Pereira Rita de Cássia De Faria
Published: June 2022

O estudo tem como objetivo extrair o mapeamento e a caracterização da produção científica acerca da educação em marketing no século XXI (2001 – 2020). O procedimento adotado foi o bibliométrico, no qual se utilizou a plataforma Web of Science para a busca dos artigos que, após os procedimentos de filtragem, resultou em 72 trabalhos. Os softwares Excel e VOSviewer© deram suporte aos procedimentos de análise. Os resultados demonstram que, no século vigente, mais especificamente a partir de 2015, o interesse pelo tema tem encontrado um crescimento contínuo. O periódico com o maior número de artigos publicados é o mais influente em número de citações e, expressivamente, as instituições de ensino e os journals norte-americanos dominam as publicações na área. Por fim, é importante ainda destacar que a educação em marketing deve adotar diferentes paradigmas por meio dos movimentos de hibridismo e domesticação do conhecimento para melhor apropriação e aplicabilidade dos conceitos.
EDUCAÇÃO FINANCEIRA NAS DECISÕES DE POUPANÇA: UM ESTUDO DE CASO NA ESCOLA MUNICIPAL AUSÔNIO ARAÚJO EM CURRAIS NOVOS - RN
Authors: Carvalho Valdemir Galvao de , Lima Maria Olivia Caline de , Lima Maria Girliane Milena de , Alves Palloma Dejaíne Batista , Carvalho Beatriz Silva de
Published: June 2022

O estudo verificou a influência do ensino da educação financeira nas decisões de poupança sobre o comportamento dos alunos das turmas do 5º ano da Escola Municipal Ausônio Araújo, por meio da implementação do projeto de extensão da Universidade Federal do Rio Grande do Norte, intitulado “Educação Financeira nas Escolas”. O universo compreende turmas do 5º ano, e a amostra foi composta por 180 alunos, sendo 45 participantes do projeto implementado nos anos de 2018, e 45 no ano de 2019, e um grupo de controle com 45 não participantes do projeto no ano de 2018, e 45 no ano de 2019. Para a análise dos dados, foi utilizado um questionário estruturado em escala de Likert e o teste de diferença de média não paramétrico de Wilcoxon. Os resultados sugerem que os grupos que participaram das aulas de educação financeira nos anos de 2018 e 2019 apresentaram um maior conhecimento em relação às respostas das proposições do que o grupo de controle. O projeto é relevante e contribui com a tomada de decisão referente à vida financeira dos alunos. Porém, em relação ao domínio das habilidades financeiras, os alunos apresentaram dificuldades e limitações para a tomada da decisão, evidenciando a importância de maior diálogo sobre o assunto no lar e nas relações interpessoais. Além disso, houve maior compromisso e iniciativa por parte do Ministério da Educação em relação à  implementação efetiva da educação financeira nas escolas em âmbito nacional.