bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic Influences of Culture on Cooperation in the Prisoner's Dilemma
Authors: Wong Rosanna Yin-mei , Hong Ying-yi
Published: July 2022

This study tested whether priming of cultural symbols activates cultural behavioral scripts and thus the corresponding behaviors, and also whether the behaviors activated are context-specific. Specifically, to activate the cultural knowledge of Chinese-American bicultural participants, we primed them with Chinese cultural icons or American cultural icons. In the control condition, we showed them geometric figures. Then, the participants played the Prisoner's Dilemma game with friends or strangers (the context manipulation). As expected, participants showed more cooperation toward friends when Chinese cultural knowledge was activated than when American cultural knowledge was activated. By contrast, participants showed a similarly low level of cooperation toward strangers after both Chinese and American culture priming. These findings not only support previous evidence on culture priming of social judgment and self-construals, but also (a) provide the first evidence for the effects of culture priming on behaviors and (b) demonstrate the boundary condition of culture priming.
Constructed Criteria
Authors: Uhlmann Eric Luis , Cohen Geoffrey L.
Published: July 2022

This article presents an account of job discrimination according to which people redefine merit in a manner congenial to the idiosyncratic credentials of individual applicants from desired groups. In three studies, participants assigned male and female applicants to gender-stereotypical jobs. However, they did not view male and female applicants as having different strengths and weaknesses. Instead, they redefined the criteria for success at the job as requiring the specific credentials that a candidate of the desired gender happened to have. Commitment to hiring criteria prior to disclosure of the applicant's gender eliminated discrimination, suggesting that bias in the construction of hiring criteria plays a causal role in discrimination.
Rural health disparities in health care utilization for dementia in Minnesota
Authors: Rhew Sung Han , Jacklin Kristen , Bright Patrick , McCarty Catherine , Henning‐Smith Carrie , Warry Wayne
Published: July 2022

Purpose

We visualized rural‐urban differences in inpatient hospitalization and emergency department (ED) health care utilization (HCU) for older adults with dementia to understand the HCU of rural versus urban older adults in Minnesota and to examine in greater detail the variability of HCU in rural areas.

Methods

For 3 older adult age groups, we utilized Healthcare Cost and Utilization Project (H‐CUP) datasets from 2016 to 2018 to profile hospital admission rates, and ED visit rates related to dementia stratified by rurality and regions. Rates were visualized by spatial interpolation method. We then used logistic regression analysis adjusted by multiple covariates to evaluate rural‐urban differences of the chance of having a dementia diagnosis in HCU.

Findings

Minnesota rural areas showed 17.6% lower age‐adjusted rate (AAR) of dementia mortality than urban areas. AARs of ED visits for dementia were 12.4% higher in rural ZIP codes, whereas AARs of hospitalization were 24.7% lower. After controlling for neighborhood‐level risk factors, such as income, education, health behaviors, and provider access, the odds ratios of having dementia diagnosis are 12% lower if an ED visit patient lives in rural as opposed to an urban area (OR = 0.88, P<.0001).

Conclusions

In comparison to AAR, the fully adjusted data showed larger rural‐urban predictors of having dementia diagnoses in hospitalizations and ED utilizations and demonstrated differences between AAR of ED visit and odds ratios of having dementia diagnosis. A regional comparison revealed that dementia ED visits were higher for Northeast MN compared to Minnesota's largest metropolitan region.
The promise of music therapy for Alzheimer's disease: A review
Authors: Matziorinis Anna Maria , Koelsch Stefan
Published: July 2022

Alzheimer's disease (AD) is a progressive neurodegenerative disease associated with cognitive decline. Memory problems are typically among the first signs of cognitive impairment in AD, and they worsen considerably as the disease progresses. However, musical memory is partially spared in patients with AD, despite severe deficits in episodic (and partly semantic) memory. AD patients can learn new songs, encode novel verbal information, and react emotionally to music. These effects of music have encouraged the use and development of music therapy (MT) for AD management. MT is easy to implement and well‐tolerated by most patients and their caregivers. Effects of MT in patients with AD include improved mood, reduced depressive scores and trait anxiety, enhanced autobiographical recall, verbal fluency, and cognition. Here, we review musical memory in AD, therapeutic effects of studies using MT on AD, and potential mechanisms underlying those therapeutic effects. We argue that, because AD begins decades before the presentation of clinical symptoms, music interventions might be a promising means to delay and decelerate the neurodegeneration in individuals at risk for AD, such as individuals with genetic risk or subjective cognitive decline.
Evaluation of the risk factors for BK virus‐associated hemorrhagic cystitis in pediatric bone marrow transplantation patients: Does post‐transplantation cyclophosphamide increase the frequency?
Authors: Ersoy Gizem Zengin , Bozkurt Ceyhun , Aksoy Basak Adakli , Öner Özlem Başoğlu , Aydoğdu Selime , Çipe Funda , Sütçü Murat , Özkaya Ozan , Fışgın Tunç
Published: July 2022

Background

BKV‐HC is one of the most significant complications of HSCT. This retrospective study aimed to determine the frequency of BKV‐HC in pediatric patients undergoing HSCT, detect the associated risk factors for the development of BKV‐HC, and explore the effects of post‐transplantation Cy use.

Methods

Three hundred twenty‐seven patients (girls: 121, boys: 206) were analyzed according to sex, conditioning regimen, transplantation type, donor relatedness, stem cell source, the presence and grade of aGVHD, CMV co‐existence, and Cy use.

Results

Multivariate analysis confirmed the prognostic importance of age (OR: 4.865), TBI use, the presence of aGVHD (OR: 2.794), CMV coinfection (OR: 2.261), and Cy use (OR: 27.353). A statistically significant difference was found between the mean BKV‐HC follow‐up times compared with post‐transplantation Cy intake (p < .001). The BKV‐HC rate increased as the number of risk factors of the patient increased.

Conclusion

BKV‐HC is an essential complication of HSCT primarily associated with Cy use, the presence of aGVHD, and donor relatedness. The present study shows that the use of Cy in the post‐transplantation period further increases BKV‐HC risk in pediatric patients, regardless of dose.
Testing methodologies for the calibration of advanced plasticity models for sheet metals: A review
Authors: Rossi Marco , Lattanzi Attilio , Morichelli Luca , Martins João M. P. , Thuillier Sandrine , Andrade‐Campos António , Coppieters Sam
Published: July 2022

Numerical simulations have become essential in engineering and manufacturing processes involving plasticity. The reliability and effectiveness of the simulations depend strongly on the accuracy of the adopted constitutive model. Accordingly, in recent years, an increasing interest is pointed towards experimental procedures and characterization methods that can be used to identify the constitutive parameters of advanced plasticity models, which allow to simulate properly the plastic behaviour of complex materials like, for instance, high strength steel. This paper provides a thorough review of the current state‐of‐the‐art, looking at both academia and industry. The available methodologies can be subdivided in two main areas: quasi‐homogeneous material tests with analytical or numerical post‐treatment of the experimental data and heterogeneous tests coupled with inverse methods for parameter identification. For each method, a brief description and references to norms and articles is provided, illustrating the advantages and the disadvantages.
Platelet transfusion and mortality in patients with sepsis‐induced thrombocytopenia: A propensity score matching analysis
Authors: Wu Shanshan , Chen Qin , Pan Jingye , Zhou Aiming
Published: July 2022

Background and Objectives

Thrombocytopenia is common among sepsis patients. Platelet transfusions are frequently administered to increase platelet counts, but their clinical impacts remain unclear in sepsis‐induced thrombocytopenia. The goal of this study was to explore the association between platelet transfusion and mortality in patients with sepsis‐induced thrombocytopenia.

Materials and Methods

The study was based on the Medical Information Mart for Intensive Care (MIMIC) III database. Septic patients with severe thrombocytopenia (a platelet count ≤ 50/nl) were included in the study and were divided into two groups: a platelet transfusion group (PT group) and a no platelet transfusion group (NPT group). The primary outcome was in‐hospital mortality, and the secondary outcomes were the length of intensive care unit (ICU) stay (LOS‐ICU) and 90‐day mortality. Propensity score matching multivariable logistic regression was used to reduce the imbalance.

Results

A total of 1733 patients were included: 296 patients were included in the PT group and 1437 patients were included in the NPT group. After propensity score matching, 296 paired patients constituted each group. Crude hospital mortality was significantly higher in the PT group than in the NPT group (145 [48.99%] vs. 567 [39.46%], p = 0.002). In the extended multivariable logistic models for hospital mortality, the odds ratio (OR) of receiving a platelet transfusion was consistently significant in all six models (OR range, 1.340–1.525, p < 0.05 for all). In the following subgroups, platelet transfusion was associated with increased in‐hospital mortality: age > 60 years; sex: female; sequential organ failure assessment score ≤8; simplified acute physiology score ≤ 47; platelet count >29/nl and the complication of congestive heart failure. However, there were no significant differences in the 90‐day mortality rate (170 [57.43%] vs. 741 [51.57%], p = 0.066) or the LOS‐ICU (5.84 [2.68–11.78] vs. 4.94 [2.18–12.72], p = 0.442) between the two groups. All these results remained stable after adjustment for confounders and in the comparisons after propensity score matching.

Conclusions

The propensity score‐matched analysis showed that platelet transfusion was associated with increased in‐hospital mortality in septic patients with severe thrombocytopenia (a platelet count ≤ 50/nl). However, it was not associated with 90‐day mortality or the length of ICU stay.
Design and Characterization of a Flexible Self-Inflating Mechanical Structure
Authors: Kamrava Soroush , Tatari Milad , Tjiptowidjojo Yustianto , Nayeb-Hashemi Hamid
Published: July 2022

Inflatable structures are commonly used in a variety of engineering applications such as robotics, space structures, medical devices, and automotive safety devices. However, inflation in these systems often requires a non-flexible external pressurized fluid source. Integration of the pressurized fluid source and the flexible construct sacrifices some of the main advantages of the soft structures such as overall flexibility of the system, weight, and cost of fabrication. In this paper, we introduce a novel design for self-inflating structure with embedded pressurizing module. The design is based on integrating a flexible dome with a cylinder. The pressure inside the cylinder is controlled by subjecting dome to a cyclic compression, causing air exchange between the dome and the cylinder. The performance of this design is fully validated through finite element simulations using fluid structure interactions as well as experimental investigations. The results show that a higher pressure is achieved by having smaller dome height. In addition to controlling internal pressure of the cylinder, the design can be used to control the stiffness of the flexible structure such as soft robotics through pressurization. An application of this conceptual device such as pressurizing a tire is presented. This device is integrated within a tire and tire rotation as well as load on the tire have been shown to pressurize the tire. The final pressure and time to achieve maximum pressure depend on the load to the axel of the tire and tire rotational speed, respectively.
Deaerator Performance Monitoring and Inspection Guideline
Authors:   The Water Technology Subcommittee of the ASME Research and Technology Committee on Water and Steam in Thermal Power Systems
Published: July 2022

The ASME steam/water cycle equipment performance monitoring and inspection guideline series focuses on specific pieces of equipment in the steam/water cycle and provides the user with information on how to plan for, conduct, and interpret the results of equipment inspections. This guideline was prepared by a task group of this subcommittee under the guidance of Colleen M. Scholl. The task group consisted of representatives of manufacturers, operators, and consultants involved with the design, manufacture, operation, and monitoring of industrial and utility deaerators and deaerating heaters. Members of this group are listed in the acknowledgments.

The ASME Research and Technology Committee will review, revise, and reissue this document from time to time as necessary to comply with advances in technology in the design of these units and the water treatment options.
From Athlete to Advocate: The Changing Media Coverage of Michael Phelps Pre- and Postretirement
Authors: Jackson Joshua R. , Dirks Emily J. , Billings Andrew C.
Published: July 2022

Michael Phelps was one of the first athletes to openly struggle with attention-deficit/hyperactivity disorder, anxiety, and depression while still competing. During his career, his perceived identity was tied to his status as an athlete. In retirement, his identity shifted to that of a mental health advocate. This study examines the word choice of newspaper articles on the topic of Phelps and mental health using both social identity and framing theories. Mentions of suicide and seeking help, along with the descriptions of specific types of mental illness and perceived identity assigned to Phelps, were compared between two time periods. Results showed that during Phelps’s career, articles were much more likely to discuss his attention-deficit/hyperactivity disorder diagnosis and not as likely to discuss suicide, seeking help, and depression. After his retirement, articles were more likely to identify Phelps as an advocate and less likely to focus on him as a celebrity.
Communicating the Value of Fan Identity in the Sport Industry: Commentary on Consumer Neuroscience Possible Research Ideas
Authors: Cayolla Ricardo
Published: July 2022

The sport industry has an enormous influence on today’s society, and the various media platforms and stakeholders have a considerable share of that influence. Sport communication has an essential part in that impact. The strong identification consumers create and develop with sports brands has a huge meaning in their lives. In the sphere of consumer neuroscience, there are few studies on the sport industry. This commentary launches possible research ideas, namely about the importance of brand strength in consumers’ minds, as well as the true impact that consumer identification (i.e., fan identity) has on the sport industry.
Respiratory mucosal immunity against SARS-CoV-2 after mRNA vaccination
Authors: Tang Jinyi , Zeng Cong , Cox Thomas M. , Li Chaofan , Son Young Min , Cheon In Su , Wu Yue , Behl Supriya , Taylor Justin J. , Chakaraborty Rana , Johnson Aaron J. , Shiavo Dante N. , Utz James P. , Reisenauer Janani S. , Midthun David E. , Mullon John J. , Edell Eric S. , Alameh Mohamad G. , Borish Larry , Teague William G. , Kaplan Mark H. , Weissman Drew , Kern Ryan , Hu Haitao , Vassallo Robert , Liu Shan-Lu , Sun Jie
Published: July 2022

SARS-CoV-2 mRNA vaccination induces robust humoral and cellular immunity in the circulation; however, it is currently unknown whether it elicits effective immune responses in the respiratory tract, particularly against variants of concern (VOCs), including Omicron. We compared the SARS-CoV-2 S–specific total and neutralizing antibody responses, and B and T cell immunity, in the bronchoalveolar lavage fluid (BAL) and blood of COVID-19–vaccinated individuals and hospitalized patients. Vaccinated individuals had significantly lower levels of neutralizing antibody against D614G, Delta (B.1.617.2), and Omicron BA.1.1 in the BAL compared with COVID-19 convalescents despite robust S-specific antibody responses in the blood. Furthermore, mRNA vaccination induced circulating S-specific B and T cell immunity, but in contrast to COVID-19 convalescents, these responses were absent in the BAL of vaccinated individuals. Using a mouse immunization model, we demonstrated that systemic mRNA vaccination alone induced weak respiratory mucosal neutralizing antibody responses, especially against SARS-CoV-2 Omicron BA.1.1 in mice; however, a combination of systemic mRNA vaccination plus mucosal adenovirus-S immunization induced strong neutralizing antibody responses not only against the ancestral virus but also the Omicron BA.1.1 variant. Together, our study supports the contention that the current COVID-19 vaccines are highly effective against severe disease development, likely through recruiting circulating B and T cell responses during reinfection, but offer limited protection against breakthrough infection, especially by the Omicron sublineage. Hence, mucosal booster vaccination is needed to establish robust sterilizing immunity in the respiratory tract against SARS-CoV-2, including infection by the Omicron sublineage and future VOCs.
A Comparative Analysis of Physiologically Based Pharmacokinetic Models for Human Immunodeficiency Virus and Tuberculosis Infections
Authors: Mtshali Sinenhlanhla , Jacobs Byron A.
Published: July 2022

Physiologically based pharmacokinetic (PBPK) models have gained in popularity in the last decade in both drug development and regulatory science. PBPK models differ from classical pharmacokinetic models in that they include specific compartments for tissues involved in exposure, toxicity, biotransformation, and clearance processes connected by blood flow.
Enzyme Discovery in Anaerobic Fungi (Neocallimastigomycetes) Enables Lignocellulosic Biorefinery Innovation
Authors: Lankiewicz Thomas S. , Lillington Stephen P. , O’Malley Michelle A.
Published: July 2022

Lignocellulosic biorefineries require innovative solutions to realize their full potential, and the discovery of novel lignocellulose-active enzymes could improve biorefinery deconstruction processes. Enzymatic deconstruction of plant cell walls is challenging, as noncarbohydrate linkages in hemicellulosic sidechains and lignin protect labile carbohydrates from hydrolysis.
Metagenomes from Eastern Brazilian Amazonian Floodplains in the Wet and Dry Seasons
Authors: Venturini Andressa M. , Gontijo Júlia B. , da França Aline G. , Moura José M. S. , Nüsslein Klaus , Bohannan Brendan J. M. , Rodrigues Jorge L. M. , Tsai Siu M.
Published: July 2022

Here, we report the metagenomes from two Amazonian floodplain sediments in eastern Brazil. Tropical wetlands are well known for their role in the global carbon cycle. Microbial information on this diversified and dynamic landscape will provide further insights into its significance in regional and global biogeochemical cycles.
Staphylococcus aureus
Infection Initiates Hypoxia-Mediated Transforming Growth Factor-β1 Upregulation to Trigger Osteomyelitis
Authors: Zhang Wei , Lin Yiwei , Zong Yang , Ma Xin , Jiang Chaolai , Shan Haojie , Xia Wenyang , Yin Lifu , Wang Nan , Zhou Lihui , Zhou Zubin , Yu Xiaowei
Published: July 2022

The pathogenesis of osteomyelitis induced by
Staphylococcus aureus
remains unclear. To develop therapeutic approaches for osteomyelitis, it is important to understand the molecular mechanisms of its pathogenesis. Our results suggests that hypoxia/HIF-1α/TGF-β1 signaling is involved in osteomyelitis pathogenesis. Thus, these findings highlight the potential of this signaling components as therapeutic targets for the treatment of osteomyelitis.
Marine
Synechococcus
sp. Strain WH7803 Shows Specific Adaptative Responses to Assimilate Nanomolar Concentrations of Nitrate
Authors: Domínguez-Martín María Agustina , López-Lozano Antonio , Melero-Rubio Yesica , Gómez-Baena Guadalupe , Jiménez-Estrada Juan Andrés , Kukil Kateryna , Diez Jesús , García-Fernández José Manuel
Published: July 2022

Marine
Synechococcus
are a very abundant group of photosynthetic organisms on our planet. Previous studies have shown blooms of these organisms when nanomolar concentrations of nitrate become available.
Functional Characterization of Sugar Transporter CRT1 Reveals Differential Roles of Its C-Terminal Region in Sugar Transport and Cellulase Induction in Trichoderma reesei
Authors: Wang Zhixing , Yang Renfei , Lv Wenhao , Zhang Weixin , Meng Xiangfeng , Liu Weifeng
Published: July 2022

The lignocellulose-degrading fungus
T. reesei
has been widely used in industrial cellulases production. Understanding the precise cellulase gene regulatory network is critical for its genetic engineering to enhance the mass production of cellulases.
Insights into Pyrroloquinoline Quinone (PQQ) Effects on Soil Nutrients and Pathogens from Pepper Monocropping Soil under Anaerobic and Aerobic Conditions
Authors: Li Xin , Zhang Mingxing , Zhang Qingzhuang , Tan Fangjun , Gong Zheng , Xie Yunhe , Tao Yu , Chen Jie
Published: July 2022

The attention to PQQ (pyrroloquinoline quinone) effect on soil nutrients and pathogens was less paid in monocropping soils. However, the underlying microbial interacting mechanism remains unclear.
Trends in weight loss attempts among children in England
Authors: Ahmad Aryati , Little Melissa , Piernas Carmen , Jebb Susan
Published: July 2022

Objectives

To describe trends in reported weight loss attempts among school-aged children and to investigate its sociodemographic determinants.

Design

We analysed data of children who participated in the Health Survey for England from 1997 to 2016 (n=34 235). This repeated cross-sectional survey reported weight loss attempts and sociodemographic characteristics. Body weight and height were measured by trained interviewers, and body mass index for age z-score was calculated. Multivariable logistic regression was used to investigate the sociodemographic determinants.

Setting

England.

Participants

Children (8–17 years).

Main outcome measures

Weight loss attempts by year, age group, gender, BMI for age z-score, ethnicity and household income.

Results

The prevalence of reported weight loss attempts increased significantly from 21.4% (1997–1998) to 26.5% (2015–2016). The increase was significant for boys, older children, Asian children, children from lower income households and in all categories of BMI for age z-score. Significant predictors of weight loss attempts included having overweight (8–12 years old, OR 4.01 (%CI 3.47 to 4.64); 13–17 years old, OR 1.96 (%CI 1.58 to 2.42)) or obesity (8–12 years old, OR 13.57 (%CI 11.94 to 15.43); 13–17 years old, OR 4.72 (%CI 3.94 to 5.66)) as well as being older, girls, from ethnic minority groups or low household income.

Conclusion

The prevalence of reported weight loss attempts among children is increasing at a faster rate than the rise in excess weight and includes an increasing proportion of children with a ‘healthy’ weight. The increase in the prevalence of reported weight loss attempts among children is greatest among subgroups with lower baseline prevalence.
Under-representation of female athletes in research informing influential concussion consensus and position statements: an evidence review and synthesis
Authors: D'Lauro Christopher , Jones Emily Ruth , Swope Lily MC , Anderson Melissa N , Broglio Steven , Schmidt Julianne D
Published: July 2022

Objective

We aimed to quantify the female athlete composition of the research data informing the most influential consensus and position statements in treating sports-related concussions.

Design

We identified the most influential concussion consensus and position statements through citation and documented clinician use; then, we analysed the percentage of male and female athletes from each statement’s cited research.

Data sources

We searched PubMed on 26 August 2021 with no date restrictions for English language studies using the terms ‘concussion position statement’ and ‘concussion consensus statement.’

Eligibility criteria for selecting studies

Based on each statement having multiple statement editions, documented clinician use, and substantial citation advantages, we selected the National Athletic Trainers’ Association (NATA, 2014), International Conference on Concussion in Sport (ICCS, 2017) and the American Medical Society for Sports Medicine (AMSSM, 2019). We extracted all cited studies from all three papers for assessment. For each paper analysing human data, at least two authors independently recorded female athlete participant data.

Results

A total of 171 distinct studies with human participants were cited by these three consensus and position papers and included in the female athlete analyses (93 NATA; 13 ICCS; 65 AMSSM). All three statements documented a significant under-representation of female athletes in their cited literature, relying on samples that were overall 80.1% male (NATA: 79.9%, ICCS: 87.8 %, AMSSM: 79.4%). Moreover, 40.4% of these studies include no female participants at all.

Conclusion

Female athletes are significantly under-represented in the studies guiding clinical care for sport-related concussion for a broad array of sports and exercise medicine clinicians. We recommend intentional recruitment and funding of gender diverse participants in concussion studies, suggest authorship teams reflect diverse perspectives, and encourage consensus statements note when cited data under-represent non-male athletes.
Designing and conducting adaptive trials to evaluate interventions in health services and implementation research: practical considerations
Authors: Lauffenburger Julie C , Choudhry Niteesh K , Russo Massimiliano , Glynn Robert J , Ventz Steffen , Trippa Lorenzo
Published: July 2022

Randomised controlled clinical trials are widely considered the preferred method for evaluating the efficacy or effectiveness of interventions in healthcare. Adaptive trials incorporate changes as the study proceeds, such as modifying allocation probabilities or eliminating treatment arms that are likely to be ineffective. These designs have been widely used in drug discovery studies but can also be useful in health services and implementation research and have been minimally used. In this article, we use an ongoing adaptive trial and two completed parallel group studies as motivating examples to highlight the potential advantages, disadvantages, and important considerations when using adaptive trial designs in health services and implementation research. We also investigate the impact on power and the study duration if the two completed parallel group trials had instead been conducted using adaptive principles. Compared with traditional trial designs, adaptive designs can often allow the evaluation of more interventions, adjust participant allocation probabilities (eg, to achieve covariate balance), and identify participants who are likely to agree to enrol. These features could reduce resources needed to conduct a trial. However, adaptive trials have potential disadvantages and practical aspects that need to be considered, most notably: outcomes that can be rapidly measured and extracted (eg, long term outcomes that take considerable time to measure from data sources can be challenging), minimal missing data, and time trends. In conclusion, adaptive designs are a promising approach to help identify how best to implement evidence based interventions into real world practice in health services and implementation research.
Design and implementation of a novel patient-centered empowerment approach for pain optimisation in children undergoing major surgery
Authors: Chidambaran Vidya , Simpson Blair , Brower Laura , Hanke Rachel , Mecoli Marc , Lane Blake , Williams Sara , McKenna Emily , Bates Christina , Kraemer Aimee , Sturm Peter , Brown Rebeccah , Dunseath Linda , Vogel Craig , Garcia Victor
Published: July 2022

Background

Paediatric surgery is a stressful experience for patients and caregivers. While standardised protocols are the norm, patient-centred approaches are needed to empower patients/caregivers for an optimal perioperative pain experience. To address this gap, we employed a patient-centred approach using design thinking (DT) methodology to develop insights, map processes, identify opportunities and design solutions for individualised empowerment tools.

Methods

In consultation with DT experts, a multidisciplinary team of stakeholders (healthcare providers, patients who underwent pectus excavatum/scoliosis surgery and their caregivers), were invited to participate in surveys, interviews and focus groups. The project was conducted in two sequential stages each over 24 weeks—involving 7 families in stage 1 and 16 patients/17 caregivers in stage 2. Each stage consisted of three phases: design research (focus groups with key stakeholders to review and apply collective learnings, map processes, stressors, identify influencing factors and opportunities), concept ideation (benchmarking and co-creation of new solutions) and concept refinement.

Results

In stage 1, mapping of stress/anxiety peaks identified target intervention times. We identified positive and negative influencers as well as the need for consistent messaging from the healthcare team in our design research. Current educational tools were benchmarked, parent-child engagement dyads determined and healthcare-based technology-based solutions conceived. The ‘hero’s journey’ concept which has been applied to other illness paradigms for motivation successfully the was adapted to describe surgery as a transformative experience. In stage 2, patient and caregiver expectations, distinct personas and responses to perioperative experience were categorised. Educational tools and an empowerment tool kit based on sensorial, thinking, relaxation and activity themes, tailored to parent/child categories were conceptualised.

Conclusion

DT methodology provided novel family centred insights, enabling design of tailored empowerment toolkits to optimise perioperative experience. Adapting the hero’s journey call to adventure may motivate and build resilience among children undergoing surgery.
Relationship between dyspnoea and related factors in patients with cancer: a cross-sectional study
Authors: Matsuda Yoshinobu , Hasuo Hideaki , Narita Keiichi , Matsuoka Hiromichi , Morita Ryo , Kiuchi Daisuke , Ikari Tomoo , Hori Tetsuo , Okazaki Koya , Sakai Kiyohiro , Aiki Sayo , Okabayashi Hiroko , Oyamada Shunsuke , Ariyoshi Keisuke , Tokoro Akihiro , Fukunaga Mikihiko
Published: July 2022

Objectives

Dyspnoea is a common and distressing symptom in patients with cancer. We aimed to analyse the association between dyspnoea and related factors and to estimate their causal relationship.

Methods

A cross-sectional study was conducted. Patients with cancer with dyspnoea and a mean Numerical Rating Scale (NRS) of ≥3 over 24 hours were enrolled at 10 institutions in Japan from December 2019 to February 2021. The outcomes included dyspnoea, cough and pain NRS over 24 hours, Eastern Cooperative Oncology Group Performance Status, Hospital Anxiety and Depression Scale, Somatosensory Amplification Scale, opioids for dyspnoea and respiratory failure. Path analyses were conducted to estimate the direct and indirect paths with reference to dyspnoea and related factors.

Results

A total of 209 patients were enrolled and 208 patients were included in the analysis. Cough worsened dyspnoea (β=0.136), dyspnoea increased emotional distress (β=1.104), emotional distress increased somatosensory amplification (β=0.249) and somatosensory amplification worsened cough (β=0.053) according to path analysis.

Conclusion

There may be a vicious circle among dyspnoea and related factors: cough worsened dyspnoea, dyspnoea increased emotional distress, emotional distress increased somatosensory amplification and somatosensory amplification worsened cough. When treating dyspnoea in patients with cancer, managing these factors aimed at interrupting this vicious circle may be useful.

Trial registration number

UMIN Clinical Trials Registry (UMIN000038820).
Inoperable malignant bowel obstruction: palliative interventions outcomes – mixed-methods systematic review
Authors: Patterson Michael , Greenley Sarah , Ma Yangmyung , Bullock Alex , Curry Jordan , Smithson Jacquelyn , Lind Michael , Johnson Miriam J
Published: July 2022

Background

Parenteral nutrition (PN) and palliative venting gastrostomies (PVG) are two interventions used clinically to manage inoperable malignant bowel obstruction (MBO); however, little is known about their role in clinical and quality-of-life outcomes to inform clinical decision making.

Aim

To examine the impact of PN and PVG on clinical and quality-of-life outcomes in inoperable MBO.

Design

A mixed-methods systematic review and narrative synthesis.

Data sources

The following databases were searched (from inception to 29 April 2021): MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL, Bielefeld Academic Search Engine, Health Technology Assessment and CareSearch for qualitative or quantitative studies of MBO, and PN or PVG. Titles, abstracts and papers were independently screened and quality appraised.

Results

A total of 47 studies representing 3538 participants were included. Current evidence cannot tell us whether these interventions improve MBO survival, but this was a firm belief by patients and clinicians informing their decision. Both interventions appear to allow patients valuable time at home. PVG provides relief from nausea and vomiting. Both interventions improve quality of life but not without significant burdens. Nutritional and performance status may be maintained or improved with PN.

Conclusion

PN and PVG seem to allow valuable time at home. We found no conclusive evidence to show either intervention prolonged survival, due to the lack of randomised controlled trials that have to date not been performed due to concerns about equipoise. Well-designed studies regarding survival for both interventions are needed.

PROSPERO registration number

CRD42020164170.
Histopathology reporting for personalised medicine: focus on clinical utility
Authors: Mason Anna Elizabeth , Varma Murali
Published: July 2022

Histopathology guidelines generally focus on standardised collection of data items to facilitate completeness and reproducibility of histopathology reporting. A data item is categorised as either core (mandatory) or non-core (recommended but not mandatory), irrespective of the clinical scenario. However, a data item that is critical for patient management in one clinical setting may have little clinical significance in another setting. A diagnosis of limited extent Gleason score 3+3=6 prostate cancer is critical in a patient being investigated for raised serum prostate-specific antigen but would be clinically irrelevant in a repeat biopsy from a patient on an active surveillance protocol. We outline an alternative approach that is focused on the clinical utility of the data items and the requirements of personalised medicine. While all core data items are required to be reported, understanding how these parameters are used to guide patient management will enable pathologists to focus time and resources on the critical aspects of an individual case. Detailed immunohistochemical workup and obtaining a second opinion would not be necessary if resolution of the differential diagnosis is of limited clinical significance. We also highlight some challenges encountered when adopting this approach and suggest some solutions that could positively impact histopathology reporting and patient care.
Onset-to-treatment time and aneurysmal regression predict improvement of cranial neuropathy after flow diversion treatment in patients with symptomatic internal carotid artery aneurysms
Authors: Akiyama Ryo , Ishii Akira , Kikuchi Takayuki , Okawa Masakazu , Yamao Yukihiro , Abekura Yu , Ono Isao , Sasaki Natsuhi , Tsuji Hirofumi , Imamura Hirotoshi , Hatano Taketo , Sakai Nobuyuki , Miyamoto Susumu
Published: July 2022

Background

Although flow diversion plays a pivotal role in treating internal carotid artery aneurysms presenting with cranial neuropathy, predictors of symptom improvement have not been established.

Objective

To investigate improvement of symptoms after flow diversion treatment in patients with internal carotid artery aneurysms causing cranial neuropathy, with sufficient follow-up period. Additionally, to examine factors associated with improvement of symptoms.

Methods

This retrospective multicenter study examined patients with unruptured internal carotid artery aneurysms presenting with cranial neuropathy who were treated using flow diversion and followed up for at least 12 months. Study outcomes were transient worsening of symptoms and symptom status 12 months after treatment. Patient and aneurysm characteristics were statistically analyzed.

Results

Seventy-seven patients were included. Data needed for outcome analysis were available for 66 patients. At the 1-, 3-, 6-, 12-month, and last follow-ups, the proportion of patients with resolved or improved symptoms was 26% (20/77), 51% (39/77), 74% (57/77), 83% (64/77), and 79%(62/77), respectively. Symptom onset-to-treatment time <6 months (OR=24.2; 95% CI 3.09 to 188.84; p=0.002) and aneurysmal regression (OR=23.1; 95% CI 1.97 to 271.75; p=0.012) were significantly associated with symptom improvement. Transient symptom worsening and worse symptoms at 12 months occurred in 19/77 (25%) and 2/77 (3%) patients, respectively.

Conclusions

The rate of cranial neuropathy symptom improvement after flow diversion increased over the first 12 months after treatment, but not thereafter. Treatment within 6 months of symptom onset and aneurysmal regression were predictors of symptom improvement.
Making space for disability studies within a structurally competent medical curriculum: reflections on long Covid
Authors: Hunt Joanne
Published: July 2022

While critically informed approaches to medical education are increasingly advocated in literature, discussion of the potential role of disability studies in informing pedagogy and practice is largely lacking. The emergence of long Covid, alongside the strong possibility of a wave of covid-related disability, underlines an urgent need for medicine to develop more contextualised, nuanced and structurally competent understandings of chronic illness and disability. This article argues that the integration of thinking from disability studies into medical curricula offers a pathway to such understanding, informing a more equitable, holistic and patient-centred approach to practice. Further, a structurally competent, antiableist approach positions clinicians and patients as allies, working together within a structural context that constrains both parties. Such positioning may mitigate tensions within the clinical encounter, tensions that are well documented in the realm of marginalised chronic illness and disability. While the possibilities arising from a partnership between disability studies and medicine are numerous, the foci here are the social relational model of disability and the concept of psycho-emotional disablism, within a broader framework of critical disability studies. It is argued that inadequate healthcare provision and policy in the realm of long Covid can be understood as a form of structural and psycho-emotional disablism, arising from and reinforcing an ableist psychosocial imaginary permeated with neoliberal assumptions, and carrying a risk of furthering both disability and impairment. After considering long Covid through these particular lenses, the article concludes with a discussion of how a partnership between disability studies and a structurally competent approach to medical education might translate into practice.
Efficacy and safety of ixekizumab treatment in patients with axial spondyloarthritis: 2-year results from COAST
Authors: Braun Jürgen , Kiltz Uta , Deodhar Atul , Tomita Tetsuya , Dougados Maxime , Bolce Rebecca , Sandoval David , Lin Chen-Yen , Walsh Jessica
Published: July 2022

Objectives

To study the efficacy and safety of ixekizumab (IXE) in patients with radiographic (r-) and non-radiographic (nr-)axial spondyloarthritis (axSpA) for up to 116 weeks.

Methods

COAST-Y (NCT03129100) is the 2-year extension study following COAST-V, COAST-W and COAST-X. Patients were treated with either 80 mg IXE every 4 weeks or 2 weeks, as assigned in the originating studies. Efficacy was assessed in all participants continuously treated with IXE through week 116 and in subgroups based on disease subtype and dosing. Missing data were handled by non-responder imputation for categorical variables and modified baseline observation carried forward for continuous variables. Safety data were analysed in all patients having received ≥1 IXE dose.

Results

Of 932 patients who received ≥1 IXE dose, 773 enrolled in COAST-Y (82.9%); 665 of which (86.0%) completed week 116. Of 352 continuously treated patients, the proportion achieving Assessment of Spondyloarthritis International Society (ASAS40) at week 52 was 51.4%, which increased to 56.0% at week 116. The proportion of patients achieving ASAS40 at week 116 was 64.9% and 57.7% for biological disease-modifying antirheumatic drug (bDMARD)-naïve patients with r-axSpA and nr-axSpA, respectively, and 47.0% for TNFi-experienced patients. The proportion of patients achieving Ankylosing Spondylitis Disease Activity Score <2.1 through week 116 was 57.0% and 52.9% for bDMARD-naïve patients with r-axSpA and nr-axSpA, respectively, and 33.6% for TNFi-experienced patients. Incidences of treatment-emergent adverse events and serious adverse events were consistent with previous reports.

Conclusion

IXE treatment led to sustained long-term improvements in patients with axSpA, with similar efficacy for r-axSpA and nr-axSpA, and for patients receiving the approved every 4 weeks dose. The safety profile of IXE was consistent with previous reports. No new safety signals were identified.
Poststroke motor, cognitive and speech rehabilitation with brain–computer interface: a perspective review
Authors: Mane Ravikiran , Wu Zhenzhou , Wang David
Published: July 2022

Brain–computer interface (BCI) technology translates brain activity into meaningful commands to establish a direct connection between the brain and the external world. Neuroscientific research in the past two decades has indicated a tremendous potential of BCI systems for the rehabilitation of patients suffering from poststroke impairments. By promoting the neuronal recovery of the damaged brain networks, BCI systems have achieved promising results for the recovery of poststroke motor, cognitive, and language impairments. Also, several assistive BCI systems that provide alternative means of communication and control to severely paralysed patients have been proposed to enhance patients’ quality of life. In this article, we present a perspective review of the recent advances and challenges in the BCI systems used in the poststroke rehabilitation of motor, cognitive, and communication impairments.
Review of resource utilization of Fe-rich sludges: purification, upcycling, and application in wastewater treatment
Authors: Yu Chen , Dongxu Liang , Hongyu Chen , Suiyi Zhu , Xianze Wang , Jiakuan Yang , Xinfeng Xie , Eskola Joseph , Dejun Bian
Published: July 2022

This paper discusses the resource utilization of Fe-rich sludges generated as waste products from water treatment, hydrometallurgy, surface finishing, and dye chemical industries. Apart from the conventional landfill disposal of such sludges, the work focuses on sludge purification for new commercial products, including iron red/black dyes, an iron concentrate powder, a polyferric flocculant, a catalyst, and a magnetic adsorbent. Among such purifications, a new strategy was developed to recycle Fe-rich sludges for a new Fe/S-bearing flocculant. Given that Fe-rich sludges may contain rare and/or heavy metals, the purification of sludges as high-purity hematite nanoparticles and other valuable products is detailed as a new insight. Accordingly, the mechanisms for the phase transformation of Fe-bearing minerals and the purification of valuable Fe oxides are deeply considered. The work summarizes the pilot- and/or field-scale application for recycling of Fe-rich sludge and proposes the development of a new Fe/S flocculant and a high-purity hematite product.
On quasinormal modes in 4D black hole solutions in the model with anisotropic fluid
Authors: Bolokhov S. V. , Ivashchuk V. D.
Published: July 2022

We consider a family of four-dimensional black hole solutions from Dehnen et al. (Grav Cosmol 9:153arXiv:gr-qc/0211049, 2003) governed by natural number$$q= 1, 2, 3 , \dots $$q=1,2,3,⋯, which appear in the model with anisotropic fluid and the equations of state:$$p_r = -\rho (2q-1)^{-1}$$pr=-ρ(2q-1)-1,$$p_t = - p_r$$pt=-pr, where$$p_r$$prand$$p_t$$ptare pressures in radial and transverse directions, respectively, and$$\rho > 0$$ρ>0is the density. These equations of state obey weak, strong and dominant energy conditions. For$$q = 1$$q=1the metric of the solution coincides with that of the Reissner–Nordström one. The global structure of solutions is outlined, giving rise to Carter–Penrose diagram of Reissner–Nordström or Schwarzschild types for odd$$q = 2k + 1$$q=2k+1or even$$q = 2k$$q=2k, respectively. Certain physical parameters corresponding to BH solutions (gravitational mass, PPN parameters, Hawking temperature and entropy) are calculated. We obtain and analyse the quasinormal modes for a test massless scalar field in the eikonal approximation. For limiting case$$q = + \infty $$q=+∞, they coincide with the well-known results for the Schwarzschild solution. We show that the Hod conjecture which connect the Hawking temperature and the damping rate is obeyed for all$$q \ge 2$$q≥2and all (allowed) values of parameters.
Distinguishing sources of ammonium in groundwater at former gasworks sites using nitrogen isotopes
Authors: Thomas R. A. P. , Riding M. J. , Robinson J. D. F. , Brown S. J. A. , Taylor C.
Published: July 2022

Ammonium is a common contaminant found in the soils and groundwater at former gasworks, associated with historical gas production and the storage and disposal of by-product. However, it can also be present in groundwater at gasworks sites from a variety of natural and other anthropogenic sources. This study evaluates the use of nitrogen isotope analysis at eight former gasworks sites in the UK as a forensic tool to differentiate between ammonium from gasworks and non-gasworks sources. It also provides an understanding of how the parent coal, gas-making technology and by-product processing can influence the presence of ammonium on a former gasworks, and the importance of understanding the site layout when sampling.

Results of this study indicate that gasworks sources would be indicated typically by a

δ

15
N of between −3.2 and +10.7‰, which correlate to published isotopic ranges specifically for coal and coal by-products. This broad range includes published values for the isotopic signature of parent coal (

δ

15
N of −3.2 to +6.3‰,), coal pyrolysis residue/tar (

δ

15
N of 4.2–10.7‰,), gas-purifier waste (

δ

15
N of 2–5‰) and coking-works-derived ammonium sulfate (

δ

15
N of −0.5‰). This suggests that gas-purification waste may have a distinct isotopic range compared to coal tar, a finding supported by results from Site A. Gasworks-sourced nitrogen typically had a lower

δ

15
N value than non-gasworks sources, and predominantly in the

δ

15

N

(
N

H

4

)

form. This study demonstrates nitrogen isotope analysis coupled with traditional hydrochemistry and a detailed site investigation is shown to have potential for use as part of the environmental forensic toolkit.