bluuebunny/crossref_metadata_2025 huggingface dataset:
How can NHS trusts in England optimise strategies to improve the mental health and well-being of hospital doctors? The Care Under Pressure 3 (CUP3) realist evaluation study protocol
Authors: Bramwell Charlotte , Carrieri Daniele , Melvin Anna , Pearson Alison , Scott Jessica , Hancock Jason , Pearson Mark , Papoutsi Chrysanthi , Wong Geoff , Mattick Karen
Published: November 2023

Introduction

The growing incidence of mental ill health in doctors was a major issue in the UK and internationally, even prior to the COVID-19 pandemic. It has significant and far-reaching implications, including poor quality or inconsistent patient care, absenteeism, workforce attrition and retention issues, presenteeism, and increased risk of suicide. Existing approaches to workplace support do not take into account the individual, organisational and social factors contributing to mental ill health in doctors, nor how interventions/programmes might interact with each other within the workplace. The aim of this study is to work collaboratively with eight purposively selected National Health Service (NHS) trusts within England to develop an evidence-based implementation toolkit for all NHS trusts to reduce doctors’ mental ill health and its impacts on the workforce.

Methods and analysis

The project will incorporate three phases. Phase 1 develops a typology of interventions to reduce doctors’ mental ill health. Phase 2 is a realist evaluation of the existing combinations of strategies being used by acute English healthcare trusts to reduce doctors’ mental ill health (including preventative promotion of well-being), based on 160 interviews with key stakeholders. Phase 3 synthesises the insights gained through phases 1 and 2, to create an implementation toolkit that all UK healthcare trusts can use to optimise their strategies to reduce doctors’ mental ill health and its impact on the workforce and patient care.

Ethics and dissemination

Ethical approval has been granted for phase 2 of the project from the NHS Research Ethics Committee (REC reference number 22/WA/0352). As part of the conditions for our ethics approval, the sites included in our study will remain anonymous. To ensure the relevance of the study’s outputs, we have planned a wide range of dissemination strategies: an implementation toolkit for healthcare leaders, service managers and doctors; conventional academic outputs such as journal manuscripts and conference presentations; plain English summaries; cartoons and animations; and a media engagement campaign.
Delphi consensus study to develop guidelines for the management of adults with borderline personality disorder in the emergency department: a protocol
Authors: Prosser Aaron , Hong Victor , Helfer Bartosz , Fudge David , Patterson Janet , Rosebush Patricia , Frey Benicio N , Links Paul
Published: November 2023

Introduction

Clinicians caring for adults with borderline personality disorder (BPD) in acute settings such as the emergency department (ED) have little evidence/guidance to base decisions on. Specific/detailed guidance for managing BPD in the ED is needed given the morbidity and mortality risks, high service utilisation, unique challenges and risk of iatrogenic interventions. The primary objective of this study is to use a consensus method to develop a guideline for managing adults with BPD in the ED. This protocol and the key questions for the guideline were developed with the advice of people with BPD and their family members/support persons.

Methods and analysis

We will perform a four-phase Delphi study of an expert panel of clinicians, researchers, adults with BPD and their family members/support persons. Various disciplines (psychiatry, psychology, emergency medicine, nursing, social work) and treatment approaches will be included in the expert panel. An online questionnaire will be developed from systematic reviews, qualitative assessments of pivotal literature, and opinions suggested by the panel (phase 1). The panel will rate their agreement on opinions for each key question covering areas of emergency care of adults with BPD using two rounds of this questionnaire (phases 2 and 3). Opinions meeting predefined thresholds for consensus will be brought to consensus meetings moderated by an independent chair (phase 4). The purpose of these meetings is to finalise the set and phrasing of the opinions for each area of emergency care. These final opinions will be the recommendations in the guideline. If there are significant differences of opinion, the guideline will present both recommendations alongside one another.

Ethics and dissemination

This study has received ethics approval by the Hamilton Integrated Research Ethics Board in Hamilton, Ontario, Canada. The results of this study will be disseminated through peer-reviewed publications, conferences and national professional and patient/family/support associations.
Evaluation of the priority primary care centre program to reduce emergency department burden in regional Victoria, Australia: a mixed-method study
Authors: Frith Madison , Randall Sean , Savira Feby , Swann Jamie , White Naomi , Giddy Andrew , McLean Kirsty , Peeters Anna , Robinson Suzanne
Published: November 2023

Introduction

In Australia, the Victorian State Government has established a number of priority primary care centres (PPCCs) across the state to address the increasing demand for emergency departments (EDs). PPCCs are general practitioner-led, free-of-charge services that aim to provide care for conditions that require urgent attention but do not require the high-acuity care of an ED. This study aims to evaluate the implementation processes, outcomes and the impact of the PPCC on reducing ED demand within Barwon, Warrnambool and Grampians Health Services in the Western region of Victoria, Australia.

Methods and analysis

This is a convergent mixed-method study. Qualitative data collection will be undertaken through semistructured interviews to understand the experiences of PPCC patients, PPCC clinical staff, PPCC managerial and administrative staff and ED clinical staff. A documentary analysis will be conducted on the materials relating to the implementation of the PPCC. The quantitative component will involve interrupted time series analysis of de-identified administrative data, comprising ED presentation records and PPCC clinical records. Implementation science frameworks will be integrated throughout the study. The RE-AIM framework is a guide used for the planning and evaluation of programmes through five outcomes: reach, effectiveness, adoption, implementation and maintenance. The Consolidated Framework for Implementation Research will be integrated.

Ethics and dissemination

This study has received ethical approval from Deakin University HREC (Ref No. 2023-046) and Barwon Health HREC (Ref No. 94374). Findings will be disseminated as reports, presentations and peer-reviewed journal articles.
Impact of a short online course on the accuracy of non-ophthalmic diabetic retinopathy graders in recognising glaucomatous optic nerves in Vietnam
Authors: Olawoye Olusola Oluyinka , Ha Thu Huong , Pham Ngoc , Nguyen Lam , Cherwek David Hunter , Fowobaje Kayode Raphael , Ross Craig , Coote Michael , Chan Ving Fai , Kahook Malik , Peto Tunde , Azuara-Blanco Augusto , Congdon Nathan
Published: November 2023

Purpose

To test an online training course for non-ophthalmic diabetic retinopathy (DR) graders for recognition of glaucomatous optic nerves in Vietnam.

Methods

This was an uncontrolled, experimental, before-and-after study in which 43 non-ophthalmic DR graders underwent baseline testing on a standard image set, completed a self-paced, online training course and were retested using the same photographs presented randomly. Twenty-nine local ophthalmologists completed the same test without the training course. DR graders then underwent additional one–to-one training by a glaucoma specialist and were retested. Test performance (% correct, compared with consensus grades from four fellowship-trained glaucoma experts), sensitivity, specificity, positive and negative predictive value, and area under the receiver operating (AUC) curve, were computed.

Results

Mean age of DR graders (32.6±5.5 years) did not differ from ophthalmologists (32.3±7.3 years, p=0.13). Online training required a mean of 297.9 (SD 144.6) minutes. Graders’ mean baseline score (33.3%±14.3%) improved significantly after training (55.8%±12.6%, p<0.001), and post-training score did not differ from ophthalmologists (58.7±15.4%, p=0.384). Although grader sensitivity reduced before [85.5% (95% CI 83.5% to 87.3%)] versus after [80.4% (78.3% to 82.4%)] training, specificity improved significantly [47.8 (44.9 to 50.7) vs 79.8 (77.3 to 82.0), p<0.001]. Grader AUC also improved after training [66.6 (64.9 to 68.3)] to [80.1 (78.5 to 81.6), p<0.001]. Additional one-to-one grader training by a glaucoma specialist did not further improve grader scores.

Conclusion

Non-ophthalmic DR graders can be trained to recognise glaucoma using a short online course in this setting, with no additional benefit from more expensive one–to-one training. After 5-hour online training in recognising glaucomatous optic nerve head, scores of non-ophthalmic DR graders doubled, and did not differ from local ophthalmologists. Intensive one-to-one training did not further improve performance
Protecting patients and learners: educational leadership on the fringes
Authors: Ahluwalia Sanjiv , Hughes Elizabeth
Published: November 2023

The development of high-quality clinicians takes place through immersion in clinical practice facilitated by educational supervisors with appropriate capabilities and organisational support to undertake the role. Learners give feedback on the quality of their learning experience on placement, which provides insights about the quality of clinical care received by patients.

In this article, we explore the role of educational leaders in engaging with learner feedback about patient care, the challenges and tensions this generates, and the path through resolution. We use a lived example to showcase the issues raised and offer reflections on the challenges faced.
Heart-to-heart with ChatGPT: the impact of patients consulting AI for cardiovascular health advice
Authors: Lautrup Anton Danholt , Hyrup Tobias , Schneider-Kamp Anna , Dahl Marie , Lindholt Jes Sanddal , Schneider-Kamp Peter
Published: November 2023

Objectives

The advent of conversational artificial intelligence (AI) systems employing large language models such as ChatGPT has sparked public, professional and academic debates on the capabilities of such technologies. This mixed-methods study sets out to review and systematically explore the capabilities of ChatGPT to adequately provide health advice to patients when prompted regarding four topics from the field of cardiovascular diseases.

Methods

As of 30 May 2023, 528 items on PubMed contained the term ChatGPT in their title and/or abstract, with 258 being classified as journal articles and included in our thematic state-of-the-art review. For the experimental part, we systematically developed and assessed 123 prompts across the four topics based on three classes of users and two languages. Medical and communications experts scored ChatGPT’s responses according to the 4Cs of language model evaluation proposed in this article: correct, concise, comprehensive and comprehensible.

Results

The articles reviewed were fairly evenly distributed across discussing how ChatGPT could be used for medical publishing, in clinical practice and for education of medical personnel and/or patients. Quantitatively and qualitatively assessing the capability of ChatGPT on the 123 prompts demonstrated that, while the responses generally received above-average scores, they occupy a spectrum from the concise and correct via the absurd to what only can be described as hazardously incorrect and incomplete. Prompts formulated at higher levels of health literacy generally yielded higher-quality answers. Counterintuitively, responses in a lower-resource language were often of higher quality.

Conclusions

The results emphasise the relationship between prompt and response quality and hint at potentially concerning futures in personalised medicine. The widespread use of large language models for health advice might amplify existing health inequalities and will increase the pressure on healthcare systems by providing easy access to many seemingly likely differential diagnoses and recommendations for seeing a doctor for even harmless ailments.
Electrical energy by electrode placement for cardioversion of atrial fibrillation: a systematic review and meta-analysis
Authors: Vinter Nicklas , Holst-Hansen Mikkel Zacharias Bystrup , Johnsen Søren Paaske , Lip Gregory Y H , Frost Lars , Trinquart Ludovic
Published: November 2023

Objective

Electrode patch position may not be critical for success when cardioverting atrial fibrillation (AF), but the relevance of applied electrical energy is unclarified. Our objective was to perform a meta-analysis of randomised trials to examine the dose–response relation between energy level and cardioversion success by electrode position in elective cardioversion.

Methods

We searched PubMed, Embase, The Cochrane Library, Google Scholar and Scopus Citations. Inclusion criteria were randomised controlled trials using biphasic shock waves and self-adhesive patches, and publication date from 2000 to 2023. We used random-effects dose-response models to meta-analyse the relation between energy level and cardioversion success by anterolateral and anteroposterior position. Random-effects models estimated pooled risk ratios (RR) for cardioversion success after the first and the final shocks between the two electrode positions.

Results

We included five randomised controlled trials (N=1078). After the first low-energy shock, the electrode position was not significantly associated with the likelihood of successful cardioversion (pooled RR anterolateral vs anteroposterior placement 1.28, 95% CI 0.93 to 1.76, with considerable heterogeneity). After a high-energy final shock, there was no evidence of an association between the electrode position and the cumulative chance of cardioversion success (pooled RR anterolateral vs anteroposterior 1.05, 95% CI 0.97 to 1.14). Regardless of electrode position, cardioversion success was significantly less likely with shock energy levels < 200J compared with 200J.

Conclusion

Evidence from contemporary randomised trials suggests that higher level of electrical energy is associated with higher conversion rate when cardioverting AF with a biphasic shockwave. Positioning of electrodes can be based on convenience.
TITAN CSR: a new self-retaining retractor for abdominal surgery
Authors: Brigmon Erika Paola , Eastridge Brian
Published: November 2023

Background

Self-retaining retractors provide hands-free exposure and allow surgeons to use their hands to perform surgery rather than manually retract tissues. Non-table-mounted retractors offer rapid assembly, but they have been traditionally limited in their ability to provide adequate exposure of the abdomen. Table-mounted retractors provide excellent exposure, but their cumbersome and time-intensive assembly often precludes their use in emergency settings. The TITAN CSR surgical retractor is a novel, lightweight, expandable, and modular system which offers the benefits of both designs by providing rapid assembly and effective abdominal exposure without a table attachment. We describe our experience with this new retractor system.

Methods

Retrospective case series of selected trauma and emergency surgery laparotomies at an urban academic level 1 trauma center using the TITAN CSR surgical retractor during a 1-year period.

Results

The TITAN CSR surgical retractor was used to provide exposure for trauma and emergency surgery laparotomies in both adult and pediatric patients in 89 cases from July 2021 to July 2022. Without requiring a table attachment, the TITAN CSR retractor provided hands-free surgical exposure during a variety of procedures including traumatic hysterectomy, gastrorrhaphy, enterorrhaphies and colectomy. With the added utility of attaching Bookwalter-compatible retractor blades, it provided effective exposure of retroperitoneal structures. These structures included the inferior vena cava, left femoral vessels, and duodenum. All laparotomies presented were successfully completed without setting up a post or a connection to the surgical table.

Discussion

The TITAN CSR surgical retractor was successfully used in a number of difficult trauma and emergency surgery laparotomies, providing effective intra-abdominal and retroperitoneal exposure without necessitating an attachment to the surgical table. This retractor has the potential to replace current retractor systems in abdominal surgery, providing the benefits of table-mounted and non-table-mounted designs while removing their various disadvantages.
Disaster planning for a surgical surge: when mass trauma threatens to overwhelm your operating rooms
Authors: Kelley Katherine M , Toscano Nicole , Gestring Mark L , Capella Jeannette , Newton Christopher , Bukur Marko , Shatz David V , Winfield Robert D , Fox Adam , Fallat Mary E , Kuhls Deborah A , Glinik Galina , Doucet Jay , Gates Jonathan , Remick Kyle N
Published: November 2023

Mass casualty events particularly those requiring multiple simultaneous operating rooms are of increasing concern. Existing literature predominantly focuses on mass casualty care in the emergency department. Hospital disaster plans should include a component focused on preparing for multiple simultaneous operations. When developing this plan, representatives from all segments of the perioperative team should be included. The plan needs to address activation, communication, physical space, staffing, equipment, blood and medications, disposition offloading, special populations, and rehearsal.
Biophysical model for DNA mutations induced by retroviral genome insertion based on the probability density function of mutation distribution
Authors: Tsuruyama Tatsuaki , Hiratsuka Takuya
Published: November 2023

Research into the biophysical properties of deoxyribonucleic acid (DNA) and the mechanisms underlying genetic mutations has undergone marked advancements. The intriguing nature of mutations resulting from retroviral DNA insertion has garnered considerable attention. Whether these mutations are random or region-specific, the distribution patterns of mutation sites have been the focus of numerous research endeavours. This mutation mechanism originates from interactions between host DNA and the pre-integration complex (PIC), comprising retroviral DNA and an integrase enzyme that facilitates its incorporation into the host DNA. Our study focused on the Zfp521 gene locus, recognised for its pronounced susceptibility to insertional mutations, particularly around unique palindromic sequences. We employed two biophysical models to predict mutation distribution within a range of 50 base pairs centred on these sequences. The first is a probabilistic collision model emphasising PIC and target DNA interactions. The second model is a DNA diffraction lattice, where the PIC behaves according to probability density. Although both models adeptly illuminated the probability distributions of target sites, the second model was more successful in predicting the PIC integration sites based on DNA biophysical properties. This highlights the pivotal role of intricate interactions between the PIC and target DNA, suggesting that mutations can be predicted in a stochastic manner.
Empirical Analysis of SSE 50 Index Volatility Based on GARCH Model
Authors: Huang Shiwang , Liu Niukun , Wang Zhichao
Published: November 2023

Volatility is an important index for measuring the risk in the financial market. The research on the volatility of the financial market is the basis of risk prevention and asset pricing. The volatility of the market is predicted by using financial time series analysis and Generalized Autoregressive Conditional Heteroskedasticity (GARCH) model. This paper uses the 5 min closing price of the Shanghai 50 index from January 2021 to December 2021 as the small sample data, and the daily closing price of the Shanghai 50 index from January 2012 to December 2020 as the large sample data. The large sample data of SSE 50 index are divided into five sample groups with different interval lengths, and GARCH models are established to empirically analyze the volatility of its return. The “realized” volatility method is used to process the small sample data of the Shanghai Stock Exchange 50 index, and the estimated value of volatility is obtained as the substitute for the real value. The predicted value of five groups of data is compared with the real value, and the influence of sample size on the predicted value is analyzed. The results show that GARCH’s estimation coefficient is very significant and has the expected characteristics, which verifies the existence of persistent volatility aggregation, and the daily return fluctuation of the closing price of the Shanghai 50 index is largely affected by the news about volatility and lagging volatility in the previous period. This result shows that the daily return of the Shanghai Stock Exchange 50 index has sustained high volatility, the investment risk of the Shanghai stock market increases, and the regulatory authorities should take appropriate measures to prevent systemic risks.
CNV-FB: A Feature bagging strategy-based approach to detect copy number variants from NGS data
Authors: Li Chengyou , Fan Shiqiang , Zhao Haiyong , Liu Xiaotong
Published: November 2023

Copy number variation (CNV), as a type of genomic structural variation, accounts for a large proportion of structural variation and is related to the pathogenesis and susceptibility to some human diseases, playing an important role in the development and change of human diseases. The development of next-generation sequencing technology (NGS) provides strong support for the design of CNV detection algorithms. Although a large number of methods have been developed to detect CNVs using NGS data, it is still considered a difficult problem to detect CNVs with low purity and coverage. In this paper, a new calculation method CNV-FB is proposed to detect CNVs from NGS data. The core idea of CNV-FB is to randomly sample the read depth values of the genome fragment, and then each sample is individually detected for outliers, and finally combined into a final outlier score. The CNV-FB method was applied to simulation data and real data experiments and compared with the other five methods of the same type. The results show that the CNV-FB method has a better detection effect than other methods. Therefore, the CNV-FB method may be an effective algorithm for detecting genomic mutations.
VxH: A Systematic Determination of Efficient Hierarchical Voxel Structures
Authors: Rifai Mouad , Johnsson Lennart
Published: November 2023

Three-dimensional (3D) maps with many millions to billions of points are now used in an increasing number of applications, with processing rates in the hundreds of thousands to millions of points per second. In mobile applications, power and energy consumption for managing such data and extracting useful information thereof are critical concerns. We have developed structures and methodologies with the purpose of minimizing memory usage and associated energy consumption for indexing and serialization of voxelized point-clouds. The primary source of points in our case is airborne laser scanning, but our methodology is not restricted to only this setting. Our emulated results show a memory usage reduction factor of roughly up to 200× that of Octree/Octomap and a file size reduction factor of up to 1.65× compared with the predominating compression scheme for airborne Lidar data, LASzip. In addition, our structures enable significantly more efficient processing since they are included in a hierarchical structure that captures geometric aspects.
The Great Organ System Debates
Authors: Lundmark Jennifer
Published: November 2023

Which organ system is “most important” when running a marathon? To answer this question, different groups of students were assigned different organ systems to see who could come up with the best argument.
The ventilatory response to modified rebreathing is unchanged by hyperoxic severity: implications for the hyperoxic hyperventilation paradox
Authors: Huggard Joshua D. , Guluzade Nasimi A. , Duffin James , Keir Daniel A.
Published: November 2023

Normobaric hyperoxia stimulates ventilation (V̇E) in a time- and dose-dependent manner. Whether this occurs via an oxygen (O2)-specific mechanism or secondary to carbon dioxide (CO2) retention at the central chemoreceptors remains unclear. We measured the ventilatory response to hyperoxic CO2 rebreathing with O2 clamped at increasingly higher pressures. We hypothesized that the V̇E versus PCO2 relationship is fixed and independent of PO2. On four occasions, twenty participants (10F; mean±SD age: 24±4 years) performed three repetitions of modified rebreathing in 4, randomized, isoxic-hyperoxic conditions: mild: PO2=150 mmHg; moderate: PO2=200 mmHg; high: PO2=300 mmHg; and extreme: PO2≈700 mmHg. Breath-by-breath V̇E, end-tidal CO2 (PETCO2) and O2 (PETO2) were measured by pneumotach and gas analyzer. For each rebreathing trial, the PETCO2 at which V̇E rose was identified as the ventilatory recruitment threshold (VRT, mmHg), data before VRT provided baseline V̇E (V̇EBSL, L∙min-1) and the slope of the response above VRT gave central chemoreflex sensitivity (V̇ES, L∙min-1∙mmHg-1). For each condition, VRT, V̇EBSL, and V̇ES from like-trials were averaged and repeated measures ANOVA assessed between-condition differences. There were no effects of PETO2 on V̇EBSL (mild: 7.4±4.2 L∙min-1; moderate: 6.9±4.2 L∙min-1; high: 6.5±3.7 L∙min-1; extreme: 7.5±2.7 L∙min-1; p=0.24), VRT (mild: 42.8±3.2 mmHg; moderate: 42.5±2.7 mmHg; high: 42.3±2.7 mmHg; extreme: 41.8±2.7 mmHg; p=0.07), or V̇ES (mild: 4.88±2.6 L∙min-1∙mmHg-1; moderate: 4.76±2.2 L∙min-1∙mmHg-1; high: 4.81±2.3 L∙min-1∙mmHg-1; extreme: 4.39±1.9 L∙min-1∙mmHg-1; p=0.41). The V̇E-PCO2 relationship is unaltered across a range of mild to extreme PO2. Brief exposure to normobaric hyperoxia may not independently stimulate breathing nor does it alter central chemoreflex sensitivity.
Left Juxtaposition of the Right Atrial Appendage: Pitfalls in Diagnosis
Authors: Singhapakdi Kanya , Sourour Wesam , Kimball Thomas R.
Published: November 2023

Several congenital anomalies of the right atrial appendage (RAA) have been described including aneurysm, herniation (in association with a pericardial defect), and left juxtaposition. The left juxtaposition of the RAA (LJRAA), first described by Birmingham in 1893 and subsequently introduced by Dixon in 1954, is usually associated with complex cardiac malformations such as obstruction of the left ventricular outflow tract. In this case report, we will describe an unusual variant of LJRAA in the absence of any other cardiac defects, which was initially misinterpreted as an aortic dissection. The correct diagnosis was made after careful reinterpretation and the use of multiple imaging modalities as highlighted.
Analysis of Volterra Integrodifferential Equations with the Fractal-Fractional Differential Operator
Authors: Kamran  , Subhan Aisha , Shah Kamal , Subhi Aiadi Suhad , Mlaiki Nabil , Alotaibi Fahad M.
Published: November 2023

In this paper, a class of integrodifferential equations with the Caputo fractal-fractional derivative is considered. We study the exact and numerical solutions of the said problem with a fractal-fractional differential operator. The abovementioned operator is arising widely in the mathematical modeling of various physical and biological problems. In our scheme, first, the integrodifferential equation with the fractal-fractional differential operator is converted to an integrodifferential equation with the Riemann–Liouville differential operator. Additionally, the obtained integrodifferential equation is then converted to the equivalent integrodifferential equation involving the Caputo differential operator. Then, we convert the integrodifferential equation under the Caputo differential operator using the Laplace transform to an algebraic equation in the Laplace space. Finally, we convert the obtained solution from the Laplace space into the real domain. Moreover, we utilize two techniques which include analytic inversion and numerical inversion. For numerical inversion of the Laplace transforms, we have to evaluate five methods. Extensive results are presented. Furthermore, for numerical illustration of the abovementioned methods, we consider three problems to demonstrate our results.
FAM222A, Part of the BET-Regulated Basal Endothelial Transcriptome, Is a Novel Determinant of Endothelial Biology and Angiogenesis—Brief Report
Authors: Tzani Aspasia , Haemmig Stefan , Cheng Henry S. , Pérez-Cremades Daniel , Heuschkel Marina Augusto , Jamaiyar Anurag , Singh Sasha A. , Aikawa Masanori , Yu Paul B. , Wang Tianxi , Sun Ye , Feinberg Mark W. , Plutzky Jorge
Published: November 2023

BACKGROUND:

BETs (bromodomain and extraterminal domain–containing epigenetic reader proteins), including BRD4 (bromodomain-containing protein 4), orchestrate transcriptional programs induced by pathogenic stimuli, as intensively studied in cardiovascular disease and elsewhere. In endothelial cells (ECs), BRD4 directs induced proinflammatory, proatherosclerotic transcriptional responses; BET inhibitors, like JQ1, repress these effects and decrease atherosclerosis. While BET effects in pathogenic conditions have prompted therapeutic BET inhibitor development, BET action under basal conditions, including ECs, has remained understudied. To understand BET action in basal endothelial transcriptional programs, we first analyzed EC RNA-Seq data in the absence versus presence of JQ1 before using BET regulation to identify novel determinants of EC biology and function.

METHODS:

RNA-Seq datasets of human umbilical vein ECs without and with JQ1 treatment were analyzed. After identifying C12orf34, also known as FAM222A (family with sequence similarity 222 member A), as a previously unreported, basally expressed, potently JQ1-induced EC gene, FAM222A was studied in endothelial and angiogenic responses in vitro using small-interference RNA silencing and lentiviral overexpression, in vitro, ex vivo and in vivo, including aortic sprouting, matrigel plug assays, and murine neonatal oxygen-induced retinopathy.

RESULTS:

Resting EC RNA-Seq data indicate BETs direct transcriptional programs underlying core endothelial properties including migration, proliferation, and angiogenesis. BET inhibition in resting ECs also significantly induced a subset of mRNAs, including FAM222A—a unique BRD4-regulated gene with no reported EC role. Silencing endothelial FAM222A significantly decreased cellular proliferation, migration, network formation, aorta sprouting, and Matrigel plug vascularization through coordinated modulation of VEGF (vascular endothelial growth factor) and NOTCH mediator expression in vitro, ex vivo, in vivo; lentiviral FAM222A overexpression had opposite effects. In vivo, siFAM222A significantly repressed retinal revascularization in neonatal murine oxygen-induced retinopathy through similar angiogenic signaling modulation.

CONCLUSIONS:

BET control over the basal endothelial transcriptome includes FAM222A, a novel, BRD4-regulated, key determinant of endothelial biology and angiogenesis.
Non–Interferon-Dependent Role of STING Signaling in Pulmonary Hypertension
Authors: Pham Ann T. , Oliveira Aline C. , Albanna Muhammad , Alvarez-Castanon Jimena , Dupee Zadia , Patel Diya , Fu Chunhua , Mukhsinova Laylo , Nguyen Amy , Jin Lei , Bryant Andrew J.
Published: November 2023

BACKGROUND:

Patients with constitutive activation of DNA-sensing pathway through stimulator of IFN (interferon) genes (STING), such as those with STING-associated vasculopathy with onset in infancy, develop pulmonary hypertension (PH). However, the role of STING signaling in general PH patients is heretofore undescribed. Here, we seek to investigate the role of STING in PH development.

METHODS:

STING expression in patient lung samples was examined. PH was induced in global STING-deficient mice and global type I IFN receptor 1–deficient mice using bleomycin or chronic hypoxia exposure. PH development was evaluated by right ventricular systolic pressure and Fulton index, with additional histological and flow cytometric analysis. VEGF (vascular endothelial growth factor) expression on murine immune cells was quantified and evaluated with multiplex and flow cytometry. Human myeloid-derived cells were differentiated from peripheral blood mononuclear cells and treated with either STING agonist or STING antagonist for evaluation of VEGF secretion.

RESULTS:

Global STING deficiency protects mice from PH development, and STING-associated PH seems independent of type I IFN signaling. Furthermore, a role for STING-VEGF signaling pathway in PH development was demonstrated, with altered VEGF secretion in murine pulmonary infiltrated myeloid cells in a STING-dependent manner. In addition, pharmacological manipulation of STING in human myeloid-derived cells supports in vivo findings. Finally, a potential role of STING-VEGF-mediated apoptosis in disease development and progression was illustrated, providing a roadmap toward potential therapeutic applications.

CONCLUSIONS:

Overall, these data provide concrete evidence of STING involvement in PH, establishing biological plausibility for STING-related therapies in PH treatment.
Germination Characteristics and Seedling Growth of Pseudolysimachion nakaianum (Ohwi) T. Yamaz. Seeds According to Light Quality Type
Authors: Kwon Hyuck Hwan , Oh Hye Jin , Cho Wonwoo
Published: November 2023

Background and objective: This study was conducted to understand the effect of different quality of light-emitting diodes (LED) on the germination characteristics and growth of Pseudolysimachion nakaianum.Methods: The LED light irradiation was divided into white, red, blue, and red:blue (1:1). To investigate the germination characteristics, 30 seeds were placed in a Petri dish in three replicates for 8 days. Average germination rate, germination speed, germination uniformity, and average germination time were measured. To investigate the growth of seedlings, plant height, plant width, leaf length, leaf width, leaf number, fresh weight, dry weight and T/R ratio were examined 6 weeks after sowing, and chlorophyll fluorescence (maximum quantum yield, electron transport rate) was measured.Results: The final germination rate and germination speed were highest at red:blue (1:1) LED irradiation. Regarding growth and chlorophyll fluorescence measurements, red:blue LED showed the best growth results, with no significant difference in Fv/Fm between different types of light quality, and the electron transport rate was the highest under red:blue LED irradiation. Also, total fresh/dry weight and T/R ratio were highest for red:blue LED, it is presumed to promote the biomass of entire plant.Conclusion: The results proved that Pseudolysimachion nakaianum showed red LED conditions promoted germination, but cultivation under red:blue LED conditions is judged to be suitable for seedling growth and photosynthesis.
A Phenomenological Study on Self-growth through the Experience of Horticultural Therapy by Welfare Horticultural Therapists
Authors: Song Eun-hye , Song Hyun
Published: November 2023

Background and objective: The purpose of this study is to investigate whether welfare horticultural therapists (hereinafter referred to as "welfare HTs") have achieved self-growth through horticultural therapy experiences.Methods: The subjects of this study are 8 welfare HTs who have actively worked for more than 3 years after receiving a welfare HT license from the Korea Horticultural Therapy Welfare Association. As a research method, Colaizzi's phenomenological method was used. Through the study, a total of 123 semantic components, 34 themes, and 14 theme clusters were collected under 5 categories.Results: The five categories are 'feeling dissatisfied with life', 'encountering horticultural therapy', 'being mesmerized by horticultural therapy', 'difficulties in horticultural therapy', and 'experiencing self-growth through horticultural therapy'. The findings of this study are as follows. Welfare HTs have developed themselves through horticultural therapy experiences. They have had a desire to develop themself into a better existence since learning about horticultural therapy, and working in the treatment field, using plants, through the recovery of clients and various difficult experiences, has consoled them and improved their emotional control and self-esteem.Conclusion: This study has the following significance. First, it focused on the specific context of working as a welfare HT. Second, it attempts an empirical study on self-growth through the experiences of welfare HTs, an important element in the field of horticultural therapy, research of which has thus far been focused only on therapy programs . Third, it sought to determine how welfare HTs achieve self-growth, so it seems that welfare HTs will be able to use these findings to learn about and develop the abilities required to prepare themselves as mature experts.
Structural Equation Modeling Analysis of Factors Affecting the Loyalty of Forest Trail Users
Authors: Kang Byung-Hoon , Kim Dong-Hoon , Ko Myeong-Chul , Lee Jeong-Hee
Published: November 2023

Background and objective: With the increasing public awareness of health due to COVID-19 and the quality of life, people have come to prefer natural spaces with fewer crowds. Public use of forest trails is increasing as a place that satisfies the demand for such natural spaces. As a result, the basic plans for trails and mountaineering support were established, and there has been government-level support such as the establishment of the Korea Mountaineering Support Center, which resulted in a quantitative and qualitative increase in the use of forest trails. Accordingly, efforts must be made to ensure satisfaction and loyalty in using forest trails.Methods: Therefore, this study identified the factors affecting the overall satisfaction and loyalty toward forest trails through structural equation modeling. As for the research data, we used data from the Fact-finding Survey on Forest Welfare Facility Users to analyze the use of forest trails.Results: As a result, safety and comfort, kindness, travel time, and program experience variety had a significant effect directly and indirectly on overall satisfaction and loyalty. Safety and comfort affected personal activity experience variety, while kindness affected program experience variety. For travel time, the direct effect on loyalty showed a positive correlation, but the indirect effect showed a negative correlation.Conclusion: These results showed that safety should be considered a top priority on forest trails, and that long travel time to forest trails could be a factor that increases loyalty by offering various programs. In addition, loyalty has a multifaceted correlation between several factors, suggesting that it is necessary to consider not only direct effects but also indirect effects.
An Analysis of Care Farm Status as Basic Data for the Quality Management of Agro-Healing Facilities
Authors: Hong In-Kyoung , Lee Sang-Mi , Moon Ji-Won , Yoo Eun-Ha
Published: November 2023

Background and objective: This study was conducted to identify the current status of domestic agricultural business operations related to the design and business model of care farms in order to manage quality for the certification of excellent Agro-Healing Facilities (AHFs) that meet the needs of the times given the increasing demand for agro-healing.Methods: An online survey was conducted of 170 agro-healing business entities nationwide, and the collected data were frequency-coded using SPSS Ver. 25. Chi-square was conducted for frequency analysis and significance was tested by one-way ANOVA.Results: For the type of business, individual businesses were the most common (118 businesses), and for the total sales of the business, 30 million won to less than 100 million won was the most common (57 businesses. For the total number of employees, businesses with 2 workers were the largest group (35.9%). In terms of the qualification standards for the CEOs and employees of care farms, 152 employees (89.4%) had completed education in agro-healing. In terms of the land use status of care farms, 141 individual businesses (82.9%) owned lands, and the average land area was 123,626.05 ㎡ for farmland, 178,195.98 ㎡ for land, and 62,511.51 ㎡ for plant cultivation area. The most frequently planted plant was sweet potatoes, and the least planted was plum. For functional plants mainly used in the programs, vegetables were the most common, followed by flowers, fruit trees and landscaping plants, special and food crops, and herbs. A non-parametric χ² test of all items was statistically significant (p < .001).Conclusion: The AHF certification scheme, which will be implemented from the end of June 2024, will select excellent facilities from among existing AHFs to provide correct information to the public and lay a foundation that will support the spread of sustainable agro-healing. It is expected that this study will provide useful basic data for establishing care farm business models and seeking future direction for care farms.
A Critique of some Arguments in the Case for Integrated Studies
Authors: Kirk Gordon
Published: November 2023

Five arguments which suggest that the integrated curriculum is superior to the subject-based curriculum are examined. It is maintained that the common weakness of these arguments is that each confuses the principle of curriculum organization with other, quite independent principles. The purpose of the article is not to discredit the notion of the integrated curriculum, but to show that some of the arguments put forward in support of this mode of curriculum organization are spurious.
One new species of the genus Acosmetura (Orthoptera: Tettigoniidae: Meconematinae) from Hunan, China
Authors: CHEN CHUN , XU HAO , SHI FUMING
Published: November 2023

This paper reports one new species of the genus Acosmetura Liu, 2000, i.e., Acosmetura compressa sp. nov. from Hunan, China. In addition, morphological photographs of the new species and a distribution map of the known species of the genus are provided. The type specimens are deposited in the Museum of Hebei University.
Back in Youth: Social Unbecoming in the Study of West African Masculinities
Authors: Bjarnesen Jesper
Published: November 2023

African youth became a central research theme in anthropology and related disciplines in the early 2000s, drawing renewed attention to the lives and aspirations of a segment of the continent's population that, since the independence era, has become increasingly demographically dominant but socially and politically marginalised. Reflecting on an extended case study of male ex-combatants in urban Burkina Faso, this paper offers a critical reading of the anthropological scholarship on African youth, emphasising, first, that much of this literature is most usefully read as studies of diverse (West) African masculinities and, second, that the literature has underplayed the extent to which achievements of social progression tend to be acutely reversible in contexts of precarity or radical social change, throwing the unfortunate, as it were, back in youth.
Revisiting Audio Observations to Collect Qualitative Data During the COVID-19 Pandemic
Authors: Borchers Nils S. , Badermann Mandy , Zurstiege Guido
Published: November 2023

With its physical distancing rules, the COVID-19 pandemic regulations urged researchers working in a qualitative paradigm to find pandemic-ready approaches to data collection. While many researchers turned to modern videoconferencing software, we explored an alternative route, and revisited audio observations. Audio observations replace the researcher as observer with audio recorders. Audio observations were pioneered in the 1960s, and continued to attract interest into the 1980s. Connecting with the methods literature from this earlier phase of interest, we evaluate a study design that combines audio observations with an interactive task that we applied to study active parental mediation of harmful media content. Drawing on a re-coding of data from two waves of data collection, we report on participants’ awareness of the observation episodes, issues with the recording quality, and the situational control during the observation episodes. We conclude that, although truly not a panacea, the combination of audio observations with interactive tasks not only helps to confront the challenges of physical distancing but also constitutes a serious alternative to more established qualitative data gathering approaches—even beyond pandemic restrictions. Thus, this article contributes to the extension of the methods repertoire in qualitative research.
On- and off-label utilisation of antipsychotics in Australia (2000–2021): Retrospective analysis of two medication datasets
Authors: Radha Krishnan Ramya Padmavathy , Harrison Christopher , Buckley Nicholas , Raubenheimer Jacques Eugene
Published: November 2023

Objective:

To determine antipsychotic utilisation patterns in Australian adults from 2005 to 2021, with a focus on on-label and off-label prescriptions.

Methods:

We examined antipsychotic dispensing trends in adults from 2005 to 2021 using a 10% sample of the Pharmaceutical Benefits Scheme (PBS) dataset, which contains patient-level information on medicines dispensed throughout Australia. The lack of diagnostic information in PBS was substituted by analysing BEACH (Bettering the Evaluation And Care of Health) dataset, a cross-sectional national survey from 2000 to 2016, consisting of data from general practitioner–patient encounters.

Results:

There were 5.6 million dispensings for 164,993 patients in PBS throughout this period; 69% patients had >1 dispensing, with a median of 6 per patient. Calculating the estimated period of exposure gave a total of 693,562 treatment episodes, with a median duration of 80 days. There were steady increases in both the incidence and prevalence of antipsychotic dispensings, mainly due to oral second-generation antipsychotics. The most commonly prescribed antipsychotics were quetiapine, olanzapine and risperidone, with a significant portion of patients receiving low-dose quetiapine without dose titration. Analysis of diagnostic indications from BEACH indicated that 27% of antipsychotic prescriptions were off-label for indications such as depression, dementia, anxiety and insomnia, at much lower prescribed daily dosages.

Conclusion:

The increasing prescribing and off-label use highlights concerns about chronic adverse effects caused by antipsychotics. The combined analysis of medication dispensings and the diagnostic indications for which they are prescribed is a novel approach and throws a spotlight on the need for additional monitoring of antipsychotics.
An Evaluation of a Tailored Peer Mediation Program for Incarcerated Women in Italy
Authors: Coppola Ilaria , Rania Nadia
Published: November 2023

Programs aimed at women prisoners are limited. The objective of this work is to evaluate the effectiveness of a peer mediation program implemented in an Italian women’s prison. Two focus groups were conducted with seven incarcerated women who participated in the program. The four mediators who conducted the program compiled a total of 12 reflective diaries. The data were analyzed using Grounded Theory. The results highlight the effectiveness of the program, which was perceived as a tool to develop functional relationship and conflict management strategies and to promote greater self-awareness. These intervention programs are fundamental in enhancing the specific characteristics of the individual and promoting the development of skills and resources necessary for successful reintegration into society.