bluuebunny/crossref_metadata_2025 huggingface dataset:
Cause-specific excess mortality after first diagnosis of bipolar disorder: population-based cohort study
Authors: Paljärvi Tapio , Herttua Kimmo , Taipale Heidi , Lähteenvuo Markku , Tanskanen Antti , Fazel Seena , Tiihonen Jari
Published: July 2023

Background

Bipolar disorder (BD) is associated with increased mortality, but evidence on cause-specific mortality is limited.

Objective

To investigate cause-specific premature excess mortality in BD.

Methods

Finnish nationwide cohort study of individuals with and without a diagnosis of BD who were aged 15–64 years during 2004–2018. Standardised mortality ratios (SMRs) with 95% CIs were calculated for BD using the mortality rates in the Finnish general population without BD as weights. Causes of death were defined by the International Classification of Diseases, 10th revision codes.

Findings

Of the included 47 018 individuals with BD, 3300 (7%) died during follow-up. Individuals with BD had sixfold higher mortality due to external causes (SMR: 6.01, 95% CI: 5.68, 6.34) and twofold higher mortality due to somatic causes (SMR: 2.06, 95% CI: 1.97, 2.15). Of the deaths due to external causes, 83% (1061/1273) were excess deaths, whereas 51% (1043/2027) of the deaths due to somatic causes were excess. About twice the number of potential years of life were lost in excess due to external causes than due to somatic causes. Alcohol-related causes contributed more to excess mortality than deaths due to cardiovascular disease.

Conclusion

External causes of death contributed more to the mortality gap than somatic causes after controlling for age-specific background general population mortality.

Clinical implication

A balanced consideration between therapeutic response, different treatment options and risk of cause-specific mortality is needed to prevent premature mortality in BD and to reduce the mortality gap.
Sustainability and impact of the implementation of a frailty checklist for the acute medical unit: experience from a tertiary public hospital in Singapore
Authors: Kasunuran-Cruz Maria Teresa , Tan Drusilla Kai Yan , Yeo Charmaine Yan , Hooi Benjamin Ming-Yew , Soong John Tshon Yit
Published: July 2023

Background

Accelerated population ageing is associated with an increasing prevalence of frailty. International guidelines call for systematic assessment and timely interventions for older persons requiring acute care. Checklists have been applied successfully in healthcare settings.

Objective

This study describes the implementation of a safety checklist for frailty in the acute medical unit (AMU) of a tertiary public hospital in Singapore. We explored the sustainability of processes up to 6 months after initial implementation. Additionally, we investigated process and system outcome benefits following the implementation of the checklist.

Methods

This retrospective observational study used case notes review of patients admitted to the AMU of a tertiary public hospital in Singapore from February to August 2019. Process outcomes measured to include compliance with AMU frailty checklist assessments and interventions at 24 hours of hospital admission. System and patient outcomes studied to include the length of hospital stay; 30-day emergency department reattendance rate; 30-day hospital readmission rate and inpatient mortality. Propensity scores were used to create balanced cohorts for comparison between those with complete and incomplete compliance with the checklist. Logistic regression was used to adjust for known confounders.

Results

Average weekly (all-or-nothing) compliance with the frailty checklist (14.7%) was sustained for 6 months. Where assessments detected high risk, appropriate interventions were appropriately triggered (44%–97.4%). While trends to benefit systems and patient outcomes were present, these were not statistically significant. Contextual patterns are discussed.

Conclusion

A safety checklist for frailty was feasibly implemented in the AMU. The checklist was a complex intervention. Full compliance with the checklist was challenging to achieve. Further research assessing optimal patient selection criteria and how checklists may shift team behaviour is a priority.
Preventing lost-to-follow up diagnostic imaging in ambulatory care: evaluation of an electronic notification tool
Authors: Dadlez Nina M , Le Clair Amy M , Wasima Syeda , Mayer Nicole , Harvey William F , Roberts Kari , Mazzullo John , Lominac Eric , Koethe Benjamin C , Weingart Saul N
Published: July 2023

Objective

Missed or cancelled imaging tests may be invisible to the ordering clinician and result in diagnostic delay. We developed an outpatient results notification tool (ORNT) to alert physicians of patients’ missed radiology studies.

Design

Randomised controlled evaluation of a quality improvement intervention.

Setting

23 primary care and subspecialty ambulatory clinics at an urban academic medical centre.

Participants

276 physicians randomised to intervention or usual care.

Main outcome measure

90-day test completion of missed imaging tests.

Results

We included 3675 radiology tests in our analysis: 1769 ordered in the intervention group and 1906 in the usual care group. A higher per cent of studies were completed for intervention compared with usual care groups in CT (20.7% vs 15.3%, p=0.06), general radiology (19.6% vs 12.0%, p=0.02) and, in aggregate, across all modalities (18.1% vs 16.1%, p=0.03). In the multivariable regression model adjusting for sex, age and insurance type and accounting for clustering with random effects at the level of the physician, the intervention group had a 36% greater odds of test completion than the usual care group (OR: 1.36 (1.097–1.682), p=0.005). In the Cox regression model, patients in the intervention group were 1.32 times more likely to complete their test in a timely fashion (HR: 1.32 (1.10–1.58), p=0.003).

Conclusions

An electronic alert that notified the responsible clinician of a missed imaging test ordered in an ambulatory clinic reduced the number of incomplete tests at 90 days. Further study of the obstacles to completing recommended diagnostic testing may allow for the development of better tools to support busy clinicians and their patients and reduce the risk of diagnostic delays.
In memoriam: Leif Svanström (1943–2023)
Authors: Hanson Dale William , Ekman Robert , Sleet David
Published: July 2023

Leif Svanström, born in Västervik, Sweden, on 30 October 1943, was a big man in physical and intellectual stature, persona and impact. Leif trained at Lund University, obtaining a BA in Genetics and Society in 1966, an MD in Preventative Medicine in 1972 and a PhD in Accident Prevention and Injury Control in 1973. He was appointed associate professor in the Department of Social Science at Lund University in 1978 and subsequently professor of Social Medicine at the Karolinska Institutet, Stockholm, Sweden, in 1980. The research group he led generated over 30 doctorate dissertations, 6 professors, more than 1000 papers and 20 textbooks. In 1989, he chaired the inaugural World Conference on Accident and Injury Prevention in Stockholm, Sweden, a conference that remains the premier international forum for injury prevention and safety promotion. Leif championed place-based, analytical, interdisciplinary, intersectoral, real-world injury prevention and safety promotion practice, culminating in the development of the Safe Community Model that spread internationally and ultimately created a network of over 430 designated International Safe Communities, with a population footprint of over 100 million people. For all these laudable achievements, it was Leif’s charismatic ability to inspire, teach, support, motivate and sustain those around him that produced his profound impact on the practice of injury prevention and safety promotion throughout the world. Leif Svanström passed away in Sweden on 29 January 2023 at age 79.
Persistent poverty and child dental caries: time-varying exposure analysis
Authors: Matsuyama Yusuke , Isumi Aya , Doi Satomi , Fujiwara Takeo
Published: July 2023

Background

This study investigated the cumulative impact of persistent poverty on dental caries among elementary schoolchildren in Japan.

Methods

Data were derived from four-wave longitudinal data of children in all public elementary schools in Adachi City, Tokyo, Japan, from 2015 to 2020 (n=4291, response rate: 80.1%–83.8%). Poverty status, defined as annual household income <JPY3 million, material deprivation or payment difficulties for lifeline utilities, was assessed by caregiver questionnaires when the children were in the first, second, fourth and sixth grades. School dentists assessed dental caries. We estimated the difference in the number of primary and permanent teeth with incidences of dental caries from second to sixth grade by persistent poverty and never having experienced poverty. Targeted maximum likelihood estimation was used to consider baseline and time-varying confounders.

Results

Children with persistent poverty experienced more dental caries (mean: 3.81, SD: 3.73) than children who had never experienced poverty (mean: 2.39, SD: 3.27). After controlling for confounders, being in persistent poverty was significantly associated with having more dental caries than never being in poverty (mean difference: 1.54, 95% CI 0.60, 2.48). The magnitude of the association was greater than that of poverty assessed at first grade only (mean difference: 0.75, 95% CI 0.35, 1.16) or experience of poverty at any of the four waves (mean difference: 0.69, 95% CI 0.39, 0.99).

Conclusion

The cumulative impact of persistent poverty could be larger than the poverty assessed at a single time point.
Does employment status mediate the association between disability status and mental health among young adults? Evidence from the Household, Income and Labour Dynamics in Australia (HILDA) survey
Authors: Shields Marissa , Spittal Matthew J , Aitken Zoe , Dimov Stefanie , Kavanagh Anne , King Tania Louise
Published: July 2023

Objective

Young adults with disabilities are less likely to be employed and more likely to have poor mental health than peers without disabilities. Growing evidence shows that social determinants of health may be causally related to mental health outcomes of people with disabilities. We aimed to assess if the disability to mental health association was mediated by employment status among young adults aged 20–35 years.

Methods

Four consecutive years (2016–2019) of data from the Household, Income and Labour Dynamics in Australia survey were used to conduct a causal mediation analysis. We decomposed the total causal effect of disability status on mental health (Short Form-36 Mental Health Inventory-5) into the natural direct effect from disability to mental health and the natural indirect effect representing the pathway through the employment mediator (being employed; being unemployed or wanting to work).

Results

3435 participants (3058 with no disabilities, 377 with disabilities) were included in the analysis. The total causal effect of disability status on mental health was an estimated mean decrease in mental health of 4.84 points (95% CI −7.44 to –2.23). The indirect effect, through employment status, was estimated to be a 0.91-point decline in mental health (95% CI −1.50 to –0.31).

Conclusions

Results suggest disability has an effect on the mental health of young adults; a proportion of this effect appears to operate through employment. The mental health of young adults with disabilities could potentially be improved with interventions to improve employment outcomes among this group, and by supporting individuals with disabilities into suitable employment.
Learning from parental experience in a neonatal surgical unit: a qualitative service evaluation
Authors: Littlejohns Anna , Crouzen Emile , Mernenko Rebecca , Metcalfe Fiona , Moni-Nwinia Waaka , Chauhan Hemma , Johnson Bethan , McConachie Douglas , Lawson Elizabeth , Tricklebank Victoria , McElwaine John G , Sagoo Gurdeep S , McKechnie Liz , Latchford Gary , Sutcliffe Jonathan
Published: July 2023

Objectives

Patient experience is directly related to health outcomes, and parental experience can be used as a proxy for this in neonatal care. This project was designed to assess parental experience of neonatal surgical care to inform future service developments and improve the care we provide.

Methods

This was a qualitative study using rapid qualitative analysis. The study was carried out in a large neonatal surgical intensive care unit in the UK. Parents of infants treated by the neonatal surgical team between March 2020 and February 2021, during the COVID-19 pandemic were included. Purposive sampling was used to ensure that a representative range of parents were interviewed. A semistructured interview was created and tested in a previous phase of work. This questionnaire was used to ask parents open questions about different aspects of their infants’ healthcare journey from the antenatal phase through to discharge from the neonatal unit (NUU).

Results

Rapid qualitative analysis was employed, and parental experiences were grouped into five main categories: before admission to the NNU, initial admission to NNU, information and support, COVID-19 and discharge. Within these five groups, we highlighted positive experiences to be fed back to the healthcare teams to reinforce good practice, areas that warranted improvement and suggestions for service development.

Conclusions

The wealth of data generated from the interviews has been summarized and shared with healthcare teams who are putting the service improvement suggestions into practice. The tool is available for services that wish to measure parental experience.
The reduction of saccadic inhibition by distractor repetition
Authors: Shan Yijing , Edelman Jay A.
Published: July 2023

This work combines approaches studying saccadic inhibition and visual adaptation to demonstrate that saccadic inhibition is largely eliminated with stimulus repetition. This is likely to be the largest demonstrated effect of visual stimulus context on saccadic inhibition. It also provides evidence for the existence of a mechanism that acts to suppress the effect of frequently appearing visual stimuli on purposive eye movement behavior in dynamic visual environments.
TargetingKRAS-Mutated NSCLC: Novel TKIs and Beyond
Authors: Cantor David J. , Aggarwal Charu
Published: July 2023

KRAS-mutated non–small cell lung cancer (NSCLC) is the most common genetically altered subtype of NSCLC, yet targeted therapies remain limited. Multiple studies have investigated combinations of MEK inhibitors with chemotherapy without success. Here we discuss these studies and novel approaches to targeting KRAS-mutated NSCLC.

See related article by Gadgeel et al., p. 3641
Homiletical-liturgical Perspectives on Life in the Anthropocene: The Preeminence of People's Cognition, Weltanschauung, and Homeless Minds
Authors: Kruger Ferdi Petrus
Published: July 2023

The central theme of this article is the matter of church participants’ engagement in liturgy and how this could enhance their capacity for making moral decisions when it comes to life in the Anthropocene. First, one should acknowledge that liturgists in faith communities have to deal with the notion of people enclaved in the idea of homeless minds. They are exposed to contradictory views on reality. The concept of cognitive dissonance needs to be addressed, and without constructive homiletical-liturgical address of this matter, it will lead to people looking for answers elsewhere. Liturgy inevitably enables participants to see things they do not or may not want to. People want to make sense of life and experiences in daily life, a process well-known as cognition. It should also be acknowledged that without reflection on the functioning of attitudes within Weltanschauung's framework, numerous challenges for any debate on life in the Anthropocene will be experienced. First, this article offers a description of the currently concerning aspects to be found under this rubric. Second, systemizing perspectives based on the philosophy of religion, anthropology, bioethics, and cognitive psychology are examined as centered on the intimate interplay with ethical conduct in viewing the world and liturgy. Finally, the following research question is formulated and briefly discussed: How could a homiletical-liturgical praxeology dealing with the homeless mind enable its participants to cultivate a Weltanschauung committed to a focused interest in the Anthropocene? The methodological approach of Browning has been carefully identified to arrange the research into coherent phases and reflect on the research question.
Voices of (m)otherhood: Listening to the experiences of single and childless women
Authors: Chan Rebecca , Rossen Larissa , Kwee Janelle
Published: July 2023

Single and childless women over the age of 35 constitute an expanding demographic in North America and many parts of the world, yet our society continues to place importance on marriage and family as markers of life success. This study explored how eight single (never-married) and childless women experience themselves during early midlife (ages 35–45) utilizing the Listening Guide method of analysis. Three categories of participant voices were uncovered in this research: voices which conveyed the positivity of living a single and childless identity (i.e. the voices of hope, faith, gratitude, nurturance, freedom, and resilience), voices which conveyed the struggles of living a single and childless identity (i.e. the voices of invisibility, shame, confusion, loneliness, guilt, longing, and uncertain waiting), and the voice of ambivalence. Implications for clinical practice and research are discussed.
“Defund” or “Refund” the Police?: City Council Responsiveness to the Black Lives Matter Protests
Authors: Hoang Bai Linh , Benjamin Andrea
Published: July 2023

In this research note, we investigate the degree to which local governments reduced or expanded the budgets of police departments in the aftermath of the nation-wide protests organized by the Black Lives Matter movement during the summer of 2020. We also consider the political and social factors that might explain local councils’ decisions on the budget. In analyzing an original dataset of about 100 of the most populous U.S. cities, we do not find strong evidence of government efforts to “defund” the police. However, across various specifications of potential responsiveness to the movement's demands, we do find that mayoral partisanship may be associated with local government decisions to meaningfully reduce their police budgets or abstain from increasing them, but even this relationship may not be sustained in the longer term. Thus, we encourage more research on barriers that potentially inhibit local government responsiveness to social movements like Black Lives Matter.
Toward conceptualizations of musical creativities in secondary education: An integrative literature review between 1990 and 2020
Authors: Lage-Gómez Carlos , Chatelain Sabine , Cremades-Andreu Roberto
Published: July 2023

Creativity has been described as an indissociable component of music education, complex to conceptualize and often overgeneralized. This article provides an overview of existing research on musical creativities in secondary education between 1990 and 2020. A total of 76 articles published in peer-reviewed journals are reviewed according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. To present and discuss the results, several dimensions of creativity research have been clustered into five categories: product, person/group, creative process, context, and domain. The 22.37% of the articles focus on the creative process, 14.47% on the context, 13.16% on the person/group perspective, and 1.32% on the product. The 48.68% of the studies focus on the domain perspective, showing an emphasis on specific activities traditionally associated with musical creativity like composing or improvising. Music listening is not present, and various forms of musical creativities are underrepresented. Over these three decades, an increasing orientation on teaching and learning within a sociocultural framework can be observed. In addition, the pedagogical challenges concern an expanded vision of creativity, albeit based on a specific and precisely defined framework.
Understanding how bundles of party reforms are shaped: A snowballing sequence in the French-speaking Belgian liberal party (MR)
Authors: Legein Thomas
Published: July 2023

This article introduces the concept of bundle as a new powerful tool in the study of party reforms. The intensive and intricate nature of the engineering political parties undertake to preserve the status quo amidst a challenging environment tends to be obscured by the focus on their so-called ‘conservative nature’. Applied to the process tracing of a large sequence of reforms implemented by the Belgian French-speaking liberal party (MR) between 2019 and 2022, the bundle concept provides the opportunity to go beyond the narrow vision of party reforms only defined and empirically studied so far through their type, size and success. I triangulate a variety of sources to uncover mechanisms through which a handful of key party actors - as powerful steering agents - perceive and translate environmental factors into specific reforms. The bundle analysis brings notably to light a key sequencing mechanism – a snowball effect – explaining how the sequence actually unfolded and fed on itself, challenging our hitherto accepted understanding of party engineering. This study also offers a transferable conceptual framework with valuable insights for wider use in the field, providing an avenue for theory building through causal analysis.
The relationship between school mental health service use in high school and educational outcomes of adolescents with psychiatric disorders
Authors: Kang-Yi Christina D , Arnold Kimberly T , Tieu Tiffany , Olubiyi Oluwatoyin , Xie Ming , Lawson Gwendolyn M , Locke Jill , Pisciella Aelesia E
Published: July 2023

This study aimed to examine the relationship between school mental health service use in high school and educational outcomes of adolescents with psychiatric disorders. The sample included 2617 adolescents who were enrolled in eighth grade in a large urban school district in the United States, were enrolled in Medicaid during eighth grade, and had a mental health diagnosis. Psychiatric hospitalization, school enrollment, school absences, out-of-school suspensions, school dropouts, and school exits for negative reasons were examined as mental health and educational outcomes. Compared with adolescents who used school mental health services for 2 years following eighth grade, adolescents who did not use school mental health service during the high school years had a significantly lower annual number of days enrolled in school and higher rates of exiting school for negative reasons such as school dropout and long-term hospitalization. Our findings support the positive role of school mental health care delivery in high schools in preventing negative educational outcomes for adolescents with psychiatric disorder.
Profiles of First-Generation College Students: Social, Financial, Academic, and Cultural Barriers to College Lives
Authors: Ko Kwangman , Bartoszuk Karin , Peek Steven Austin , Hurley Michelle
Published: July 2023

First-generation college students (FGCSs) are known to experience more difficulty in the college education environment compared to continuing-generation college students. The current study used a person-centered approach to investigate subgroups of FGCSs that have had similar experiences of social, financial, academic, and cultural barriers in their college lives. A total of 382 undergraduate students in the U.S. participated in the study. A latent profile analysis revealed there may be two particular profiles for FGCSs including these four barriers. FGCSs in Profile 2 reported more social, financial, academic, and cultural barriers. In addition, these students also reported lower levels of self-esteem and higher levels of stress, anxiety, depression, and drop-out intention than those in Profile 1. Students’ gender, their parent's marital status, and the estimated debt after graduation significantly predicted profile membership. Interventions to support FGCSs will also be discussed.
Walking in Between: a Collaged Storytelling of Data Collection During the Pandemic
Authors: Li Beixi
Published: July 2023

Collage inquiry is an arts-based research approach that encourages researchers and participants to exercise nonlinear thinking. The purpose of this article is to present a collaged storytelling of my qualitative data collection experience during the COVID-19 pandemic. In the academic research cycle, data collection was most likely to be affected by the pandemic. Using my data collection digital footprints as primary materials, I reflected on my collage-making steps and the unexpected insights and learning emerged in the process. The collage-making process enriched my understanding of qualitative research and my scholarly identity as a responsible qualitative researcher.
Literary accountability and the future of human rights protection
Authors: Destrooper Tine
Published: July 2023

Human rights are increasingly described as in crisis. One reason for this is that existing legal accountability mechanisms cannot adequately deal with intricate and multilayered human rights violations that occur in vastly complex social contexts. Thus, if human rights are to continue to offer a widely accepted framework for thinking about (social) justice, we urgently need to revisit the very notion of human rights accountability in ways that allow for better protection as well as for a more ambitious normative project. This requires re-focusing the debate about human rights accountability on questions of human rights normativity. This article explores which roles literature can play in this regard. It proposes the notion of literary accountability as a conceptual device to (a) recenter the debate around the normative objectives of human rights accountability, (b) offer modalities for ensuring some form of responsibility attribution, notably where other accountability venues are closed or deemed insufficient, and (c) operate within the paradigm of legal accountability to push the boundaries of this paradigm. What each of these three manifestations of literary accountability have in common is that they foreground the need for a more forward-looking and multi-dimensional approach to accountability that seeks to reconnect the normative reality of human rights on one hand, with their imbrication in the concrete worlds of law, politics, and practicalities on the other.
Application of artificial intelligence in medical technologies: A systematic review of main trends
Authors: Bitkina Olga Vl , Park Jaehyun , Kim Hyun K.
Published: July 2023

Objective

Artificial intelligence (AI) has been increasingly applied in various fields of science and technology. In line with the current research, medicine involves an increasing number of artificial intelligence technologies. The introduction of rapid AI can lead to positive and negative effects. This is a multilateral analytical literature review aimed at identifying the main branches and trends in the use of using artificial intelligence in medical technologies.

Methods

The total number of literature sources reviewed is n = 89, and they are analyzed based on the literature reporting evidence-based guideline PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) for a systematic review.

Results

As a result, from the initially selected 198 references, 155 references were obtained from the databases and the remaining 43 sources were found on open internet as direct links to publications. Finally, 89 literature sources were evaluated after exclusion of unsuitable references based on the duplicated and generalized information without focusing on the users.

Conclusions

This article is identifying the current state of artificial intelligence in medicine and prospects for future use. The findings of this review will be useful for healthcare and AI professionals for improving the circulation and use of medical AI from design to implementation stage.
What Teams Do: Exploring Volunteer Content Moderation Team Labor on Facebook
Authors: Gibson Anna D.
Published: July 2023

Social media sites such as Facebook depend on tens of millions of volunteer moderators across the globe to facilitate platform-based discussion forums. While research has revealed much about the work that these moderators do, some fundamental questions remain. For example, why do volunteer moderators commonly work as teams rather than individuals? In this article, I use data gathered through digital ethnography with Facebook Group moderators to explore the benefits and challenges of moderation team work. I develop a three-part framework to articulate how teams facilitate logistical, discursive, and emotional labor. Finally, I argue that this empirical analysis reveals otherwise hidden and unacknowledged dimensions of volunteer moderation work that make platform-hosted discussion groups possible.
Three Psychometric Scales for Groove Research: Inner Representation of Temporal Regularity, Time-Related Interest, and Energetic Arousal
Authors: Senn Olivier , Bechtold Toni Amadeus , Jerjen Rafael , Kilchenmann Lorenz , Hoesl Florian
Published: July 2023

This study develops three composite psychometric scales for the use in listening experiments across music psychology. The new scales measure the following three psychological constructs: (1) Inner representation of temporal regularity: This scale allows listeners to assess to what extent they experience a subjective feeling of temporal regularity and predictability while listening to music. The scale consists of four items, and it measures the underlying construct with good reliability (Cronbach's α = .88). (2) Time-related interest: This scale measures how much listeners feel that the rhythm of the music captures their attention. The scale consists of three items and shows good reliability (α = .85). (3) Energetic arousal: This scale measures how much the listeners feel energized while they are listening to music. The scale uses four items and has excellent reliability (α = .95). The development of the scales was motivated by the psychological model of musical groove in which the three underlying psychological constructs play an important role; the new scales serve to test the model hypotheses. The three scales can also be administered separately and might prove to be useful in research contexts within music psychology that investigate subjective experiences of temporal regularity, interest, or energetic arousal in music listeners.
The conflicting geographies of social frontiers: Exploring the asymmetric impacts of social frontiers on household mobility in Rotterdam
Authors: Olner Dan , Pryce Gwilym , van Ham Maarten , Janssen Heleen
Published: July 2023

Social frontiers arise when there are sharp differences in the demographic composition of adjacent communities. This paper provides the first quantitative study of their impact on household mobility. We hypothesise that conflicting forces of white flight and territorial allegiance lead to asymmetrical effects, impacting residents on one side of the frontier more than the other due to differences in the range of housing options available to different groups, and different symbolic interpretations of the frontier. Using Dutch registry data for the city of Rotterdam we identify ethnic social frontier locations using a Bayesian spatial model ( Dean et al., 2019 ), exploiting the data’s one hundred metre resolution to estimate frontiers at a very small spatial scale. Regression analysis of moving decisions finds that the ethnic asymmetry of the frontier matters more than ethnicity of individual households. On the ethnic minority side of the frontier, households of all ethnicities in the 28–37 age range have reduced probability of moving compared to non-frontier parts of the city. The opposite is true on the Dutch native side of the frontier. We supplement this analysis with flow models which again find strong frontier effects. Our findings illustrate how the study of social frontiers can shed light on local population dynamics and neighbourhood change.
Small interfering RNA–mediated allele-selective silencing of von Willebrand factor in vitro and in vivo
Authors: Jongejan Yvonne K. , Schrader Echeverri Elisa , Dirven Richard J. , Paunovska Kalina , Linthorst Noa A. , de Jong Annika , Wellershoff Johannes C. , van der Gouw Kim D. , van Vlijmen Bart J. M. , Dahlman James E. , Eikenboom Jeroen C. J.
Published: July 2023

An imbalance in von Willebrand factor (VWF) may either lead to bleeding (von Willebrand disease, VWD) or thrombosis. Both disorders have shortcomings in the currently available treatments. VWF itself could be a potential therapeutic target because of its role in both bleeding and thrombosis. Inhibiting VWF gene expression through allele-selective silencing of VWF with small interfering RNAs (siRNAs) could be a personalized approach to specifically inhibit mutant VWF in VWD or to normalize increased VWF levels in thrombotic disorders without complete VWF knockdown. Therefore, we investigated a method to allele-selectively silence the VWF gene in mice as a therapeutic strategy. Fourteen candidate siRNAs targeting murine Vwf of either the C57BL/6J (B6) or the 129S1/SvImJ (129S) strain were tested in vitro in cells expressing B6- and 129S-Vwf for inhibitory effect and allele-selective potential. Together with a nonselective siVwf, 2 lead candidate siRNAs, siVwf.B6 and siVwf.129S, were further tested in vivo in B6 and 129S mice. Efficient endothelial siRNA delivery was achieved by siRNA encapsulation into 7C1 oligomeric lipid nanoparticles. Treatment with the nonselective siVwf resulted in dose-dependent inhibition of up to 80% of both lung messenger RNA and plasma VWF protein in both mouse strains. In contrast, the allele-selective siVwf.B6 and siVwf.129S were shown to be effective in and selective solely for their corresponding mouse strain. To conclude, we showed efficient endothelial delivery of siRNAs that are highly effective in allele-selective inhibition of Vwf in mice, which constitutes an in vivo proof of principle of allele-selective VWF silencing as a therapeutic approach.
Young people’s proposals for a web-based intervention for sexual health promotion: a French qualitative study
Authors: Martin Philippe , Alberti Corinne , Gottot Serge , Bourmaud Aurélie , de La Rochebrochard Elise
Published: July 2023

Background

Promoting sexual health is key to improving the supportive behaviors and well-being of young people. With the advent of the Internet, web-based features for sexual health promotion may be attractive to a diverse range of young people. This study aims to assess young people’s proposals regarding a web-based intervention for sexual health promotion.

Methods

Nineteen French young people aged 15–24 years participated to the study. In a semi-structured interview, they presented their views on a web-based intervention for sexual promotion. Data were coded with N’Vivo and subjected to qualitative thematic analysis to explore their proposals.

Results

The majority of participants (n = 18) thought that a web-based intervention for sexual health promotion would be attractive. Young people interviewed made 31 concrete proposals for sexual health promotion on the Internet. Participatory and interactive dimensions on the internet appeared essential, with the need for stimulating activities and interaction with peers, but also with competent professionals and moderation. Face to the risks of the internet, they expressed the need of a secure and confidential space, to generate trust and participation in intervention. For participants, sexual health should be addressed in all its dimensions, taking into account the relational, sexual, and gender dimensions, and by incrementing on the internet valid, credible and personalized content.

Conclusions

In sexual health promotion, young people are indispensable stakeholders who can make concrete proposals and can also participate in content creation and research. More broadly, in health promotion, involving target audiences in decisions represents a promising perspective.
Suprascapular nerve entrapment caused by a large hematoma of the scapula: a case report
Authors: Joo Yong Bum , Lee Woo Yong , Chung Hyung Jin
Published: July 2023

Background

Suprascapular nerve entrapment is a rare disorder that is frequently misdiagnosed as another disease. The suprascapular nerve is commonly entrapped at the following two sites: the suprascapular and spinoglenoid notches. Nerve entrapment at the spinoglenoid notch causes infraspinatus muscle weakness and atrophy. Patients present with posterior shoulder pain and weakness. Magnetic resonance imaging is used to confirm the diagnosis of a spinoglenoid cyst and nerve compression. Open or arthroscopic aspiration or decompression is indicated for patients with cysts in whom conservative treatment has failed and those with cysts associated with suprascapular nerve compression.

Case presentation

Herein, we describe the case of a 49-year-old man with suprascapular nerve entrapment caused by a large cyst, namely, a hematoma, in the superior scapular and spinoglenoid notches. Open surgical decompression of the suprascapular nerve was performed owing to an intact rotator cuff and glenoid labrum.

Conclusion

Posterior shoulder pain promptly resolved without complications.
Implementation strategies, facilitators, and barriers to scaling up and sustaining post pregnancy family planning, a mixed-methods systematic review
Authors: Nabhan Ashraf , Kabra Rita , Allam Nahed , Ibrahim Eman , Abd-Elmonem Norhan , Wagih Nouran , Mostafa Nourhan , Kiarie James ,   Family Planning Research Collaborators, Zenhom Ahmed , Ashraf Alyaa , Alshabrawy Amal , Atwa Emry , Elghamry Fatma , Abouelnaga Mai , Kodsy Mariam , Elgendi Marwa , Snosi Marwa , Kamel Menna , Salama Mohamed , Makram Nada , Sakna Noha , Eltayeb Salma , bahnasy Samhaa , Galal Sara , Taha Shorouk
Published: July 2023

Background

Post pregnancy family planning includes both postpartum and post-abortion periods. Post pregnancy women remain one of the most vulnerable groups with high unmet need for family planning. This review aimed to describe and assess the quality of the evidence on implementation strategies, facilitators, and barriers to scaling up and sustaining post pregnancy family planning.

Methods

Electronic bibliographic databases (MEDLINE, PubMed, Scopus, the Cochrane Library, and Global Index Medicus) were searched from inception to October 2022 for primary quantitative, qualitative, and mixed method reports on scaling up post pregnancy family planning. Abstracts, titles, and full-text papers were assessed according to the inclusion criteria to select studies regardless of country, language, publication status, or methodological limitations. Data were extracted and methodological quality assessed using the Mixed Methods Appraisal Tool. The convergent integrated approach and a deductive thematic synthesis were used to identify themes and sub-themes of strategies to scale up post pregnancy family planning. The health system building blocks were used to summarize barriers and facilitators. GRADE-CERQual was used to assess our confidence in the findings.

Results

Twenty-nine reports (published 2005–2022) were included: 19 quantitative, 7 qualitative, and 3 mixed methods. Seven were from high-income countries, and twenty-two from LMIC settings. Sixty percent of studies had an unclear risk of bias. The included reports used either separate or bundled strategies for scaling-up post pregnancy family planning. These included strategies for healthcare infrastructure, policy and regulation, financing, human resource, and people at the point of care. Strategies that target the point of care (women and / or their partners) contributed to 89.66% (26/29) of the reports either independently or as part of a bundle. Point of care strategies increase adoption and coverage of post pregnancy contraceptive methods.

Conclusion

Post pregnancy family planning scaling up strategies, representing a range of styles and settings, were associated with improved post pregnancy contraceptive use. Factors that influence the success of implementing these strategies include issues related to counselling, integration in postnatal or post-abortion care, and religious and social norms.

Trial registration

Center for Open Science, OSF.IO/EDAKM
Beyond Plan-Do-Study-Act cycle – staff perceptions on facilitators and barriers to the implementation of telepresence robots in long-term care
Authors: Wong Joey , Young Erika , Hung Lillian , Mann Jim , Jackson Lynn
Published: July 2023

Background

Quality improvement (QI) programs with technology implementations have been introduced to long-term care (LTC) to improve residents’ quality of life. Plan-Do-Study-Act (PDSA) cycle is commonly adopted in QI projects. There should be an appropriate investment of resources to enhance learning from iterative PDSA cycles. Recently, scholars explored possibilities of implementation science (IS) with QI methods to increase QI projects’ generalisability and make them more widely applicable in other healthcare contexts. To date, scant examples demonstrate the complementary use of the two methods in QI projects involving technology implementation. This qualitative study explores staff and leadership teams’ perspectives on facilitators and barriers of a QI project to implement telepresence robots in LTC guided by the Consolidated Framework for Implementation Research (CFIR).

Methods

We employed purposive and snowballing methods to recruit 22 participants from two LTC in British Columbia, Canada: operational and unit leaders and interdisciplinary staff, including nursing staff, care aides, and allied health practitioners. CFIR was used to guide data collection and analysis. Semi-structured interviews and focus groups were conducted through in-person and virtual meetings. Thematic analysis was employed to generate insights into participants’ perspectives.

Results

Our analysis identified three themes: (a) The essential needs for family-resident connections, (b) Meaningful engagement builds partnership, and (c) Training and timely support gives confidence. Based on the findings and CFIR guidance, we demonstrate how to plan strategies in upcoming PDSA cycles and offer an easy-to-use tool ‘START’ to encourage the practical application of evidence-based strategies in technology implementation:Share benefits and failures;Tailor planning with staff partners;Acknowledge staff concerns;Recruit opinion leaders early; andTarget residents’ needs.

Conclusions

Our study offers pragmatic insights into the complementary application of CFIR with PDSA methods in QI projects on implementing technologies in LTC. Healthcare leaders should consider evidence-based strategies in implementing innovations beyond PDSA cycles.
Identification of cell subpopulations associated with disease phenotypes from scRNA-seq data using PACSI
Authors: Liu Chonghui , Zhang Yan , Gao Xin , Wang Guohua
Published: July 2023

Background

Single-cell RNA sequencing (scRNA-seq) has revolutionized the transcriptomics field by advancing analyses from tissue-level to cell-level resolution. Despite the great advances in the development of computational methods for various steps of scRNA-seq analyses, one major bottleneck of the existing technologies remains in identifying the molecular relationship between disease phenotype and cell subpopulations, where “disease phenotype” refers to the clinical characteristics of each patient sample, and subpopulation refer to groups of single cells, which often do not correspond to clusters identified by standard single-cell clustering analysis. Here, we present PACSI, a method aimed at distinguishing cell subpopulations associated with disease phenotypes at the single-cell level.

Results

PACSI takes advantage of the topological properties of biological networks to introduce a proximity-based measure that quantifies the correlation between each cell and the disease phenotype of interest. Applied to simulated data and four case studies, PACSI accurately identified cells associated with disease phenotypes such as diagnosis, prognosis, and response to immunotherapy. In addition, we demonstrated that PACSI can also be applied to spatial transcriptomics data and successfully label spots that are associated with poor survival of breast carcinoma.

Conclusions

PACSI is an efficient method to identify cell subpopulations associated with disease phenotypes. Our research shows that it has a broad range of applications in revealing mechanistic and clinical insights of diseases.
Random capillary glucose levels throughout pregnancy, obstetric and neonatal outcomes, and long-term neurodevelopmental conditions in children: a group-based trajectory analysis
Authors: Chen Shuyun , Persson Margareta , Wang Rui , Dalman Christina , Lee Brian K. , Karlsson Håkan , Gardner Renee M.
Published: July 2023

Background

Gestational diabetes mellitus (GDM) is associated with both short- and long-term risks, although it is unknown if risks vary by severity, timing, and duration of gestational hyperglycemia. We aimed to identify trajectories of random capillary glucose (RCG) levels throughout pregnancy and assess their associations with both obstetric/neonatal outcomes and children’s risk of neurodevelopmental conditions (NDCs) (i.e., autism, intellectual disability, and attention-deficit/hyperactivity disorders [ADHD]).

Methods

A population-based cohort study was conducted involving 76,228 children born to 68,768 mothers without pregestational diabetes. Group-based trajectory modeling was utilized to identify distinct glucose trajectories across RCG values throughout the course of pregnancy. The associations between these trajectory groups and obstetric/neonatal outcomes as well as children’s NDCs were then assessed using generalized estimating equation models with a logit link. The Benjamini-Hochberg (BH) procedure was employed to adjustP-values for multiple comparisons, controlling the false discovery rate (FDR).

Results

Five distinct glucose trajectory groups were identified, each with varying percentages diagnosed with GDM. Their associations with obstetric/neonatal outcomes as well as children’s NDCs varied. For example, when compared to the “Persistently Low” group, other groups exhibited varying degrees of increased risk for large-for-gestational-age babies, with the exception of the “High in Early Pregnancy” group. Compared to the “Persistently Low” group, all other trajectory groups were associated with NDC outcomes, except the “High in Mid-Pregnancy” group. However, none of the associations with offspring NDCs remained significant after accounting for the FDR correction.

Conclusions

Persistent high glucose levels or moderately elevated glucose levels throughout pregnancy, as well as transient states of hyperglycemia in early or mid-pregnancy, were found to be associated with increased risks of specific obstetric and neonatal complications, and potentially offspring NDCs. These risks varied depending on the severity, timing, duration, and management of hyperglycemia. The findings underscore the need for continuous surveillance and individualized management strategies for women displaying different glucose trajectories during pregnancy. Limitations such as potential residual confounding, the role of mediators, and small sample size should be addressed in future studies.