bluuebunny/crossref_metadata_2025 huggingface dataset:
Can an Electoral System Ensure Real Representation? The Poona Pact and Preferable Dalit Representatives
Authors: Biswas Sujay
Published: June 2023

This article challenges the traditional view that Dalits† gave up their right to representation when Ambedkar signed the Poona Pact and agreed to joint electorates, which allowed caste Hindus to elect ‘failed’ Dalit candidates of the primaries in the final polls. The article shows that upper-caste Hindus cast their votes for the same Dalit candidates in the final elections who received the highest Dalit votes in the primaries through an examination of the provincial elections in 1936−1937 and 1945−1946. The article argues that Dalit candidates elected either through joint or separate electorates cannot necessarily guarantee the autonomy of Dalit representatives. It contends that only Dalit legislators having the epistemic aspect emphasised by Ambedkar and the empathetic character underlined by Gandhi can be preferable representatives of Dalit interests.
Hegemony of Exotic Material Culture of the Adis: A Review on Cross-culture Interaction of the Tibetans and Adis
Authors: Nayak Prasanta Kumar , Pertin Mijina
Published: June 2023

One of the tribes of Arunachal Pradesh, the Adis, lacked the skill to produce finished goods they used, yet they obtained them from Tibet by means of long-distance trade. Tibetan material culture adopted by the Adis was borrowed directly through cross-border trade and indirectly from the neighbouring tribes. The exotic goods had multitude of functions in the Adi society. The use of such goods in the Adi society had no relation with the purpose they were actually produced for. Some had different values in terms of utility. The cultural value of such goods got inculcated in Adi society due to their meaning-based application. In due course of time, some got indigenised and carried face value as wealth of the Adis. This paper aims at understanding the hegemony of the Tibetan material culture in Adi society. Focus shall be shed on the overview of the dynamism of material culture with an illustration which is prevalent at present too. It brought changes in the belief and socio-economic life of the Adis. It is significant to bring it to light because the appropriation of exotic materials played a vital role in the historical trajectory of the Adis. The study here is empirical as well as historical. Primarily, oral narratives of the persons who have witnessed this process during the second half of the twentieth century are considered in data collection. In addition, available written accounts are taken into account to theme out this paper.
Cost-related prescription non-adherence and patient-reported outcomes in systemic lupus erythematosus: The Michigan Lupus Epidemiology & Surveillance program
Authors: Minhas Deeba , Marder Wendy , Hassett Afton L , Zick Suzanna M , Gordon Caroline , Harlow Sioban D , Wang Lu , Barbour Kamil E , Helmick Charles G , McCune W Joseph , Somers Emily C
Published: June 2023

Objectives

Medication access and adherence play key roles in determining patient outcomes. We investigated whether cost-related non-adherence (CRNA) to prescription medications was associated with worse patient-reported outcomes in a population-based systemic lupus erythematosus (SLE) cohort.

Methods

Sociodemographic and prescription data were collected by structured interviews in 2014–2015 from patients meeting SLE criteria in the established Michigan Lupus Epidemiology & Surveillance (MILES) Cohort. We examined the associations between CRNA and potential confounders such as sociodemographics and health insurance coverage, and outcome measures of SLE activity and damage using multivariable linear regression.

Results

462 SLE participants completed the study visit: 430 (93.1%) female, 208 (45%) Black, and mean age 53.3 years. 100 (21.6%) participants with SLE reported CRNA in the preceding 12 months. After adjusting for covariates, CRNA was associated with both higher levels of current SLE disease activity [SLAQ: β coeff 2.7 (95% CI 1.3, 4.1), p < 0.001] and damage [LDIQ β coeff 1.4 (95% CI 0.5, 2.4), p = 0.003]. Race, health insurance status, and fulfilling Fibromyalgia (FM) Survey Criteria were independently associated with both higher (worse) SLAQ and LDIQ scores; female sex was further associated with higher SLAQ scores.

Conclusion

Patients with SLE who reported CRNA in the previous 12 months had significantly worse self-reported current disease activity and damage scores compared to those not reporting CRNA. Raising awareness and addressing barriers or concerns related to financial implications and accessibility issues in care plans may help to improve these outcomes.
Hermann von Boyen the Elder and his Impact on the Prussian Army After 1815
Authors: Jędrysiak Jacek
Published: June 2023

Author of Hermann von Boyen's biography, Friedrich Meinecke stated that the contributions of Prussian twice (1815–1819 and 1841–1847) Minister of War to the military theory were almost completely forgotten. Despite the existence of many thousands of manuscript pages, this opinion is still considered valid to this day. The chief architect of the Landwehr system was also the founder of the concept of the ‘defence system’, crucial to understanding Prussian military thought in the first half of the nineteenth century. This idea influenced, in my opinion, the way of thinking about warfare within the Prussian Army far more than the Carl von Clausewitz's Vom Kriege.
Impact of Mortgage Repayments Withdrawal Threat on Banking Stocks: An Event Study in China
Authors: He Junlin , Lau Wei-Theng , Yu Lei , Zhu Yunchen
Published: June 2023

In July 2022, several media outlets reported news of Chinese homebuyers refusing to repay mortgages on unfinished buildings. It is uncertain whether this event would have had an impact on bank returns as, there is not an overwhelming amount of literature available. Therefore, we collected data from 43 A-share listed banks and the CSI 300 Index for 191 trading days. Based on the Theory of the Efficient Market Hypothesis, we used an Event Study Method to explore whether the returns of bank stocks were affected by this event. By calculating the Average Abnormal Returns and Cumulative Abnormal Returns of the samples, we found that although the withdrawal of mortgage repayments by homebuyers had a short-term significant negative impact on the returns of banks’ stocks, it was quickly absorbed by the market. We consider this may be related to the risk announcements issued by some banks. Additionally, we have provided recommendations for homebuyers, banks, and relevant institutions based on our findings.
Border Region Railway Development in Sino- Indian Geopolitical Competition
Authors: Shrivastva Chitresh , Roy Stabak , Ashok Dhruv
Published: June 2023

India and China share about 3,488 km long International Boundary, which has three sectors: Western, Middle and Eastern. The Eastern sector comprises two Northeastern states, that is, Arunachal Pradesh measuring 1,124 kms and Sikkim measuring 219 kms, respectively. Due to recent changes in the geopolitical relationship with China, border management and transport infrastructure development have occupied centre stage. In recent years, the Government of India has taken initiatives to develop railway infrastructure in Northeast India. The study will focus on the role of railway transportation in Sino-Indian geopolitical competition. The study is based on secondary data collected from the office of General Manager, Northeast Frontier Railway, the Census of India and reports of Memorandums of Understanding between India and China. The study reveals that railway infrastructure along the border creates geo-psychological pressures on both countries, influencing the divergent geopolitical relationship between India and China. Railway diplomacy is a tool kit of critical geopolitics which reveals the contours of geopolitical competition in borderlands.
Training and specialisation of psychiatrists in ADHD
Authors: Ryan Margaret
Published: June 2023

Objective

To identify the level of training of Australian psychiatrists in Attention Deficit Hyperactivity Disorder (ADHD), and to compare the number of psychiatrists specialising in ADHD versus other psychiatric conditions on the basis of the prevalence of conditions, by interrogating the RANZCP ‘Find a Psychiatrist’ database.

Conclusion

Fewer psychiatrists listed in the RANZCP database specialise in ADHD than in many other psychiatric conditions. Given that 5% of the Australian population suffers from ADHD, the condition can have significant adverse outcomes and is a common comorbidity with other psychiatric conditions, the RANZCP Training Program would be improved by requiring an in-depth knowledge of ADHD. Further training in ADHD would assist many practising psychiatrists.
Bovine respiratory syncytial virus infection in feedlot cattle cases in Argentina
Authors: Ferella Alejandra , Streitenberger Nicolás , Pérez Aguirreburualde María S. , Dus Santos María J. , Fazzio Luis E. , Quiroga María A. , Zanuzzi Carolina N. , Asin Javier , Carvallo Francisco , Mozgovoj Marina V. , Uzal Francisco A.
Published: June 2023

Although bovine respiratory syncytial virus (BRSV) infection has been reported in cattle in Argentina, it has not been associated with pneumonia in Argentina. We report here 5 cases of bovine pneumonia associated with BRSV. Autopsies were performed on 35 beef cattle with gross and/or microscopic lesions of pneumonia from 3 commercial feedlots. Lung samples in 5 of 35 animals were BRSV-positive by reverse-transcription nested PCR. The lungs of 2 of these 5 animals were coinfected with Mannheimia haemolytica, and 1 with bovine viral diarrhea virus 1. Microscopically, the lungs of 3 of the 5 BRSV PCR–positive animals had fibrinosuppurative bronchopneumonia, with or without pleuritis; 2 of the 5 had interstitial pneumonia. We conclude that BRSV is part of the bovine respiratory disease complex in Argentina.
Dynamics modelling and influencing factor analysis of a rocket-launcher coupling system considering uncertain parameters
Authors: Miao Yunfei , Wang Guoping , Rui Xiaoting , Li Bo
Published: June 2023

Vibration characteristic is an important factor affecting the motion of rocket in the launcher and its firing performance. In this paper, a rocket-launcher coupling dynamics model is proposed by applying the transfer matrix method for multibody systems. Considering manufacturing error and nonlinear contact force, the dynamics equations of the rocket-launcher coupling system during the whole process of firing are deduced. Combined with the dynamics model and equations, a dynamics simulation system is developed with uncertain parameters. The uncertain parameter description scheme and probability sampling scheme are proposed to obtain dynamics characteristic and firing performance of the system. The relevant tests are carried out to verify simulation results. Then, the factors affecting the firing performance are discussed. In view of the analysis results, the influence weight of initial disturbance on firing precision is 85% under the condition of full-loading continuous firing, and the swing angular velocity of rocket at muzzle is the main influence factor.
New Patients in Treatment for Opioid Addiction in Spain
Authors: Pulido Jose , Pastor-Moreno Guadalupe , Guerras Juan Miguel , Belza María José , Cáceres Ana , Cea-Soriano Lucía , Sordo Luis
Published: June 2023

Introduction:

Patients seeking first time treatment for opioid consumption reflect the characteristics of the consumer population. This group has not been studied in Spain in decades. The objective of this study was to characterize the opioid user population seeking first time treatment (incidents) and compare them group with those with prior treatment (prevalents).

Methods:

Cross-sectional study (N = 3325) with patients with opioid addiction seeking care at public addiction centers in the Community of Madrid from 2017 through 2019. Differentiation and comparisons were carried out using bivariate analysis, adjusted by sociodemographic characteristics related and those related to substance use consumption in incident and prevalent patients.

Results:

About 12.2% were incidents. Compared to prevalents, there were more foreigners (34.1% vs 19.1% P < .001), but with a better social network. Regarding opioid use, incidents were less likely to use injection (10.7% compared to 16.8% P = .008), but had greater daily frequency (75.8% vs 52.2%, P < .001). The age of initial consumption was greater (27 years vs 21.3 years, ( P < .001)). About 15.5% of incidents sought care for non-heroin opioids, compared to 4.8% of prevalents ( P < .001). Women sought care at twice the rate of men (29.3% vs 12.3%; P > .001).

Discussion:

New patients presented a profile with many stable characteristics, but which highlighted an increase in the use of other opioids, as occurs in the international context. Surveillance of the new patient characteristics can serve as an early indicator of consumption changes in. Thus, periodic monitoring is important.
New pathways to crisis resilience: solutions for improved digital connectivity and capability in rural Australia
Authors: Marshall Amber , Wilson Carrie-Ann , Dale Allan
Published: June 2023

Despite recent investments in telecommunications infrastructure in regional Australia, a digital divide remains between rural and urban communities. The impacts of comparatively limited digital connectivity in rural Australia include fewer opportunities for economic participation, difficulty accessing health and educational services, and challenges responding to crisis events such as natual disasters and the COVID-19 pandemic. There is an acute need for improved access to robust mobile and broadband services before, during and after crises in rural Australia. This article presents solutions for improved digital connectivity and digital capability in Far North Queensland, founded in a project that brought together researchers, business owners, councils, development organisations, technical experts and service providers to collaboratively identify and define telecommunications challenges related to a catastrophic flood in 2019. The research supports telecommunications providers, state and local governments, and community development organisations working together to collaboratively invest in technical and social solutions that enable rural communities to achieve greater crisis resilience.
The collaboration dilemma in smart city projects: Time to ask the right questions
Authors: Thabit Sara , Mora Luca
Published: June 2023

This Connexions article links collaboration in smart city projects, a contemporary and undertheorised social challenge, with theories on assemblage thinking, organisation, and public value creation. Using this multidisciplinary lens, we critically analyse smart city theory and expose the inability of prevailing collaborative models to properly account for the complexities of real-world practices. Building on our observations, we formulate a new and more robust theoretical perspective on smart city collaboration, which helps us trigger new research questions that focus on procedural, relational and diversity factors previously ignored.
Problematic familial alcohol use and adolescent outcomes: Do associations differ by parental education?
Authors: Wahlström Joakim , Magnusson Charlotta , Svensson Johan , Låftman Sara Brolin
Published: June 2023

Aim: To investigate the associations between problematic familial alcohol use and adolescent subjective health, binge drinking, relationships with parents, school performance, and future orientation, and to study whether these associations differ in relation to parental education. Methods: Cross-sectional data from the Stockholm School Survey (SSS) collected among students in the 9th and 11th grades in 2018 and in 2020 were used (n = 19,415). Subjective health, parent-youth relationships, and school performance were coded as continuous variables; binge drinking and future orientation were coded as binary variables. Familial drinking included three categories: problematic; don't know/missing; and not problematic. Parental university education distinguished between adolescents with two, one, or no university-educated parent(s). Control variables included gender, grade, family structure, migration background, parental unemployment, and survey year. Linear and binary logistic regression analyses were performed. Results: Problematic familial alcohol use was associated with worsened subjective health, a higher likelihood of engaging in binge drinking, worse relationships with parents, and a higher likelihood of having a pessimistic future orientation, even when adjusting for all control variables. Having less than two university-educated parents was associated with a higher likelihood of reporting problematic familial alcohol use. Parental university education moderated the association between problematic familial alcohol use and binge drinking as this relationship was stronger for adolescents with no and one university-educated parent(s). Conclusions: Adolescents with problematic familial alcohol use fared worse with regards to all studied outcomes, except for school performance. Parental university education only moderated the association between problematic familial alcohol use and binge drinking. However, since problematic familial alcohol use was more common among adolescents with less than two university-educated parents, we argue that at the group level, this category may be more negatively affected by alcohol abuse in the family. Policy interventions could benefit from having a socioeconomic perspective on how children are affected by alcohol's harms to others.
School principals, selection criteria, and responsibilities: Challenges in educational policy implementation
Authors: Khanal Jeevan , Regmi Kapil Dev
Published: June 2023

Failure in implementing education policy affects not only school leadership practices but also the overall quality of public education. This study aims to investigate the implementation of educational policies made for (a) the recruitment of school principals and (b) guiding their responsibilities in community schools of Nepal. Drawing on interviews conducted with 12 principals and six teachers, we examine whether Education Regulation enacted by the Government of Nepal in 2002—mainly Rule 93 on the criteria for the selection of principals and Rule 94 on their assigned responsibilities—was fully implemented. Our findings show that overpoliticization in school management, top-down approaches to policymaking, lack of transparency and awareness about policy provisions, and workload pressures for principals have resulted into implementation failure. For implementing educational policies related to school leadership, frequent training for principals, presence of media for parental awareness, and legal institutions for justice are important.
Endovascular thrombectomy for ischemic stroke with large core volume: An updated, post-TESLA systematic review and meta-analysis of the randomized trials
Authors: Kobeissi Hassan , Adusumilli Gautam , Ghozy Sherief , Kadirvel Ramanathan , Brinjikji Waleed , Albers Gregory W , Heit Jeremy J , Kallmes David F
Published: June 2023

Background

Limited randomized controlled trials (RCTs) have been performed comparing endovascular thrombectomy (EVT) to medical therapy (MEDT) for acute ischemic stroke with extensive baseline ischemic injury (AIS-EBI). We conducted a systematic review and meta-analysis of RCTs reporting EVT for AIS-EBI.

Methods

Using the Nested Knowledge AutoLit software, we conducted a systematic literature review from inception to 12 February 2023 within Web of Science, Embase, Scopus, and PubMed databases. Results of the TESLA trial were included on 10 June 2023. We included RCTs that compared EVT to MEDT for AIS with large ischemic core volume. The primary outcome of interest was a modified Rankin Score (mRS) 0-2. Secondary outcomes of interest included early neurological improvement (ENI), mRS 0-3, thrombolysis in cerebral infarction (TICI) 2b-3, symptomatic intracranial hemorrhage (sICH), and mortality. A random-effects model was used to calculate risk ratios (RRs) and their corresponding 95% confidence intervals (CIs).

Results

We included four RCTs with 1310 patients, 661 of whom underwent EVT and 649 of whom were treated with MEDT. EVT was associated with greater rates of mRS 0-2 (RR = 2.33, 95% CI = 1.75–3.09; P-value < 0.001), mRS 0-3 (RR = 1.68, 95% CI = 1.33–2.12; P-value < 0.001), and ENI (RR = 2.24, 95% CI = 1.55–3.24; P-value < 0.001). Rates of sICH (RR = 1.99, 95% CI = 1.07–3.69; P-value = 0.03) were greater in the EVT group. Mortality (RR = 0.98, 95% CI = 0.83–1.15; P-value = 0.79) was comparable between the EVT and MEDT groups. The rate of successful reperfusion in the EVT group was 79.9% (95% CI = 75.6–83.6).

Conclusions

Although the rate of sICH was greater in the EVT group, EVT conferred a greater clinical benefit to MEDT for AIS-EBI based on available RCTs.
Towards Legality and Affect
Authors: Christ Birte , Schniedermann Wibke
Published: June 2023

The contributions to this special issue on “Towards Legality and Affect” engage with Greta Olson’s recent challenges to the discipline of Law and Literature in From Law and Literature to Legality and Affect (Oxford UP 2022). They grapple with Olson’s reconceptualization of legality and her emphasis on the role of affect by way of case studies that include diverse media and transnational perspectives.
Maternal satisfaction with emergency obstetric and newborn care services in Ethiopia and the associated factors: A systematic review and meta-analysis
Authors: Kassa Bekalu Getnet , Beyene Fentahun Yenealem , Demilew Basaznew Chekol
Published: June 2023

Background:

In approximately 15% of all pregnancies, a potentially fatal complication that necessitates medical attention arises, requiring a significant obstetrical intervention for the pregnant women to survive. Between 70% and 80% of maternal life-threating complication have been treated through emergency obstetric and newborn services. This study investigates women’s satisfaction with emergency obstetric and newborn care services in Ethiopia and factors associated with their satisfaction.

Methods:

In this systematic review and meta-analysis, we searched electronic databases, such as PubMed, Google Scholar, HINARI, Scopus, and Web of Sciences for primary studies. A standardized data collection measurement tool was used to extract the data. STATA 11 statistical software was used to analyze the data, and I2 tests were used to evaluate heterogeneity. The pooled prevalence of maternal satisfaction was predicted using a random-effects model.

Results:

Eight studies were included. The pooled prevalence of maternal satisfaction with emergency obstetric and neonatal care services was 63.15% (95% confidence interval: 49.48–76.82). Age (odds ratio = 2.88, 95% confidence interval: 1.62–5.12), presence of birth companion (odds ratio = 2.66, 95% confidence interval: 1.34–5.29), satisfaction with health workers’ attitudes (odds ratio = 4.02, 95% confidence interval: 2.91–5.55), educational status (odds ratio = 3.59, 95% confidence interval: 1.42–9.08), length of stay at health facility (odds ratio = 3.71, 95% confidence interval: 2.79–4.94), and antenatal care visits (odds ratio = 2.22, 95% confidence interval: 1.52–3.24) were associated with maternal satisfaction with emergency obstetric and neonatal care service.

Conclusion:

This study found a low level of overall maternal satisfaction with emergency obstetric and neonatal care services. To increase maternal satisfaction and utilization, the government should focus on improving the standards of emergency maternal, obstetric, and newborn care by identifying gaps in maternal satisfaction regarding the services provided by healthcare professionals.
Modifiable and non-modifiable risk factors for failure of non-operative treatment of pediatric forearm fractures: Where can we do better?
Authors: Talathi Nakul S , Shi Brendan , Policht Jeremy , Mooney Bailey , Chen Kevin Y , Silva Mauricio , Thompson Rachel M
Published: June 2023

Introduction:

Distal third forearm fractures are common fractures in children. While outcomes are generally excellent, some patients fail initial non-operative management and require intervention. The purpose of this study is to identify independent risk factors associated with failure of closed reduction.

Methods:

We conducted a retrospective review of distal third forearm fractures in children treated with closed reduction and casting. Patients were divided into two cohorts—those who were successfully closed reduced and those who failed initial non-operative management. Demographic characteristics, cast type, cast index, radiographic fracture, soft tissue characteristics, and quality of reduction were analyzed between groups.

Results:

A total of 207 children treated for distal third forearm fractures were included for analysis. A total of 190 (91.8%) children maintained their reduction while 17 (8.2%) failed initial non-operative management. Modifiable risk factors associated with loss of reduction on univariate analysis included the use of a long arm cast (p = 0.003), increased post-reduction displacement (p = 0.02), and increased post-reduction angular deformity (p = 0.01). Non-modifiable risk factors included increased body mass index (p = 0.02), increased presenting fracture displacement (p = 0.002), and increased width of the soft tissue envelope at the fracture site (p = 0.0001). The use of long arm casts (13% vs 2%, odds ratio = 6.44) and soft tissue width (60.6 vs 50.4 mm, odds ratio = 1.1) remained significant risk factors for loss of reduction after multivariate analysis.

Conclusion:

Both larger soft tissue envelope at the site of the fracture and long arm cast immobilization are independently associated with an increased risk of failing initial closed reduction in distal third forearm fractures in the pediatric population.

Level of evidence:

level III Case Control Study
Firsthand Accounts of U.S. Teachers Pumping Milk at Work: A Poetic Inquiry
Authors: Toedt Elise
Published: June 2023

This article uses poetic inquiry (Faulkner, 2016; Leavy, 2015; Prendergast, 2009) to foreground the firsthand experiences of K-12 teachers expressing milk at work in the United States. The poems illustrate a fundamental irony for the predominantly female-identified teaching force: Teachers are expected to nurture other people’s children without proper time, space, and resources to nurture their infants via pumping milk while at work. The poems demonstrate a need for additional time and space to express milk and a need for clear policies and practices to support pregnancy, birth, and bodyfeeding for teachers. More universally, the poems speak to the regimented nature of schools and the impact on teacher’s bodies. The first four poems were each written from four individual participant interviews, and member-checked with each participant. The last three poems are a compilation of direct responses from 20 participants describing the feelings, sensations, and emotions related to pumping at work.
Active inhibition of the retro-cue effect in visual working memory: Evidence from event-related potential
Authors: Gao Chao , Zhang Qi , Zhang Xiaoxiao
Published: June 2023

This study used the event-related potential (ERP) technique to investigate whether active inhibition exists in retro-cue Effect (RCE) in visual working memory using modified retro-cue tasks. In this modified task, the participants were first asked to memorize six color blocks and then presented with directed remembering or directed forgetting cues; finally, their working memory performance was tested. For behavioral results, due to the extension of the memory interval, this study did not find RCE in accuracy but reflected it in the total reaction time. For ERP results, the frontal late positive potential (LPP) followed by the directed forgetting condition was larger than that followed by directed remembering and baseline conditions, and there was no significant difference between directed remembering and baseline conditions. There was no significant difference in parietal P3 followed by both the directed remembering and directed forgetting conditions, which were significantly larger than the baseline condition. This result reveals that active inhibition plays an important role in directed forgetting RCE. There was a correlation between parietal P3 and frontal LPP with the same time window but different scalp regions in the directed forgetting condition, indicating a potential relationship between active inhibition and retelling in directed forgetting RCE.
Hearing-impaired and deaf individuals’ perceptions of primary healthcare in Sweden: A mixed-methods study
Authors: Snögren Maria , Andersson Eveline , Muotka Béatrice , Hallgren Jenny
Published: June 2023

People with impaired hearing or deafness often perceive communication barriers when and participating in their daily lives, such as when contacting primary healthcare, leading to a risk of them using emergency services for less urgent conditions. Therefore, the aim of the present study was to describe the perceptions of individuals with hearing impairments and deafness in relation to the treatment and communication they received from primary healthcare professionals. The study employed a mixed-methods design, and the data comprised questionnaire responses from 101 individuals with hearing impairments or deafness, including 11 open-ended questions, analyzed with conventional content analysis. The study was evaluated using the COREQ checklist and the GRAMMS guidelines to further improve the transparency of the research. The results indicate that healthcare professionals who are responsive, considerate, and respectful regarding communication were perceived among people with hearing impairments or deafness to be professionals. The ideal healthcare encounter for people with hearing impairments or deafness would be where the healthcare professionals could perform sign language, which would allow the healthcare professional to communicate freely. Healthcare professionals need more knowledge about how they can best meet, care for, and communicate with individuals with hearing impairments or deafness.
Parent-Adolescent Transmission of Socioeconomic Status: Testing Serial Mediation of Conflict Behaviors, Emotion Regulation, and Empathy
Authors: Fakkel Matthijs , Peeters Margot , Vollebergh Wilma A.M. , Branje Susan
Published: June 2023

In this study, we investigated whether the intergenerational transmission of SES is mediated by parental and adolescents’ conflict behaviors, emotion regulation, and empathy. Longitudinal serial mediation analyses were performed on a subset of adolescents ( Mage = 13.03) and their parents from the RADAR cohort study ( N = 320, 52.2% boys) in the Netherlands. Results showed partial support for intergenerational transmission of SES, mostly between mothers and girls. However, no mediation effect was found, primarily because parental SES was mostly unrelated to parental conflict behaviors. Parental conflict behaviors did affect adolescent conflict behaviors, emotion regulation, and empathy, which in turn were associated with SES outcomes in young adulthood. This study nuances the proposition of the family stress model that parents from a lower SES background – as a result of economic stress – display less constructive and more destructive conflict behaviors.
The Imperial Connections of the Thar Desert: Environment, Power and Political Alliances
Authors: Choudhary Manisha
Published: June 2023

In the history of India, the Thar Desert always had a backseat due to its harsh weather conditions and apprehensions flowing from the adverse weather conditions. Ignorance of the region for long in writings of the discipline has pushed the region under the carpet and if any approach has been made to explore its history, it has been mainly in terms of the nomadic (Mer, Rebari, etc.) and professional groups like musicians (Maganiyars, Bhopa, etc.) and folk artists (Kalbeliyas, Dum, etc.). Keeping an insight of all the works done so far around the region of Thar, this study is an attempt to explore the ecological components of the Thar Desert as without taking stock of its resources, it will be impossible to relate with its history. It is significant to explore the ecological ingredients of the Thar Desert as their economic worth led to the formation of political alliances amongst various ruling houses—close and afar—as they all wanted a share in its resources and that too peacefully. Finally, all these associations led to the expansion of the imperial control that was aiming to gain a larger share in the resources and regulate the political moves of this environmentally harsh region.
Prevalence of histologically confirmed adenomyosis in a chronic pelvic pain cohort
Authors: Stewart Chelsea E , Castellanos Mario E , Nadella Samantha P , Eliason Rachel , Doehrman Pooja , Gubbels Ashley
Published: June 2023

Introduction:

We aimed to determine the prevalence of pathology confirmed adenomyosis in women with chronic pelvic pain (CPP) who underwent surgical management with total hysterectomy, and to identify associated risk factors and demographic variables.

Methods:

This is a retrospective cohort study involving 1186 patients treated in a CPP-specialty clinic who underwent surgical management with hysterectomy between January 2010 and December 2021.

Results:

About 532/1186 (44.9%) of the cohort were diagnosed with adenomyosis on pathology following total hysterectomy. The average age of patients with adenomyosis was older than those without adenomyosis [41 years vs 38 years ( p < 0.001)]. There were no statistically significant differences in symptoms of menstrual bleeding, pelvic pain, dysmenorrhea, or dyspareunia. Those with adenomyosis were more likely to be Hispanic ( p < 0.001), have a history of pregnancy ( p < 0.001), and have chronic cervicitis ( p = 0.037). Uterine weight was significantly higher in the group with adenomyosis ( p = 0.033) especially when excluding leiomyoma ( p = 0.006).

Discussion:

The prevalence of adenomyosis on surgical pathology in a CPP cohort was higher than that reported for the general population. Uterine weights are higher in adenomyosis, even when controlling for leiomyoma. Classically attributed symptoms of adenomyosis were not useful predictors for the disease.
Implementation of a Novel Telehealth Patient Advisory Council
Authors: Rollston Rebekah L. , Gallogly Winifred , Lynch-Coffey Alex , Hoffman Liza , Clear Brian
Published: June 2023

Patient engagement in healthcare delivery processes has been increasingly emphasized in recent years, which can be accomplished in part by Patient Advisory Councils (PACs). Although well-established in brick-and-mortar facilities, the use of PACs in pure telehealth settings is limited. Bicycle Health, a digital health organization that provides biopsychosocial treatment of opioid use disorder (OUD) via telehealth, sought to increase patient engagement regarding care delivery and innovation, ultimately launching a telehealth Patient Advisory Council. Herein we discuss implementation challenges and iterative changes to address each challenge. Key learnings include the following: Patients with OUD are often subject to significant stigma, including by healthcare professionals. This is a key factor to consider when recruiting and engaging patients; trust building is key and can help to overcome both perceived and actual stigma. Inclusion of core staff persons who have lived experience with the respective health condition—in this case, OUD—is beneficial. Utilizing a formal framework, such as the Model for Improvement (utilized widely by the Institute for Healthcare Improvement), to guide improvement work is helpful for providing structure to feedback conversations, though this framework should be presented to patients in accessible language.
Phase 2 study of PD-1 blockade following autologous transplantation for patients with AML ineligible for allogeneic transplant
Authors: Solomon Scott R. , Solh Melhem , Morris Lawrence E. , Holland H. Kent , Bachier-Rodriguez Lizamarie , Zhang Xu , Guzowski Caitlin , Jackson Katelin C , Brown Stacey , Bashey Asad
Published: June 2023

Allogeneic transplant remains the best postremission therapy for patients with nonfavorable risk acute myeloid leukemia (AML). However, some patients are ineligible because of psychosocial barriers, such as lack of appropriate caregiver support. We hypothesized that immune checkpoint inhibition after autologous transplant might represent effective postremission therapy in such patients. We conducted a phase 2 study of autologous transplantation followed by administration of pembrolizumab (8 cycles starting day +1). Twenty patients with nonfavorable AML in complete remission were treated (median age, 64 years; CR1, 80%); 55% were non-White and adverse-risk AML was present in 40%. Treatment was well tolerated, with only 1 nonrelapse death. Immune-related adverse events occurred in 9 patients. After a median follow-up of 80 months, 14 patients remain alive, with 10 patients in continuous remission. The estimated 2-year LFS was 48.4%, which met the primary end point of 2-year LFS >25%; the 2-year overall survival (OS), nonrelapse mortality, and cumulative incidences of relapse were 68%, 5%, and 46%, respectively. In comparison with a propensity score–matched cohort group of patients with AML receiving allogeneic transplant, the 3-year OS was similar (73% vs 76%). Patients in the study had inferior LFS (51% vs 75%) but superior postrelapse survival (45% vs 14%). In conclusion, programmed cell death protein–1 blockade after autologous transplant is a safe and effective alternative postremission strategy in patients with nonfavorable risk AML who are ineligible for allogeneic transplant, a context in which there is significant unmet need. This trial was registered at www.clinicaltrials.gov as #NCT02771197.
Cancer survival prediction by learning comprehensive deep feature representation for multiple types of genetic data
Authors: Hao Yaru , Jing Xiao-Yuan , Sun Qixing
Published: June 2023

Background

Cancer is one of the leading death causes around the world. Accurate prediction of its survival time is significant, which can help clinicians make appropriate therapeutic schemes. Cancer data can be characterized by varied molecular features, clinical behaviors and morphological appearances. However, the cancer heterogeneity problem usually makes patient samples with different risks (i.e., short and long survival time) inseparable, thereby causing unsatisfactory prediction results. Clinical studies have shown that genetic data tends to contain more molecular biomarkers associated with cancer, and hence integrating multi-type genetic data may be a feasible way to deal with cancer heterogeneity. Although multi-type gene data have been used in the existing work, how to learn more effective features for cancer survival prediction has not been well studied.

Results

To this end, we propose a deep learning approach to reduce the negative impact of cancer heterogeneity and improve the cancer survival prediction effect. It represents each type of genetic data as the shared and specific features, which can capture the consensus and complementary information among all types of data. We collect mRNA expression, DNA methylation and microRNA expression data for four cancers to conduct experiments.

Conclusions

Experimental results demonstrate that our approach substantially outperforms established integrative methods and is effective for cancer survival prediction.

Availability and implementation

https://github.com/githyr/ComprehensiveSurvival.
Change of prescription for patients with schizophrenia or major depressive disorder during admission: real-world prescribing surveys from the effectiveness of guidelines for dissemination and education psychiatric treatment project
Authors: Hashimoto Naoki , Yasui-Furukori Norio , Hasegawa Naomi , Ishikawa Shuhei , Hori Hikaru , Iida Hitoshi , Ichihashi Kayo , Miura Kenichiro , Matsumoto Junya , Numata Shusuke , Kodaka Fumitoshi , Furihata Ryuji , Ohi Kazutaka , Ogasawara Kazuyoshi , Iga Jun-ichi , Muraoka Hiroyuki , Komatsu Hiroshi , Takeshima Masahiro , Atake Kiyokazu , Kido Mikio , Nakamura Toshinori , Kishimoto Taishiro , Hishimoto Akitoyo , Onitsuka Toshiaki , Okada Tsuyoshi , Ochi Shinichiro , Nagasawa Tatsuya , Makinodan Manabu , Yamada Hiroki , Tsuboi Takashi , Yamada Hisashi , Inada Ken , Watanabe Koichiro , Hashimoto Ryota
Published: June 2023

Background

Polypharmacy of additional psychotropics alongside the main treatment drug (antipsychotics in schizophrenia and antidepressants in major depressive disorder) is common in Japan. Our goal is to align psychotropic prescription in Japan with international standards, while reducing the differences between facilities. To achieve this goal, we aimed to compare prescriptions at the time of hospital admission and discharge.

Methods

Data on prescriptions at admission and discharge from 2016 to 2020 were collected. We divided the patients into four groups: (1) mono_mono group, monotherapy of the main drug at admission and discharge; (2) mono_poly group, monotherapy at admission and polypharmacy at discharge; (3) poly_poly group, polypharmacy at admission and discharge; and (4) poly_mono group, polypharmacy at admission and monotherapy at discharge. We compared the changes in dosage and number of psychotropics among the four groups.

Results

For both schizophrenia and major depressive disorder, the patients who received monotherapy with the main drug at admission were likely to receive main drug monotherapy at discharge and vice versa. For schizophrenia, the polypharmacy was prescribed more often in the mono_poly group than that in the mono_mono group. The prescription was not changed at all for more than 10% of the patients.

Conclusions

It is critical to avoid a polypharmacy regimen to ensure that guideline-compliant treatment is provided. We expect higher rates of monotherapy with the main drug after the EGUIDE lectures.

Trial registration

The study protocol was registered in the University Hospital Medical Information Network Registry (UMIN000022645).
National screening for Egyptian children aged 1 year up to 12 years at high risk of Autism and its determinants: a step for determining what ASD surveillance needs
Authors: Metwally Ammal M. , Helmy Mona A. , Salah El-Din Ebtissam M. , Saleh Rehan M. , Abdel Raouf Ehab R. , Abdallah Ali M. , Khadr Zeinab , Elsaied Amal , El-Saied Mostafa M. , Bassiouni Randa I. , Nagi Dina A. , Shehata Manal A. , El-Alameey Inas R. , El-Hariri Hazem M. , Salama Somia I. , Rabah Thanaa M. , Abdel-Latif Ghada A. , El Etreby Lobna A. , Elmosalami Dalia M. , Sami Samia M. , Eltahlawy Eman , Ibrahim Nihad A. , Elghareeb Nahed A. , Badawy Hala Y. , Dewdar Eman M. , Ashaat Engy A.
Published: June 2023

This study aimed to provide a national estimate of the prevalence of the high risk of autism spectrum disorder (ASD) and their determinants. A national screening survey was conducted for 41,640 Egyptian children aged 1 to 12 years in two phases. Tools used were Vineland's Adaptive Behavior Scales, Modified Checklist for Autism in Toddlers, Gilliam Autism Rating scale, and Denver II Developmental screening test. The overall prevalence of children at high risk of ASD was 3.3% (95% CI:3.1%–3.5%). Children living without mothers in homes, suffered from convulsions (AOR = 3.67; 95%CI:2.8–4.8), a history of cyanosis after birth (AOR = 1.87; 95% CI:1.35–2.59) or history of LBW babies (AOR = 1.53; 95% CI:1.23–1.89) carried higher odds of being at high risk of ASD.
Good practice recommendations on implementation evaluation for policies targeting diet, physical activity, and sedentary behaviour
Authors: Wendt Janine , Scheller Daniel A. , Banik Anna , Luszczynska Aleksandra , Forberger Sarah , Zeeb Hajo , Scheidmeir Marie , Kubiak Thomas , Lien Nanna , Meshkovska Biljana , Lobczowska Karolina , Romaniuk Piotr , Neumann-Podczaska Agnieszka , Wieczorowska-Tobis Katarzyna , Steinacker Jürgen M. , Mueller-Stierlin Annabel S.
Published: June 2023

Health policies aim to achieve specific health goals through system-level changes, unlike common health interventions that focus on promoting specific health behaviors on individual level. However, reliable data on the feasibility and implementation of policy actions across Europe are lacking. Moreover, no practice-oriented guidance exists for policy makers and implementers on how to evaluate policy implementation.

As part of the Policy Evaluation Network, we aimed to synthesise knowledge on how to evaluate the implementation of policies promoting healthy diets, physical activity, and reducing sedentary behaviours. The multidisciplinary working group comprised 16 researchers and conducted two scoping reviews, three systematic reviews, two meta-reviews, two qualitative case studies and one quantitative case study over three years. The target populations included the general population, those at risk for obesity, and school children. Based on these reviews and case studies, this article summarises and presents the findings and lessons learned regarding the implementation evaluation of policies in nine case reports.

Drawing on these experiences, three critical requirements for policy implementation evaluation were set: 1) conduct a comprehensive policy implementation evaluation from a multi-level perspective, 2) use implementation frameworks to address processes, determinants, and outcomes, and 3) engage relevant stakeholders in policy implementation evaluation. Finally, the consensus process resulted in 10 steps for the implementation evaluation of policies to promote physical activity and a healthy diet and to reduce sedentary behaviours, which adhere to the requirements and resources of the targeted policy.

The findings of an implementation evaluation can lead to a better understanding of why policies work or not and can serve as a basis for developing solutions. This practice-oriented guidance outlines factors that should be considered in policy implementation evaluation to address its complexity. In this way, involved researchers and practitioners are empowered to engage in the evaluation process to close the knowledge gap regarding policy implementation.
Measuring effects of screen time on the development of children in the Philippines: a cross-sectional study
Authors: Dy Angel Belle C. , Dy Alane Blythe C. , Santos Samantha Katrina
Published: June 2023

Background

Screen time in young children is discouraged because of its negative effects on their development. However, excessive screen media use has been rising, particularly during the global pandemic when stay-at-home mandates were placed on young children in several countries. This study documents potential developmental effects of excessive screen media use.

Method

This is a cross-sectional study. Participants were 24 to 36 month old Filipino children recruited through non-probable convenience sampling from August to October 2021. Regression analyses were performed to test the association between screen time and changes in scaled scores for skills and behaviors determined from the Adaptive Behavior Scale and to identify factors associated with increased screen media use.

Results

Increased odds of excessive use of screen media of children by 4.19 when parents watch excessively and 8.56 times greater odds when children are alone compared to watching with a parent or other children. When adjusted for co-viewing, more than 2 h of screen time is significantly associated with decrease in receptive and expressive language scores. The effects on personal skills, interpersonal relationships and play and leisure skills were only statistically significant at 4 to 5 or more hours of screen time use.

Conclusion

The study found that spending no more than 2 h screen time had minimal negative effects on development and that use beyond 2 h was associated with poorer language development among 2 year olds. There is less excessive screen media use when a child co-views with an adult, sibling or other child and when parents likewise have less screen time themselves.