bluuebunny/crossref_metadata_2025 huggingface dataset:
Private sector service workers' well-being before and during the COVID-19 pandemic
Authors: Erkkola Maijaliisa , Walsh Hanna M , Saari Tiina , Lehto Elviira , Rahkonen Ossi , Nevalainen Jaakko
Published: May 2023

Background
Workers attending to the essential functions of society have been most affected by COVID-19, but the well-being of workers outside the health care sector has scarcely been documented. We describe well-being profiles of Finnish blue-collar workers in private sector services and changes in their well-being during the COVID-19 pandemic.
Methods
Altogether 6345 members of the Service Union United provided cross-sectional pre-COVID data in 2019, and 2702 provided follow-up data on health-related indicators in November 2020. Job industry-specific profiles (retail, hospitality, and property maintenance) and change patterns were analysed. Regression models appropriate for different response types with a random intercept and time component were used.
Results
Before COVID-19, the well-being profile − food security, body mass index, alcohol use, smoking, and self-perceived health and adequacy of income − was worse among service workers than the population average and it varied by industry sector. During the first year of COVID-19 self-perceived health deteriorated (OR 0.78, 95% CI 0.70–0.87). The proportion of severely food insecure fell from a third to a quarter (OR for improvement 2.66, 95% CI 2.37–2.99). Slight improvements were observed in heavy episodic drinking, smoking, and self-perceived adequacy of income. Employees in property maintenance were the most vulnerable regarding well-being profile and COVID-19-related changes.
Conclusion
COVID-19 caused divergent changes, including improved food security and deteriorated self-perceived health. Workers with the lowest socioeconomic profile and those facing job uncertainty were the most vulnerable to adverse outcomes. Provision of support to these groups is essential in welfare policy considerations.
Short Video Recommendation based on Multilabel Learning and Multiview Representation
Authors: Carter Valentina , Williams Dario , Johnson Luigi , Clark Kiernan
Published: May 2023

With the emergence of short videos as a new form of media, there has been a surge in the production of short video content by users on various platforms. The popularity of short videos stems from their ability to meet users' needs for diversified and fragmented content consumption. However, the abundance and complexity of short video data create challenges for video recommendation. Short videos contain rich multimodal information in both temporal and spatial dimensions. This feature makes users interested in videos in various forms: interested in the content of a particular shot of a video, interested in the storyline described in a video, interested in the music associated with a video, etc. Existing video recommendation systems only consider a single type of recommended content, and directly recommend videos to users as a whole, which does not meet the deeper needs of users. Short video contains different semantic content, and the results and methods of short video recommendation should not be limited to the overall video recommendation only. In this paper, we take advantage of the consistency of multi-view features for multimedia content understanding to obtain an eigenstable representation from the characteristics of short videos themselves. From the existing studies, video recommendation mainly focuses on the content or metadata of a single modality in the video, but ignores the multimodality of video content and the multi-perspective nature of recommendation strategies. In this paper, we take the advantage of the consistency of multi-modal features for multimedia content understanding to obtain an eigenstable representation, and extract the content of multiple modalities from the video for more comprehensive video content analysis, and fuse the information of each modality to realize a multi-perspective video recommendation method.
Identification of novel, potent, and selective compounds against malaria using Glideosomal Associated Protein 50 as a drug Target
Authors: Agrawal Prakhar , Kumari Surekha , Mohammed Asif , Malhotra Pawan , Sharma Upendra
Published: May 2023

Phylum apicomplexan consists of parasites like Plasmodium and Toxoplasma. These obligate intracellular parasites enter host cells via an energy-dependent process using a specialized machinery called glideosome. In the present study, we used Plasmodium falciparum GAP 50, a glideosome-associated protein as a target to screen 951 different compounds from diverse chemical libraries. Using different screening methods, eight compounds, Hayatinine, Curine, MMV689758 (Bedaquiline), MMV1634402 (Brilacidin), and MMV688271, MMV782353, MMV642550, and USINB4-124-8 were identified which showed promising binding affinity (KD < 75 µM) along with sub-micromolar range anti-parasitic efficacy and selectivity index for malaria parasite > 100 fold. These eight compounds were effective against the chloroquine-resistant PfINDO and artemisinin-resistant, PfCam 3.1R359T strain. Studies on the effect of these compounds at asexual blood stages showed that these eight compounds act differently at different developmental stages, indicating the binding of these compounds to other Plasmodium proteins besides binding to PfGAP50. We further studied the effect of compounds in vivo P. berghei mouse model of malaria. Importantly, orally delivered Bedaquiline (50 mg/Kg b. wt.) showed substantial suppression of parasitemia, and three out of seven mice were cured of the infection. Thus, our study provides new scaffolds for the development of antimalarials that may act at multiple Plasmodium life cycle stages.
Excess Readmission rates for Heart Failure and Pneumonia by Hospital Type
Authors: Brahmbhatt Viraj
Published: May 2023

Improvement of quality care is a major goal for modern healthcare. Quality of care is often measured through readmission rates for specific conditions such as heart failure, pneumonia, total arthroplasty of knee/hip, etc. This data has been used by the Center for Medicare and Medicaid Services (CMS)`to adjust reimbursement rates for hospitals with excessive readmissions. Different hospital operation and management models possess structural differences that may impact the rates of readmission. This study investigated whether there were significant differences in the readmission rates for Academic, Non-Profit, and For-Profit hospitals. The results may be important in reshaping guidelines to assess hospitals based on readmission rates. The average excess readmissions for heart failure were Non-Profit hospitals for 1.0047, For Profit for 1.013, and Academic for .975. The Anova for this set returned a p-value of 1.70284E-05 meaning that the results were statistically significant. As such, Academic hospitals have statistically lower readmission rates for heart failure. The excess readmission rates for pneumonia yielded 1.025 for Non-Profit, 1.024 for For-Profit, and .99 for Academic hospitals. The Anova returned a p-value of 2.4899E-09 which suggests the differences seen are statistically significant. As such, academic hospitals also have a statistically lower rate of pneumonia readmissions. The study possess implications on on consumer decision making in choosing a hospital. In addition to this, algorithms for benchmarking as well as CMS adjustments to reimbursement rates may consider factoring the hospital ownership type.
On the convergence of an inertial proximal algorithm with a Tikhonov regularization term
Authors: Laszlo Szilard Csaba
Published: May 2023

This paper deals with an inertial proximal algorithm that contains a Tikhonov regularization term, in connection to the minimization problem of a convex lower semicontinuous function f. We show that for appropriate Tikhonov regularization parameters the value of the objective function in the sequences generated by our algorithm converges fast (with arbitrary rate) to the global minimum of the objective function and the generated sequences converges weakly to a minimizer of the objective function. We also obtain the fast convergence of the discrete velocities towards zero and some sum estimates. Nevertheless, our main goal is to obtain strong convergence results and also pointwise and sum estimates for the same constellation of the parameters involved. Our analysis reveals that the extrapolation coefficient and the Tikhonov regularization coefficient are strongly correlated and there is a critical setting of the parameters that separates the cases when strong convergence results or weak convergence results can be obtained.
AMS subject classification. 46N10, 65K05, 65K10, 90C25, 90C30
Association Between Glycated Hemoglobin Index and Triglycerides-Glucose Index in a Sample of Non-Diabetic Individuals and Its Relation With Insulin Resistance
Authors: Andrade Luís Jesuino de Oliveira , de Oliveira Luís Matos , de Oliveira Gabriela Correia Matos , Bittencourt Alcina Maria Vinhaes , Neto José Dantas de Melo , Baptista Gustavo Magno
Published: May 2023

Introduction
Studies have shown that elevations of the triglyceride/glucose index (TyG) as well as the glycation of hemoglobin index (HGI) are associated with several complications related to insulin resistance (IR).
Objective
To evaluate the association between HGI and TyG index in a sample of non-diabetic individuals and it’s relation with IR.
Method
A cross-sectional study was conducted with 32 non-diabetic individuals. The variables analyzed included age, gender, body mass index, and laboratory data (triglycerides, glucose, HbA1c, and insulin). We calculated the TyG index, HOMA-IR, and HGI. Simple and multivariate linear regression analyses were also performed, in addition to ANOVA and Pearson's correlation between variables.
Results
The multivariate linear regression analysis of the analyzed sample revealed a significant correlation between the TyG index and HGI, which was confirmed by the T-test. The results indicated a strong positive correlation between the TyG index and HGI, with a Pearson correlation coefficient of 0.98.
Conclusion
The HGI, TyG index and IR showed a significant association in the analyzed sample. This suggests that both indices are highly reliable in measuring IR and glucose metabolism and may be markers of risk independent of FPG, and the other variables evaluated in this study.
Same players, new rules: Redefining the roles of aimP, AimR, and AimX in the arbitrium communication system
Authors: Zamora-Caballero Sara , Brady Aisling , Quiles-Puchalt Nuria , Sol Francisca Gallego del , Mancheño-Bonillo Javier , Felipe-Ruíz Alonso , Meijer Wilfried J J , Penadés José R , Marina Alberto
Published: May 2023

Phages can use a small-molecule communication system, termed arbitrium, to coordinate lysis-lysogeny decisions. It was proposed that this system contains three main players. AimR is a transcriptional activator that promotes expression of aimX, a small RNA which favours the lytic cycle of the phage by inhibiting the phage master repressor using an uncharacterised cis-antisense mechanism. The third player, AimP, is a peptide that accumulates after several rounds of phage infection. When this occurs, AimP binds to AimR inhibiting its function, a process that promotes lysogeny, since aimX will not be transcribed. Here we redefined the role for the main players and identified new key ones, explaining the molecular basis of the arbitrium system. Our results demonstrate that AimR is an antiterminator that eliminates the function of a terminator located between aimP and aimX, which are expressed then as part of a bicistronic operon that initiates in the aimP promoter. Importantly, our genetic, biochemical, and structural analyses also demonstrate that aimX is not a regulatory small RNA but encodes a peptide, AimX, which promotes the lytic cycle of the phage by binding to the second repressor of the arbitrium system, YopN, eliminating its function. Our results reveal the mechanism by which the arbitrium system controls lysis/lysogeny.
Conhecimento de agricultores sobre aves em uma comunidade rural no Semiárido da Paraíba: uma abordagem da etnoornitologia
Authors: Santos Suellen da Silva , Soares Hyago Keslley de Lucena , Soares Vanessa Moura dos Santos , Lucena Camilla Marques de , Lucena Reinaldo Farias Paiva de
Published: May 2023

O presente estudo foi desenvolvido na Comunidade Rural de Santa Rita, Município do Congo, Paraíba, Brasil. Registrou-se o conhecimento e uso das aves pela comunidade rural estudada. Realizaram-se entrevistadas semiestruturadas com 50 informantes. As informações foram analisadas por meio do Valor de Uso (VU) e do teste de correlação de Spearman. Foram registradas 68 aves, distribuídas em 20 ordens, 35 famílias e 62 gêneros, atribuídas ao uso alimentar (42 spp), criação em cativeiro (40 spp) e medicinal (2 spp). 15 aves foram descritas como bioindicadores de eventos climáticos, capazes de prenunciar ocorrências desagradáveis (morte) ou positivas (boas notícias). Seis espécies foram consideradas pragas por provocar danos a lavoura, especialmente de produção de milho e feijão. As aves com fins utilitários são capturadas através de quatro técnicas, destacando-se o uso do assaprão. Paroaria dominicana obteve os maiores valores no VU_geral (VU = 1) e no VU_potencial (VU = 0,96). No VU_atual, Sporophila albogularis (VU = 0,16) destacou-se. As espécies mais conhecidas tendem a serem mais utilizadas. Os resultados evidenciaram que as espécies das ordens Columbiformes e Passeriformes são as mais apreciadas na Comunidade Santa Rita.
The impact of cookie regime change on the effectiveness of automatic retargeting in advertising
Authors: Semerádová Tereza , Weinlich Petr
Published: May 2023

The constantly evolving legislation concerning the usage of cookies raises many concerns about the effectiveness of targeted online advertisements. Retargeting represents an advanced targeting strategy requiring detailed user data and thus may be potentially highly sensitive to cookie restrictions. The retargeting effectiveness is tested in terms of type (standard, dynamic), advertising platform (Meta Ads, Google Ads), and the ad performance development in time. The data were collected through a Czech home goods online retailer. This paper tests the effectiveness of 432 retargeting ads collected during the opt-out cookie regime by comparing them with 432 retargeting ads collected after the transition to the opt-in cookie regime. The study created 216 ads on Google and 216 ads on Facebook. The entire experiment took one month to be implemented in 2021 and repeated in precisely the same manner in 2022. After this period, data were processed with SPSS Statistics. Both Facebook and Google (Conversion Lift) provide A/B testing tools. The results suggest that standard retargeting ads are more effective in utilitarian browsing. In contrast, dynamic retargeting is more successful in reaching users in the hedonic environment of social networks. Moreover, the performance of retargeting ads evolves in the different stages along the customer journey. There are differences in the total number of tracked users in terms of the transition from the opt-out to the opt-in cookie regime. However, the performance of programmatic advertising appears moderately affected.
AcknowledgmentThis work is supported by the Technology Agency of the Czech Republic under the Program of Applied Research ZETA through the Grant TJ02000206 – Developing the skills necessary for the digital business transformation.
Using DNA markers to reconstruct the lifetime morphology of barley grains from carbonized cereal crop remains unearthed at Usvyaty Settlement
Authors: Semilet Tatiana , Shvachko Natalia , Smirnova Natalia , Shipilina Lilia , Khlestkina Elena
Published: May 2023

Research on taxonomic and genetic diversity of cultivated plants provides valuable data that help to clarify how the flora of cultivated plants was formed in a particular region. Paleogenetics, a discipline that developed at the intersection of molecular biology, archeology and genetics, helps to explore plant origin and changes in plant genotype during evolution. By the 12th century, the economy of medieval Northern Russia was based on a developed farming culture. Tracing the origin of its constituent agricultural traditions is an important fundamental task. The objective of this work was to study and identify the species affiliation of carbonized fossil remains of plants that grew in the Russian Northwest in the 12th century using morphological and molecular genetic methods. The results of the morphological analysis of grain fossils showed that most of the unearthed plant material was barley. Other cereals, such as wheat, rye and oat, were also observed. Molecular genetic studies helped to clarify the species affiliation of partially destroyed grains and reconstruct their lifetime morphology.
Cultura e linguagem: concepções da expressão “mulherão da porra” em textos de diferentes gêneros
Authors: Klein Liziane Giovana , Bueno Accorsi Ana Maria
Published: May 2023

A língua e as diferentes linguagens que utilizamos para nos comunicar são determinadas e influenciadas pela cultura na qual estamos inseridos. Novas expressões linguísticas, gestos e símbolos irrompem todo o tempo e são introduzidos no nosso discurso diário de maneira natural. Por conseguinte, torna-se fundamental a análise de novas expressões para se entender o contexto em que se inserem. Um desses casos é o da expressão “mulherão da porra”. Para tanto, este artigo analisa três ocorrências dessa expressão em textos de diferentes gêneros – no blog Descomplica os Trinta, na crônica O que é um mulherão da p.? e no videoclipe Mulherão da porra, da dupla Munhoz e Mariano – a fim de examinar se a expressão agrega ao universo feminino esse significado ligado à virilidade masculina pelo uso da locução adjetiva “da porra” como reforço positivo, empoderamento, ou como equiparação de forças. Percebeu-se, através da análise, que a expressão é geralmente utilizada como ênfase ao empoderamento feminino e equiparação de forças entre os gêneros. Além disso, conota um padrão de mulheres que, em comum, são belas e bem-sucedidas financeiramente, o que indica que a expressão varia muito em seu significado de acordo com o objetivo discursivo de quem a utiliza.
Marco regulatório na administração pública municipal: uma análise da sua implementação na região metropolitana de Porto Alegre
Authors: Scartezini Carreño Daiane , Silva do Nascimento Ana Jussara
Published: May 2023

Foi realizada uma pesquisa junto aos portais de 25 municípios da Região Metropolitana de Porto Alegre, municípios estes com menos de 100 mil habitantes, com o objetivo de analisar como as Administrações Municipais estão publicizando as parcerias com as Organizações da Sociedade Civil - OSC. Foi analisado o cenário após 4 (quatro) anos da implementação do marco regulatório, nos municípios, e 7 (sete) anos da lei 13.019/2014 e a suas alterações pela lei 13.204/20105, que foi uma revolução nas parcerias com o terceiro setor.
Investigação de Staphylococcus aureus resistente à meticilina em estetoscópios de uso hospitalar
Authors: DAmato Thauany Rodrigues Leal , Carreiro Mônica de Almeida , Melo Dayanne Araújo de , Oliveira Marcelo Sttrazzeri , Machado Fernanda Rocha , Silva Catia Maria Santos Diogo da
Published: May 2023

A pesquisa teve por objetivo evidenciar a presença de S. aureus resistentes à meticilina em estetoscópios. Tratou-se de uma pesquisa qualitativa, descritiva e de campo. Foi coletado amostras, por meio de swabs, das hastes metálicas e do diagragma de 26 estetoscópiono período de setembro de 2022 na Clínica Médica de um hospital. Após, as amostras foram cultivadas em ágar Manitol Vermelho de Fenol e identificação por coloração de gram e teste de catalase, identificação fenotípica pela prova da coagulase e de resistência a meticilina em cepas de Staphylococcus aureus pela técnica de difusão em disco com o antimicrobiano cefoxitina. Verificou-se a contaminação de 92,3% dos estetoscópios analisados. Quanto as características morfo-tintoriais, todas as amostras foram do tipo gram positiva, com predominância cocos (80,8%). Em 57,6% deram coagulase positiva e 42,3% coagulase negativa. A pesquisa aponta que todas a bactérias avaliadas são do gênero Staphylococcus spp. Desses, 57,6% correspondem coagulase positiva fermentador possível Staphylococcus aureus e 42,3% Staphylococcus coagulase negativa. Foi encontrado 60% das bactérias do tipo Staphylococcus aureus resistentes a meticilina.  Conclui-se que o estetoscópio carreia Staphylococcus aueus resistentes à meticilina podendo haver a contaminação cruzada entre os pacientes e desenvolver Infecções Relacionadas à Assistência à Saúde. Assim, reforça as necessidades de haver medidas de controle, redução e prevenção  a disseminação de microrganismos resistentes, sobretudo a atenção a prática de higienização de equipamentos de saúde e lavagem correta das mãos.
Palavras-Chave: Estetoscópios; Microbiologia; Infecção Hospitalar; Segurança do Paciente; Enfermagem.
Potency of Biodiesel Production from The Local Used Frying Oil Through The Electrocatalysis Method
Authors: Aulia Haris Numan
Published: May 2023

The objective of this study was to optimize the operating conditions for an electrocatalytic method of producing biodiesel from local used frying oil (UFO). The effects of electrical voltages (5-30 V), methanol-to-oil molar ratios (4:1-8:1), KOH catalyst concentrations (0.5-1.25% w/w), and electrolysis time (30-120 min) on biodiesel yield were investigated. The highest biodiesel yield of 95.3% was obtained at a voltage of 30 V, methanol-to-oil molar ratio of 6:1, catalyst concentration of 1% w/w, and electrolysis time of 120 min. A regression model was developed to predict the optimum operating conditions, resulting in a maximum biodiesel yield of 95.54%. The predicted optimum operating conditions were a voltage of 24.4 V, methanol-to-oil molar ratio of 5.8:1, catalyst concentration of 1% w/w, and electrolysis time of 120 min. The net profit of the biodiesel business using local UFO as a feedstock was estimated to be IDR 738,000 per month based on a simple economic calculation. These findings demonstrate the potential for using electrocatalytic methods to produce biodiesel from local UFO, and the economic feasibility of producing biodiesel in small-scale industries.
Phenotypic Performance and The Characterization of Growth Hormone (GH|AluI) in Bangkok Chicken Breed
Authors: Budi M.Hari Setia , Depison Depison , Gushairiyanto Gushairiyanto
Published: May 2023

This study aimed to determine Bangkok chicken’sphenotypic characteristics and growth hormone genes using the PCR-RFLP method. The samples used were 50 Bangkok chickens. Research in the field is taking phenotypic traits data. Research in the laboratory is carried out by DNA isolation, amplification, and restriction. This study showed that DOC weight,body weight, and bodyweight gain of DOC-1 month, 1-2 months, 2-3 months of Bangkok chickens were significantly different (P <0.05) higher than female Bangkok chickens. The results of the molecular analysis of DNA isolation were precise, then the amplification of the GH gene fragment with a product length of 997 bp and restriction obtained a ++ genotype. Allele frequencies and genotypes obtained in the Bangkok chicken GH|AluI genesare monomorphic. Conclusion: the phenotypic characteristics of the average body weight, the body weightgainof male Bangkok chicken was higher than that of female. Allele frequencies and genotypes of Bangkok chicken are monomorphic.
Feasibility Study of Quail Farming Business at Nurul Quran Islamic Boarding School in Bali, Indonesia
Authors: Prafitri Rizki , Marliana Dina , Sadikin Khaerunnisa Firdaus , Al Akrom Ahmad Nur Musyarrof , Natsir Muhammad Halim , Febrianto Nanang , Yulianti DyahLestari , Sjofjan Osfar , Susilo Agus
Published: May 2023

Nurul Quran Islamic boarding school (so called pondok pesantrenin Bahasa Indonesia)would develop a quail farming business to provide agriculture skills and develop entrepreneurship for the students and alumni. Quailfarming is selected because it is relatively easy, lucrative, has productivity up to 90%, produces130-300 eggs per week, and does not requirean extensive farming area. This study aims toanalyzethe feasibility study of the quail farming business at Nurul QuranIslamic boarding school, Bali,Indonesia. The method usedin this study was purposive sampling. The economic analysisincludes cost, revenue, Return on Investment and SWOT analysis. Thefindingsindicate that the quail farming business will be most efficient at a scale of 3,000birdswithatotalcostofRp214,849,351andtotalrevenueof Rp297,975,000per period.The return per cost of the business is 1.39; the boarding schoolwill achieve areturnofinvestmentupto51.22%.TheSWOTanalysisshows that the quail farming business at the boarding schoolhas an excellent opportunity. However,the boarding schoolshouldhavesomestrategiestominimizetheweaknessesandthreatsthatcouldchallenge the business. The boarding schoolneeds to develop human resources before starting thebusiness, maximize the potential of the boarding school, market access, technology,and networkingwith the Muslimcommunity as themarketing strategy for the quail farmingbusiness.
Laying Hens Growth Performance in the Peak Production Phase Offered Bio-Herbal as a Feed Additive
Authors: Nuningtyas Yuli Frita , Natsir Muhammad Halim , Widyastuti Eny Sri , Sjofjan Osfar , Susilo Agus , Widiati Aris Sri , Lestari Suci Puji
Published: May 2023

Theaim of this research was to evaluatethe effect of the addition of bio-herbal as a feed additive on feed consumption,hen day production, feed egg ratioand mortality of laying hens. The materialsin this experiment used200 laying hens of the Hyline strainage 28to 36 weeks (reared for 60 days). The method used in this study was an invivoexperimental method using a Completely Randomized Design (CRD) with treatmentsconsisting of P0 = drinking water without bio-herbals (control treatment), T1 = control treatment + bio-herbal yellow, P2 = control treatment + bio-herbal green, and T3 = control treatment + bio-herbal combination yellow and green (alternately every one week). Data were analyzed using Analysis of Variance (ANOVA) and if there was a significant effect,then testedwith Duncan's Multiple Range Test. The observed variables were feed consumption, Hen Day Production(HDP), feed egg ratioand mortality. The results showed that the addition of bio-herbals hadno significant effect (P> 0.05) on the feed consumption, hen day production, feed egg ratioand mortality. It can be concluded bio-herbal green gives the best results in improving egg quality. Due to the bioactive compoundsof bio-herbal green, theyconsist of probiotic and phytobiotic.
Novice Teachers Navigating Mentoring Relationships in the United States
Authors: Sydnor Jacqueline
Published: May 2023

Amid the national teaching shortage in the United States, it is now more critical than ever to sustain teachers. Consequently, the purpose of this study is to understand which mentoring experiences and induction support can aid in this objective.  Framed by Bakhtin’s theory of dialogism, this study's longitudinal, qualitative nature explores the experiences of novice teachers (NTs) in elementary schools in the United States whose critical first years occurred amid a global pandemic.  More specifically, we focus on the formal and informal support they experienced while becoming a teacher.  Analysis of the data, which included in-depth interviews with the NTs revealed two key themes: 1) deprioritizing mentoring, and 2) inconsistencies in mentoring.  The implications of this study aim to extend the existing literature, offering action-based evidence to improve mentoring and induction.  Focusing on the retention of NTs via support and mentoring benefits the field now and into the future.
Child Temperament and Child-care Support are Related to Better Mother-child Relationship Quality
Authors: Yalcintas Sumeyra , Pike Alison
Published: May 2023

The current study identifies associates of mother-first-born-child relationship quality of an important period that is when expecting a second child. Based on Belsky’s determinants of parenting model (Belsky, 1984), we suggested three domains to relate to mother-child relationship quality, maternal personal resources (well-being, effortful control), child characteristics (temperament, behaviour problems) and contextual factors (household chaos, child-care support, marital satisfaction). Forty-five mothers (Mage= 34.78 years; SDage = 3.86 years) and their typically developing first-born children (Mchild age=32.26 months; SDage = 6.27) were visited at home in the south of England, Sussex, UK, where mothers completed questionnaires and mother-child interactions were videotaped. Results demonstrated that easier child temperament, better maternal well-being, less household chaos and more child-care support were related to more positive mother-child relationship quality. Together the variables explained 23% of the variance in relationship quality.  The child’s easy temperament, chaos and child-care support provided unique variance in explaining the mother-child relationship. These results contribute to the literature on expecting a second child and yield several implications. The findings also provide guidance for future intervention programs. In order to improve the mother-child relationship quality, child executive functioning may be a fruitful target for intervention, as well as increased support for child-care and decreased household chaos.
Clinicopathological and Prognostic Relevance of Tumoral Suppression of Tumorigenicity 2 Expression in Patients With Surgically Resected Pancreatic Carcinoma
Authors: NAGASE MAMIKO , IBUKI EMI , HABA REIJI , OKANO KEIICHI , KADOTA KYUICHI
Published: May 2023

Background/Aim: The interleukin (IL)-33/suppression of tumorigenicity 2 (ST2) pathway promotes cancer development and remodels the tumor microenvironment. However, the role of tumoral ST2 expression remains controversial in some solid malignancies. In this study, we have investigated the clinicopathological and prognostic relevance of tumoral ST2 expression in patients with resected pancreatic carcinoma after neoadjuvant chemoradiotherapy. Patients and Methods: We analyzed data from 76 patients with surgically resected pancreatic ductal adenocarcinoma after neoadjuvant chemoradiotherapy, between 2009 and 2018. Tissue microarrays were constructed and immunohistochemical analysis was performed for ST2. Associations between variables were analyzed using chi-square tests. Disease-specific survival (DSS) and disease-free survival (DFS) were analyzed using log-rank tests. Results: High expression of ST2, which was observed in 43 patients (57%), was more frequent in patients with high T status (p=0.002), lymphatic invasion (p=0.049), and ≤50% of tumor cells destroyed by chemoradiotherapy (p=0.043; Evans grade I-IIA vs. IIB). In stage I patients, DFS was significantly lower in patients with high ST2 expression (median, 10.6 months) than in those with low ST2 expression (median, 43.4 months; p=0.046). Conclusion: High tumoral ST2 expression is associated with high T status, lymphatic invasion, and lower histopathological response grade in patients with pancreatic carcinoma after neoadjuvant chemoradiotherapy.
The Usefulness of Total Laryngectomy in Sarcopenic Patients With Hypopharyngeal and Laryngeal Cancer
Authors: KITANO MUTSUKAZU , KOIKE SATORU , TAMAKI HISATOMO , IWAMOTO SHUSUKE , MIYAMOTO KAZUHIRO , OHIRA NORIKO , KIMURA TAKAYUKI , SATO MITSUO , YASUMATSU RYUJI
Published: May 2023

Background/Aim: Sarcopenia has an adverse effect on postoperative complications and prognoses in head and neck cancer. This study focused on hypopharyngeal and laryngeal cancer patients with sarcopenia and analyzed the body composition following treatment when the larynx was preserved and when total laryngectomy was performed to examine the usefulness of laryngectomy. Patients and Methods: We retrospectively reviewed 88 primary hypopharyngeal and laryngeal cancer patients aged 65 years or older with cT2N0M0 or higher who visited our department. Results: There were no significant differences in the 3-year overall survival rate and the 1-year local control rate between the laryngeal preservation group and laryngectomy group. The average change one year following treatment in the laryngeal preservation group, when compared to prior to treatment, was a significant decrease in the body weight (BW) of -0.035, skeletal muscle mass (SMM) of -0.030, skeletal muscle mass index (SMI) of -0.026, body mass index (BMI) of -0.034, and grip strength (GS) of -0.066. The average change one year following treatment in the laryngectomy group, compared with prior to treatment, was an increase in BW of +0.028, SMM of +0.026, SMI of +0.008, BMI of +0.032, and GS of +0.026. Although no changes in serum biochemical testing after treatment were observed in the laryngeal preservation group, albumin, transferrin, and transthyretin all exhibited significant improvement or a tendency toward improvement in the laryngectomy group. The patients with sarcopenia before treatment in the laryngeal preservation group had a significantly higher incidence of aspiration pneumonia. Conclusion: The presence or absence of sarcopenia before starting treatment is considered to be an index for selecting total laryngectomy.
Optimal Time Point for Evaluation of Response to Pembrolizumab Treatment in Japanese Patients With Metastatic Urothelial Carcinoma
Authors: INAMOTO TERUO , SATO RYO , MATSUSHITA YUTO , UCHIMOTO TAIZO , NAKAMURA KO , KOMURA KAZUMASA , NISHIMURA KAZUKI , YANO YUSUKE , NISHIO KYOSUKE , KINOSHITA SHOKO , FUKUSHIMA TATSUO , MATSUNAGA TOMOHISA , NAKAMORI KEITA , TSUTSUMI TAKESHI , TSUJINO TAKUYA , UEHARA HIROFUMI , TAKAHARA KIYOSHI , MIYAKE HIDEAKI , AZUMA HARUHITO
Published: May 2023

Background/Aim: The duration of pembrolizumab use in actual daily practice might be shorter than that in clinical trials because termination of pembrolizumab therapy is at the discretion of the physician. We retrospectively reviewed the response to pembrolizumab in Japanese patients with metastatic urothelial carcinoma (mUC) in relation to the time to response (TTR). Patients and Methods: The records of 165 patients treated with pembrolizumab for mUC were retrospectively analyzed. Response was evaluated at 2, 4, 6 and 8 months. TTR along with time to best response were analyzed. Phase II-III clinical trials were also reviewed to compare the TTR and time to best overall response. Results: The median patient age was 70 years. The objective response rate in the total cohort was 27.1% (42 out of 155 patients). Median TTR was 2.4 months and the time to best response was 3.1 months. Radiological evaluation at each time point significantly predicted overall survival (OS). Considering the evaluation of response at 2, 4, 6 and 8 months, the response at later time points tended to predict OS better. Multivariate analysis showed that the evaluation of response at 8 months (hazard ratio=1.91, 95% confidence interval=1.16-3.16 months; p<0.01) and best response during the treatment (hazard ratio=1.69, 95% confidence interval=1.17-2.44; p<0.01) independently predicted improved OS. Conclusion: Given that response when evaluated at a later point during pembrolizumab treatment more favorably reflected improved survival than when assessed earlier, physicians may be encouraged to wait until at least the termination of pembrolizumab treatment to determine the best response.
The Gap Between AI and Bedside: Participatory Workshop on the Barriers to the Integration, Translation, and Adoption of Digital Health Care and AI Startup Technology Into Clinical Practice
Authors: Olaye Iredia M , Seixas Azizi A
Published: May 2023

Background

Artificial intelligence (AI) and digital health technological innovations from startup companies used in clinical practice can yield better health outcomes, reduce health care costs, and improve patients' experience. However, the integration, translation, and adoption of these technologies into clinical practice are plagued with many challenges and are lagging. Furthermore, explanations of the impediments to clinical translation are largely unknown and have not been systematically studied from the perspective of AI and digital health care startup founders and executives.

Objective

The aim of this paper is to describe the barriers to integrating early-stage technologies in clinical practice and health care systems from the perspectives of digital health and health care AI founders and executives.

Methods

A stakeholder focus group workshop was conducted with a sample of 10 early-stage digital health and health care AI founders and executives. Digital health, health care AI, digital health–focused venture capitalists, and physician executives were represented. Using an inductive thematic analysis approach, transcripts were organized, queried, and analyzed for thematic convergence.

Results

We identified the following four categories of barriers in the integration of early-stage digital health innovations into clinical practice and health care systems: (1) lack of knowledge of health system technology procurement protocols and best practices, (2) demanding regulatory and validation requirements, (3) challenges within the health system technology procurement process, and (4) disadvantages of early-stage digital health companies compared to large technology conglomerates. Recommendations from the study participants were also synthesized to create a road map to mitigate the barriers to integrating early-stage or novel digital health technologies in clinical practice.

Conclusions

Early-stage digital health and health care AI entrepreneurs identified numerous barriers to integrating digital health solutions into clinical practice. Mitigation initiatives should create opportunities for early-stage digital health technology companies and health care providers to interact, develop relationships, and use evidence-based research and best practices during health care technology procurement and evaluation processes.
Factors Reducing the Use of a Persuasive mHealth App and How to Mitigate Them: Thematic Analysis
Authors: Kekkonen Markku , Korkiakangas Eveliina , Laitinen Jaana , Oinas-Kukkonen Harri
Published: May 2023

Background

Studies on which persuasive features may work for different users in health contexts are rare. The participants in this study were microentrepreneurs. We built a persuasive mobile app to help them to recover from work. Representatives of this target group tend to be very busy due to work, which was reflected in their use of the app during the randomized controlled trial intervention. Microentrepreneurs also often have dual roles; they are professionals in their line of work as well as entrepreneurs managing their own business, which may add to their workload.

Objective

This study aimed to present users’ views on the factors that hinder their use of the mobile health app that we developed and how these factors could be mitigated.

Methods

We interviewed 59 users and conducted both data-driven and theory-driven analyses on the interviews.

Results

Factors reducing app use could be divided into 3 categories: use context (problem domain–related issues, eg, the lack of time due to work), user context (user-related issues, eg, concurrent use of other apps), and technology context (technology-related issues, eg, bugs and usability). Due to the nature of the participants’ entrepreneurship, which often interferes with personal life, it became clear that designs targeting similar target groups should avoid steep learning curves and should be easy (quick) to use.

Conclusions

Personalized tunneling—guiding the user through a system via personalized solutions—could help similar target groups with similar issues better engage with and keep using health apps because of the easy learning curve. When developing health apps for interventions, background theories should not be interpreted too strictly. Applying theory in practice may require rethinking approaches for adaptation as technology has evolved rapidly and continues to evolve.

Trial Registration

ClinicalTrials.gov NCT03648593; https://clinicaltrials.gov/ct2/show/NCT03648593
Long-Term Impact of a Smartphone App on Prescriber Adherence to Antibiotic Guidelines for Adult Patients With Community-Acquired Pneumonia: Interrupted Time-Series Study
Authors: Yoon Chang Ho , Nolan Imogen , Humphrey Gayl , Duffy Eamon J , Thomas Mark G , Ritchie Stephen R
Published: May 2023

Background

Mobile health platforms like smartphone apps that provide clinical guidelines are ubiquitous, yet their long-term impact on guideline adherence remains unclear. In 2016, an antibiotic guidelines app, called SCRIPT, was introduced in Auckland City Hospital, New Zealand, to provide local antibiotic guidelines to clinicians on their smartphones.

Objective

We aimed to assess whether the provision of antibiotic guidelines in a smartphone app resulted in sustained changes in antibiotic guideline adherence by prescribers.

Methods

We analyzed antibiotic guideline adherence rates during the first 24 hours of hospital admission in adults diagnosed with community-acquired pneumonia using an interrupted time-series study with 3 distinct periods post app implementation (ie, 3, 12, and 24 months).

Results

Adherence increased from 23% (46/200) at baseline to 31% (73/237) at 3 months and 34% (69/200) at 12 months, reducing to 31% (62/200) at 24 months post app implementation (P=.07 vs baseline). However, increased adherence was sustained in patients with pulmonary consolidation on x-ray (9/63, 14% at baseline; 23/77, 30% after 3 months; 32/92, 35% after 12 month; and 32/102, 31% after 24 months; P=.04 vs baseline).

Conclusions

An antibiotic guidelines app increased overall adherence, but this was not sustained. In patients with pulmonary consolidation, the increased adherence was sustained.
Consultation Rate and Mode by Deprivation in English General Practice From 2018 to 2022: Population-Based Study
Authors: Vestesson Emma Maria , De Corte Kaat Lieve An , Crellin Elizabeth , Ledger Jean , Bakhai Minal , Clarke Geraldine M
Published: May 2023

Background

The COVID-19 pandemic has had a significant impact on primary care service delivery with an increased use of remote consultations. With general practice delivering record numbers of appointments and rising concerns around access, funding, and staffing in the UK National Health Service, we assessed contemporary trends in consultation rate and modes (ie, face-to-face versus remote).

Objective

This paper describes trends in consultation rates in general practice in England for key demographics before and during the COVID-19 pandemic. We explore the use of remote and face-to-face consultations with regard to socioeconomic deprivation to understand the possible effect of changes in consultation modes on health inequalities.

Methods

We did a retrospective analysis of 9,429,919 consultations by general practitioners, nurses, or other health care professionals between March 2018 and February 2022 for patients registered at 397 general practices in England. We used routine electronic health records from Clinical Practice Research Datalink Aurum with linkage to national data sets. Negative binomial models were used to predict consultation rates and modes (ie, remote versus face-to-face) by age, sex, and socioeconomic deprivation over time.

Results

Overall consultation rates increased by 15% from 4.92 in 2018-2019 to 5.66 in 2021-2022 with some fluctuation during the start of the COVID-19 pandemic. The breakdown into face-to-face and remote consultations shows that the pandemic precipitated a rapid increase in remote consultations across all groups, but the extent varies by age. Consultation rates increased with increasing levels of deprivation. Socioeconomic differences in consultation rates, adjusted for sex and age, halved during the pandemic (from 0.36 to 0.18, indicating more consultations in the most deprived), effectively narrowing relative differences between deprivation quintiles. This trend remains when stratified by sex, but the difference across deprivation quintiles is smaller for men. The most deprived saw a relatively larger increase in remote and decrease in face-to-face consultation rates compared to the least deprived.

Conclusions

The substantial increases in consultation rates observed in this study imply an increased pressure on general practice. The narrowing of consultation rates between deprivation quintiles is cause for concern, given ample evidence that health needs are greater in more deprived areas.
Long-Term Impact of a Smartphone App on Prescriber Adherence to Antibiotic Guidelines for Adult Patients With Community-Acquired Pneumonia: Interrupted Time-Series Study (Preprint)
Authors: Yoon Chang Ho , Nolan Imogen , Humphrey Gayl , Duffy Eamon J , Thomas Mark G , Ritchie Stephen R
Published: May 2023

BACKGROUND

Mobile health platforms like smartphone apps that provide clinical guidelines are ubiquitous, yet their long-term impact on guideline adherence remains unclear. In 2016, an antibiotic guidelines app, called SCRIPT, was introduced in Auckland City Hospital, New Zealand, to provide local antibiotic guidelines to clinicians on their smartphones.

OBJECTIVE

We aimed to assess whether the provision of antibiotic guidelines in a smartphone app resulted in sustained changes in antibiotic guideline adherence by prescribers.

METHODS

We analyzed antibiotic guideline adherence rates during the first 24 hours of hospital admission in adults diagnosed with community-acquired pneumonia using an interrupted time-series study with 3 distinct periods post app implementation (ie, 3, 12, and 24 months).

RESULTS

Adherence increased from 23% (46/200) at baseline to 31% (73/237) at 3 months and 34% (69/200) at 12 months, reducing to 31% (62/200) at 24 months post app implementation (P=.07 vs baseline). However, increased adherence was sustained in patients with pulmonary consolidation on x-ray (9/63, 14% at baseline; 23/77, 30% after 3 months; 32/92, 35% after 12 month; and 32/102, 31% after 24 months; P=.04 vs baseline).

CONCLUSIONS

An antibiotic guidelines app increased overall adherence, but this was not sustained. In patients with pulmonary consolidation, the increased adherence was sustained.