bluuebunny/crossref_metadata_2025 huggingface dataset:
And in The End: A 1980s Liverpool Youth Magazine
Authors: Grant John
Published: July 2022

This article will examine the 1980s magazine The End first published in Liverpool by young people following 2 years of Margaret Thatcher’s Conservative election victory in 1979. The End editors and contributors have previously been discussed within popular culture, but there is a lack of academic consideration of the magazine itself. The End has been absorbed within the wider “Casual Cultural” appraisal—soccer subcultures of fashion and “terrace culture.” The End stands alone as it embraced the difficult life experiences of school leavers and endeavored to apply a humorous and acidly sarcastic twist to the dull consequences of unemployment and economic recession. This paper will explore the social, economic, and industrial landscape at the time of The End’s inception and capture the thoughts and motivations of those who first published the magazine. An exploration will examine the devastation of one industry as a representation of many businesses and manufacturing plants in Liverpool that relocated or ceased trading in the early 1980s. It explores the multi-layered texture and observational humor within The End.
COVID-19: Factors Predicting Depressive Symptoms in People Aging With Long-Term Physical Disabilities
Authors: Chen Szu-Wei , Rice Susan , Storey Katelyn , Keglovits Marian , Devine Megen , Yan Yan , Stark Susan
Published: July 2022

The mental health impact of the COVID-19 pandemic may be greater than that of the viral infection. This impact is likely greater for disadvantaged groups such as people with long-term physical disabilities (PwLTPD). This cross-sectional study used a multiple linear regression model to examine factors associated with depressive symptoms and to understand their relative importance during the onset of the COVID-19 pandemic. The model explained 58% of the variance in depressive symptoms. Anxiety was the most important predictor, accounting for 8% of variance. Higher levels of anxiety, loneliness, and financial stress; prior diagnosis of depression; and non-Black race predicted a higher level of depressive symptoms in PwLTPD during the onset of the COVID-19 pandemic. Occupational therapy practitioners should strategically acknowledge predictors of depression that cannot be modified and actively address those that can be modified through evidence-based interventions to improve depressive symptoms in PwLTPD.
The Behavioural Economics of Music: Systematic review and future directions
Authors: Anglada-Tort Manuel , Masters Nikhil , Steffens Jochen , North Adrian , Müllensiefen Daniel
Published: July 2022

Music-related decision-making encompasses a wide range of behaviours including those associated with listening choices, composition and performance, and decisions involving music education and therapy. Although research programmes in psychology and economics have contributed to an improved understanding of music-related behaviour, historically, these disciplines have been unconnected. Recently, however, researchers have begun to bridge this gap by employing tools from behavioural economics. This article contributes to the literature by providing a discussion about the benefits of using behavioural economics in music-decision research. We achieve this in two ways. First, through a systematic review, we identify the current state of the literature within four key areas of behavioural economics—heuristics and biases, social decision-making, behavioural time preferences, and dual-process theory. Second, taking findings of the literature as a starting point, we demonstrate how behavioural economics can inform future research. Based on this, we propose the Behavioural Economics of Music (BEM), an integrated research programme that aims to break new ground by stimulating interdisciplinary research in the intersection between music, psychology, and economics.
Long-term outcomes of homodigital neurovascular island flap reconstruction of fingertip injuries in children
Authors: Yildirim Tugrul , Gunturk Ozgun Baris , Erol Kubilay , Toros Tulgar
Published: July 2022

We evaluated the long-term functional and cosmetic results of homodigital neurovascular island flap (NIF) used to reconstruct extensive pulp defects with bone exposure in children. Twenty-three children (mean age 4.8 years, range 1–10 years) with fingertip injuries were reconstructed with a pedicled homodigital NIF and evaluated in terms of sensation quality, cold intolerance, scar formation, nail deformity, range of motion and overall finger length at a mean follow up of 7.8 years (range 2–13). Eleven patients reported cold sensitivity in the operated fingertip, and 15 presented with hook nail deformities at the final follow-up. The total active motion of the injured finger was significantly lower than that of the uninjured side ( p < 0.001). NIFs is a safe, reliable reconstructive treatment for fingertip loss in children, but commonly encountered issues in the long term include an extension lag of the interphalangeal joints, hook nail deformities and cold intolerance.     Level of evidence: IV
Kingdom of Fear: Royal Governance under Thailand's King Vajiralongkorn
Authors: Chachavalpongpun Pavin
Published: July 2022

This article examines royal governance under King Maha Vajiralongkorn (Rama X) for the light it sheds on Thailand's recent political development. It is argued that the existence of “fear” defines Vajiralongkorn's relationship with the people. For members of the ruling class, fear keeps them in check. Within the palace, promotion and demotion are vital for control. The Royal Gazette (Rachakitjanubeksa) has become a platform for public humiliation that operates to inculcate fear. For the public, fear proliferates through a variety of means, including employing laws to punish critics of the monarchy, particularly the exploitation of lèse-majesté law, with the state's keen cooperation. But the 2020 protests, which demanded immediate monarchical reform, seriously challenged Vajiralongkorn's fear-based royal governance. The Thai case demonstrates that fear, a centuries-old form of governance used by many rulers to control their subjects, is no longer an effective tool of governance in modern, middle-class-driven, capitalist societies, like Thailand. Fear has a tendency to backfire on a sovereign if overused.
Remission of a Primary, Recurrent Thoracic Ewing Sarcoma in a 74-year-old woman
Authors: Tungate Robert M. , Lara Kristi , Patel Dakshesh , Fedenko Alexander , Hu James
Published: July 2022

Ewing sarcoma is a primitive neuroectodermal tumor which seldom presents with primary disease in people over age 40 and outside of the appendicular or axial skeleton. We examine a case of primary thoracic Ewing Sarcoma diagnosed initially by CT-guided biopsy in a woman at the age of 74 years. The disease progressed after initial combined modality therapy consisting of neoadjuvant chemotherapy, surgical resection, and adjuvant radiation therapy and two additional courses of multiagent chemotherapy. After relapse of her disease, subsequent second- and third-line systemic agents which included chemotherapy and targeted agents were given with disease stabilization achieved now over 30 months from initial diagnosis. To our knowledge, this is the first report of a primary pulmonary Ewing sarcoma diagnosed in a patient greater than 70 years of age in whom multiple remissions have been achieved with tolerable toxicities.
There's an app for that, but nobody's using it: Insights on improving patient access and adherence to digital therapeutics in Germany
Authors: Dahlhausen Florian , Zinner Maximillian , Bieske Linn , Ehlers Jan P , Boehme Philip , Fehring Leonard
Published: July 2022

Background

Mobile health applications and their subset digital therapeutics—defined as evidence-based software interventions to prevent, manage, or treat a medical condition—offer great potential to improve patient care. However, such solutions often struggle to reach widespread adoption.

Objective

This study seeks to explore healthcare stakeholders’ roles and potential for fostering patient access and adherence to evidence-based digital therapeutics and thereby improve health outcomes from the perspective of digital therapeutics developers and distributors.

Methods

Semi-structured qualitative and semiquantitative interviews were conducted with 19 experts from developers and distributors of digital therapeutics in Germany to discuss their perceived relevance of different healthcare stakeholders and strategies in promoting patient access and adherence to digital therapeutics.

Results

Healthcare professionals were found to have the greatest potential to promote both access and patient adherence to digital therapeutics, followed by health insurers, pharmaceutical companies, and patients themselves. In terms of patient access, healthcare professionals have potential due to their ability to prescribe digital therapeutics. Other stakeholders’ potential stems from their capacity to influence healthcare professionals prescription decision. In terms of patient adherence, only healthcare professionals are of high relevance by onboarding patients and monitoring digital therapeutics use. Most healthcare stakeholders currently do not fully leverage their potential. Further educating healthcare professionals and simplifying processes for them, empowering patients to seek treatment with digital therapeutics, and designing digital therapeutics’ product features for better adherence can help improve patient access and adherence.

Conclusions

Established healthcare stakeholders and digital therapeutics developers both need to take action to improve patient access and adherence to digital therapeutics. Several macro-level changes can support these efforts, including broader information dissemination, improved financial incentives, simplified prescription and activation processes, and a wider adoption of blended care and pay-for-performance payment models.
A conceptual framework for developing a glocalized school-based curriculum
Authors: HUANG Jing Ivy
Published: July 2022

The research was initially driven by an empirical requirement adopting foreign early childhood curricula for a K12 program from kindergarten to high school. After reviewing existing global or international curricula adopted and adapted in different research contexts, a handful of researches have been conducted in China’s context. However, the growth of internationalized K12 schools is rapid and the demand for glocalized school-based curriculum (SBC) is urgent in China. Therefore, a conceptual framework for developing a glocalized SBC was developed based on general curriculum development models, school-based curriculum development models, and the consideration of the contexts. The framework is expected can not only provide the current research with technical support in terms of integrating global curricula and local curricula for one specific kindergarten but it can also be applied by other researchers whose researches are related to curriculum development, specifically in the early childhood field and involving global and local context and curricula adaptation.
Studying the Experience of Care Through Latent Class Analysis: An Application to Italian Neonatal Intensive Care Units
Authors: Spezia Nicola , Soncin Mara , Masella Cristina , Agasisti Tommaso
Published: July 2022

Though many data on the experience of care of patients and caregivers are collected, they are rarely used to improve the quality of health care delivery. One of the main causes is the widespread struggle in interpreting and enhancing these data, requiring the introduction of new techniques to extract intelligible, meaningful, and actionable information. This research explores the potentiality of the latent class analysis (LCA) statistical model in studying experience data. A cross-sectional survey was administered to 482 parents of infants hospitalized in several Italian neonatal intensive care units. Through a 3-step LCA, four subgroups of parents with specific experience profiles, sociodemographic characteristics, and levels of satisfaction were identified. These were composed of parents who reported (1) a positive experience (36%), (2) problematic communication with unit staff (30%), (3) limited access to the unit and poor participation in their baby's care (26%), and (4) a negative experience (8%). Through its explorative segmentation, LCA can provide valuable information to design quality improvement interventions tailored to the specific needs and concerns of each subgroup.
Contradictions in Nation-Building: The Story of the Kandyans
Authors: Lecamwasam Hasini
Published: July 2022

The evolution of the ‘Kandyans’ of Sri Lanka, now considered a (culturally distinct) part of the country’s Sinhala majority, presents an intriguing puzzle. Even though they currently very much identify with the nationalist imagination and unitary state project of the greater Sinhala collectivity, they were historically the first in the island to forward a federal demand. As such, inquiring into how the Kandyans found it possible to integrate, politico-ideologically as much as materially, to the majority polity promises to be a worthy pursuit. It is even more intriguing when one considers the retention of their cultural distinction from other Sinhalese, notwithstanding politico-ideological integration. In seeking answers to this puzzle, the present study reveals that the plantation economy, administrative restructuring of the island and the choice of Buddhism as the exemplification of the cultural identity of Sri Lanka have been instrumental in the formation as well as subsequent dilution of the Kandyan identity over time. In this equation, the colonial intervention ironically has been crucial in marking the distinction of Kandy’s identity, and—rather unwittingly—its later integration with the larger Sinhala polity as well.
Asia Pacific Theological Association: Three Decades of Contribution toward Pentecostal Research and Ministry Training
Authors: Austin Denise A. , Carter John F.
Published: July 2022

The Assemblies of God World Missions of the USA lists over 2,500 affiliated Bible schools, extension centers, and seminaries in the regions it serves worldwide, collectively with over 170,000 students. While some research has explored the history of theological education in the Asia Pacific, few have examined Pentecostal training in the region. This article argues that, over the last thirty years, Asia Pacific Theological Association has helped shape Pentecostal theological education in the Asia Pacific and worldwide through its (1) national representation, (2) localized training and scholarship, (3) global impact on theological education, and (4) networking for interinstitutional cooperation.
Black boys matter – A Black supplementary school’s approach to supporting SEMH needs
Authors: Ricketts Laura , Kambouri Maria , Majors Karen
Published: July 2022

The birth of Black Supplementary Schools (BSSs) in the 1960s was a socio-political movement. They sought to reduce the failings of Black children in the mainstream education system by offering them additional learning spaces. However, there is limited research on their functionality and how they support children with Special Educational Needs (SEN), such as Social, Emotional and Mental Health (SEMH). This study sought to shed light on the role a BSS played in supporting Black boys who had been labelled with challenging behaviour by their mainstream educational provision and were at risk of or had been permanently excluded. The research adopted a single case-study design, employing qualitative data collection using semi-structured interviews. Thematic analysis was used to analyse the data; five main themes found were ‘Education is more than academia’, ‘Strong sense of belonging’, ‘People empowerment through unique opportunities’, ‘Knowing and growing thy self’ and ‘Supporting systemic strategies’. The recent insurgence of ‘Black Lives Matter’ highlighted that racial inequalities remain deeply embedded within the structural mechanisms of society. This research sheds light on the ways in which BBS’s support Black children to succeed educationally. Moreover, there are further implications for education settings, educators and other education professionals including Educational Psychologists.
Waterscapes and hydrosocial territories: Thinking space in political ecologies of water
Authors: Flaminio Silvia , Rouillé-Kielo Gaële , Le Visage Selin
Published: July 2022

Over the past two decades, ‘waterscape’ and ‘hydrosocial territory’ have gained momentum in political ecologies of water. These concepts explore the material outcomes of the interplay of social and biophysical processes by building on two different core concepts of geography (‘landscape’ and ‘territory’). Relying on a quantitative and qualitative analysis of a corpus comprising 113 articles (1999–2019), this paper investigates the commonalities and divergences in the spatialities of water that these concepts convey. We show that the two concepts delineate two close but nevertheless different analytical threads with regard to water-related spatialities. Yet, the use of the concepts waterscape or hydrosocial territory does not directly result from a theorisation of space that would be specific to different spatial contexts, but rather from what is studied in these spaces, that is, the socio-spatial inequalities or injustices that characterise them, and the transformations – either radical or incremental – that shape them.
Effect of layups on the mechanical properties of overlaid laminated bamboo lumber made of radial bamboo slices
Authors: Guan Xin , Yin Haining , Lin Che , Zhan Weihui
Published: July 2022

Radial bamboo strips are being widely used for structural applications due to the higher yield and high strength. However, there was a sharp taper at the top of bamboo which made nodal diaphragm removed incompletely during the process of stripping. The residual bump could bring about poor bonding strength between adjacent radial bamboo strips. In addition, the traditional radial bamboo strips should be weaved before the next step of processing, which caused a lot of material wastes and consumed a lot of labor and time. In order to address these problems, a novel lumber product made of laminated radial bamboo slices was developed by the proper arrangement of core layer and surface layer. The major and minor directions of a panel were defined as the parallel- and perpendicular-to-its arrangement ones in the core layer, respectively. It was found that (1) the layups with double-layer bamboo mats and radial bamboo slices could produce better mechanical properties. The effective modulus of elasticity in major and minor direction was about 7032.5 MPa and 5016.0 MPa, respectively. The effective modulus of rupture in major and minor direction was about 81.0 MPa and 43.6 MPa, respectively; (2) the density distribution tended to be uniform, with a density of about 0.7 g/cm3 that was lower than other similar bamboo-based materials (about 1.0 g/cm3); and (3) the failures occurred in bamboo slices rather than along the bond lines, suggesting good bond quality achieved in this study.
Comparative analysis of detection techniques for glyphosate in urine and in water
Authors: Vélot Christian , Poitou Frédéric , de Vendômois Joël Spiroux
Published: July 2022

Background

Glyphosate is the declared active component of the most extensively used herbicides in the world, and is therefore widely present in the environment. Glyphosate urinary levels represent a relevant biomarker for each individual’s exposure to glyphosate-based herbicides. However, GLY urine level measurement is controversial because different detection methods have led to contradictory results, especially in the cases of enzyme-linked immunosorbent assay (ELISA) versus liquid chromatography coupled to tandem mass spectrometry (LC/MS–MS) for urine, and ELISA versus high-performance liquid chromatography coupled to fluorescence detection (HPLC/Fluo) for water.

Methods

We compared the ELISA method to the LC/MS–MS or HPLC/Fluo one by submitting to two laboratories (Biocheck, Germany and Labocéa, France, respectively) identical urine and water samples, spiked or not with precise concentrations of glyphosate, but also with two chemically similar molecules: glycine and aminomethylphosphonic acid, GLY’s analogue and primary metabolite, respectively.

Results

Both laboratories claimed similar glyphosate quantification threshold (LOQ): 0.08 and 0.05 ng/mL, respectively. Each one of the tested methods proved to be specific for glyphosate and therefore did not result in any cross-detection with glycine and aminomethylphosphonic acid. However, these methods showed differences both in reproducibility and reliability depending on the matrix used (water or urine).

Conclusion

While the ELISA method gave less accurate results than the HPLC/Fluo technique when applied to water samples, the glyphosate concentrations measured in urine were much more reliable and reproducible with the ELISA technology than those obtained with the LC/MS–MS one.
Effect of pedo-climatic conditions on physicochemical characteristics and agro-industrial potential of three native oilseeds fruits from Burkina Faso
Authors: Sama Hemayoro , Traoré Dieudonné Kimbié , Guenné Samson , Hilou Adama , Dicko Mamoudou H.
Published: July 2022

Background

Plants are greatly affected by pedoclimatic conditions. They can alter the physiology of plants and affect seeds agro-morphological and physicochemical characteristics. It is therefore conceivable that tree species which have a potential as oil/fat producing plants are affected by pedoclimatic conditions variability. This study aims to evaluate the effect of pedoclimatic conditions variation on the physicochemical characteristics and the agro-industrial potential of three oilseeds fruits  from Burkina Faso: Balanites aegyptiaca, Sclerocarya birrea and Lannea microcarpa.

Results

A characterization of the size, chemical composition and weight of 100 seeds of the three native oilseeds from Banfora (Sudanian zone), Ouagadougou (Sudano-Sahelian zone) and Ouahigouya (Sahelian zone) was carried out. Results showed that seed size, seed weight and chemical composition varied significantly according to the pedoclimatic zone of the collection  significant correlations between seed size, 100-seed weight, total ash and also for seed oil content and moisture have also been revealed. Principal component analysis (PCA) associated increases in seed size and total ash content with high annual rainfall and low temperature areas, while increases in seed oil content were associated with low rainfall and high annual temperature areas.

Conclusion

Seed size and seed weight were associated with high rainfall and low temperature, while high temperature and low rainfall were associated with oil accumulation in the seeds. However, the limit number of replications of physicochemical characteristics analyses, a limitation of the study, does not allow an exhaustive conclusion to be drawn from the study.
Economic evaluations of radioembolization with Itrium-90 microspheres in hepatocellular carcinoma: a systematic review
Authors: Alonso J. C. , Casans I. , González F. M. , Fuster D. , Rodríguez A. , Sánchez N. , Oyagüez I. , Burgos R. , Williams A. O. , Espinoza N.
Published: July 2022

Background

Transarterial radioembolization (TARE) with yttrium-90 microspheres is a clinically effective therapy for hepatocellular carcinoma (HCC) treatment. This study aimed to perform a systematic review of the available economic evaluations of TARE for the treatment of HCC.

Methods

The Preferred Reported Items for Systematic reviews and Meta-Analyses guidelines was followed by applying a search strategy across six databases. All studies identified as economic evaluations with TARE for HCC treatment in English or Spanish language were considered. Costs were adjusted using the 2020 US dollars based on purchasing-power-parity ($US PPP).

Results

Among 423 records screened, 20 studies (6 cost-analyses, 3 budget-impact-analyses, 2 cost-effectiveness-analyses, 8 cost-utility-analyses, and 1 cost-minimization analysis) met the pre-defined criteria for inclusion. Thirteen studies were published from the European perspective, six from the United States, and one from the Canadian perspectives. The assessed populations included early- (n = 4), and intermediate-advanced-stages patients (n = 15). Included studies were evaluated from a payer perspective (n = 20) and included both payer and social perspective (n = 2). TARE was compared with transarterial chemoembolization (TACE) in nine studies or sorafenib (n = 11). The life-years gained (LYG) differed by comparator: TARE versus TACE (range: 1.3 to 3.1), and TARE versus sorafenib (range: 1.1 to 2.53). Of the 20 studies, TARE was associated with lower treatment costs in ten studies. The cost of TARE treatment varied widely according to Barcelona Clinic Liver Cancer (BCLC) staging system and ranged from 1311 $US PPP/month (BCLC-A) to 71,890 $US PPP/5-years time horizon (BCLC-C). The incremental cost-utility ratio for TARE versus TACE resulted in a 17,397 $US PPP/Quality-adjusted-Life-Years (QALY), and for TARE versus sorafenib ranged from dominant (more effectiveness and lower cost) to 3363 $US PPP/QALY.

Conclusions

Economic evaluations of TARE for HCC treatment are heterogeneous. Overall, TARE is a cost-effective short- and long-term therapy for the treatment of intermediate-advanced HCC.
Short-term effects of ambient temperature on the risk of preeclampsia in Nanjing, China: a time-series analysis
Authors: Zhao Tingting , Long Wei , Lu Peng
Published: July 2022

Objectives

Previous studies on the association between temperature and preeclampsia mainly considered temperature on a monthly or seasonal time scale. The objective of this study was to assess the preeclampsia risk associated with short-term temperature exposure using daily data.

Study design

Daily preeclampsia hospitalization data, daily meteorological data and daily air pollutant data from Nanjing were collected from 2016 to 2017. Both the T test and distributed lag nonlinear model (DLNM) were applied to assess the short-term effect of temperature on preeclampsia risk. Three kinds of daily temperature, including the daily mean temperature, daily minimum temperature and daily maximum temperature, were analysed.

Results

When the daily number of preeclampsia hospital admissions was divided into two subgroups based on temperature, it was significantly larger on cold days than on hot days. Regarding the mean temperature, a very low level of mean temperature (4.5 °C, lag = 0–20) and a low level of mean temperature (9.1 °C, lag = 0–20) increased the cumulative relative risk of preeclampsia by more than 60%. At the same time, a very high level of mean temperature (28.7 °C, lags = 0–10, 0–15, 0–20) and a high level of mean temperature (24.1 °C, lags = 0–10, 0–15) decreased the cumulative relative risk of preeclampsia by more than 35%. At a minimum temperature, a very low level of minimum temperature (0.9 °C, lag 0–5) and a low level of minimum temperature (5.6 °C, lag 0–5) increased the cumulative relative risk of preeclampsia by more than 55%. At the same time, a high level of mean temperature (20.9 °C, lags = 0, 0–5) decreased the cumulative relative risk of preeclampsia by more than 20%. The maximum temperature result was similar to the mean temperature result.

Conclusions

Both direct and lag effects of low temperature on preeclampsia were demonstrated to be significant risk factors. These results could be used to help pregnant women and the government reduce preeclampsia risk.
Health resource utilization and cost before versus after initiation of second-generation long-acting injectable antipsychotics among adults with schizophrenia in Alberta, Canada: a retrospective, observational single-arm study
Authors: Wong Kai On , Klarenbach Scott W. , Martins Karen J. B. , Chue Pierre , Dursun Serdar M. , Snaterse Mark , Guigue Alexis , So Helen , Luu Huong , Vu Khanh , Richer Lawrence
Published: July 2022

Background

Long-acting injectable (LAI) antipsychotics, along with community treatment orders (CTOs), are used to improve treatment effectiveness through adherence among individuals with schizophrenia. Understanding real-world medication adherence, and healthcare resource utilization (HRU) and costs in individuals with schizophrenia overall and by CTO status before and after second generation antipsychotic (SGA)-LAI initiation may guide strategies to optimize treatment among those with schizophrenia.

Methods

This retrospective observational single-arm study utilized administrative health data from Alberta, Canada. Adults (≥ 18 years) with schizophrenia who initiated a SGA-LAI (no use in the previous 2-years) between April 1, 2014 and March 31, 2016, and had ≥ 1 additional dispensation of a SGA-LAI were included; index date was the date of SGA-LAI initiation. Medication possession ratio (MPR) was determined, and paired t-tests were used to examine mean differences in all-cause and mental health-related HRU and costs (Canadian dollars), comprised of hospitalizations, physician visits, emergency department visits, and total visits, over the 2-year post-index and 2-year pre-index periods. Analyses were stratified by presence or absence of an active CTO during the pre-index and/or post-index periods.

Results

Among 1,211 adults with schizophrenia who initiated SGA-LAIs, 64% were males with a mean age of 38 (standard deviation [SD] 14) years. The mean overall antipsychotic MPR was 0.39 (95% confidence interval [CI] 0.36, 0.41) greater during the 2-year post-index period (0.84 [SD 0.26]) compared with the 2-year pre-index period (0.45 [SD 0.40]). All-cause and mental health-related HRU and costs were lower post-index versus pre-index (p < 0.001) for hospitalizations, physician visits, emergency department visits, and total visits; mean total all-cause HRU costs were $33,788 (95% CI -$38,993, -$28,583) lower post- versus pre-index ($40,343 [SD $68,887] versus $74,131 [SD $75,941]), and total mental health-related HRU costs were $34,198 (95%CI -$39,098, -$29,297) lower post- versus pre-index ($34,205 [SD $63,428] versus $68,403 [SD $72,088]) per-patient. Forty-three percent had ≥ 1 active CTO during the study period; HRU and costs varied according to CTO status.

Conclusions

SGA-LAIs are associated with greater medication adherence, and lower HRU and costs however the latter vary according to CTO status.
Influence of clinical factors on the protective or deleterious impact of genetic variants in orthodontically induced external root resorption: an observational study
Authors: Silva Henriqueta Coimbra , Lavado Nuno , Canova Filomena , Lopez Miguel Guevara , Regateiro Fernando J. , Pereira Sónia A.
Published: July 2022

Background

Prediction of susceptibility to Orthodontically Induced External Apical Root Resorption (OIEARR) has been hampered by the complex architecture of this multifactorial phenotype. The aim of this study was to analyze the impact of the interaction of multiple variables in the susceptibility to OIEARR.

Methods

The study evaluated 195 patients requiring orthodontic treatment. Nine clinical and treatment variables, single nucleotide polymorphisms (SNPs) from five genes and variables interactions were analyzed as risk factors for OIEARR using a multiple linear regression model.

Results

The model explained 29% of OIEARR variability (ANOVA: p < 0.01). Duration of treatment was the most important predictor and gender was the second, closely followed by premolar extraction. For genes encoding osteoprotegerin (OPG), the receptor activator of nuclear factor κ B (RANK) and the IL1 receptor antagonist (IL1RN), the effect of analyzed variants changed from protective to deleterious depending on the duration of treatment and the age of the patient.

Conclusions

This work shows that in OIEARR the impact of genetic susceptibility factors is dynamic changing according to clinical variables.
Cytotoxicity, acute and sub-chronic toxicities of the fruit extract of Tetrapleura tetraptera (Schumm. & Thonn.) Taub. (Fabaceae)
Authors: Bonsou Idrios N. , Mbaveng Armelle T. , Nguenang Gaëlle S. , Chi Godloves F. , Kuete Victor , Efferth Thomas
Published: July 2022

Background

Tetrapleura tetraptera is a medicinal spice traditionally used to treat cancer, diabetes, and several other ailments. This study analyzed the cytotoxicity of the dichloromethane methanol extract of T. tetraptera fruits (TTF) and its constituents. The toxicity profile of the TTF extract was also evaluated in rats.

Methods

The Cytotoxicity of this extract was evaluated using the resazurin reduction assay (RRA). Acute and sub-chronic toxicity studies were performed according to the protocol described by the Organisation for Economic Cooperation, and Development (OECD). Hematological, serum, and urine biochemical parameters, as well as histological sections of the liver and kidney, were also evaluated based on standard methods.

Results

The TTF extract, compound 5, and the reference drug doxorubicin were active in all 9 tested cancer cell lines. The recorded IC50 ranged from 18.32 μM (against B16-F1 murine melanoma cells) to 36.18 μM (against SKMel-505 BRAF wildtype melanoma cells) for TTF, from 10.02 μM (towards MaMel-80a BRAF-V600E homozygous mutant melanoma cells) to 31.73 μM (against SKMel-28 BRAF-V600E homozygous mutant melanoma cells) for compound 5, and from 0.22 μM (against B16-F1 cells) to 9.39 μM (against SKMel-505 cells) for doxorubicin. The study of acute toxicity test showed that the lethal dose (LD50) of this extract was greater than 5000 mg/kg body weight. In the sub-chronic toxicity studies, variations were observed in some biochemical parameters, especially at higher doses.

Conclusion

TTF and its most active compound (5) are found to be potential cytotoxic agents, meanwhile, TTF was safe when given a single oral dose of 5000 mg/kg. However, caution is necessary in case of prolonged oral administration due to potential alterations of renal function at high doses (> 1000 mg/kg).
A qualitative exploration of cultural safety in nursing from the perspectives of Advanced Practice Nurses: meaning, barriers, and prospects
Authors: Pirhofer Jacqueline , Bükki Johannes , Vaismoradi Mojtaba , Glarcher Manela , Paal Piret
Published: July 2022

Background

Cultural safety requires healthcare professionals and organisations to improve healthcare, facilitate patient access to healthcare, and achieve equity within the workforce.

Methods

This ethnomethodological study, which consisted of two phases, explored the concept of cultural safety from the perspective of Advanced Practice Nurses. Semi-structured interviews and the nominal group technique were used to prioritise challenges related to cultural safety, identify barriers to clinical practise and assess educational needs. The data collected was subjected to thematic analysis.

Results

Nurses working in Austria, Germany and Switzerland were recruited (N = 29). Accordingly, the phenomenon of cultural safety in health care is not generally known and there is little prior knowledge about it. The most frequently discussed themes were communication difficulties, lack of knowledge, the treatment of people with insufficient language skills and expectations of treatment goals and outcomes, which can lead to conflicts and accusations of unequal treatment due to diverse cultural backgrounds.

Conclusion

Diverse cultures are encountered in German-speaking healthcare settings. Cultural safety is also about healthcare staff, as nurses with different socialisations encounter prejudice, discrimination and racism. Although the issue of power was not discussed, academic nurses were willing to make an effort to change. Only a minority were aware that lasting change requires challenging one’s own cultural structures and adapted behaviours, rather than pushing for the mere acquisition of cultural competence. Organisations were encouraged to introduce self-reflection sessions and provide better access to translation services to improve equity and support nurses.
Pilot of rapid implementation of the advanced practice provider in the workflow of an existing tele-critical care program
Authors: Laudanski Krzysztof , Huffenberger Ann Marie , Scott Michael J. , Wain Justin , Ghani Danyal , Hanson C. William
Published: July 2022

Incorporating the advanced practice provider (APP) in the delivery of tele critical care medicine (teleCCM) addresses the critical care provider shortage. However, the current literature lacks details of potential workflows, deployment difficulties and implementation outcomes while suggesting that expanding teleCCM service may be difficult. Here, we demonstrate the implementation of a telemedicine APP (eAPP) pilot service within an existing teleCCM program with the objective of determining the feasibility and ease of deployment. The goal is to augment an existing tele-ICU system with a balanced APP service to assess the feasibility and potential impact on the ICU performance in several hospitals affiliated within a large academic center. A REDCap survey was used to assess eAPP workflows, expediency of interventions, duration of tasks, and types of assignments within different service locations. Between 02/01/2021 and 08/31/2021, 204 interventions (across 133 12-h shift) were recorded by eAPP (nroutine = 109 (53.4%); nurgent = 82 (40.2%); nemergent = 13 (6.4%). The average task duration was 10.9 ± 6.22 min, but there was a significant difference based on the expediency of the task (F [2; 202] = 3.89; p < 0.022) and type of tasks (F [7; 220] = 6.69; p < 0.001). Furthermore, the eAPP task type and expediency varied depending upon the unit engaged and timeframe since implementation. The eAPP interventions were effectively communicated with bedside staff with only 0.5% of suggestions rejected. Only in 2% cases did the eAPP report distress. In summary, the eAPP can be rapidly deployed in existing teleCCM settings, providing adaptable and valuable care that addresses the specific needs of different ICUs while simultaneously enhancing the delivery of ICU care. Further studies are needed to quantify the input more robustly.
Managing innovation: a qualitative study on the implementation of telehealth services in rural emergency departments
Authors: Nataliansyah Mochamad Muska , Merchant Kimberly A. S. , Croker James A. , Zhu Xi , Mohr Nicholas M. , Marcin James P. , Rahmouni Hicham , Ward Marcia M.
Published: July 2022

Background

Telehealth studies have highlighted the positive benefits of having the service in rural areas. However, there is evidence of limited adoption and utilization. Our objective was to evaluate this gap by exploring U.S. healthcare systems’ experience in implementing telehealth services in rural hospital emergency departments (TeleED) and by analyzing factors influencing its implementation and sustainability.

Methods

We conducted semi-structured interviews with 18 key informants from six U.S. healthcare systems (hub sites) that provided TeleED services to 65 rural emergency departments (spoke sites). All used synchronous high-definition video to provide the service. We applied an inductive qualitative analysis approach to identify relevant quotes and themes related to TeleED service uptake facilitators and barriers.

Results

We identified three stages of implementation: 1) the start-up stage; 2) the utilization stage; and 3) the sustainment stage. At each stage, we identified emerging factors that can facilitate or impede the process. We categorized these factors into eight domains: 1) strategies; 2) capability; 3) relationships; 4) financials; 5) protocols; 6) environment; 7) service characteristics; and 8) accountability.

Conclusions

The implementation of healthcare innovation can be influenced by multiple factors. Our study contributes to the field by highlighting key factors and domains that play roles in specific stages of telehealth operation in rural hospitals. By appreciating and responding to these domains, healthcare systems may achieve more predictable and favorable implementation outcomes. Moreover, we recommend strategies to motivate the diffusion of promising innovations such as telehealth.
Reduced frequencies of Foxp3+GARP+ regulatory T cells in COPD patients are associated with multi-organ loss of tissue phenotype
Authors: Hou Jia , Wang Xia , Su Chunxia , Ma Weirong , Zheng Xiwei , Ge Xiahui , Duan Xiangguo
Published: July 2022

Background

Expression of glycoprotein A dominant repeat (GARP) has been reported to occur only in activated human naturally occurring regulatory T cells (Tregs) and their clones, and not in activated effector T cells, indicating that GARP is a marker for bona fide Tregs. A different phenotype of chronic obstructive pulmonary disease (COPD) may have a different immunologic mechanism.

Objective

To investigate whether the distribution of Tregs defined by GARP is related to the multi-organ loss of tissue phenotype in COPD.

Methods

GARP expression on T cells from peripheral blood and bronchoalveolar lavage (BAL) collected from patients with COPD was examined by flow cytometry. The correlation of GARP expression to clinical outcomes and clinical phenotype, including the body mass index, lung function and quantitative computed tomography (CT) scoring of emphysema, was analyzed.

Results

Patients with more baseline emphysema had lower forced expiratory volume, body mass index (BMI), worse functional capacity, and more osteoporosis, thus, resembling the multiple organ loss of tissue (MOLT) phenotype. Peripheral Foxp3+GARP+ Tregs are reduced in COPD patients, and this reduction reversely correlates with quartiles of CT emphysema severity in COPD. Meanwhile, the frequencies of Foxp3+GARP− Tregs, which are characteristic of pro-inflammatory cytokine production, are significantly increased in COPD patients, and correlated with increasing quartiles of CT emphysema severity in COPD. Tregs in BAL show a similar pattern of variation in peripheral blood.

Conclusion

Decreased GARP expression reflects more advanced disease in MOLT phenotype of COPD. Our results have potential implications for better understanding of the immunological nature of COPD and the pathogenic events leading to lung damage.
Association of circulating vaspin levels and patients with metabolic-associated fatty liver disease: a systematic review and meta-analysis
Authors: Zhu Yuqing , Ke Yani , Hu Yijie , Wu Kaihan , Liu Shan , Hu Jie
Published: July 2022

Background

The incidence rate of metabolic-associated fatty liver disease (MAFLD) is increasing annually; however, there are still no effective methods for establishing an early diagnosis and conducting real-time tracing. Vaspin can affect the metabolic processes in the body, and it is closely associated with many metabolic diseases. Many previous studies have speculated on the association between vaspin and MAFLD, but the results of these studies have not been conclusive. This meta-analysis examined the differences in circulating vaspin levels between patients with MAFLD and healthy individuals.

Methods

Six databases and other sources were searched with free terms and Medical Subject Headings terms, and a total of 13 articles were included (900 cases and 669 controls). RevMan 5.3 and Stata 16 were used for analysis. The standardised mean difference (SMD) and 95% confidence interval (CI) were used to assess the overall outcomes. Cohen’s kappa coefficient was applied to examine the differences between the two authors in the selection of studies and in the evaluation of the quality of evidence for the studies.

Results

The results demonstrated that there was no significant difference in the circulating vaspin levels between the MAFLD group and healthy group (SMD = 0.46, 95% CI: [− 0.12, 1.04]). The subgroup analysis suggested that area and body mass index (BMI) may be the sources of heterogeneity, and the results of univariate meta-regression analysis were consistent with those of the subgroup analysis (P = 0.005 and P < 0.001, respectively). Furthermore, BMI may better explain the source of heterogeneity (P = 0.032) in the multivariate meta-regression analysis.

Conclusion

In summary, no significant correlation was observed between the circulating vaspin levels and MAFLD. BMI may be an important factor affecting this correlation, which may provide a reference for further studies on mechanism and diagnosis of MAFLD.
Long-term cancer risk in heterozygous familial hypercholesterolemia relatives: a 25-year cohort study
Authors: Kjærgaard Kasper Aalbæk , Harborg Sixten , Jensen Henrik Kjærulf , Borgquist Signe
Published: July 2022

Background

Heterozygous familial hypercholesterolemia (HeFH) due to low-density lipoprotein receptor (LDLR) mutations predisposes patients to highly elevated levels of cholesterol, and patients are at increased risk of adverse cardiovascular events and other morbidities. Whether the LDLR mutation and high cholesterol levels affect the risk of cancer remains unknown. The purpose of the present study was to assess the long-term cancer risk in HeFH relatives.

Methods

Study participants were identified by cascade screening during 1992–1994. A comparison cohort was matched 10:1 to the relatives from the Danish general population based on birth year, gender and address. All participants were followed until a cancer diagnosis, migration, death, or end of follow-up as of December 31, 2019. The primary endpoint was any incident cancer diagnosis.

Results

In total, we included 221 relatives with a median age of 37 years (interquartile range: 27–53 years). A total of 117 (53%) of the relatives carried a LDLR gene mutation. The crude hazard ratio of our primary endpoint did not reveal any differences in cancer incidence in mutation-carrying relatives compared with the general population cohort (1.18; 95% CI, 0.81–1.71). Nonmutation-carrying relatives however had a lower cancer incidence than the general population (0.45: 95% CI, 0.26–0.80). Thus, the risk among mutation-carrying HeFH relatives compared with nonmutation-carrying HeFH relatives was increased (HR: 2.39; 95% CI, 1.24–4.61).

Conclusion

In Denmark, LDLR mutation-carrying HeFH relatives did not have a different cancer risk than the general population. In contrast, nonmutation-carrying relatives had a lower risk of cancer.