bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of Indigenous health workers in the delivery of comprehensive primary health care in Canada, Australia, and New Zealand: a scoping review protocol
Authors: Violette Richard , Spinks Jean , Kelly Fiona , Wheeler Amanda
Published: May 2021

Objective:

The aim of this review is to identify and describe Indigenous health workers’ roles, functions, activities, and involvement in decision-making in the provision of primary health care for Indigenous peoples and communities in Canada, Australia, and New Zealand.

Introduction:

The Indigenous health worker workforce is the cornerstone to providing culturally safe, primary health care for Indigenous peoples and communities. Yet, wide-ranging role variation has created a general lack of understanding of who Indigenous health workers are, what Indigenous health workers do, and how to best coordinate their roles and skills with other care providers to further improve the health care experience and outcomes for Indigenous peoples and communities.

Inclusion criteria:

This review will consider full text, peer-reviewed publications and gray literature that include Indigenous health workers who identify as belonging to, and are recognized as such by their communities, any First Peoples group in Canada (First Nations, Inuit, Métis), Australia (Aboriginal, Torres Strait Islander), and New Zealand (Māori); and who describe their role as the provision of primary health care to Indigenous peoples and communities, in clinical and non-clinical settings, in both mainstream health systems and within community-controlled primary health care sectors.

Methods:

MEDLINE, CINAHL, Scopus, Embase, Informit (Indigenous Collection, New Zealand Collection, Rural and Remote Health Database, APAIS-ATSIS, Aboriginal and Torres Strait Islander health bibliography), Sociological Abstracts, and Australian Indigenous HealthInfoNet will be searched for studies. Additional sources of unpublished literature, including government websites and community-controlled health organization websites in Canada, Australia, and New Zealand, will also be searched. Articles in English and French will be included, with no set date restrictions. Screening and selection will follow JBI methodology and findings will be summarized in tabular form accompanied by narrative text.
Experiences of health care personnel in promoting a sense of home for older adults living in residential care facilities: a qualitative systematic review protocol
Authors: Matarese Maria , Mauro Lucia , Notarnicola Ippolito , Cinque Alessandro , Bonacci Sara , Covelli Giuliana , Casciato Stefano
Published: May 2021

Objective:

The objective of this review is to evaluate the experiences of health care personnel in promoting a sense of home for older adults living in residential care facilities.

Introduction:

Moving to a residential care facility represents a critical moment for older adults as it disrupts their life and distances them from significant people and objects in their life. Health care personnel working in residential care facilities can assist residents by promoting a feeling of being at home for these residents. There is a lack of qualitative evidence reporting the experiences of health care personnel with regards to promoting a sense of home for older adults living in residential care facilities.

Inclusion criteria:

This review will consider qualitative studies that explore the experiences of health care personnel in promoting a sense of home for people aged 65 years and over living in residential care facilities, including, but not limited to, nursing homes, residential care homes, retirement homes, assisted-living facilities, and skilled nursing facilities.

Methods:

The review will use a meta-aggregation approach following the JBI methodology for systematic reviews of qualitative evidence. MEDLINE, CINAHL, Embase, PsycINFO, Scopus, and Web of Science databases will be searched, together with Google Scholar, OpenGrey, and ProQuest Dissertations and Theses Global. Studies published in English, Italian, French, Portuguese, and Spanish will be included. Qualitative findings will be pooled using the JBI System for the Unified Management, Assessment and Review of Information. Methodological quality will be evaluated using the standard JBI critical appraisal checklist for qualitative research. The ConQual approach will be used to assess the confidence in the findings.

Systematic review registration number:

PROSPERO CRD42020214383
CASCADE3 A Monte Carlo event generator based on TMDs
Authors: Baranov S. , Bermudez Martinez A. , Estevez Banos L. I. , Guzman F. , Hautmann F. , Jung H. , Lelek A. , Lidrych J. , Lipatov A. , Malyshev M. , Mendizabal M. , Taheri Monfared S. , Kampen A. M. van , Wang Q. , Yang H.
Published: May 2021

The Cascade3 Monte Carlo event generator based on Transverse Momentum Dependent (TMD) parton densities is described. Hard processes which are generated in collinear factorization with LO multileg or NLO parton level generators are extended by adding transverse momenta to the initial partons according to TMD densities and applying dedicated TMD parton showers and hadronization. Processes with off-shell kinematics within $$k_{{t}}$$

k
t

-factorization, either internally implemented or from external packages via LHE files, can be processed for parton showering and hadronization. The initial state parton shower is tied to the TMD parton distribution, with all parameters fixed by the TMD distribution.
Probing thermal fluctuations through scalar test particles
Authors: Camargo G. H. S. , Lorenci V. A. De , Ferreira Junior A. L. , Ribeiro C. C. H.
Published: May 2021

The fundamental vacuum state of quantum fields, related to Minkowski space, produces divergent fluctuations that must be suppressed in order to bring reality to the description of physical systems. As a consequence, negative vacuum expectation values of classically positive-defined quantities can appear. This has been addressed in the literature as subvacuum phenomenon. Here it is investigated how a scalar charged test particle is affected by the vacuum fluctuations of a massive scalar field in D + 1 spacetime when the background evolves from empty space to a thermal bath, and also when a perfectly reflecting boundary is included. It is shown that when the particle is brought into a thermal bath it gains an amount of energy by means of positive dispersions of its velocity components. The magnitude of this effect is dependent on the temperature and also on the field mass. However, when a reflecting wall is inserted, dispersions can be positive or negative, showing that subvacuum effect happens even in a finite temperature environment. Furthermore, a remarkable result is that temperature can even improve negative velocity fluctuations. The magnitude of the residual effects depends on the switching interval of time the system takes to evolve between two states.
New Exact Solutions of Date Jimbo Kashiwara Miwa Equation Using Lie Symmetry Groups
Authors: Bibi Khudija , Ahmad Khalil
Published: May 2021

In this article, new exact solutions of

2
+
1

-dimensional Date Jimbo Kashiwara Miwa (DJKM) equation are constructed by applying the Lie symmetry method. By considering similarity variables obtained through Lie symmetry generators, considered

2
+
1

-dimensional DJKM equation is transformed into a linear partial differential equation with reduction of one independent variable. Afterwards by using Lie symmetry generators of this linear PDE, different invariant solutions involving exponential and logarithmic functions are explored which lead to the new exact solutions of the DJKM equation. Graphical representations of the obtained solutions are also presented to show the significance of the current work.
Dual Targeting of Chromatin Stability By The Curaxin CBL0137 and Histone Deacetylase Inhibitor Panobinostat Shows Significant Preclinical Efficacy in Neuroblastoma
Authors: Xiao Lin , Somers Klaartje , Murray Jayne , Pandher Ruby , Karsa Mawar , Ronca Emma , Bongers Angelika , Terry Rachael , Ehteda Anahid , Gamble Laura D. , Issaeva Natalia , Leonova Katerina I. , O'Connor Aisling , Mayoh Chelsea , Venkat Pooja , Quek Hazel , Brand Jennifer , Kusuma Frances K. , Pettitt Jessica A. , Mosmann Erin , Kearns Adam , Eden Georgina , Alfred Stephanie , Allan Sophie , Zhai Lei , Kamili Alvin , Gifford Andrew J. , Carter Daniel R. , Henderson Michelle J. , Fletcher Jamie I. , Marshall Glenn , Johnstone Ricky W. , Cesare Anthony J. , Ziegler David S. , Gudkov Andrei V. , Gurova Katerina V. , Norris Murray D. , Haber Michelle
Published: May 2021

Purpose:

We investigated whether targeting chromatin stability through a combination of the curaxin CBL0137 with the histone deacetylase (HDAC) inhibitor, panobinostat, constitutes an effective multimodal treatment for high-risk neuroblastoma.

Experimental Design:

The effects of the drug combination on cancer growth were examined in vitro and in animal models of MYCN-amplified neuroblastoma. The molecular mechanisms of action were analyzed by multiple techniques including whole transcriptome profiling, immune deconvolution analysis, immunofluorescence, flow cytometry, pulsed-field gel electrophoresis, assays to assess cell growth and apoptosis, and a range of cell-based reporter systems to examine histone eviction, heterochromatin transcription, and chromatin compaction.

Results:

The combination of CBL0137 and panobinostat enhanced nucleosome destabilization, induced an IFN response, inhibited DNA damage repair, and synergistically suppressed cancer cell growth. Similar synergistic effects were observed when combining CBL0137 with other HDAC inhibitors. The CBL0137/panobinostat combination significantly delayed cancer progression in xenograft models of poor outcome high-risk neuroblastoma. Complete tumor regression was achieved in the transgenic Th-MYCN neuroblastoma model which was accompanied by induction of a type I IFN and immune response. Tumor transplantation experiments further confirmed that the presence of a competent adaptive immune system component allowed the exploitation of the full potential of the drug combination.

Conclusions:

The combination of CBL0137 and panobinostat is effective and well-tolerated in preclinical models of aggressive high-risk neuroblastoma, warranting further preclinical and clinical investigation in other pediatric cancers. On the basis of its potential to boost IFN and immune responses in cancer models, the drug combination holds promising potential for addition to immunotherapies.
Effects of Sacubitril/Valsartan on Serum Lipids in Heart Failure With Preserved Ejection Fraction
Authors: Selvaraj Senthil , Claggett Brian L. , Packer Milton , Zannad Faiez , Anand Inder S. , Pieske Burkert , Zhao Ziqiang , Shi Victor C. , Lefkowitz Martin P. , McMurray John J. V. , Solomon Scott D.
Published: May 2021

Background

Dyslipidemia is common in heart failure with preserved ejection fraction. Sacubitril/valsartan improves glycemic control and augments natriuretic peptide signaling, providing mechanisms by which sacubitril/valsartan may affect serum lipids. However, empiric data on these effects are lacking.

Methods and Results

We analyzed 4774 participants from PARAGON‐HF (Prospective Comparison of Angiotensin Receptor–Neprilysin Inhibitor With Angiotensin‐Receptor Blockers Global Outcomes in Heart Failure With Preserved Ejection Fraction) with available screening lipids. During follow‐up visits, we analyzed the treatment effect on lipid levels and assessed for interaction by baseline lipid levels. At the 16‐week visit, we adjusted these treatment effects for the change in several biomarkers (including hemoglobin A
1c
and urinary cyclic guanosine monophosphate/creatinine [a biomarker of natriuretic peptide activation]). The average age was 73±8 years, 52% were women, 43% had diabetes mellitus, and 64% were on statin therapy. Compared with valsartan, sacubitril/valsartan reduced triglycerides −5.0% (95% CI, −6.6% to −3.5%), increased high‐density lipoprotein cholesterol +2.6% (95% CI, +1.7% to +3.4%), and increased low‐density lipoprotein cholesterol +1.7% (95% CI, +0.4% to +3.0%). Sacubitril/valsartan reduced triglycerides most among those with elevated baseline levels (triglycerides≥200 mg/dL) (
P
‐interaction<0.001), and at 16 weeks by −13.0% (95% CI, −18.1% to −7.6%), or −29.9 (95% CI, −44.3 to −15.5) mg/dL, in this group. Adjusting for the change in urinary cyclic guanosine monophosphate/creatinine significantly attenuated treatment effects on triglycerides and high‐density lipoprotein cholesterol, but not low‐density lipoprotein cholesterol, while adjusting for other biomarkers did not significantly alter the treatment effects.

Conclusions

Sacubitril/valsartan significantly reduces triglycerides compared with valsartan, an effect that was nearly threefold stronger in those with elevated baseline triglycerides. Modest increases in high‐density lipoprotein cholesterol and low‐density lipoprotein cholesterol cholesterol were also observed with therapy. The underlying mechanism(s) of changes in high‐density lipoprotein cholesterol and triglycerides are related to sacubitril/valsartan’s effects on natriuretic peptide activity.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01920711.
Out‐of‐Pocket Annual Health Expenditures and Financial Toxicity From Healthcare Costs in Patients With Heart Failure in the United States
Authors: Wang Stephen Y. , Valero‐Elizondo Javier , Ali Hyeon‐Ju , Pandey Ambarish , Cainzos‐Achirica Miguel , Krumholz Harlan M. , Nasir Khurram , Khera Rohan
Published: May 2021

Background

Heart failure (HF) poses a major public health burden in the United States. We examined the burden of out‐of‐pocket healthcare costs on patients with HF and their families.

Methods and Results

In the Medical Expenditure Panel Survey, we identified all families with ≥1 adult member with HF during 2014 to 2018. Total out‐of‐pocket healthcare expenditures included yearly care‐specific costs and insurance premiums. We evaluated 2 outcomes of financial toxicity: (1) high financial burden—total out‐of‐pocket healthcare expense to postsubsistence income ratio of >20%, and (2) catastrophic financial burden with the ratio of >40%—a bankrupting expense defined by the World Health Organization. There were 788 families in the Medical Expenditure Panel Survey with a member with HF representing 0.54% (95% CI, 0.48%–0.60%) of all families nationally. The overall mean annual out‐of‐pocket healthcare expenses were $4423 (95% CI, $3908–$4939), with medications and health insurance premiums representing the largest categories of cost. Overall, 14% (95% CI, 11%–18%) of families experienced a high burden and 5% (95% CI, 3%–6%) experienced a catastrophic burden. Among the two‐fifths of families considered low income, 24% (95% CI, 18%–30%) experienced a high financial burden, whereas 10% (95% CI, 6%–14%) experienced a catastrophic burden. Low‐income families had 4‐fold greater risk‐adjusted odds of high financial burden (odds ratio [OR] , 3.9; 95% CI, 2.3–6.6), and 14‐fold greater risk‐adjusted odds of catastrophic financial burden (OR, 14.2; 95% CI, 5.1–39.5) compared with middle/high‐income families.

Conclusions

Patients with HF and their families experience large out‐of‐pocket healthcare expenses. A large proportion encounter financial toxicity, with a disproportionate effect on low‐income families.
First Branchial Cleft Anomalies: Rare Work Type I and Type II Entities
Authors: Tarazis Konstantinos , Garefis Konstantinos , Garefi Maria , Nikolaidis Vasilios , Chatziavramidis Angelos , Markou Konstantinos
Published: May 2021

First branchial cleft anomalies (FBCAs) are the most infrequent malformations that occur during the development of the branchial apparatus, appearing in less than 8% of all branchial anomalies. Traditionally, they are classified into Work type I and II, depending on their origin. We present a pair of rare FBCAs: a case of a preauricular Work type I cyst with twin fistulae coursing toward the parotid gland and a Work type II cyst of significant dimensions.
Knowing bears: An ethnographic study of knowledge and agency in human–bear cohabitation
Authors: Toncheva Svetoslava , Fletcher Robert
Published: May 2021

This article explores a case of human–wildlife cohabitation in the Rodopi mountains of Bulgaria, wherein people and brown bears ( Ursus arctos) have adapted to living together in relative harmony. While this is due to a variety of factors, chief among these is the way both people and bears appear to pursue knowledge of one another and act on this knowledge so as to actively minimize potential for conflict. We draw on this case to contribute to growing discussion concerning how nonhumans should be understood and included within conservation policymaking. While conservation has conventionally been understood as something humans do on behalf of other species, a growing body of “more-than-human” research challenges this perspective as “anthropocentric” in arguing that nonhumans should be considered “co-constitutive actors” of the spaces they occupy. Based on this understanding, some go so far as to assert that a “multispecies ethics” demands that nonhumans be actively included in decision-making concerning such spaces’ governance. While our study indeed demonstrates that both humans and bears seem to mold their behavior in relation to their sensing of the other’s behavior, it also demonstrates that knowledge of bears’ behavior is ultimately always interpreted by humans in conservation management. Moreover, different groups of stakeholders hold different knowledge of bears that influence their attitudes and behavior towards the animals. The study thus raises important questions concerning how to incorporate bears (and other nonhumans) within conservation decision-making, and whose knowledge should be privileged in the process.
Phylogenetic history influences convergence for a specialized ecology: comparative skull morphology of African burrowing skinks (Squamata; Scincidae)
Authors: Stepanova Natasha , Bauer Aaron M.
Published: May 2021

Background

Skulls serve many functions and as a result, are subject to many different evolutionary pressures. In squamates, many fossorial species occupy a unique region of skull morphospace, showing convergence across families, due to modifications related to head-first burrowing. As different substrates have variable physical properties, particular skull shapes may offer selective advantages in certain substrates. Despite this, studies of variation within burrowers have been limited and are typically focused on a single origin of fossoriality. We focused on seven skink genera (Acontias, Typhlosaurus, Scelotes, Sepsina, Feylinia, Typhlacontias, and Mochlus; 39 sp.) from southern Africa, encompassing at least three independent evolutions of semi-fossoriality/fossoriality. We used microCT scans and geometric morphometrics to test how cranial and mandibular shape were influenced by phylogenetic history, size, and ecology. We also qualitatively described the skulls of four species to look at variation across phylogenetic and functional levels, and assess the degree of convergence.

Results

We found a strong effect of phylogenetic history on cranial and mandibular shape, with size and substrate playing secondary roles. There was a clear gradient in morphospace from less specialized to more specialized burrowers and burrowers in sand were significantly different from those in other substrates. We also created an anatomical atlas for four species with each element described in isolation. Every bone showed some variation in shape and relative scaling of features, with the skull roofing bones, septomaxilla, vomer, and palatine showing the most variation. We showed how broad-scale convergence in traits related to fossoriality can be the result of different anatomical changes.

Conclusions

Our study used geometric morphometrics and comparative anatomy to examine how skull morphology changes for a highly specialized and demanding lifestyle. Although there was broad convergence in both shape and qualitative traits, phylogenetic history played a large role and much of this convergence was produced by different anatomical changes, implying different developmental pathways or lineage-specific constraints. Even within a single family, adaptation for a specialized ecology does not follow a singular deterministic path.
A population‐based study to develop juvenile arthritis case definitions for administrative health data using model‐based dynamic classification
Authors: Feely Allison , Lim Lily SH , Jiang Depeng , Lix Lisa M.
Published: May 2021

Background

Previous research has shown that chronic disease case definitions constructed using population-based administrative health data may have low accuracy for ascertaining cases of episodic diseases such as rheumatoid arthritis, which are characterized by periods of good health followed by periods of illness. No studies have considered a dynamic approach that uses statistical (i.e., probability) models for repeated measures data to classify individuals into disease, non-disease, and indeterminate categories as an alternative to deterministic (i.e., non-probability) methods that use summary data for case ascertainment. The research objectives were to validate a model-based dynamic classification approach for ascertaining cases of juvenile arthritis (JA) from administrative data, and compare its performance with a deterministic approach for case ascertainment.

Methods

The study cohort was comprised of JA cases and non-JA controls 16 years or younger identified from a pediatric clinical registry in the Canadian province of Manitoba and born between 1980 and 2002. Registry data were linked to hospital records and physician billing claims up to 2018. Longitudinal discriminant analysis (LoDA) models and dynamic classification were applied to annual healthcare utilization measures. The deterministic case definition was based on JA diagnoses in healthcare use data anytime between birth and age 16 years; it required one hospitalization ever or two physician visits. Case definitions based on model-based dynamic classification and deterministic approaches were assessed on sensitivity, specificity, and positive and negative predictive values (PPV, NPV). Mean time to classification was also measured for the former.

Results

The cohort included 797 individuals; 386 (48.4 %) were JA cases. A model-based dynamic classification approach using an annual measure of any JA-related healthcare contact had sensitivity = 0.70 and PPV = 0.82. Mean classification time was 9.21 years. The deterministic case definition had sensitivity = 0.91 and PPV = 0.92.

Conclusions

A model-based dynamic classification approach had lower accuracy for ascertaining JA cases than a deterministic approach. However, the dynamic approach required a shorter duration of time to produce a case definition with acceptable PPV. The choice of methods to construct case definitions and their performance may depend on the characteristics of the chronic disease under investigation.
Methodology of the DCCSS later fatigue study: a model to investigate chronic fatigue in long-term survivors of childhood cancer
Authors: Penson Adriaan , van Deuren Sylvia , Bronkhorst Ewald , Keizer Ellen , Heskes Tom , Coenen Marieke J. H. , Rosmalen Judith G. M. , Tissing Wim J. E. , van der Pal Helena J. H. , de Vries Andrica C. H. , van den Heuvel-Eibrink Marry M. , Neggers Sebastian , Versluys Birgitta A. B. , Louwerens Marloes , van der Heiden-van der Loo Margriet , Pluijm Saskia M. F. , Grootenhuis Martha , Blijlevens Nicole , Kremer Leontien C. M. , van Dulmen-den Broeder Eline , Knoop Hans , Loonen Jacqueline
Published: May 2021

Background

A debilitating late effect for childhood cancer survivors (CCS) is cancer-related fatigue (CRF). Little is known about the prevalence and risk factors of fatigue in this population. Here we describe the methodology of the Dutch Childhood Cancer Survivor Late Effect Study on fatigue (DCCSS LATER fatigue study). The aim of the DCCSS LATER fatigue study is to examine the prevalence of and factors associated with CRF, proposing a model which discerns predisposing, triggering, maintaining and moderating factors. Triggering factors are related to the cancer diagnosis and treatment during childhood and are thought to trigger fatigue symptoms. Maintaining factors are daily life- and psychosocial factors which may perpetuate fatigue once triggered. Moderating factors might influence the way fatigue symptoms express in individuals. Predisposing factors already existed before the diagnosis, such as genetic factors, and are thought to increase the vulnerability to develop fatigue. Methodology of the participant inclusion, data collection and planned analyses of the DCCSS LATER fatigue study are presented.

Results

Data of 1955 CCS and 455 siblings was collected. Analysis of the data is planned and we aim to start reporting the first results in 2022.

Conclusion

The DCCSS LATER fatigue study will provide information on the epidemiology of CRF and investigate the role of a broad range of associated factors in CCS. Insight in associated factors for fatigue in survivors experiencing severe and persistent fatigue may help identify individuals at risk for developing CRF and may aid in the development of interventions.
Development and head-to-head comparison of machine-learning models to identify patients requiring prostate biopsy
Authors: Yu Shuanbao , Tao Jin , Dong Biao , Fan Yafeng , Du Haopeng , Deng Haotian , Cui Jinshan , Hong Guodong , Zhang Xuepei
Published: May 2021

Background

Machine learning has many attractive theoretic properties, specifically, the ability to handle non predefined relations. Additionally, studies have validated the clinical utility of mpMRI for the detection and localization of CSPCa (Gleason score ≥ 3 + 4). In this study, we sought to develop and compare machine-learning models incorporating mpMRI parameters with traditional logistic regression analysis for prediction of PCa (Gleason score ≥ 3 + 3) and CSPCa on initial biopsy.

Methods

A total of 688 patients with no prior prostate cancer diagnosis and tPSA ≤ 50 ng/ml, who underwent mpMRI and prostate biopsy were included between 2016 and 2020. We used four supervised machine-learning algorithms in a hypothesis-free manner to build models to predict PCa and CSPCa. The machine-learning models were compared to the logistic regression analysis using AUC, calibration plot, and decision curve analysis.

Results

The artificial neural network (ANN), support vector machine (SVM), and random forest (RF) yielded similar diagnostic accuracy with logistic regression, while classification and regression tree (CART, AUC = 0.834 and 0.867) had significantly lower diagnostic accuracy than logistic regression (AUC = 0.894 and 0.917) in prediction of PCa and CSPCa (all P < 0.05). However, the CART illustrated best calibration for PCa (SSR = 0.027) and CSPCa (SSR = 0.033). The ANN, SVM, RF, and LR for PCa had higher net benefit than CART across the threshold probabilities above 5%, and the five models for CSPCa displayed similar net benefit across the threshold probabilities below 40%. The RF (53% and 57%, respectively) and SVM (52% and 55%, respectively) for PCa and CSPCa spared more unnecessary biopsies than logistic regression (35% and 47%, respectively) at 95% sensitivity for detection of CSPCa.

Conclusion

Machine-learning models (SVM and RF) yielded similar diagnostic accuracy and net benefit, while spared more biopsies at 95% sensitivity for detection of CSPCa, compared with logistic regression. However, no method achieved desired performance. All methods should continue to be explored and used in complementary ways.
Training interns in nutrition and dietetics: a cross-sectional study of the barriers and motivators to being a Registered Dietitian Nutritionist preceptor
Authors: Hutchins Andrea M. , Winham Donna M. , Fellows Jinette P. , Heer Michelle M.
Published: May 2021

Background

As is common across the health professions, training of Registered Dietitian Nutritionists (RDNs) requires experiential learning for interns/students to gain skills and demonstrate entry-level competency. Preceptors are essential to the experiential learning component of health care professional training, providing supervision and mentoring as students and interns gain the skills required for entry-level practice competency. Over the past 27 years, 47–73% of applicants to dietetic internships have received a placement. Practitioners willing to volunteer as preceptors are needed to generate more internship or experiential learning opportunities for the profession to continue to meet workforce demands.

Methods

The objective of this national-level online cross-sectional survey was to identify perceptions and attitudes associated with the preceptor role and incentives that might encourage precepting by current RDNs. A random sample of RDN and Nutrition and Dietetic Technicians, Registered (NDTR) professionals from the Commission on Dietetic Registration credentialed practitioner database were eligible to participate in the online survey. The main outcome measures included perceptions, attitudes, and preferred incentives to precept compared by preceptor experience categories (current, former, never precepted). Comparisons of perceptions, attitudes, and preferred incentives were made between preceptor experience categories using Chi-square and ANOVA.

Results

Of 2464 invitations, 308 participants had complete variables for analysis. Top incentives were the opportunity to earn continuing education units (65.9%) and having expenses paid to attend a national conference (49.5%). Significantly more (P < 0.001) “former” and “never” preceptors reported the ability to choose when to take an intern, training on how to teach and communicate with interns, and access to an “on-call” specialist as incentives compared to “current” preceptors. Significantly more (P < 0.01) “never” preceptors reported training on internship expectations and the ability to provide input on intern selection process as incentives compared to “current” or “former” preceptors.

Conclusions

Incentives to serve as a preceptor differ based on “current”, “former”, or “never” precepted status. Promoting and strategizing solutions to the current imbalance between the greater number of dietetic internship applicants compared to preceptors should be targeted based on preceptor status to retain current preceptors, encourage former preceptors to return and recruit professionals who have never served.
The albumin-to-alkaline phosphatase ratio as an independent predictor of future non-alcoholic fatty liver disease in a 5-year longitudinal cohort study of a non-obese Chinese population
Authors: Sheng Guotai , Peng Nan , Hu Chong , Zhong Ling , Zhong Mingchun , Zou Yang
Published: May 2021

Background

The albumin-to-alkaline phosphatase ratio (AAPR) is a newly developed index of liver function, but its association in patients with non-alcoholic fatty liver disease (NAFLD) has not been established. The aim of this study was to investigate the association between the AAPR and NAFLD in a non-obese Chinese population.

Methods

The study included 10,749 non-obese subjects without NAFLD at baseline and divided them into quintiles according to the AAPR. A Cox multiple regression model was used to examine the association between the AAPR and its quintiles and the incidence of NAFLD.

Results

The average age of the study population was 43.65 ± 15.15 years old. During the 5-year follow-up, 1860 non-obese subjects had NAFLD events. In the Cox multiple regression model, after adjusting the model according to important risk factors, the AAPR and NAFLD risk were independently correlated, and with a gradual increase in the AAPR, the NAFLD risk decreased gradually (HR: 0.61, 95% CI: 0.47, 0.81; P-trend< 0.0001). Additionally, there were significant interactions between the AAPR and BMI, blood pressure and lipids (P-interaction < 0.05). Stratified analysis showed that the risk of AAPR-related NAFLD decreased in people with normal blood pressure and lipid levels, while the risk of AAPR-related NAFLD increased abnormally in people who were underweight.

Conclusions

This longitudinal cohort study provides the first evidence that the AAPR is an independent predictor of future NAFLD events in non-obese people. For non-obese people with a low AAPR, especially those with BMI < 18.5 kg/m2, more attention should be given to the management of risk factors for NAFLD to prevent future NAFLD.
Complete spatial characterisation of N-glycosylation upon striatal neuroinflammation in the rodent brain
Authors: Rebelo Ana Lúcia , Gubinelli Francesco , Roost Pauline , Jan Caroline , Brouillet Emmanuel , Van Camp Nadja , Drake Richard R. , Saldova Radka , Pandit Abhay
Published: May 2021

Background

Neuroinflammation is an underlying pathology of all neurological conditions, the understanding of which is still being comprehended. A specific molecular pathway that has been overlooked in neuroinflammation is glycosylation (i.e., post-translational addition of glycans to the protein structure).N-glycosylation is a specific type of glycosylation with a cardinal role in the central nervous system (CNS), which is highlighted by congenital glycosylation diseases that result in neuropathological symptoms such as epilepsy and mental retardation. Changes inN-glycosylation can ultimately affect glycoproteins’ functions, which will have an impact on cell machinery. Therefore, characterisation ofN-glycosylation alterations in a neuroinflammatory scenario can provide a potential target for future therapies.

Methods

With that aim, the unilateral intrastriatal injection of lipopolysaccharide (LPS) in the adult rat brain was used as a model of neuroinflammation. In vivo andpost-mortem, quantitative and spatial characterisation of both neuroinflammation andN-glycome was performed at 1-week post-injection of LPS. These aspects were investigated through a multifaceted approach based on positron emission tomography (PET), quantitative histology, reverse transcription-quantitative polymerase chain reaction (RT-qPCR), liquid chromatography and matrix-assisted laser desorption ionisation mass spectrometry imaging (MALDI-MSI).

Results

In the brain region showing LPS-induced neuroinflammation, a significant decrease in the abundance of sialylated and core fucosylated structures was seen (approximately 7.5% and 8.5%, respectively), whereas oligomannoseN-glycans were significantly increased (13.5%). This was confirmed by MALDI-MSI, which provided a high-resolution spatial distribution ofN-glycans, allowing precise comparison between normal and diseased brain hemispheres.

Conclusions

Together, our data show for the first time the complete profiling ofN-glycomic changes in a well-characterised animal model of neuroinflammation. These data represent a pioneering step to identify critical targets that may modulate neuroinflammation in neurodegenerative diseases.
High-fat diet impairs duodenal barrier function and elicits glia-dependent changes along the gut-brain axis that are required for anxiogenic and depressive-like behaviors
Authors: Seguella Luisa , Pesce Mirella , Capuano Riccardo , Casano Fabrizio , Pesce Marcella , Corpetti Chiara , Vincenzi Martina , Maftei Daniela , Lattanzi Roberta , Del Re Alessandro , Sarnelli Giovanni , Gulbransen Brian D. , Esposito Giuseppe
Published: May 2021

Background

Mood and metabolic disorders are interrelated and may share common pathological processes. Autonomic neurons link the brain with the gastrointestinal tract and constitute a likely pathway for peripheral metabolic challenges to affect behaviors controlled by the brain. The activities of neurons along these pathways are regulated by glia, which exhibit phenotypic shifts in response to changes in their microenvironment. How glial changes might contribute to the behavioral effects of consuming a high-fat diet (HFD) is uncertain. Here, we tested the hypothesis that anxiogenic and depressive-like behaviors driven by consuming a HFD involve compromised duodenal barrier integrity and subsequent phenotypic changes to glia and neurons along the gut-brain axis.

Methods

C57Bl/6 male mice were exposed to a standard diet or HFD for 20 weeks. Bodyweight was monitored weekly and correlated with mucosa histological damage and duodenal expression of tight junction proteins ZO-1 and occludin at 0, 6, and 20 weeks. The expression of GFAP, TLR-4, BDNF, and DCX were investigated in duodenal myenteric plexus, nodose ganglia, and dentate gyrus of the hippocampus at the same time points. Dendritic spine number was measured in cultured neurons isolated from duodenal myenteric plexuses and hippocampi at weeks 0, 6, and 20. Depressive and anxiety behaviors were also assessed by tail suspension, forced swimming, and open field tests.

Results

HFD mice exhibited duodenal mucosa damage with marked infiltration of immune cells and decreased expression of ZO-1 and occludin that coincided with increasing body weight. Glial expression of GFAP and TLR4 increased in parallel in the duodenal myenteric plexuses, nodose ganglia, and hippocampus in a time-dependent manner. Glial changes were associated with a progressive decrease in BDNF, and DCX expression, fewer neuronal dendritic spines, and anxiogenic/depressive symptoms in HFD-treated mice. Fluorocitrate (FC), a glial metabolic poison, abolished these effects both in the enteric and central nervous systems and prevented behavioral alterations at week 20.

Conclusions

HFD impairs duodenal barrier integrity and produces behavioral changes consistent with depressive and anxiety phenotypes. HFD-driven changes in both peripheral and central nervous systems are glial-dependent, suggesting a potential glial role in the alteration of the gut-brain signaling that occurs during metabolic disorders and psychiatric co-morbidity.
Effective treatment of electrical storm by a wearable cardioverter defibrillator in a patient with severely impaired left ventricular function after myocardial infarction: a case report
Authors: Andresen Henrike , Sasko B. , Patschan D. , Pagonas N. , Ritter O.
Published: May 2021

Background

The implantation of cardioverter defibrillators (ICDs) is an established therapy in the prevention of sudden cardiac death in patients with systolic dysfunction after myocardial infarction. To avoid immediate implantation of an ICD, wearable cardioverter defibrillator vests (WCD) can be used to protect patients against malignant rhythm disorders, while at the same time drug-based heart failure therapy has to be initiated. This drug therapy can improve left ventricular ejection fraction and primary prophylactic cardioverter defibrillator implantation may not be necessary. However, the recent Vest Prevention of Early Sudden Death Trial (VEST) questioned the regular use of the WCD in this setting.

Case presentation

A 47-year-old Caucasian man with severely impaired left ventricular function early after myocardial infarction was prescribed a WCD as primary prophylaxis to prevent sudden cardiac death. Seven days after the patient was supplied with a WCD, the patient suffered from an electrical storm with recurrent ventricular tachycardia (VT), which was successfully terminated 17 times by the WCD. On coronary angiography, the formerly infarct-related right coronary artery had TIMI (Thrombolysis in Myocardial Ischemia Trial) III flow, and a remaining stenosis in the left anterior descending artery (LAD) was stented, which did not stop recurrent VT. In the electrophysiology (EP) study, a focus was mapped in the left inferior ventricle, which was ablated. This stopped the VT. A second radio-frequency (RF) ablation in the same area was necessary after 14 days. Finally, a permanent cardioverter defibrillator was implanted.

Conclusion

We report the case of a patient who survived recurrent episodes of VT early after myocardial infarction by effective defibrillation with a WCD. The WCD is a useful device to bridge time until a final decision for implantation of a defibrillator.
Vertical price transmission in Swiss dairy and cheese value chains
Authors: Hillen Judith
Published: May 2021

In Switzerland, there are separated value chains for dairy and cheese products, which differ in terms of industry concentration, value chain governance, and product characteristics. We analyze how milk prices are passed on along these different value chains. Using detailed price data on farm gate, wholesale, export, and retail levels, we apply asymmetric vector autoregressive and vector error correction models to study vertical price transmission in Swiss dairy and cheese chains. Contrary to most existing literature, we find almost no long-run price relationships and no significant asymmetries between the different stages and products and discuss the potential reasons.
Associations between family social circumstances and psychological distress among the university students of Bangladesh: To what extent do the lifestyle factors mediate?
Authors: Huda Md. Nazmul , Billah Masum , Sharmin Sonia , Amanullah A. S. M. , Hossin Muhammad Zakir
Published: May 2021

Background

While there is a growing body of empirical studies focusing on the social and behavioral predictors of psychological health, the mechanisms that may underlie the reported associations have not been adequately explored. This study aimed to examine the association of social and lifestyle factors with psychological distress, and the potential mediating role of the lifestyle factors in the estimated associations between social circumstances and psychological distress.

Methods

A total of 742 tertiary level students (53% females) from a range of socio-economic backgrounds and multiple educational institutions participated in this cross-sectional study. The 12-items General Health Questionnaire (GHQ-12) was utilized for measuring psychological distress. Data related to students’ socio-demographic characteristics, family social circumstances, and lifestyle factors were also collected. Modified Poisson regression analysis was used to estimate the risk ratios (RR) and their 95% confidence intervals (CI).

Results

The multivariable regression analysis suggests heightened risks of psychological distress associated with low parental Socio-Economic Position (SEP) (RR: 1.36; 95% CI: 1.07, 1.76), childhood poverty (RR: 1.31; 95% CI: 1.11, 1.55), and living away from the family (RR: 1.28; 95% CI: 1.07, 1.54). Among the lifestyle factors, past smoking, physical inactivity, inadequate fruit intake, and poor sleep quality were strongly associated with psychological distress and these associations persisted when the family social circumstances and lifestyle factors were mutually adjusted for. The lifestyle factors did not considerably mediate the estimated associations between family social circumstances and psychological distress.

Conclusion

The social and lifestyle factors operated independently to increase students’ risk of psychological distress. Accordingly, while promoting students’ healthy lifestyles may reduce the overall burden of psychological distress, any equity initiative aiming to minimize the social inequalities in psychological health should be targeted to improving the living conditions in early life.
Faculty as reflective practitioners in emergency online teaching: an autoethnography
Authors: Jung Insung , Omori Sawa , Dawson Walter P. , Yamaguchi Tomiko , Lee Seunghun J.
Published: May 2021

This study aimed to chronicle and understand the emergency online teaching experience of five faculty members in a liberal arts college located in Tokyo, Japan during the COVID-19 pandemic of 2020, adopting the autoethnographic method. It explored the nature and dimensions of problems the faculty members faced, resources used to make sense of problems encountered, and actions they took to solve the problems as reflective practitioners in emergency online teaching. It also examined differences between faculty members over time. Analysis of seven weeks of autobiographic reflective journals during a 10-week academic term revealed that the faculty members encountered a range of problems during the classes, especially student-related and technology-related issues. When encountering problems, faculty members utilized references such as their past experience in face-to-face classroom teaching. Faculty members with more online teaching experience were more adaptable and flexible in mobilizing other references to solve problems. Overall, all members worked as reflective learners and practitioners who continued to reflect on the problems they faced and find solutions. These findings suggest that engaging in reflection-in-action and reflection-on-action can be effective ways for faculty members to develop their competencies to solve problems in emergency online teaching situations when responding to unprecedented challenges and issues is continuously needed.
The BSR-PsA: study protocol for the British Society for Rheumatology psoriatic arthritis register
Authors: Jones Gareth T. , Macfarlane Gary J. , Forrest Keenan Karen , McNamee Paul , Neilson Aileen R. , Siebert Stefan , Burden A. David , Kay Lesley , Helliwell Philip S.
Published: May 2021

Background

Psoriatic arthritis (PsA) presents a unique clinical challenge. Affecting joints, skin, nails, and other organs, it is associated with various comorbidities and has a significant impact on quality of life, social participation and working life. While biologic and other targeted synthetic disease modifying anti-rheumatic drugs (bDMARDs and tsDMARDs) have revolutionised therapy, questions remain about the long-term safety of these agents, and their effectiveness and cost-effectiveness in the real-world clinical setting.

Methods/design

The British Society for Rheumatology Psoriatic Arthritis Register (BSR-PsA) is a prospective registry of patients with PsA, recruited from across Great Britain, who are (a) commencing a bDMARD/tsDMARD; or (b) naïve to all bDMARDs/tsDMARDs. Ethical approval was given by the NHS West of Scotland Research Ethics Committee 3 (reference: 18/WS/0126). Clinical data are extracted from participants’ medical records, including symptom onset and diagnosis, joint, skin and nail symptoms, dactylitis and enthesitis. Physical measurements (height, weight and 66/68 joint counts) and a detailed drug history are taken. Participants are also asked to complete questionnaires comprising instruments relating to general health and quality of life, axial disease, sleep and fatigue, impact of disease, functional status, mental health, other symptoms, and occupational status. The study duration is 5 years in the first instance, and all participants are followed up annually until the end of the study. Participants commencing a bDMARD/tsDMARD are also followed up three and six months after the start of therapy. Disease activity, including C-reactive protein, is assessed at each visit; and participants from some centres are invited to donate blood and urine samples for the creation of a biobank.

Discussion

Complementing data from randomised trials, results from this study will contribute to the evidence base underpinning the clinical management of psoriatic arthritis. Various analyses will determine the effectiveness and safety of bDMARDs/tsDMARDs in the real-world, will examine the clinical and biological predictors of treatment response, and will provide real-world data on the cost-effectiveness of these therapies, as well as providing informative data important to patients such as quality of life and occupational outcomes.

Trial registration

The full study protocol is registered on the Open Science Framework (https://osf.io/jzs8n).