bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of mood after severe acquired brain injury: Interviews with UK clinical psychologists and medical professionals
Authors: Rose Alexandra E , Cullen Breda , Crawford Sarah , Evans Jonathan J
Published: September 2024

Objective

Mood assessment is challenging when people have cognitive and receptive communication impairments after severe brain injury. This study explored how UK-based medical and psychology professionals working with people with severe cognitive and communication impairments after brain injury assess mood in this population.

Design

Following their participation in an online survey, professionals were invited to participate in individual semi-structured interviews. Interviews were analysed using thematic analysis to label explicit data (semantic themes) and implicit data (latent themes).

Participants

Twenty-three clinical psychologists and nine medical professionals participated in online or in-person interviews.

Results

Both groups explicitly reported using a combination of collateral information, history, observations, and patient interviews when assessing mood in this population. Medical professionals did not routinely use standardised measures and clinical psychologists often adjusted them when they used them. The respondents discussed difficulties conceptualising depression after brain injury, the experience needed by the assessor, and the need for an individualised approach for this population. Clinical psychologists discussed the pressures of working in healthcare systems and medical professionals discussed how symptoms may influence prescription choices. Seven latent themes were labelled which highlighted additional challenges and complexities experienced by those assessing mood, beyond the actual assessment process itself.

Conclusions

No ‘gold standard’ approach to assessing mood in those with cognitive and communication difficulties after severe brain injury was identified. There was overlap in assessment approaches but no clear consensus. Interviewees felt that mood assessment must be approached differently in this population and that self-report measures are not useful.
Time as a Resource for Constructing Long-term Visions among Two Generations of Feminist Activism in Peru and Ecuador
Authors: Coe Anna-Britt
Published: September 2024

Time is a central dimension to the study of long-term visions and political generations in social movements. Yet, missing from both concepts is theorizing of activist groups’ own agency in using time as a resource. I address this problem through two main contributions. First, drawing on the findings of a Grounded Theory study among two generations of feminist activism in Ecuador and Peru, I show how these constructed long-term visions through four stages: interrupting the course of gender hierarchies, getting policy change put into practice, making feminist practices accessible, and repoliticizing feminist activism. Second, I employ David Maines and colleagues’ retrieval of G.H. Mead’s theory of time to analyze how the two generations used time as a source of power differently in each stage, producing a shift regarding which generation was the driving force of the construction of long-term visions across the stages.
Effects of self-etch adhesive agitation with diode laser on dentin bond strength
Authors: Ayar Muhammet Kerim , Kul Kerim Safa
Published: September 2024

The present study assessed the effect of active application of self-etch adhesives with diode laser irradiation on the shear dentin bond strength. Sixty bovine incisors, each embedded individually in hard plaster blocks, were divided into two groups based on the adhesive system used: Group 1 Adper Easy One and Group 2 Clearfil SE Protect. Based on the application technique of self-etch adhesives, each main group was further divided into three subgroups: passive application, active application with a micro-brush, and active application with a 976-nm diode laser tip (phototherapy active application). Shear bond strength tests were conducted using a universal testing machine and the data were analyzed by two-way ANOVA. Post hoc multiple comparisons were performed with the Tukey HSD test. Additionally, the statistical analysis of failure mode distribution was carried out using the chi-squared test ( p < 0.05). While the adhesive system exhibited significant differences in shear dentin bond strengths, there were no significant differences in application techniques. Regardless of the application technique, Clearfil SE Protect demonstrated significantly higher dentin bond strength than Adper Easy One. In the present study, the utilization of phototherapy through a 976-nm diode laser for the active application of the tested self-etch adhesives demonstrated similar initial dentin bond strengths to conventional application methods.
Optimal design of high efficiency wireless charging system for electric vehicle: AHO–GBDT technique
Authors: Kalaiselvan K. , Venkatesan M. , Rachananjali K. , Bhuvaneswari G.
Published: September 2024

This paper proposed a hybrid technique that optimizes the design of wireless charging systems (WCSs) for electric vehicles (EVs). The proposed technique combines the Archerfish hunting optimizer (AHO) and the gradient boosting decision tree (GBDT) algorithms, hence named the AHO–GBDT technique. The proposed strategy's goal is to enhance the efficiency, minimize cost, and increase coupling coefficient. The AHO algorithm optimizes the design parameters of WCS for EVs. The GBDT dynamically adjusts and optimizes the hyper-parameters, fine-tuning the algorithm for optimal performance. The outcome displays that the proposed strategy can greatly enhances the wireless charging system's efficiency. The proposed strategy is done in MATLAB software and assessed for performance with different existing strategies. The AHO–GBDT algorithm outperforms particle swarm optimizer (PSO), color harmony algorithm (CHA), and owl search algorithm (OSA) in terms of efficiency, which achieves 98.5%, while compared to 97.2%, 96.8%, and 96.4%, respectively. The proposed method shows the highest efficiency, power, and coupling coefficient compared to other existing the PSO, CHA, and OSA methods.
System Innovation: A Holistic Approach to Disrupting With Love and Human Caring, by Julie Kennedy Oehlert and Kathleen Sitzman
Authors: Rivera Ashley
Published: September 2024

The bright vision presented by this book provides an invigorating push to bring out the inner anarchist hidden in even the most complacent of health professionals. This book renews the ongoing discussion of how theory-driven change can be used to ground and promote the integration of love and human caring into system innovation. Each chapter of this book provides concrete and realistic application strategies to front-line practice and gives intensive guidance on how to linguistically and intellectually challenge the barriers within an organization that can undermine a vision of holistic caring. For leaders of teams, this book provides invaluable tools to build a culture of caring and maintain a team that perceives caring from both leadership and the organization as a whole. For team members, this book is a reminder that an expectation of workplace culture that is positive, supportive, and fosters growth is not out of reach; it simply has yet to be implemented within their system.
Unpacking platform governance through meaningful human agency: How Chinese moderators make discretionary decisions in a dynamic network
Authors: Zhao Lu , Zhang Ruichen
Published: September 2024

How platforms moderate online content remains “black-boxed” due to diverging and sometimes conflicting logics in the governance network of different forces and stakeholders. The key to unpacking the “black-box” lies with meaningful human agency in balancing these logics in contextualized practice. This article examines human moderators’ decision-making based on qualitative data drawn from Chinese leading platforms. Grounded theory analysis theorizes various contributing (f)actors and introduces a model of “bounded discretion and tacit interaction in an elastic dynamic” to address moderation decision-making. It argues that it is though bounded human agency that platform governance is enacted, negotiated, and further “black-boxed” as inevitable human inconsistencies and contingencies are molded into governance. This study provides useful categories for analyzing platform moderation, encodes meaningful human agency as bounded discretion in the governance network, and unpacks the “black-box” of platform governance as an unfolding process of interactions among institutions, forces, and most importantly, human participants.
A Bayesian detector-based approach for determining arrival and departure times of negative pressure waves in pipeline leakage localization
Authors: Han Yang , Feng Xin , Li Minghao , Todd Michael D
Published: September 2024

The pipeline leakage detection and location method based on negative pressure wave (NPW) characteristics are widely used in existing pipe network systems. The accuracy of leakage localization significantly relies on precisely picking up the arrival time of the NPW. A novel method based on Bayesian detection theory is proposed to determine both the arrival and the departure times of the NPW. The use of NPWs as features was theoretically derived based on the transient fluid dynamics of the pipeline, and then the nonstationary NPW was transformed into a piecewise stationary Gaussian process by differencing the pressure time series data. A Bayesian optimal detector was constructed to identify the multiple transition points (corresponding to the arrival and departure times) in the differentiated pressure data to identify the NPW. A series of pipeline leakage tests were carried out to verify the effectiveness of the proposed method. It is demonstrated that the combination of time differencing nonstationary pressure data and employing the Bayesian detector can precisely capture the arrival and departure times of NPWs, enabling more accurate leakage localization in the pipeline.
A novel high-precision lightweight concrete bridge crack image recognition method based on knowledge distillation
Authors: Fan Qian , Xie Jun , Xia Zhanghua , Tan Yunhua , Zhu Sanfan , Wang Jiayu
Published: September 2024

To meet the demand for high-precision recognition and real-time processing when using intelligent detection methods in daily concrete bridge crack detection tasks, a high-precision lightweight crack image recognition method based on knowledge distillation is proposed. Through semisupervised learning, the information embedded in unlabeled data is used to train a lightweight network to obtain high-precision crack recognition results. First, by comparing the recognition accuracy of lightweight network under different training strategies, the effectiveness of the knowledge distillation method in improving the accuracy of lightweight network is verified. Second, a label-free knowledge distillation method for engineering detection is proposed. Finally, using MobileNetv3 as the student model, under the self-built three-classification dataset of nearly 700,000 images, the accuracy reached 99.84% through the proposed knowledge distillation method, which is very close to the teacher model ResNeXt101 accuracy (−0.08%), and MobileNetv3 compared with ResNeXt101 its model inference speed increased by more than 13 times. At the same time, the MobileNetv3 model improves the inference speed by more than 13 times and reduces the number of model parameters by more than 35 times compared to the ResNeXt101 model. The research results fully demonstrate that under the premise of having a large amount of unlabeled data, using the proposed knowledge distillation method, the recognition accuracy of the trained lightweight model has a significant advantage over the existing lightweight network training strategies.
Pulmonary Artery Endograft Implantation Using a Parallel Stent Grafting Technique to Enable the Treatment of a Bronchial Anastomosis Complication After Lung Transplantation
Authors: Schmid Bruno P. , Scordamaglio Paulo Rogério , Samano Marcos N. , Cunha Marcela Juliano S. , Valle Leonardo G. M. , Galastri Francisco L. , Nasser Felipe , Affonso Breno B.
Published: September 2024

Background

Bronchial stenosis associated with bronchial anastomosis dehiscence after lung transplantation is a catastrophic complication following lung transplantation with a paucity of therapeutic solutions.

Purpose

To describe an adaptation of the parallel stent grafting technique in the pulmonary arterial territory to treat this challenging situation.

Research Design

This is a case report of a 52-year-old patient who presented bronchus stenosis and bronchial anastomosis dehiscence after lung transplantion. Bronchial stenting and lung retransplantation were contraindicated. Therefore, an endovascular approach using pulmonary artery endograft placement to prevent bleeding during repeated right bronchial balloon dilation was propposed. The technique consists of the deployment of an aortic extender endoprosthesis in the right main pulmonary artery and a balloon expandable stent in the upper lobe pulmonary artery (using a parallel graft configuration) through the common femoral and right internal jugular veins, respectively. Intraoperative transesophageal echocardiogram and one-lung ventilatory ventilation are needed.

Results

The patient underwent a new bronchoscopy 16 days after the procedure, that showed epithelization at the previous eroded zone, enabling bronchocopic balloon dialtion to be safely performed. A post-operative contrast-enhanced CT scan revealed an adequate positioning of the stent grafts. Despite all eforts, the patient succumbed to ventilator associated pneumonia on postoperative day 108.

Data Analysis

The technique's advantages include its feasibility even in situations in which other techniques may be contraindicated and its potential use in emergencies. Its limitations include the need for experienced interventionists to perform it, and the potential risk of acute tricuspid regurgitation.

Conclusion

This study illustrates the early feasibility of the parallel stent grafting technique applied to the pulmonary artery territory. However, it's safety profile regarding infectious risk was not demontrated.
Remote postoperative management using Ecological Momentary Computerized Adaptive Testing (EMCAT): feasibility assessment survey
Authors: Bele Sumedh , Rodrigues Jeremy , Beard David , Harrison Conrad
Published: September 2024

Our survey of 38 surgeons shows that Ecological Momentary Computerized Adaptive Testing (EMCAT), a platform to remotely collect patient-reported outcome measures (PROMs) is acceptable to surgeons, and 36 of 38 are willing to participate in future randomized control trials comparing EMCAT versus routine follow-up.

Level of evidence: IV
Association Between SARS-CoV-2 Vaccination and Development of Antinuclear Antibodies Among Students
Authors: Laskowski Karol , Paszkiewicz Justyna , Plewik Dorota , Szepeluk Adam , Hozyasz Kamil K.
Published: September 2024

Introduction:

Antinuclear antibodies (ANA) are the hallmark of many connective tissue disorders (including lupus), which comprise roughly 5% to 10% of chronic debilitating diseases causing morbidity and mortality. In society, fear of these diseases increases illness-related uncertainty because the prognosis of progression is often difficult to determine and at least some symptoms fluctuate unpredictably. In the anti-vaccination movement, the question of the possible connection between vaccination and connective tissue disorders and other autoimmune diseases has grown to rank as an important argument for rejecting vaccination. In 2021, every fifth Polish first-degree nursing student decided to not be vaccinated against COVID-19.

Objective:

This study aimed to explore the prevalence of antinuclear antibodies in students vaccinated and unvaccinated against COVID-19.

Participants and Methods:

A single university cross-sectional study was performed in a small academic centre in Poland, where 210 students were recruited in 2022. All the participants were screened for SARS-CoV-2 IgG and antinuclear antibodies.

Results:

The mean age of the students who rejected vaccination was higher than that of those who were vaccinated. Among nursing students, 30.0% of vaccinated and 58.3% of unvaccinated individuals had COVID-19. The frequency of antinuclear antibodies was 3 times lower in vaccinated students than in unvaccinated students (2/159 vs 2/51; P > .05).

Conclusion:

The results of our study did not confirm the rationality of rejecting vaccinations against COVID-19 for fear of developing autoimmune diseases among healthy students.
When the first try fails: re-implementation of SIMPL in a general surgery residency
Authors: Hsu Phillip J. , Wnuk Gregory , Leininger Lisa , Peterson Samantha , Hughes David T. , Sandhu Gurjit , Zwischenberger Jay B. , George Brian C. , Aubry Staci
Published: September 2024

Background

Workplace-based assessment (WBA) can facilitate evaluation of operative performance; however, implementation of WBA is sometimes unsuccessful. The American Board of Surgery Entrustable Professional Activities WBA project was launched in July 2023. Some programs will face the challenge of re-implementation of a WBA following previous failures. It is unknown what interventions are most effective for WBA re-implementation. Our goal is to identify barriers and facilitators to re-implementing SIMPL, an operative performance WBA.

Methods

The System for Improving and Measuring Procedural Learning (SIMPL) was implemented at our residency in 2018, but usage rates were low. We interviewed residents and faculty to identify barriers to usage and opportunities for improvement. Residents reported that SIMPL usage declined because of several factors, including a low faculty response rate, while some faculty reported not responding because they were unable to login to the app and because usage was not mandated. We then re-implemented SIMPL using a plan based on Kotter’s Model of Change. To evaluate impact, we analyzed rates of SIMPL usage when it was first implemented, as well as before and after the date of re-implementation.

Results

In September 2022, we re-implemented SIMPL at our program with measures addressing the identified barriers. We found that, in the six months after re-implementation, an average of 145.8 evaluations were submitted by residents per month, compared with 47 evaluations per month at the start of the original implementation and 5.8 evaluations per month just prior to re-implementation. Faculty completed 60.6% of evaluations and dictated feedback for 59.1% of these evaluations, compared with 69.1% at implementation (44% dictated) and 43% prior to re-implementation (53% dictated).

Conclusions

After identifying barriers to implementation of a WBA, we re-implemented it with significantly higher usage by faculty and residents. Future opportunities exist to implement or re-implement assessment tools within general surgery programs. These opportunities may have a significant impact in the setting of national standardization of workplace-based assessment among general surgery residencies.
Marginal adaptation of customized gutta percha cone with calcium silicate based sealer versus MTA and biodentine apical plugs in simulated immature permanent teeth (an in vitro study)
Authors: Mina Mary M. , Moussa Sybel M. , Aboelseoud Mahmoud R.
Published: September 2024

Background

This study aimed to compare the marginal adaptation of a single customized gutta percha cone with calcium silicate-based sealer versus mineral trioxide aggregate (MTA) and Biodentine apical plugs in simulated immature permanent teeth.

Methods

Thirty-nine extracted human maxillary anterior teeth were selected, prepared to simulate immature permanent teeth with an apical diameter 1.1 mm, placed in moist foam and divided into three groups. Group 1: Obturation with a single customized gutta percha cone and calcium silicate sealer. Group 2: MTA apical plug. Group 3: Biodentine apical plug. After incubation, teeth were horizontally sectioned at 1 mm and 3 mm from the apex and marginal adaptation was evaluated using scanning electron microscope (SEM).

Results

Biodentine showed the least mean gap size at both 1 and 3 mm from the apex with no statistically significant differences compared to MTA (p > 0.05). The single customized cone with calcium silicate based sealer showed the greatest mean gap size at both 1 and 3 mm from the apex with a statistically significant difference compared to the other groups (p < 0.001).

Conclusion

Biodentine and MTA apical plugs provide a significantly better marginal adaptation to the dentinal walls than a single customized gutta percha cone with calcium silicate based sealer in simulated immature permanent teeth.
Trajectories of peripheral white blood cells count around the menopause: a prospective cohort study
Authors: Dai Qiaoyun , Zhang Yaya , Zhao Xiujuan , Yang Xueying , Sun Huayu , Wu Shouling , Chen Shuohua , Wang Jianmei , Cao Zongfu , Ma Xu
Published: September 2024

Background

Menopause significantly impacts the immune system. Postmenopausal women are more susceptible to infection. Nonetheless, the pattern of change in peripheral white blood cell counts around the menopause remains poorly understood.

Methods

We conducted a prospective longitudinal cohort study with repeated measurements using Kailuan cohort study of 3632 Chinese women who participated in the first checkup (2006–2007) and reached their final menstrual period (FMP) by the end of the seventh checkup (2018–2020). Peripheral WBC count indicators included total white blood cells (TWBC), neutrophils (NEUT), lymphocytes (LYM), and monocytes (MON). Multivariable mixed effects regressions fitted piece-wise linear models to repeated measures of WBC count indicators as a function of time before or after the final menstrual period (FMP). Interaction and subgroup analysis were used to explore the effects of age and body mass index (BMI) on changes in WBC indicators around FMP.

Results

WBC count indicators decreased before the FMP, and the reduction in TWBC, NEUT, and MON continued for 2 years following the FMP. LYM and NEUT declined during < -1 years and − 4 ∼ + 2 years relative to FMP, respectively. A reduction in MON was observed pre-FMP, extending continuously through the two-year period post-FMP. TWBC declined from − 3 to + 2 years relative to FMP, but both MON and TWBC increased during > + 2 years. The baseline age had an interaction effect on changes in WBC indicators during specific menopausal stages, except for TWBC. Individuals in different age subgroups showed distinct trajectories for NEUT, LYM and MON around the FMP. High baseline BMI had a synergistic effect on changes in specific menopause segments for TWBC, LYM, and MON. The impact of menopause on TWBC and LYM was postponed or counterbalanced in high BMI individuals. Individuals in three BMI subgroups experienced similar MON changes around FMP, and there were slight variations during < -4 years.

Conclusions

Menopause was associated with count changes of peripheral WBC. The trajectories of various WBC types differ around menopause. Age and BMI affected WBC trajectory around menopause. The menopause period may represent a window of opportunity to promote immune health in middle-aged women.
Too stressed to think? A scoping review of the literature for healthcare educators utilising high acuity clinical scenarios
Authors: Betson Jason , Fein Erich C. , Long David , Horrocks Peter
Published: September 2024

Background

The practise of paramedicine can be highly stressful particularly where urgent lifesaving decisions need to be made. Traditionally, educators have adopted the approach of placing students in simulated stressful situations as a way of learning to cope with these challenges. It is unclear from the literature whether traditional stress inoculation enhances or hinders learning. This scoping review aims to identify and examine both the peer-reviewed and grey literature reporting physiological stress responses to high-acuity scenarios in paramedicine and cognate healthcare disciplines.

Methods

Adhering strictly to JBI Evidence Synthesis Manual for conducting a scoping review, medical subject headings and areas, keywords and all other possible index terms were searched across EBSCOhost (Medline, CINAHL and APA PsycInfo), Scopus and, PubMed. English language articles both published (peer-reviewed academic papers, reports and conference proceedings) and unpublished (grey literature, Google Scholar reports) were included, and publications citing retrieved articles were also checked.

Results

Searches performed across five electronic databases identified 52 articles where abstracts indicated potential inclusion. From this, 22 articles which reported physiological or psychophysiological responses to stressful scenario-based education were included.

Conclusion

This review identified that an acceptable level of stress during simulation can be beneficial, however a point can be exceeded where stress becomes a hinderance to learning resulting in underperformance. By identifying strategies to moderate the impact of acute stress, educators of paramedic and other healthcare students can utilise high-acuity clinical scenarios to their andragogical armamentarium which has the potential to improve real-world clinical outcomes.
Putting patients first: when home-based care staff prioritise loyalty to patients above the system and themselves. An ethnographic study
Authors: Hertzberg Cecilie Knagenhjelm , Magelssen Morten , Heggestad Anne Kari Tolo
Published: September 2024

Background

The growing number of older people worldwide poses challenges for health policy, particularly in the Global North, where policymakers increasingly expect seniors to live and receive care at home. However, healthcare professionals, particularly in home-based care, face dilemmas between adhering to care ideals and meeting external demands. Although they strive to uphold ethical care standards, they must deal with patients’ needs, cooperation with colleagues and management guidelines. Home-based care is an essential part of healthcare services in Norway, but staff struggle with high patient numbers and time management. This article focuses on how staff deal with ethical challenges related to contextual and organisational constraints.

Methods

An ethnographic fieldwork in three municipalities in South-East Norway. The first author conducted three to four months of participant observation in each municipality. In addition, she conducted in-depth interviews with key informants in two municipalities and a focus group interview with seven home-based care workers in one municipality. The data was analysed by using a reflexive thematic analysis.

Results

Staff in home-based care are frequently more loyal to the patient than to the system and to their own needs. To provide good care, all informants disregarded the patient’s formal decision, i.e. they provided more care than the formalised decision stipulated. To prioritise beneficence to patients, informants also disregarded some of the rules applicable in home-based care. In addition, staff accepted risks to their own safety and health to provide care in the patient’s home.

Conclusion

The loyalty of home-based care staff to their patients can go beyond their loyalty to the rules of the system and even their own safety. This commitment might be attributed to a sense of doing meaningful work, to providing relationship-based and individualised care, and to strong moral courage. However, the staff’s emphasis on flexibility and individualised care also brings challenges related to unclear boundaries related to patient care.
Sparking nurses’ creativity: the roles of ambidextrous leadership and psychological safety
Authors: El-Gazar Heba Emad , Baghdadi Nadiah A. , Abdelaliem Sally Mohammed Farghaly , Zoromba Mohamed Ali
Published: September 2024

Background

The leadership practices of nurse managers significantly impact the creativity of staff nurses; however, the effects of ambidextrous leadership on nurses’ creativity are not yet clear. Additionally, the underlying mechanism of this relationship remains to be identified.

Aim

The study aimed to examine the effect of ambidextrous leadership on nurses’ creativity, directly and indirectly through psychological safety.

Methods

In this cross-sectional study, data were collected from October 2023 to January 2024 involving 241 nurses working at three hospitals in Port Said, Egypt. The Ambidextrous Leadership Scale, Psychological Safety Scale, and the Individual Creativity Scale were employed. Descriptive analysis, correlation analysis, and structural equation modeling were conducted.

Results

Nurse managers’ ambidextrous leadership was positively associated with nurses’ creativity. Psychological safety fully mediated the association between ambidextrous leadership and nurses’ creativity.

Conclusion

The study suggests that enhancing the ambidexterity of nurse leaders can foster a sense of psychological safety, which, in effect, contributes to increased creativity among nurses.

Implication for nursing policymaking

There is a need for healthcare policies and strategies that are supportive of the implementation of ambidextrous leadership practices and promote psychological safety among nurses.
Implementing peer support into practice in mental health services: a qualitative comparative case study
Authors: Gillard Steve , Foster Rhiannon , White Sarah , Bhattacharya Rahul , Binfield Paul , Eborall Rachel , Gibson Sarah L , Harnett Daniella , Simpson Alan , Lucock Mike , Marks Jacqueline , Repper Julie , Rinaldi Miles , Salla Anthony , Worner Jessica
Published: September 2024

Background

Peer workers are people with personal experience of mental distress, employed within mental health services to support others with similar experiences. Research has identified a range of factors that might facilitate or hinder the introduction of new peer worker roles into mental health services. While there is mixed evidence for the effectiveness of peer worker delivered interventions, there are no studies exploring how implementation might be associated with effect.

Methods

This was a qualitative comparative case study using data from interviews with 20 peer workers and their five supervisors. Peer workers delivered peer support for discharge from inpatient to community mental health care as part of a randomised controlled trial. In the trial, level of participant engagement with peer support was associated with better outcome (hospital readmission). Study sites with higher levels of engagement also had higher scores on a measure of fidelity to peer support principles. We compared data from sites with contrasting levels of engagement and fidelity using an analytical framework derived from implementation theory.

Results

In high engagement-high fidelity sites, there was regular work with clinical teams preparing for working alongside peer workers, and a positive relationship between staff on inpatient wards and peer workers. The supervisor role was well resourced, and delivery of peer support was highly consistent with the intervention manual. In low engagement-low fidelity sites peer workers were employed in not-for-profit organisations to support people using public mental health services and in rural areas. Supervisors faced constrained resources and experienced barriers to joint working between organisations. In these sites, peer workers could experience challenging relationships with ward staff. Issues of geography and capacity limited opportunities for supervision and team-building, impacting consistency of delivery.

Conclusions

This study provides clear indication that implementation can impact delivery of peer support, with implications for engagement and, potentially, outcomes of peer worker interventions. Resourcing issues can have knock-on effects on consistency of delivery, alongside challenges of access, authority and relationship with clinical teams, especially where peer workers were employed in not-for-profit organisations. Attention needs to be paid to the impact of geography on implementation.

Trial registration

ISRCTN registry number ISRCTN10043328, registered 28 November 2016.
Helicobacter pylori seropositivity associates with hyperglycemia, but not obesity, in Danish children and adolescents
Authors: Kløve Sigri , Stinson Sara E. , Romme Fie O. , Butt Julia , Graversen Katrine B. , Lund Morten A. V. , Fonvig Cilius E. , Waterboer Tim , Perez-Perez Guillermo I. , Hansen Torben , Holm Jens-Christian , Andersen Sandra B.
Published: September 2024

Background

Helicobacter pylori colonizes the human stomach and may affect the inflammatory response, hormone production related to energy regulation, and gastrointestinal microbiota composition. Previous studies have explored a potential association between H. pylori infection and pediatric obesity with varying results. Considering the immunomodulatory effects of early-life infection with H. pylori that can confer beneficial effects, we hypothesized that we would find an inverse relationship between H. pylori seropositivity and obesity among Danish children and adolescents.

Methods

We assessed H. pylori seroprevalence in 713 subjects from an obesity clinic cohort and 990 subjects from a population-based cohort, aged 6 to 19 years, and examined its association with obesity and other cardiometabolic risk factors.

Results

No association was found between H. pylori and body mass index standard deviation score (BMI SDS). H. pylori seropositivity was, however, significantly associated with higher fasting plasma glucose levels and the prevalence of hyperglycemia.

Conclusion

While we did not find an association between H. pylori seropositivity and BMI SDS, we observed a significant association with higher fasting plasma glucose levels and increased prevalence of hyperglycemia, suggesting that H. pylori infection may contribute to impaired glucose regulation in Danish children and adolescents.

Graphical abstract
Evaluation of comparative effect between aluminum hydroxide gel and montanide (ISA 70) in potency and protection of locally prepared rabbit hemorrhagic disease virus 2 (RHDV2) vaccines in rabbits
Authors: Ahmed Doha Abd Alrahman , Sadiek Yasmin , Eldin Mostafa Saif , Ibrahim Ragab S. , Amen Omar , Abodalal Samah El Sayed Ali
Published: September 2024

Background

Rabbit hemorrhagic disease (RHD) is an acute infectious disease that damages the rabbit industry by producing significant mortality rates in young and adult rabbits. RHD is better controlled by vaccination.

Objective

The current study's goal was to prepare and evaluate the immuno-enhancing effect of montanide ISA70 and aluminum hydroxide (Al(OH)3) gel incorporated within the inactivated RHDV2 vaccine and assess the vaccine's protective efficacy against the homologous and heterologous local RHDV2 strains in rabbits.

Methods

Inactivated RHDV vaccines were prepared using Montanide ISA70 oil or Al(OH)3 gel adjuvants and submitted to sterility, safety, and potency tests. 200 rabbits were equally divided into 4 groups: G1 (control), G2 (vaccinated with gel-incorporated vaccine), G3 (vaccinated with montanide-incorporated vaccine), and G4 (vaccinated with gel- and montanide-incorporated vaccines). Individual blood samples were collected from one week to six months from all groups. The vaccine's potency was measured by the HI test and protection percentage post challenge.

Results

Data revealed slightly increasing HI titer means reaching the 1st peak at 4 weeks post-vaccination (7.33, 7.67, and 7.33 log2 in the 2nd, 3rd, and 4th groups, respectively), then slightly decreasing and peaked again, giving 9.33 log2 for the2nd group at 3 months post-vaccination (MPV), 10.67 log2 for 3rd the group, and 10.33 log2 for the 4th group at 5 months post-vaccination. Titer gradually decreased but remained protective. The protection rate ranged from 80–100% and 80–90% for homologous and heterologous local RHDV2 vaccines, respectively, within 3 weeks and 6 months post-challenge. The montanide oil RHDV2 vaccine induced better protection than the aluminum gel RHDV2 vaccine.

Conclusion

The results demonstrated evidence of cross-protection between RHDV2 strains. The oil emulsion vaccine induced higher and longer-lasting antibody titers than those obtained with the RHDV2 aluminum gel vaccine.
Decreased plasma gelsolin fosters a fibrotic tumor microenvironment and promotes chemoradiotherapy resistance in esophageal squamous cell carcinoma
Authors: Hsieh Chih-Hsiung , Ho Pei-Shiuan , Wang Wen-Lun , Shih Fu-Hsuan , Hong Chen-Tai , Wang Pei-Wen , Shieh Dar-Bin , Chang Wei-Lun , Wang Yi-Ching
Published: September 2024

Background

Stromal fibrosis is highly associated with therapeutic resistance and poor survival in esophageal squamous cell carcinoma (ESCC) patients. Low expression of plasma gelsolin (pGSN), a serum abundant protein, has been found to correlate with inflammation and fibrosis. Here, we evaluated pGSN expression in patients with different stages of cancer and therapeutic responses, and delineated the molecular mechanisms involved to gain insight into therapeutic strategies for ESCC.

Methods

Circulating pGSN level in ESCC patients was determined by enzyme-linked immunosorbent assay analysis, and the tissue microarray of tumors was analyzed by immunohistochemistry staining. Cell-based studies were performed to investigate cancer behaviors and molecular mechanisms, and mouse models were used to examine the pGSN-induced tumor suppressive effects in vivo.

Results

Circulating pGSN expression is distinctively decreased during ESCC progression, and low pGSN expression correlates with poor therapeutic responses and poor survival. Methylation-specific PCR analysis confirmed that decreased pGSN expression is partly attributed to the hypermethylation of the GSN promoter, the gene encoding pGSN. Importantly, cell-based immunoprecipitation and protein stability assays demonstrated that pGSN competes with oncogenic tenascin-C (TNC) for the binding and degradation of integrin αvβ3, revealing that decreased pGSN expression leads to the promotion of oncogenic signaling transduction in cancer cells and fibroblasts. Furthermore, overexpression of pGSN caused the attenuation of TNC expression and inactivation of cancer-associated fibroblast (CAF), thereby leading to tumor growth inhibition in mice.

Conclusions

Our results demonstrated that GSN methylation causes decreased secretion of pGSN, leading to integrin dysregulation, oncogenic TNC activation, and CAF formation. These findings highlight the role of pGSN in therapeutic resistance and the fibrotic tumor microenvironment of ESCC.
Consideration of inequalities in effectiveness trials of mHealth applications – a systematic assessment of studies from an umbrella review
Authors: Abdelmalak Nancy , Burns Jacob , Suhlrie Laura , Laxy Michael , Stephan Anna-Janina
Published: September 2024

Background

The growing use of mobile health applications (apps) for managing diabetes and hypertension entails an increased need to understand their effectiveness among different population groups. It is unclear if efficacy and effectiveness trials currently provide evidence of differential effectiveness, and if they do, a summary of such evidence is missing. Our study identified to what extent sociocultural and socioeconomic inequalities were considered in effectiveness trials of mobile health apps in diabetic and hypertensive patients and if these inequalities moderated app effectiveness.

Methods

We built on our recent umbrella review that synthesized systematic reviews (SRs) of randomized controlled trials (RCTs) on the effectiveness of health apps. Using standard SR methodologies, we identified and assessed all primary RCTs from these SRs that focused on diabetes and/or hypertension and reported on health-related outcomes and inequality-related characteristics across intervention arms. We used the PROGRESS-Plus framework to define inequality-related characteristics that affect health opportunities and outcomes. We used harvest plots to summarize the subgroups (stratified analyses or interaction terms) on moderating effects of PROGRESS-Plus. We assessed study quality using the Risk of Bias 2 tool.

Results

We included 72 published articles of 65 unique RCTs. Gender, age, and education were the most frequently described PROGRESS-Plus characteristics at baseline in more than half of the studies. Ethnicity and occupation followed in 21 and 15 RCTs, respectively. Seven trials investigated the moderating effect of age, gender or ethnicity on app effectiveness through subgroup analyses. Results were equivocal and covered a heterogenous set of outcomes. Results showed some concerns for a high risk of bias, mostly because participants could not be blinded to their intervention allocation.

Conclusions

Besides frequently available gender, age, and education descriptives, other relevant sociocultural or socioeconomic characteristics were neither sufficiently reported nor analyzed. We encourage researchers to investigate how these characteristics moderate the effectiveness of health apps to better understand how effect heterogeneity for apps across different sociocultural or socioeconomic groups affects inequalities, to support more equitable management of non-communicable diseases in increasingly digitalized systems.

Registration

https://osf.io/89dhy/.
Building a healthy generation together: parents’ experiences and perceived meanings of a family-based program delivered in ethnically diverse neighborhoods in Sweden
Authors: Farias Lisette , Hellenius Mai-Lis , Nyberg Gisela , Andermo Susanne
Published: September 2024

Introduction and aim

Ethnically diverse neighborhoods encounter pronounced inequalities, including housing segregation and limited access to safe outdoor spaces. Residents of these neighborhoods face challenges related to physical inactivity, including sedentary lifestyles and obesity in adults and children. One approach to tackling health inequalities is through family-based programs tailored specifically to these neighborhoods. This study aimed to investigate parents’ experiences and perceptions of the family-based Open Activities, a cost-free and drop-in program offered in ethnically diverse and low socioeconomic neighborhoods in Sweden.

Methods

Researchers’ engagement in 15 sessions of the Open Activities family-based program during the spring of 2022, and individual interviews with 12 participants were held. Data were analyzed using reflexive thematic analysis.

Results

The analysis resulted in three main themes and seven sub-themes representing different aspects of the program’s meaning to the participants as parents, their families, and communities. The main themes describe how parents feel valued by the program, which actively welcomes and accommodates families, regardless of cultural differences within these neighborhoods. The themes also show how cultural norms perceived as barriers to participation in physical activity can be overcome, especially by mothers who express a desire to break these norms and support girls’ physical activity. Additionally, the themes highlight the importance of parents fostering safety in the area and creating a positive social network for their children to help them resist criminal gang-related influences.

Conclusions

The program’s activities allowed parents to connect with their children and other families in their community, and (re)discover physical activity by promoting a sense of community and safety. Implications for practice include developing culturally sensitive activities that are accessible to and take place in public spaces for ethnically diverse groups, including health coordinators that can facilitate communication between groups. To enhance the impact of this program, it is recommended that the public sector support the creation of cost-free and drop-in activities for families who are difficult to reach in order to increase their participation in physical activity, outreach, and safety initiatives.
Dynamic trends of ischemic heart disease mortality attributable to high low-density lipoprotein cholesterol: a joinpoint analysis and age-period-cohort analysis with predictions
Authors: Li Min , Wang Beibei , Wang Lan , Tong Ling , Zhao Gang , Wang Biao , Guo Jingli
Published: September 2024

Aims

The purpose of this study was to analyze the dynamic trends of ischemic heart disease (IHD) mortality attributable to high low-density lipoprotein cholesterol (LDL-C).

Methods

Data on IHD mortality attributable to high LDL-C from 1990 to 2021 were extracted from the global disease burden database. Joinpoint software was used to estimate the average annual percentage change (AAPC) in the age-standardized mortality rate (ASMR). An age‒period‒cohort model was used to analyze the impacts of age, period, and cohort on these changes. The Bayesian framework was used to predict IHD mortality attributable to high LDL-C from 2022 to 2040.

Results

The overall ASMR of IHD attributable to high LDL-C decreased from 50. 479 per 100,000 people in 1990 to 32.286 per 100,000 people in 2021, and ASMR of IHD attributable to high LDL-C was higher in males than in females. The longitudinal age curves of the overall IHD mortality attributable to high LDL-C showed a monotonic upward trend, especially after 65 years of age. The period and cohort effect relative risk (RR) values of overall IHD mortality attributable to high LDL-C showed a downward trend. The overall ASMR of IHD attributable to high LDL-C is predicted to show a downward trend, and male IHD mortality attributable to high LDL-C is expected to be higher than that of females.

Conclusion

This study revealed a sustained decrease in IHD mortality attributable to high LDL-C over three decades, with a continued decline expected. Despite this, gender disparities persist, with males experiencing higher mortality rates and elderly individuals remaining a vulnerable group.
Warmer environmental temperature accelerates aging in mosquitoes, decreasing longevity and worsening infection outcomes
Authors: Barr Jordyn S. , Martin Lindsay E. , Tate Ann T. , Hillyer Julián F.
Published: September 2024

Background

Most insects are poikilotherms and ectotherms, so their body temperature is predicated by environmental temperature. With climate change, insect body temperature is rising, which affects how insects develop, survive, and respond to infection. Aging also affects insect physiology by deteriorating body condition and weakening immune proficiency via senescence. Aging is usually considered in terms of time, or chronological age, but it can also be conceptualized in terms of body function, or physiological age. We hypothesized that warmer temperature decouples chronological and physiological age in insects by accelerating senescence. To investigate this, we reared the African malaria mosquito, Anopheles gambiae, at 27 °C, 30 °C and 32 °C, and measured survival starting at 1-, 5-, 10- and 15-days of adulthood after no manipulation, injury, or a hemocoelic infection with Escherichia coli or Micrococcus luteus. Then, we measured the intensity of an E. coli infection to determine how the interaction between environmental temperature and aging shapes a mosquito’s response to infection.

Results

We demonstrate that longevity declines when a mosquito is infected with bacteria, mosquitoes have shorter lifespans when the temperature is warmer, older mosquitoes are more likely to die, and warmer temperature marginally accelerates the aging-dependent decline in survival. Furthermore, we discovered that E. coli infection intensity increases when the temperature is warmer and with aging, and that warmer temperature accelerates the aging-dependent increase in infection intensity. Finally, we uncovered that warmer temperature affects both bacterial and mosquito physiology.

Conclusions

Warmer environmental temperature accelerates aging in mosquitoes, negatively affecting both longevity and infection outcomes. These findings have implications for how insects will serve as pollinators, agricultural pests, and disease vectors in our warming world.