bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating assertions by a Wells Fargo CEO of a ‘return to ethical conduct’
Authors: Amernic Joel , Craig Russell
Published: March 2022

We explore the language used by the CEO of Wells Fargo, Timothy Sloan, to sustain claims that Wells Fargo and its staff would behave in an ethically appropriate way in the future. We focus on Sloan’s opening written statement to the Committee on Banking, Housing and Urban Affairs of the United States Senate on 3 October 2017. This statement was intended to salvage Wells Fargo’s reputation after it had been savaged by widespread allegations of unethical conduct. Sloan sought to display ethical leadership by drawing the senators’ and other stakeholders’ attention to an (alleged) epiphany in the managerial mindset of the company. This paper contributes by proposing three desirable hallmarks by which to analyze claims of ethical leadership: balanced framing, principled use of ideology and metaphor, and justified rhetoric. These hallmarks are then explored to assess the ethical leadership discourse in Sloan’s statement. The paper demonstrates that analysis of the micro discourse of a CEO can reveal lack of a sound appreciation of the human complexity of a large organization, superficial assumptions of leadership and followership, and cloud the location of agency for ethical lapses. We conclude that the written statement submitted to the senate committee by CEO Sloan was unconvincing in enlisting belief that Wells Fargo would ‘return to ethical conduct’.
Human safety study of a selective neuronal adenylate cyclase 1 inhibitor NB001 which relieves the neuropathic pain and blocks ACC in adult mice
Authors: Wang Weicong , Chen Qi-Yu , Zhao Pengpeng , Zhong Jingbo , Wang Yan , Li Xiaorong , Zhuo Min , Chen Xia
Published: March 2022

Calcium-dependent, neuronal adenylyl cyclase subtype 1 (AC1) is critical for cortical potentiation and chronic pain. NB001 is a first-in-class drug acting as a selective inhibitor against AC1. The present study delineated the pharmacokinetic (PK) properties of human-used NB001 (hNB001) formulated as immediate-release tablet. This first-in-human (FIH) study was designed as randomized, double-blind, placebo-controlled trial. hNB001 showed placebo-like safety and good tolerability in healthy volunteers. A linear dose-exposure relationship was demonstrated at doses between 20 mg and 400 mg. The relatively small systemic exposure of hNB001 in human showed low bioavailability of this compound through oral administration, which can be improved through future dosage research. Food intake had minimal impact on the absorption of hNB001 tablet. Animal experiments further confirmed that hNB001 had strong analgesic effect in animal models of neuropathic pain. In brain slice prepared from the anterior cingulate cortex (ACC), bath application of hNB001 blocked the induction of long-term potentiation (LTP). These results from both rodents and human strongly suggest that hNB001 can be safely used for the future treatment of different types of chronic pain in human patients.
Are there differences in symptoms experienced by midlife climacteric women with and without metabolic syndrome? A scoping review
Authors: Min Se Hee , Yang Qing , Min Se Won , Ledbetter Leila , Docherty Sharron L , Im Eun-Ok , Rushton Sharron
Published: March 2022

Introduction:

Midlife climacteric women with metabolic syndrome are at high risk for experiencing a complex array of symptoms. The aim of this scoping review was to identify the prevalence, types, and clustering of symptoms in midlife climacteric women with metabolic syndrome and to compare them to symptoms of midlife climacteric women without metabolic syndrome.

Methods:

A three-step search method was used according to Joanna Briggs Institute methodology. Eligibility criteria of participants, concept, context, and types of evidence were selected in alignment with the review questions. Seven databases (PubMed, Embase, Web of Science, CINAHL, PsycINFO, ProQuest Dissertation & Theses, OpenGrey) were searched using search terms with no language or date restrictions. Title and abstract screening, full-text review, data charting, and data synthesis were conducted by two independent researchers based on the eligibility criteria.

Results:

The search yielded 3813 studies after removing duplicates with 48 full-text papers assessed for eligibility. A total of eight studies were reviewed and analyzed which reported the prevalence and types of symptoms individually or grouped based on each body system. Midlife climacteric women with metabolic syndrome experience a wide prevalence of individual and grouped urogenital, vasomotor, psychological, sleep, and somatic symptoms. Mental exhaustion had the highest prevalence (84.4%) among the individual symptoms, and urogenital symptoms had the highest prevalence (81.3%) among the grouped symptoms. There were mixed findings on symptoms between midlife climacteric women with metabolic syndrome and without metabolic syndrome. No studies focused on symptom clusters.

Conclusion:

Our findings will serve as a knowledge basis for understanding symptoms experienced by midlife climacteric women with metabolic syndrome. This new knowledge can assist clinicians in effectively assessing and managing their symptoms in clinical settings and inform future development of targeted symptom management interventions.
Where’s My Consciousness-Ometer? How to Test for the Presence and Complexity of Consciousness
Authors: Hunt Tam , Ericson Marissa , Schooler Jonathan
Published: March 2022

Tools and tests for measuring the presence and complexity of consciousness are becoming available, but there is no established theoretical approach for what these tools are measuring. This article examines several categories of tests for making reasonable inferences about the presence and complexity of consciousness (defined as the capacity for phenomenal/subjective experience) and also suggests ways in which different theories of consciousness may be empirically distinguished. We label the various ways to measure consciousness the measurable correlates of consciousness (MCC) and include three subcategories in our taxonomy: (a) neural correlates of consciousness, (b) behavioral correlates of consciousness, and (c) creative correlates of consciousness. Finally, we reflect on how broader philosophical views about the nature of consciousness, such as materialism and panpsychism, may also be informed by the scientific process.
Reliability analysis and optimal replacement for a k-out-of-n system under a δ-shock model
Authors: Lorvand Hamed , Kelkinnama Maryam
Published: March 2022

Consider a k-out-of- n system which is subject to shocks that arrive at random times. This study develops [Formula: see text]-shock model, among the variants of well-known shock models, for such system which consists of independent components. In a [Formula: see text]-shock model, the system fails when the inter-arrival between two consecutive shocks is less than a critical threshold value of [Formula: see text]. Depending on the number of components that fail due to the occurrence of the shocks, we introduce two [Formula: see text]-shock models. The reliability function and mean time to failure of the system are discussed when the time between shocks has an arbitrary distribution. Furthermore, the problem of finding the optimal preventive time concerned with minimizing a mean cost per unit time is investigated. Numerical examples based on a simulation study are also provided to illustrate theoretical achievement.
Lessons Learnt From a Greenfield Hangar-Based 1,000-Bedded Temporary Hospital in India
Authors: Upadhyay Akhilesh Kumar , Patnaik Saroj Kumar , Chandrasekhara T. , Tilak T. V. S. V. G. K. , Kushagra Patel , Singh Bhatia Surinder
Published: March 2022

During the COVID-19 pandemic, the total number of hospital beds in the National Capital Region (NCR) of Delhi was 54,321 (roughly 300 beds per one lakh population), which was inadequate for the patients. Therefore, the Indian government initiated the construction of a 1,000-bedded greenfield hangar-based hospital to bridge the healthcare gap. As a result, Intensive Care Unit (ICU) beds in the facility augmented the COVID-19 care ICU beds in the city by 11%. The authors were involved in the planning, developing, and initiating the functioning of 1,000-bedded Dedicated COVID-19 Hospital (DCH). The hospital was conceptualized, built, and operationalized in 12 days only. Lessons learned from this experience would be of benefit should similar situations arise in future. Coordinating structural designing early with the entire project team—from facility administrators and medical practitioners to architects, consultants, and contractors—can result in a structure that better matches the facility’s long-term needs and often saves construction time and costs. This article enumerates various challenges faced and the way they were addressed. This hangar-based hospital can be rapidly constructed and deployed on a massive scale. While structural integrity is essential, the planning team was particularly aware of the patient-centric modality of healthcare. Many modifications were carried out in the structure based on patient inputs. Informal discussions with discharged patients and relatives revealed that the human-centric approach was the mainstay of the therapy.
Validation of the Student Version of the Perceptions of Inclusion Questionnaire in Primary and Secondary Education Settings
Authors: Knickenberg Margarita , Zurbriggen Carmen L. A. , Schwab Susanne
Published: March 2022

Considering students’ voices and perspectives is indispensable in educational contexts. Therefore, instruments of measurement that are reliable and valid and can be used easily without complications are needed in schools. The Perceptions of Inclusion Questionnaire (PIQ) is a short instrument used to assess three central dimensions of inclusion, namely emotional and social inclusion and academic self-concept. Previous evaluations indicate in general high psychometric properties. This study aimed to evaluate the construct validity of the three scales of the PIQ’s student version using different approaches in two samples from primary (grade 4, N = 721) and secondary (grade 7, N = 393) schools. The results of confirmatory factorial analyses confirmed the PIQ’s three factors in both samples which are also measurement equivalent across grades. Plausible correlations with additional divergent and convergent scales reveal that the PIQ measures the theoretically assumed constructs—emotional and social inclusion as well as academic self-concept—validly.
Shared Solitude
Authors: Khemka Anita , Kokiloo Imran
Published: March 2022

Shared Solitude was born out of a literal and forced isolation as a result of a family emergency, coinciding with the very unplanned and brutal lockdown, enforced by a political system hell-bent on being seen as decisive. It made us question the status quo we had grown accustomed to and the dichotomy of our daily lives. One of our early sitters, Ishita echoed our views, ‘Living in lockdown has been a revelation. I have realized that [certain] relationships, having time to read, being with dogs, and having enough meaningful work in the day is enough for me—this is all I would like to keep in my life’. This burgeoning clarity and purpose about one’s life, we realized, was shared by many people. This project thus set out to excavate memory, the joyous and painful, and confronts the universal dilemma of ownership, possession and letting go.
An examination of Chinese character writing errors: Developmental differences among Chinese as a foreign language learners
Authors: Deng Siqi , Hu Wenhua
Published: March 2022

With interlanguage corpora, this study investigates the handwriting errors by Chinese as a foreign language (CFL) learners from eight countries and three language families (Indo-European languages, Slavic languages, Romance languages), including wrongly written characters and misused characters. The results indicate that the most common mistake among elementary, intermediate and advanced learners is wrongly written characters mainly caused by misuse of components, especially confusion between components and miswriting of components. Besides, stroke errors also matter. The reduction and improper location of strokes, in particular, trouble learners a great deal. As to the misused characters, how to differentiate similar characters is where the difficulties lie. On the whole, from the elementary stage to the intermediate stage, both types of errors decrease significantly, while after the intermediate stage, the decrease of wrongly written characters is more significant than that of the misused characters. Moreover, for advanced learners, the frequencies of these errors are basically the same. The study findings demonstrate that it is crucial for CFL learners to rapidly develop their awareness of orthography between the elementary and intermediate stages. This will last roughly 9 months. Advanced learners are usually well aware of orthography, but their awareness development of the form, pronunciation and meaning is not synchronized. They still make mistakes with details when writing. This research is instructive in the teaching of Chinese character handwriting. It points out the problems and countermeasures of online Chinese character handwriting courses during the pandemic and thus contributes advice to online Chinese character teaching during the long-term future.
Impact of the Covid-19 epidemic on a US sample of patients with myasthenia gravis
Authors: Gutierrez Gloria , Girma Helen , Kuhnell Pierce , Macaluso Maurizio , Kaminski Henry J.
Published: March 2022

Introduction:

The Covid-19 pandemic has devastated the world and demonstrated the inadequacy of health care in the United States. To assess its impact, the Rare Disease Clinical Research Network conducted a survey to assess the pandemic on the rare disease community of patients, including those with myasthenia gravis (MG).

Methods:

A cross-sectional survey was designed to target people or their care givers who live in the United States, have a rare disease, and are under 90 years of age. Respondents logged onto a dedicated web page and completed the survey online, which requested demographic, disease-specific, drug treatment, and symptom information as well as assessment of Covid-19 impact on them. The survey was open from May 2020 to December 2020.

Results:

Five hundred ninety-four with self-reported myasthenia gravis completed the survey, which was the largest number of respondents. Sixty percent of respondents were women with a mean age of 60 years. Eighty-nine percent identified as White. Respondents did not appreciate a worsening of symptoms after the pandemic. Only 7 respondents reported the diagnosis of Covid-19 but 11% indicated they had difficulty accessing care at the time of the survey.

Discussion and Conclusion:

Patients with MG complained of worse access to medical care during the early months of the pandemic, including challenges in diagnosis of suspected Covid-19 infection. A major limitation of the survey is its inability to access minority populations. Nevertheless, the results of the Rare Disease Clinical Research Network (RCDRN) survey of patients with MG provide clear evidence that the pandemic has demonstrated the deficiencies in US healthcare.
Emerging Roles and Responsibilities of Auditors and CFOs in the Light of Transforming Risk Landscape
Authors: Vij Madhu , Palan Jayant
Published: March 2022

A new perspective of risk management in the context of emergence of new technologies and innovations has not only changed the risk landscape in the last few years but has also prompted an important shift in the role of auditors and Chief Financial Officers (CFOs) in organizations. Auditors along with senior management need to take a holistic and forward trending view on the emerging risk and risk management practices. They need to be transparent about arriving at the audit opinion and expand their coverage in implementing and improving compliance, governance and risk management-related processes and controls within an organization. New ways and perspectives of risk management have emerged and board, senior leaders, regulators, leaders have all expanded their focus to include the concept of enterprise risk management (ERM). The realities of an ever-changing world with frequent business disruptions have made the concept of ERM important in companies. With the changing times and dynamic scenario that has arisen due to the pandemic, leading organizations are increasingly expecting auditors and CFOs to ensure that they integrate risk into strategic decision-making so as to make smarter decisions. Auditors need to move away from a siloed approach to a more consolidated risk assessment and monitoring perspective. They need to add focus to the top risk areas, think about the return for the organization, avoid unnecessary governance and compliance, and provide objective assurance to the board regarding risk management efficiency.
Treatment and clinical endpoints in polycythemia vera: seeking the best obtainable version of the truth
Authors: Gotlib Jason
Published: March 2022

Polycythemia vera (PV) is a Philadelphia chromosome-negative myeloproliferative neoplasm driven by the JAK2 V617F (or rarely exon 12) mutation. Its natural history can extend over a few decades, and therefore treatment planning is predicated on continual reassessment of traditional risk features (age, prior thrombosis) to evaluate the need for cytoreduction besides foundational therapy with low-dose aspirin and stringent phlebotomy. Shorter- and longer-term patient goals should be considered in light of several variables such as comorbid conditions (especially cardiovascular risk factors), disease symptoms, and the risk-benefit profile of available drugs. While hydroxyurea has been the pro forma choice of cytoreduction for many practitioners over the last half-century, the more recent regulatory approvals of ruxolitinib and ropeginterferon-alfa-2b, based on phase 3 randomized trials, highlight an expanding portfolio of active drugs. Obtaining high-level evidence for short-term clinical trial endpoints such as hematocrit control, symptom burden/quality of life, splenomegaly, and JAK2 V617F allele burden lies within the timeline of most studies. However, in many cases, it may not be possible to adequately power trials to capture significant differences in the typically low event rates of thrombosis as well as longer-horizon endpoints such as evolution to myelofibrosis and acute myeloid leukemia and survival. This Perspective highlights the challenges of addressing these data gaps and outstanding questions in the emerging treatment landscape of PV.
Unsupervised explainable AI for molecular evolutionary study of forty thousand SARS-CoV-2 genomes
Authors: Iwasaki Yuki , Abe Takashi , Wada Kennosuke , Wada Yoshiko , Ikemura Toshimichi
Published: March 2022

Background

Unsupervised AI (artificial intelligence) can obtain novel knowledge from big data without particular models or prior knowledge and is highly desirable for unveiling hidden features in big data. SARS-CoV-2 poses a serious threat to public health and one important issue in characterizing this fast-evolving virus is to elucidate various aspects of their genome sequence changes. We previously established unsupervised AI, a BLSOM (batch-learning SOM), which can analyze five million genomic sequences simultaneously. The present study applied the BLSOM to the oligonucleotide compositions of forty thousand SARS-CoV-2 genomes.

Results

While only the oligonucleotide composition was given, the obtained clusters of genomes corresponded primarily to known main clades and internal divisions in the main clades. Since the BLSOM is explainable AI, it reveals which features of the oligonucleotide composition are responsible for clade clustering. Additionally, BLSOM also provided information concerning the special genomic region possibly undergoing RNA modifications.

Conclusions

The BLSOM has powerful image display capabilities and enables efficient knowledge discovery about viral evolutionary processes, and it can complement phylogenetic methods based on sequence alignment.
The fate of indeterminate liver lesions: What proportion are precursors of hepatocellular carcinoma?
Authors: Cococcia Sara , Dutta Priti , Moghim Melika , Hogan Brian , Tanwar Sudeep , Marshall Aileen , Macdonald Douglas , Yu Dominic , O’Beirne James , Rosenberg William M. , Trembling Paul M.
Published: March 2022

Background

The natural history and incidence of hepatocellular carcinoma (HCC) arising from indeterminate liver lesions are not well described. We aimed to define the incidence of HCC in a cohort of patients undergoing surveillance by magnetic resonance imaging (MRI) and estimate any associations with incident HCC.

Methods

We performed a retrospective follow-up study, identifying MRI scans in which indeterminate lesions had been reported between January 2006 and January 2017. Subsequent MRI scan reports were reviewed for incident HCC arising from indeterminate lesions, data were extracted from electronic patient records and survival analysis performed to estimate associations with baseline factors.

Results

One hundred and nine patients with indeterminate lesions on MRI were identified. HCC developed in 19 (17%) patients over mean follow up of 4.6 years. Univariate Cox proportional hazards analysis found incident HCC to be significantly associated with baseline low platelet count (hazard ratio (HR) = 7.3 (95% confidence intervals (CI) 2.1–24.9), high serum alpha-fetoprotein level (HR = 2.7 (95% CI 1.0–7.1)) and alcohol consumption above fourteen units weekly (HR = 3.1 (95% CI 1.1–8.7)). Multivariate analysis, however, found that only low platelet count was independently associated with HCC (HR = 5.5 (95% CI 0.6–5.1)).

Conclusions

HCC arises in approximately one fifth of indeterminate liver lesions over 4.6 years and is associated with a low platelet count at the time of first diagnosis of an indeterminate lesion. Incidence of HCC was more common in people with viral hepatitis and in those consuming > 14 units of alcohol per week. Our data may be used to support a strategy of enhanced surveillance in patients with indeterminate lesions.
Gastrointestinal symptoms are associated with a lower risk of hospitalization and mortality and outcomes in COVID-19
Authors: Delavari Alireza , Asgari Samaneh , Alimohamadi Yousef , Vosoogh-Moghaddam Abbass , Sadeghi Anahita , Shahrousvand Shokouh , Zakeri Armin , Moradzadeh Rahmatollah , Akbarpour Samaneh
Published: March 2022

Background

We aimed to find the association between gastrointestinal (GI) and respiratory symptoms with mortality and hospitalization among COVID-19 patients.

Methods

We analyzed the registered data of COVID-19 patients from February 20, 2020, to March 10, 2021. Depending on the patients’ disease symptoms, four categories were defined: patients with only GI symptoms, patients with only respiratory symptoms, patients with both symptoms, and patients with other symptoms. Logistic regression analysis was used to assess the association of groups with outcomes.

Results

A total of 42,964 patients from 23 hospitals were included, of which 26.5% patients had at least one or more GI symptoms. Of total patients, 51.58% patients were hospitalized among which 22.8% had at least one or more GI symptoms. GI symptoms significantly decreased the odds of mortality (OR 0.72, 95% CI 0.56–0.92), but respiratory symptoms increased the odds for mortality (1.36: 1.24–1.50), compared with patients with other symptoms. Moreover, the odds ratio of patients who had both respiratory and GI symptoms increased (1.52: 1.31–1.78) compared with patients with other symptoms. The same results were observed for hospitalization as the outcome.

Conclusions

Our study showed that the presence of GI symptoms in COVID-19 at the time of admission was associated with a lower odds of hospitalization and mortality; however, this association had higher odds for respiratory symptoms.
Characterization of short-chain fatty acids in patients with ulcerative colitis: a meta-analysis
Authors: Xu Hao-Ming , Zhao Hai-Lan , Guo Gong-Jing , Xu Jing , Zhou You-Lian , Huang Hong-Li , Nie Yu-Qiang
Published: March 2022

Background

Studies investigating the changes in short-chain fatty acids (SCFAs) in patients with ulcerative colitis (UC) have yielded inconsistent results. We performed a meta-analysis of studies that investigated the alterations in different SCFAs among UC patients to assess their role in the development of UC.

Methods

Three databases were searched for relevant studies published as of April 2021. Results are presented as standardized mean difference (SMD) with 95% confidence interval (95% CI).

Results

Eleven studies were included in the meta-analysis. Compared to healthy subjects, UC patients had significantly lower concentrations of total SCFAs (SMD = − 0.88, 95%CI − 1.44, − 0.33; P < 0.001), acetate (SMD = − 0.54, 95% CI − 0.91, − 0.17; P = 0.004), propionate, (SMD = − 0.37, 95% CI − 0.66, − 0.07; P = 0.016), and valerate (SMD = − 0.91, 95% CI − 1.45, − 0.38; P < 0.001). On subgroup analysis based on disease status, patients with active UC had reduced concentrations of acetate (SMD = − 1.83, 95% CI − 3.32, − 0.35; P = 0.015), propionate (SMD = − 2.51, 95% CI − 4.41, − 0.61; P = 0.009), and valerate (SMD = − 0.91, 95% CI − 1.45, − 0.38; P < 0.001), while UC patients in remission had similar concentrations with healthy subjects. Patients with active UC had lower butyrate level (SMD = − 2.09, 95% CI − 3.56, − 0.62; P = 0.005) while UC patients in remission had higher butyrate level (SMD = 0.71, 95% CI 0.33, 1.10; P < 0.001) compared with healthy subjects.

Conclusion

UC patients had significantly decreased concentrations of total SCFAs, acetate, propionate, and valerate compared with healthy subjects. In addition, inconsistent changes of certain special SCFAs were observed in UC patients with different disease status.
An evaluation of injurious falls and Fall-Risk-Increasing-Drug (FRID) prescribing in ambulatory care in older adults
Authors: Elliott Taylor R. , Westneat Susan , Karanth Shama D. , Abner Erin L. , Kucharska-Newton Anna M. , Moga Daniela C.
Published: March 2022

Background

Falls are a major public health problem affecting millions of older adults each year. Little is known about FRID prescribing behaviors after injurious falls occur. The primary objective of this study was to investigate whether an injurious fall is associated with being prescribed a new FRID.

Methods

We conducted a cross-sectional analysis using data from the National Ambulatory Medical Care Survey (2016). We included visits from patients age ≥ 65 years and classified visits based on presence of an injurious fall. The outcome of interest was prescription of new FRID between those with and without an injurious fall. Multivariable logistic regression weighted for sampling and adjusted for demographics, health history and other medications was used. Age and Alzheimer’s disease were examined as potential effect measure modifiers. Odds ratios and 95% confidence intervals were reported. Bayes factor upper bounds were also reported to quantify whether the data were better predicted by the null hypothesis or the alternative hypothesis.

Results

The sample included 239,016,482 ambulatory care visits. 5,095,734 (2.1%) of the visits were related to an injurious fall. An injurious fall was associated with a non-statistically significant increase in odds of at least one new FRID prescription: adjusted OR = 1.6 (95% CI 0.6, 4.0). However, there was non-statistically significant evidence that the association depended on patient age, with OR = 2.6 (95% CI 0.9, 7.4) for ages 65–74 versus OR = 0.4 (95% CI 0.1, 1.6) for ages ≥ 75. In addition to age, Alzheimer’s disease was also identified as a statistically significant effect measure modifier, but stratum specific estimates were not determined due to small sample sizes.

Conclusions

Ambulatory care visits involving an injurious fall showed a non-statistically significant increase in odds of generating a new FRID prescription, but this association may depend on age.
Health care system and patient costs associated with receipt of minimally adequate treatment for depression and anxiety disorders in older adults
Authors: Lamoureux-Lamarche Catherine , Berbiche Djamal , Vasiliadis Helen-Maria
Published: March 2022

Background

Depression and anxiety disorders in older adults are associated with a great burden. Research has shown that less than 50% of adults receive adequate treatment in primary care settings for these disorders. Rare are the studies however assessing adequate treatment in older adults and associated costs from the societal perspective. Given the episodic nature of common mental disorders, this study aims to assess the three-year costs from a restricted societal perspective (including health system and patient perspectives) associated with receipt of minimally adequate treatment for depression and anxiety disorders in older adults consulting in primary care.

Methods

This primary care cohort study included 358 older adults aged 65 years and older with either a self-reported or physician diagnosis of depression or an anxiety disorder covered under Quebec’s public drug plan. Receipt of minimally adequate treatment was assessed according to Canadian guidelines and relevant reports. Outpatient and inpatient service use, medication costs and physician billing fees were obtained from provincial administrative databases. Unit costs were calculated using provincial financial and activity reports and relevant literature. A propensity score was created to estimate the probability of receiving minimally adequate treatment and the inverse probability was used as a weight in analyses. Generalized linear models, with gamma distribution and log link, were conducted to assess the association between receipt of minimally adequate treatment and costs.

Results

Overall, receipt of minimally adequate treatment was associated with increased three-year costs averaging $5752, $536, $6266 for the health system, patient and societal perspectives, respectively, compared to those not receiving minimally adequate treatment. From the health system perspective, participants receiving minimally adequate treatment had higher costs related to emergency department (ED) (difference: $457,p = 0.001) and outpatient visits (difference: $620,p < 0.001), inpatient stays (difference: $2564,p = 0.025), drug prescriptions (difference: $1243,p = 0.002) and physician fees (difference: $1224,p < 0.001). From the patient perspective, receipt of minimally adequate treatment was associated with higher costs related to loss of productivity related to ED (difference: $213,p < 0.001) and outpatient visits (difference: $89,p < 0.001).

Conclusions

Older adults receiving minimally adequate treatment for depression and anxiety disorders incurred higher societal costs reaching $2089 annually compared to older adults not receiving minimally adequate treatment. The main cost drivers were attributable to hospitalizations and prescription drug costs.
Engagement with protective behaviours in the UK during the COVID-19 pandemic: a series of cross-sectional surveys (the COVID-19 rapid survey of adherence to interventions and responses [CORSAIR] study)
Authors: Smith Louise E. , Potts Henry W. W. , Amlȏt Richard , Fear Nicola T. , Michie Susan , Rubin G. James
Published: March 2022

Background

Behaviour is key to suppressing the COVID-19 pandemic. Maintaining behaviour change can be difficult. We investigated engagement with hand cleaning, reducing the number of outings, and wearing a face covering over the course of the pandemic.

Methods

We used a series of 64 cross-sectional surveys between 10 February 2020 and 20 January 2022 (n ≈ 2000 per wave). Surveys investigated uptake of hand cleaning behaviours, out of home activity (England only, n ≈ 1700 per wave) and wearing a face covering (England only, restricted to those who reported going out shopping in the last week, n ≈ 1400 per wave).

Results

Reported hand cleaning has been high throughout the pandemic period (85 to 90% of participants consistently reporting washing their hands thoroughly and regularly with soap and water frequently or very frequently). Out of home activity has mirrored the easing and re-introduction of restrictive measures. Total number of outings were higher in the second national lockdown than in the first and third lockdowns. Wearing a face covering increased steadily between April to August 2020, plateauing until the end of measurement in May 2021, with approximately 80% of those who had been out shopping in the previous week reporting wearing a face covering frequently or very frequently.

Conclusions

Engagement with protective behaviours increased at the start of the pandemic and has remained high since. The greatest variations in behaviour reflected changes to Government rules. Despite the duration of restrictions, people have continued to adopt personal protective behaviours that were intended to prevent the spread of COVID-19.
Muscle architecture, growth, and biological Remodelling in cerebral palsy: a narrative review
Authors: Handsfield Geoffrey G. , Williams Sîan , Khuu Stephanie , Lichtwark Glen , Stott N. Susan
Published: March 2022

Cerebral palsy (CP) is caused by a static lesion to the brain occurring in utero or up to the first 2 years of life; it often manifests as musculoskeletal impairments and movement disorders including spasticity and contractures. Variable manifestation of the pathology across individuals, coupled with differing mechanics and treatments, leads to a heterogeneous collection of clinical phenotypes that affect muscles and individuals differently. Growth of muscles in CP deviates from typical development, evident as early as 15 months of age. Muscles in CP may be reduced in volume by as much as 40%, may be shorter in length, present longer tendons, and may have fewer sarcomeres in series that are overstretched compared to typical. Macroscale and functional deficits are likely mediated by dysfunction at the cellular level, which manifests as impaired growth. Within muscle fibres, satellite cells are decreased by as much as 40–70% and the regenerative capacity of remaining satellite cells appears compromised. Impaired muscle regeneration in CP is coupled with extracellular matrix expansion and increased pro-inflammatory gene expression; resultant muscles are smaller, stiffer, and weaker than typical muscle. These differences may contribute to individuals with CP participating in less physical activity, thus decreasing opportunities for mechanical loading, commencing a vicious cycle of muscle disuse and secondary sarcopenia. This narrative review describes the effects of CP on skeletal muscles encompassing substantive changes from whole muscle function to cell-level effects and the effects of common treatments. We discuss growth and mechanics of skeletal muscles in CP and propose areas where future work is needed to understand these interactions, particularly the link between neural insult and cell-level manifestation of CP.
Suppurative thyroiditis caused by ingested fish bone in the thyroid gland: a case report on its diagnostics and surgical therapy
Authors: Hendricks Anne , Meir Michael , Hankir Mohammed , Lenschow Christina , Germer Christoph-Thomas , Schneider Michael , Wiegering Armin , Schlegel Nicolas
Published: March 2022

Background

Accidental ingestion of fish bone is a common cause of otolaryngological emergency. Migration of the ingested bone into the thyroid gland, however, occurs very rarely. The associated clinical presentation, symptoms and duration of discomfort are also highly variable between patients and can be diagnostically challenging.

Case presentation

Here, we report the case of a 71-year-old female patient presenting with an ingested fish bone that migrated into the right thyroid lobe as a rare cause of suppurative thyroiditis with the clinical features of sepsis. We outline the diagnostic approach, peri- and intraoperative management as well as complications. It is proposed that besides endoscopy, imaging methods such as ultrasound or computed tomography may be necessary to verify the diagnosis and location of an ingested fish bone. Prompt surgical removal of the foreign body and resection of the infectious focus is recommended to minimize the risk of local inflammation, recurrent nerve lesions and septic complications arising from the spread of infection.

Conclusion

Fish bone migration into the thyroid gland is an extremely rare event, the successful detection and surgical management of which can be achieved through a careful interdisciplinary approach.
Syndrome of inappropriate secretion of antidiuretic hormone following high dose rate brachytherapy for prostate cancer: a case report
Authors: Ayoola Adeoluwa , Sodji Quaovi H. , Chin Sharon , Panousis Periklis , Bagshaw Hilary P. , Buyyounouski Mark K.
Published: March 2022

Background

The syndrome of inappropriate secretion of antidiuretic hormone is a disorder characterized by the excess release of antidiuretic hormone and can result in hyponatremia. If managed inappropriately, severe hyponatremia can cause seizures, cerebral edema, and even death. There are various known causes of this inappropriate release of antidiuretic hormone, including malignancy, CNS disorders, and disturbances in the hypothalamic-pituitary-renal axis. However, reports of syndrome of inappropriate secretion of antidiuretic hormone after brachytherapy for prostate cancer are exceedingly rare.

Case presentation

We report a case of symptomatic hyponatremia secondary to the inappropriate secretion of antidiuretic hormone after prostate high-dose rate brachytherapy under general anesthesia in a patient with adenocarcinoma of the prostate.

Conclusions

In rare instances, inappropriate secretion of antidiuretic hormone can occur after high-dose rate brachytherapy for prostate cancer. The cause is likely multifactorial, involving pain or discomfort ensuing from the surgical procedure, the general anesthesia or intraoperative drugs administered. However, due to the potential severity of the side effects, timely diagnosis is crucial to ensure prompt, and effective management.
Collaborative learning in small groups in an online course – a case study
Authors: Haugland Mildrid Jorunn , Rosenberg Ivar , Aasekjær Katrine
Published: March 2022

Background

The ability to learn collaboratively and work in teams is an essential competency in both educational and healthcare settings, and collaborative student activities are acknowledged as being an important part of the pedagogical approach in higher education and teaching. The course that was the focus of this research, a 15-ECTS-credit online course in philosophy of science, ethics, and research methods, was offered online as part of 11 master’s-level health programmes at a university in Norway. Collaborative learning in combination with digital teaching tools was the preferred pedagogical approach in the online course. The aim of the study was to describe, explore and discuss how the students collaborated in small groups in an online course to learn.

Methods

We performed six focus groups and 13 individual interviews from February 2018 to May 2019, conducting a qualitative case study with a content analysis of the data collected. The participants were master students in the same faculty at a university in Norway. All the included participants had fulfilled the 15 ECTS credit course.

Results

Our study revealed that the collaboration in small groups resulted in three different working processes, depending on the students’ ability to be flexible and take responsibility for their own and common learning. The three different working processes that emerged from our data were 1. joint responsibility – flexible organization; 2. individual responsibility – flexible organization; and 3. individual responsibility – unorganized. None of the groups changed their working process during their course, even though some experienced their strategy as inadequate.

Conclusions

Our study showed that despite similar factors such as context, assignments and student autonomy, the students chose different collaboration strategies to accomplish the online course learning objectives. Each group chose their own working process, but only the strategy 1. joint responsibility – flexible organization seemed to promote collaboration, discussion, and team work to complete the complex assignments in the online course. The result from our study may be helpful in designing and planning future online courses; hence online learning requires a focus on how students collaborate and learn online, to gain knowledge and understanding through group discussion.
Using information technology to optimize the identification process for outpatients having blood drawn and improve patient satisfaction
Authors: Wu Li-Feng , Zhuang Guo-Hua , Hu Qi-Lei , Zhang Liang , Luo Zhang-Mei , Lv Yin-Jiang , Tang Jian
Published: March 2022

Background

This study explored the application effect of information technology in optimizing the patient identification process.

Methods

The method for optimizing the identification process involved in drawing blood among outpatients using information technology was executed from July 2020. In this paper, 959 patients who had blood drawn from January to June 2020 were included as the pre-optimization group, and 1011 patients who had blood drawn from July to December 2019 were included as the post-optimization group. The correct rate of patient identification, waiting time, and patient satisfaction before and after the optimization were statistically analyzed. The changes in these three indexes before and after the optimization implementation, as well as the application effects, were compared.

Results

The correct rate of patient identification after optimization (99.80%) was higher than before optimization (98.02%) (X2 = 13.120; P < 0.001), and the waiting time for having blood drawn was also significantly shortened (t = 8.046; P < 0.001). The satisfaction of patients was also significantly improved (X2 = 20.973; P < 0.001).

Conclusions

By combining information technology with the characteristics of blood collection in our hospital, using the call system to obtain patient information, then scan the QR code of the guide sheet for automatic verification, and finally manually reconfirm patient information, which can significantly reduce the occurrence of identification errors, improve work efficiency and improve patients' satisfaction.
Disseminated Mycobacterium genavense infection in a guinea pig (Cavia porcellus): a case report
Authors: Minich David J. , Agrawal Alea , Kania Stephen A. , Hespel Adrien-Maxence , Cushing Andrew , Meraz Dory , Sheldon Julie
Published: March 2022

Background

Mycobacteria are found in many environmental conditions and infect a variety of species, including rodents and rabbits. Guinea pigs are used experimentally as a model for Mycobacterium tuberculosis, but natural mycobacteriosis in guinea pigs has not been reported.

Case presentation

A 1.5-year-old female guinea pig was found acutely deceased with no premonitory illness. On gross post-mortem examination, multifocal to coalescing, raised, firm, pale tan nodules with discrete, irregular margins were noted over the surfaces of all lung lobes. Histopathology revealed nodules composed of clustered foamy macrophages and multinucleated giant cells containing numerous bacterial rods. Similar bacteria-laden macrophages were noted within sections of the liver, heart, palpebral conjunctiva, duodenum, and cecum. Polymerase chain reaction was performed on tissues collected during post-mortem examination. The 16S rRNA gene product was sequenced and was identical to the Mycobacterium genavense type strain.

Conclusions

To the best of the author’s knowledge, this report details the first documented case of Mycobacterium genvaense infection in a guinea pig and a follow up investigation of close-contact animals. Given their experimental susceptibility and this clinical case report, mycobacteriosis should be considered as a differential in guinea pigs exhibiting weight loss in the absence of other clinical signs. With the potential for zoonotic transmission in immunosuppressed individuals, precautions should be taken to safeguard human health in cases of guinea pigs with suspected M. genavense infection.
Traditional uses and practices of edible cultivated Allium species (fam. Amaryllidaceae) in Sweden
Authors: de Vahl Erik , Svanberg Ingvar
Published: March 2022

Background

While the utilitarian crops grown in vicarage gardens in pre-industrial Sweden have been fairly well documented, our knowledge of plants cultivated for food among the peasants and crofters is limited. Nevertheless, garden vegetables and herbs played a much more important role in the diet of the rural population from a nutritional point of view than, say, wild plants, at least in the southern part of the country. This study aims to explore the importance of edible cultivated onions, Allium, and their various cultivars and old landraces that were once—and in some cases still are—grown in home gardens.

Methods

This study is based on documentation collected from national surveys carried out by the Swedish National Programme for Diversity of Cultivated Plants (POM), and from an intense search for references to the cultivation and use of carious onions in the historic garden literature, herbals and ethnographic records found in responses to folklife questionnaires.

Results

The rural population in pre-industrial Sweden cultivated various kinds of bulb onions. They are known under various folk names, although their taxonomic affiliation has been unclear. Many folk taxa have been classified and named by their use, while other names refer to the practices associated with the cultivation system. These onions were often described as especially well suited for storage over winter. Onions have had a wide range of uses in Sweden. In some parts of Sweden, onions were eaten during church service in order to keep the churchgoers awake. Several types of onion have commonly been used as condiments in pickled herring dishes, spreads, sauces, foods made of blood and offal, dumplings, meat dishes and soups. Garlic was used for medicinal and magical purposes, as well as for ethnoveterinary medicine. Onion skins have traditionally been used for dyeing eggs at Easter.

Conclusion

Genetic diversity of vegetables and garden crops represents a critical resource to achieve and maintain global food security. Therefore, ethnobiologists studying agricultural societies should place more focus on old landraces, cultivars and cultivation practices in order to understand the importance of garden crops for a society. They are an important element of sustainability.