bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants of community acquired pneumonia among 2 to 59 months of age children in Northeast Ethiopia: a case-control study
Authors: Bazie Getaw Walle , Seid Nebat , Admassu Bitiya
Published: September 2022

Background

Pneumonia is the leading cause of mortality and morbidity in under-five children. Regardless of this fact, efforts to identify determinants of pneumonia have been limited in the study area. The aim of this study was to identify determinants of community-acquired pneumonia among 2–59 months of age children in Northeast Ethiopia.

Methods

Facility-based unmatched case-control study was conducted from February to April, 2019 among 444 (148 cases and 296 controls) 2–59 months of age children in Northeast Ethiopia. Cases were children with pneumonia, while controls were non-pneumonia children. Data were collected using a structured and pre-tested questionnaire by integrated management of neonatal and childhood illness trained nurses. The data were entered into Epi Data and then transferred to SPSS version 23 for analysis. Binary logistic regression analysis was used to test associations between the independent and the dependent variables. Variables with P-value ≤ 0.05 in the multivariable logistic regression model were declared as significant variables.

Results

Children having older age mother (AOR = 0.03, 95% CI; 0.01,0.14), having mothers who are housewife (AOR = 0.19, 95% CI; 0.07,0.54), not having separate kitchen (AOR = 5.37; 95% CI: 1.65,17.43), having a history of diarrhea in the last 2 weeks (AOR = 10.2; 95% CI: 5.13, 20.18), having a history of acute lower respiratory infection in the last 2 weeks (AOR = 8.3, 95% CI: 3.32, 20.55) and having a history of parental asthma in the family (AOR = 4.9, 95% CI: 2.42, 10.18) were found to be determinants of community-acquired pneumonia.

Conclusions

Children having older age mother, having mothers who are housewife, not having separate kitchen, having a history of diarrhea in the last 2 weeks, having a history of acute lower respiratory infection in the last 2 weeks and having a history of parental asthma in the family were found to be determinants of community-acquired pneumonia. Therefore, all health institutions should promote early treatments and prevention of diarrhea and acute lower respiratory infections of under-five children at the health facility and household level.
Out-of-pocket costs for oral anticancer drugs.
Authors: Arora Nivedita , Hussaini S. M. Qasim , Sedhom Ramy , Blaes Anne Hudson , Dusetzina Stacie B , Gupta Arjun
Published: September 2022

14

Background: Oral anticancer drug annual out-of-pocket costs (OOPCs) for Medicare beneficiaries are frequently > $10,000. Many of these medications are available as multiple formulations (e.g., tablet/capsule) and multiple strengths (e.g., 25mg/50mg). Oral medications are typically priced per unit (pill), allowing for more cost-effective prescribing when patients use fewer pills to obtain a recommended dose. It is unclear whether cancer drugs follow this traditional paradigm. We sought to assess the relationship between drug formulation features and OOPCs. Methods: We included 20 oral anticancer drugs with the highest spending in Medicare Part D in 2020. For each drug, we identified formulations, strengths, and schedules using NCCN guidelines and UptoDate. For each product, we calculated a lowest expected annual drug OOPC for all relevant strengths/schedules using the 2022 Part D Plan Finder. For example, the drug osimertinib is available in 40 and 80 mg tablets, with total daily doses of 80 and 160mg, reflecting 4 pricing scenarios. We assessed costs for 1 year of monthly fills. We compared cost ratios across formulations for each drug. Results: Of the 20 drugs, 17 (85%) were available as brand-name only; 3 (15%) were also available as generic. Fifteen (75%) were available as a single formulation only (e.g., tablet only); 5 (25%) were available as multiple formulations (e.g., tablet and capsule). Eighteen (90%) were available in multiple strengths. Median annual drug OOPCs was $12,979. For brand vs generic comparisons (n = 4, keeping other variables constant, 1 drug could have > 1 comparison due to different strengths), brand coverage for imatinib and 250 mg abiraterone tablets was limited, leading to high cost ratios (brand/generic > 50). For 2 other comparisons, the brand was less costly (abiraterone 500 mg tablets, ratio 0.85) and more costly (everolimus 10 mg tablets, ratio 1.18) for 1 each. For tablet vs capsules/others (n = 4), tablets were cheaper for 2 (ratio, 0.63- 0.96), a little more costly for 1 (ratio 1.04), and a lot more costly for 1 (ratio 2.13, ibrutinib 140 mg). For comparisons across strengths of the same formulation to achieve the same total dose (n = 14), using lower strength/higher fill quantity was more costly for 10 drugs (median ratio 1.79), the same for 1, and less costly for 3 (ratios 0.35- 0.89). Conclusions: Even when considering the least costly Part D plan, 2022 oral anticancer drug OOPCs remain high. Counter to expectations, in some cases generics were more costly than brands, and more pills at a lower dose were less costly than fewer pills. There was no consistent pattern. Oncologists and pharmacists cannot be expected to know the unpredictable OOPC ramifications of biologically equivalent prescription decisions. As cancer primarily affects older adults, often living on fixed incomes, policy-level change to lower OOPCs are necessary to avoid financial ruin and enhance access for Medicare beneficiaries.
Between and within drug variation in copayments for common oral anti-cancer medications at an academic medical center.
Authors: Swartz Scott , Clark Mackenzie , White Jared , Lo Mimi , Gupta Arjun , Lin Tracy Kuo , Chino Fumiko , Ragavan Meera Vimala
Published: September 2022

18

Background: The use of oral anti-cancer medications- which are often high priced with significant cost sharing to the patient- is increasing. Transparency of out-of-pocket costs and payment responsibility has historically been limited due to the wide variation in coverage by insurance plans and pharmacy benefits. Our study utilized a novel pharmacy database to describe within-drug and between-drug variation in patient copayments for ten common oral anti-cancer medications. Methods: We conducted a retrospective cohort study including all patients prescribed an oral cancer-directed therapy through the University of California, San Francisco (UCSF) Specialty Pharmacy between January 1,2021 and December 31, 2021. The unit of analysis was defined as patient-drug. Copayments were standardized as 30-day costs. Data was abstracted through our institution’s Specialty Pharmacy prescribing database and linked to demographic data through the institutional electronic medical record system. Between drug variation in copayments was analyzed using Pearson chi square tests. Results: There were 1,357 total patient-drug combinations over the study period. Medicare Part D was the primary payor (44%) followed by commercial insurance (25%). The ten most frequently prescribed medications (Table) accounted for 50% of all oral anti-cancer prescriptions. Minimum monthly copayment for all medications was $0. There were significant differences across medications in the percentage of patients with a mean copayment above $150 (Χ2 = 33.9, p < 0.001) and percentage of patients receiving financial assistance (Χ2 = 63, p < 0.001). Conclusions: There was a high amount of within-drug and between-drug variation in copayments within an integrated specialty pharmacy program. It is essential to identify patients with high copayments early on in cancer treatment and connect them with tangible resources to help mitigate the growing financial impact of these medications.[Table: see text]
Home-based geriatric oncology care: A feasibility study.
Authors: Ozcan Gonca , Braish Julie , Mohammed Turab J , Hong Catriona , Mott Nicole , Eanniello Mary , Shahrokni Armin , Salner Andrew L. , Yu Peter Paul , Nipp Ryan David , Elias Rawad
Published: September 2022

62

Background: The Comprehensive Geriatric Assessment (CGA) improves the outcomes of older patients with cancer, and by identifying of geriatric impairments the CGA can guide the development of supportive interventions. However, the implementation of these interventions in a real-world setting can be burdensome for patients, particularly when additional visits are required in an often frail population. Therefore, our team developed a collaborative model for home-based delivery of CGA-guided interventions. Methods: We performed a retrospective review of community-dwelling patients aged ≥ 70 years with an active cancer diagnosis who were deemed to be frail by a CGA and who received home-based CGA-guided supportive interventions under a collaborative care model established by the geriatric oncology and the palliative home care teams at Hartford HealthCare Cancer Institute between October 2020 and April 2022. The collaboration is based on multidisciplinary discussion of the CGA results / interventions and weekly rounds to discuss patient’s progress and emerging needs. Results: A total of 182 patients received a CGA during the study period, 54% (n = 99) were determined to be frail based on impairment in ≥ 7 geriatric domains. Among all eligible patients, 19 patients (19%) were included in the collaborative model. The median age of enrolled patients was 84 years (74-90), 12/19 (63%) had metastatic cancer, 7/19 (37%) received systemic treatment, and 8/19 (42%) received radiation. The average number of geriatric impairments per patients was 9.5 (7-12). Geriatric impairments addressed at home were skilled nursing (19/19), physical therapy (18/19), occupational therapy (12/19), speech-language-pathology (2/19), nutrition (5/19), or social worker (11/19) support at home. The average number of unplanned hospitalizations was 1.16 per patient (range 0-4), and the average unplanned emergency room visit was 0.89 per person (range 0-4) during study time. Transition to hospice occurred in 8/19 patients (42%), the median time to transition to hospice was 33.5 days (15-167). Conclusions: This study demonstrates the feasibility of a collaborative model for home-based geriatric oncology care in a real-world setting to help reduce the burden of care on patients and ensure patient-centered delivery of CGA-guided interventions. Findings underscore the need for future work to evaluate the impact of this novel geriatric oncology care model on patient outcomes.
Pre-existing mental illness and guideline-concordant treatment for breast cancers among older women.
Authors: Bhattacharya Manami , Parsons Helen , Blaes Anne Hudson , Call Kathleen , McAlpine Donna
Published: September 2022

138

Background: Guideline-concordant care (GCC) of breast cancer greatly improves survival. Women with mental illness experience worse survival after breast cancer; in this study, we examined whether women with mental illnesses pre-existing their breast cancer diagnosis receive GCC for breast cancer as often as women without. Methods: We used Surveillance and Epidemiology and End Results (SEER) cancer registry and Medicare claims (SEER-Medicare) to select cases of women (67+ years old) with Stage I-III breast cancers (n = 89,172). Mental illness was measured through diagnostic codes within 2 years before cancer diagnosis and categorized as serious mental illness (SMI: schizophrenia, bipolar disorder, depression with psychosis, and other psychotic disorders); depression or anxiety; or other mental illnesses. To determine receipt of GCC we used the National Comprehensive Cancer Network’s (NCCN) treatment guidelines, commonly referenced by oncologists as best practices. Outcomes included 1. surgery and radiation completion for all cancers (complete/incomplete treatment/no surgery); 2. surgery, radiation completion, and chemotherapy initiation (complete/incomplete/no surgery) for triple negative and HER2+ breast cancers; and 3. radiation completion after mastectomy for Stage III cancers with lymph involvement. We used generalized ordinal logistic regression to compare outcomes with mental illness categories, controlling for demographic, cancer-related, and clinical factors. Results: We found that 28.8% of women in this study had at least one diagnosis of a mental illness in the two years prior to their breast cancer diagnosis and 1.7% had SMI. Women with SMI are more likely to not receive surgery than women without (OR = 1.24, CI = 1.02-1.60). Women with mental illnesses have a higher risk of not completing radiation after breast conserving surgery (SMI: OR = 1.24, CI = 1.01-1.30, Depression and anxiety: OR = 1.11, CI = 1.06-1.16, other mental illnesses: OR = 1.09 CI = 1.01-1.16). Women with SMI and triple negative or HER2+ cancers are more likely to not complete all treatment (OR = 1.65, CI = 1.22-2.24). Conclusions: Women with mental illnesses may be at higher risk for incomplete treatment or lack of treatment initiation, especially for multi-part treatment, such as completion of radiation and initiation of chemotherapy, which may contribute to worse survival outcomes. Breast cancer and mental illness are both common illnesses among older women in the United States. Health systems should consider strategies for improving GCC among women with mental illness and breast cancer.
“It really does not matter to me, they can be two purple unicorns”: Barriers and facilitators to sexual orientation and gender identity (SOGI) measurement in the NCI Community Oncology Research Program (NCORP).
Authors: Mullins Megan A , Rankin Aaron , Washington Ariel , Stasenko Marina , Friese Christopher Ryan , Cooley Mary E. , Hudson Matthew F. , Wallner Lauren P.
Published: September 2022

170

Background: Despite recommendations from numerous clinical bodies (e.g., ASCO), less than 20% of NCORP-affiliated practices regularly collect SOGI data. This gap compromises the ability to identify and correct care inequities experienced by sexual and gender minority (SGM) individuals. Therefore, we evaluated provider- and clinic- level barriers and facilitators to SOGI collection at NCORP practices across the US. Methods: We conducted 14 interviews across seven NCORP oncology practices via Zoom. We purposefully sampled to ensure geographic, racial, and ethnic diversity of patient populations. We interviewed one clinician (oncologist, advanced practice provider) and one clinic staff member per practice. The Consolidated Framework for Implementation Research (CFIR) informed thematic analysis that identified barriers and facilitators to SOGI data collection. Interviews were recorded, transcribed, and coded by two coders who adjudicated any discordance. Analyses were conducted in NVivo. Results: Thematic saturation occurred after interviews at six practices, with interviews at the seventh practice confirming saturation. Participants represented five geographic regions and included three Minority Underserved practices and two rural practices. Several organizational context characteristics influenced SOGI data collection: access to knowledge, information technology infrastructure, staff processes, and perceived relative priority of SOGI for an oncology visit. All oncologists expressed a low relative priority of sexual orientation data for oncology care. Gender identity had higher priority because it influences how clinicians should address patients. At the clinic level, this low relative priority coincides with a lack of processes and policies for collecting SOGI from all patients. At the oncology care team level, perceived irrelevance to oncology care was related to discomfort in asking SOGI, fear of patient discomfort, and limited awareness of SOGI in electronic health records. Suggested solutions included: normalizing asking SOGI questions, giving patients privacy to complete SOGI, and clarifying relevance of SOGI for clinical purposes. Understanding how SOGI improves patient experiences was a facilitator for collection. Conclusions: Within this NCORP practice sample, SOGI data collection barriers included clinician-perceived low relative priority for collection, and perceptions that SOGI disclosure does not influence care quality, despite most interviewees expressing a strong desire to show respect to patients and provide high quality cancer care. Oncology teams may benefit from training on culturally sensitive SOGI collection, education on SOGI data relevance to oncology practices, and support for implementing SOGI data collection policies.
Patterns of olanzapine prescribing for those receiving highly emetogenic chemotherapy.
Authors: Childs Daniel S , Helfinstine David A , Sangaralingham Lindsey R. , Orme Jacob , O'Sullivan Ciara Catherine , Loprinzi Charles L. , Ruddy Kathryn Jean
Published: September 2022

232

Background: Olanzapine has an important role in preventing and treating nausea and vomiting from highly emetogenic chemotherapy (HEC). This drug, for the last 5 years, has been a component of most major antiemesis guidelines. The aim of the current study was to assess how often olanzapine has been prescribed for patients receiving HEC. Methods: A retrospective analysis was performed using an OptumLabs de-identified clinical database of medical and pharmacy claims. The database was filtered for patients starting HEC in the interval of 2006 to Q2 of 2021. Descriptive statistics were used to analyze patient characteristics and year-by-year antiemetic prescribing patterns, coinciding with cycles 1 and 2 of chemotherapy. Results: A total of 63,154 distinct patients were included. The median age was 58 years (range, 18-88). Over a quarter of the patients identified as Black, Hispanic, Asian, or other. Breast (45.2%) and hematologic (20.8%) cancers were the most common diagnoses. In 2016, olanzapine was prescribed to only 1.4% of patients with cycle 1 of HEC. Prescriptions increased modestly each year, and by 2021, 13.9% of patients received olanzapine with their first cycle of chemotherapy. An additional 5.7% of patients received olanzapine for breakthrough symptoms or enhanced prophylaxis during cycle 2. In 2021, over three-quarters of patients were prescribed antiemetics in a guideline concordant manner, with either an olanzapine-containing quadruplet (12.2%), an NK1 receptor antagonist triplet (64.5%), or an olanzapine triplet (exact number suppressed due to small sample size). Conclusions: The rate of olanzapine prescribing is less than might be expected following its inclusion in major antiemesis guidelines. This finding highlights the challenges of disseminating information and keeping prescribing systems updated with the newest evidence in supportive oncology.
Implementation of a streamlined prior authorization process to improve clinician wellness and cancer care delivery.
Authors: Bhardwaj Aarti Sonia , Pintova Sofya , Liu Mark , Noble-Kirk Alana , Blunck Peter , Smith Cardinale B.
Published: September 2022

428

Background: Prior authorizations (PAs) for chemotherapy are increasingly becoming a barrier to timely and quality care delivery for cancer patients. There is an extraordinary administrative burden placed on clinical teams to participate in peer to peers (P2P) and file appeals when authorization specialists are unable to efficiently find the necessary clinical data in the EHR. 1 This leads to delays in care, staff burnout driven by decreased job satisfaction, loss of revenue from decreased clinician productivity and from chemotherapy given emergently but not retroactively reimbursed. 2 In partnership with the cancer registry team and Epic, we propose a workflow that shifts the clerical work required for PAs from the clinical teams to the certified tumor registrars (CTRs) using smart form optimization so the finance team has all the required information in one place to successfully and efficiently process the PAs. Methods: A list of common data elements including performance status, cancer biomarkers, line of treatment, goals of treatment and stage were identified. We are leveraging the staging smart form in EPIC to auto-populate these elements when available and then use CTRs to enter cancer stage, fill in any gaps and validate the data. Once approved by the CTR, the chemotherapy plan will be available in the authorization work queue for efficient processing. In 2020, we had 1,389 chemotherapy plans entered and about 38% of these required clinical intervention for financial clearance. We will track the number of P2Ps being conducted post-implementation and compare this to numbers prior to implementation. We will use descriptive statistics and t-test to compare these values. We are anticipating a 25% decrease in P2Ps. We will survey oncology physicians in June 2022 to measure baseline perceived physician impact of PAs and burnout and then again in January 2023 to measure the impact post-implementation. Results: A wellness survey was administered to Medical Oncology faculty within the Mount Sinai Health System pre-pandemic in 2020 and in 2021 and among respondents, approximately 1/3 have moderate to severe burnout risk pre- and post-pandemic. Coordination of care and PAs were rated as the largest barriers to wellbeing, and this increased from 43% pre- to 71% post-pandemic indicating a significant area of opportunity to improve wellbeing among medical oncology faculty. Conclusions: By leveraging technology and non-clinical staff workflows to improve the processing of insurance PAs of ambulatory intravenous chemotherapy, we aim to improve timeliness of quality care delivery to patients and clinical staff wellness. West CP et.al. Physician burnout: contributors, consequences and solutions. J Intern Med. Jun 2018;283(6):516-529. Lin NU et al. Increasing Burden of Prior Authorizations in the Delivery of Oncology Care in the United States. J Oncol Pract. Sep 2018;14(9):525-528.
Primary CNS Lymphoma: Progress With Dose-Intensive Consolidation
Authors: Rubenstein James L.
Published: September 2022

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology , to patients seen in their own clinical practice.
Differences in HDL-Bound Apolipoproteins in Patients With Advanced Liver Fibrosis Due to Nonalcoholic Fatty Liver Disease
Authors: Bril Fernando , Pearce Ryan W , Collier Timothy S , McPhaul Michael J
Published: September 2022

Context

The mechanisms leading to increased cardiovascular disease in patients with nonalcoholic fatty liver disease (NAFLD) and advanced liver fibrosis remain incompletely understood.

Objective

This study assessed HDL-bound proteins in patients with NAFLD with or without advanced fibrosis.

Methods

This cross-sectional study at a university hospital included 185 patients with or without type 2 diabetes (T2D). Patients underwent liver proton magnetic resonance spectroscopy to measure intrahepatic triglyceride accumulation and those with NAFLD underwent a percutaneous liver biopsy. Advanced lipid testing with lipoprotein subfraction measurements and targeted proteomics of HDL-bound proteins was performed.

Results

Patients with and without advanced fibrosis had similar clinical characteristics, except for lower HDL-C (34 ± 8 vs 38 ± 9 mg/dL, P = 0.024) and higher prevalence of T2D in advanced fibrosis. Patients with advanced fibrosis had lower HDL particle number. A panel of 28 HDL-bound proteins were targeted and quantified by multiple reaction monitoring liquid chromatography–tandem mass spectrometry. Five proteins were found to be decreased in patients with advanced fibrosis (ApoC-I [P < 0.001], ApoC-IV [P = 0.012], ApoM [P = 0.008], LCAT [P = 0.014], and SAA4 [P = 0.016]). No differences were observed in these proteins in patients with vs without NAFLD or steatohepatitis. The pCAD index, associated with coronary artery disease and cardiovascular mortality, was significantly higher in patients with advanced fibrosis (97 ± 5 vs 86 ± 25, P = 0.04).

Conclusion

Patients with NAFLD with advanced fibrosis showed significant differences in HDL-bound protein levels; this translated into increased cardiovascular risk based on pCAD index. Different lipoprotein composition and function may explain the link between liver disease and increased cardiovascular mortality in these patients.
Non-autonomous cell death induced by the Draper phagocytosis receptor requires signaling through the JNK and SRC pathways
Authors: Serizier Sandy B. , Peterson Jeanne S. , McCall Kimberly
Published: September 2022

The last step of cell death is cell clearance, a process critical for tissue homeostasis. For efficient cell clearance to occur, phagocytes and dead cells need to reciprocally signal to each other. One important phenomenon that is under-investigated, however, is that phagocytes not only engulf corpses but contribute to cell death progression. The aims of this study were to determine how the phagocytic receptor Draper non-autonomously induces cell death, using the Drosophila ovary as a model system. We found that Draper, expressed in epithelial follicle cells, requires its intracellular signaling domain to kill the adjacent nurse cell population. Kinases Src42A, Shark and JNK (Bsk) were required for Draper-induced nurse cell death. Signs of nurse cell death occurred prior to apparent engulfment and required the caspase Dcp-1, indicating that it uses a similar apoptotic pathway to starvation-induced cell death. These findings indicate that active signaling by Draper is required to kill nurse cells via the caspase Dcp-1, providing novel insights into mechanisms of phagoptosis driven by non-professional phagocytes.
Aquatic therapy in neuromotor recovery - case study
Authors: Vizitiu Elena , Constantinescu Mihai , Poraicu Corina
Published: September 2022

Abstract: Worldwide neurological disorders that particularly affect the central nervous system are a major health challenge, leading to deficits accompanied by neuromorphic sequelae with implications for the functional state of the body. Background: Current studies show that hemorrhagic stroke occurs mainly at a young age, often fatal as opposed to ischemic stroke that characterizes old age or an alert lifestyle, both types of strokes can result in motor sequelae and functional (mild, moderate or severe hemiparesis or haemiplegia). The peculiarity of the studied case is the coexistence of multiple comorbidities which require an interdisciplinary team to solve (neurologist, cardiologist, endocrinologist, physiotherapist, psychotherapist, aquatic therapy instructor). The aim of our paper is to demonstrate the efficiency of exercise in the aquatic environment, facilitating the recovery of the functions of the neuro-myo-arthro-kinetic apparatus as well as the cardiovascular and metabolic functions. Results: The main objective is general and muscular relaxation, re-education of external and proprioceptive sensitivity, orthostatic posture and gait reeducation, in conditions of stability and balance. Conclusions: Through the means of aquatic therapy, an attempt is made to obtain the independence of self-care in order to interrelate with the environment, to regain the ADLs, , the family and socio-professional reintegration of the patient.
Keywords: study; stroke; recovery; aquatic therapy; patient
Critical delay factors for construction projects in Central Aceh District, Indonesia
Authors: Rauzana Anita , Zahrah Aghnia , Dharma Wira
Published: September 2022

Background: Construction development in Indonesia is growing rapidly, especially in Central Aceh District. Construction projects often experience risks, so that risk events can have a serious impact on the viability of the project. Project delays can result in cost overruns and project losses. Therefore, it is necessary to identify the factors causing project delays.The purpose of this study was to (1) identify the risk factors that cause delays in construction projects and (2) determine those particular risk factors that have a greater influence on construction projects. The location of this research was Central Aceh District.

Methods: The data in this study were primary data in the form of a questionnaire and secondary data obtained from the literature related to this particular type of research. Questionnaires were distributed to respondents, namely contractor companies located in the Central Aceh District. The questionnaires were distributed to determine respondents' opinions about the level of influence of risk factors causing project delays. We used a validity test, reliability test, and descriptive analysis for data processing.

Results: Based on the results of the study from 47 respondents, the “very high influence” category (Mode=5) for the tool malfunction factor, cost estimation inaccuracy, increased work costs, implementation of new technologies, details, accuracy and conformity to specifications that are not appropriate, worker quarrels, poor project planning and management, poor condition at locations and accessibility difficulty.

Conclusions: Of the 80 risk factors that caused project delays, eight risk factors were found to have a very high influence on the implementation of construction projects in Central Aceh District.

Practical implications: The results of this study provide knowledge to contractor companies about the delay factors that have the most influence on project implementation so that they are expected to be able to manage risks to avoid losses.
Dataset for the attitudes and practices regarding COVID-19 preventive measures in diverse settings of Mozambique: a qualitative study
Authors: Magaço Amilcar , Cumbane Constantino , Cossa Hermínio
Published: September 2022

Background: In this data note, we provide the details of a qualitative study database conducted before the first wave of the COVID-19 pandemic in Mozambique. During this period (from September 2020), several compulsory COVID-19 preventive measures were put forth as a response to the emerging pandemic in the country. Data were collected aiming to evaluate home confinement behaviours, household members’ mobility, and the mobility routes and other attitudes and practices related to COVID-19 preventive measures at the community level.

Methods: A cross-sectional, descriptive, mixed method study was conducted involving adults from different regions in Mozambique. Data were collected using a combination of rapid ethnography and rapid rural assessment methods consisting of telephone-based semi-structured interviews, informal conversations, non-participant observations and short questionnaires. The COREQ guidelines for reporting qualitative studies were performed.

Results: 295 semi-structured interviews (SSI) with adult household members were included in the study. Of these, 23 were conducted face-to-face and 272 by telephone, covering 24 districts and cities in 9 provinces. More than half (53.9%) of participants were females and aged 18 - 98 years old (median [interquartile range] = 35 [29-43]). Most had a relevant role in the household, with formal education and had to leave home for income generating.

Conclusion: This data, available in our repository, favours several angles of assessments of behaviour related to home confinement, mobility and routes of a population group prior to the first wave of the COVID-19 outbreak.
The role of genetic factors in microtia: A systematic review
Authors: Putri Indri Lakhsmi , Stephanie Alexandria , Pramanasari Rachmaniar , Kon Moshe , Wungu Citrawati Dyah Kencono
Published: September 2022

Background: Microtia is a congenital malformation of the outer ears caused by improper embryonic development. The origin of microtia and causes of its variations remain unknown. Because of the lack of clarity regarding the role of genetic variables in microtia, we conducted a systematic review to qualitatively identify the genes most important in the development of microtia to provide an up-to-date review.

Methods: Using six search engines, we searched all published studies related to the genetic factors of isolated microtia and syndromic microtia. The identified publications were screened and selected based on inclusion and exclusion criteria by the authors and assessed for methodological quality using the Joanna Briggs Institute (JBI) critical appraisal tools. We found 40 studies, including 22 studies on syndromic microtia and 18 studies on isolated microtia. Data extraction of each study was arranged in tabulation for syndromic and isolated microtia. The extracted data were: first author’s surname, year of publication, country of origin, study design, sample characteristic and gene assessed.

Results: After the data were extracted, analyzed, and reviewed, the most common gene suspected to be involved in isolated microtia was Homeobox A2 (HOXA2, 12.1%). Conversely, in syndromic microtia, the two most common genes supposed to play a role were Fibroblast Growth Factor 3 (FGF3, 47.2%) and Treacher–Collins–Franceschetti syndrome 1 (TCOF1, 30.2%). From the studies, the three most prevalent genes associated with microtia were HOXA2 (10%), FGF3 (8.4%), and TCOF1 (5.4%). In syndromic microtia, the most common mutation types were deletion in TCOF1 (46.9%) and missense and deletion in FGF3 (both 38%), and in isolated microtia, the most common mutation type was silent in HOXA2 (54.2%).

Conclusions: In summary, genetic factors are involved in microtia; thus, molecular analysis is strongly advised.

PROSPERO registration: CRD42021287294 (25/10/21).
Protocol for the perioperative outcome risk assessment with computer learning enhancement (Periop ORACLE) randomized study
Authors: Fritz Bradley , King Christopher , Chen Yixin , Kronzer Alex , Abraham Joanna , Ben Abdallah Arbi , Kannampallil Thomas , Budelier Thaddeus , Montes de Oca Arianna , McKinnon Sherry , Tellor Pennington Bethany , Wildes Troy , Avidan Michael
Published: September 2022

Background: More than four million people die each year in the month following surgery, and many more experience complications such as acute kidney injury. Some of these outcomes may be prevented through early identification of at-risk patients and through intraoperative risk mitigation. Telemedicine has revolutionized the way at-risk patients are identified in critical care, but intraoperative telemedicine services are not widely used in anesthesiology. Clinicians in telemedicine settings may assist with risk stratification and brainstorm risk mitigation strategies while clinicians in the operating room are busy performing other patient care tasks. Machine learning tools may help clinicians in telemedicine settings leverage the abundant electronic health data available in the perioperative period. The primary hypothesis for this study is that anesthesiology clinicians can predict postoperative complications more accurately with machine learning assistance than without machine learning assistance.

Methods: This investigation is a sub-study nested within the TECTONICS randomized clinical trial (NCT03923699). As part of TECTONICS, study team members who are anesthesiology clinicians working in a telemedicine setting are currently reviewing ongoing surgical cases and documenting how likely they feel the patient is to experience 30-day in-hospital death or acute kidney injury. For patients who are included in this sub-study, these case reviews will be randomized to be performed with access to a display showing machine learning predictions for the postoperative complications or without access to the display. The accuracy of the predictions will be compared across these two groups.

Conclusion: Successful completion of this study will help define the role of machine learning not only for intraoperative telemedicine, but for other risk assessment tasks before, during, and after surgery.

Registration: ORACLE is registered on ClinicalTrials.gov: NCT05042804; registered September 13, 2021.
Case Report: Hemophagocytic lymphohistiocytosis associated with acute polymyositis
Authors: Iktidar Mohammad Azmain , Jabin Nowshin , Khan Md. Tajwar Rahman , Anjum Subrina
Published: September 2022

Hemophagocytic lymphohistiocytosis (HLH) is a rare condition marked by uncontrolled histiocyte proliferation and activation, and phagocytosis of normal hematopoietic cells. This disease is rare, and a concurrent presentation with acute polymyositis is rare. A 14-year-old male was admitted to Chattogram Medical College Hospital with a high-grade fever for 25 days, generalized severe body aches, and multiple large joint pain in the lower limb for the same duration. On examination, the patient was found to have splenomegaly, tenderness in both knee joints, symmetrical proximal weakness of both lower limbs, several sensory losses, and loss of bowel and bladder control. The laboratory data showed that he had anemia, thrombocytopenia, hyperferritinemia, hypertriglyceridemia, hypofibrinogenemia, hypoalbuminemia, raised D-dimer, and serum creatine phosphokinase (S. CPK). Along with these, a bone marrow biopsy revealed hemophagocytic cells, and he was diagnosed with HLH with acute polymyositis (PM). The patient was treated with intravenous (IV) hydrocortisone and dexamethasone. Clinical stability was achieved with gradual improvement of initial symptoms and biochemical markers. The patient was discharged with oral steroids at a tapering dose and was advised to regularly follow-up.
Experimental study and machine learning model to predict formability of magnesium alloy sheet
Authors: Viswanadhapalli Balaji , V.K Bupesh Raja , Nagaraju Krishna Chythanya
Published: September 2022

Background: Magnesium alloy is not only light in weight but also possesses moderate strength. Magnesium AZ31-H24 alloy sheet has many applications in the automotive and aerospace industries. Experimental stretch forming tests are performed on this sheet to measure the material’s formability by constructing forming limit diagrams.

Methods: Several tests of Nakazima were carried out on rectangular samples at 24, 250, 350°C and 0.01, 0.001 mm/s using a hemispherical punch. The work done to predict the formability of magnesium alloys has not been recorded in recent literature on machine learning models. Hence, the researchers of this article choose to explore the same and build three models to predict the formability of magnesium alloy through Random Forest algorithm, Extreme Gradient Boosting, and Multiple linear Regression.

Results: The Random Forest showed high accuracy of 96% in prediction.

Conclusions: It is concluded that the need for physical experiments can be greatly minimized in formability studies by using machine learning concepts.
A study protocol to prepare an RBD protein for vaccine against COVID-19
Authors: Jahangir ZMG Sarwar , Marnik Arleta Helena
Published: September 2022

Background: SARS-CoV-2 pandemic is a global threat to humans and the world’s economy. Effective and safe vaccines against this virus are essential to control and eradicate the pandemic. The currently applied vaccines carry SARS-CoV-2 spike-protein mRNA/cDNA. These vaccines go through several cellular processes in the recipients for producing antigens. On the contrary, the SARS-CoV-2 RBD (receptor binding domain)-protein is an antigen. It will directly stimulate antibody production against SARS-CoV-2. Hence, we propose to produce SARS-CoV-2 RBD-protein as a fast acting, effective and safe vaccine. 

Methods: We propose to reconstruct a plasmid carrying three types of  DNA sequences: RBD cDNA, FP (fusion peptide) DNA and sfGFP(superfolder-green-fluorescent-protein), cDNA creating the RBD-FP-sfGFP DNA within an orf (open-reading-frame). Escherichia coli, C2566H, transformed with the reconstructed plasmid will express RBD-FP-sfGFP fusion protein producing green fluorescent cfu (colony forming unit). The RBD-protein will be separated from the sfGFP using an FP specific enterokinase, and eluted by HIC (hydrophobic-interaction-chromatography), detected with a BioVision-Elisa-Kit, and quantified by spectrophotometry at UV280nm and immune simulation will be carried out using C57BL mice. 

Results: The plasmid reconstruct will carry ampr (ampicillin-resistant) gene as a selective marker and a T7 promoter controlling the expression of RBD-FP-sfGFP fusion protein. The transformed Escherichia coli will efficiently express the RBD-FP-sfGFP fusion protein. The highly efficient sfGFP fused within the RBD-FP-sfGFP will produce green fluorescent cfu. The RBD-FP-sfGFP protein extract from the green cfu, digested by enterokinase and separated by the HIC will produce pure immunoreactive RBD protein. 

Conclusion: A positive BioVision-ELISA test detects <10 pg RBD protein/ml of the sample. A larger sample of the purified RBD protein can be used as a vaccine following a standard formulation and safety protocols. Once administered, the RBD protein will stimulate antibody production against the SARS-CoV-2 virus. The RBD protein has no potential to recombine with human genome.
Predicting acceptance and adoption of renewable energy community solutions: the prosumer psychology
Authors: Brambati Francois , Ruscio Daniele , Biassoni Federica , Hueting Rebecca , Tedeschi Alessandra
Published: September 2022

Background: This paper, in the frame of social acceptance of renewable energies and innovative community-based production and consumption models, aims at supporting a data-driven approach able to deal with climate change and identify and quantify the psycho-sociological dimensions and factors that could support the transition from a technology-driven approach to a consumer-driven approach throughout the emerging “prosumer business models”. In addition to the already existing Social Acceptance dimensions, this paper tries to identify a purely individual psychological fourth dimension to understand the processes and factors that underlie individual acceptance and adoption of new renewable energy business models, with the realization of a Prosumer Acceptance Index.

Methods: Questionnaire data collection has been performed throughout an online survey platform, combining standardized and ad-hoc questions adapted for the research purposes, based on the developed theoretical model.

To identify the main factors (individual/social) influencing the relation with renewable energy technology adoption, a Factorial Analysis has been conducted to identify the latent variables that are related to each other. Linear regression has been conducted to identify and quantify the factors that could better predict behavioural intention to become a prosumer.

Results: Five latent psychological factors were revealed: concern about environmental issues, interest in energy sharing, concern on climate change, social influence and impact on bill cost. Three variables were found to significantly measure and predict the scores of the “Acceptance in becoming a prosumer” ad hoc scale: attitude, economic incentive and age.

Conclusions: This research can facilitate policymakers and stakeholders to better understand which relevant psycho-sociological factors are intervening in the renewable energy technology acceptance processes and what and how specifically target when proposing change towards sustainable energy production and consumption.
New challenges for the Human Oceans Past agenda
Authors: Holm Poul , Barrett James , Brito Cristina , Ludlow Francis
Published: September 2022

We contend that the harvest of marine resources played a critical, but as yet underappreciated and poorly understood, role in global history. In a review of the field of marine environmental history and archaeology we conclude that while much progress has been made, especially in the last two decades, fundamental questions remain unanswered. In order to make full use of the rapid growth of Big Data and ongoing methodological breakthroughs there is a need for collaborative and comparative research. Such joint efforts on a global scale must be guided by a focus on common, simple yet challenging, questions. We propose a Human Oceans Past research agenda to call for multi- and trans-disciplinary archaeological, historical and palaeoenvironmental/palaeoecological research to investigate: (1) when and where marine exploitation was of significance to human society; (2) how selected major socio-economic, cultural, and environmental forces variously constrained and enabled marine exploitation; and (3) what were the consequences of marine resource exploitation for societal development. We contend that this agenda will lead to a fundamental revision in our understanding of the historical role of marine resources in the development of human societies.
Domestic Tourism in the Russian Economy: Analysis of the Current State of the Industry
Authors: Gridneva B.
Published: September 2022

The current difficult geopolitical situation, as well as the unfavorable epidemiological situation, have formed a new way of life, consumption and labor activity among Russians. Today, Russians are increasingly choosing neighboring or distant regions of our country for tourist trips, giving a new impetus to the development of domestic tourism. The article describes the current trends in the functioning of domestic tourism and its role in the socio-economic development of the country and individual regions.
Obywatelstwo jako ekskluzywny przywilej. Prawo krajowe w Kraju Schwyz w późnym średniowieczu i nowożytności oraz jego oddziaływanie (do współczesności)
Authors: Landolt Oliver
Published: September 2022

W artykule podjęto temat rozwoju praw krajowych (w szczególności praw obywatelskich) w Kraju Schwyz w późnym średniowieczu i w okresie nowożytnym, kraju położonym w przedalpejskiej i alpejskiej Szwajcarii Centralnej. Sformułowane w tamtejszej legislacji prawa obywatelskie stawały się w tym czasie coraz bardziej ekskluzywnym przywilejem, przyznawanym coraz mniejszej liczbie osób. Obejmowało ono prawne (polityczne i ekonomiczne) korzyści, których nie mieli pozostali mieszkańcy tych terenów. Długofalowe działania tych regulacji prawnych odczuwalne są do dziś. Tłumaczenie Renata Skowrońska
„Uprzejmie proszę o sprawdzenie, czy możliwe jest anulowanie denaturalizacji”. Studium wybranych przypadków walki migrantów żydowskich z pozbawieniem ich obywatelstwa niemieckiego w Wolnym Państwie Brunszwiku po 1933 roku
Authors: Voges Jonathan
Published: September 2022

W artykule przeanalizowano – posługując się konkretnymi przykładami – reakcje Żydówek i Żydów, którzy imigrowali do Brunszwiku z Europy Środkowo-Wschodniej, na Ustawę o cofnięciu naturalizacji z początków rządów narodowych socjalistów. Jego tematem jest zrozumienie precyzyjnych strategii stosowanych przez dotknięte tą ustawą osoby, które miały na celu zapobieżenie cofnięciu naturalizacji. Z jednej strony odwoływano się więc do wymienionych w rozporządzeniu wykonawczym do ustawy klauzul wyjątków („szczególne zasługi” i „szczególne wyróżnienie w I wojnie światowej”). Przywoływano również inne uzasadnienia, takie jak szczególnie trudna sytuacja społeczna, spodziewane komplikacje z zagranicą lub plany migracji. Tłumaczenie Renata Skowrońska
Reprezentowanie interesów pracowników czy przedłużone ramię Partii? O roli związku zawodowego w służbie zdrowia PRL w latach 1947–1963
Authors: Foik Melanie
Published: September 2022

Związek zawodowy w służbie zdrowia PRL-u pełnił rolę swego rodzaju „pasu transmisyjnego” Partii. Jednocześnie realizował on również klasyczne zadania związkowe, mające na celu poprawę warunków pracy i życia pracowników. W środowisku sekcji pielęgniarskiej wytworzyła się na tym tle atmosfera protestu, która rozładowała się w strajku warszawskich pielęgniarek w roku 1963. Tłumaczenie Renata Skowrońska