bluuebunny/crossref_metadata_2025 huggingface dataset:
Technology and addiction: What drugs can teach us about digital media
Authors: Hartogsohn Ido , Vudka Amir
Published: July 2022

Comparisons between digital media and narcotic drugs have become increasingly common in the vigorous discussion on smartphone addiction and technology addiction. Commentators have used evocative terms such as “digital heroin,” “electronic cocaine,” and “virtual drugs” when discussing users’ growing dependence on their devices. This article looks at the spreading discourse comparing digital media with drugs from a set of interdisciplinary perspectives including media studies, political economy, critical theory, science and technology studies, and addiction studies. It engages several key questions: To what extent can heavy smartphone use be considered an addiction, and how is it similar or different from drug addiction? How do the analogies between media and drugs fit within prevalent imaginaries of information technologies, and within the greater cultural themes and preoccupations of late capitalism? And finally, what can drugs teach us about the possible escape routes from our society's current predicament?
Health at age 17 in Norwegian adolescents: Mental and physical status in the national cohort born in 2001
Authors: Borud Einar Kristian , Fadum Elin Anita , Carlsen Ellen Øen , Håberg Siri Eldevik
Published: July 2022

Aims:

We present self-reported data on physical and mental health at age 17 years from 82% of Norwegians born in 2001.

Methods:

In Norway, the Armed Forces require that each resident who reaches the age of 17 years completes a self-administered declaration of health that is used for military selection. The declaration collects information on height and weight, various clinically diagnosed diseases, mental and behavioural disorders, and other health conditions where clinical diagnosis is not required. In 2018, there were 65,913 adolescents born in 2001 living in Norway, of whom 10,223 were exempt from completing the declaration; declarations were therefore sent to 55,690 participants. We included 54,132 participants who completed the declaration (response rate 97.2%): 27,220 male and 26,912 female respondents.

Results:

We found that 18% of male and 28% of female respondents reported at least one clinically diagnosed disease, mental disorder or behavioural disorder. Among health condition where clinical diagnosis was not required, 19% of male and 37% of female respondents reported anxiety/depression affecting daily life and 10 versus 18% reported migraines/recurring headaches. The respondents probably represent the healthiest part of the total cohort of 17-year-old Norwegians because those who are exempt from completing the declaration are already considered unfit for military service.

Conclusions:

These data represent a rich resource for further research. Similar data exist for the birth cohorts in 1993–2003. We encourage further research that can help decision-makers identify areas of concern that should be targeted for interventions.
Living in the frame of structural violence: Institutional regulations and daily life in Lleida, Spain
Authors: Solís Juan M. , Ballesté-Isern Eduard , Úbeda Miquel
Published: July 2022

This article investigates how structural violence is reflected in the daily life of the peripheries of a medium-sized city in the interior of Spain. For this, three categories of analysis are used: inquisitive violence, coercive violence and horizontal violence. Forms of resistance are also highlighted. This makes it possible to trace the various ways that state institutions act and behave to exercise power over people. These actions have direct consequences for ‘vulnerable’ population, inducing feelings of humiliation, personal and group suffering, the perpetuation of social inequality, the lack of democratic freedoms, and the creation of violent or exploitative practises. Likewise, this path allows us to see how neoliberal logics are applied, their consequences and, most importantly, how they generate new normalities and livelihoods that serve as discursive support for new applications of antisocial policies.
Archaeology, land tenure, and Indigenous dispossession in Mexico
Authors: Holley-Kline Sam
Published: July 2022

In this paper, I examine a case of dispossession that made land belonging to Indigenous Totonac residents of San Antonio Ojital part of the archaeological site of El Tajín. To do so, I examine the failure of a 2016 claim made to Mexico’s Comisión Nacional de Derechos Humanos. Rather than this being a case of purpose-driven dispossession or an unintended consequence of well-meaning policies, I trace the ultimate causes to multicultural recognition, 19th-century land reforms, and the expansion of archaeological research in El Tajín. Liberal land reforms brought a private property regime into being through enrollment and inscription, and Totonac landowners around El Tajín used the regime to their benefit. As El Tajín expanded though excavation, archaeologists and landowners used the private property regime’s conception of space to address conflicts in El Tajín. The resulting pragmatic accommodations would ultimately fail landowners when an archaeological megaproject came in. Ultimately, I argue for an historical and contextual understanding of archaeology and land tenure to understand the discipline’s diverse relationships with dispossession.
Psychological Distress and Political Distrust during a Global Health Crisis: Evidence from a Cross-National Survey
Authors: Kim Harris Hyun-soo
Published: July 2022

In addition to causing unprecedented mortality and wreaking havoc on national economies, the coronavirus disease pandemic has significantly undermined public mental health. How has the pandemic-induced psychological and mental distress contributed to declining political trust cross-nationally? Using a large-scale global survey comprising respondents from Africa, Americas, Asia, Middle East, and Europe, the present study addresses this question. Results from multilevel analysis show that across dozens of low- as well as high-income countries, pandemic distress experienced by individuals is negatively linked with political trust (public confidence in the government’s capacity and transparency). Moreover, this relationship is conditional on alternative “performance measures” or contextual moderators: Human Development Index, Corruption Perceptions Index, and Fragile States Index. Specifically, the magnitude of the association between pandemic distress and political distrust increases in countries that are less economically developed, perceived to be more corrupt, and politically more fragile or vulnerable.
The Evolution from Occupational Health to Healthy Workplaces
Authors: Kirsten Wolf
Published: July 2022

Occupational health has evolved as a field over the last 20 years, most significantly over the last 2 years. The COVID-19 pandemic has increased the amount and complexity of challenges for occupational health professionals and at the same time provided a unique opportunity for the field in light of the heightened focus on health at the workplace. Responsibilities have become broader and more multi-faceted including areas such as mental wellbeing and psychosocial risk factors. The pandemic has shown us that the workplace is an essential setting to promote health with a growing number of employers investing in policies and programs for their employees. However, many global health campaigns and large scale national initiatives do not include the workplace setting in their strategy to the detriment of the their effectiveness. In addition to the pressing global health needs, two recent developments have propelled workplace health to the forefront and are asking questions of employers. The Sustainable Development Goals as well as the ESG (Environment, Social, Governance) agenda on behalf of the financial sector are pushing the corporate sector to act responsibly beyond seeking profits and disclose related policies and actions. Healthy workplaces are essential for global development and progress.
Error allocation model and coordination control for stringer–skin T-shape structure welding robot with multiple manipulators
Authors: Zeng Qingfei , Liu Xuemei , Liu Ziru
Published: July 2022

A new kind of 18 degrees of freedom gantry robot with multiple manipulators could be used to complete the double-sided laser beam welding of stringer–skin T-shape structure for aircraft skin. The coordination control combined with error allocation model analysis is proposed to improve the stability and accuracy of the robot in this article. Firstly, the error model of the stringer–skin T-shape structure welding robot end effectors is analyzed. The score of the robot end effectors position error caused by each joint is obtained. Secondly, according to the path-points transformation matrix of the local coordinate system relative to the base coordinate system, the desired position of stringer–skin T-shape structure welding robot end effectors is calculated to be the input of the control model aiming at the dual-beam laser welding process. Then, the double closed-loop control strategy is proposed for stringer–skin T-shape structure welding robot coordinated motion on the basis of the end error analysis results and proportional-integralderivative (PID) method. Finally, ADAMS and MATLAB are used to establish a co-simulation platform to verify the effectiveness of the proposed coordination control strategy.
Dialysis and a plant-based diet to achieve physiologic urea levels for fetal benefit: Normal pregnancy outcome despite chronic kidney disease and hypertension
Authors: Seed Emma , Gilbertson Elise
Published: July 2022

Chronic kidney disease significantly increases the risk of adverse maternal and perinatal outcomes. A growing body of evidence suggests that intensive dialysis, achieving physiologic pre-dialysis blood urea, is associated with decreased morbidity. We report a case of a successful pregnancy outcome in a 32-year-old nulliparous woman with stage 4 chronic kidney disease who underwent haemodialysis from 11 to 31 weeks' gestation for fetal benefit and concurrently trialled a plant-based diet. We hypothesise that her dietary changes assisted with urea reduction, enabling her to become dialysis independent. Although we must recognise that such pregnancies remain high risk, as demonstrated both in this case and more recent literature, advances in complex obstetric care and dialysis protocols may now give women with chronic kidney disease a realistic hope of a successful pregnancy.
Supratentorial cortical ependymoma: A systematic literature review and case illustration
Authors: Cuoco Joshua A , Strohman Andrew C , Stopa Brittany M , Stump Michael S , Entwistle John J , Witcher Mark R , Olasunkanmi Adeolu L
Published: July 2022

Cortical ependymomas are currently not considered a subgroup of supratentorial ependymomas; however, there is a growing body of literature investigating the natural history of these lesions compared to supratentorial ependymomas. We performed a systematic literature review of cortical ependymomas with a focus on the natural history, clinical characteristics, and clinical outcomes of these lesions as compared to supratentorial ependymomas. Our search revealed 153 unique cases of cortical ependymomas. The mean age on presentation was 21.2 years. Males and females comprised 58.8% (90/153) and 41.2% (63/153) of cases, respectively. The most common presenting symptom was seizure activity occurring in 44.4% of the cohort (68/153). The recently recognized C11orf95-RELA fusion was identified in 13.7% of the cohort (21/153) and 95.5% of cases (21/22) reporting molecular characterization. World Health Organization grades 2 and 3 were reported in 52.3% (79/151) and 47.7% (72/151) of cases, respectively. The frontal lobe was involved in the majority of cases (54.9%, 84/153). Gross total resection was achieved in 80.4% of cases (123/153). Tumor recurrence was identified in 27.7% of cases (39/141). Mean clinical follow-up was 41.3 months. Mean overall survival of patients who expired was 27.4 months whereas mean progression-free survival was 15.0 months. Comparatively, cortical ependymomas with C11orf95- RELA fusions and supratentorial ependymomas with C11orf95 RELA fusions exhibited differing clinical outcomes. Further studies with larger sample sizes are necessary to investigate the significance of RELA fusions on survival in cortical ependymomas and to determine whether cortical ependymomas with C11orf95- RELA fusions should be classified as a distinct entity.
Using the Experiences and Perceptions of Health Care Workers to Improve the Health Care Response to the COVID-19 Pandemic
Authors: Trinh Lieu Thi Thuy , Stubbs Joanne M. , Gilroy Nicole , Schindeler Suzanne , Achat Helen
Published: July 2022

Background:

We sought the opinions of health care workers (HCWs) at a designated COVID-19 facility receiving the first cases to identify workplace modifications and inform effective changes to maximize health and safety at the onset of a crisis.

Methods:

A cross-sectional study utilized open- and close-ended questions gathered demographic and work details, experiences and perspectives on infection control, communication, support, and the workplace. Qualitative data were analyzed thematically and quantitative were analyzed using descriptive statistics.

Findings:

Of 340 HCWs, most approved of the organization’s response to minimizing risk (81.0%), infection control training (81.1%), and supplies (74.3%). Key actions included up-to-date guidelines (93.6%) and specialized infectious diseases clinics (94.9%). Conclusions: HCWs rated the organization’s adaptive changes highly, noting areas for improvement such as transparency and timeliness of communication. Incorporating input from HCWs when responding to health crises was beneficial to maximize staff health and safety and consequently that of patients.
Forecasting Hourly Spot Prices in Indian Electricity Market
Authors: Mukherjee Paramita , Coondoo Dipankor , Lahiri Poulomi
Published: July 2022

In this paper, we present a study on forecasting hourly electricity spot prices for India. Forecasting electricity prices is challenging for its special characteristics. Based on hourly data covering several years, ARMAX models are estimated for forecasting for individual regions. Along with ARMA, intra-day, inter-day and hourly variations and seasonalities on weekdays, holidays and festive days are incorporated. Combinations of static and dynamic forecasts are also examined. The results indicate that prices for Sundays and holidays differ significantly from weekdays; also, a clear region-specific difference between prices in winter and summer months is observed. Price behaviour in the Southern region is different from other regions. The fitted models perform well for forecasting horizons of hourly prices of up to five days. The fitted ARMAX models have an easily implementable simple structure. Such forecasts provide valuable insights for policymakers and market participants, as they incorporate several features of the Indian electricity market, including various dimensions of seasonality of demand.

JEL Classifications: C53, Q47, C51
Visualizing How Race, Support for Black Lives Matter, and Gun Ownership Shape Views of the U.S. Capitol Insurrection of January 6, 2021
Authors: Bucci Rebecca , Kirk David S. , Sampson Robert J.
Published: July 2022

Protest movements linked to racial inequality in policing and antigovernment sentiment have roiled the United States in recent years. In this visualization, the authors examine how race, support for Black Lives Matter (BLM), and gun ownership predict views about the political uprising of January 6, 2021, at the U.S. Capitol. On the basis of a 2021 survey from a long-term longitudinal study, the authors show that views of the Capitol insurrection do not vary by race, contrary to expectations. However, there is a positive association between support for BLM and views of January 6 participants as “extremists,” especially among Whites, independent of age, sex, respondent’s education, parental education, and childhood neighborhood poverty. Race and gun ownership also interact, with White gun owners an outlier in viewing the insurrection more favorably. Black gun owners, on the contrary, viewed it most negatively.
Witnessing violence: Stories from a migration support worker
Authors: Judge Nicole , Loughnan Claire
Published: July 2022

In August 2019, academics, practitioners and advocates as well as individuals with lived experiences of confinement, came together at the University of Melbourne to reflect on the parallels between the spaces and practices of care and control in diverse sites of confinement. This research workshop sought to generate insights into places of confinement from varying perspectives. In the following dialogue between former migration support worker, Judge, and one of the editors of this Special Themed Collection of papers, Loughnan, the daily violence of Australia's immigration detention system is brought to light. Judge shares her stories of working in regional offshore processing centres. This provides important insights into the Australian government's border protection policies, described as one of the harshest in the world. Judge witnessed this first-hand when she was employed by the Australian Government to implement these policies and laws as a migration support worker. During this time, she was consistently faced with a tension between her role responsibility and her ethical obligations to others. The decisions she made to document these practices, to resist and then speak out have had a lasting impact on her: she says she is compelled to continue to document these stories, despite the severity of potential criminal repercussions for doing so under ‘gag orders’ on imposed on detention staff through laws enacted by the Australian Government.
Assessing the discriminative ability of the respiratory exchange ratio to detect hyperlactatemia during intermediate-to-high risk abdominal surgery
Authors: Karam Lydia , Desebbe Olivier , Coeckelenbergh Sean , Alexander Brenton , Colombo Nicolas , Laukaityte Edita , Pham Hung , Lanteri Minet Marc , Toubal Leila , Moussa Maya , Naili Salima , Duranteau Jacques , Vincent Jean-Louis , Van der Linden Philippe , Joosten Alexandre
Published: July 2022

Background

A mismatch between oxygen delivery (DO2) and consumption (VO2) is associated with increased perioperative morbidity and mortality. Hyperlactatemia is often used as an early screening tool, but this non-continuous measurement requires intermittent arterial line sampling. Having a non-invasive tool to rapidly detect inadequate DO2 is of great clinical relevance. The respiratory exchange ratio (RER) can be easily measured in all intubated patients and has been shown to predict postoperative complications. We therefore aimed to assess the discriminative ability of the RER to detect an inadequate DO2 as reflected by hyperlactatemia in patients having intermediate-to-high risk abdominal surgery.

Methods

This historical cohort study included all consecutive patients who underwent intermediate-to-high risk surgery from January 1st, 2014, to April 30th, 2019 except those who did not have RER and/or arterial lactate measured. Blood lactate levels were measured routinely at the beginning and end of surgery and RER was calculated at the same moment as the blood gas sampling. The present study tested the hypothesis that RER measured at the end of surgery could detect hyperlactatemia at that time. A receiver operating characteristic (ROC) curve was constructed to assess if RER calculated at the end of the surgery could detect hyperlactatemia. The chosen RER threshold corresponded to the highest value of the sum of the specificity and the sensitivity (Youden Index).

Results

Among the 996 patients available in our study cohort, 941 were included and analyzed. The area under the ROC curve was 0.73 (95% CI: 0.70 to 0.76; p < 0.001), with a RER threshold of 0.75, allowing to discriminate a lactate > 1.5 mmol/L with a sensitivity of 87.5% and a specificity of 49.5%.

Conclusion

In mechanically ventilated patients undergoing intermediate to high-risk abdominal surgery, the RER had moderate discriminative abilities to detect hyperlactatemia. Increased values should prompt clinicians to investigate for the presence of hyperlactatemia and treat any potential causes of DO2/VO2 mismatch as suggested by the subsequent presence of hyperlactatemia.
Predictors and histological effects of preoperative chemoradiotherapy for rectal cancer and control of lateral lymph node metastasis
Authors: Miyakita Hiroshi , Chan Lin Fung , Okada Kazutake , Kayano Hajime , Mori Masaki , Sadahiro Sotaro , Yamamoto Seiichiro
Published: July 2022

Introduction

Standard treatment strategy for low rectal cancer in Japan is different from Western countries. Total mesorectum excision (TME) + lateral lymph node dissection (LLND) is mainly carried out in Japan, whereas neoadjuvant chemoradiotherapy (nCRT) + TME is selected in Western countries. There is no clear definition of preoperative diagnosis of lateral lymph node metastasis. If we can predict lateral lymph node swelling that can be managed by nCRT from lateral lymph node swelling that require surgical resection, clinical benefit is significant. In the current study we assessed characteristics of the lateral lymph node recurrence (LLNR) and LLND that can be managed by nCRT.

Patients and Methods

Patients with low rectal cancer (n = 168) underwent nCRT between 2009 and 2016. We evaluated CEA, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and lateral lymph node short axis pre and post nCRT, respectively, and also evaluated tumor shrinkage rate, tumor regression grade (TRG). We evaluated the relationship between each and LLNR.

Results

LLND was not carried out all patients. Factors associated with LLNR were PLR and lymph node short axis pre and post nCRT. (p = 0.0269, 0.0278, p < 0.0001, p < 0.0001, respectively). Positive recurrence cut-off values of lateral lymph node short-axis calculated were 11.6 mm pre nCRT and 5.5 mm post nCRT.

Conclusion

Results suggest that PLR before and after CRT was associated with control of LLNR, and LLND should be performed on lateral lymph nodes with short-axis of 5 mm and 11 mm pre and post nCRT.
The effect of the multimodal intervention including an automatic notification of catheter days on reducing central line-related bloodstream infection: a retrospective, observational, quasi-experimental study
Authors: Bae Sohyun , Kim Yoonjung , Chang Hyun-Ha , Kim Sungjin , Kim Hyun-Ji , Jeon Hyeyoung , Cho Juhee , Lee Juyoung , Chae Hwajin , Han Gyeongmin , Kim Shin-Woo
Published: July 2022

Background

A central venous catheter (CVC) is an important medical device, but it could be preceding infection and the risk of central line-associated bloodstream infection (CLABSI). CLABSI is a common healthcare-associated infection but results in high cost and mortality; therefore, various efforts to reduce CLABSI have been attempted.

Methods

This is a retrospective, observational, quasi-experimental study in the intensive care unit (ICU) of a single tertiary care hospital. We reviewed and analysed the data of CLABSI rates and days from the insertion to the removal of the temporary CVC between January 2018 and June 2021 with transient periods over 9 months. Sequentially, all patients with the CVC in the ICU underwent the following interventions: maximal barrier precaution, automatic notification of catheter days and 2% chlorhexidine gluconate bathing. A segmented regression analysis of interrupted time series was conducted to compare the CLABSI rates before and after the introduction of multimodal interventions. During study periods, the impact of interventions on CLABSI was evaluated using multivariate logistic regression analyses.

Results

A total of 76,504 patient-days, 28,312 catheter days and 66 CLABSI cases were reviewed in ICU-hospitalised patients. As additional interventions, the CLABSI rate declined from 3.1 per 1000 CVC days to 1.2 per 1000 CVC days in post-interventions. In the pre-intervention and post-intervention periods, 4146 patents had one more short-term CVC. In the multivariate logistic regression analyses, multimodal intervention was one of determinants reducing CLABSI rates (odds ratio (OR), 0.52 [95% confidence interval {CI}, 0.28–0.94]). Indwelling time of CVC over 10 days was the risk factor for CLABSI rates (OR, 6.27 [95% CI, 3.36–12.48]). Of the three interventions, the automatic notification of catheter days was associated with decreased median monthly total CVC days and duration of CVC days per patient.

Conclusions

Multidisciplinary and evidence-based interventions could lead to a decrease in the CLABSI rates. Moreover, the automatic notification of catheter days of the electronic medical healthcare system has shortened the time of indwelling CVC.
Long-term reductions in disease impact in patients with chronic migraine following preventive treatment with eptinezumab
Authors: Blumenfeld Andrew , Ettrup Anders , Hirman Joe , Ebert Bjarke , Cady Roger
Published: July 2022

Background

Eptinezumab is an anti-calcitonin gene-related peptide humanized monoclonal antibody approved for the preventive treatment of migraine in adults. The PREVAIL study demonstrated a favorable safety profile with sustained reductions in overall migraine-related burden in patients with chronic migraine (CM). This post hoc analysis aimed to examine item-level changes in the Migraine Disability Assessment (MIDAS) questionnaire over 2 years in participants with CM on eptinezumab treatment.

Methods

PREVAIL was an open-label, phase 3 trial that included 96 weeks of treatment where 128 adults received intravenous eptinezumab administered over 30 min every 12 weeks (wks) for up to 8 doses of 300 mg. MIDAS was administered at baseline, Wk12, and every 12wks thereafter. Two supplementary MIDAS items not included in the total score calculation assessed number of headache days in the past 3 months (MIDAS headache) and average headache pain severity (from 0 [none] to 10 [worst]). MIDAS total scores were summed from 5 items, each quantifying the number of days in the past 3 months with migraine-related disability. Items 1, 3, and 5 assessed absenteeism, namely how many days the patient missed work/school (Q1), household work (Q3), or family/social/leisure activities (Q5). Items 2 and 4 were measures of presenteeism, namely how many days the patient had reduced productivity in work/school (Q2) or household work (Q4).

Results

Mean MIDAS headache days decreased from 47.4 (baseline) to 17.1 (Wk12) and 16.3 (Wk104). The average headache pain severity score (0‒10) decreased from a mean of 7.3 (baseline) to 5.5 (Wk12) to 4.5 (Wk104). Mean MIDAS scores measuring absenteeism (Q1, 3, 5) changed from 9.7 days at baseline to 3.2 days (Wk12) and to 3.9 days (Wk104). Mean MIDAS scores measuring presenteeism (Q2, 4) at Wk12 decreased from 14.2 days at baseline to 5.2 days (Wk12, 104). Patients categorized with very severe MIDAS disability had a mean total MIDAS score of 84.8, with an average reduction of 56.7 days (Wk12), which was maintained at 32 days at Wk104.

Conclusions

Long-term treatment with eptinezumab in patients with CM suggested sustained reductions in MIDAS-quantified disability, consistent with the sustained reductions in headache frequency and pain severity.

Trial registration

ClinicalTrials.gov identifier: NCT02985398.
Improving health-related quality of life in women with breast, blood, and gynaecological Cancer with an eHealth-enabled 12-week lifestyle intervention: the women’s wellness after Cancer program randomised controlled trial
Authors: Seib Charrlotte , Anderson Debra , McGuire Amanda , Porter-Steele Janine , McDonald Nicole , Balaam Sarah , Sapkota Diksha , McCarthy Alexandra L.
Published: July 2022

Background

The residual effects of cancer and its treatment can profoundly affect women’s quality of life. This paper presents results from a multisite randomized controlled trial that evaluated the clinical benefits of an e-health enabled health promotion intervention (the Women’s Wellness after Cancer Program or WWACP) on the health-related quality of life of women recovering from cancer treatment.

Methods

Overall, 351 women previously treated for breast, blood or gynaecological cancers were randomly allocated to the intervention (WWACP) or usual care arms. The WWACP comprised a structured 12-week program that included online coaching and an interactive iBook that targeted physical activity, healthy diet, stress and menopause management, sexual wellbeing, smoking cessation, alcohol intake and sleep hygiene. Data were collected via a self-completed electronic survey at baseline (t0), 12 weeks (post-intervention, t1) and 24 weeks (to assess sustained behaviour change, t2). The primary outcome, health-related quality of life (HRQoL), was measured using the Short Form Health Survey (SF-36).

Results

Following the 12-week lifestyle program, intervention group participants reported statistically significant improvements in general health, bodily pain, vitality, and global physical and mental health scores. Improvements were also noted in the control group across several HRQoL domains, though the magnitude of change was less.

Conclusions

The WWACP was associated with improved HRQoL in women previously treated for blood, breast, and gynaecological cancers. Given how the synergy of different lifestyle factors influence health behaviour, interventions accounting for the reciprocity of multiple health behaviours like the WWACP, have real potential for immediate and sustainable change.

Trial registration

The protocol for this randomised controlled trial was submitted to the Australian and New Zealand Clinical Trials Registry on 15/07/2014 and approved on 28/07/2014 (ACTRN12614000800628).
Clinical and genetic features of primary ciliary dyskinesia in a cohort of consecutive clinically suspect children in western China
Authors: Li Ying , Fu Wenlong , Geng Gang , Dai Jihong , Fu Zhou , Tian Daiyin
Published: July 2022

Background

Primary ciliary dyskinesia (PCD) is a rare, inherited disorder of the motile cilia that exhibits genetic and clinical heterogeneity among different populations. PCD diagnosis remains challenging owing to the heterogeneity of associated clinical features and lack of a gold standard diagnostic test.

Objective

The aim of this study was to analyze the clinical and genetic characteristics of a group of children with clinically suspected PCD in one region of China, with the goal of providing a more robust knowledge base regarding the genetic stratification underlying this disease in Chinese populations.

Methods

We retrospectively analyzed the data from 38 patients with clinically suspected PCD who had undergone next-generation sequencing (NGS) between November 2016 and March 2021 in the respiratory department of a tertiary Children‘s hospital in Western China. The genetic features of the confirmed cases were summarized by reviewing data associated with other cohorts of Chinese children.

Results

Overall, 16 patients were ultimately diagnosed with PCD with a median age of 8.5 years. All patients presented with a chronic wet cough, 93.75% exhibited chronic or recurrent sinusitis/rhinitis, 43.75% experienced recurrent wheezing, 56.25% reported respiratory symptoms present since infancy, 31.25% had a history of neonatal respiratory distress (NRD), and 25% exhibited otitis media. Only 18.75% of these patients exhibited laterality defects. High frequencies of DNAH11 mutations were detected by integrating data from PCD patient cohorts in China.

Conclusion

The high frequency of DNAH11 mutations may limit the utility of transmission electron microscopy (TEM) as a first-line approach to diagnosing PCD in China in the absence of other indicators.
Work-related injuries among 5 – 17 years-old working children in Egypt: findings from a national child labor survey
Authors: Fouad Ahmed Mahmoud , Amer Shaimaa A. A. M. , Abdellatif Yasser Omar , Elotla Sally Fawzy
Published: July 2022

Background

Egypt has agreed and ratified international regulations that strict child labor. However, the country still struggles with high prevalence of child labor and the associated negative social and health effects. The objective of this study was to identify the prevalence and determinants of work-related injuries among working children in Egypt.

Methods

This study involved a secondary data analysis of the National Child Labor Survey (NCLS) conducted in 2010 by The Central Agency for Public Mobilization and Statistics (CAPMAS) in Egypt with technical and financial support from the ILO’s International Program on the Elimination of Child Labor (IPEC) through its Statistical Information and Monitoring Program on Child Labor (SIMPOC). The total number of working children who responded to questions of work-related injuries in the NCLS child questionnaire was 7485 children.

Results

The prevalence of work-related injuries among working children in Egypt was estimated as 24.1% (95% CI: 22.0%—26.2%), of whom the majority were superficial wounds (87.3%). Among children who reported work-related injuries, 57.9% did not stop work or schooling because of the most serious injury, while 39.6% had stopped temporarily and 2.6% had stopped completely. The main determinants of work-related injuries among working children in the study sample were gender (boys), age of starting work (5–11 years), type of main economic activity (industry and services), type of main workplace (plantation, farms, or garden), the average work hours per week (28 h or more), and exposure to ergonomic and safety, and chemical hazards at work.

Conclusions

The estimated high prevalence of work-related injuries among working children aged 5–17 years in Egypt raises the health risks concerns associated with child labor. Findings of this study on the determinants of work-related injuries could guide policies and interventions to combat child labor and the associated health risks, including work-related injuries.
An analysis of the construct validity and responsiveness of the ICECAP-SCM capability wellbeing measure in a palliative care hospice setting
Authors: Myring Gareth , Mitchell Paul Mark , Kernohan W. George , McIlfatrick Sonja , Cudmore Sarah , Finucane Anne M. , Graham-Wisener Lisa , Hewison Alistair , Jones Louise , Jordan Joanne , McKibben Laurie , Muldrew Deborah H. L. , Zafar Shazia , Coast Joanna
Published: July 2022

Background

For outcome measures to be useful in health and care decision-making, they need to have certain psychometric properties. The ICECAP-Supportive Care Measure (ICECAP-SCM), a seven attribute measure (1.Choice, 2.Love and affection, 3.Physical suffering, 4.Emotional suffering, 5.Dignity, 6.Being supported, 7.Preparation) developed for use in economic evaluation of end-of-life interventions, has face validity and is feasible to use. This study aimed to assess the construct validity and responsiveness of the ICECAP-SCM in hospice inpatient and outpatient settings.

Methods

A secondary analysis of data collated from two studies, one focusing on palliative care day services and the other on constipation management, undertaken in the same national hospice organisation across three UK hospices, was conducted. Other quality of life and wellbeing outcome measures used were the EQ-5D-5L, McGill Quality of Life Questionnaire – Expanded (MQOL-E), Patient Health Questionnaire-2 (PHQ-2) and Palliative Outcomes Scale Symptom list (POS-S). The construct validity of the ICECAP-SCM was assessed, following hypotheses generation, by calculating correlations between: (i) its domains and the domains of other outcome measures, (ii) its summary score and the other measures’ domains, (iii) its summary score and the summary scores of the other measures. The responsiveness of the ICECAP-SCM was assessed using anchor-based methods to understand change over time. Statistical analysis consisted of Spearman and Pearson correlations for construct validity and paired t-tests for the responsiveness analysis.

Results

Sixty-eight participants were included in the baseline analysis. Five strong correlations were found with ICECAP-SCM attributes and items on the other measures: four with theEmotional sufferingattribute (Anxiety/depressionon EQ-5D-5L,PsychologicalandBurdenon MQOL-E andFeeling down, depressed or hopelesson PHQ-2), and one withPhysical suffering(Weakness or lack of energyon POS-S). ICECAP-SCM attributes and scores were most strongly associated with the MQOL-E measure (0.73 correlation coefficient between summary scores). The responsiveness analysis (n = 36) showed the ICECAP-SCM score was responsive to change when anchored to changes on the MQOL-E over time (p < 0.05).

Conclusions

This study provides initial evidence of construct validity and responsiveness of the ICECAP-SCM in hospice settings and suggests its potential for use in end-of-life care research.
A defined anthocyanin mixture sourced from bilberry and black currant inhibits Measles virus and various herpesviruses
Authors: Sivarajan Rinu , Oberwinkler Heike , Roll Valeria , König Eva-Maria , Steinke Maria , Bodem Jochen
Published: July 2022

Background

Anthocyanin-containing plant extracts and carotenoids, such as astaxanthin, have been well-known for their antiviral and anti-inflammatory activity, respectively. We hypothesised that a mixture of Ribes nigrum L. (Grossulariaceae) (common name black currant (BC)) and Vaccinium myrtillus L. (Ericaceae) (common name bilberry (BL)) extracts (BC/BL) with standardised anthocyanin content as well as single plant extracts interfered with the replication of Measles virus and Herpesviruses in vitro.

Methods

We treated cell cultures with BC/BL or defined single plant extracts, purified anthocyanins and astaxanthin in different concentrations and subsequently infected the cultures with the Measles virus (wild-type or vaccine strain Edmonston), Herpesvirus 1 or 8, or murine Cytomegalovirus. Then, we analysed the number of infected cells and viral infectivity and compared the data to non-treated controls.

Results

The BC/BL extract inhibited wild-type Measles virus replication, syncytia formation and cell-to-cell spread. This suppression was dependent on the wild-type virus-receptor-interaction since the Measles vaccine strain was unaffected by BC/BL treatment. Furthermore, the evidence was provided that the delphinidin-3-rutinoside chloride, a component of BC/BL, and purified astaxanthin, were effective anti-Measles virus compounds. Human Herpesvirus 1 and murine Cytomegalovirus replication was inhibited by BC/BL, single bilberry or black currant extracts, and the BC/BL component delphinidin-3-glucoside chloride. Additionally, we observed that BC/BL seemed to act synergistically with aciclovir. Moreover, BC/BL, the single bilberry and black currant extracts, and the BC/BL components delphinidin-3-glucoside chloride, cyanidin-3-glucoside, delphinidin-3-rutinoside chloride, and petunidin-3-galactoside inhibited human Herpesvirus 8 replication.

Conclusions

Our data indicate that Measles viruses and Herpesviruses are differentially susceptible to a specific BC/BL mixture, single plant extracts, purified anthocyanins and astaxanthin. These compounds might be used in the prevention of viral diseases and in addition to direct-acting antivirals, such as aciclovir.
An educational intervention to facilitate appropriate subspecialty referrals: a study assessing resident communication skills
Authors: Stave Elise A. , Greenberg Larrie , Hamburger Ellen , Ottolini Mary , Agrawal Dewesh , Lewis Karen , Barber John R. , Bost James E. , Harahsheh Ashraf S.
Published: July 2022

Background

Our goal was to improve pediatric residents' advanced communication skills in the setting of referral to address the entrustable professional activity of subspecialty referral identified by the American Board of Pediatrics. To accomplish this aim, we created a referral and consultation curriculum to teach and assess core communication skills in subspecialty referral involving an adolescent with syncope, an anxiety-provoking symptom that is rarely associated with serious pathology.

Methods

We utilized blended multimodal educational interventions to improve resident communication skills in referral of patients. Trainees participated in 1) an interactive online module on syncope focusing on “red-flag” symptoms that would warrant a subspecialty cardiology referral and 2) a 4-h intervention with Standardized Parents (SPs), focusing on the case-based application of communication skills. Communication skills were assessed by two pre- and post- Objective Structured Clinical Examination encounters of patients with syncope, with an SP evaluation using a 20-item checklist. Analysis was performed with Sign test and McNemar’s test. Trainees provided feedback on a Critical Incident Questionnaire, which was analyzed qualitatively.

Results

Sixty-four residents participated. There was an overall improvement in communication skills based on SP scores (82.7 ± 10.9% to 91.7 ± 5.0%, p < 0.001), and 13/20 items demonstrated significant improvement post-intervention. Residents’ improved performance enabled them to address patient/family emotions, explain referral logistics, and clarify concerns to agree on a plan.

Conclusions

By participating in this curriculum, residents’ communication skills improved immediately post-intervention. Further research is needed to assess if this intervention improves patient care by providing residents with enduring skills to judiciously manage the referral process.
The development of a visual dashboard report to assess physician assistant and nurse practitioner financial and clinical productivity
Authors: Kidd Vasco Deon , Liu Joe Haoming , Reamer-Yu Andy , Wang Joann Hao , Deng Mei
Published: July 2022

The evolving COVID-19 pandemic has unevenly affected academic medical centers (AMCs), which are experiencing resource-constraints and liquidity challenges while at the same time facing high pressures to improve patient access and clinical outcomes. Technological advancements in the field of data analytics can enable AMCs to achieve operational efficiencies and improve bottom-line expectations. While there are vetted analytical tools available to track physician productivity, there is a significant paucity of analytical instruments described in the literature to adequately track clinical and financial productivity of physician assistants (PAs) and nurse practitioners (NPs) employed at AMCs. Moreover, there is no general guidance on the development of a dashboard to track PA/NP clinical and financial productivity at the individual, department, or enterprise level. At our institution, there was insufficient tracking of PA/NP productivity across many clinical areas within the enterprise. Thus, the aim of the project is to leverage our institution’s existing visualization tools coupled with the right analytics to track PA/NP productivity trends using a dashboard report.

Methods

We created an intuitive and customizable highly visual clinical/financial analytical dashboard to track productivity of PAs/NPs employed at our AMC.

Results

The APP financial and clinical dashboard is organized into two main components. The volume-based key performance indicators (KPIs) included work relative value units (wRVUs), gross charges, collections (payments), and payer-mix. The session utilization (KPIs) included (e.g., new versus return patient ratios, encounter type, visit volume, and visits per session by provider). After successful piloting, the dashboard was deployed across multiple specialty areas and results showed improved data transparency and reliable tracking of PAs/NPs productivity across the enterprise. The dashboard analytics were also helpful in assessing PA/NP recruitment requests, independent practice sessions, and performance expectations.

Conclusion

To our knowledge, this is the first paper to highlight steps AMCs can take in developing, validating, and deploying a financial/clinical dashboard specific to PAs/NPs. However, empirical research is needed to assess the impact of qualitative and quantitative dashboards on provider engagement, revenue, and quality of care.
Role of matrix metalloprotease-2 and MMP-9 in experimental lung fibrosis in mice
Authors: Bormann Tina , Maus Regina , Stolper Jennifer , Tort Tarrés Meritxell , Brandenberger Christina , Wedekind Dirk , Jonigk Danny , Welte Tobias , Gauldie Jack , Kolb Martin , Maus Ulrich A.
Published: July 2022

Background

Idiopathic pulmonary fibrosis (IPF) is a diffuse parenchymal lung disease characterized by exuberant deposition of extracellular matrix (ECM) proteins in the lung interstitium, which contributes to substantial morbidity and mortality in IPF patients. Matrix metalloproteinases (MMPs) are a large family of zinc-dependent endopeptidases, many of which have been implicated in the regulation of ECM degradation in lung fibrosis. However, the roles of MMP-2 and -9 (also termed gelatinases A and B) have not yet been explored in lung fibrosis in detail.

Methods

AdTGF-β1 was applied via orotracheal routes to the lungs of WT, MMP-2 KO, MMP-9 KO and MMP-2/-9 dKO mice on day 0 to induce lung fibrosis. Using hydroxyproline assay, FlexiVent based lung function measurement, histopathology, western blot and ELISA techniques, we analyzed MMP-2 and MMP-9 levels in BAL fluid and lung, collagen contents in lung and lung function in mice on day 14 and 21 post-treatment.

Result

IPF lung homogenates exhibited significantly increased levels of MMP-2 and MMP-9, relative to disease controls. Enzymatically active MMP-2 and MMP-9 was increased in lungs of mice exposed to adenoviral TGF-β1, suggesting a role for these metalloproteinases in lung fibrogenesis. However, we found that neither MMP-2 or MMP-9 nor combined MMP-2/-9 deletion had any effect on experimental lung fibrosis in mice.

Conclusion

Together, our data strongly suggest that both gelatinases MMP-2 and MMP-9 play only a subordinate role in experimental lung fibrosis in mice.
Mannose-binding lectin does not explain the dismal prognosis after an acute coronary event in dysglycaemic patients. A report from the GAMI cohort
Authors: Meziani Sara , Ferrannini Giulia , Bjerre Mette , Hansen Troels K. , Ritsinger Viveca , Norhammar Anna , Gyberg Viveca , Näsman Per , Rydén Lars , Mellbin Linda G.
Published: July 2022

Background

Mannose binding lectin (MBL) has been suggested to be associated with an impaired cardiovascular prognosis in dysglycaemic conditions, but results are still contrasting.

Our aims are (i) to examine whether MBL levels differ between patients with an acute myocardial infarction (MI) and healthy controls and between subgroups with different glucose tolerance status, and (ii) to investigate the relation between MBL and future cardiovascular events.

Methods

MBL levels were assessed at discharge and after 3 months in 161 AMI patients without any previously known glucose perturbations and in 183 age- and gender-matched controls from the Glucose metabolism in patients with Acute Myocardial Infarction (GAMI) study. Participants were classified as having dysglycaemia, i.e. type 2 diabetes or impaired glucose tolerance, or not by an oral glucose tolerance test. The primary outcome was a composite of cardiovascular events comprising cardiovascular death, AMI, stroke or severe heart failure during 11 years of follow-up. Total and cardiovascular mortality served as secondary outcomes.

Results

At hospital discharge patients had higher MBL levels (median 1246 μg/L) than three months later (median 575 μg/L; p < 0.01), the latter did not significantly differ from those in the controls (801 μg/L; p = 0.47). MBL levels were not affected by dysglycaemia either in patients or controls. Independent of glycaemic state, increasing MBL levels did not predict any of the studied outcomes in patients. In unadjusted analyses increasing MBL levels predicted cardiovascular events (hazard ratio HR: 1.67, 95% confidence interval CI 1.06–2.64) and total mortality (HR 1.53, 95% CI 1.12–2.10) in the control group. However, this did not remain in adjusted analyses.

Conclusions

Patients had higher MBL levels than controls during the hospital phase of AMI, supporting the assumption that elevated MBL reflects acute stress. MBL was not found to be independently associated with cardiovascular prognosis in patients with AMI regardless of glucose state.