bluuebunny/crossref_metadata_2025_split huggingface dataset:
Capacity building of district health management teams in the era of provincial health administration reform in the Democratic Republic of Congo: a realist evaluation protocol
Authors: Bosongo Samuel , Belrhiti Zakaria , Chenge Faustin , Criel Bart , Marchal Bruno 
Published: July 2023

IntroductionIn 2006, the Congolese Ministry of Health developed a health system strengthening strategy focusing on health district development. This strategy called for reforming the provincial health administration in order to better support the health district development through leadership and management capacity building of district health management teams. The implementation is currently underway, yet, more evidence on how, for whom and under what conditions this capacity building works is needed. The proposed research aims to address this gap using a realist evaluation approach.Methods and analysisWe will follow the cycle of the realist evaluation. First, we will elicit the initial programme theory through a scoping review (completed in December 2022, using MEDLINE, Health Systems Evidence, Wiley Online Library, Cochrane Library, Google Scholar and grey literature), a review of health policy documents (completed in March 2023), and interviews with key stakeholders (by June 2023). Second, we will empirically test the initial programme theory using a multiple-embedded case study design in two provincial health administrations and four health districts (by March 2024). Data will be collected through document reviews, in-depth interviews, non-participant observations, a questionnaire, routine data from the health information management system and a context mapping tool. We will analyse data using the Intervention-Context-Actor-Mechanism-Outcome configuration heuristic. Last, we will refine the initial programme theory based on the results of the empirical studies and develop recommendations for policymakers (by June 2024).Ethics and disseminationThe Institutional Review Board of the Institute of Tropical Medicine and the Medical Ethics Committee of the University of Lubumbashi approved this study. We will also seek approvals from provincial-level and district-level health authorities before data collection in their jurisdictions. We will disseminate the study findings through the publication of articles in peer-reviewed academic journals, policy briefs for national policymakers and presentations at national and international conferences.
Cancer-related breathlessness: opioids other than morphine – comprehensive literature review
Authors: Sakaguchi Tatsuma 
Published: July 2023

IntroductionAlthough there is low-quality evidence, there has been an increase in publications on the experience of evaluating and managing cancer-related breathlessness using opioids other than morphine.MethodsThe author conducted a non-systematic literature review in the PubMed/Medline and Embase until 4 October 2022. Eligible studies have evaluated the efficacy of opioids other than morphine for cancer-related breathlessness. Studies focused on sedation, anaesthesia, paediatric patients, opioid toxicity or basic research were excluded. Reviews/meta-analyses and non-English language publications were also excluded.ResultsA total of 1556 records were identified, of which 23 studies including 469 patients who were treated with fentanyl (n=223), oxycodone (n=171) and hydromorphone (n=75) were considered eligible. Six phase II randomised clinical trials (RCTs), four observational studies and four case reports of fentanyl were found. For breathlessness on exertion, fentanyl yielded promising results, but no RCT showed significant superiority of fentanyl to placebo or morphine. For terminal breathlessness, three RCTs, five non-randomised or observational studies and one case report on oxycodone or hydromorphone were found. Although the results of the observational studies suggested that oxycodone and hydromorphone might be effective alternatives to morphine, the superiority over placebo or non-inferiority to morphine had not been demonstrated in the RCTs.ConclusionAs an alternative to morphine, the author recommends fentanyl for breathless crisis or breathlessness on exertion, and oxycodone or hydromorphone for terminal breathlessness in advanced cancer. Larger and well-designed studies based on firm research policies are needed to confirm this current knowledge.
Do physical symptoms predict psychological issues in patients with cancer?: the Memorial Symptom Assessment Scale—Short Form
Authors: Webber Katherine , Davies Andrew Neil , Waghorn Melanie 
Published: July 2023

ObjectivesThis study aimed to determine if individual physical symptoms were predictive of psychological disorders.MethodsThis study was a secondary analysis of data from two studies which used the Memorial Symptom Assessment Scale—Short Form (MSAS-SF) to assess both physical and psychological symptoms. Correlation between individual symptoms and the validated psychological subscale (MSAS-PSYCH) were performed using Spearman’s coefficient. Linear regression analysis was performed to assess whether correlated symptoms predicted the presence of psychological disorders.Results1507 patients’ data were analysed. The physical symptoms of pain, lack of energy, drowsiness, dizziness, constipation, ‘feeling bloated’ and ‘I don’t look like myself’ were correlated with MSAS-PSYCH. Other physical symptoms existed independently to psychological symptoms. None of these physical symptoms were independently predictive of a mood disorder.ConclusionsThis study presents a large data set evaluating psychological symptom correlations. There are certain physical symptoms which correlate with mood disorders, but these are not independently predictive. It is not known whether the correlative data are cause or effect. Comprehensive assessment remains essential to assess all problems.Trial registration numberThe trial registered was at National Institute for Health Research Clinical Research Network Portfolio (Central Portfolio Management System (CPMS) ID 30723) Integrated Research Application System Identification (IRAS) ID 198753.
Quality of death educational programme in a national reference palliative care unit
Authors: De Oliveira Livia Costa , Rosa Karla Santos da Costa , Salman Amirah Adnan , Salman Manuela Samir Maciel , Simões Alessandra Gomes , Siqueira Alex Sandro de Azeredo , Richard Amanda Alves Orsini , Yamaguchi Angelica , Ribeiro João Barroso , Vinicius da Silva Marcus , Bolzan Mônica , Freitas Renata , Bryan Liz 
Published: July 2023

ObjectiveTo report the experience of offering the Quality End of Life Care for All (QELCA) Programme, highlighting the distinct methodology for the training of health professionals.DevelopmentThe QELCA Programme, intellectual property of St Christopher’s Hospice, was offered to seven health professionals working in the hospital palliative care unit at the National Cancer Institute, between June and December 2022, with the support of Premier Institute. The programme, which originates in the UK, has been evaluated there and is currently being evaluated in Hong Kong, and is delivered in two phases: (1) a 5-day immersion programme; (2) monthly sessions of Action Learning for 6 months. Participants realised that communication between members of the multidisciplinary team, as well as between health professionals and patients/loved ones, was one of the key challenges for achieving quality of death in the hospital palliative care unit. This insight empowered them to drive forward significant changes in practice that promise to improve quality of care.ConclusionThe QELCA Programme enabled participants to engage in active problem-solving to promote the relief of suffering of patients and their families in end-of-life care.
Geographic Market Definition in Commercial Health Insurer Matters: A Unified Approach for Merger Review, Monopolization Claims, and Monopsonization Claims
Authors: Haas-Wilson Deborah , Zetenyi Kristof , Gorin Brian 
Published: July 2023

We provide a methodology for geographic market definition when the product(s) being purchased or sold has an intrinsic geographic component, such as (1) the sale of commercial health plans and (2) the purchase of health care providers’ services by commercial health plans. In these situations, we show that a straightforward application of the Horizontal Merger Guidelines issued by the U.S. Department of Justice and the Federal Trade Commission (hereafter, Guidelines) that uses the customer or supplier location to define the geographic market is not sufficient and can result in markets that are unintuitively small. This is often addressed by applying an assumption about aggregating based on similar competitive conditions. The practice of relying on the assumption of similar competitive conditions across counties, metropolitan statistical areas, or other geographic areas, without a methodology to support this assumption, could lead to market definitions that are too narrow or too broad and could influence the assessments of the extent of market concentration and the presence or absence of market power. We outline a framework that is consistent with the Guidelines and does not require a reliance on the assumption of aggregation based on similar competitive conditions. JEL Classification L12, L40, K21, D42, I11
Depression, anxiety, insomnia and dysmenorrhea in stressed fingolimod-treated women with multiple sclerosis
Authors: Gammoh Omar , Ennab Wail 
Published: July 2023

Objective This study examined the prevalence and correlates of depression, anxiety, insomnia, and dysmenorrhea in stressed fingolimod-treated women with multiple sclerosis. Methods This cross-sectional study recruited female patients diagnosed with multiple sclerosis and high stress scores from Al-Bashir Hospital in Jordan. Depression was assessed by the Patient Health Questionnaire (PHQ-9); anxiety by the Generalized Anxiety Disorder (GAD-7) scale; insomnia by the Insomnia Severity Index (ISI-A) scale; and dysmenorrhea severity by a measure assessing working ability, location, intensity, days of pain, and miscellaneous dysmenorrhea symptoms (WaLIDD). Results A total of 129 patients were recruited for the study. Severe depression was reported in 55.8%, severe anxiety in 62.0%, severe insomnia in 36.4%, and severe dysmenorrhea in 23.3%. Multivariate analyses revealed that depressive symptoms were associated with dysmenorrhea (OR = 3.55, 95% CI = 1.56–8.12, p = 0.003); anxiety symptoms with “not using dysmenorrhea analgesics” (OR = 2.74, 95% CI = 1.16–6.46, p = 0.02) and dysmenorrhea symptoms (OR = 4.74, 95% CI = 1.94–11.59, p = 0.001); insomnia symptoms with age above 30 years (OR = 4.34, 95% CI = 1.64–11.51, p = 0.003); and dysmenorrhea symptoms with the presence of chronic diseases (OR = 4.21, 95% CI = 1.28–13.92, p = 0.02), anxiety symptoms (OR = 3.03, 95% CI = 1.18–7.73, p = 0.02), and insomnia symptoms (OR = 3.00, 95% CI = 1.18–7.64, p = 0.02). Conclusion Stressed women with multiple sclerosis in Jordan experience high rates of depression, anxiety, insomnia, and dysmenorrhea. Characteristics related to these conditions may help clinicians to identify those at risk. Longitudinal studies are needed to determine the causal nature of these associations.
Effect of teak wood on recycled HDPE/pine wood composites subjected to termite attack and accelerated weathering
Authors: Cruz-Estrada Ricardo H , Guillén-Mallette Javier , López-Naranjo Edgar J , Zacarías-Calderón Edgar 
Published: July 2023

This study aimed to investigate the impact of including teak wood in recycled high-density polyethylene wood plastic composites (WPC) with pine wood on their resistance to degradation caused by termite attack and accelerated weathering. A 23 factorial experimental design was conducted with three repetitions in the center to analyze the weight loss and termite mortality during the experiments. The factors studied were the days of exposure to accelerated weathering, days of exposure to termite attack, and the concentration of teak wood in the composite. Surface characterizations (SEM and FTIR) were carried out to analyze the exposed surfaces and determine the chemical modification of the composite components. The results showed that the WPC manufacturing process promotes a heterogeneous distribution of the wood particles, being greater within the center of the samples than on the surface. Specimens exposed to both accelerated weathering and termite attack resulted in a certain weight loss and termite mortality, depending on the material, conditions of exposure, and the content of teak wood in the WPC. When those compounds were subjected to accelerated weathering followed by termite attack they exhibited a higher termite attack. The presence of teak wood in the WPC produced a reduction in the effects of termite attack and accelerated weathering on weight loss and an increase in termite mortality compared to the WPC with only pine wood, as teak wood contains extractables with termiticidal action. The lowest value of weight loss (0.06%) was observed for the WPC with the highest amount of teak wood with termite attack, resulting in a termite mortality rate of 100% after 17 days of exposure.
Influences of High School Physical Learning Environments on Students’ Anxiety in China
Authors: Li Mengqi , Lu Zhipeng , Xu Leiqing 
Published: July 2023

Background: High school students are at an increased risk of developing generalized anxiety disorder (GAD) due to significant pressure to achieve academic success. Aim: Although it is known that a school’s physical learning environment can influence students’ GAD, there is limited research examining this relationship. To fill this knowledge gap, a cross-sectional study was conducted among 230 students from two high schools in China. Methods: A survey questionnaire captured students’ GAD self-evaluations (dependent variables), perceptions/preferences of their school physical environment (independent variables), and social and personal conditions (confounding variables). Bivariate analysis showed that students’ GAD scores were associated with multiple factors related to the learning environment, physical activities, and personal characteristics. The multivariate analysis examined the relationship between GAD scores and physical learning environment variables while controlling for confounding variables. Results: The results indicated that adequate lighting ( B = −0.154, p = .029) and perceived effectiveness of using self-service cafeterias in reducing anxiety ( B = −0.138, p = .044) were significantly associated with GAD scores. Conclusions: These findings provide evidence for the importance of designing high schools with students’ mental health in mind. Specifically, school administrators and designers should consider how to improve the physical learning environment by incorporating natural light, a self-service cafeteria, and spaces for physical activities to promote students’ mental well-being.
Survival Trends and Profiling of Gastric Mixed Adenoneuroendocrine Carcinoma (gMANEC) in the Current Era
Authors: Gupta Shreya , McDonald James D. , Rossi Alexander J. , Hernandez Jonathan M. , Davis Jeremy L. , Blakely Andrew M. 
Published: July 2023

Background: Gastric mixed adenoneuroendocrine carcinoma (gMANEC) is a histopathologic diagnosis with at least 30% each of exocrine and endocrine components. Although prognosis is thought to be driven by the relative exocrine or endocrine dominance, gMANEC has been clinically treated as gastric adenocarcinoma (gAC). The overall survival of gMANEC as compared to gastric neuroendocrine carcinoma (gNEC) or gAC remains undefined. Methods: Using the National Cancer Database, patients with gastric tumors were queried from 2004 to 2016 for gMANEC, gNEC, and gAC histologies. Demographic and clinicopathologic features were recorded. Univariate and multivariate Cox proportional hazards analyses were performed to delineate factors associated with overall survival (OS). Results: Overall, 404 patients diagnosed with gMANEC were identified. Patients had a median age 68 years, were majority male, and predominantly Caucasian. Gastric MANEC was more frequently poorly differentiated (73%vs 52% (gAC) vs 20% (gNEC), P < .001) with lymphovascular invasion (57%vs 38%vs 27%, P < .001) and lymph node involvement (59%vs 49%vs 36%, P < .001); these factors were associated with worse OS on univariable analysis. Finally, tumors >5 cm and lymph node involvement were independent predictors of worse survival. The median OS of patients with gMANEC was 41.5 months. Conclusion: Gastric MANEC and gAC have a similarly dismal prognosis and thus should be continued to treat like gAC. Pathologic nodal metastasis, tumor size and grade are useful prognostic factors.
Targeting TIM-3 for hematological malignancy: latest updates from the 2022 ASH annual meeting
Authors: Tan Jiaxiong , Tan Huo , Li Yangqiu 
Published: July 2023

AbstractT cell immunoglobulin domain and mucin domain-3 (TIM-3) is an important immune checkpoint (IC) protein in cancer immunosuppression that is considered a novel target for immunotherapy. Moreover, TIM-3, an immuno-myeloid regulator, is highly expressed on the cells of several solid tumors and myeloid leukemia stem cells (LSCs). TIM-3 blockade was shown to have dual effects for directly inhibiting leukemia cells and restoring T cell activation. We summarize several of the latest reports on the role of TIM-3 in immunotherapy for hematological malignancies from the 2022 ASH Annual Meeting (ASH2022).
Case Report: Optical coherence tomography angiography findings in radiation retinopathy
Authors: Ammari Wafa , Zaghdoudi Asma , Berriche Olfa , Messaoud Riadh 
Published: July 2023

We report the observation of a 31-year-old patient followed for a nasopharyngeal carcinoma since 2009, treated by locoregional radiotherapy, with a cumulative dose of 70 Gray. This case presented all ocular complications of radiotherapy; radiation retinopathy (RR), which is the most severe complication, could be diagnosed earlier and have a better prognosis if optic coherence tomography angiography (OCTA) was performed. She presented with a progressive decline in bilateral visual acuity. Ophthalmologic examination revealed bilateral posterior subcapsular cataract, radiation retinopathy, and optic neuropathy. The OCT B-scan showed more pronounced macular edema in the right eye. The OCTA revealed enlargement of the central avascular zone and loss of the deep and superficial retinal vascular network. The patient received three consecutive monthly intravitreal injections of anti-vascular endothelial growth factor (VEGF), without improvement in visual acuity. The aim of this case report is to present the contribution of OCT-A in the diagnosis of radiation maculopathy, and attribute these changes to ischemia at the level of the retinal vascular network.
Autophagy orchestrates the crosstalk between cells and organs
Authors: Piletic Klara , Alsaleh Ghada , Simon Anna Katharina 
Published: July 2023

AbstractOver the recent years, it has become apparent that a deeper understanding of cell‐to‐cell and organ‐to‐organ communication is necessary to fully comprehend both homeostatic and pathological states. Autophagy is indispensable for cellular development, function, and homeostasis. A crucial aspect is that autophagy can also mediate these processes through its secretory role. The autophagy‐derived secretome relays its extracellular signals in the form of nutrients, proteins, mitochondria, and extracellular vesicles. These crosstalk mediators functionally shape cell fate decisions, tissue microenvironment and systemic physiology. The diversity of the secreted cargo elicits an equally diverse type of responses, which span over metabolic, inflammatory, and structural adaptations in disease and homeostasis. We review here the emerging role of the autophagy‐derived secretome in the communication between different cell types and organs and discuss the mechanisms involved.
Poesía colombiana actual
Authors: Vega Bedoya Wilfredo Esteban 
Published: July 2023

Si en 1960 G. G. Márquez pudo trazar su desolado inventario con el devastador título: “La literatura colombiana, un fraude a la nación”, y Cobo Borda pudo realizar en 1979 su remake para el caso de la poesía, con el no menos lapidario: “Tradición de la pobreza”, no es menos cierto que hoy, en los últimos tramos de la segunda década del siglo XXI, valoraciones de ese tenor no resultarían tan pertinentes como aquellas lo fueron en su momento.Median casi dos décadas entre ambos inventarios que marcan puntos fronterizos de inflexión. Justamente, en el marco de esas dos décadas se produce el arribo de nuestra literatura a su entera modernidad.
Changes in activity of metalloproteinases 2 and 9 in rat liver in experimental model of cholestasis taking into account its duration and assessment of selected features
Authors: Suszyński Krzysztof , Białoń Natalia , Górka Dariusz , Dolińska Anna , Górka Mikołaj 
Published: July 2023

WstępCholestaza, inaczej zastój żółci, pojawia się wówczas, gdy dochodzi do zablokowania przepływu żółci. Obecnie wyróżnia się dwa rodzaje cholestazy: zewnątrzwątrobową i wewnątrzwątrobową. Do czynników wywołujących cholestazę zalicza się m.in.: alkoholowe i niealkoholowe stłuszczenia wątroby, infekcje, choroby dróg żółciowych, nowotwory dróg żółciowych czy choroby trzustki. Celem przeprowadzonych badań była ocena cech cholestazy i zmian w aktywności metaloproteinaz 2 i 9.Materiał i metodyMateriał badawczy stanowiło 36 szczurów samców szczepu Sprague-Dawley o masie ciała 350–420 g. Zwierzęta podzielono na 3 grupy badane i 3 grupy kontrolne, po 6 zwierząt w każdej. W grupach badanych wywołano model cholestazy zewnątrzwątrobowej. Zwierzęta z grup badanych i kontrolnych reoperowano kolejno po upływie 3, 7 i 14 dni. Aktywność wybranych metaloproteinaz określono metodą zymograficzną. Następnie ocenie mikroskopowej poddano preparaty histopatologiczne, oceniając charakterystyczne dla wątroby szczura cechy cholestazy.WynikiWszystkie grupy poddano analizie statystycznej z użyciem testu Kruskala i Wallisa dla wartości nieparametrycznych. Komputerowa analiza densytometryczna wyników zymografii uzyskanych z pobranego materiału wykazała aktywność MMP-2 i MMP-9. Znamienne statystycznie różnice oznaczono w przypadku MMP-2, stwierdzając jej podwyższoną aktywność w grupach I C, III C (*p < 0,05) w porównaniu z grupami kontrolnymi. Zaobserwowano tendencję wzrostową.WnioskiWraz z upływem czasu trwania cholestazy wzrasta aktywność MMP-2. Wyniki analizy histopatologicznej wybranych cech cholestazy wykazały, iż znamiennie wyższe oceny uzyskiwały zwierzęta w doświadczalnym modelu cholestazy.
Predicting the future trends for circular economy
Authors: Rana Daksh , Mir Nuaim Bashir , Dwivedi Aditya , Nagpal Renuka , Mehrotra Deepti 
Published: July 2023

Abstract

Considering sustainability and resource efficiency goals, the circular economy has gained significant attention as a promising economic model. To achieve this the countries worldwide are putting their attention on total municipal waste generation and its disposal methods with focus on recycling. For sustainable development of the country, policy makers need to design a new economic framework that should target reduction in the waste generation and enhancement in its reusage. Keeping in view this need the Organisation for Economic Cooperation and Development (OECD) explored twelve key factors associated with the circular economy for European countries. For better understanding Heat map analysis is done on total municipal waste generation and recycling for ten countries. The trend analysis is also performed to get insight into how countries should plan their future policy designs keeping sustainability in the limelight. The study employs an ARIMA model to predict trends in two crucial components of the circular economy: municipal waste generation and recycling rates. The predicting modelling approach will provide a targeted measures to policy makers to handle the waste efficiently.