bluuebunny/crossref_metadata_2025 huggingface dataset:
Environmental Scarcity and Natural Resource-Related Disputes in East Hararghe and West Hararghe Zones, Oromia, Ethiopia
Authors: Hussein Jeylan Wolyie , Degago Adinew Tadesse , Keno Gutema Imana
Published: November 2024

This article reports our longitudinal ethnographic study on the nexus between environmental scarcity and natural resource-related disputes in East Hararghe and West Hararghe zones of the Oromia Region, Ethiopia. The data required for the study were obtained through key informant interviews, informal conversations, ethnographic observations and field notes. We systematically organized and analysed the data in such a way that they would reveal the impacts of the long-standing interactions between environmental scarcity and human factors in laying the foundations for and shaping natural resource-related disputes in the study area. The study suggests that natural resource-related disputes in the study area are rooted in the inability to create systems of societal resilience in the face of increasing environmental scarcity. Based on the findings of the study, we underscore that the concerned government and non-government agencies need to take integrated measures to promote environmental protection, environmental justice, conflict sensitivity and socio-ecological resilience.
Communicating About Renewable Energy With Satire: The Influence of Gentle and Harsh Humor Tones on Perceived Message Credibility and Information Reliance
Authors: Freiling Isabelle , Cacciatore Michael A. , Su Leona Yi-Fan , Yeon Jiyoung , Park Sohyun , Du Weiting , Zhang Jennifer Shiyue , Yeo Sara K. , Siskind Sarah Rose
Published: November 2024

Satire is often used in science communication, but it is unclear how it influences perceptions of message credibility and reliance on the information. We examine how two satire types (gentle, harsh) influence perceived message credibility and information reliance, which we define as using the information in discussions or for attitudinal and behavioral changes. Using a partial mediation model, we found no effects of gentle satire, but harsh satire negatively influenced message credibility, which was positively linked to information reliance. Contrary to previous research, we found that the satire type matters. Practical implications include being cautious when using harsh satire.
Design Labs—The Power of With
Authors: Kennedy Oehlert Julie
Published: November 2024

Design labs are one of the most exciting multidimensional communication and disruption strategies available to health-care teams today. A design lab can be as simple as a gathering of people who use the framework of design thinking to iterate solutions and innovations to problems in their environment. Design labs support teams in exploring solutions for current health-care challenges, in a safe, creative space. They are a place where nurses can explore their own practice and iterate organizational policies and processes.
Radiation therapy in combination with immune checkpoint inhibitors in metastatic lung cancer: Effect of fractionation
Authors: Rosso Christopher , Reed Melissa , Walde Natalie , Voutsadakis Ioannis A
Published: November 2024

Immunotherapy with checkpoint inhibitors has improved the outcomes of patients with metastatic lung cancer in recent years. Despite improved prognosis, not all patients respond to treatment. Therapeutic interventions to build on the success of immune checkpoint inhibitors are needed. A retrospective review of patient records for patients who had received immune checkpoint inhibitors in a single cancer center over 4 years was undertaken. Demographic and disease characteristics of patients with metastatic non-small cell lung cancer were recorded. Data on other treatments including chemotherapy and radiation therapy were extracted, and survival outcomes were calculated. Most (81.8%) of the 77 metastatic lung cancer patients examined had received palliative radiation therapy within 3 months of starting immune checkpoint inhibitors. While the survival outcomes of these patients did not differ from patients who had not received radiotherapy, patients who had undergone hypofractionated radiotherapy (defined as one or more fractions of 700 cGy or higher) displayed a better overall survival (OS) than the rest of the cohort. Palliative radiation therapy administered in proximity with immune checkpoint inhibitors immunotherapy had no effect on the OS of metastatic lung cancer patients. However, patients receiving palliative radiotherapy with fractions above 700 cGy showed better OS. Further studies are needed to optimize a combination strategy.
Deadnamed and Denied Justice: The Role of Deadnaming and Other Factors in Transgender Homicide Clearance
Authors: Lantz Brendan , Mills Jack M. , Faulkner Lexi , Wenger Marin R.
Published: November 2024

Fatal violence against transgender people is a critical issue in contemporary America. There is also significant reason to believe that many transgender homicides are left unsolved. There has, however, been no systematic analysis of these patterns. This study uses data from a newly-collected, comprehensive database of transgender homicides occurring between 2010 and 2021 to conduct logistic regression analyses predicting the likelihood of clearance by arrest, accounting for the presence of deadnaming and various victim sociodemographic characteristics. Taken together, our research identifies two clear findings regarding the clearance of transgender homicide. First, we observe clear differences in the frequency of deadnaming by the police according to victim characteristics, such that incidents involving Black victims and victims with a history of involvement in sex work are more likely to involve deadnaming. Second, we find that homicide incidents in which transgender victims are deadnamed by the police are significantly and substantially less likely to be cleared by arrest, relative to transgender homicides. These findings suggest the critical importance of eliminating instances of deadnaming among police investigations of transgender homicides, not only for moral reasons, but also as a clear barrier to police efficacy in solving murder cases.
Delayed Lactogenesis II in High-Risk Pregnancies: What Should We Care
Authors: Liu Qianqian , Lin Hanxiang
Published: November 2024

Background: The timely initiation of lactogenesis II is crucial for postpartum women, with delays having significant clinical implications. This study aimed to evaluate the determinants of delayed lactogenesis II (DOL II) in high-risk pregnant women to guide clinical interventions and postnatal care protocols. Methods: We conducted a study involving high-risk pregnant women who gave birth and were admitted to our hospital’'s obstetric intensive care unit for postpartum surveillance and treatment from February 1, 2023, to April 30, 2024. We utilized Pearson correlation analysis and logistic regression to determine factors linked to DOL II. Results: Our study included 206 high-risk pregnant women, with 85 (41.26%) experiencing DOL II. Pearson correlation analysis indicated strong associations between DOL II and maternal age (r = 0.452), gestational hypertension (r = 0.514), gestational diabetes (r = 0.487), and delayed colostrum secretion (r = 0.506), all statistically significant ( p < 0.05). Logistic regression analysis identified age 35 years or older (OR = 2.115, 95%CI: 1.785–2.466), gestational hypertension (OR = 2.404, 95%CI: 2.125–3.107), gestational diabetes (OR = 2.556, 95%CI: 2.008–2.879), and colostrum secretion later than one hour postpartum (OR = 3.126, 95%CI: 2.682–3.605) as independent risk factors for DOL II, all with p < 0.05. Conclusions: The incidence of DOL II is significantly elevated in high-risk pregnant women, especially those aged 35 or older, those with gestational diabetes and hypertension, and those who delay the initiation of breastfeeding. It is imperative that clinical practices prioritize enhanced prenatal care and health education, robust lactation support, and improved lactation awareness among postpartum women to reduce the prevalence of DOL II.
Determinants of Handwashing at Critical Times Among Mothers/Caregivers of Children Under-Five Years Old: Panel Data Evidence From Rural Afghanistan
Authors: Murendo Conrad , Mottershead Richard , Kimani Edwin , Chandan Kumar
Published: November 2024

Background:

Very few studies have used panel data regression models to estimate the determinants of handwashing with water and soap at critical times in a developing country.

Objective:

To analyse the predictors of handwashing with water and soap at critical times among mother/caregivers of children under-5 years in rural Afghanistan.

Method:

This study used data from 1208 mothers/caregivers of children under-5 years who were selected and interviewed at baseline and endline in 7 provinces using systematic probability proportional-to-size sampling method.

Results:

Mother/caregivers with access to handwashing facility with water and soap had 1.20 higher odds of washing hands at 5 critical times. Treatment at public facility, an indirect proxy of health education and having children under 2 years was associated with 1.07 and 1.05 higher odds of washing hands at 5 critical times. Access to handwashing with water and soap, treatment at public facility and children under 2 years were significant and robust to alternative specification of handwashing at least 3 times. Mothers/caregivers who reported contracting infectious diseases in the past 6 months had 1.04- and 1.52-times higher odds of handwashing at 5 critical times and at least 3 times respectively.

Conclusion:

Access to handwashing facility with water and soap, health education, children under 2 years and occurrence of infectious diseases were the predictors of appropriate handwashing behaviour. Therefore, there is need to improve the availability of handwashing facilities with clean water and soap to promote appropriate handwashing behaviour at critical times. In addition, there is need to promote activities that increase disposable income for households to purchase soap and handwashing facilities. There is need to promote healthcare seeking behaviour for mothers to access medical treatment and health hygiene education at public facilities vital for prevention of infectious diseases.
Disability barriers autistic girls face in secondary education: A systematic review
Authors: Urbaniak Kathryn , D’Amico Miranda
Published: November 2024

Autistic adolescent girls face complex and diverse challenges in the school setting, specifically mental health issues, unmet social and education needs, and social exclusion. This review provides an overview of research relating to the barriers autistic females face in school settings by reporting on their experiences as well as those of autistic women reflecting on their past. This literature review presents peer-reviewed journal articles published from January 2013 to March 2023. Based on the 17 identified articles, the barriers girls face in the compulsory education setting centred on 4 themes of societal barriers grounded in gender; the institutional or physical barriers of schools; social and communicative expectations; and stigmatization. These results underscore the need for future research to centre diverse autistic lived experiences and knowledge, and autistic inclusion at all levels of participation, from self-advocacy and peer support spaces to the co-development of training and policy.

Lay abstract

Autistic adolescent girls face complex and diverse challenges in the school setting, specifically mental health issues, unmet social and education needs, and social exclusion. The purpose of this review was to provide a general idea of research relating to the experiences of autistic females in secondary school settings by reporting on their experiences and the lived experiences of autistic women reflecting on their past. Based on the identified articles, the barriers girls face in the compulsory education setting centred on four themes of societal barriers grounded in gender; the institutional or physical barriers of schools; social and communicative expectations; and stigmatization. The study highlighted that there is a need to sensitize and educate widely on the topic of autism for teachers, to support staff, school psychologists and peers of autistic youth. The results call attention to the need for future research to focus on the different lived experiences and knowledge of autistic girls.
Trans experiences of epistemic recognition against the backdrop of the Finnish trans act reform
Authors: Heimonen Mona , Pantti Mervi
Published: November 2024

Gender recognition law reforms, proposing greater trans equality and agency, are pivotal moments of hope for gender minorities, but they can also result in harmful public debates. Pairing the theories of recognition and epistemic injustice, we examine trans experiences of epistemic recognition in relation to the Finnish Trans Act reform debate. Through thematic analysis of 31 semi-structured interviews with trans and non-binary individuals, we show that the denial of epistemic recognition and respect in the context of – sometimes demeaning or hostile – public debate can harm trans individuals’ social trust. This can erode their sense of safety and trust in daily social encounters but also amplify distrust towards epistemic institutions they perceive to deny their epistemic recognition. While increased media interest can provide opportunities for epistemic empowerment, trans individuals might, due to the loss of social trust, disengage with mainstream media and refrain from participating in public discourse concerning their own rights.
Response reconstruction based on measurement matrix optimization in compressed sensing for structural health monitoring
Authors: Zhang Xiao Hua , Xiao Xing Yong , Yang Ze Peng , Fang Sheng En
Published: November 2024

Structural health monitoring (SHM) data have a large volume, increasing the cost of data storage and transmission and the difficulties of structural parameter identification. The compressed sensing (CS) theory provides a signal acquisition and analysis strategy. Signal reconstruction using limited measurements and CS has attracted significant interest. However, the dynamic responses obtained from civil engineering structures contain noise, resulting in sparse samples and reducing the signal reconstruction accuracy. Therefore, we propose an optimization algorithm for the measurement matrix integrating the Karhunen-Loeve transform (KLT) and approximate QR decomposition (KLT-QR) to improve the accuracy of dynamic response reconstruction of SHM data. The KLT reduces the correlation between the measurement matrix and the sparse basis. The approximate QR decomposition is used to improve the independence between the column vectors of the measurement matrix, optimizing the measurement matrix. The experimental results for a laboratory steel beam indicate that the proposed KLT-QR algorithm outperforms three other algorithms regarding the accuracy of dynamic response reconstruction (acceleration, displacement, and strain), especially at high compression ratios. The acceleration responses from the Ji’an Bridge are utilized to verify the advantages of the proposed algorithm. The results demonstrate that the KLT-QR algorithm has the highest accuracy of reconstructing the vibration signals and yields better Fourier spectra than the conventional Gaussian measurement matrix.
Dynamic characteristics and transmission efficiency of energy-harvesting shock absorber with low speed and heavy duty capacity
Authors: Zhou Zhuxin , Xu Yang , Xie Guosheng
Published: November 2024

Traditional hydraulic shock absorbers commonly encounter challenges such as cavitation, oil leakage, and the management of energy dissipation. The proposed regenerative shock absorber, which utilizes a ball screw mechanism, offers advantages such as high efficiency and heavy load capacity. This paper focuses on the design, modeling, and testing of a mechatronic shock absorber. Virtual prototype simulation techniques are employed to investigate the dynamic behaviors of the shock absorber. The paper presents a systematic efficiency model of a shock absorber, which is based on the ball screw and gearbox mechanisms. The study comprehensively analyzes the effects of rotation speed, axial load, and structure parameters on transmission efficiency. The results demonstrate that a peak power of 38 W can be achieved with a damping force of only 340 N, and the recovery efficiency can reach up to 28%. The experimental test results validate the effectiveness and reliability of the proposed dynamic and efficiency models. The originality of this study lies in the development of a novel energy-harvesting shock absorber with a ball screw mechanism in series with a gearbox, which shows excellent energy recovery potential and transmission efficiency under low speed and high duty conditions.
The power and potential of space and place in family group conferencing: Reimagining the role of the venue in child protection practice
Authors: Bernheim Bekkah , Fisher Tim , Marquez Lucia , Stabler Lorna
Published: November 2024

Family Group Conferencing is a family-led decision-making process used in children’s social care in the UK. Unlike traditional meetings between families and professionals when there is a safeguarding concern, Family Group Conferences are often held outside children’s services’ premises in a ‘neutral’ venue. In this article, we critique the idea that a meeting location can be neutral as spaces may be experienced differently, and hold multiple meanings, for the family, their network and professionals who take part. Starting from the premise that relationships with and in space have the potential to disrupt power imbalances and affect families’ and professionals’ experiences, we propose the meeting location for the Family Group Conference is instead viewed as a core component of the intervention. This bespoke approach begins with the question, how could the meeting venue improve the experiences of Family Group Conferencing for families and professionals? To answer this question, we use two fictional vignettes written from the perspectives of a young woman and her social worker. The vignettes were created based on the combined practice and research experience of the co-authors and are used in the article as a tool to theorise the possible benefits and limitations of considering the meeting venue as an intervention component. By reimagining how meeting somewhere meaningful to the family could influence families’ and professionals’ experiences of Family Group Conferencing this paper contributes to social work research and practice in the UK and beyond.
Who's Down With UDP?—Not Epilepsy; Purinergic Microglial Ca2+ Signaling Mediates Epileptogenesis
Authors: Buchanan Gordon F.
Published: November 2024

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Electrocortical Profiles in Relation to Childhood Adversity and Depression Severity: A Preliminary Report
Authors: Jaworska Natalia , de la Salle Sara , Schryver Bronwen , Birmingham Meagan , Phillips Jennifer L , Blier Pierre , Knott Verner
Published: November 2024

Objective: Assessment of electroencephalographic (EEG) activity in depression has provided insights into neural profiles of the illness. However, there is limited understanding on how symptom severity and risk factors, such as childhood adversity, influence EEG features. Methods: Eyes-closed EEG was acquired in N = 28 depressed individuals being treated in a tertiary psychiatric setting. Absolute alpha, beta, theta, and delta power and inter-/intra-hemispheric coherence were examined. Relations between the Montgomery-Åsberg Depression Scale (MADRS) and Adverse Childhood Experience (ACE) Questionnaire and EEG features were assessed. Results: Individuals in the high (MADRS≥30) versus lower (MADRS ≤ 29) symptom severity group exhibited greater overall beta power, and lower Fp1-Fp2 delta and theta coherence. Those with high (≥3) versus lower (≤2) ACE scores exhibited greater T7-T8 beta coherence. Lowest F3-F4 beta coherence was observed in those with high ACE/high depression severity. A negative correlation existed between F8-P8 alpha coherence and symptom severity. Conclusions: Those with higher depression severity exhibit increased beta power, possibly reflecting a hyper-vigilant state. Depression severity and ACE history may produce subtle alterations in frontal delta/theta and temporal/frontal beta coherence regions. Significance: This is the first study to examine the neural impact of depression severity and ACE-assessed childhood trauma in depressed individuals receiving treatment in a tertiary setting, accounting for the clinical reality of the prevalence of their co-occurrence.
Why Bystanders Report Intimate Partner Violence Anonymously: A Qualitative Analysis of Real-Life Cases
Authors: van Baak Carlijn
Published: November 2024

Although bystanders can play an important role in combating intimate partner violence (IPV), they also experience unique barriers and challenges that may prevent them from involvement. While anonymous reporting could potentially address some of these barriers, this form of intervention has rarely been studied. Using a thematic analysis of case files ( N = 34 reports), this study investigates bystanders’ reasons to report suspicions of IPV anonymously to a domestic violence hotline. Results indicate that anonymity allowed bystanders to balance the desire to protect the victim(s) from harm with the fear of potential consequences for themselves and/or their relationship with the victim(s).
Leader-follower formation control of nonholonomic mobile robots subject to robots failure
Authors: Abdul-razaq Yusuf , Marquez Horacio J
Published: November 2024

Over the years, control of autonomous vehicles in a defined formation has been the subject of much research. Albeit leader-follower approach being one of the most used in formation control, it suffers a major practical drawback of leader failure while cruising in formation. In this work, we aim to solve this problem by proposing a novel assignment algorithm that assigns a new leader from the follower robots to ensure robots complete their given task when their leader fails. This algorithm also assign role to new robots joining the group, as well as the failed robot when rescued back to the team. We drive robots towards their desired trajectories to achieve formation using a Lyapunov-based time-varying state tracking controller from the literature. Due to role switching amongst member robots, we propose a new variant of the limit-cycle obstacle avoidance algorithm to ensure smooth and collision free transition. Simulations and experiments are performed using the robot operating system framework due to its flexibility to verify the effectiveness and reliability of the proposed algorithms.
Exploring the sophistications of unexplained recurrent pregnancy loss: A case-control study
Authors: Que Trinh Thi , The Nguyen Van , Trang Vu Thi Thu , Truong Le Van , Van Ta Thanh , Phuong Doan Thi Kim
Published: November 2024

Background:

Unexplained recurrent pregnancy loss (URPL) is a significant obstetric challenge affecting maternal health and well-being. Genetic factors, including mutations in the methylenetetrahydrofolate reductase (MTHFR) gene and elevated homocysteine levels, are increasingly recognized as contributors to URPL, though their precise roles remain complex. This study aimed to comprehensively explore these factors.

Objectives:

This study examines the links between MTHFR gene polymorphisms (C677T and A1298C), plasma homocysteine levels, and URPL. It also aims to create a predictive model for URPL based on these factors.

Design:

A case-control study with Vietnamese women who had at least one pregnancy between January 2017 and June 2020, recruited from Medlatec Hospital and Hanoi Medical University. Participants included URPL cases ( n = 128) and controls ( n = 126).

Methods:

Participants were selected based on specific criteria. Main analyses identified the optimal multivariable logistic regression model for predicting URPL using Bayesian Model Averaging, with the optimal model chosen based on the highest Area Under the Curve (AUC) and posterior probability. A nomogram for clinical risk prediction was developed based on parameters from the optimal model.

Results:

URPL cases exhibited significantly higher plasma homocysteine levels (11.73 ± 6.08 µmol/L) compared to controls (7.64 ± 1.78 µmol/L), correlating with increased URPL risk (OR: 1.64, 95% confidence interval (CI): 1.41–1.96; p < 0.001). The MTHFR C677T variant showed strong associations with URPL, particularly the CT genotype (OR: 6.07, 95% CI: 3.00–12.93; p < 0.001) and TT genotype (OR: 14.62, 95% CI: 2.85–114.77; p = 0.003). Similarly, the A1298C variant demonstrated elevated URPL risk with the AC genotype (OR: 2.73, 95% CI: 1.34–5.78; p = 0.007) and CC genotype (OR: 12.43, 95% CI: 3.17–64.22; p = 0.001).

Conclusion:

This study provides insights into the complex interplay of MTHFR gene mutations, elevated homocysteine levels, and URPL. Genetic testing and biomarker assessment may play a crucial role in customizing risk assessment and management strategies for women at risk of URPL.
Individual control of input rate improves recall of spoken discourse by adult users of cochlear implants: An exploratory study
Authors: O’Leary Ryan M , Capach Nicole Hope , Hansen Thomas A , Kinney Alex J , Payne Taylor A , Wingfield Arthur , Svirsky Mario A
Published: November 2024

Although cochlear implants (CI) successfully replace the sense of hearing, they do not restore natural hearing. Still, CI users adapt to this novel signal, reaching meaningful levels of speech recognition in clinical tests that focus on repetition of words and short sentences. However, many patients who score above average in clinical speech perception tests complain that everyday speech interactions are both difficult and cognitively draining. In part, this difficulty may be due to the naturally rapid pace of everyday discourse. We report a study in which 12 CI users aged 23 to 77, recalled multi-sentence discourse presented without interruption, or in the condition of interest, when passages were paused at major linguistic boundaries, with participants given control of when to initiate the next segment. Comprehension of the discourse structure was based on a formalised representational system that organises discourse elements hierarchically to index the relative importance of different elements to the overall understanding of the discourse. Results showed (a) better recall when CI users were allowed to control the discourse pace; (b) an overall effect of aging, with older CI users recalling discourse less accurately; (c) better recall for passages with higher average inter-word predictability; (d) a “semantic hierarchy effect” reflected by better recall of main ideas versus minor details; (e) an attenuation of the semantic hierarchy effect for low predictability passages. Results underscore the benefits of extra processing time in addressing CI listening challenges and highlight the limited ecological validity of single-word or single-sentence speech recognition tests.
Do motor representations influence declarative memory for graspable objects? A test with action priming and short-term hand nonuse
Authors: Villatte Jérémy , Taconnat Laurence , Kalénine Solène , Wamain Yannick , Toussaint Lucette
Published: November 2024

This study addressed the role of motor representations in declarative memory (i.e., semantic and episodic). Based on embodied and grounded theories of cognition, it is often suggested that motor representations contribute to declarative memory. According to the action priming effect, graspable objects are categorised faster when primed by pictures of a congruent hand grip, as motor representations (how to grasp it) and semantic information (what it is) are closely related. Moreover, motor representations may contribute to episodic memory functioning. We immobilised participants’ dominant hand for 24 hr to impair their processing of hand-related motor representations. This method is known to elicit rapid updating of cortical hand representations, and a slowdown in cognitive tasks linked to hand-related motor cognition. We expected to observe a decreased action priming effect following short-term hand nonuse. We further predicted that in a subsequent recognition task, objects that had been encoded following congruent action priming would be recognised faster by controls, but not by previously immobilised participants. Results did not show any effect of hand nonuse on action priming, suggesting that motor representations are not a decisive factor for this effect. Nonetheless, prime congruence influenced subsequent recognition. Immobilised participants were slower to recognise objects previously seen with an unrelated hand grip prime compared with a congruent one. This result suggests a contribution of motor representation to declarative memory, in particular when the sensorimotor system has previously been impaired.
ECG-based machine learning model for AF identification in patients with first ischemic stroke
Authors: Yu Chih-Chieh , Peng Yu-Qi , Lin Chen , Chiang Chia-Hsin , Liu Chih-Min , Lin Yenn-Jiang , Lin Lian-Yu , Lo Men-Tzung
Published: November 2024

Background:

The recurrence rate of strokes associated with atrial fibrillation (AF) can be substantially reduced through the administration of oral anticoagulants. However, previous studies have not demonstrated a clear benefit from the universal application of oral anticoagulants in patients with embolic stroke of undetermined source. Timely detection of AF remains a challenge in patients with stroke.

Aim:

This study aims to develop a convolutional neural network (CNN) model to accurately identify patients with AF using a 12-lead sinus-rhythm electrocardiogram (ECG) recorded around the time of the first ischemic stroke. In addition, this study also evaluates the model’s ability to predict future occurrence of AF.

Methods:

A CNN model was trained with ECG data from patients at Taipei Veterans General Hospital. External validation was performed on ischemic stroke patients from National Taiwan University Hospital. The model’s performance was assessed for detecting AF at the stroke event and predicting future AF occurrences.

Results:

The model demonstrated an area under curve (AUC) of 0.91 for internal validation and 0.69 for external validation in identifying AF at the stroke event, with sensitivity and negative predictive value both achieving 97%. Kaplan–Meier survival analysis of patients without a prior diagnosis of AF revealed a significant increase in future AF incidence among the high-risk group identified by the model (adjusted hazard ratio: 4.06; 95% confidence interval: 2.74-6.00).

Conclusions:

The CNN model effectively identifies AF in stroke patients using 12-lead ECGs and predicts future AF events, facilitating early anticoagulation therapy and potentially reducing recurrent stroke risk. Further prospective studies are warranted to confirm these findings.
Understanding the underlying causes of degenerative neural diseases
Authors: Shields Bo , Silverdale Monty , Prokop Andreas
Published: November 2024

Degenerative neural diseases (DNDs), such as dementia, Parkinson’s disease, motor neuron disease and multiple sclerosis, are becoming more prevalent in our ageing society. Here we explain why different DND classes display characteristic disease-specific symptoms, but also why they often share common features triggered by a wide range of very different causes. Explanations are drawn from the complex biology of nerve fibres, which are the cable-like processes of nerve cells that tend to be prime lesion sites in DNDs. We hope that our explanations will help GPs to improve their understanding of DNDs, which might then facilitate conversations with affected patients about their condition and also lower the threshold to engage in further reading on the topic.
Timing of endoscopy in cirrhotic patients with acute variceal bleeding: protocol of a multicenter randomized controlled trial
Authors: Qi Xingshun , Li Yiling , Li Bimin , Luo Xuefeng , Liu Xiaofeng , Zhang Chunqing , Chen Mingkai , Kong Derun , Wu Yunhai , Romeiro Fernando Gomes , Basaranoglu Metin , Zhang Jianzhong , Li Qianqian , Wang Ran , Shao Xiaodong , Guan Lin , Wang Ningning , You Yu , He Mingyan , Wang Xiaoze , Huang Ju , Wu Wenming , Li Qun , Zhang Mingyan , Wang Guangchuan , Zhang Chi , Cheng Du , Zhang Qianqian , Mei Xuechan , Sun Na , Ban Yuan , Marcondes Mariana Barros , Yamashiro Fabio da Silva , Mutlu Emine , Zheng Zheng , Peng Mengyuan , Xu Wentao , Li Zhe , Chai Lu , Linghu Enqiang
Published: November 2024

Background:

Endoscopy is important for the diagnosis and treatment of acute upper gastrointestinal bleeding (AUGIB), especially acute variceal bleeding (AVB), in liver cirrhosis. However, the optimal timing of endoscopy remains controversial, primarily because the currently available evidence is of poor quality, and the definition of early endoscopy is also very heterogeneous among studies. Herein, a multicenter randomized controlled trial (RCT) is performed to explore the impact of the timing of endoscopy on the outcomes of cirrhotic patients with AVB.

Methods:

A total of 368 cirrhotic patients presenting with AUGIB who are highly suspected to be from AVB will be enrolled. They will be stratified according to the severity of liver function and clinical presentation at admission and then randomly assigned at a 1:1 ratio into early (within 12 h after admission) and delayed (within 12–24 h after admission) endoscopy groups within each stratum. The primary outcomes include the rates of 5-day failure to control bleeding after admission and 6-week rebleeding. The secondary outcomes include 6-week mortality and incidence of adverse events.

Conclusion:

Considering existing evidence originates from non-randomized studies, this RCT will provide high-quality evidence to uncover whether cirrhotic patients with AVB should undergo early endoscopy to control bleeding and improve survival.

Trial registration:

ClinicalTrials.gov identifier: NCT06031402.
Appropriateness of small molecule agents for patients with IBD of childbearing age – a RAND/UCLA appropriateness panel
Authors: Selinger Christian , Laube Robyn , Limdi Jimmy K. , Headley Kate , Kent Alexandra , Kok Klaartje , Fraser Aileen , Newman Victoria , Ludlow Helen , Rees Fiona , Sagar Nidhi , Walker Erin
Published: November 2024

Background:

Many women of childbearing age with inflammatory bowel disease (IBD) require advanced therapies. While biologics are largely low risk during pregnancy, the novel small molecules tofacitinib, filgotinib, upadacitinib and ozanimod (TFUO) have shown concerning teratogenic effects, and decreased fertility in animal studies. Therefore, their use in women of childbearing age needs careful consideration.

Design:

RAND/University of California Los Angeles (UCLA) Appropriateness Method (RAM).

Objective:

To evaluate the appropriateness of TFUO in women of childbearing age.

Methods:

We convened a panel of six gastroenterologists, two IBD nurses, one IBD pharmacist and three expert patients. Following a literature review, 13 statements were drafted and voted upon in 2 rounds.

Results:

All 13 statements were deemed appropriate. The panel concluded that women with IBD of childbearing age who wish to commence therapy with TFUO, need to use effective contraception and be counselled regarding the risk in unplanned pregnancies. For women using contraception while on Janus kinase inhibitor (JAKi) therapy, we suggest the preferred use of progesterone-only or non-hormonal long-acting contraception. TFUO are contraindicated during pregnancy and breast feeding. We recommend that women receiving TFUO cease therapy in time to establish clinical remission for at least 3 months prior to conception. Therapies other than TFUO should be considered as first-line therapy in women with IBD of childbearing age, except in select individual circumstances. TFUO may be appropriate for women of childbearing age after failure of, intolerance or contraindications to one biological agent.

Conclusion:

TFUO should be avoided during pregnancy and breastfeeding, and alternative therapies should be considered as first-line treatments.

We provide clinical practice recommendations regarding the use of TFUO for IBD in women of childbearing age.
Consumo de alcohol, tabaco y cannabis en profesionales sanitarios en España durante la fase pandémica aguda de COVID-19
Authors: Villanueva-Blasco Víctor Jose , Guillamó-Mínguez Carlos , Lozano-Polo Adelaida , Villanueva-Silvestre Verónica , Vázquez-Martínez Andrea
Published: November 2024

Introducción:

la pandemia de la COVID-19 expuso a los profesionales sanitarios a circunstancias que incrementaron su estrés, recurriendo al consumo de sustancias como estrategia de afrontamiento.

Objetivos:

conocer el patrón de consumo de alcohol, tabaco y cannabis en profesionales sanitarios españoles en el periodo prepandemia y durante la fase pandémica aguda (FPA), diferenciando en función de la profesión y estableciendo si hubo diferencias entre ambos periodos.

Métodos:

estudio descriptivo no probabilístico con muestreo por conveniencia. Participaron 630 profesionales sanitarios. Se utilizó una encuesta en línea con categorización de la profesión sanitaria, AUDIT-C para consumo de alcohol, preguntas ad hoc para tabaco, y CAST para cannabis. Se realizó análisis de frecuencia y diferencia de medias ( t de Student, Z Wilcoxon), reportando el tamaño del efecto y Phi.

Resultados:

el 57.1 % de los profesionales sanitarios mostró consumo de la riesgo de la alcohol antes de la FPA; disminuyendo al 42.4 % en la FPA. Entre los consumidores, la proporción de consumidores de riesgo previa a la FPA fue del 95 % en todas las profesiones sanitarias y superior al 65 % durante la FPA. Entre ambos periodos, únicamente hubo un descenso significativo en médicos/as (χ2 MN = 8.108; p < 0.004). Respecto al tabaco, el 14.1 % afirmó consumirlo, observándose un incremento significativo del consumo medio de cigarrillos entre ambos periodos ( t(80) = −3.994; p < 0,001), explicado por el incremento entre psicólogos/as ( t(42) = −3.245; p < 0.002). Respecto al cannabis, el 2.7 % afirmó haberlo consumido, presentando el 14.3 % adicción moderada y el 7.1 % dependencia.

Conclusiones:

durante la crisis sanitaria se produjo una reducción del consumo de alcohol, tabaco y cannabis entre profesionales sanitarios, siendo desigual por categoría profesional. Sin embargo, se detectaron incrementos del consumo y consumos de riesgo en algunos colectivos, señalándose las implicaciones para su salud y labor sanitaria. Se propone impulsar medidas de promoción de la salud mental en los centros sanitarios que incorporen estrategias de abordaje de sustancias.
Anxiety, memory, and social impairments in the YAC128 mouse model of Huntington’s disease
Authors: Marinina Ksenia S , Bezprozvanny Ilya B , Egorova Polina A
Published: November 2024

Background

Huntington’s disease (HD) is an autosomal dominant hereditary disorder, caused by an expansion of polyglutamine in the huntingtin protein. HD is characterized by a progressive decline in motor functions. This decline includes involuntary movements (chorea) and the worsening of controlled motions caused mainly by neuronal dysfunction in the striatum. In addition to the deterioration of motor symptoms, HD patients also suffer from cognitive changes, mood swings, apathy, depression, outbursts of anger, psychosis, and social withdrawal.

Objective

A comprehensive examination of cognitive, affective, and social changes in the HD mouse model is required for the development of combined therapy for both motor and non-motor deficits in HD.

Methods

The behavioral tests for anxiety, memory, and social traits were used in this study.

Results

YAC128 HD transgenic mice exhibited anxiolytic behavior in the novel brightly illuminated environment of the open field and light-dark place preference tests. Moreover, YAC128 HD mice also suffered from a decline in their recognition memory during the novel object recognition test. YAC128 HD mice demonstrated reduced exploration interest during the open field with a non-social target as well as during the first day of the three-chamber social test. Social interaction was also impaired in YAC128 HD mice as it was shown in the social interaction with resident intruder test.

Conclusions

YAC128 HD mouse model may be used as a model system to test the possible treatments for both motor and non-motor symptoms including memory loss, agitation and social withdrawal.
Forensic Pathologist Testimony, Part 2: Special Issues and Considerations
Authors: Ely Susan F. , Gill James R.
Published: November 2024

Introduction

Forensic pathologists routinely testify in courts of law as part of their occupation. As such, part of their training involves learning how to testify responsibly and competently. As experts, they are permitted to offer opinions in order to assist the triers of fact.

Results

This review examines such concepts as burden of proof by manner of death, mechanisms of death, survival intervals, and the differences between possibilities, probabilities, and reasonable degree of medical certainty. It also addresses legal concepts and issues that may arise in court, including those of pain and suffering, cognitive bias, objections, attempts at witness impeachment, and surrogate witness testimony, as well as a summary of pertinent case law.

Discussion

The special issues and considerations of the expert forensic pathologist are discussed with the aim to summarize some of the key issues that may arise in court for the forensic pathologist.
Forensic Pathologist Testimony, Part 1: Common Questions and Considerations
Authors: Gill James R. , Ely Susan F.
Published: November 2024

Introduction

Forensic pathologists are the only medical specialists who routinely testify in courts of law as part of their occupation. As such, one element of their training involves learning how to testify responsibly and competently. Individuals qualified as experts are permitted to offer opinions in order to assist the triers of fact.

Results

We review the forensic pathologist's primary role as an expert witness which is to lay out concepts clearly, methodically, and objectively, in medicine, pathophysiology, toxicology, and injury, to convey these concepts with understandable, plain language, and to explain how certain evidence, physical, medical, and historical, supports their conclusions and/or presents limitations.

Discussion

We discuss various components about testifying in court, some common expert questions posed to the forensic pathologist, and what concepts and facts they might consider when answering them. We do not offer a prescription as to how one should answer these questions specifically, but rather we provide a single resource that summarizes some of the key issues that may arise in court for the forensic pathologist.
Training Load and Injuries in Volleyball: An Approach Based on Different Methods of Calculating Acute to Chronic Workload Ratio
Authors: Timoteo Thiago Ferreira , Debien Paula Barreiros , Fonseca Diogo Simões , Felício Diogo Carvalho , Bara Filho Mauricio Gattás
Published: November 2024

Background:

Many questions persist regarding the relationship between training load and injuries in volleyball, as well as the best method for calculating acute:chronic workload ratio (ACWR). This study aimed to investigate the relationship between different metrics of training load and risk of injury in male professional volleyball players.

Hypothesis:

ACWR, as a training load measure, is useful for identifying injury risk in volleyball players, regardless of calculation method.

Study Design:

Longitudinal, prospective, and observational design conducted over 3 seasons of professional male volleyball.

Level of Evidence:

Level 3.

Methods:

The study included 43 male volleyball players. Internal training load was quantified using the Session Rating of Perceived Exertion. From daily training load values, absolute measures and relative measures were computed. For relative measures, 7 days were employed for acute training load, and 21 and 28 days for chronic training load. A distinction was made between coupled calculation and uncoupled calculation. Injuries were documented using the Injury Surveillance Form proposed by the International Volleyball Federation.

Results:

ACWR calculated in a coupled manner and by a rolling average demonstrated higher injury risks when analyzing the complete periods (odds ratio [OR] ACWR 7:28 = 2.040; ACWR 7:21 = 1.980) and competitive period (OR ACWR 7:28 = 2.044; ACWR 7:21 = 2.087). In contrast, during the preseason, the coupled exponential averages were more sensitive to the risk of injury (OR ACWR 7:28 = 4.370; ACWR 7.504).

Conclusion:

Both measures using rolling averages and those calculated from exponential averages can be employed to identify the risk of injuries in volleyball athletes.

Clinical Relevance:

The findings of this study can be useful to coaching staff, fitness trainers, and healthcare professionals involved in the challenge of reducing the risk of injury in volleyball athletes. The need for continuous monitoring and real-time adjustments of training load is emphasized.
The European Works Council and the coverage of expert costs
Authors: Majoros Thomas , Obrecht Sascha
Published: November 2024

In a recent case of the Austrian Supreme Court (OGH 29.8.2023, 8 ObA 28/23k), a European Works Council sought legal advice and wanted the costs to be covered by the central management of a group of undertakings. This request was denied on the ground that the European Works Council could also have obtained the same advice free of charge from a representative body. The Supreme Court ruled that the central management must also bear the expert costs in these cases and thus clarified that the European Works Council is not obliged to choose services that are free of charge.

Case: Austrian Supreme Court ( Oberster Gerichtshof – OGH) of 29.8.2023, 8 ObA 28/23k, ECLI:AT:OGH0002:2023:008OBA00028.23 K.0829.000.
Social media influencers and political influence operations: The Data Boys example in Nigeria
Authors: Uwalaka Temple , Amadi Fred , Enyindah Stella C
Published: November 2024

This study examines how ‘Data Boys’ covertly used social media platforms to promote, rehabilitate and sustain the image of political leaders in Nigeria. Data for this study are from an online qualitative survey of 25 social media influencers in Nigeria. Three broad themes (hyping a politician, remuneration and results) emerged from the data. Results reveal that Data Boys promote their political leaders by equivocation of identities, exaggerating the performance of their principals, falsifying corruption allegations against their principals’ competitor and concealing the transgressions of their principals. The paper conceptualises the rise of Data Boys in Nigeria’s political sphere and highlights ways through which they execute their online operations. The study argues that instead of using their networked communicative power for factual debate and respectful dialogues, that the Data Boys have been used as vehicles for covert message dissemination and other sponsored contents which could potentially go against public interest. The study concludes that the posture of Data Boys is inimical to public relations practice as their overtly negative and monolithic view of online influence cheapens the significance of social media influencer praxis and electioneering campaigns in Nigeria.