bluuebunny/crossref_metadata_2025 huggingface dataset:
The Stentless Toronto SPV Bioprosthesis for Aortic Valve Replacement
Authors: Walther T. , Autschbach R. , Falk V , Baryalei M. , Scheidt A. , Dalichau H. , Mohr F. W.
Published: September 2024

The Toronto SPV bioprosthesis for aortic valve replacement has been prospectively evaluated in 100 patients, since March 1993. Intraoperative transoesophageal and postoperative transthoracic echocardiography were used to assess valve function. Follow-up was complete in 74 patients at 6 months and in 38 patients at 1 year. The average valve size implanted was 26.5 mm. Some 37 patients had additional coronary artery bypass grafting surgery. The hospital mortality rate was 4%. Non-structural valve dysfunction occurred in one patient and late endocarditis in another patient required operation. There were no other valve complications. None of the patients developed clinically relevant aortic valve incompetence during follow-up and there was a significant decrease in pressure gradients, increase in valve orifice areas and decrease in left ventricular hypertrophy.
Ultrasonographic and Histologic Characteristics of Symptom-Free and Symptomatic Carotid Plaque
Authors: Kardoulas D. G. , Katsamouris A. N. , Gallis P. Th. , Philippides Th. Ph. , Anagnostakos N. K. , Gorgoyannis D. S. , Gourtsoyannis N. C.
Published: September 2024

The purpose of the study was to determine the reliability of ultrasonography in assessing plaque pathology and to relate it to clinical symptoms. Ten symptom-free patients and 26 with symptomatic carotid plaques with a stenosis >70%. as detected by arteriography, were assessed by duplex. The findings were compared with the clinical presentation and plaque pathology. Pathological specimens of the plaque that had <60% fibrous tissue were associated with an increased incidence of past stroke ( P = 0.002). Plaque ulceration, haemorrhage and calcium were all unrelated to the clinical presentation. Using the pathological specimen as the ‘gold standard’, ultrasonography was unable to detect plaque ulceration or haemorrhage. Plaque regularity, irregularity, homogeneity and heterogeneity were not consistent with plaque pathology or the clinical presentation. The fibrous tissue was significantly greater (73%) in plaques with an echogenic character compared with those with an echolucent morphology (63%; P = 0.04). Moreover, echolucent plaques were most common in symptomatic patients and echogenic plaques in symptom-free patients ( P = 0.002).
Duodenal Obstruction following Elective Abdominal Aortic Aneurysm Repair
Authors: Campagnol M. , Di Giacomo M. , Cruciani R. , Cavallaro A.
Published: September 2024

A case where duodenal obstruction complicated elective repair of abdominal aortic aneurysm is reported. A review of the literature shows that the incidence of this rare complication has probably been underestimated. Patients should be treated expectantly, regardless of the pathogenesis of the obstruction.
Non-Invasive Evaluation of Right Gastroepiploic Artery with Colour Doppler Echography
Authors: Agrifoglio M. , Di Matteo S. , Parolari A. , Naliato M. , Antona C. , Alamanni F. , Biglioli P.
Published: September 2024

The right gastroepiploic artery has been increasingly used as a coronary bypass graft. Short- and mid-term patency rates support the supposition that the right gastroepiploic artery is a satisfactory bypass conduit. However, conclusive angiographic data on long-term patency rates are still lacking An echo-colour Doppler method was used to detect patency of the right gastroepiploic artery grafts through an upper abdominal approach. A group of 24 patients with a right gastroepiploic artery graft to the right or posterior descending coronary artery, all of whom also had a postoperative angiographic study which showed 100% patency of the graft were used as a reference group.

A second group of 89 patients was also investigated only with echo-colour Doppler during the postoperative period (mean 8.0 (range 1–48) months). A patent right gastroepiploic artery graft showed a biphasic velocity pattern. Systolic peak velocity ranged from 8 to 26 cm and diastolic peak velocity from 4 to 13 cm. The right gastroepiploic artery diameter ranged from 1.7 to 2.4 mm and flow from 10.2 to 58.8 ml. Among the second group were three patients who had, at their echo-colour Doppler examination, a possible occlusion of the right gastroepiploic artery graft; an angiographic study was conducted and the graft closure confirmed in all cases Serial echo-colour Doppler evaluation of the right gastroepiploic artery blood flow pattern and diameter is a non-invasive and safe method to check the patency and flow capacity of the artery graft in follow-up studies.
A Case of Neonatal Ductus Arteriosus Aneurysm
Authors: d'Udekem Y. , Rubay J. E. , Sluysmans T.
Published: September 2024

A case of successfully operated neonatal ductus arteriosus aneurysm is described. Cardiac catheterization was performed to confirm the diagnosis because of a misinterpretation of the anatomy on transthoracic echocardiography. Rupture, embolism and infection are described complications of such aneurysms. Surgery should therefore be recommended without delay.
Assessing Arterial Inflow before Infra-Inguinal Bypass Grafting: A Survey of the Members of the Vascular Surgical Society of Great Britain and Ireland
Authors: Whiteley M. S. , Galland R. B.
Published: September 2024

The optimal assessment of arterial inflow is controversial. We investigated current preferences of inflow assessment prior to infra-inguinal bypass grafting. A questionnaire was sent to 364 members of the Vascular Surgical Society of Great Britain and Ireland asking about inflow assessment in different clinical situations, access to resources, size of hospital and number of grafts performed each year. Questionnaires analysed = 169. Angiography was used by 89.5%, most single view. Two views angiography was used more often by surgeons performing more than 20 femoro-distal grafts each year (79.3 versus 37.6%). Routine use of iliac duplex was < 20%: poor femoral pulse increased this to near 30%. About 90% of respondents had access to colour flow duplex. Most respondents use single-plane angiography to assess inflow before infra-inguinal grafting. Two views and functional tests are used more commonly by surgeons working in larger or teaching hospitals and those performing more grafts.
Health-Related Quality of Life and Functional Outcome following Arterial Reconstruction for Limb Salvage
Authors: Seabrook G. R. , Cambria R. A. , Freischlag J. A. , Towne J. B.
Published: September 2024

Vascular surgery outcomes have traditionally been measured by limb salvage and graft patency. However, as health care resources are rationed, the patient's functional outcome and quality of life will require assessment. The in situ saphenous vein graft has proven successful in achieving long-term limb salvage for patients with critical ischemia, with the expectation of preserving a life-style and sense of well-being that would be lost with limb amputation. This study was conducted to measure functional capacity and quality of life in these patients. Seventy patients with successful in situ saphenous vein bypass grafts constructed for limb-threatening ischemia, followed for a mean of 45.6 months in a surveillance program with normal graft flow characteristics, were compared with a group of age and gender-matched controls with normal limb pressures and no history of vascular occlusive disease. A questionnaire was designed from standardized health status scales and administered to the two groups to assess symptoms, health perceptions, physical functioning and life quality. When comparing the groups of revascularized and control patients, symptoms and perceptions about their health were similar. However, the revascularized patients had significantly decreased functional capacity in their ability to walk various distances ( P ≤ 0.005), perform household tasks ( P ≤ 0.001) and bathe ( P ≤ 0.001). The patient group with vascular grafts functioned as well as the controls only in activities of dressing and using the toilet. Indicators of life quality that rate independence and mobility, including the ability to procure groceries ( P ≤ 0.001), prepare meals ( P ≤ 0.005) participate in social activities ( P ≤ 0.001) and drive an automobile ( P ≤ 0.01). were also significantly limited in the patients with successful vascular reconstructions. Although achieving long-term limb salvage and graft patency, the patients in this group of successful vascular reconstructions retain functional disabilities that require significant care. Despite these physical handicaps, these patients have a remarkably similar sense of well-being and lack of somatic complaints compared with the control group. This medical outcome study identifies the functional capacity and lifetime needs for vascular surgery patients that will provide useful data for those responsible for allocating health care resources.
The Effects of Methylprednisolone on Complement, Immunoglobulins and Pulmonary Neutrophil Sequestration during Cardiopulmonary Bypass
Authors: Dernek Sadettin , Tünerir Bülent , Sevin Behçet , Aslan Recep , Uyguç Özer , Kural Tuğrul
Published: September 2024

In this study, the authors administered high dose (30 mg/kg body weight i.v.) methylprednisolone before cardiopulmonary bypass to observe the effects on complement, immunoglobulins and pulmonary neutrophil sequestration. Fifty patients undergoing valve replacements were included in this study. Patients were divided into two groups: group I (20 patients) served as control and did not receive methylprednisolone, group II (30 patients) received methylprednisolone. Blood samples for complements (C3c and C4) were taken, before cardiopulmonary bypass, at 5, 10 and 30 min intervals from the end of cardiopulmonary bypass, after reversal of heparin with protamine infusion, and after skin closure. Blood samples for immunoglobulins were taken before cardiopulmonary bypass. 30 min after onset of cardiopulmonary bypass and after skin closure. After onset of cardiopulmonary bypass, all C3c and C4 levels decreased in both groups. There was a significant decrease in C4 levels at end of cardiopulmonary bypass and after protamine infusion in group I compared with group II ( P < 0.05). C3c levels in group I decreased significantly compared with group II after 30 min of cardiopulmonary bypass and after protamine infusion ( P < 0.05). All immunoglobulin (IgG, IgM, IgA) levels were decreased in both groups, but the decrease in IgG was statistically significant after skin closure in group 1 compared with group II ( P < 0.05). Pulmonary neutrophil sequestration was higher in the control group compared with the methyl-prednisolone group ( P < 0.05). In conclusion, methylprednisolone administration before cardiopulmonary bypass may prevent the harmful effects of complement activation, immunoglobulin denaturation and neutrophil sequestration in the pulmonary capillary system.
Cardiac Assessment with Thallium Scanning Prior to Aortic Aneurysm Repair
Authors: Quigley F. G. , Clark D. , Avramovic J.
Published: September 2024

Coronary artery disease occurs commonly in patients with aortic aneurysms and is a major cause of morbidity and mortality. The role of screening and intervention for cardiac disease prior to aneurysm repair is controversial. The outcome after cardiac screening with thallium scanning and/or angiography in 102 consecutive patients undergoing aortic aneurysm repair was documented. Significant coronary artery disease was found in 34 (33%) patients and two patients had either coronary artery bypass or angioplasty prior to aneurysm repair. There was no cardiac mortality after aneurysm repair and the overall mortality on an intention-to-treat basis was 2%. There was good correlation between prior history of cardiac events, electrocardiography (ECG) and the results of screening with thallium scanning and angiography. There was no correlation between cardiac history. ECG and the incidence of cardiac events in the postoperative period. Significant coronary artery disease was found in 33% of patients without a cardiac history or abnormal ECG. Cardiac screening with thallium scanning confirmed a high incidence of significant coronary disease in patients with aortic aneurysm. In this study, cardiac intervention followed by expedient aneurysm repair in 20 patients was associated with zero mortality. The short-term benefit of such a policy is difficult to prove and its main advantage may be better long-term survival.
Vection and Performance During Attention-Demanding Tasks in Virtual Reality
Authors: Kio Onoise G. , Allison Robert S.
Published: September 2024

We investigated how attention-demanding aural and visual discrimination tasks attenuate visually-induced self-motion (vection) and how task accuracy and response time are affected by experiencing various levels of vection-inducing motion in a virtual environment. Seventeen seated observers were presented simulated motion at various virtual camera speeds from stationary to 15 m/s in a straight virtual corridor through a Vive Pro Virtual Reality headset as they performed aural, visual discrimination tasks, or no task at all. Observers generally perceived less vection at all motion levels when they performed visual discrimination tasks compared to when they had no task. Increased vection was associated with reduced accuracy on the visual task and increased response time to the aural task. These results suggest that the amount of vection perceived in virtual reality simulators can be attenuated when users perform attention-demanding tasks related to visual processing, and, conversely, vection-producing motion can affect performance in attention-demanding tasks.
My Theory, my Tool, my Tribe: Unpacking Scholars’ Perspectives on the Evolution of Transformative Learning
Authors: Fedeli Monica , Olatunji Taiwo Isaac
Published: September 2024

Tracking the evolution of transformative learning theory (TLT) has primarily been conducted through literature review while overlooking potential insights from empirical meta-studies. We examined evolving perspectives on TLT through a meta-analysis of scholars’ engagements within the field. We incorporated narrative interviews with twelve scholars, using thematic analysis to draw insights from their experiences and contributions. Employing the Community of Practice (CoP) framework, we explored the collective shaping of TLT by its academic community, exploring themes such as critical and appreciative views on Mezirow and TLT foundational concepts, the theory’s application in research and teaching, its theoretical connections, its geographical expansion, publication contributions, and community building. The findings highlighted the dynamic and socially constructed nature of transformative learning field and its adaptability to diverse contexts and contemporary challenges. The study underscored the importance of collaboration and community building among scholars, which not only sustains the theory but also propels its evolution, ensuring its continued relevance. Moving forward, we advocated for continued innovation in theory and practice within the transformative learning community.
Supranational criminal enforcement in the island of Aphrodite: EPPO’s symbiosis with the Attorney General of the Cyprus Republic
Authors: Tsadiras Alexandros
Published: September 2024

This article assesses the application of the EPPO apparatus in the Cypriot legal system and demonstrates its ability to challenge and transform basic constitutional principles of criminal enforcement in the island. The discussion begins with some crucial reflections on the EPPO’s structure and mission in the Union configuration, which contextualise the ensuing narration. That is followed by a succinct analysis of the prevailing principles of the Cyprus investigative and prosecutorial regime, which improves our appreciation of its specificities. Next the most salient aspects of the implementing legislation are thoroughly explored, thus unveiling the conceptual disposition of the Cypriot administration and legislature towards the EPPO transplant. The inquiry proceeds with consideration of the difficulties raised by the EPPO’s cohabitation with the domestic prosecutorial authority. The article concludes with a brief remark on future EPPO related litigation.
3D-auxetic elastomeric cellular structures for impact protection
Authors: Blake Peter , El Hawary Omar , Myronidis Konstantinos , Pinto Fulvio , Fallon Chanel
Published: September 2024

Lightweight protective armour solutions have potential applications ranging from infrastructure cladding and damage tolerant aerospace composites to sports helmets and body armour. Elastomeric cellular structures are a promising candidate solution and with advances in 3D-printing technology, ever more complex geometries can be explored in the pursuit of enhanced performance. Auxetic structures, which exhibit negative Poisson’s ratio behaviour and reported improved mechanical properties are of interest. Recently, 3D-auxetic structures have demonstrated the potential to outperform their 2D counterparts. This work investigates the performance of four candidate elastomeric cellular structures, 3D-printed in thermoplastic polyurethane (TPU): one non-auxetic, two 2D-auxetic and one 3D-auxetic. The structures are subjected to quasi-static compression, cyclic compression and low-velocity impact tests. Energy absorption diagrams, based on quasi-static compression data, are produced which demonstrate that the choice of most efficient energy absorbing structure depends on the specific energy of the threat. It is found that the 3D-auxetic re-entrant honeycomb structure outperforms all others for specific energies greater than 13.3 mJ/cm3. Cyclic compression tests demonstrate excellent recoverability, and thus reusability of all structures. Hysteresis is observed for all specimens, increasing with increasing maximum strain. Generally, the 3D-auxetic structure provides the greatest energy dissipation. The behaviour observed in the low-velocity impact tests appear consistent with the trends identified in the quasi-static tests. The 3D-auxetic structure is the best choice for absorbing high impact energies since it results in a lower stress being transferred when subject to an impact energy which causes densification. This work demonstrates the potential for 3D-auxetic elastomeric cellular structures to provide superior protective performance.
Enhancing Students’ Critical Thinking Through Mathematics in Higher Education: A Systemic Review
Authors: Wang Qian , Abdullah Abdul Halim
Published: September 2024

Critical thinking (CT) is an essential competency for global citizens in the 21st century. Few systematic reviews have evaluated and analyzed instructional interventions to enhance CT in mathematics at the university. This study includes 15 studies on cultivating CT among undergraduate students through instructional interventions within the mathematics curriculum. Quantitative and qualitative methods were employed to provide information and feedback on study and intervention characteristics, analyze the features and effects of multiple interventional strategies, and assess instruments by coding categories. The results indicate that it is essential for instructors to identify the specific CT objectives, including features, criteria, and standards of CT, before intervention. Several teaching strategies are alternatives for developing undergraduate students’ CT abilities through the mathematics curriculum; however, flexibility and availability are necessary to allow students and instructors to adapt and coordinate. Further, multiple assessment instruments are essential for the instructional intervention.
Understanding Language Learners’ Perceptions of Teachers’ Roles in Online Education: A Metaphor Analysis
Authors: Vahdani-Sanavi Reza , Demirkol Tuba
Published: September 2024

This study investigates language learners’ perception of Turkish teachers’ roles in an online setting using metaphor analysis. The aim of this qualitative study was to see how learners viewed their teachers’ roles in the setting. Using this data collection tool through convenient sampling, this study elicited 161 language learners’ perceptions of teachers’ role in an online context during the COVID-19 era between December and January 2020. Analyzing the data, the researchers came up with 10 different conceptual metaphors depicting learners’ beliefs about their teachers’ roles. The results identified some differences between how learners view teachers’ roles in an online mode of education compared to the conventional one as other studies suggest. The implications of these findings for teachers in general and language teachers in particular are discussed, highlighting what can be done to cushion the adverse effects of this novel medium of instruction.
Individuals’ Motivations and Engagement With Paralympic Content on Social Media: A Longitudinal Analysis Across Six Summer and Winter Games
Authors: Mamo Yoseph Z. , Haegele Justin A.
Published: September 2024

Despite the recent growth in Paralympic sport programming and viewership on social media, there remains a limited understanding of social media users’ motivations for consuming and engaging with Paralympic content. Drawing on Uses and Gratifications (U&G) theory, the purpose of this study is to examine the motivations of social media users for consuming Paralympic content and the relationship between different types of motivations and social media engagement. Our data collection spanned six Paralympic Games, both Summer and Winter, from 2012 to 2022, resulting in the analysis of 1,297 tweets from unique X (formerly known as Twitter) users. Findings suggest that the prevalent motives for consuming Paralympics content on X include information, integration and interaction, political stance, empowerment, inspiration, and entertainment. Regarding engagement, inspirational content is most likely to be liked, while integration and interaction, and entertainment are more likely to be retweeted.
Sun protection knowledge and behaviors of agricultural workers in Turkey: a cross-sectional study
Authors: Asil Elif Uner , Dagli Ayşe , Aygun Ozcan
Published: September 2024

Background

Agricultural workers are at risk of developing skin cancer due to prolonged exposure to the sun during their daily work. This study was conducted to determine sun protection knowledge and behaviours of agricultural workers in Turkey.

Methods

The cross-sectional study was conducted with 460 participants working in agriculture. The data were collected using a sociodemographic form, Skin Cancer and Sun Knowledge Scale and Sun Protection Behaviour Scale. The data were analysed using One Way ANOVA and Independent Samples t Test.

Results

Participants mean total score on the Skin Cancer and Sun Knowledge Scale was 15.24 ± 2.47 (max-min 0–25) and the mean total score on the Sun Protection Behaviour Scale was 24.10 ± 4.46 (max-min 8–40). Statistically significant disparities were observed between the SCBS, SPBS and their sub-divisions along with the working period, age, marital status, gender, level of education, income status, skin type and agricultural working status of the participants (p < .05).

Conclusion

The study found that people working in the agriculture had inadequate sun protection behaviours and knowledge. Based on the study’s results, it is proposed to create intervention programmes that specifically target single, male, middle-aged or older individuals with extended working hours and low levels of education and income.
Social comparison feedback in online teacher training and its impact on asynchronous collaboration
Authors: Lu Yao , Ma Ning , Yan Wen-Yu
Published: September 2024

In the area of online teacher training, asynchronous collaboration faces several challenges such as limited learner engagement and low interaction quality, thereby hindering its overall effectiveness. Drawing on social comparison theory, providing social comparison feedback to teacher-learners in online asynchronous collaborative learning offers benefits, but also has drawbacks. While social comparison has been explored in diverse fields, its role in education remains unclear. In this study, we selected 95 primary and secondary school teachers participating in an online training course. Using randomized controlled trial design, we provided the experimental group with social comparison feedback, while the control group received only self-referential feedback. We used epistemic network analysis, lag sequential analysis, and social network analysis to identify the impact of social comparison feedback on group-regulated focus, group-interactive behaviors, and social network structures. The results showed that social comparison feedback significantly enhanced teachers’ online asynchronous collaborative learning.
Aphasia outcome: the role of diffusion tensor tractography in patients with acute ischemic stroke
Authors: Alloush Taha K. , Emara Tamer H. , Mahmoud Mostafa K. Ramadan , Abdulghani Khaled O. , Alloush Adel T. , El-Sudany Ayman H.
Published: September 2024

Backgrounds

Recovery for poststroke aphasia has a decelerating trajectory, with the greatest improvement is within weeks and the slope of change decreasing over time. Therefore, it is essential to predict the prognosis of aphasia at an early stage as it could provide useful data in specific plans for management strategies. The aim of this work was to assess the arcuate fasciculus in stroke patients with aphasia and its impact on predicting the outcome. A prospective study was performed including 25 patients with acute ischemic stroke and aphasia and 10 healthy control subjects with no history of neurologic or psychiatric disease. All patients underwent language assessment using an Arabic version of the Comprehensive Aphasia Test (Arabic CAT), with the resultant mean T-score aphasia quotient (AQ). Early assessment of stroke and delayed assessment at three months. All patients had diffusion-weighted magnetic resonance imaging (DWI-MRI) of the brain to localize the lesion and 3D diffusion tensor imaging (DTI) of the arcuate fasciculus (AF) within 30 days of stroke.

Results

Patients in whom the AF could not be reconstructed had a poor score in early and late AQ and a poor prognosis compared to those in whom the AF could be reconstructed. Preservation of the left AF on DTI could mean the potential recovery of aphasia after stroke.

Conclusion

The prognosis of aphasia in patients whose left AF could be reconstructed was better than those whose left AF could not be reconstructed, irrespective of the AF's integrity. That is why, we can assume that evaluation of the DTI of the left AF at early stages of stroke can help in predicting outcome of aphasia.
Influence of self-compassion on fatigue and psychological wellbeing among psychiatric nurses
Authors: Behilak Sahar , Abdullah Saleh , Ahmed Gellan K. , Saraya Ola Ali Abd El-Fatah Ali
Published: September 2024

Background

Psychiatric mental health nurses often work in highly demanding environments and situations and are exposed to multiple work-based stressors simultaneously. We aimed to explore the influence of self-compassion on fatigue and psychological wellbeing, and to evaluate the possible contributing factors for self-compassion, fatigue, and psychological wellbeing among psychiatric nurses. A descriptive correlational study using a convenience sample was used to employ 50 psychiatric nurses. Participants categorized into three groups based on their scores on The Self-Compassion Scale (SCS-SF): Group 1: low self-compassion, Group 2: moderate self-compassion, and Group 3: high self-compassion. All participants were assessed by socio-demographic data questionnaire, Fatigue Assessment Scale (FAS), and Psychological Wellbeing Scale.

Results

Regarding FAS and wellbeing, group 1 had the highest mean of both scores, whereas group 3 had the lowest mean of both scores. Psychiatric nurses with high self-compassion were significantly more likely to be male, have a lower overall fatigue score, and have better psychological wellbeing. Psychiatric nurses with high fatigue scores were more likely to be female, married, have diploma, have less self-compassion, and have poorer psychological wellbeing.

Conclusions

Psychiatry nurses with higher self-compassion had lower fatigue score and better psychological wellbeing. Gender and education level were significant factors for self-compassion and fatigue.
The burden of suicide across different altitudes: 11-year geodemographic analysis conducted in 221 cantons in Ecuador ranging from 0 to 4300 m of elevation
Authors: Ortiz-Prado Esteban , Izquierdo-Condoy Juan S. , Fernandez-Naranjo Raul , Vásconez-González Jorge , Encalada Sebastián , Mosquera Johanna , Cordovez Simone , Camino Nicole , Montenegro-Salazar Daniela , Viscor Ginés , Diaz Ana María , Paz Clara
Published: September 2024

Background

The World Health Organization and the Global Burden of Disease study estimate that almost 800 000 people die from suicide yearly. The role of non-traditional risk factors such as climate and high-altitude exposure are poorly understood.

Aims

This study aims to determine a potential relationship between altitude exposure and suicide rates among 221 cantons located at different altitudes ranging from 0 to 4300 m.

Method

We conducted an 11-year, country-wide, population-based analysis on age- and gender-standardised suicide rates in Ecuador, based on the official data from the National Institute of Statistics, using all available self-harm death codes (ICD-10 codes X60–X84).

Results

A total of 11 280 cases of suicide were reported during 2011–2021. Suicide rates were higher among men (11.48/100 000). In terms of elevation, suicide rates were significantly higher among people from high-altitude cantons (3.7/100 000) versus those from low-altitude cantons. When applying the International Society Mountain Medicine categorisation, suicide rates were significantly higher at moderate- (4.3/100 000), high- (3.6/100 000) and very-high-altitude cantons (4.4/100 000) when compared with low-altitude locations (2.5/100 000).

Conclusions

Ecuador is one of the few countries that has a vast range of cantons located at different altitudes. We found that living at higher elevations is positively associated with greater suicide rates. Although the rates are significantly greater as elevation increases, a clear linear relationship is not apparent, likely because of the interplay of socioeconomic factors, including urbanicity. The effect of chronic hypobaric hypoxia on mood cannot be ruled out, although the existence of causal mechanisms remains to be elucidated.
The minimal important difference in obsessive-compulsive disorder: An analysis of double-blind SSRI trials in adults
Authors: Cohen Sem E. , Zantvoord Jasper B. , Mattila Taina K. , Storosum Bram W.C. , de Boer Anthonius , Denys Damiaan
Published: September 2024

Background

The change in symptoms necessary to be clinically relevant in obsessive-compulsive disorder (OCD) is currently unknown. In this study, we aimed to create an empirically validated threshold for clinical significance or minimal important difference (MID).

Methods

We analyzed individual participant data from short-term, double-blind, placebo-controlled registration trials of selective serotonin reuptake inhibitors in adult OCD patients. Data were collected from baseline to week 12. We used equipercentile linking to equate changes in the Clinical Global Impression (CGI) scale to changes in the Yale-Brown Obsessive-Compulsive Scale (YBOCS). We defined the MID as the YBOCS change linked to a CGI improvement of 3 (defined as “minimal improvement”).

Results

We included 7 trials with a total of 1216 patients. The CGI-scores and YBOCS were moderately to highly correlated. The MID corresponded to 4.9 YBOCS points (95% CI 4.4–5.4) for the full sample, or a 24% YBOCS-decrease compared to baseline. The MID varied with baseline severity, being lower in the group with mild symptoms and higher in the group with severe symptoms.

Conclusions

By linking the YBOCS to the CGI-I, this is the first study to propose an MID in OCD trials. Having a clearly defined MID can guide future clinical research and help interpretation of efficacy of existing interventions. Our results are clinician-based; however, there is further need for patient-reported outcomes as anchor to the YBOCS.
Federated, multi-agent, deep reinforcement learning
Authors: Ψάλτης Αθανάσιος
Published: September 2024

Το τοπίο της τεχνητής νοημοσύνης (ΤΝ) αναδιαμορφώνεται από την Ομόσπονδη Μάθηση (ΟΜ), μια αποκεντρωμένη προσέγγιση στη μηχανική μάθηση (ΜΜ) που ενισχύει την ιδιωτικότητα δεδομένων και τη συνεργατική εκπαίδευση μοντέλων. Αυτή η διατριβή εξετάζει τις προκλήσεις και τις δυνατότητες της ΟΜ, επικεντρώνοντας στην βελτιστοποίηση της αποδοτικότητας επικοινωνίας, την ενίσχυση της απόδοσης μοντέλου και τη διασφάλιση της ανθεκτικότητας σε διάφορα περιβάλλοντα. Η έρευνα περιλαμβάνει μια λεπτομερή ανασκόπηση της λογοτεχνίας και την ταυτοποίηση των βασικών προκλήσεων στην ΟΜ. Διεξήχθησαν μια σειρά από μελέτες για να αντιμετωπιστούν συγκεκριμένες πτυχές: η βελτιστοποίηση της μετάδοσης δεδομένων και η διαχείριση διάφορων αρχιτεκτονικών μοντέλων, η κατανομή δεδομένων και η επιλογή κόμβων, η μάθηση αναπαράστασης και η ομόσπονδη απόσταξη, η σταδιακή μάθηση και η διατήρηση γνώσης, καθώς και η εκπαίδευση μοντέλων με περιορισμένα δεδομένα. Κάθε επιμέρους μελέτη συνέβαλε στον τομέα αναπτύσσοντας καινοτόμους αλγορίθμους, τους οποίους δοκίμασε σε προσομοιωμένα περιβάλλοντα ΟΜ και συνέκρινε με υπάρχουσες μεθόδους. Τα κύρια ευρήματα της έρευνας περιλαμβάνουν τη βελτίωση της αποδοτικότητας της επικοινωνίας με μειωμένες απαιτήσεις υπερφόρτωσης και εύρους ζώνης, την ενίσχυση της απόδοσης του μοντέλου στη διαχείριση ετερογενών δεδομένων και μεταβλητότητας της αρχιτεκτονικής του μοντέλου, αποτελεσματικές στρατηγικές για την αντιμετώπιση της καταστροφικής λήθης και μεθοδολογίες ευέλικτες σε περιορισμένα και διασκορπισμένα δεδομένα. Η εφαρμοσιμότητα της ΟΜ αποδείχθηκε σε πρακτικά σενάρια, επιδεικνύοντας τη δυναμική της σε διάφορους τομείς. Συμπερασματικά, η διατριβή συνεισφέρει σημαντικά στην προώθηση της ΟΜ. Αντιμετωπίζει θεμελιώδεις προκλήσεις και αποδεικνύει την προσαρμοστικότητα και την αποτελεσματικότητα της ΟΜ σε εφαρμογές του πραγματικού κόσμου. Τα ευρήματα τονίζουν τον ρόλο της ΟΜ ως μεθόδου που εξασφαλίζει την ιδιωτικότητα, αυξάνει την αποδοτικότητα και επιδεικνύει ευελιξία στον τομέα της τεχνητής νοημοσύνης και της μηχανικής μάθησης.
Religijność skazanych kobiet – dynamika zjawiska. Na podstawie badań przeprowadzonych wśród kobiet osadzonych w Oddziale Zewnętrznym w Lublińcu
Authors: Grabowska Barbara , Czajka Paweł
Published: September 2024

W artykule przedstawiono i omówiono wyniki badań panelowych przeprowadzonych w kwietniu 2023 roku w grupie 77 kobiet odbywających karę pozbawienia wolności w Oddziale Zewnętrznym w Lublińcu Zakładu Karnego w Herbach. Wyniki tych badań porównano z wcześniejszymi badaniami zrealizowanymi w czerwcu 2012 roku w takiej samej liczebnie grupie kobiet w ówczesnym Zakładzie Karnym w Lublińcu. Celem badań było poznanie zmian, jakie zaszły w religijności osadzonych kobiet w zakresie: znajomości prawd religijnych, odczuwania związku emocjonalnego z religią, poziomu praktyk religijnych, powiązania życia moralnego z religią i odczuwania związku z Kościołem.
Uzyskane wyniki uprawniają do stwierdzenia, że wśród osadzonych dominuje przeciętny poziom religijności (najczęściej deklarowany poziom średni samooceny odczuwania związku emocjonalnego z religią, poziomu praktyk religijnych, powiązania życia moralnego z religią i odczuwania związku z Kościołem), ale równocześnie uwidocznia się zmiana w kierunku postaw bardziej radykalnych (wzmocnienie lub osłabienie religijności) poprzez zwiększenie deklaracji samoocen omawianych aspektów na poziomach bardzo silnym, silnym, słabym i bardzo słabym. Wyniki te wskazują na możliwe „odkościelnienie religijności”, co jest zapewne związane z istotnymi przemianami zachodzącymi w polskim społeczeństwie.
Secondary Raw Materials in the Circular Economy: A Multi-Perspective Study
Authors: Remeikienė Rita , Gasparėnienė Ligita , Matulienė Snieguolė , Szarucki Marek
Published: September 2024

The book offers a comprehensive examination of the theoretical and practical aspects of secondary raw material markets within the context of the circular economy. The utilisation of secondary raw materials is of vital importance in the reduction of reliance on non-renewable primary resources, and plays a pivotal role in the development of circular economy business models, as emphasised by the OECD and the EU Circular Economy Action Plan. The study highlights the significance of secondary raw materials (i.e. aluminium, plastics, textiles, etc.) in promoting sustainability and competitiveness, particularly in sectors characterised by high resource consumption. The monograph seeks to provide a multifaceted understanding of secondary raw material markets, offering valuable insights into their development and the legal frameworks necessary to support a sustainable circular economy. The book is structured into four chapters, each addressing a discrete aspect of the secondary raw material market. The initial chapter addresses the sustainable management of these materials, examining the challenges and opportunities encountered by businesses and including case studies that illustrate successful practices. The second chapter explores the conceptual aspects of the secondary raw material market, examining its role within the circular economy and identifying key indicators and challenges for future market development. The third chapter presents exemplary practices from countries such as Belgium, the Netherlands, and Estonia, with a particular focus on innovative strategies and the role of trading platforms in market advancement. The concluding chapter examines the legal dimensions of trade in waste and secondary raw materials, contrasting international and Lithuania’s national regulatory frameworks and analysing judicial practices to elucidate their implications for sustainable resource management. This monograph represents the collective output of scientific collaboration between authors affiliated with the Public Security Academy of Mykolas Romeris University (Lithuania) and the Strategic Analysis Department of the Krakow University of Economics (Poland).
Growth, yield, and yield components of tomato varieties (Solanum lycopersicum L.) influenced by the application of blended fertilizers (NPS) at Jimma, South-West Ethiopia
Authors: Ger Khat Gach , Belew Derbew , Nebiyu Amsalu , Barnabas John
Published: September 2024

The effects of blended fertilizer rates (NPS) on growth, production, and yield components of tomato varieties (Solanum lycopersicum L.) were studied utilizing irrigation facilities at Jimma University's College of Agriculture and Veterinary Medicine (JUCAVM). Strategic experiments were set up as 2x5 factorial testing in a randomized comprehensive block design (RCBD), with ten treatments combined and three replications. The treatment included five rates of mixed (NPS) fertilizer (0 kg ha-1, 50 kg ha-1, 100 kg ha, 150 kg ha-1, and 200 kg ha-1) and two tomato varieties. (Melka shola and Gelelma). Data were obtained on tomato growth, yield, and yield component characteristics. Significant results indicated the impacts of mixed fertilizers (NPS) on tomato cultivars in terms of marketable fruit weight by size group, number of total fruit yield per plant, and total fruit yield per hectare.The mixed fertilizer rate (NPS) and tomato types had substantial interaction effects on the percentage of fruit set and the number of marketable fruits per plot. association investigation revealed a positive association between tomato varieties growth, yield, and yield components. Significantly, the highest number of total fruit yield per plant (55.617), marketable fruit weight by size group (67.33 g), marketable fruit number per plot (211.67), and total fruit yield per hectare (38.183 t ha-1) were obtained at 150 kg ha-1 and 200 kg ha-1 blended (NPS) fertilizer, respectively, with the lowest at control.Melka shola produced the most overall fruit yields per plant (54.013) and per hectare (26.570 t ha-1) than Gelelma. Under Jimma conditions, 150 kg ha-1 of blended (NPS) fertilizer and Melka shola produced the highest yields. As a result, additional research should be conducted with many locations on blended fertilizer rate (NPS) mixed with tomato types.
Assessing the Potential of Biochar Derived from Tropical Deciduous Tree Broussonetia Papyrifera for Crop Improvement
Authors: Gupta Ipsa , Chuskit Rigzin , Singh Rishikesh , Kaur Shalinder , Kaushik Anupama , Batish Daizy R.
Published: September 2024

In this study, we assessed the effects of biochar prepared from an invasive tree, Broussonetia papyrifera on the growth of selected pulse (Cajanus cajan and Vigna radiata) and cereal (Oryza sativa and Zea mays) crops under laboratory conditions. Two experiments were designed, one with biochar powder and another with biochar water extract to mimic the environmental conditions of the growing season of the crops. The findings of the study revealed that the seeds of pulse crops responded slower during the initial days (3 to 7 days) of exposure to the biochar powder whereas a marked increase in root and shoot growth parameters was observed with increasing doses of biochar at 15th day, compared with the control. With an initial increase in growth behaviour of pulses (at 3rd day), a stable growth response was observed at 7th and 15th days under control treatments. Both cereal and pulse crops showed better growth responses with increasing dose of biochar, and maximum growth was observed at 1-2% (for powder) and 2-4% (for extract) biochar doses. Application of powdered biochar showed better growth responses than the extract, as it facilitated gradual-release of nutrients, thus allowed the plants to stay healthy for a longer period of time. The results underscore the importance of using biochar based on the specific crop types, seed sizes, and growth stages to fully utilize its potential in sustainable agriculture. Harnessing the beneficial attributes of biochar not only enhances soil quality and crop yields but also presents a promising avenue for environmentally friendly weed control and resource utilization, aligning with broader objectives of agricultural sustainability and food security. Further investigations focused on optimizing biochar formulations and conducting field-scale trials will be essential in realizing its transformative impact on global agricultural practices.Top of Form
Molecular Characterization of Plant Growth Promoting Rhizobacteria Isolated from Nodules of Cicer arietinum Plant
Authors: Singh Anamika , Verma Rakesh Kumar
Published: September 2024

Agriculture has recently prioritized Plant Growth Promoting Rhizobacteria (PGPR) due to their significance in the rhizosphere, which is an ecological unit in the biosphere. Isolating PGPR from Cicer arietinum (chickpea) nodules and characterizing its PGP activities was the purpose of the present study. The research showed that the specific strain could manufacture several useful chemicals, such as hydrogen cyanide (HCN), ammonia, siderophore, indole acetic acid (IAA) and nitrogenase. Furthermore, the isolate was identified as Bacillus licheniformis AS11 through 16s rRNA analysis, and alignment analysis showed 99% similarity with the Bacillus licheniformis KPA12 isolate. It's worth highlighting that, Bacillus licheniformis AS11 a potential PGPR, is considered a valuable asset for agriculture when it has a positive effect on plant growth. Therefore, Bacillus licheniformis AS11 can be a beneficial and constructive addition to the field of agriculture. These findings suggest potential applications in sustainable agriculture by improving crop yield through natural growth-promoting mechanisms and reducing reliance on chemical fertilizers.
A qualitative review of adolescent childbirth experiences, its impact on development and the need for age-specific care
Authors: Füzy Elizabeth , Fouché Nicola , Clow Sheila Elizabeth
Published: September 2024

Background/Aims

Treatment and interventions for adolescent mothers during birth are often informed by research conducted with adult women. This approach does not consider the fact that adolescents are still in a developmental phase with age-specific needs and the consequent effect on their birth experiences. This review's aim was to explore the available literature in relation to the need for age-specific care for adolescents during birth.

Methods

An aggregated qualitative review was conducted using narrative synthesis with comprehensive searches of EBSCOhost, Scopus, JSTOR, Pubmed, Science Direct and Cochrane. Thematic analysis and a narrative synthesis were used to present the results based on the research objectives.

Results

A total of seven studies were included, published between 2002 and 2022. Eight elements of age-specific care for adolescent mothers were identified: be sensitive to her needs, manage her pain, treat her with respect, provide information, include her in decision making, guide her, have empathy for her needs and offer non-judgmental care.

Conclusions

There is a dearth of research on the experiences and needs of adolescent mothers during birth. Birth impacts developmental tasks for adolescents and age-specific care is vital for more positive birth experiences.

Implications for practice

More training and research are required to develop and implement a framework for age-specific care during pregnancy and birth.
Clinical and non-clinical team collaboration to develop breast referral triage to improve service delivery in secondary care
Authors: Halliday Suzanne , Townsend Sean , Beech Nicola , Greeno Kellie , Myers Ayrton , Cockell Heliose , Lowe Joanne
Published: September 2024

Aims:

This evaluation combines clinical and non-clinical collaborative breast referral triage to gain an understanding relating to the value of triage, by identifying ‘suspected cancer’ and ‘cancer not suspected’ populations, improve the patient pathway, and facilitate optimised resource availability.

Method:

An iterative service improvement method was used, with distinct phases of the process outlined to facilitate testing of ideas. The evaluation ran for 13 weeks in 2022. Regular team member meetings were arranged to discuss and agree improvement aims and outcomes.

Findings:

A triage flowchart was developed collaboratively, and subsequently adopted by the non-clinical booking team. Bespoke clinics were established, demonstrating no evidence of increased risk to patients, and meeting 28-day Faster Diagnosis Standard (FDS) requirements.

Conclusion:

breast referral triage of ‘suspected cancer’ and ‘cancer not suspected’ patients, using a clinical and non-clinical collaborative approach facilitates improved service visibility, prioritisation, management, and measurement. This also supports delivery of the 2019 NHS Long Term Plan to enhance earlier and faster cancer diagnosis by optimising access to diagnostic resources where required.