bluuebunny/crossref_metadata_2025 huggingface dataset:
Roblox-based tsunami survival game: A tool to stimulate early childhood disaster preparedness skills
Authors: Maulida Adelia , Hanif Hasnan , Kamal Maulana , Suryani Oktari Rina
Published: November 2023

Disaster education for early childhood is crucial, especially in Indonesia, which is located within the Ring of Fire, an area prone to various disasters, including tsunamis. Children are a vulnerable group in disaster situations, as they are susceptible to physical and psychological negative impacts. In this context, a game-based approach becomes an attractive alternative as it combines interactive and enjoyable learning experiences. The objective of this study is to explore the effectiveness of using this game as a means of teaching tsunami preparedness. The Tsunami Survival game has visually appealing, child-friendly graphics and easily understandable elements. This study was conducted at Darul Hikmah Kindergarten in Kajhu Village, Aceh Besar District, focusing on the utilization of a game-based approach, specifically the Roblox-based Tsunami Survival game, to educate and stimulate disaster preparedness skills among 20 children aged 4-6 years. The game has equipped children about the actions to be taken during a tsunami through engaging storytelling and gameplay. It incorporates age-appropriate content, interactive gameplay, and virtual scenarios to engage children in learning about evacuation, emergency response, and survival skills. Pre- and post-intervention assessments were conducted to evaluate the impact of the game-based approach on the children's disaster preparedness skills. At the same time, questionnaires and interviews gathered qualitative data on their engagement and perceived learning outcomes. The expected outcomes include improvement knowledge and awareness of tsunami preparedness, as well as insights into the practical implementation of game-based learning in early childhood education. This research contributes to the development of effective strategies for disaster education and resilience-building among young children, leveraging the popularity and accessibility of gaming platforms.
Content Validity of Collective Efficacy Questionnaire for Natural Disasters Based on Aceh Local Wisdom
Authors: Hayati Keumala , Ulfa Tenri Pada Andi , Mawarpury Marty
Published: November 2023

Disaster preparedness is one of the efforts to reduce the impact of disasters. This preparedness is very important for people who directly feel the disaster and the impact of the disaster itself. Preparedness behavior in this community can be influenced by collective efficacy, namely the ability of community members to work together and take action in dealing with disasters. For this reason, it is necessary to develop an instrument that can measure collective efficacy in the context of disaster. This research focuses on developing instruments that can measure the collective efficacy of communities in the context of natural disasters based on local wisdom adapted to the local culture of Aceh. Collective efficacy instruments were developed, and content validity was tested. This article describes the procedure for calculating content validity coefficients. The purpose of this study was to conduct content validity of collective efficacy questionnaire for natural disasters based on Aceh local wisdom. Content validity refers to the extent to which the instrument covers the content that is supposed to be measured. Content validity was assessed using a five-point Likert scale and then analyzed using Aiken‟s V formula to obtain the content validity coefficient. Item analysis was carried out by 7 experts in the fields of psychometrics, social science, disaster science, and measurement who assessed content representation based on construction, relevance, and clarity. As a result, of the 47 items that were validated, 7 items did not meet the valid requirements because the content validity coefficient was below 0.75.
The role of Acehnese women in enhancing community preparedness through the inter-generational transmission of local and indigenous knowledge
Authors: Khaira Raudhatul , Abulkhair M. Faris , Fathin Kurnia Muhammad , Safira Rizqiya , Suryani Oktari Rina
Published: November 2023

Intergenerational transmission of traditional knowledge plays an important role. The involvement of women shows a significant impact on building family and community preparedness. However, limited attention paid to the unique contributions of Acehnese women has identified an erosion of traditional knowledge systems in the local context. This study explores the role and involvement of Acehnese women in the intergenerational transmission of knowledge about disaster preparedness based on local wisdom. A qualitative study in Banda Aceh and Aceh Besar involving interviews with key informants namely where they live, victims or non-victims of the 2004 Aceh tsunami, and career women or housewives. Acehnese ethnic women living in coastal areas were sampled randomly and purposively. Ten agreed to participate and were interviewed. The face-to-face interviews were recorded, transcribed, and analyzed using an analytical framework. The interviews revealed that the role and involvement of women in the transmission of local knowledge and practices was hampered by cultural and political factors which caused the erosion of this knowledge.
The Role of Coping Strategies in the Resilience of Health Workers During Covid-19 Pandemic
Authors: Ichwati Aulia Chayank , Mudatsir Mudatsir , Mawarpury Marty
Published: November 2023

During the COVID-19 pandemic, health workers are at the highest risk of infection so appropriate coping strategies are needed to survive the situation. This study aims to examine the role of coping strategies ((problem focused coping, emotion focused coping, and avoidance coping) on the resilience of health workers in hospitals. Using the Brief COPE questionnaire for coping strategy variables with α 0.888 and the Connor-Davidson Resilience Scale (CD-RISC) for resilience with α 0.89. The sampling technique used proportional random sampling with 86 respondents. Data analysis using multiple regression shows that there is a significant effect between coping strategy variables on resilience with a value of p = 0.008 (p <0.05), there is a significant effect between Problem Focused Coping on resilience with a value of p = 0.000 (p <0.05), there is a significant effect between Emotion Focused Coping on resilience with a value of p = 0.012 (p <0.05), and there is a significant effect between Avoidance Coping on resilience with a value of p = 0.037 (p <0.05). Coping and resilience strategies that are widely used by health workers at the Meuraxa Regional General Hospital, Banda Aceh City during the pandemic are drawing closer to God, praying, believing in God, being proud of achievements, social support, and the ability to adapt. The results of this research can be used as input for related agencies so that they can hopefully form resilient health workers.
Extensive fatal Pyoderma gangrenosum in a dog after drug
exposure
Authors: Schaefer Laura , Kloß Elena , Henrich Manfred , Thom Nina
Published: November 2023

A 4-year-old, spayed female mixed breed dog was presented with large crater-like,
well-demarcated, erosive and ulcerative necrotic lesions of the skin, elevated
body temperature and lethargy, that began 14 days after vaccination and
treatment with fluralaner and milbemycin/praziquantel. Cytology revealed
severe pyogranulomatous inflammation with moderate numbers of extracellular
microorganisms. Histopathologic examination showed severe multifocal
pyogranulomatous dermatitis and panniculitis with severe dermal edema and severe
neutrophilic exocytosis with band-like infiltration of the lower portion of the
epidermis consistent with pyoderma gangrenosum. Despite intensive
immunosuppressive and antimicrobial therapy and intensive inpatient care, the
dog was euthanized 16 days after admission due to complications with clinical
signs of sepsis, acute dyspnea and thoracic effusion.
Threshold collision induced dissociation of protonated water clusters
Authors: Zamith Sébastien , Kassem Ali , L’Hermite Jean-Marc , Joblin Christine , Cuny Jérôme
Published: November 2023

We report threshold collision induced dissociation experiments on protonated water clusters thermalized at low temperature for sizes n = 19–23. Fragmentation cross sections are recorded as a function of the collision energy and analyzed with a statistical model. This model allows us to account for dissociation cascades and provides values for the dissociation energies of each cluster. These values, averaging around 0.47 eV, are in good agreement with theoretical predictions at various levels of theory. Furthermore, the dissociation energies show a trend for the n = 21 magic and n = 22 anti-magic numbers relative to their neighbours, which is also in agreement with theory. These results provide further evidence to resolve the disagreement between previously published experimental values. A careful quantitative treatment of cascade dissociation in this model introduces interdependence between the dissociation energies of neighboring sizes, which reduces the number of free fitting parameters and improves both reliability and uncertainties on absolute dissociation energies deduced from experiments.
Growth of tin-free germanium carbon alloys using carbon tetrabromide (CBr4)
Authors: Reza Md. Shamim , Dey Tuhin , Arbogast Augustus W. , Muhowski Aaron J. , Holtz Mark W. , Stephenson Chad A. , Bank Seth R. , Wasserman Daniel , Wistey Mark A.
Published: November 2023

Direct bandgap group IV materials could provide intimate integration of lasers, amplifiers, and compact modulators within complementary metal–oxide–semiconductor for smaller, active silicon photonics. Dilute germanium carbides (GeC) with ∼1 at. % C offer a direct bandgap and strong optical emission, but energetic carbon sources such as plasmas and e-beam evaporation produce defective materials. In this work, we used CBr4 as a low-damage source of carbon in molecular beam epitaxy of tin-free GeC, with smooth surfaces and narrow x-ray diffraction peaks. Raman spectroscopy showed substitutional incorporation of C and no detectable sp2 bonding from amorphous or graphitic carbon, even without surfactants. Photoluminescence shows strong emission compared with Ge.
On the selection of Morris trajectories for parametric sensitivity analysis in spectroscopic ellipsometry modeling
Authors: Likhachev D. V.
Published: November 2023

Spectroscopic ellipsometry and some other optical metrology techniques, such as reflectometry and scatterometry, are model-based optical measurements and, therefore, require appropriate modeling to determine the geometric and material properties of substrates, thin films, and multilayer structures. Parametric sensitivity analysis (SA) provides essential assistance in the model-building process to quantify the relative importance of model parameters for model output and to identify those with high/little influence. SA can be performed in a variety of ways, and this article discusses an application of the Morris or elementary effect (EE) method, a screening type SA procedure, to spectroscopic ellipsometry modeling. The method is a global SA technique and uses a stepping of m parameters along certain so-called “trajectories” or sequences of points in parameter space, randomly constructed in order to maximally fill the volume of the m-dimensional parameter space. However, it was thought that the EE method relies greatly on a sampling strategy or a way of selecting “optimized trajectories” in the parameter space, i.e., a necessary number of trajectories chosen to be well spread over the space to properly cover the entire realistic ranges of all input factors. Here, we use two sampling methods for selecting trajectories with possibly different distributions and investigate their effects on the estimation of various sensitivity measures in spectroscopic ellipsometry data modeling. The SA results indicate that the performance of the sampling strategy should not be judged only by maximizing the trajectory spread but also include some additional convergence criteria for the sensitivity measures.
Growth of β-Ga2O3 and ϵ/κ-Ga2O3 on AlN(0001) by molecular-beam epitaxy
Authors: Raghuvansy Sushma , McCandless Jon P. , Schowalter Marco , Karg Alexander , Alonso-Orts Manuel , Williams Martin S. , Tessarek Christian , Figge Stephan , Nomoto Kazuki , Xing Huili Grace , Schlom Darrell G. , Rosenauer Andreas , Jena Debdeep , Eickhoff Martin , Vogt Patrick
Published: November 2023

The heteroepitaxial growth and phase formation of Ga2O3 on Al-polar AlN(0001) templates by molecular-beam epitaxy (MBE) are studied. Three different MBE approaches are employed: (i) conventional MBE, (ii) suboxide MBE (S-MBE), and (iii) metal-oxide-catalyzed epitaxy (MOCATAXY). We grow phase-pure β-Ga2O3(2̄01) and phase-pure ϵ/κ-Ga2O3(001) with smooth surfaces by S-MBE and MOCATAXY. Thin film analysis shows that the crystallographic and surface features of the β-Ga2O3(2̄01)/AlN(0001) and ϵ/κ-Ga2O3(001)/AlN(0001) epilayers are of high crystalline quality. Growth and phase diagrams are developed to synthesize Ga2O3 on AlN by MBE and MOCATAXY and to provide guidance to grow Ga2O3 on several non-oxide surfaces, e.g., AlN, GaN, and SiC, by MBE, S-MBE, and MOCATAXY.
Synthesis and antibacterial activity of 6″-decanesulfonylacetamide-functionalised amphiphilic derivatives of amikacin and kanamycin
Authors: Farr Dylan C. , Tan Lendl , Furness Juanelle , Grice I. Darren , West Nicholas P. , Houston Todd A.
Published: November 2023

Aminoglycoside antibiotics represent the first class of successful drugs in the treatment of tuberculosis; however, mycobacteria and other bacterial species possess several drug resistance mechanisms to inactivate these natural products. In the past 15 years, a variety of amphiphilic aminoglycosides have been shown to have improved activity against infectious microorganisms and to subvert resistance mechanisms. Here, we report on four novel synthetic compounds derived from two existing potent antitubercular compounds and describe their activity against both Mycobacterium tuberculosis and Staphylococcus aureus. It was found that a decanesulfonylacetamide-based conjugate of amikacin displayed promising preliminary antitubercular activities, warranting further investigation to assess the therapeutic potential of these unique antimicrobials.
Transforming the grid for a more environmentally and socially sustainable electricity system in Great Britain is a slow and uneven process
Authors: Lockwood Matthew
Published: November 2023

Electricity system decarbonization is key for environmental sustainability. From a consumption–production perspective, much attention has been paid to changes in how electricity is generated and used, but electricity systems also rely on a grid infrastructure that connects and integrates production and consumption, and which will also need to transform. At the same time, new technologies in the electricity system, including the grid, offer the potential for more socially sustainable ways of producing and consuming energy. However, in practice, change has been slow, uneven, and often dysfunctional. A socio-technical transitions approach offers insights into why this is so, seeing electricity system change not simply in technical and economic terms, but also as the outcomes of interactions between technology and social and political processes. The approach draws attention to the particular challenges of achieving rapid transitions in complex critical infrastructures like electricity with strong institutional logics of security. This article applies this approach to the case of Great Britain, where despite strong commitments to sustainability in the form of high-level climate policy, the electricity grid has often been a constraint on the pace of change. The nature of the British transition is explained partly by weak links between these high-level goals on the one hand and the detailed rules and practices in the electricity system on the other. It is also explained by patterns of ownership and grid regulation in the British case that protect incumbents and make it difficult for new actors to develop the system in more socially sustainable directions.
Sex-dependent phenological responses to climate vary across species’ ranges
Authors: Xie Yingying , Thammavong Hanna T. , Berry Lily G. , Huang Chingyan H. , Park Daniel S.
Published: November 2023

Anthropogenic climate change has significantly altered the flowering times (i.e., phenology) of plants worldwide, affecting their reproduction, survival, and interactions. Recent studies utilizing herbarium specimens have uncovered significant intra- and inter-specific variation in flowering phenology and its response to changes in climate but have mostly been limited to animal-pollinated species. Thus, despite their economic and ecological importance, variation in phenological responses to climate remain largely unexplored among and within wind-pollinated dioecious species and across their sexes. Using both herbarium specimens and volunteer observations of cottonwood (
Populus
) species, we examined how phenological sensitivity to climate varies across species, their ranges, sexes, and phenophases. The timing of flowering varied significantly across and within species, as did their sensitivity to spring temperature. In particular, male flowering generally happened earlier in the season and was more sensitive to warming than female flowering. Further, the onset of flowering was more sensitive to changes in temperature than leaf out. Increased temporal gaps between male and female flowering time and between the first open flower date and leaf out date were predicted for the future under two climate change scenarios. These shifts will impact the efficacy of sexual reproduction and gene flow among species. Our study demonstrates significant inter- and intra-specific variation in phenology and its responses to environmental cues, across species’ ranges, phenophases, and sex, in wind-pollinated species. These variations need to be considered to predict accurately the effects of climate change and assess their ecological and evolutionary consequences.
PST-Radiomics: a PET/CT lymphoma classification method based on pseudo spatial-temporal radiomic features and structured atrous recurrent convolutional neural network
Authors: Wang Meng , Jiang Huiyan
Published: November 2023

Objective. Existing radiomic methods tend to treat each isolated tumor as an inseparable whole, when extracting radiomic features. However, they may discard the critical intra-tumor metabolic heterogeneity (ITMH) information, that contributes to triggering tumor subtypes. To improve lymphoma classification performance, we propose a pseudo spatial-temporal radiomic method (PST-Radiomics) based on positron emission tomography computed tomography (PET/CT). Approach. Specifically, to enable exploitation of ITMH, we first present a multi-threshold gross tumor volume sequence (GTVS). Next, we extract 1D radiomic features based on PET images and each volume in GTVS and create a pseudo spatial-temporal feature sequence (PSTFS) tightly interwoven with ITMH. Then, we reshape PSTFS to create 2D pseudo spatial-temporal feature maps (PSTFM), of which the columns are elements of PSTFS. Finally, to learn from PSTFM in an end-to-end manner, we build a light-weighted pseudo spatial-temporal radiomic network (PSTR-Net), in which a structured atrous recurrent convolutional neural network serves as a PET branch to better exploit the strong local dependencies in PSTFM, and a residual convolutional neural network is used as a CT branch to exploit conventional radiomic features extracted from CT volumes. Main results. We validate PST-Radiomics based on a PET/CT lymphoma subtype classification task. Experimental results quantitatively demonstrate the superiority of PST-Radiomics, when compared to existing radiomic methods. Significance. Feature map visualization of our method shows that it performs complex feature selection while extracting hierarchical feature maps, which qualitatively demonstrates its superiority.
Assessing variation in faecal glucocorticoid concentrations in gray whales exposed to anthropogenic stressors
Authors: Pirotta Enrico , Fernandez Ajó Alejandro , Bierlich K C , Bird Clara N , Buck C Loren , Haver Samara M , Haxel Joseph H , Hildebrand Lisa , Hunt Kathleen E , Lemos Leila S , New Leslie , Torres Leigh G
Published: November 2023

Understanding how individual animals respond to stressors behaviourally and physiologically is a critical step towards quantifying long-term population consequences and informing management efforts. Glucocorticoid (GC) metabolite accumulation in various matrices provides an integrated measure of adrenal activation in baleen whales and could thus be used to investigate physiological changes following exposure to stressors. In this study, we measured GC concentrations in faecal samples of Pacific Coast Feeding Group (PCFG) gray whales (Eschrichtius robustus) collected over seven consecutive years to assess the association between GC content and metrics of exposure to sound levels and vessel traffic at different temporal scales, while controlling for contextual variables such as sex, reproductive status, age, body condition, year, time of year and location. We develop a Bayesian Generalized Additive Modelling approach that accommodates the many complexities of these data, including non-linear variation in hormone concentrations, missing covariate values, repeated samples, sampling variability and some hormone concentrations below the limit of detection. Estimated relationships showed large variability, but emerging patterns indicate a strong context-dependency of physiological variation, depending on sex, body condition and proximity to a port. Our results highlight the need to control for baseline hormone variation related to context, which otherwise can obscure the functional relationship between faecal GCs and stressor exposure. Therefore, extensive data collection to determine sources of baseline variation in well-studied populations, such as PCFG gray whales, could shed light on cetacean stress physiology and be used to extend applicability to less-well-studied taxa. GC analyses may offer greatest utility when employed as part of a suite of markers that, in aggregate, provide a multivariate measure of physiological status, better informing estimates of individuals’ health and ultimately the consequences of anthropogenic stressors on populations.
Discovery of potential plasma protein biomarkers for ventricular fibrillation due to first ST-elevation myocardial infarction via proteomics
Authors: Stampe N K , Ottenheijm M E , Drici L , Wewer Albrechtsen N J , Nielsen A B , Christoffersen C , Warming P E , Engstroem T , Winkel B G , Jabbari R , Tfelt-Hansen J , Glinge C
Published: November 2023

Background

Although most sudden cardiac deaths are a consequence of ventricular fibrillation (VF) subsequent to myocardial infarction, the underlying biological mechanisms of VF in the setting of ischemia are largely unknown. We used an unbiased mass-spectrometry (MS)-based proteomic approach to improve our understanding of the molecular VF mechanisms.

Purpose

We aimed to identify and characterize proteins that are associated with VF during first ST-elevation myocardial infarction (STEMI).

Methods

We included 230 participants from a Danish ongoing case-control study on patients with first STEMI with VF (case, n=110) and without VF (control, n=120) before guided catheter insertion for primary percutaneous coronary intervention. Using MS-based proteomics on plasma samples collected within 24h of symptom onset, we investigated the plasma proteome. After quality control, one patient was excluded and the difference in the quantitative proteome composition between cases and controls were analysed using t-tests, and further corrected for multiple comparison using the Benjamini-Hochberg procedure (q-value). Cardiac enzymes and anterior infarct location were used in a subset as a proxy for large myocardial damage.

Results

In 229 STEMI patients (72% men, median age 62 years (interquartile range (IQR): 54-70)), a total of 401 unique proteins were identified with a median of 257 proteins (IQR: 244-281) quantified per patient. A total of 26 proteins were associated with VF, these proteins were involved in several biological processes. The most frequent processes were blood coagulation, hemostasis and immunity. After correcting for multiple testing, two up-regulated proteins remained significantly associated with VF, actin beta-like 2 (ACTBL2, FC 2.25, p<0.001, q=0.023) and coagulation factor XIII-A (F13A1, FC 1.48, p<0.001, q=0.023). The most up-regulated protein was ACTBL2, and the second most up-regulated protein was actin alpha 2 (ACTA2, FC 1.72, p=0.001, q=0.073). None of the three proteins were correlated with cardiac enzymes or anterior infarct location.

Conclusion

VF due to first STEMI was significantly associated with two up-regulated proteins (ACTBL2 and F13A1). None of these proteins were correlated with infarct size which could reflect novel underlying molecular VF mechanisms.
Prevalence of subclinical coronary artery atherosclerosis in the general population- apollo subclinical coronary atherosclerosis project (ASCAP)
Authors: Narra L , Oomman A , Showkathali R , Mao R , Immaneni S , Gunasekaran S , Yalamanchi R , Reddy Y V C , Dondapati S , Subban V
Published: November 2023

Background

Coronary artery disease (CAD) is a major cause of mortality and morbidity in our country. CAD affects Indian population at least a decade earlier than the people of European ancestry, often impacting the most productive years of an individual’s life. CAD is often silent or may strike without warning, underscoring the importance of prevention. We used computerized tomography (CT) coronary angiography (CT-CAG) to determine the prevalence, severity, and characteristics of CAD and its association with coronary artery calcium (CAC) scores in general population.

Purpose

Detection of coronary atherosclerosis using CT-CAG, in addition to CAC score, may help in early preventive strategies. In doing so, we can identify population at risk at an early stage and manage them accordingly either by lifestyle modifications, medications or if needed further intervention.

Methods

This study included 451 individuals aged 40 years and above with no known CAD (no previous myocardial infarction or cardiac procedures) and with high-quality results from CT-CAG. Non-contrast images were used for calculating CAC score. CT-CAG was reported per segment, defined as- no atherosclerosis, 1% to 49% stenosis (insignificant atherosclerosis), or ≥50% stenosis (significant atherosclerosis).

Results

Out of the 451 individuals, 72% were men and 27.9% were women. Any CT-CAG detected atherosclerosis was found in 60%; any significant stenosis (≥50%) in 27.7%; no stenosis in 39.9% and any noncalcified plaque <50% in 32.3% of this population. (Table 1) Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending (LAD) artery. Prevalence of CT-CAG detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all the individuals had atherosclerosis and 95.8% had significant stenosis. In those with zero CAC score, 59.4% had no atherosclerosis and 7.5% had significant stenosis. (Table 2)

Conclusion

Using CT-CAG in a large sample of the general population without CAD, has shown that silent coronary atherosclerosis is more common than expected. High CAC scores convey a significant probability of substantial stenosis, and zero CAC score does not exclude atherosclerosis, particularly in those at higher baseline risk.
Effects of once-weekly semaglutide on major adverse cardiovascular events in patients with type 2 diabetes and polyvascular disease: a post hoc analysis of the SUSTAIN 6 trial
Authors: Kobo O , Cavender M A , Hinsch Gylvin S , Kuhlman A B , Rasmussen S , Verma S
Published: November 2023

Background

The presence of polyvascular disease (defined as atherosclerosis involving ≥2 distinct vascular territories) is a strong, independent predictor of subsequent cardiovascular (CV) events in patients with type 2 diabetes (T2D). In the SUSTAIN 6 trial, the glucagon-like peptide-1 receptor agonist once-weekly (OW) subcutaneous semaglutide reduced major adverse cardiovascular events (MACE; a composite of death from CV causes, non-fatal myocardial infarction and non-fatal stroke) in patients with T2D at high CV risk.

Purpose

This analysis of SUSTAIN 6 assessed the effect of OW semaglutide on MACE in patients with T2D, stratified by the number of atherosclerotic vascular territories at baseline.

Methods

Patients in SUSTAIN 6 were randomised to receive 0.5 or 1.0 mg OW subcutaneous semaglutide or placebo. The median follow-up was 2.1 years. In this post hoc analysis, the SUSTAIN 6 population was stratified according to documented atherosclerosis: polyvascular disease (≥2 vascular territories), single vascular disease (1 vascular territory) or no atherosclerotic cardiovascular disease (ASCVD). Time to first MACE was analysed using a stratified Cox proportional hazards model, with pooled treatment by vascular risk group as fixed factors.

Results

In SUSTAIN 6, 640 patients (19.4%) had polyvascular disease, 1821 patients (55.2%) had vascular disease in one arterial bed and 836 patients (25.4%) had no ASCVD at baseline. Demographic and clinical characteristics at baseline are presented in the Table. In the total population, the presence of polyvascular disease and single vascular disease was associated with a greater risk of MACE, compared with no ASCVD (hazard ratio [HR]: 2.25 [95% confidence interval – CI: 1.47;3.52] and HR: 1.64 [95% CI: 1.11;2.48], respectively). In the SUSTAIN 6 trial, OW semaglutide significantly reduced the risk of MACE vs placebo (HR: 0.74 [95% CI: 0.58;0.95]). In this analysis, the risk of MACE was consistently lower with OW semaglutide vs placebo across those with polyvascular disease, single vascular disease and no ASCVD (pinteraction=0.98) (Figure). The absolute risk reductions for OW semaglutide vs placebo at 2 years were 3.37% [95% CI: –1.28;8.02] (number needed to treat [NNT] 30) in patients with polyvascular disease, 2.02% [95% CI: –0.30;4.34] (NNT 50) in patients with single vascular disease and 0.78% [95% CI: –1.96;3.52] (NNT 128) in patients with no ASCVD.

Conclusion

Patients with polyvascular disease in the SUSTAIN 6 trial population are at over two times greater risk of MACE than those without ASCVD. The MACE risk reduction with OW semaglutide vs placebo is consistent across people with T2D and polyvascular disease, single vascular disease or no ASCVD. However, patients with T2D and polyvascular disease may derive greater absolute benefit from semaglutide treatment owing to their higher risk.
Can Insurgents Capture Aid through Credit Claiming? Evidence from Afghanistan
Authors: Breslawski Jori
Published: November 2023

The provision of development aid has become a favored counterinsurgency strategy, with governments reasoning that the delivery of needed services will improve civilians’ perceptions of the government, and consequently decrease civilian collaboration with insurgents. However, this reasoning relies on the critical assumption that civilians attribute projects to the government, and not to the very insurgents that the government seeks to defeat. In information poor environments like civil wars, it may be relatively easy for armed groups to capture the reputational benefits of aid by engaging in credit claiming. Drawing upon on a survey experiment in Afghanistan, I find that civilians who are told that the Taliban allowed a project in their village to occur are more likely to identify the Taliban as a facilitator of development projects, in spite of their own, real-life, experiences. While the effect size is modest, the finding points to the ability of armed groups to capture the reputational benefits of aid through purely rhetorical strategies, with implications for the viability of development aid as a counterinsurgency strategy.
An error of punishment defences in the context of schooling
Authors: McKee DaN
Published: November 2023

Whenever justification of classroom punishment has been attempted it has usually been on grounds that punishment acts either appropriately pedagogically, teaching students how to behave morally, or is a necessary evil that enables the practical running of the school so that it may carry out its educational business. By itself the first justification leaves punishment in schools as only an extension of wider social attitudes about the virtue of punishing perceived moral wrongdoing, rather than providing any distinct argument for punishment specific to the special circumstances of the school. By highlighting an entanglement between the moral and the conventional, and between discipline and punishment, within the context of the school, I shall argue that the essentially contested nature of education and its purpose, and the related question of the school’s suitability as a venue for it, means that the school’s most promising defence of its use of punishment—that punishment of students might somehow be necessary for enabling the important educative business of the school—becomes undone. Schooling and education are not necessarily synonymous, and as schools provide only one vision of education—and this vision is contestable—then upholding the business of any one school in order for it to achieve its particular unsettled and disputed purpose is not a morally sufficient reason to coerce a student’s compliance through regimes of ‘harm intended as harm’.
Adhesive capsulitis following COVID-19 vaccination: a case report and review of literature
Authors: Alshehri Mohammed , Alsalman Mohammed , Alsebayel Firas M
Published: November 2023

Shoulder injury related to vaccine administration (SIRVA) has been frequently reported adverse event following COVID-19 vaccination. Multiple studies have reported various injuries including subacromial bursitis, rotator cuff tears, nerve injury, and most commonly, adhesive capsulitis. Adhesive capsulitis is defined as an inflammatory disease of the joint capsule characterized by pain and stiffness. Herein, we present a case of a 38-year-old female, known to have uncontrolled diabetes mellites and asthma, presented to upper extremity orthopedic clinic complaining of 6 months history of left shoulder pain and limited range of motion following COVID-19 vaccination administration. Clinical examination and radiological studies were consistent with adhesive capsulitis, the patient was then referred for intensive rehabilitation program that provided adequate response. In conclusion, the main etiology of SIRVA has been attributed to suboptimal injection technique, a standardized definition, implementation of safe vaccines injection protocols, and further education and awareness of SIRVA is needed to healthcare practitioners to allow better understanding and prevention.
Winners and losers from occupational segregation across Europe: the role of gender and migration status
Authors: Palencia-Esteban Amaia , del Río Coral
Published: November 2023

Using measures rooted in welfare economics, this article quantifies the economic consequences arising from occupational segregation by gender and migration status in twelve European countries. We also identify the most inclusive European labor markets by building counterfactual distributions. In particular, we remove cross-country differences in immigrants’ origin, years of residence, and education, thus determining the contribution that these variables make to the geographical disparities. Our results reveal that the economic consequences of segregation are negative for most foreign workers, especially for immigrant women in Italy, Spain, Germany, and Slovenia. Portugal emerges as a reference point because immigrant workers have a better position compared to other countries, which does not seem to arise from their basic individual characteristics. Our analysis highlights the importance of policy actions aimed at improving the occupational sorting of immigrant workers, such as investing in skills development, avoiding occupational downgrading, and incorporating a gender perspective.
Standardizing Evidence-Based Practice Review Processes Across the Defense Health Agency Enterprise
Authors: Newnam Rachel , Migliore Laurie , Ransom Jeffrey C
Published: November 2023

Background

The Defense Health Agency (DHA) Campaign Plan identifies Ready Reliable Care (RRC) as one of the eight strategic initiatives. A critical aspect of RRC is standardizing evidence-based practice (EBP) across Military Health System to include training, technology, equipment, and processes. The TriService Nursing Research Program hosted an EBP Summit to address this expectation.

Methods

The EBP Summit evaluated capabilities and gaps critical for implementing EBP into the DHA. This article summarizes the capabilities and gaps associated with administrative processes and infrastructure standardization, specifically EBP review and approval support processes, as well as utilization of the electronic Institution Review Board (eIRB) software platform.

Results

The environmental scan across services revealed consistency in procuring Exempt Determination Official reviews and garnering formal determination letters before the start of EBP initiatives. The Army and Navy Nursing Centers for Clinical Inquiry report variability in the utilization of eIRB, although the Air Force centers consistently utilize eIRB to submit proposed EBP. However, there is variability across all services in how the proposal is categorized (EBP, process improvement, and quality assurance) and in the availability of mentoring support for the submission.

Conclusion

Strategic recommendations to address the identified gaps are establishing a TriService Clinical Inquiry Working Group for process and product standardization, identifying EBP champions for each DHA market to educate and facilitate EBP review and submission processes, and establishing EBP review forums led by EBP subject matter experts. The authors suggest funding for program development and evaluation.
Clinical Inquiry in Nursing Readiness Fellowship: Increasing Air Force Nurse Corps Evidence-Based Practice Leadership Infrastructure
Authors: Migliore Laurie , Jumpp Savannah , Fox Amanda , Huffman Sarah , Holko Holly , Wiese Carla , Grant Dawn , Bedford Theresa , Hicks Enesha , Killian Jacqueline
Published: November 2023

Background

Increasing demands to generate, translate, and implement evidence into practice in manpower and budget-constrained environments triggered innovative support for the nursing scientific community. The Clinical Inquiry in Nursing Readiness (CINR) fellowship is a solution to integrate readiness into clinical inquiry priorities and develop future experts in the field.

Methods

This article describes the fellowship program structure, implementation, and contributions to nursing science, readiness, and professional development. We share specific recommendations based on our experiences to enhance and sustain this valuable fellowship program.

Results

Six fellows have completed the CINR fellowship since its launch in July 2019. Fellows garnered $40,000 in grant funds for five evidence-based practices, two research studies, and six clinical inquiry initiatives. So far, the fellows have produced 20 knowledge products: Three published manuscripts, three evidence-based resource toolkits, nine professional conference presentations (one international), five professional certifications, a variety of organization-wide leadership briefings, and two military decorations specific to the pandemic response.

Conclusions

Establishing a fellowship program to develop a pipeline of readiness-focused nurse scientists and evidence-based practice experts builds future capacity for the enterprise while professionally developing individual nurses for advanced degrees and clinical inquiry leadership roles. Individuals and organizations aspiring to promote a culture of nursing inquiry may benefit from fellowships such as the CINR program.
A Scoping Review of Graduate Nurses’ Education and Use of QSEN Competencies
Authors: Ferro Allison L , Yoder Linda H
Published: November 2023

Introduction

The QSEN Institute developed the quality and safety education for nurses (QSEN) competencies for both undergraduate and graduate-prepared nurses to support their development of the knowledge, skills, and attitudes needed to deliver safe, quality care. The purpose of this scoping review was to (1) determine the extent of evidence about the current use of QSEN competencies in graduate nursing curricula and (2) determine the application of the QSEN competencies among graduate-prepared nurses in clinical practice.

Materials and Methods

Arksey and O’Malley’s methodological framework for scoping reviews was used to explore the literature about the use of the QSEN competencies in graduate nursing education and practice available in PubMed, Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online, and Web of Science. Quality was assessed using Melnyk, Gallagher-Ford, and Fineout-Overholt’s critical appraisal tools.

Results

In total, 423 articles were reviewed, 10 of which met inclusion criteria; five described quality improvement projects, two addressed curricular design, and three were program evaluations. Only one article described the use of QSEN competencies in practice. Overall, the amount of literature was scant and of low quality. All the articles described the use of QSEN competencies in graduate education except one, which also described them in practice in a graduate nurse residency program.

Conclusions

Although the QSEN competencies were adopted for use in graduate curricula and practice settings, there is a wide variation in the actual use and application with limited reporting of outcomes. The graduate QSEN competencies can be leveraged to equip nurses with the knowledge, skills, and attitudes to address quality and safety challenges in any nursing environment including the operational environment in deployed and austere settings. This review provides recommendations to address gaps in research, graduate nursing education, and clinical practice.
ANGI-06. BIOLOGY OF GLIOBLASTOMA INVASION: A SINGLE-CELL LEVEL ANALYSIS OF TUMOR CORE VS. INFILTRATING EDGE
Authors: Pai Balagopal , Chang Wan Sze , Zaslavsky Elena , Tsankova Nadejda
Published: November 2023

Glioblastoma (GBM) is a highly proliferative and diffusely infiltrating tumor, consisting of a necrotic core showing extensive microvascular proliferation and an infiltrating edge that extends beyond the surgical resection margin. The aggressiveness of GBM can be attributed to the existence of glioma stem-like cell populations (GSC) at this infiltrating edge. Although many studies have characterized GSC biology in culture, their contributions to invasion in vivo, and in the context of their microenvironment, remains poorly understood. In this study, we used macro-dissected biopsies of the tumor core and the infiltrative edge from six genetically-distinct glioblastoma tumors, to generate a spatiotemporal map of tumor invasion at a single-cell level. Unbiased clustering of ~40,000 nuclei and integrated analysis identified various cell types composing the tumor microenvironment, with predominance of tumor cells at the core and non-neoplastic cells at the edge, as expected. Inferred copy number alterations based on gene expression confirmed tumor cell identity in the core and the edge datasets. Differential expression analysis of core vs. edge tumor clusters revealed distinct transcriptomic signatures including several genes previously implicated in GBM invasion, such as EGFR, matrix metalloproteinases, and MAPK signaling pathway members. Several genes from this newly defined “GBM invasion signature” were further validated in a PDX invasion model, in which the transcriptome within the tumor core and infiltrative edge were similarly sequenced and analyzed at the single cell level. We are currently employing 10X-visium combined with immunohistochemistry to spatially deconvolute and corroborate the defined GBM invasion/infiltration signature at the tissue level in tumor biopsies. Overall, our study aims to provide high resolution map of glioma tumor invasion that can prioritize new and unique targetable pathways.
BIOM-20. NEAT1 EXPRESSION IS ASSOCIATED WITH GLIOBLASTOMA PATIENT RESPONSE TO IMMUNE CHECKPOINT INHIBITORS
Authors: Toker Joseph , Iorgulescu J Bryan , Ling Alexander , Villa Genaro , Parida Laxmi , Getz Gad , Wu Catherine , Reardon David , Antonio Chiocca E , Mineo Marco
Published: November 2023

Glioblastoma (GBM) is the most common and aggressive primary brain cancer. Despite advances in therapeutic intervention, including maximal tumor resection, chemotherapy, and radiotherapy, GBM patient median survival remains approximately 20.9 months. A promising approach to overcome current therapeutic challenges is the use of inhibitors of immune checkpoints, such as PD-1/PD-L1, which have been demonstrated to be effective against many different solid cancers. Despite the strong interest in applying these strategies to GBM, clinical studies evaluating the efficacy of monoclonal antibodies against PD-1/PD-L1 have yielded disappointing results. However, an analysis of the data from these studies, considering clinical factors such as MGMT promoter methylation and the use of steroids, indicated that immune checkpoint inhibitor (ICI) therapy may benefit a subset of GBM patients. Moreover, additional clinical studies in GBM have demonstrated the importance of the timing of ICI treatment, although the markers associated with response remain unclear. Therefore, understanding the molecular basis of clinical response to PD-1/PD-L1 inhibitors is critical to identify GBM patients who can benefit from this type of therapy. By analyzing the transcriptomic profile of two different cohorts of GBM patients, we identify NEAT1 as a long noncoding RNA upregulated in GBM patients with longer survival upon anti-PD-1/PD-L1 treatment. Higher expression of NEAT1 was associated with upregulation of the interferon-gamma pathway and downregulation of cell-cycle-related genes. Single-cell RNA-sequencing analysis showed that higher NEAT1 expression in tumor cells correlated with the number of infiltrating macrophages and microglia. Among the GBM immune infiltrates, we found that macrophages and microglia had the highest NEAT1 median expression. Macrophage expression of NEAT1 was associated with enrichment in the TNF-alpha signaling pathway and the regulation of different inflammatory cytokines. Our findings suggest that NEAT1 is an important factor in shaping the tumor-immune microenvironment and a potential marker to predict GBM patient response to ICI.