bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimising Pavement Performance in Douala City Using a Mixture of Clay and Sand Fractions
Authors: Abanda Andre , Thierry Odi , Benjamin Bahel , Fokwa Didier , Christophe Kikmo
Published: June 2024

Pavements are complex structures composed of multiple layers, designed to withstand various types of stress, including mechanical, organic, and climatic. The pavement is constantly subjected to cyclic, dynamic-mechanical actions caused by road traffic and different axle loads. Classified as engineering structures, the standard theoretical durability of this type of construction is generally estimated to be around one hundred years. However, this objective may not be achieved if the designer does not take into account certain specific factors that are endogenous and exogenous to the structure. Therefore, the durability of a road can be achieved through an optimized design that meets the needs defined by the public authorities and the context of its socio-economic framework. This passage discusses the factors that affect the performance of pavements, including soil type, machinery used, users, and climatic conditions. Exceeding axle loads, which form the basis of pavement design calculations, is also a disruptive factor from a civic perspective. A pavement consists of multiple layers, each made up of materials that must meet strict quality criteria and respect the anthropological, economic, social, and natural environment. It is important to consider all of these factors when constructing a pavement to ensure its longevity and avoid any negative impacts on the surrounding area. Additionally, it is crucial to maintain the pavement to prevent any loss of economic or infrastructural development opportunities. Several road infrastructures in urban and inter-urban areas experience issues that result from a combination of causes, each with varying degrees of impact. Douala is one such city where civil engineering projects are subject to an environment that is not conducive to the longevity of infrastructure, especially road infrastructure. The city is situated on a surface layer covered by a predominantly sandy-clay soil. This study aims to propose a proportional mixture of clay and sand soil fractions to create an anvil effect during compaction. The objective is to create a hybrid backfill material that can achieve a high compaction rate. Good compaction is crucial for achieving optimal pavement layer performance. The thickness of the material to be laid is greatly affected by this characteristic, which in turn affects the volume of equipment depreciation and user comfort. This has a significant impact on a wide range of socio-economic benefits. Based on soil mechanics and geotechnical tests, a new material is proposed to combat the early onset of disorders such as potholes, ruts, erosion, or pavement collapse in bad weather or heavy traffic.
High levels of anxiety and depression in women farmers from Ecuador: A cross-section study in Coastal and Highlands regions
Authors: Siteneski Aline , Gómez Mieles Viviana Septimia , Romero Riaño Paola Andrea , Montes Escobar Karime , Lapo-Talledo German Josuet , Dueñas-Rodriguez Andrea Valeria , Palma Cedeño María Antonieta , Villacis Lascano Yliana Consuelo , Echeverria Zurita Lincon Oliver
Published: June 2024

Background:

Previous studies have shown that women farmers are particularly vulnerable to mental health disorders such as depression and anxiety.

Aims:

This study aimed to investigate the prevalence of anxiety and depression in women farmers from Ecuador Coastal and Highlands regions.

Method:

General Anxiety Disorder‑7 (GAD‑7) and Patient Health Questionnaire‑9 (PHQ‑9) were applied. In addition, self-reported number of children, days off, hours of work, pesticide use, sleep habits and years of work in agriculture, were also collected. This cross-sectional study occurred during 2023 with 443 women, for Coastal (197) and Highlands (246), respectively. Multivariable binary logistic regression models were performed to obtained adjusted odds ratios (aOR) and their 95% confidence intervals (95% CI).

Results:

34.5% of Coastal women had depression, while 27.2% of Highlands women had depression. 20.3% of coastal women farmers had anxiety, while in the Highlands 24.8% had anxiety. Coastal mestizo and montubio women exhibited lower probability of depression, but this was not significant in the Highlands. Coastal women farmers that did not have children showed lower odds of depression (aOR 0.05, 95% CI [0.01, 0.34]). A lower likelihood of depression was observed in coastal women that worked more than 8 hours (aOR 0.22, 95% CI [0.07, 0.72]). Women from the Highlands that had shortened sleep duration exhibited lower odds of depression and anxiety.

Conclusions:

A higher proportion of depressed women farmers was observed in the Coast region and slightly higher numbers of anxiety cases in the Highlands. The number of children may cause workload and is correlated with depression in Coastal women.
How Do Personal Opinions Relate to Online Expressions? An Experimental Study Among Muslim Minority Groups in The Netherlands
Authors: Wuestenenk Nick , van Tubergen Frank , Stark Tobias H. , Ellemers Naomi
Published: June 2024

There has been much debate about how cultural differences between ethnic groups may affect the cohesion of multicultural societies. Still, we know little about the extent to which cultural differences between groups also materialize into behavioral differences, especially in online settings. To study this, we conducted an experiment in which second-generation Moroccan and Turkish Dutch participants first indicated their personal opinion on sexual liberalism, and then participated in discussions on this topic on an online platform. On the discussion platform, participants were randomly assigned to either a progressive, conservative or mixed online discussion. Overall, we found that the convergence between personal opinions and online expressions was stronger for progressive than for conservative participants. Additionally, conservatives (but not progressives) were less likely to express their personal opinions, and more likely to deviate from their personal opinions, when they were exposed to an incongruent versus congruent online environment.
One Size Doesn’t Fit All: An Exploratory Typological Approach to Understanding Criminal Career Heterogeneity in Intimate Partner Homicide
Authors: Péloquin Olivier , Chopin Julien , Fortin Francis , Guay Jean-Pierre , Chartrand Eric , Paquette Sarah
Published: June 2024

Approximately one in seven homicides globally is committed by a partner within an intimate relationship. While criminology research on intimate partner homicide (IPH) perpetrators is extensive, their interactions with law enforcement remain underexplored. This study examines the criminal trajectories of IPH perpetrators to ascertain whether they exhibit common or diverse patterns. Utilizing data from Quebec’s official criminal events database, the study analyzes variables concerning the criminal histories of 1,780 individuals involved in attempted or completed IPH through latent profile analysis. Findings indicate five distinct profiles among IPH perpetrators: one-time, low-volume intimate partner violence (IPV), moderate-volume IPV, high-volume violence, and high-volume polymorphous perpetrators. The external validity of these profiles is assessed using additional criminal career, contextual, and situational variables. Implications for the justice system’s practices and challenges are also discussed.
Lenders’ Environmental Monitoring: Evidence From Environmental Covenants in Private Loan Contracts
Authors: Lee Ruby , Zakota Mark
Published: June 2024

We investigate the role of covenants in private loan contracts that place requirements or limitations on borrowers’ environmental actions (hereafter, “environmental covenants”). Utilizing a machine learning algorithm, we find that environmental covenants are highly prevalent, appearing in 54% of loan contracts in our sample. The use of these covenants is significantly associated with borrowers’ environmental risk exposure, borrower–lender information asymmetry, and key contract terms, such as collateral and loan maturity. The association between environmental risk and environmental covenants is more pronounced when borrowers face greater financial distress, lenders have a stronger reputation, and there is a higher risk of regulatory enforcement. Additional analysis shows that the presence of a board committee overseeing environmental matters reduces lenders’ demand to contractually address the borrower’s environmental risk. Collectively, our results provide novel insights into the contractual mechanisms addressing environmental risk and the factors shaping lenders’ environmental monitoring demand.
Views on advance care planning of family members of older adults with Turkish and Moroccan backgrounds: An exploratory interview study
Authors: Demirkapu Hakki , Edally Wael , De Vleminck Aline , Van den Block Lieve , De Maesschalck Stéphanie , Devroey Dirk
Published: June 2024

Background:

Significantly fewer individuals with migration backgrounds than native-born individuals undertake advance care planning. Older adults with Turkish and Moroccan backgrounds represent one of the largest ageing non-Western minority groups in Europe. Their relatives could play important roles in facilitating or hindering advance care planning, but their views remain underexplored.

Aim:

To explore advance care planning knowledge, experience, views, facilitators and barriers among older Turkish and Moroccan adults’ relatives in Belgium.

Design:

Qualitative thematic analysis of semi-structured interview data.

Setting/participants:

Twenty-two relatives of older Turkish and Moroccan adults in Brussels, Mechelen and Antwerp, recruited via general practitioners.

Results:

Participants had limited advance care planning knowledge and had not discussed it with healthcare professionals. Some found discussing end-of-life preferences with relatives beneficial; others opposed the discussion of specific topics or felt discussions were unnecessary, as they felt responsible for caregiving and trusted by their relatives to make future decisions. Barriers included personal and relational characteristics, emotional difficulty and perceived non-urgency. Facilitators included information in older adults’ native languages, general practitioners’ cautious initiation and the involvement of several family members.

Conclusions:

Relatives of older people with Turkish and Moroccan backgrounds are unfamiliar with advance care planning and have highly variable views on it. People should be given opportunities to discuss advance care planning in a culturally appropriate manner, and the diversity of perspectives regarding whether and how to engage in such planning should be recognised. ClinicalTrials.gov no. NCT05241301.
The 15-minute city concept: The case study within a neighbourhood of Thessaloniki
Authors: Shoina Maria , Voukkali Irene , Anagnostopoulos Apostolos , Papamichael Iliana , Stylianou Marinos , Zorpas Antonis A
Published: June 2024

Cities, crucial cultural hubs, mould individual and group identities. The global urban expansion, with over half the population in urban areas, presents interconnected challenges such as pollution, poverty, inequality, ageing infrastructure, resource overconsumption, land use changes, biodiversity impact and climate change. Addressing these demands ambitious actions targeting political, social and economic systems for transformative change. The theoretical framework guiding city transformation centres on an interdisciplinary approach influenced by the Smart and Green Transition. The ‘15-minute city’ concept, emphasizing human scale and urban experience, proposes that cities enable residents to meet daily needs within a short walk or bike ride. The aim of this study was the exploration of its implementation in Greek cities, particularly Thessaloniki, which reveals inherent characteristics supporting the 15-minute concept. Through an interdisciplinary approach rooted in the Smart and Green Transition framework, the research provides concrete guidance for policymakers in tailoring urban planning strategies, allocating resources effectively and crafting policies conducive to successful and sustainable urban transformations. Moreover, prioritizing public engagement highlights the significance of community involvement in shaping urban development plans, ensuring that proposed initiatives align with residents’ needs and desires. In essence, this research contributes tangible insights and actionable recommendations for Greek cities, paving the way for more liveable, resilient and sustainable urban environments.
Developmental Education for College Students with Learning and Attention Disabilities
Authors: Wells Ryan S. , Chen Ling
Published: June 2024

As postsecondary developmental education policy reforms are implemented, increased attention must be given to students with learning and attention disabilities. The purpose of this study was to bring these students into the conversation, by examining their representation in developmental education broadly, as well the effect of this intervention on their college persistence and credit accumulation. Results show students with learning or attention disabilities are overrepresented in developmental education and could experience heterogenous effects on their postsecondary outcomes. Policymakers should be purposeful about consideration of this growing group of students in continued developmental education reforms.
Working Time Mismatch and Employee Subjective Well-being across Institutional Contexts: A Job Quality Perspective
Authors: Ling Wanying , Wang Senhu , Lu Zhuofei
Published: June 2024

Despite the well-documented negative impact of working time mismatch on employee subjective well-being, little is known about the extent to which this association can be explained by job quality and how these patterns may differ across institutional contexts. Utilizing panel data from the UK and cross-country data from Europe, the decomposition analyses show that for underemployment, more than half of the negative effects are explained by low job quality, especially poor career prospects. For overemployment, more than a third of its negative effect is explained by low job quality, with poor prospects, social environment and work–life balance being significant contributing factors. This interplay between job quality and working time mismatch on subjective well-being varies notably across different welfare and employment regimes. These findings reveal how job quality dimensions differentially contribute to the well-being of overemployed and underemployed individuals, highlighting the distinctive role of institutional context.
The emergence and organizational choices of patient advocacy associations: Evidence from the Italian context
Authors: Morandi Federica , Di Brino Eugenio , Cicchetti Americo
Published: June 2024

Background

Within many advanced healthcare systems, patient advocacy associations are gaining a more relevant role in healthcare policy decisions. These associations provide help, representation, and voice to patients and citizens. However, although their role is important, a paucity of research exists analyzing their foundation dynamics, including their organizational decision, from a managerial perspective. To fill this knowledge gap, we formulated two research questions to investigate the motivations underlying the foundation of patient advocacy associations and the institutional pressures influencing the changes that have occurred in these associations throughout their evolution.

Methods

Using a semi-structured questionnaire developed as part of a larger research project, we collected data about 31 patient advocacy associations operating within the Italian National Health Service. We employed qualitative analysis to examine the associations’ birth and evolution as well as the motivations and influences driving change within the sampled organizations.

Results

Questionnaire responses provided information about the patient advocacy associations’ histories and highlighted their close links with the Italian National Health Service. Our results indicated the motivations for the associations’ establishment could be grouped into five categories: support at the system level, patient protection and support, actions to increase awareness, actions for improving patients’ health and quality of life, and dissemination of knowledge. We also identified the frequency and nature of the changes within the associations and explored the institutional pressures that influenced these organizational changes.

Conclusions

The results can be interpreted considering the organizational theories that focus on organizations’ establishment decisions and how external pressures impact organizations’ dynamics and evolution.
Loss of control of herpes suppression following bariatric surgery
Authors: Samraj Shyam , Olasoji Kimberley , Patel Raj
Published: June 2024

We report a 42-year-old female with confirmed recurrent genital herpes (HSV-2), which was well controlled on suppressive antiviral therapy with aciclovir 400 mg twice daily. The patient required bariatric surgery in order to manage what was deemed a dangerously high BMI. A Roux-en-Y procedure was performed which effectively reduced her weight; however, herpes suppression become ineffective post operatively, with serious herpes related complications, despite increasing the total dose of aciclovir and the frequency from twice daily to three times a day. Complete herpes control was restored by changing therapy to valaciclovir 500 mg twice daily. The Roux-en-Y procedure is the most common form of bariatric surgery. Consequences on the efficacy of different herpes antivirals can be predicted from what is known of their properties and sites of absorption. Similar problems with herpes virus suppression may be avoided by an anticipated change in therapy preoperatively.
Study on UPLC–MS/MS Method for Four Compositions of Cangzhu
Authors: Qiyong Ren , Jikai Sun , Lili Qin , Min Zhang , Junying Ma , Jun Liu , Honglian Zhang
Published: June 2024

Background

The legal quality control of Cangzhu is used the single component as an evaluation indicator, which would not be enough to reflect the authenticity of quality. It is necessary to select several typical chemical components as the basis for quality control of medicinal materials and decoction pieces to reflect the content of effective ingredients.

Purpose

Based on UPLC-MS/MS, the study aimed to build the content determination method of atractyloidin, atractylidin A, atractylenolide I, and atractylenolide III in Cangzhu from different sources.

Materials and Methods

Agilent SB-C18 (2.1 × 100 µm, 1.8 µm) was used to be the stationary phase. The mobile phase system was formed by water-formic acid (1000:1) and acetonitrile-formic acid (1000:1) in gradient elution. The column temperature set at 40℃, and the flow rate was 0.3 mL min–1.

Results

The contents of atractyloidin, atractylidin A, atractylenolide I, and atractylenolide III had good linearity in a certain range (r2 ≥ 0. 9990). The RSD of the precision, stability and repetitive test results were less than 3.00%. In addition, the content of the four components were some different among different patches of Cangzhu.

Conclusion

The method was simple, rapid and highly sensitive, which was suitable for the determination of atractyloidin, atractylidin A, atractylenolide I, and atractylenolide III in Cangzhu.
Resilient Leadership During COVID-19 Pandemic
Authors: Buskila Yaffa , Chen-Levi Tamar , Kayne Andrea , Schechter Chen
Published: June 2024

This study aims to explore how school leaders applied resilience in order to cope with the Covid-19 pandemic. This qualitative study used semistructured interviews with 26 school leaders. Results yielded three main manners of applying resilience: (a) be proactive, pragmatic, and creative; (b) find meaning and set goals; (c) lead the emotional climate. The study can contribute to the scholarly understanding of leaders’ resilience in crisis times as well as to professional development programs for nurturing resilience among school leaders.
Simultaneous Application of Acid Protease and Transglutaminase on Wool and its Optimisation to Achieve Machine Washable Care Claim
Authors: Madān Pavittar Punit Singh , Chakraborty J. N.
Published: June 2024

In the previous work by the same authors, optimisation of sequential application of acid protease and transglutaminase was carried out to achieve Woolmark specification AW-1 for the machine washable care claim, that is, less than 3% total shrinkage. As a result of optimisation, the total warp shrinkage reduced to 2.64% with only 2.82% loss in warp tensile strength. In this work, simultaneous application of acid protease and transglutaminase was explored and optimised using Box–Behnken design of experiment. The optimisation was carried out using two criteria. In the first criterion, the model was used to predict treatment parameters for minimum total warp shrinkage with minimum loss in warp tensile strength. Taking these predicted treatment parameters, wool was treated with acid protease (1%, owf) and transglutaminase (2.8%, owf) at pH ∼5.3 and 50°C for 60 min. After treatment, the total warp shrinkage reduced to only 4.32% with 4.65% loss in warp tensile strength. This was not only higher than the optimised sequential application of both the enzymes but also failed to meet the Woolmark specification for machine washable care claim. So, the second criterion was used in which the prediction was taken for treatment parameters to achieve the minimum total warp shrinkage without any constraints on loss in warp strength. Again, taking these predicted treatment parameters, wool was treated with acid protease (1.3%, owf), transglutaminase (1.6%, owf), pH ∼4.7 at 55°C for 85 min. Under these treatment conditions, the total warp shrinkage reduced to 2.89% with 10.1% loss in warp strength. Furthermore, interaction between the enzymes also plays a role in the outcomes of the treatment. It was evident that there was a loss in transglutaminase activity as a result of acid protease digestion. However, there was no loss in the activity of acid protease, indicating that transglutaminase did not have any negative influence on the activity of acid protease.
ATM germ line pathogenic variants affect outcomes in children with ataxia-telangiectasia and hematological malignancies
Authors: Elitzur Sarah , Shiloh Ruth , Loeffen Jan L. C. , Pastorczak Agata , Takagi Masatoshi , Bomken Simon , Baruchel Andre , Lehrnbecher Thomas , Tasian Sarah K. , Abla Oussama , Arad-Cohen Nira , Astigarraga Itziar , Ben-Harosh Miriam , Bodmer Nicole , Brozou Triantafyllia , Ceppi Francesco , Chugaeva Liliia , Dalla Pozza Luciano , Ducassou Stephane , Escherich Gabriele , Farah Roula , Gibson Amber , Hasle Henrik , Hoveyan Julieta , Jacoby Elad , Jazbec Janez , Junk Stefanie , Kolenova Alexandra , Lazic Jelena , Lo Nigro Luca , Mahlaoui Nizar , Miller Lane , Papadakis Vassilios , Pecheux Lucie , Pillon Marta , Sarouk Ifat , Stary Jan , Stiakaki Eftichia , Strullu Marion , Tran Thai Hoa , Ussowicz Marek , Verdu-Amoros Jaime , Wakulinska Anna , Zawitkowska Joanna , Stoppa-Lyonnet Dominique , Taylor A. Malcolm , Shiloh Yosef , Izraeli Shai , Minard-Colin Veronique , Schmiegelow Kjeld , Nirel Ronit , Attarbaschi Andishe , Borkhardt Arndt
Published: June 2024

Ataxia-telangiectasia (A-T) is an autosomal-recessive disorder caused by pathogenic variants (PVs) of the ATM gene, predisposing children to hematological malignancies. We investigated their characteristics and outcomes to generate data-based treatment recommendations. In this multinational, observational study we report 202 patients aged ≤25 years with A-T and hematological malignancies from 25 countries. Ninety-one patients (45%) presented with mature B-cell lymphomas, 82 (41%) with acute lymphoblastic leukemia/lymphoma, 21 (10%) with Hodgkin lymphoma and 8 (4%) with other hematological malignancies. Four-year overall survival and event-free survival (EFS) were 50.8% (95% confidence interval [CI], 43.6-59.1) and 47.9% (95% CI 40.8-56.2), respectively. Cure rates have not significantly improved over the last four decades (P = .76). The major cause of treatment failure was treatment-related mortality (TRM) with a four-year cumulative incidence of 25.9% (95% CI, 19.5-32.4). Germ line ATM PVs were categorized as null or hypomorphic and patients with available genetic data (n = 110) were classified as having absent (n = 81) or residual (n = 29) ATM kinase activity. Four-year EFS was 39.4% (95% CI, 29-53.3) vs 78.7% (95% CI, 63.7-97.2), (P < .001), and TRM rates were 37.6% (95% CI, 26.4-48.7) vs 4.0% (95% CI, 0-11.8), (P = .017), for those with absent and residual ATM kinase activity, respectively. Absence of ATM kinase activity was independently associated with decreased EFS (HR = 0.362, 95% CI, 0.16-0.82; P = .009) and increased TRM (hazard ratio [HR] = 14.11, 95% CI, 1.36-146.31; P = .029). Patients with A-T and leukemia/lymphoma may benefit from deescalated therapy for patients with absent ATM kinase activity and near-standard therapy regimens for those with residual kinase activity.
Nano silica’s role in regulating heavy metal uptake in Calendula officinalis
Authors: Samani Maryam , Ahlawat Yogesh K. , Golchin Ahmad , Alikhani Hossein Ali , Baybordi Ahmad , Mishra Sadhna , Şimşek Özhan
Published: June 2024

Background

Soil contamination with heavy metals poses a significant threat to plant health and human well-being. This study explores the potential of nano silica as a solution for mitigating heavy metal uptake in Calendula officinalis.

Results

Greenhouse experiments demonstrated, 1000 mg•kg− 1 nano silica caused a 6% increase in soil pH compared to the control treatment. Also in 1000 mg. kg− 1 nano silica, the concentrations of available Pb (lead), Zn (zinc), Cu (copper), Ni (nickel), and Cr (chromium) in soil decreased by 12%, 11%, 11.6%, 10%, and 9.5%, respectively, compared to the control. Nano silica application significantly reduces heavy metal accumulation in C. officinalis exposed to contaminated soil except Zn. In 1000 mg.kg− 1 nano silica shoots Zn 13.28% increased and roots Zn increased 13% compared to the control treatment. Applying nano silica leads to increase the amount of phosphorus (P) 25%, potassium (K) 26% uptake by plant, In 1000 mg.kg − 1 treatment the highest amount of urease enzyme activity was 2.5%, dehydrogenase enzyme activity, 23.6% and the highest level of alkaline phosphatase enzyme activity was 13.5% higher than the control treatment.

Conclusion

Nano silica, particularly at a concentration of 1000 mg.kg − 1, enhanced roots and shoots length, dry weight, and soil enzyme activity Moreover, it increased P and K concentrations in plant tissues while decreasing heavy metals uptake by plant.
Antiarrhythmic drug therapy and catheter ablation in patients with paroxysmal or persistent atrial fibrillation: a systematic review and meta-analysis
Authors: Chander Subhash , Kumari Roopa , Luhana Sindhu , Shiwlani Sheena , Parkash Om , Sorath FNU , Wang Hong Yu , Tan Sam , Rahaman Zubair , Mohammed Yaqub Nadeem , Lohana Abhi Chand , Sakshi FNU , Vaish Esha , Sadarat FNU
Published: June 2024

Background

Catheter ablation and antiarrhythmic drug therapy are utilized for rhythm control in atrial fibrillation (AF), but their comparative effectiveness, especially with contemporary treatment modalities, remains undefined. We conducted a systematic review and meta-analysis contrasting current ablation techniques against antiarrhythmic medications for AF.

Methods

We searched PubMed, SCOPUS, Cochrane CENTRAL, and Web of Science until November 2023 for randomized trials comparing AF catheter ablation with antiarrhythmics, against antiarrhythmic drug therapy alone, reporting outcomes for > 6 months. Four investigators extracted data and appraised risk of bias (ROB) with ROB 2 tool. Meta-analyses estimated pooled efficacy and safety outcomes using R software.

Results

Twelve trials (n = 3977) met the inclusion criteria. Catheter ablation was associated with lower AF recurrence (relative risk (RR) = 0.44, 95%CI (0.33, 0.59), P ˂ 0.0001) and hospitalizations (RR = 0.44, 95%CI (0.23, 0.82), P = 0.009) than antiarrhythmic medications. Catheter ablation also improved the physical quality of life component score (assessed by a 36-item Short Form survey) by 7.61 points (95%CI -0.70-15.92, P = 0.07); but, due to high heterogeneity, it was not statistically significant. Ablation was significantly associated with higher procedural-related complications [RR = 15.70, 95%CI (4.53, 54.38), P < 0.0001] and cardiac tamponade [RR = 9.22, 95%CI (2.16, 39.40), P = 0.0027]. All-cause mortality was similar between the two groups.

Conclusions

For symptomatic AF, upfront catheter ablation reduces arrhythmia and hospitalizations better than continued medical therapy alone, albeit with moderately more adverse events. Careful patient selection and risk-benefit assessment are warranted regarding the timing of ablation.
Association of potentially inappropriate medications with prognosis among older patients with non-small cell lung cancer
Authors: Ma Zhuo , Xu Man , Fu Mengyuan , Huang Tao , Shi Luwen , Zhang Yuhui , Guan Xiaodong
Published: June 2024

Background

Potentially inappropriate medications (PIMs) are common among older adults with cancer, but their association with overall survival (OS) among non-small cell lung cancer (NSCLC) patients remains unclear. This study aimed to investigate the association between the use of PIMs and OS in patients with NSCLC.

Methods

In this cohort study, we included patients ≥ 65 years with newly diagnosed NSCLC from January 2014 to December 2020. Potentially inappropriate medication (PIM) is defined by the Beers criteria of 2019 at baseline and within six months following the initiation of systemic therapy. Multivariable Cox regression model was built to assess the association between PIMs and overall survival (OS).

Results

We finally included 338 patients with a median follow-up for OS of 1777 days. The prevalence of patients receiving at least one PIM was 39.9% (135/338) and 61.2% (71/116) at baseline and after systemic therapy, respectively. The most important factor associated with PIM use was the number of prescribed medications (P < 0.001). Baseline PIM use and PIM after systemic therapy were significantly associated with inferior OS (476 days vs. 844 days, P = 0.044; and 633 days vs. 1600 days, P = 0.007; respectively). In multivariable analysis, both baseline PIM use and PIM after systemic therapy were independent predictors of poor prognosis (adjusted HR, 1.33; 95% CI, 1.01–1.75; P = 0.041; and adjusted HR, 1.86; 95% CI, 1.11–3.14; P = 0.020; respectively).

Conclusions

PIMs are prevalent among older patients with NSCLC and are independent predictors of NSCLC prognosis. There is an urgent need for clinicians to conduct medication reconciliation and appropriate deprescribing for this population, especially for patients with multiple PIMs.
Providing and receiving support through a tailor-made mobile app: a qualitative study on experience of professionals and family caregivers to persons with dementia
Authors: Kagwa Aber Sharon , Dorell Åsa , Konradsen Hanne , Vikström Sofia , Kabir Zarina Nahar
Published: June 2024

Background

The ageing population and the rise of persons with dementia (PWD) living at home have increased the need for support by family caregivers (FC). Research suggests that most FCs are unprepared for the complex role of informal caregiving. The use of mobile applications (apps) provide a cost-effective and efficient opportunity for community-based social care professionals to provide tailor-made support to FCs. The literature indicates that there are limited mobile apps available to meet the needs of the FCs to PWD living at home. The aim of this study was to explore how social care professionals and FCs to PWD living at home experience providing and receiving support through a tailor-made mobile app named STAV.

Methods

A qualitative descriptive design was applied. Data were collected through semi-structured interviews with 11 community-based social care professionals and 19 FCs of PWD living at home. The data were analyzed inductively using thematic analysis.

Results

The social care professionals and the FCs’ experience of providing and receiving support through a mobile app was represented by the following themes: Accessibility to support – Bridging the gap, Engaging from a distance, and Limitations of the support.

Conclusions

This study highlights the need for FCs to PWD to receive support that is tailor-made to their needs as caregivers. The findings from this study can help community-based social care providers plan and organize long-distance support for FCs to PWD living at home. The findings further support the use of a mobile app as a complement to traditional means of support for FCs to PWD which can facilitate their knowledge, awareness, and self-care management.
Addressing loneliness and social isolation through the involvement of primary and secondary informal caregivers in nursing homes: a scoping review
Authors: Autschbach Dominique , Hagedorn Anika , Halek Margareta
Published: June 2024

Objectives

To clarify the mechanisms of interventions addressing loneliness and social isolation in older adults living in nursing homes through the involvement of primary and secondary informal caregivers.

Methods

This scoping review was performed by two independent reviewers, covering the period between 2011 and 2022 and the databases MEDLINE, CINAHL, PsycINFO and Scopus. It included terms related to (A) informal caregivers, (B) nursing homes, (C) psychosocial interventions, (D) involvement and (E) social isolation or loneliness.

Results

Thirty-three studies met the inclusion criteria. Although there were various definitions and assessment tools related to social isolation and loneliness, the studies referred to three dimensions of these concepts in nursing home residents: the quantity of social interactions, the perception of these encounters and biographical changes in social relationships. Most studies did not explicate the mechanisms of these interventions. The review uncovered the following aspects of intervention mechanisms: increasing opportunities for social contact, creating meaningful encounters, maintaining existing relationships with primary informal caregivers and establishing new ones with secondary informal caregivers.

Conclusion

Studies reporting on interventions addressing loneliness and social isolation in nursing home residents need to clarify and detail their intervention mechanisms in order to foster more targeted interventions. In addition, there is a need for further research on large-scale programs or care philosophies in this field and the development of intervention designs, which allow for tailored intervention formats in order to respond to the individual perception of social relationships.
Impact of Vancomycin trough levels monitoring on uncomplicated methilcillin-resistant Staphylococcus aureus bacteremia in chronic kidney disease on hemodialysis, retrospective cohort
Authors: Ramirez-Osorio Julian Felipe , Velez-Hernandez Juan Esteban , Fernandez-Castaño Nathalia , Rojas-Hernandez David Felipe , Jaimes Fabian
Published: June 2024

Background

CKD patients on hemodialysis (HD) with Staphylococcus aureus (SA) bacteremia present high morbidity, mortality and increased risk of MRSA. Vancomycin is the antibiotic of choice in these cases, it has a narrow therapeutic margin and inadequate dosage generates a risk of toxicity, therefore, the recommendation is to dosage it through serum levels.

Methods

This is a retrospective cohort study in 3 hospitals of third level of complexity in the city of Medellin in which there were differences in the measurement and implementation of vancomycin25 dosage based on trough levels (VL) in patients with chronic kidney disease on hemodialysis (CKD- HD) with uncomplicated bacteremia based infection by methilcillin-resistant Staphyloccocus aureus (MRSA). The primary outcome was the composite of hospital mortality, clinical response (fever, hemodynamic instability and altered consciousness), complications associated with bacteremia, or bacteriological response failure (positive cultures at first week follow-up) at 7 days. The composite variables were analyzed individually as secondary outcomes.

Results

The main unadjusted outcome (OR 1.3, CI 0.6 - 2.7) and adjusted for age, Charlson index, loading dose, initial dose, dosing frequency and MIC to vancomycin (OR 1.2, CI 0.5 - 2.7). Regarding adjusted secondary outcomes: clinical response (OR 1.4 CI 0.3 - 5.8), death (OR 1.3 CI 0.3 - 4.6) and complications (OR 0.9, CI 0.37 - 2.2).

Conclusions

We conclude that the measurement of trough levels in patients with HD-CKD does not modify the composite outcome. The main limitation is the sample size and type of study, randomized control trials may be required to confirm the results presented.
Performance of fine needle aspiration cytology and Ziehl-Neelsen staining technique in the diagnosis of tuberculosis lymphadenitis
Authors: Kumbi Hawi , Ali Musa Mohammed , Abate Alegntaw
Published: June 2024

Introduction

Proper diagnosis of tuberculosis (TB) lymphadenitis is critical for its treatment and prevention. Fine needle aspirate cytology (FNAC) is the mainstay method for the diagnosis of TB lymphadenitis in Ethiopia; however, the performance of FNAC has not been evaluated in the Eastern Region of Ethiopia. This study aimed to evaluate the performance of FNAC and Ziehl-Neelsen (ZN) staining compared with that of GeneXpert for the diagnosis of TB lymphadenitis.

Methods

Fine needle aspiration (FNA) specimens collected from 291 patients suspected of having TB lymphadenitis were examined using FNAC, ZN, and GeneXpert to diagnose TB lymphadenitis. Gene-Xpert was considered the reference standard method for comparison. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and kappa coefficient were determined using SPSS version 25.

Results

The sensitivity, specificity, PPV, and NPV of ZN for diagnosing TB lymphadenitis were 73.2%, 97.4%, 96.2%, and 80.1% respectively. There was poor agreement between ZN and GeneXpert (Kappa=-0.253). The sensitivity, specificity, PPV, and NPV of FNAC were 83.3%, 94.8%, 93.5%, and 86.3% respectively. There was moderate agreement between the FNAC and GeneXpert (Kappa = 0.785).

Conclusion

The fine needle aspiration cytology (FNAC) is a more sensitive test for the diagnosis of TB lymphadenitis than ZN. The FNAC showed a moderate agreement with the GeneXpert assay. This study recommends the FNA GeneXpert MTB/RIF test in preference to FNAC for the diagnosis of TB lymphadenitis to avoid a missed diagnosis of smear-negative TB lymphadenitis.
Atherosclerosis is associated with plasma Aβ levels in non-hypertension patients
Authors: Chen Chen , Anqi Wang , Ling Gao , Shan Wei , Liangjun Dang , Suhang Shang , Kang Huo , Fan Gao , Jingyi Wang , Qiumin Qu , Jin Wang
Published: June 2024

Background

Growing evidence indicated that to develop of atherosclerosis observed more often by people with Alzheimer’s disease (AD), but the underlying mechanism is not fully clarified. Considering that amyloid-β (Aβ) deposition in the brain is the key pathophysiology of AD and plasma Aβ is closely relate to Aβ deposition in the brain, in the present study, we investigated the relationships between atherosclerosis and plasma Aβ levels.

Methods

This was a population based cross-sectional study. Patients with high risk of atherosclerosis from Qubao Village, Xi’an were underwent carotid ultrasound for assessment of atherosclerosis. Venous blood was collected on empty stomach in the morning and plasma Aβ1−40 and Aβ1−42 levels were measured using ELISA. Multivariate logistic regression analysis was performed to investigate the relationships between carotid atherosclerosis (CAS) and plasma Aβ levels.

Results

Among 344 patients with high risk of atherosclerosis, 251(73.0%) had CAS. In the univariate analysis, the plasma Aβ levels had no significant differences between CAS group and non-CAS group (Aβ1−40: 53.07 ± 9.24 pg/ml vs. 51.67 ± 9.11pg/ml, p = 0.211; Aβ1−42: 40.10 ± 5.57 pg/ml vs. 40.70 pg/ml ± 6.37pg/ml, p = 0.285). Multivariate logistic analysis showed that plasma Aβ levels were not associated with CAS (Aβ1−40: OR = 1.019, 95%CI: 0.985–1.054, p = 0.270;Aβ1−42: OR = 1.028, 95%CI: 0.980–1.079, p = 0.256) in the total study population. After stratified by hypertension, CAS was associated with plasma Aβ1−40 positively (OR = 1.063, 95%CI: 1.007–1.122, p = 0.028) in the non-hypertension group, but not in hypertensive group. When the plasma Aβ concentrations were classified into four groups according to its quartile, the highest level of plasma Aβ1−40 group was associated with CAS significantly (OR = 4.465, 95%CI: 1.024–19.474, p = 0.046).

Conclusion

Among patients with high risk of atherosclerosis, CAS was associated with higher plasma Aβ1−40 level in non-hypertension group, but not in hypertension group. These indicated that atherosclerosis is associated with plasma Aβ level, but the relationship may be confounded by hypertension.
Association of total sleep duration variability with risk of new stroke in the middle-aged and elderly Chinese population
Authors: Ma Jiangping , Ma Nuo , Zhang Lu , Xu Linghao , Liu Xueyuan , Meng Guilin
Published: June 2024

Objective

To investigate the association between total sleep duration variability and stroke in the middle-aged and elderly population in China.

Methods

Data were collected from the 2011, 2013, 2015, and 2018 surveys of the China Health and Retirement Longitudinal Study (CHARLS). A total of 3485 participants, who had not experienced a stroke until 2015 and completed the follow-up in 2018, were enrolled to analyze the relationship between total sleep duration variability and new stroke. Total sleep duration was calculated by summing self-reported nocturnal sleep duration and daytime napping. The variability was determined by calculating the standard deviation (SD) of total sleep duration across the first three waves. A binary logistic regression model was utilized to analyze this association.

Results

Of the 3485 participants, 183 (5.25%) sustained a stroke event. A dose-response relationship was observed, indicating an increased stroke risk of 0.2 per unit (hours) increase in total sleep duration variability [OR (95% CI): 1.20 (1.01–1.42)]. Upon stratification by sex groups, this increased risk was significant only in men [OR (95% CI): 1.44 (1.12–1.83)].

Conclusion

Increased total sleep duration variability was associated with an increased risk of stroke in the middle-aged and elderly, independent of factors such as age, nocturnal sleep duration, napping habits, region of residence, hypertension, diabetes mellitus, dyslipidemia, BMI, smoking, drinking habits, and marital status. However, a more notable correlation was observed in males.
Health impacts of lifestyle and ambient air pollution patterns on all-cause mortality: a UK Biobank cohort study
Authors: Pu Lining , Zhu Yongbin , Shi Xiaojuan , Wang Huihui , Pan Degong , He Xiaoxue , Zhang Xue , Wang Liqun , Liu Xiaojuan , He Shulan , Sun Xian , Li Jiangping
Published: June 2024

Background

Extensive evidence indicates that both lifestyle factors and air pollution are strongly associated with all-cause mortality. However, little studies in this field have integrated these two factors in order to examine their relationship with mortality and explore potential interactions.

Methods

A cohort of 271,075 participants from the UK Biobank underwent analysis. Lifestyles in terms of five modifiable factors, namely smoking, alcohol consumption, physical activity, diet, and sleep quality, were classified as unhealthy (0–1 score), general (2–3 score), and healthy (4–5 score). Air pollution, including particle matter with a diameter ≤ 2.5 μm (PM2.5), particulate matter with a diameter ≤ 10 μm (PM10), particulate matter with a diameter 2.5–10 μm (PM2.5−10), nitrogen dioxide (NO2), and nitrogen oxides (NOx), was divided into three levels (high, moderate, and low) using Latent Profile Analysis (LPA). Cox proportional hazard regression analysis was performed to examine the links between lifestyle, air pollution, and all-cause mortality before and after adjustment for potential confounders. Restricted cubic spline curves featuring three knots were incorporated to determine nonlinear relationships. The robustness of the findings was assessed via subgroup and sensitivity analyses.

Results

With unhealthy lifestyles have a significantly enhanced risk of death compared to people with general lifestyles (HR = 1.315, 95% CI, 1.277–1.355), while people with healthy lifestyles have a significantly lower risk of death (HR = 0.821, 95% CI, 0.785–0.858). Notably, the difference in risk between moderate air pollution and mortality risk remained insignificant (HR = 0.993, 95% CI, 0.945–1.044). High air pollution, on the other hand, was independently linked to increased mortality risk as compared to low air pollution (HR = 1.162, 95% CI, 1.124–1.201). The relationship between NOx, PM10, and PM2.5−10 and all-cause mortality was found to be nonlinear (p for nonlinearity < 0.05). Furthermore, no significant interaction was identified between lifestyle and air pollution with respect to all-cause mortality.

Conclusions

Exposure to ambient air pollution elevated the likelihood of mortality from any cause, which was impacted by individual lifestyles. To alleviate this hazard, it is crucial for authorities to escalate environmental interventions, while individuals should proactively embrace and sustain healthy lifestyles.
Insights into RC time curve fit analysis of pulmonary artery pressure decay
Authors: Manouras Aristomenis , Lund Lars H. , Nagy Anikó Ilona , Johnson Jonas
Published: June 2024

The notion of a constant relationship between resistance and capacitance (RC time) in the pulmonary circulation has been challenged by more recent research. The RC time can be obtained using either a simplified empirical approach or a semilogarithmic equation. Although direct curve-fit analysis is a feasible and ostensibly reference approach for RC analysis, it remains largely unexplored. We aimed to study the relationship between various RC methods in different states of pulmonary hemodynamics.

Methods In total, 182 patients underwent clinically indicated right heart catheterization. The pressure curves were exported and processed using the MATLAB software. We calculated the RC time using the empirical method (RCEST), semilogarithmic approach (RCSL), and direct measurement of curve fit (RCFIT).

Results Among 182 patients, 137 had pulmonary hypertension due to left heart disease (PH-LHD), 35 had pulmonary arterial hypertension (PAH), and 10 demonstrated normal hemodynamics (non-PH). RCEST consistently overestimated the RCFIT and RCSL measurements by a mean of 75%. With all three methods, the RC values were longer in the PAH (RCFIT = 0.36 ± 0.14 s) than in the PH-LHD (0.27 ± 0.1 s) and non-PH (0.27 ± 0.09 s) groups (p < 0.001). Although the RCSL and RCFIT values were similar among the three subgroups, they exhibited broad limits of agreement. Finally, the RCEST demonstrated a strong discriminatory ability (AUC = 0.86, p < 0.001, CI = 0.79–0.93) in identifying PAH.

Conclusion RC time in PAH patients was substantially prolonged compared to that in PH-LHD and non-PH patients. The use of the empirical formula yielded systematic RC overestimation. In contrast, the semilogarithmic analysis provided reliable RC estimates, particularly for group comparisons.