bluuebunny/crossref_metadata_2025 huggingface dataset:
A GIS Based Study for Air Quality Monitoring of Bikaner City, Rajasthan
Authors: Dular Anil , Sharma Yash
Published: February 2025

The undesirable change in any gaseous substance present in ambient air in such concentration that may tends to be injurious to human beings and other living creature, plant, property. These substances which are responsible for such undesirable changes called air pollutants. A developmental activity like urbanization leads to potent impact on our surrounding environment, many cities around the world become more congested, concerns increase over the level of urban air pollution being generated and in particular its impact on localized human health. An attempt has been made in this study on yearly basis, pertaining to air quality standards of Bikaner city as one prominent city in the state of Rajasthan. Bikaner is the city which lies in desertic region of western Rajasthan is prominently as one of the air pollutant area affected generally by fine dust particles due to composition of soil as gypsum ingredient, despite that agricultural practices are also on large scale other factors like mining in adjoining areas, natural dust storm, three highways passes through and railway network is stretching within city is matter of concern. The study reveals that many times city has become declared as worst polluted city in India especially in context to suspended particulate matters. Some strategic location has been choosen for study which extrapolate the cause condition relationship between air pollution and their both fugitive and nonfugitive sources. The help has been taken from regional office of pollution control board as well as free samplings undertaken by researcher by using high volume sampler. The purpose of study is reveal the data in consonance of previous study that how these pollution datas are keep going in simulation for further mitigative measures and studies.
Sparse-view CT Image Reconstruction Using the Logarithmic Barrier Based Interior Point Method
Authors: Xu Heping
Published: February 2025

This work aims to develop a logarithmic barrier based interior point method capable of reconstructing CT images using under-sampled sinogram data. Unlike other compressed sensing methods, the proposed method obviates the need of the regularization parameter in the objective function. Feasibility of the algorithm and quality of the reconstructed images were examined. Methods: The sinogram data were simulated through Radon-transforming clinical CT images. The noise was added based on the Poisson and Gaussian models. The basic elements of the proposed method, logarithmic barrier (LB) method, were introduced. The relative Root-Mean-Squared Error (rRMSE) was used to evaluate the image reconstruction accuracy. The noise of the images was assessed using the Peak Signal-to-Noise Ratio (PSNR) and Mean Squared Error (MSE). Results: The PSNR, rRMSE, MSE were compared among fvFBP (full-view Filtered-Backprojection), svFBP (sparse-view Filtered-Backprojection), BB (Barzilai-Borwein), and LB methods for brain, head and neck, lung, prostate, and leg sites. The reconstructed images from svFBP suffered severe streak artifacts. The LB method was capable of reconstructing images of quality comparable to quality of those images obtained from other compressed sensing-based methods such as the BB method. Conclusion: It has been demonstrated that the compressed sensing technique based on the logatirhmic barrier method is capable of recovering satisfactory images from under-sampled projection data. This method obviates the need of the regularization parameter that specifies the relative weight between the data fidelity and total variation terms in the objective function. Insights have been gained as to implementing the proposed method for clinical imaging applications.
Impact of Postsurgical Disconnection in Aggression Disorder Treatment, Latin American Single Center Experience: A Neuronal Connectomics Analysis
Authors: Donath José , Delgado José , Luna Oscar , Salazar Manuel
Published: February 2025

Recent advancements in the study of human behavior, along with significant technological progress, have provided a more complete understanding of the neural circuits involved in aggressive responses to external stimuli. Notably, aggression as a voluntary behavior differs from reactive aggression in its neural connections and cerebral connectomics. Aggression is identified as part of a series of responses to stimuli that pose a potential threat to an individual’s physical integrity. By identifying the neural pathways involved in pathological aggression, we can modify this behavior by disrupting these pathways through functional neurosurgery. This study aims to demonstrate, through neuronal connectomics, the effects of postsurgical disconnection following functional neurosurgical procedures designed to treat aggression disorders. For many years, brain function was believed to result solely from the activity of specific cortical areas, which conditioned cognitive responses. However, recent advances in neurology, neuroimaging, neuropsychology, and neurosurgery have shifted our understanding of brain function, revealing a more complex network of connectivity. Despite we are now able to predict the location of primary cortical areas, patients may still experience unanticipated deficits in functions like judgment or memory after surgery. This suggests that traditionally silent regions of the brain may be more anatomically intricate and functionally redundant than previously understood. One of the significant advancements in neuroimaging is Diffusion Tensor Imaging (DTI), which has revolutionized psychiatric surgery, neuroendoscopy, and neuro-oncology. DTI enabled the formation of the Human Connectome Project (HCP), a large-scale initiative that provides detailed data on the brain's connectivity in healthy individuals. The most recent HCP findings have reclassified cortical regions previously described by Brodmann, based on functional connectivity, myelination, and cortical thickness. These advancements contribute to a much more detailed framework for studying brain function and its anatomical organization. This paper explores how these developments in connectomics and neuroimaging are being applied to the understanding and treatment of aggression disorders through functional neurosurgery.
Impact of Solvent Mixtures on Natural Dyes and TiO2 Nanoparticles for Dye-Sensitized Solar Cells (DSSCs)
Authors: Abel Oladejo , Tamba Simbo , Razaq Kesinro , Olayinka Oyeshola , Festus Akinboro , Victor Makinde , Adediji Adejumobi
Published: February 2025

Water, as an inorganic solvent, has traditionally been considered inefficient for dye extraction in dye-sensitized solar cells (DSSCs) due to its limited absorbance spectrum, weak bonding with semiconductor surfaces, and rapid dye degradation. Organic solvents like acetone, ethanol, and methanol are typically preferred for enhancing photo-conversion efficiency in DSSCs. This study explores the use of distilled water in combination with ethanol as an alternative solvent mixture to support the global push for low-cost, non-toxic, and eco-friendly DSSCs. Chlorophyll and anthocyanin dyes were extracted from neem leaves (Azadirachtaindica) and rosella flowers (Hibiscus sabdariffa) using distilled water and ethanol. Their absorbance properties were analyzed using UV-Vis spectroscopy, FTIR, and XRD. Among the eight dye samples, the Ne + Hw mixture showed the highest absorbance (3.5 au.) with peaks at 550 nm and 660 nm. FTIR analysis revealed a broad hydroxyl band and a C≡C triple bond trace at 2360 cm-1, indicating enhanced photon harvesting and improved electron transport for higher short-circuit current density. XRD analysis indicated increased crystallinity and a particle grain size of 126.89 nm when adsorbed on a TiO2-coated FTO substrate. These findings demonstrate enhanced DSSC performance, suggesting improved long-term stability and efficiency.
Energy Analysis of a Thermodynamic System Combined Organic Rankine Cycle and Absorption Cooling System for Power and Cooling: Effects of Pressure and Temperature
Authors: Thiao Serigne , Sow Mamadou , Fall Sokhna , Mar Awa , Kobor Diouma , Youm Issakha
Published: February 2025

In the current economic, energy and environmental context, the implementation of technologies using renewable energies as a source of power electricity and cooling production is very beneficial insofar as it allows the reduction of pollution and the cost of fossil fuels. Senegal has a sunshine potential well distributed across the country for irradiation varying from South to North between 1850 KWh/m²/year and 2250 kWh/m²/year. It is one of the best solar potentials in the world. Systems operating on the organic Rankine cycle ORC and the absorption cooling system ACS are innovative and sustainable technologies for the exploitation of low enthalpy renewable energy sources. In this present work, the thermodynamic analysis of a combined ORC and ACS system for power electricity and cold production is carried out numerically using the Engineering Equation Solver (EES) software. R245fa and water-lithium bromide mixture are used as working fluid for ORC and ACS respectively. The results obtained at the ACS subsystem level show that the COP of ACS decreases when the absorption temperature increases. This reduction goes from 0.83 to 0.55, i.e. a reduction of 0.28 for a variation of absorption temperature from 27°C to 45°C. The COP has stabilized for generator temperatures above 95°C and is in the range of 0.7 to 0.8. These fluctuations are due to the irreversibility at the level of the components of the system. For the ORC subsystem, the turbine power and ORC condenser power decrease as the ORC condensing pressure increases. Thus, the turbine power goes from 235 kW to 200 kW and the ORC condenser power goes from 80 kW to 60 kW.
The Influence of Innovativeness on the Performance of Textile-Based Manufacturing Small Enterprises in Kenya
Authors: Kiguru Samuel , Senelwa Wilberforce , Njeru Agnes
Published: February 2025

This study investigates the influence of innovativeness on the performance of textile-based manufacturing small enterprises (SMEs) in Kenya, with a focus on product, market, and process innovations. SMEs are a vital component of Kenya's economy, contributing significantly to GDP and employment. However, their growth and survival rates are a concern, particularly in the textile manufacturing sector. A mixed-method research design was employed, encompassing quantitative and qualitative approaches. The target population for this study was 1,353 SMEs across various economic blocs in Kenya. After stratified sampling a total of 292 respondents were involved in the study. Quantitative data were analyzed using SPSS, employing descriptive and inferential statistics. Qualitative data underwent content analysis. The findings reveal a substantial positive relationship between innovativeness and SME performance. Innovativeness, as reflected in product, market, and process innovations, emerged as a critical determinant of success. Innovativeness contributed 80.2% of the variation in the performance of textile-based manufacturing small enterprises in Kenya. SMEs that embraced innovation exhibited better performance outcomes. Practical recommendations are offered, including the promotion of creativity, allocation of resources for research and development, and the establishment of platforms for idea generation and collaboration. In conclusion, fostering a culture of innovation is imperative for textile-based manufacturing SMEs in Kenya. This study sheds light on the pivotal role of innovativeness in enhancing performance and competitiveness. By implementing the recommended strategies, these enterprises can navigate the dynamic business landscape effectively, positioning themselves for sustainable growth and success.
Comparative Economic Assessment of Self-protection Strategies and Climate Insurance in Developing Economies
Authors: Traore Abdelmoumine
Published: February 2025

Climate change poses significant challenges in regions with inadequate institutional support for climate-sensitive activities. This study examines two key strategies that households adopt to manage climate risks: self-protection measures and climate insurance. Self-protection measures involve proactive actions such as constructing stronger buildings, diversifying business activities, and implementing other protective mechanisms against climate extremes. These measures are often sustainable and empowering, yet they tend to be costly and challenging to implement. On the other hand, climate risk insurance serves as a financial safety net, providing economic recovery after climate-related events have occurred. However, despite being relatively affordable, climate insurance faces low demand due to various barriers, including accessibility issues and a lack of awareness. This study aims to explore the potential for combining these two approaches to enhance household resilience and promote equitable development. Overcoming barriers to adoption requires strategies such as offering grants and reimbursements to adopters, improving access to insurance products, and raising awareness about their benefits. Future research should investigate how these strategies can complement each other and explore ways to strengthen household resilience based on socio-economic differences across various regions.
Minimal Reducing Subspaces of 3-order Slant Toeplitz Operator on Hardy Space over the Disc
Authors: Zou Yang
Published: February 2025

The reducing subspace problem and the invariant subspace problem of an operator are two core problems in operator theory. There are lots of works on reducing subspaces and invariant subspaces of Toeplitz operators in recent years. A slant Toeplitz operator is a generalization of Toeplitz operator. In this paper, we study minimal reducing subspaces of the third-order slant Toeplitz operator with the symbol zN. By classifying N into three cases, we give a complete description of minimal reducing subspaces. Finally, all minimal reducing subspaces of the third-order slant Toeplitz operator with the symbol zN on the Hardy space of the disc in the complex plane are given. This paper generalizes the relevant results on reducing subspaces of second-order slant Toeplitz Operators, enriches the study of reducing subspaces of slant Toeplitz Operators on Lebesgue spaces, and of the structure of slant Toeplitz Operators.
Addressing Emotional Dysregulation in Experimental Design
Authors: Finet Alain , Laznicka Julie
Published: February 2025

This article describes the set-up of an experimental protocol to take into account the effects of emotional adaptation following stock market decision-making. Basically, the qualitative models used to analyze the behavior of small investors in experimental finance consider three areas of analysis (a socio-demographic analysis, a socio-cultural analysis and an analysis of the psychological reality of individuals). These different areas would then influence the emotions felt, which would stimulate the development of behavioral and cognitive biases. Finally, the latter would ultimately be responsible for influencing decision-making processes. Firstly, our protocol is based on this traditional view of the different factors influencing individual investors' decision-making. Secondly, we suggest a retrospective approach as we believe that the confrontation between expectations and the results generated by decision-making have a feedback effect on the emotional patterns developed by individual investors, and on their psychological reality. Indeed, the increasing number of different emotions tends to "plunge" them into an “emotional bath” in which they can no longer regulate their emotions. This could result in abandonment versus euphoria. According to some authors, “emotional dysregulation” is the result of excessive emotional involvement. Since the stock market is an uncertain environment, where decisions must be made quickly and risks are high, emotional regulation strategies become difficult to apply. Finally, this experimental protocol, supported by qualitative methodological techniques implemented sequentially, makes it possible to analyze emotions as the experiment progresses. We believe this approach offers real added value on two levels. Firstly, even though behavioral finance questions the foundations of traditional finance (and the assumption of rationality), it most often uses quantitative measurement tools. For this purpose, the literature clearly highlights the under-representation of qualitative methodologies in this field. Secondly, the few studies supported by qualitative approaches aim at identifying cause-and-effect links between elements which, in some cases, are difficult to measure and cannot be approached in a linear process. This protocol provides a precise understanding of how emotional patterns and their changes over time might affect the decision-making processes of individual investors.
Practice and Exploration of Education Reform in College Furniture Design Courses: Taking the Course of "Furniture and Display" as an Example
Authors: Miao Lei , Liu Shaohua , Sun Yan
Published: February 2025

With the development of society and economy, people's demand for the quality of furniture and display design is constantly increasing. Display plays a crucial role in enhancing the atmosphere and mood of interior decoration, and is a key component of interior design. Furniture and display design is a discipline that studies the relationship between interior design and people, but its theory and practice are relatively lacking. With the improvement of productivity and people's living standards, people not only pursue practicality, but also beauty. Furniture and furnishings are in an upward and developing trend, playing an important role in our modern and contemporary design life. In this context, we need to conduct theoretical and practical research and sorting on the display of interior spaces in Chinese and foreign buildings, so as to apply them to practice. Such research has theoretical and practical significance. The main purpose of the study is to better cultivate students' abilities in furniture design and display design. When completing proposition training, students should understand the relationship between furniture design elements, display design components, design expression content and form in homework, and enhance their innovation ability and craftsmanship spirit. The research conclusion suggests that traditional Chinese culture, artistic accomplishment, ecological environment concepts should be integrated into the teaching design of the curriculum, in order to meet the needs of students' professional knowledge while combining practical teaching with industry university research integration. The curriculum reform of furniture and display courses in this study has achieved satisfied practical results.
The Effects of Noise on Learners in the English First Additional Language Foundation Phase Class
Authors: Marumo Mpho
Published: February 2025

This paper reviews issues relating to the effects of noise on learners in the Foundation Phase. The qualitative summative evaluation was followed in the study. The semi structured interviews were conducted with 9 participants, which are 2 district officials, 3 Grade 1 educators, 1 class assistant, 2 principals, 1 head of department, and Grade 1 learners from the three mainstream schools in Bojanala District in the North West Province, South Africa. The methodology employed in this research emphasised the effect of the utilisation of the dynamic sound field amplified system (DSAS). The findings show that all participants have the experience of the background noise in the classrooms. This deterred affected educators to be audible and for learners to hear the educator clearly. The background noise, factors affecting speech intelligibility in the classroom; noise effects on academic and educator performance and the effects of the environmental noise were some of the factors mentioned as impediments to effective teaching and learning. The use of the DSAS was revered by educators and learners alike as improving teaching and learning due to the significant reduction of background noise in the classroom. The study concluded that after extensive review of national and international literature, there is a need for further research concerning mainly by outlining some current acoustic standards for classrooms.
Health Utilities in People with Hepatitis C Virus Infection: A Study Using Real-World Population-Level Data
Authors: Saeed Yasmin A. , Mitsakakis Nicholas , Feld Jordan J. , Krahn Murray D. , Kwong Jeffrey C. , Wong William W. L.
Published: February 2025

Background

Hepatitis C virus (HCV) infection is associated with reduced quality of life and health utility. It is unclear whether this is primarily due to HCV infection itself or commonly co-occurring patient characteristics such as low income and mental health issues. This study aims to estimate and separate the effects of HCV infection on health utility from the effects of clinical and sociodemographic factors using real-world population-level data.

Methods

We conducted a cross-sectional retrospective cohort study to estimate health utilities in people with and without HCV infection in Ontario, Canada, from 2000 to 2014 using linked survey data from the Canadian Community Health Survey and health administrative data. Utilities were derived from the Health Utilities Index Mark 3 instrument. We used propensity score matching and multivariable linear regression to examine the impact of HCV infection on utility scores while adjusting for clinical and sociodemographic factors.

Results

There were 7,102 individuals with hepatitis C status and health utility data available (506 HCV-positive, 6,596 HCV-negative). Factors associated with marginalization were more prevalent in the HCV-positive cohort (e.g., household income <$20,000: 36% versus 15%). Propensity score matching resulted in 454 matched pairs of HCV-positive and HCV-negative individuals. HCV-positive individuals had substantially lower unadjusted utilities than HCV-negative individuals did (mean ± standard error: 0.662 ± 0.016 versus 0.734 ± 0.015). The regression model showed that HCV positivity (coefficient: −0.066), age, comorbidity, mental health history, and household income had large impacts on health utility.

Conclusions

HCV infection is associated with low health utility even after controlling for clinical and sociodemographic variables. Individuals with HCV infection may benefit from additional social services and supports alongside antiviral therapy to improve their quality of life.

Highlights

Hepatitis C virus (HCV) infection is associated with reduced quality of life and health utility. There is debate in the literature on whether this is primarily due to HCV infection itself or commonly co-occurring patient characteristics such as low income and mental health issues. We showed that individuals with HCV infection have substantially lower health utilities than uninfected individuals do even after controlling for clinical and sociodemographic variables, based on a large, real-world population-level dataset. Socioeconomically marginalized individuals with HCV infection had particularly low health utilities. In addition to improving access to HCV testing and treatment, it may be beneficial to provide social services such as mental health and financial supports to improve the quality of life and health utility of people living with HCV.
Histologic characterization of fracture repair process in wild birds in association with gross appearance of the bone lesion
Authors: Espinosa José , Guijarro Javier , Zapico David , Criado Miguel , Ferreras María del Carmen , Pérez Valentín
Published: February 2025

This study aims to provide an in-depth examination of the histological changes that occur during the repair of untreated bone fractures in avian species, correlating these microscopic alterations with gross anatomical characteristics observed during different tissue repair phases. A total of 93 bone fractures from different wild birds were analyzed and classified based on temporality (acute, subacute, and chronic) according to the color changes of the hematoma and morphology (open or closed; simple, comminuted, or greenstick fractures). From a microscopic standpoint, a strong correlation was observed between the temporal progression observed macroscopically and the histological changes evident in each temporal category. Microscopic variations were found to depend on the nature of the fracture. Lesional patterns directly related to the macroscopic appearance of the fracture were established. Acute fractures exhibited extensive hematomas and an intense inflammatory response; subacute fractures showed immature granulation tissue and early signs of soft callus formation; and finally, chronic fractures were characterized by prominent soft calluses and hard calluses in different stages of development. The possible factors influencing each phase of the healing process, such as the characteristics of the type of fracture, the stability of the fracture site, bacterial contamination, the chronicity of the fracture, and the potential differences in the progression of histological changes between different animal species, are discussed. This association may be of clinical utility in decision-making for the treatment and prognosis of bone fractures in birds.
Oculomotor deficits in children with sensory processing difficulties
Authors: Hodgson Timothy L , Cartwright Phoebe , Dodd Joseph , Hippisley Annabelle
Published: February 2025

Background:

Atypically developing children often present with a variety of sensory processing difficulties which have been proposed to reflect abnormal development of pathways integrating sensation and action. A brain system in which the process of sensorimotor integration is particularly well understood is the oculomotor system, but no studies to date have used computerised eye tracking to assess eye movements in children with sensory processing difficulties.

Method:

Ten children with sensory processing difficulties completed a battery of oculomotor tasks comprising pro-saccades, anti-saccades, smooth pursuit tracking and sustained fixation. Eye movements were recorded using a high-resolution eye tracker.

Results:

Compared to age-matched controls, children with sensory processing difficulties were found to make more directional errors in the anti-saccade task and less-accurate smooth pursuit and sustained fixation.

Conclusion:

Consistent differences were found in oculomotor ability in children with sensory processing difficulties which are likely to impact children’s ability to process and respond to visual information within home and school contexts. Further research is needed to understand the relationship between oculomotor deficits in children with sensory processing difficulties and the presence/absence of neurodevelopmental diagnoses. Eye tracking may be of value in the future for assessment and objective evaluation of interventions for sensory processing difficulties such as sensory integration therapy.
Localized paclitaxel delivery using a novel hyaluronic acid-coated fibrous carrier produced via needle-less electrospinning
Authors: Lubasova Daniela , Mayoral Safont Mireia , McCormack Emmet
Published: February 2025

Pancreatic cancer remains one of the most challenging malignancies to treat due to its dense stromal microenvironment and resistance to conventional therapies. This study introduces a novel localized drug delivery system design to target residual cancer cells following surgery. Electrospun fibrous carriers were fabricated using needle-less electrospinning from polycaprolactone (PCL), silk fibroin (SF), and their blend. Among these, PCL carriers (average fiber diameter: 141 ± 28 nm) exhibited the highest and most sustained paclitaxel (PTX) release in vitro. Coating the PCL carrier with hyaluronic acid (HA) increased the fiber diameter to 535 ± 116 nm and modulated PTX release, shifting from an initial rapid release phase in uncoated carrier to a more gradual and sustained release over 120 hours. PTX-loaded HA-coated electrospun PCL carriers significantly reduced MiaPaCa cell viability, with only 13% viability at 96 hours compared to 22% for the non-coated carrier. This HA-coated electrospun PCL carrier offers a scalable and efficient solution for localized PTX delivery, providing sustained drug release, prolonged cytotoxic efficacy, and reduced off-target effects. Its industrial scaleability, combined with its potential for post-surgical pancreatic cancer management, presents an innovative approach to minimizing reliance on systemic chemotherapy and its associated toxicities. The use of needle-less NanospiderTM electrospinning technology further emphasizes its clinical potential, with future in vivo studies needed to confirm carrier’s safety, pharmacokinetics, and therapeutic benefits.
Efficacy and Safety of Herbal Medicine Bojungikki-Tang in Combination with Pembrolizumab versus Pembrolizumab Monotherapy for Stage IV Non-Small Cell Lung Cancer: Study Protocol for a Randomized, Open-Label, Double-Arm, Multicenter Trial
Authors: Cho Eunbyul , Yi Jin-Mu , Chun Jaemoo , Jang Ho , Yoon Seong Hoon , Lee Seung Hyeun , Jang Seung Hun , Park Dong Won , Kim Seung Joon , Um Sang-Won , Lee Sung Yong , Jeong Mi-Kyung
Published: February 2025

Background:

Non-small cell lung cancer (NSCLC) exhibits low survival rates. Although immune checkpoint inhibitors (ICIs) have become first-line treatment for NSCLC, their limited response to ICI monotherapy has led to exploration of combination treatments. However, the high incidence of treatment-related adverse events associated with conventional drug combinations has highlighted the need for alternative herbal therapy. Bojungikki-tang (BJIKT), a traditional herbal medicine, has been used to treat gastrointestinal disorders and enhance immune function. Our preclinical studies have demonstrated that BJIKT combined with anti-PD-1 or anti-PD-L1 antibodies exhibits significant efficacy in suppressing tumor growth by modulating the immunosuppressive tumor microenvironment. Building on these preclinical findings, this study aims to evaluate the efficacy and safety of BJIKT with pembrolizumab combination therapy compared to pembrolizumab monotherapy in advanced NSCLC patients.

Methods:

70 individuals with stage IV NSCLC scheduled for first-line pembrolizumab monotherapy will be randomly assigned to intervention or control groups. The primary outcome will be progression-free survival, with secondary outcomes including disease control rate, overall survival, and quality of life assessment. Adverse events will be monitored for safety. This study will explore the synergistic mechanism of combinatorial therapy using immune profiling and multi-omics analysis, and the possibility for personalized integrative therapy based on cold-heat syndrome differentiation (SD) types in East Asian medicine.

Discussion:

This study will provide novel evidence regarding survival outcomes, quality of life, and safety profiles of combined ICI and BJIKT therapy for advanced NSCLC. The exploratory data will contribute to tailoring treatments to immune-based SD types in NSCLC patients.
Assessing Meaningful Interaction in Focus Group Discussions Conducted Over WhatsApp
Authors: Dedios-Sanguineti María Cecilia , Guarin Angela , Torres-García Ariana , Martínez Gómez Mariana
Published: February 2025

Focus group discussions (FGDs) differ from other qualitative data collection techniques because they offer unique insights into how collective sense-making occurs in real time in social settings. However, systematic qualitative tools to analyze interaction in FGDs and the richness of data it yields remain scarce. In this article, we propose a seven qualitative indicator model, adapted from previous studies on FGD data quality, to assess group interaction. We apply the model to FGDs ( n = 12) conducted via the instant messaging application WhatsApp as part of a study on access to social protection programs in Colombia conducted during the COVID-19 pandemic. Our findings show that the proposed indicators can assess meaningful interaction as it unfolds in asynchronous online FGDs. Unlike existing tools that examine interaction in online FGDs quantitatively and through a dichotomous understanding (either absent or present), our proposed model seizes the idea of varying types of meaningful interaction: stance-only, basic interaction, and complex interaction. Our results suggest that complex participant interactions can emerge in online FGDs conducted via WhatsApp, therefore situating messaging apps as promising data collection sites for including hard-to-reach and highly mobile populations in research. The proposed qualitative indicators model is a useful tool for assessing interaction in FGDs and provides insights into whether and how collective sense-making occurred.
How are unrepresented defendants treated in magistrates’ courts?
Authors: Walker Charlotte
Published: February 2025

This article examines how unrepresented defendants are treated in magistrates’ courts in England and Wales. The findings are based on a small-scale study where 20 court actors were interviewed and 403 court hearings were observed. It is argued that although there are examples of good practice, where court staff do treat unrepresented defendants well and assist them to participate in the process, more needs to be done in relation to this. Currently, factors such as efficiency concerns are being prioritised over defendant engagement. This makes it more difficult for unrepresented defendants to participate in the process, which undermines their due process, liberal democratic and human rights.
Antibiotic Prescription Trends Among Pediatric Patients in Dessie Comprehensive Specialized Hospital, Ethiopia
Authors: Mengesha Yohannes , Mohammed Sualih
Published: February 2025

Introduction. Antibiotic overuse is a critical global health issue that drives antibiotic resistance, especially in low-income countries like Ethiopia, where data on prescribing practices are scarce. Objective. This study assessed antimicrobial prescription patterns in pediatric patients at Dessie Comprehensive Specialized Hospital, Northeast Ethiopia. Methods. A retrospective cross-sectional analysis of 171 pediatric inpatient prescriptions from March to April 2022 was conducted, using WHO pediatric guidelines and Ethiopia’s Standard Treatment Guideline (STG) for evaluation. Results. Among 157 analyzed prescriptions, most patients (55.4%) were hospitalized over 5 days. Severe acute malnutrition (27.4%) and meningitis (14%) were the leading causes of admission. Ceftriaxone (51%) and augmentin (19%) were frequently prescribed, with inappropriate use noted in 10.2% of cases. Injectable antibiotics were used in 62.4% of prescriptions. Conclusion. Ceftriaxone was the primary antibiotic prescribed, with a generally rational prescribing pattern. However, additional attention to patients with comorbidities and rural backgrounds is advised.
Sotatercept: A First-In-Class Activin Signaling Inhibitor for Pulmonary Arterial Hypertension
Authors: Miranda Aimon C. , Cornelio Cyrille K. , Tran Bao Anh C. , Fernandez Joel
Published: February 2025

Objective: The objective of the study is to review the characteristics, efficacy, safety, and clinical relevance of sotatercept in pulmonary arterial hypertension (PAH). Data Sources: A literature search containing search terms related to sotatercept and PAH was conducted. Embase via Elsevier, MEDLINE via Ovid, the medRxiv preprint server, Cochrane Library CENTRAL trials registry, and ClinicalTrials.gov were searched from inception through October 31, 2024. The package insert was utilized to obtain drug information and additional data. Study Selection and Data Extraction: Phase II-III clinical trials investigating sotatercept for PAH were included. Articles written in English were extracted while animal studies and phase I clinical trials were excluded. Data Synthesis: In patients with WHO Group 1, functional class II-III PAH, adding sotatercept to background therapy increased 6-minute walk distance in phase II-III trials. Pooled analysis from PULSAR (phase II) and STELLAR (phase III) showed improvements in pulmonary vascular resistance and NT-proBNP. Exploratory data from PULSAR revealed that BMPR2 genetic variant status was not associated with significant differences in treatment effects. SPECTRA (phase IIb) demonstrated improved right ventricular structure and function. Interim analysis from SOTERIA showed that treatment effects persist at 1 year. Conclusions: Sotatercept is a viable add-on therapy for patients with PAH Group 1 and functional class II-III. Additional data are needed to assess long-term outcomes among treatment-naïve patients and those with the most severe symptomatology.
Application of causal forests to randomised controlled trial data to identify heterogeneous treatment effects: a case study
Authors: Van Vogt Eleanor , Gordon Anthony C. , Diaz-Ordaz Karla , Cro Suzie
Published: February 2025

Background

Classical approaches to subgroup analysis in randomised controlled trials (RCTs) to identify heterogeneous treatment effects (HTEs) involve testing the interaction between each pre-specified possible treatment effect modifier and the treatment effect. However, individual significant interactions may not always yield clinically actionable subgroups, particularly for continuous covariates. Non-parametric causal machine learning approaches are flexible alternatives for estimating HTEs across many possible treatment effect modifiers in a single analysis.

Methods

We conducted a secondary analysis of the VANISH RCT, which compared the early use of vasopressin with norepinephrine on renal failure-free survival for patients with septic shock at 28 days. We used classical (separate tests for interaction with Bonferroni correction), data-adaptive (hierarchical lasso regression), and non-parametric causal machine learning (causal forest) methods to analyse HTEs for the primary outcome of being alive at 28 days. Causal forests comprise honest causal trees, which use sample splitting to determine tree splits and estimate treatment effects separately. The modal initial (root) splits of the causal forest were extracted, and the mean value was used as a threshold to partition the population into subgroups with different treatment effects.

Results

All three models found evidence of HTE with serum potassium levels. Univariable logistic regression OR 0.435 (95%CI [0.270, 0.683]. p = 0.0004), hierarchical lasso logistic regression standardised OR: 0.604 (95% CI 0.259, 0.701), lambda = 0.0049. Hierarchical lasso kept the interaction between the treatment and serum potassium, sodium level, minimum temperature, platelet count and presence of ischemic heart disease. The causal forest approach found some evidence of HTE (p = 0.124). When extracting root splits, the modal split was on serum potassium (mean applied threshold of 4.68 mmol/L). When dividing the patient population into subgroups based on the mean initial root threshold, risk differences in being alive at 28 days were 0.069 (95%CI [-0.032, 0.169]) and − 0.257 (95%CI [-0.368, -0.146]) with serum potassium ≤ 4.68 and > 4.68 respectively.

Conclusions

The causal forest agreed with the data-adaptive and classical method of subgroup analysis in identifying HTE by serum potassium. Whilst classical and data-adaptive methods may identify sources of HTE, they do not immediately suggest subgroup splits which are clinically actionable. The extraction of root splits in causal forests is a novel approach to obtaining data-derived subgroups, to be further investigated.
Postoperative outcomes in patients operated for extra- and intracapsular hip fractures – a secondary analysis of two randomized controlled trials
Authors: Dakhil Shams , Djuv Ane , Saltvedt Ingvild , Wyller Torgeir Bruun , Frihagen Frede , Johnsen Lars Gunnar , Taraldsen Kristin , Helbostad Jorunn L. , Watne Leiv Otto , Paulsen Aksel
Published: February 2025

Background

Hip fractures are among the most common and serious injuries in older adults. There has been a perception that extracapsular hip fractures have worse outcome than intracapsular hip fractures. We aimed to examine postoperative outcomes in patients operated for extra- and intracapsular hip fractures.

Methods

This is a secondary analysis of data from two randomized controlled trials evaluating the effect of orthogeriatric care. Bivariate analyses were conducted, comparing patients with extracapsular fracture to patients with intracapsular fracture. Mortality, length of hospital stay (LOS), new nursing home admissions, operative data and measures of functional and cognitive performance were assessed as endpoints.

Results

The primary analysis included 711 patients; 283 patients had an extracapsular fracture and 428 an intracapsular fracture. At four months follow-up, the intracapsular fracture group had significantly better Short Physical Performance Battery (SPPB) (5.0 vs. 4.0, p = 0.007), personal Activities of Daily Living (p-ADL) (17.0 vs. 16.0, p = 0.007) and instrumental ADL (i-ADL) (32.5 vs. 28.0, p = 0.049). There were no statistically significant differences between the groups at 12 months.

Conclusions

Patients with an extracapsular fracture had worse mobility and ADL levels four months postoperatively, but there were no clinically relevant differences at 12 months postoperatively.
Painful considerations in exercise-management for rotator cuff related shoulder pain: a scoping review on pain-related prescription parameters
Authors: Raulline Ullern Kaspar , Richardsen Magnus , Weerasekara Ishanka , Bogen Bård Erik
Published: February 2025

Background

Resistance exercise is recommended as the first line of treatment for rotator cuff related shoulder pain (RCRSP), but with conflicting evidence supporting the superiority of specific prescription parameters. Particularly, the role of pain-related prescription parameters remains poorly understood, despite their wide clinical application and potential impact on treatment outcomes. This review aims to investigate how pain-related prescription parameters, such as pain allowance and intensity limits, are reported, described, and applied in clinical trials assessing resistance exercise interventions for RCRSP.

Methods

Guided by PRISMA-ScR, this scoping review followed a comprehensive and systematic search in MEDLINE (Ovid), MEDLINE (EMBASE), Central (Cochrane), PEDro and CINAHL (EBSCO). Two authors independently performed title and abstract screening, and full text screening on eligible records. Randomized clinical trials (RCTs) published in English between 2018 and 2023, applying resistance exercise for RCRSP were included. Both quantitative and qualitative approaches to data analysis were conducted.

Results

The literature search identified 7500 records, of which 4588 titles and abstracts were screened after duplicate removal. Altogether, 304 full texts were screened leaving a total of 86 records in the final analysis. Fifty-eight (67%) studies did not mention the use of any pain-related prescription parameters, resulting in data extraction from the 28 remaining studies. Applied parameters were widely heterogenic, but three categories of pain allowance styles were identified and categorized into “yes”, “no” or “ambiguous”. These categories were commonly guided by specific Numerical Rating Scale (NRS)/Visual Analog Scale (VAS) limits or individual pain tolerance, used for pain monitoring and exercise progression. Citations and/or justifications for the chosen pain-related prescription parameters were reported by 10 (36%) studies, in which 5 main themes for justifications, and 3 key papers for the citations were identified.

Conclusion

This review reveals substantial reporting deficiencies regarding pain-related prescription parameters in RCTs addressing RCRSP with resistance exercise. The identified parameters varied widely, reflecting a lack of consensus and evidence-based guidance in the literature and in a clinical setting. To advance our understanding on the role of pain-related prescription parameters, more consistent reporting of these parameters in future research is warranted.

Trial registration

Published on the Open Science Framework 28.02.24: osf.io/a52kn.
Forms of distributed leadership – a case study of six workplaces in eldercare
Authors: Eriksson Andrea , Andersson Bäck Monica , Elmersjö Magdalena , Gillberg Gunnar
Published: February 2025

Background

The concept of distributed leadership has been addressed in previous research, but few studies link their analysis to current and comparative empirical studies on processes and conditions enabling or hindering the development of distributed leadership. This specific study aims to identify and analyze mechanisms that enable or hinder the development of distributed leadership among employees in eldercare.

Methods

This is a case study based on six specific workplaces in eldercare in Sweden in different ways aiming to work toward an organization that emphasizes trust and distribution of power. A realistic evaluation framework was used to understand the different workplace program theories regarding distributed leadership. Key mechanisms and how they interact with contextual factors in each case were analyzed. Comparative analyses were performed, identifying key processes in terms of realizing distributed leadership.

Results

Analyzing the program theories in the respective cases showed that they have different orientations influenced by different motives for distributed leadership, which also interact with how distributed leadership was manifested and realized. The results point specifically to the importance of the mechanism formalization processes, participatory approaches to implementation, vertical sense-making, and horizontal sense-making for the development of distributed leadership.

Conclusions

The result points to that regardless of the path for achieving distributed leadership adopted by the various workplaces studied, the common denominator for those succeeding in distributing leadership is the development of a relational agency based on shared visions, a shared understanding of roles, and responsibilities, a learning approach and a dialogue-oriented relationship between management and employees. Another critical aspect is having sufficient resources to make taking on more responsibilities attractive.