bluuebunny/crossref_metadata_2025 huggingface dataset:
Whey protein effects on properties and structure of hairtail surimi gel
Authors: Guo Gongmin , Li Qiuyue , Du Linli , Zhu Shuai , Cheng Wenwen , Ihsan Aaysha , Zheng Jie , Hu Aijun
Published: February 2025

Whey protein was added to hairtail surimi gel (HSG), the properties and structural changes were determined, and whey protein effects on them were investigated after incorporating 0.00% to 10.00% whey protein. Optimal results at 6.00% addition of whey protein were observed in texture, color, and water-holding capacity (WHC). Texture analysis exhibited a reduction in cohesiveness, resilience, and chewiness of HSG, while simultaneously increasing its firmness and springiness. Furthermore, the whiteness of HSG decreased by 5.00% and optimal WHC was observed at its maximum value. The electron microscopy images showed that HSG had a compact and smooth structure with a smaller pore size after whey protein was added. Nuclear magnetic resonance analysis demonstrated the gradual transformation of free water into immobile water in gel matrix, reaching up to 93.21%. Additionally, the formation of ionic bonds increased significantly to 2.954 mg/mL. Differential scanning calorimetry showed that the denaturation temperature of myosin was increased, however, that of actin was reduced. These insights contribute to surimi production optimization which can significantly enhance the functional characteristics of HSG, providing a basis for improved surimi-based products.
Short report: Associations of family characteristics and clinicians’ use of caregiver coaching in early intervention
Authors: Hernandez Alyssa M , Straiton Diondra , Mandell David S , Ingersoll Brooke , Crabbe Samantha , Rieth Sarah , Pellecchia Melanie
Published: February 2025

There is a great demand for quality early intervention services for autistic children and their families. Caregiver-mediated interventions are critical components of evidence-based early intervention. However, their implementation in publicly funded systems is often done with poor fidelity. Qualitative evidence suggests that family characteristics impact clinicians’ use of caregiver-mediated intervention coaching strategies. We estimated associations between family characteristics and clinicians’ use of a caregiver-mediated intervention in a publicly funded early intervention system, leveraging data from a pilot randomized trial. Data were collected from 12 clinicians and 34 families. We used multiple linear regression models to estimate associations. The association between household income and clinicians’ overall coaching fidelity demonstrated a quadratic trend ( b  = −10.4, standard error = 4.1, p < 0.05) with low fidelity for low- and high-income families relative to middle-income families. Use of in vivo feedback, one component of coaching, was similarly associated with income ( b  = −0.5, standard error = 0.2, p < 0.05). Clinicians’ coaching fidelity was lower among families in exclusively English-speaking homes than for families who speak other languages ( b = 18.4, standard error = 8.8, p < 0.05). Results suggest that associations between family characteristics and clinician behavior may be more nuanced than previously understood.

Lay abstract

There is a high demand for quality early intervention services for autistic children and their families. A key part of effective early intervention is teaching caregivers how to support their child’s development through caregiver-mediated interventions. However, in publicly funded programs, these strategies are often not followed correctly. Some studies suggest that family characteristics may influence how well clinicians apply these coaching methods. In this study, we explored the connection between family factors, like household income and language spoken at home, and the way clinicians coached families. We found that clinicians used coaching strategies less consistently with both lower- and higher-income families compared to middle-income ones. In addition, families that spoke only English at home received less consistent coaching than those who spoke other languages. These findings highlight the complex relationship between family background and how early intervention services are delivered, suggesting a need for further research.
Clinical predictors of unplanned reoperations in trauma patients with damage control surgeries for truncal injuries
Authors: Semanco Michael , Montero Jennifer , Russell Nancy , Diaz Ashley , Gaugler Andrew C.
Published: February 2025

Purpose

The purpose of our study is to identify risk factors associated with unplanned or early reoperations in trauma patients with truncal injuries who received damage control surgeries.

Methods

This was an Institutional Review Board approved, single center, retrospective cohort evaluation. Trauma patients with truncal injuries who required an index surgery for damage control followed by a reoperation were divided into two groups based on the timing of their reoperation, planned (reoperation within 24–48 h) and unplanned groups (reoperation < 24 h). The primary outcome was to identify risk factors associated with unplanned trips to the operating room following the index surgery.

Results

Of the 142 trauma patients who underwent a damage control surgery, 42 patients were included for analysis (24 in the planned group and 18 in the unplanned group). The most common causes for unplanned reoperations were hemodynamic instability ( n = 7) and bleeding ( n = 8). Vasopressor administration (OR = 10.5, 95% CI [2.475, 44.54]), shock index > 1.2 (OR = 5.9, 95% CI [1.35, 25.88], and hemoglobin (Hgb) < 10 and/or a hematocrit (Hct) < 29 (OR = 8, 95% CI [1.5, 46.65] and/or OR = 17, 95% CI [1.94, 148.85], respectively) were associated with an increased odds of an unplanned return to the operating room.

Conclusion

Following damage control surgery, vasopressor administration, elevated shock index, and decreased Hemoglobin/Hematocrit may help identify patients who are at risk of requiring early or unplanned returns to the operating room.
Diabetes apps cannot “stand alone”: A qualitative study of facilitators and barriers to the continued use of diabetes apps among type 2 diabetes
Authors: Shen Yucong , Zheng Jingyun , Lin Lingling , Hu Liyuan , Lu Zhongqiu , Gao Chenchen
Published: February 2025

Background: Diabetes apps have the potential to improve self-management among people with type 2 diabetes mellitus (T2DM) and thereby prevent complications. However, premature disengagement of diabetes apps hinders this potential. Objective: This study aimed to identify facilitators of and barriers to the continued use of apps among T2DM patients and to formulate recommendations to enhance patients’ adherence to diabetes apps. Design: Qualitative study that followed the Consolidated Criteria for Reporting. Qualitative Research (COREQ) guidelines. Methods: Semi-structured interviews were conducted among 15 T2DM patients who continued real-world use of a diabetes app over 1 month. Data were analyzed using conventional content analysis. Results: The results showed that patients were triggered to continue app use by internally directed facilitators (health concerns, need for knowledge, self-conscious emotions) and externally directed facilitators (change in medication, reminders from health professionals). However, app use declined among all participants due to user-specific barriers (increased knowledge and experience, therapeutic inertia, diabetes stigma) and app-specific barriers. Notably, different app-specific barriers were identified in different self-managers: for novice self-managers, the app provided inconsistent information; for competent self-managers, the app provided invalid information and service; and for expert self-managers, the app was no longer being intelligent and new. Conclusions: The success of diabetes app continuance cannot be achieved by diabetes apps alone; rather, diabetes patients, health professionals, medical organizations, regulators, and integration technologies need to be gathered. Consistent, relevant, and current information, timely and continual service, psychological support should be guaranteed.
Enhanced structural damage detection through combined MODWT and FFT for power spectral density separation in beam vibration analysis
Authors: Nguyen Thanh Q. , Nguyen Dong Phuong , Nguyen Phuoc T. , Nguyen Thuy T.
Published: February 2025

Structural vibration analysis often involves evaluating power spectral density to understand vibration processes. However, these spectra typically include overlapping vibration modes, complicating the analysis of individual components. This study presents a method to separate vibration modes into distinct components, simplifying structural vibration analysis. By combining maximal overlap discrete wavelet transform with fast Fourier transform, the composite vibration signal is decomposed into frequency-specific components. This approach enables precise analysis of individual vibration modes, facilitating the detection of those most sensitive to structural changes. Furthermore, the method effectively removes noise and irrelevant vibrations, enhancing the accuracy and reliability of structural evaluations.
Thermoelectric coupling study of scavenging pressure effect on fuel spray and mixing of a vibratory combustion linear engine
Authors: Chen Lang , Li Shilei , He Yituan , Yuan Chenheng
Published: February 2025

The vibratory combustion linear engine is a promising energy converter that transforms thermal energy from fuel combustion into electrical energy through mechanical vibration. However, the effect of scavenging pressure on fuel spray and mixture formation under complex coupling conditions remains underexplored. To address this, a thermoelectric coupling model was developed to simulate the impact of scavenging pressure on mixture formation by integrating vibration, scavenging, power generation, and combustion, then updates the computational results of vibration and combustion calculations with an iterative algorithm to accurately simulate the effect of scavenging pressure on the mixture formation characteristics. Results show that scavenging pressure affects engine vibration, compression ratio, and fuel injection conditions. At a scavenging pressure of 1.1 bar, the fuel evaporation rate is 98.98%, the mixing uniformity index is 58.12%, and turbulence kinetic energy is 7.11 m2/s2. As scavenging pressure increases, the mixing uniformity decreases. Meanwhile, turbulence kinetic energy and fuel evaporation rate initially increase and reach their peak around 1.4 bar, after which they begin to decrease due to increased resistance to the fuel spray at higher pressures. Increased scavenging pressure enhances airflow momentum, improving atomization and spray penetration, while prolonging ignition delay. This delay provides more time for atomization, evaporation, and mixing before combustion, ultimately improving mixture quality.
Experimental analysis on the impacts of engine-out lambda frequency and amplitude on three-way catalyst performances
Authors: Terasawa Masato , Kusaka Jin
Published: February 2025

The hybrid powertrain with an advanced three-way catalyst (TWC) can contribute to the decarbonization of current gasoline engine-powered vehicles. Compact TWCs are used in next-generation hybrid electric vehicles (HEVs) to make room for a bigger battery. However, performances of a compact TWC deteriorate under dynamic excess air ratio (lambda [Formula: see text]). Lambda perturbation (dithering or rich-lean cycling) is a technique to improve transient TWC performance. The TWC conversion rate under dynamic lambda perturbation has not been well understood in real engine experiments. This work experimentally investigates the impact of lambda perturbation (frequency f and amplitude A) using an actual engine test. The experiments are performed using a mass-production 4-cylinder, 2.4 L gasoline engine equipped with a modified TWC reactor. THC, CO, and NO conversion rates are investigated under f = 0–1.0 Hz, A = 0–0.1, and exhaust gas temperatures T = 270–350°C. The results show that NO, THC, and CO conversion rates are low for T = 270°C for all frequencies and amplitudes. NO conversion rate is improved at A ≥ 0.04 under various f and T. THC conversion rate over 80% can be obtained under T = 350°C, while CO conversion rate is nearly 100% at T = 350°C for A = 0.02–0.08 and all frequencies. The impact of [Formula: see text] frequency and amplitude on the oxidation reaction rate of CO, NO, and THC are also discussed.
An alternative reading of the European Standards and Guidelines (ESG): From Foucault’s panopticon to Freire’s humanizing pedagogy
Authors: Neophytou Lefkios
Published: February 2025

This paper critically examines the impact of neoliberalism on Quality Assurance (QA) in Higher Education (HE), employing an integrated approach that combines Foucauldian deconstruction and Freirean reconstruction. It explores the pervasive issues of accountability, standardization, and control that have increasingly dominated the field, particularly in the implementation of the European Standards and Guidelines (ESG) and the roles of national and European QA agencies. Foucault’s concepts, as recorded in the relevant literature, are applied to critique the limitations of current QA practices, which often prioritize benchmarks and compliance at the expense of genuine educational quality. Moving beyond critique, the paper incorporates Freire’s humanizing pedagogy to propose a reconstructive and transformative vision for QA. This integration of deconstruction and reconstruction enables an alternative reading of the ESG, reimagining QA as a process that transcends standardization to prioritize contextual responsiveness, inclusivity, and the unique needs of students and communities.
History education and democratic consciousness in Israel
Authors: Tal Nimrod
Published: February 2025

The article examines how Israeli state-secular education integrates the principle of continuity and change through human agency into its history curriculum, in order to cultivate democratic consciousness. Drawing on theorists such as John Dewey, Marc Bloch, and Peter Seixas, it evaluates the curriculum's potential, or its lack thereof, to promote the understanding that democracy is constantly shaped by human actions. The article argues that, while the curriculum emphasises democratic values across various chapters from ancient times to the late twentieth century, it faces challenges in fostering historical consciousness that encourages students to act as agents of democratic change. Particularly, critical issues like relations between Jews and Arabs, or the tension between the country's Jewish and democratic identities are often neglected or not historicised, undermining a comprehensive view of modern Israeli society as a product of its history.
Investigation of cleanroom clothing thermal insulation by thermal manikin and impact on thermal comfort of cleanroom users
Authors: Konečná Kateřina , Adamovský Daniel
Published: February 2025

The cleanroom environment is fundamentally influenced by the required class of cleanliness, with thermal conditions not primarily set to ensure occupant comfort. The inability to adjust temperatures, combined with strict clothing policies that do not consider clothing insulation, often leads to user dissatisfaction, potentially compromising cleanliness. Without insulation values, thermal comfort assessment, prediction of comfort temperatures, or clothing optimisation are impossible. This study aimed to determine the thermal insulation of 15 frequently used cleanroom clothing ensembles for ISO 8 to ISO 5 cleanliness using a thermal manikin. For each ensemble, the comfort air temperature was predicted according to ISO7730, and the predicted mean vote (PMV) was assessed for different ambient temperatures. Thermal insulation values ranged from 0.71 clo to 1.16 clo, resulting in predicted comfort temperatures between 17.6°C and 21.1°C. The assessment confirmed that cleanroom ensembles differ in thermal insulation depending on the class of cleanliness, leading to variations in thermal perception. Different levels of thermal satisfaction, described using the PMV index, were predicted in cleanrooms with the same air temperature but various prescribed ensembles. Selecting suitable clothing can achieve thermal comfort even in cleanrooms where user adjustment of temperature is not possible. This can account for different activity levels, personal preferences, and gender, leading to higher user satisfaction and more efficient cleanroom operation. Further research into suitable textiles and alternative clothing options is suggested to improve thermal comfort, especially for higher indoor air temperatures or specific body zones.
Upper Extremity-Cognitive Dual-Task Capacity Post-Stroke
Authors: Bachar Kirshenboim Yishai , Tzur Lebovich Shir , Weitzer Tal , Doron Dana , Bondi Moshe , Cialic Ron , Rand Debbie
Published: February 2025

Background

Dual-task capacity, which might be impaired poststroke, is needed for daily functions. Therefore, dual-task capacity should be assessed during rehabilitation. The Dual Overload Interference Test (DO-IT) is a new upper extremity (UE) protocol for assessment, combining The Box and Block Test with the Counting Backwards Test.

Objectives

To validate DO-IT by comparing between (1) young and older healthy, (2) stroke and healthy participants. Additionally, to correlate DO-IT with (3) walking-cognitive dual-task assessment (healthy), and (4) standardized cognitive and EF assessments (stroke).

Methods

A cross-sectional study included younger and older community-dwelling healthy individuals (N = 32), and younger and older individuals with stroke (N = 83). DO-IT was administered to all participants. The #blocks transferred (motor) and #correct numbers counted (cognitive) were recorded for single and dual conditions. The walking-cognitive dual-task test was administered to the healthy participants. Motor and cognitive costs were calculated as the difference between single and dual tasks. The Montreal Cognitive Assessment test (MoCA) and the Color Trail Test (CTT) assessed cognition post stroke.

Results

Older healthy adults had significantly lower dual-task motor capacity compared to younger adults (median [interquartile range] blocks: older 26 [21-38], younger 46 [38-52], P < .01). Participants with stroke showed higher motor costs than healthy participants. Dual-task costs correlated between DO-IT to walking-cognitive (motor; r = .37-.41, cognitive; r = .41-.47, P < .05). DO-IT motor cost negatively correlated with MoCA ( r = −.27, P < .05), and DO-IT motor performance correlated with MoCA/CTT-A\B ( r = .29-.60, P < .05).

Conclusions

UE-Cognitive dual-task capacity is affected post-stroke. DO-IT shows potential for use in stroke rehabilitation and its validity should be further researched.
Predicting Long-COVID Sequelae: A Multi-Label Classification Approach
Authors: Bellan Mattia , Chiocchetti Annalisa , Dossena Marco , Irwin Christopher , Piovesan Luca , Portinale Luigi
Published: February 2025

We present a study about the prediction of long-COVID sequelae through multi-label classification (MLC). Data on more than [Formula: see text] patients have been collected during a long-COVID study at Ospedale Maggiore of Novara (Italy), considering their baseline situation, as well as their condition on acute COVID-19 onset. The goal is to predict the presence of specific long-COVID sequelae after a one-year follow-up. To amplify the representativeness of the analysis, we carefully investigated the possibility of both augmenting the dataset by considering situations where different levels in the number of complications could arise, and reducing the number of features to be considered for prediction. In the first case, MLSmote under six different policies of data augmentation has been considered, while in case of feature reduction we have generated new datasets via both a supervised and an unsupervised dimension reduction approach (Relief and PCA respectively). A representative set of MLC approaches has been tested on all the available datasets. Results have been evaluated in terms of Accuracy, Exact match, Hamming score and macro-averaged AUC; they show that MLC methods can actually be useful for the prediction of specific long-COVID sequelae, under the different conditions represented by the different considered datasets. In addition, interpretability of the results has been addressed through an approach based on the SHAP method, showing that clinical interpretations of specific predictions can be actually captured by the method, together with the observation that data augmentation techniques do not harm such a kind of explanations.
Venetoclax added to CLAG regimen might improve the outcome of patients with relapsed/refractory acute myeloid leukemia
Authors: Zhang Yu , Yin Zhao , Yao Zurong , Xu Dan , Jiang Xuejie , Nie Xiaqi , Chen Dandan , Zhou Hongsheng , Shi Pengcheng , Liu Hui , Liu Qifa , Yu Guopan
Published: February 2025

Background:

We aim to analyze the efficacy and safety of Venetoclax (Ven) added to cladribine + cytarabine + granulocyte colony-stimulating factor (G-CSF) ± idarubicin or mitoxantrone (CLAG ± Ida/Mito) regimen as a salvage treatment of relapsed/refractory acute myeloid leukemia (RR-AML).

Methods:

A single-center, retrospective, cohort study was performed. Patients with RR-AML, being treated with CLAG ± Ida/Mito with versus without Ven, were retrospectively studied. The endpoints of this study were to evaluate the rate of composite complete remission (CRc), measurable residual disease (MRD), event-free survival (EFS), overall survival (OS), and relapse between CLAG and CLAG + Ven groups.

Results:

Sixty-nine patients were included, with a median age of 37 (range, 18–65) years. Thirty-one patients underwent one cycle of salvage treatment of CLAG ± Ida/Mito with Ven and 38 without. In the CLAG + Ven group, 24 (77.4%) patients acquired response, including 22 (71.0%) with composite complete remission (CRc) and 15 (48.4%) MRD-negative CRc, which was significantly higher than those (CRc 47.4%, p = 0.048; MRD-negative CRc 18.4%, p = 0.008) in the CLAG group. Subgroup analysis showed that patients without response after two courses of induction therapy, or patients with FLT3 mutations seemed to benefit more from CLAG ± Ida/Mito + Ven than CLAG ± Ida/Mito in acquiring CRc. With a median follow-up of 13 (95% CI 10.5–15.5) months, the CLAG + Ven group had a median OS of 22.9 (95% CI 19.6–26.2) months and EFS of 15.7 (95% CI 11.1–20.2) months. In contrast, the CLAG group had a median OS of 18.6 (95% CI 14.7–22.6) months and EFS of 10.7 (95% CI 6.6–14.8) months. Although not statistically significant, patients in the CLAG + Ven group showed a potential survival advantage compared to the CLAG group. AEs including all grade and grade 3/4 occurred at similar frequencies in the two groups.

Conclusions:

Ven added to CLAG ± Ida/Mito might improve the outcome of the patients with RR-AML, with well toleration, and a randomized controlled trial is needed to explored.
The impact of climate change on the epidemiology of fungal infections: implications for diagnosis, treatment, and public health strategies
Authors: George Mary E. , Gaitor Tonisha T. , Cluck David B. , Henao-Martínez Andrés F. , Sells Nicholas R. , Chastain Daniel B.
Published: February 2025

Anthropogenic climate change, primarily driven by greenhouse gas emissions, is reshaping ecosystems and creating conditions that affect 58% of all known human infectious diseases, including fungal infections. Specifically, increasing temperatures, changing precipitation patterns, and extreme weather events are influencing fungal growth, distribution, and virulence. These factors may expand the geographic range of pathogenic fungi, exposing populations to novel, potentially more virulent, or drug-resistant strains. Simultaneously, human factors such as declining immunity, aging populations, and increased use of immunosuppressive therapies are enhancing host susceptibility. This review explores the intricate relationship between climate change and fungal infections, highlighting pathogens that may demonstrate increased virulence and antifungal resistance, along with emerging novel pathogens. The clinical implications are profound, with increased morbidity, mortality, and the spread of fungal infections into new regions. Immediate action is required to develop policies, educational initiatives, and novel antifungal therapies, enhance early diagnostic capabilities, and address healthcare disparities to mitigate the growing burden of fungal infections.
“Digital? There are some good things and some less so . . .”: Understanding the ambivalent attitude of local food shoppers toward digitalized short food supply chains before and during the March 2020 lockdown
Authors: Rogeon Fabien
Published: February 2025

While the digitalization of retailing is praised by producers selling their local food through short food supply chains (SFSCs), what do shoppers think? To address this question, this research seeks to understand how shoppers react toward digitalized short food supply chains (DSFSC). A qualitative study was conducted through semi-structured interviews with 20 shoppers who utilized DSFSC for their local food shopping. These 20 shoppers were interviewed twice: before and during the March 2020 lockdown. The theoretical contribution of this article lies in understanding and conceptualizing the ambivalent attitude of shoppers toward DSFSCs. While shoppers manifest polarized reactions – positive or negative – toward specific attributes of DSFSCs, other attributes elicit both positive and negative reactions. Furthermore, the two-phase qualitative study reveals the limited influence of the lockdown on shoppers’ ambivalent attitudes toward DSFSCs. This observation is supported by quantitative work during thematic content analysis, which we highlight for its methodological value. From a managerial perspective, we propose a framework for producers to identify reactions toward DSFSCs, segment and target customers, and communicate effectively.
Optimising process parameters for enhanced performance in PLA-based fused filament fabrication: A multi-objective approach
Authors: Yorke Ezekiel , Chowdary Boppana V.
Published: February 2025

Manufacturing technologies, particularly additive manufacturing (AM), have ushered in innovative practices for complex part production, prominently exemplified by fused filament fabrication (FFF) for the production of complex parts. Significant efforts have been ongoing with a focus on improving performance measures of biodegradable bioplastics, notably polylactic acid (PLA), within the eco-conscious packaging industry. Findings in this field have given rise to FFF technologies for enhancing critical performance measures such as surface roughness (Ra) of food packaging by investigating optimal process parameters such as layer thickness, raster width, raster angle, printing speed, air gap and bed temperature, to name but a few. Additional performance measures affecting geometric part quality, such as thickness variations along horizontal and vertical geometric planes, have been analysed in previous studies to derive solutions for enhancing the correlation between process parameter input and dimensional accuracy. Despite these advancements, research on 3D-printed specimens has typically focused on manufacturing standards with thickness greater than 1 mm, as opposed to the thinner requirements of some plastic packaging products. This practice has left a gap of uncertainty regarding the potential mechanical performance of thin-film 3D-printed products for current and future applications. The necessity to induce fewer infill layers during the FFF process has sparked interest in evaluating the efficacy of process parameters in achieving reliable mechanical performance in surface quality and Z-axial dimensional accuracy compared to conventionally manufactured plastic products. This article, therefore, sought to address this uncertainty using a design of experiments (DoE) approach followed by multi-objective optimisation through the application of genetic algorithm (GA) techniques. From these efforts, optimal process parameters of layer thickness (0.151 mm), raster width (0.514 mm) and raster angle (82.75o) for the minimisation of Ra and Delta-Z (∇Z) variation in PLA-based FFF specimens. Further data analysis noted variability in the accuracy of Ra predicted R² values depending on the raster angle and void defects at the surface layer, while additional observations indicated an increase in Z-axial variation when a layer thickness of 50% of the overall specimen thickness was utilised. This study concluded by underscoring the necessity for future research in integrating multi-objective optimisation further, with the aim of not only improving the predictability of process parameter optimisation but also the detection, analysis and minimisation of defects using machine learning tools and techniques.
Systemic family therapy through the eyes of a clinical psychology trainee in 2024: History, context and clinical application
Authors: Robinson Rory
Published: February 2025

This paper is presented as a response to an invitation from the editor of Human Systems. Systemic theory and therapy have evolved over the last 70 years and each new generation of practitioners encounters the historical and contemporary literature through fresh eyes. Clinical psychology is one discipline which continues to value systemic approaches. Multiple Clinical Psychology (DclinPsy) programmes nationwide facilitate training approved by the Association for Family Therapy and Systemic Practice (AFT). The University of Plymouth is one such example. This paper offers a window into the experience of a trainee clinical psychologist attending a foundation in family therapy course, undertaken as part of their wider training on the DclinPsy. It covers a brief summary of the history of family therapy, the practitioner’s insights into how it is utilised in NHS services and its modern-day application for clinical psychology.
Regional adjustment to the NGA-East GMM for Texas, Oklahoma, and Kansas
Authors: Li Meibai , Rathje Ellen M , Stewart Jonathan P , Ramos-Sepulveda Maria E , Hashash Youssef MA
Published: February 2025

Recent research indicates that there are regionally variable differences between the [Formula: see text]—adjusted Next Generation Attenuation Relationships for Central & Eastern North-America (NGA-East) ground motion models (GMM) and recorded ground motions in Central and Eastern North America (CENA), such that region-specific adjustments are required. Increases in induced seismicity in the Texas, Oklahoma, and Kansas (TOK) region provide the motivation and the data to develop regional source, path, and site adjustments to the NGA-East central branch GMM for application to this region. For this purpose, we compiled a database within TOK of 12,756 ground motion recordings from 557 stations and 342 events with magnitudes 3.5–5.8. A mixed-effects reference empirical approach is applied to quantify the average misfit and adjustments to magnitude, distance, and site amplification scaling for TOK. The average misfit relative to the NGA-East GMM reference condition indicates overprediction at short periods and underprediction at long periods. The magnitude adjustment reduces the long-period response spectral values at magnitudes greater than about 4.5, the distance adjustment modifies the short- and mid-distance scaling, and the resulting site amplification model is similar to others developed for CENA.
Facile synthesis of copper, nickel and their bimetallic nanoparticles: optical and structural characterization
Authors: Aman Abdul Waheed , Krishnan Ganesan , Sadiqi Mohammad Abdullah , Alhajj Mahmood , Hidayat Nurul
Published: February 2025

This paper reports the synthesis and characterization of some spherical crystalline copper (Cu), nickel (Ni), and their bimetallic (Cu–Ni) nanoparticles (NPs) produced in deionized (DI) water via pulse laser ablation in liquid (PLAL) technique. XRD and SAED patterns showed the high crystallinity of the synthesized nanostructures with face-centered cubic structure. The TEM and HRTEM images revealed the nucleation of spherical nanocrystals with a size range of 2.5–25 nm, and no remarkable aggregation was seen. Some core–shell oxidized Cu and Ni nanostructures related to the dissolved oxygen in DI water were detected. The UV–Vis absorption spectra at different aging times showed that pure metal nanoparticles are more stable than bimetallic nanoparticles. Localized surface plasmon resonance (LSPR) absorption peaks were recorded at 645 nm and 596 nm wavelengths for Cu and Cu–Ni colloidal solutions, respectively. The PL emission peaks at shorter wavelengths indicated that synthesized nanoparticles are blue luminescent. The achievement of pure and spherical copper, nickel, and their bimetallic nanoparticles with enhanced optical properties could be beneficial for advancing photocatalysis and antibacterial activity.
Factors influencing quality of professional life and perceived bullying among medical residents in Iran
Authors: Assadpour Nima , Alazmani-noodeh Farshid , Baniyaghoobi Faeze , Shafiei Kisomi Zahra , Bahrami Mahdie , Ghasemnegad Seideh Madineh , Ranjbar Hadi
Published: February 2025

Objectives

During residency training, medical doctors, face significant challenges that can impact their quality of professional life, their performance, and the care they provide. The current study aimed to examine factors affecting the quality of professional life and their perception of bullying.

Design/ participants

This was a cross-sectional study with 231 medical residents.

Setting

Educational hospitals affiliated with Iran University of Medical Sciences in Tehran, Iran.

Methods

Participants completed a questionnaire that included demographic data, the Negative Act Questionnaire-Revised (NAQ-R), and the Professional Quality of Life Scale (ProQol-5). The study included 231 medical residents from medical university-affiliated hospitals.

Results

Bullying had a significant negative effect on the quality of professional life (B = -1.173, p < 0.001), while satisfaction with income positively affected it (B = 2.111, p = 0.016). Gender, marital status, feeling respected, age, shift hours, residency year, and medical-surgical department were not significant predictors. Longer shift hours per week (B = 0.306, p = 0.044) and more experienced residents (B = -1.376, p = 0.010) were associated with higher and lower bullying perceptions, respectively.

Conclusions

The study highlights the significant negative impact of bullying on the quality of professional life among medical residents. Suitable interventions should be considered to reduce this impact. Potential interventions could include implementing comprehensive training programs focused on emotional intelligence and communication skills, establishing clear reporting mechanisms for bullying incidents, and fostering a supportive workplace culture prioritizing respect and collaboration among healthcare professionals.
A novel method for screening malignant hematological diseases by constructing an optimal machine learning model based on blood cell parameters
Authors: Sun Dehua , Chen Wei , He Jun , He Yongjian , Jiang Haoqin , Jiang Hong , Liu Dandan , Li Lu , Liu Min , Mao Zhigang , Qu Chenxue , Qu Linlin , Sun Ziyong , Wang Jianbiao , Wu Wenjing , Wang Xuefeng , Xu Wei , Xing Ying , Zhang Chi , Zhang Jingxian , Zheng Lei , Zhang Shihong , Ye Bo , Guan Ming
Published: February 2025

Background

Screening of malignant hematological diseases is of great importance for their diagnosis and subsequent treatment. This study constructed an optimal screening model for malignant hematological diseases based on routine blood cell parameters.

Methods

The venous blood samples of 1751 patients collected from 10 tertiary hospitals in China were divided into a training set (1223 cases) and a validation set (528 cases). In addition to the clinical diagnostic information of the samples in the training set, 26 blood cell parameters including morphological parameters were selected using manual screening and filtering to construct eight machine learning models. These models were used to identify hematological malignancies among the validation set.

Results

Comparison of the discrimination, calibration and clinical detection performance of the eight machine learning models revealed that the artificial neural network (ANN) model performed the optimal in identifying malignant haematological diseases in the validation set (528 cases), with an area under the receiver operating characteristic curve (AUC), accuracy, sensitivity and specificity of 0.906, 0.857, 0.832 and 0.884, respectively.

Conclusion

The ANN model constructed can be used for screening of malignant hematological diseases, especially in primary hospitals that lack comprehensive diagnosis, and this ANN model will help patients to get diagnosis and treatment of malignant hematological diseases as early as possible.
Unlocking prevention: the role of health literacy in cervical cancer screening: community nursing perspective
Authors: Mohamed Amin Shaimaa , Metwally El-Sayed Mona , Hashem El-Monshed Ahmed , Hussein Ramadan Atta Mohamed
Published: February 2025

Introduction

Cervical cancer presents a significant global public health challenge, particularly affecting low- and middle-income countries like Egypt. Despite the availability of effective screening methods such as Pap smears and HPV testing, the incidence of cervical cancer remains high in Egypt. Health literacy, which refers to the ability to access, understand, and utilize basic health information and services to make informed decisions, is crucial in influencing individuals’ health behaviors, including their participation in cancer screening programs.

Objectives

To examine the correlation between health literacy levels and cervical cancer screening behaviors among women.

Methods

This study employed a multi-site cross-sectional research design from September 2023 to January 2024. The research was conducted at four primary health care (PHC) facilities in the Damanhur district of Egypt. Three hundred fifty women participated in the study, completing a comprehensive questionnaire that included a Woman’s Social and Health Form, a Cervical Cancer Knowledge Scale, a Cervical Cancer Screening Behaviors Scale, and a Health Literacy Scale (HLS-SF12).

Results

The study revealed significant relationships between the importance of health literacy (HL) in understanding cervical cancer (CC) knowledge and screening behaviors among Egyptian women. A positive correlation was found between Knowledge and HL (r = 0.507, p < 0.001). Conversely, perceived barriers negatively correlated with knowledge and HL (r = -0.172, p < 0.05; r = -0.277, p < 0.01). The regression analysis revealed that higher levels of HL were significantly associated with greater knowledge about CC (B = 0.148, p < 0.001). Conversely, knowledge about CC was also found to be a strong predictor of higher HL levels (B = 1.205, p < 0.001). These results highlight the bidirectional relationship between HL and knowledge, where improvements in one can enhance the other.

Conclusion

Addressing misconceptions and increasing knowledge about the importance of regular screenings, mainly through accessible and culturally appropriate channels, could lead to an improved uptake of cervical cancer screening services. Overall, this study lays a foundation for future research to continue exploring ways to improve cervical cancer prevention and control efforts among women.

Clinical trial number

Not applicable.
Decision-making in interhospital transfer of traumatic brain injury patients: exploring the perspectives of surgeons at general hospitals and neurosurgeons at neurotrauma centres
Authors: Cuevas-Østrem Mathias , Wisborg Torben , Røise Olav , Helseth Eirik , Jeppesen Elisabeth
Published: February 2025

Background

Traumatic brain injury (TBI) is a significant public health concern. Advancing age and comorbidities are associated with a reduced probability of being transferred to neurotrauma centres (NTCs) from non-neurosurgical acute care trauma hospitals (ACTHs). However, the extent to which these decisions reflect well-considered treatment-limiting decisions and which influence other factors have on the decision-making process remains unclear.

Objective

To increase the understanding of adults’ access to NTC care by exploring the decision-making process for interhospital transfer of patients with isolated TBI, elucidating factors influencing these decisions.

Methods

Fifteen surgeons and neurosurgeons from four hospitals in Norway were recruited through purposive sampling to four semi-structured focus group interviews. Surgeons represented ACTHs and neurosurgeons NTCs, and all participants were responsible for TBI patients' initial care and transfer decisions. Interviews were thematically analysed.

Results

We identified several factors influencing transfer decisions, captured in six main themes under one overarching theme; ‘The chance of a favourable outcome’. The six main themes reflect surgeons’ and neurosurgeons’ decision-making process, which included clinical and system-level factors: (A) ‘Establish TBI severity: Glasgow Coma Scale score and head CT’, (B) ‘Preinjury health status: comorbidity, functioning, and age’, (C) ‘Distance from ACTH to NTC: distance is time and time is brain’, (D) ‘Uncertainty and insecurity’, (E) ‘Capacity at NTC’, and (F) ‘Next of kin involvement’.

Conclusion

On-call surgeons and neurosurgeons responsible for making transfer decisions for TBI patients emphasise the importance of patient-centred decisions, including individual patients’ risk factors and overall health status.
The patient experience of CHAPLE disease: results from interviews conducted as part of a clinical trial for an ultra-rare condition
Authors: Litcher-Kelly Leighann , Ozen Ahmet , Ollis Sarah , Feldman Hagit Baris , Yaworsky Andrew , Medrano Paolo , Chongsrisawat Voranush , Perlee Lorah , Walker Marisa , Pradeep Sharanya , Turner-Bowker Diane M. , Kurolap Alina , Adiv Orly Eshach , Lenardo Michael J. , Harari Olivier A. , Jalbert Jessica J.
Published: February 2025

Background

CD55 deficiency with hyper-activation of complement, angiopathic thrombosis, and protein-losing enteropathy (CHAPLE) disease is a newly identified condition with an estimated worldwide prevalence of < 100 patients. Patient interviews can ensure that what is important to patients is assessed in a clinical trial program. Due to the rare and potentially fatal nature of CHAPLE disease, interviews were conducted as part of the pozelimab clinical trial, rather than in a separate study before the trial. The aim of the interviews was to identify the key disease-related signs, symptoms, and health-related quality-of-life (HRQoL) impacts that are important and relevant to patients with CHAPLE disease.

Methods

Interviews were conducted with patients and/or caregivers at two timepoints (screening and Week 24) during the pozelimab trial to document the signs/symptoms and HRQoL impacts of CHAPLE disease, and document the most bothersome sign/symptom at screening. At Week 24, interviews gathered additional information on the patient experience from caregivers and patients (note: the impact of pozelimab treatment was also collected, though these results are presented elsewhere).

Results

Ten patients, aged 3–19 years, were enrolled in the trial; caregivers contributed to nine interviews. Thirty-one signs‌/symptoms and 65 HRQoL impacts were reported during the interviews. Abdominal pain, diarrhea, facial and peripheral edema/‌swelling, nausea, and vomiting emerged as the core signs/‌symptoms of CHAPLE disease (i.e., experienced by ≥ 90% of patients prior to treatment). The remaining 25 signs/symptoms were experienced by four or fewer (n ≤ 4, ≤ 40.0%) patients, and 15 were only reported by one patient each. Abdominal pain and facial edema were reported as the most bothersome signs/‌symptoms (n = 9, 90.0% and n = 1, 10.0%, respectively). The most frequently reported (i.e., ≥ 80% of interviews) HRQoL impacts were restricted diet (n = 10, 100.0%), sleep disruptions (n = 10, 100.0%), missing school (n = 9, 90.0%), ability to get dressed independently (n = 8, 80.0%), and difficulty engaging in play activities (n = 8, 80.0%).

Conclusions

The main finding from these patient interviews is the identification of six core signs/symptoms of CHAPLE disease: abdominal pain, diarrhea, facial edema/swelling, peripheral edema/swelling, nausea, and vomiting. The severity of the core signs/symptoms leads to substantial impacts on patients’ lives.

Trial registration

ClinicalTrials.gov, NCT04209634. Registered 20 December 2019 https://classic.clinicaltrials.gov/ct2/show/NCT04209634.
Self-managed abortion as a humanitarian revolution: accounts of a telehealth pilot in the Middle East
Authors: Lasserre Laureline , Staderini Nelly , Hasan Maysa’a , Rossi Vanessa
Published: February 2025

Background

Access to safe abortion care (SAC) should be improved in fragile and humanitarian settings, and the implementation of interventions in that regard are currently limited. This is especially true for self-managed abortion (SMA), although it holds the potential of revolutionizing the prevention of maternal death and suffering.

Case presentation

The medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) piloted a self-managed abortion model of care in the Middle East. 22 women were remotely supported in managing their safe abortions with a counsellor over the phone, using misoprostol doses that they took at home after having taken mifepristone in our health facility. We share our experience by describing the model of care and discussing the lessons learned through its implementation.

Conclusions

The program delivered abortion services successfully and required few resources. This paper also reflects on the importance of facilitating SMA in humanitarian contexts. It increases access to care by providing increased confidentiality, close support, ample information, autonomy, and flexibility. It is simple to implement, effective, often preferred by women, and can be linked to information about contraception. The implementation of self-managed models should be expanded, notably in projects that do not have a sexual and reproductive health focus and in restrictive and challenging contexts. It represents a true revolution for access to safe abortion care.