bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Tool to Communicate the Needs of Survivors of Trauma to Health Professionals: A Mixed Methods Pilot Study
Authors: Lewtas Holly , Field Michael , Ahmad Kabir
Published: January 2025

Aim(s)

To explore the acceptability and feasibility of using a trauma‐informed communication tool to convey client needs to health professionals; and to understand the barriers and enablers for clients using the tool.

Design

Mixed methods design pilot study conducted by nurses from a regional community health service in Victoria, Australia, of purposively sampled clients who have a history of sexual assault and/or family violence and clinicians from a primary care service.

Methods

The investigators developed a pocket‐sized communication card to convey clients' history of trauma and the clients' emotional and physical needs to health care providers.

Pre‐intervention and post‐intervention surveys using validated scales (‘Acceptability of Intervention Measure’ and ‘Intervention Appropriateness Measure’) were administered via anonymous online or paper‐based survey.

Results

Sixteen clients completed the pre‐intervention survey and 12 clients completed the post‐intervention client survey. Seven Nurses and three Social Workers completed the clinician survey.

Both clients and clinicians reported high rates of acceptability and appropriateness of the tool on the outcome measures. The most commonly reported barriers to using the tool were clients forgetting to use the card and concern about how health professionals may respond.

Content analysis of qualitative data revealed themes categorised as positive impacts (prevention of re‐traumatisation), negative impacts (negative response from health professionals) and suggestions for improvement of the tool (developing a digital version, raising clinicians' awareness of the tool).

Conclusion

This novel tool has demonstrated a high degree of acceptability and applicability in a sample of clients with a history of trauma secondary to sexual assault and/or family violence, and community health clinicians, and several positive and negative impacts have been identified. Further research should focus on larger participant numbers and include developing a digital version and a clinician education component.

Implications for the Profession and/or Patient Care

Use of a tool to communicate impacts of trauma may prevent re‐telling of traumatic stories by clients and enhance quality of care delivery.

Reporting Method

The Good Reporting of a Mixed Methods Study (GRAMMS) has been used to report the results of this study.

Patient or Public Contribution

During development of the tool, it was reviewed by a lived experience consumer representative, the health organisations' consumer advisory panel, and a small sample of clients.
Quality of Nursing Care: Addressing Sexuality as Part of Prostate Cancer Management, an Umbrella Review
Authors: Neenan Catherine , Chatzi Anna V.
Published: January 2025

Background

Sexuality is a fundamental aspect of health and wellbeing. The management of prostate cancer can result in erectile dysfunction and body feminisation, resulting in loss of masculinity and alterations of body image. Prostate cancer patients identify sexuality as an unmet need and report little or no communication with their healthcare providers on the topic.

Aim

This umbrella review aims to determine the barriers that may preclude nurses from discussing sexuality with prostate cancer patients.

Design

An umbrella review of systematic review studies was undertaken using the PRISMA guidelines.

Method

Five databases were comprehensively searched, CINAHL, MEDLINE, PsycINFO, Cochrane and Prospero, from October 1, 2013 to December 1, 2023, using the defined criteria. A total of 11 systematic reviews were included in this review consisting of 10 with quantitative and 1 with quantitative/mixed methods approach.

Results

This study identified common themes, which were categorised into four groups: (a) lack of training and education, (b) age and years of clinical experience of nurses, (c) personal values and attitudes and (d) organisational factors. These factors contribute to why nurses feel unprepared and admit to not having adequate knowledge or expertise to have this discussion.

Conclusion

The findings of this study illustrate that nurses require specialised communication skills to manage sensitive discussion with patients. Education is crucial to facilitate and empower nurses to discuss sexuality with their patients. Developing a pathway to specialist referrals will encourage nurses to address this with their patients.

No Patient or Public Contribution

For the preparation of this paper, no direct involvement of patients or public has been deemed applicable to this work. This is an umbrella review paper.
Recent Advances in Non‐Invasive Digital Nursing Technologies for Chronic Pain Assessment and Management: An Integrative Review
Authors: Lee James , Mowat Rebecca , Blamires Julie , Foster Mandie
Published: January 2025

Aim

This integrative review aims to identify what nurses currently offer through digital technology and their success in managing chronic pain.

Design

An integrative review guided by Whittemore and Knafl was conducted.

Data Sources

Five databases—CINAHL, Medline, PsycINFO, PubMed, and Scopus—were utilised to gather relevant studies from January 2018 to November 2024.

Review Methods

Selected studies were assessed using the Mixed Methods Appraisal Tool and the Joanna Briggs Appraisal Tool. Braun and Clarke's thematic analysis was applied to identify pertinent themes.

Results

Digital nursing technologies such as telehealth and web‐based interventions effectively deliver interventions to assess and manage chronic pain; these technologies can reduce healthcare resource utilisation and increase accessibility. This review highlights that nurses commonly deliver exercise, cognitive‐behavioural therapy, acceptance and commitment therapy and self‐management techniques through digital technology.

Conclusion

This review indicates that web‐based interventions and telemedicine are the primary digital technologies employed by nurses for chronic pain management providing psychosocial interventions, with evidence supporting their effectiveness. Digital and web‐based technology is essential to bridge healthcare access gaps as nurses can provide this successfully with minimal nursing support and cost to the patient.

Impact

Evidence supports nurses in providing psychosocial interventions for the management of chronic pain, particularly web‐based psychosocial interventions. Nurses need to adopt digital technology to improve access to care and patient outcomes and to maintain professional development in an increasingly digital world.

Patient or Public Contribution

No patient or public contribution was used for this study.
Compassion Fatigue Among Australian Oncology Nurses Caring for Adult Cancer Patients: Antecedents, Impact and Mediators
Authors: Banks Janneka , Lopez Violeta , Thapa Deependra Kaji , Sahay Ashlyn , Cleary Michelle
Published: January 2025

Aims

To explore how Australian oncology nurses perceive and experience compassion fatigue when caring for adult cancer patients, how they mitigate compassion fatigue and identify potential interventions to address compassion fatigue.

Design

A qualitative, descriptive study.

Methods

Twenty Australian oncology nurses caring for adult cancer patients were interviewed between August and September 2023. Participants were recruited from a larger, quantitative study. Interviews were conducted virtually, transcribed verbatim and analysed using thematic analysis.

Results

Three themes and nine sub‐themes were identified. Participants viewed heavy workloads, low staffing and organisational support as contributing factors to compassion fatigue. They described compassion fatigue as a feeling of having nothing left to give, impacting their ability to self‐care, deliver quality patient care and maintain relationships. The pride participants felt in their cancer care work helped mitigate compassion fatigue. Self‐care strategies, workplace mentoring and support were identified as ways to mitigate compassion fatigue.

Conclusion

The work of oncology nurses can contribute to compassion fatigue, which may impact nurses and patient care. Organisations would benefit from supporting staff to engage in self‐care activities, professional development and mentoring.

Implications for Professional

Findings support a multi‐tiered approach to addressing compassion fatigue among oncology nurses. Organisations can prioritise adequate staffing levels, mentoring opportunities, focused well‐being interventions and provide avenues for meaningful recognition.

Reporting Method

This study adheres to the COREQ reporting guidelines.

Patient or Public Contribution

No patient or public contribution.
Oligocene Odyssey: Molecular Phylogenetic Analyses Describe the Origin and Diversification of Freshwater Gammarus in Eastern North America
Authors: Cannizzaro Andrew G. , Berg David J.
Published: January 2025

Aim

Members of the amphipod genus Gammarus have served as an excellent model for testing biogeographic hypotheses given the number of species within the genus and its unique history, with multiple taxa transitioning from marine to freshwater environments independently. However, while attention has been placed on Palearctic Gammarus, little is known about members in the Nearctic. Given trends observed within the genus, Gammarus from eastern North America (ENA) may represent another independent lineage, likely reaching the continent using a heretofore unknown pathway. We investigate the phylogenetic and evolutionary history of Gammarus spp. in this region.

Location

Eastern North America.

Taxon

Gammarus.

Methods

Sequence data for two nuclear and two mitochondrial loci were obtained for 75 individuals, four of which are newly sequenced. Based on a partitioned dataset, phylogenetic trees were reconstructed using both maximum likelihood and Bayesian inference. Bayesian trees were time‐calibrated based on a set of five mixed calibration points. RASP software was used to investigate potential ancestral areas.

Results

ENA Gammarus spp. were recovered as monophyletic, showing affinity to both Palearctic Gammarus and G. duebeni. Newly generated sequences solidify the position of Gammarus bousfieldi, which is found to be related to G. minus. Time‐calibrated phylogenies place the crown age of the ENA lineage during the Eocene/Oligocene. These timings suggest a marine origin for the lineage followed by dispersal into freshwaters.

Main Conclusions

Members of the “ENA Gammarus” are a unique lineage within the genus, originating from a marine ancestor during the Eocene/Oligocene and colonising the Nearctic shortly after. The exact route the lineage may have taken is unclear; however, three routes are proposed: (i) the Gulf of St. Lawrence, (ii) the Chesapeake Bay, and (iii) the Mississippi River. Results generated here emphasise the lineages' unique evolutionary history, highlighting novel colonisation pathways not often considered for invertebrate taxa.
Glacial History and Ecological Restrictions Shape Island‐Scale Genetic Structure and Demography in the Southernmost Bird of Prey
Authors: Balza Ulises , Lois Nicolás A. , Harrington Katie J. , León Fabiola , Pütz Klemens , Raya‐Rey Andrea , Ceballos Santiago G.
Published: January 2025

Aim

To understand the influence of Andean uplifts and glacial cycles on South American biodiversity, we delve into the population genetics and evolutionary history of a unique subantarctic island raptor specialised in exploiting marine food webs.

Location

Islands in Tierra del Fuego and Malvinas/Falklands.

Time period

Last glacial period to the present.

Taxon

Phalcoboenus australis.

Methods

We used RAD sequencing to assess genetic diversity, population structure and to model demographic history through descriptive and hypothesis‐based evolutionary methods.

Results

We found evidence of two independent lineages: one inhabiting the Fuegian archipelago and the other one occurring in the Islas Malvinas/Falkland Islands, with the latter presenting higher genetic diversity and evidence of finer‐scale population structure. The best supported demographic scenario places the divergence time of these lineages during the last glacial period (ca. 50,000 years ago), with the occurrence of gene flow during the first 27,000 years after their divergence. Recent demographic modelling supports the general pattern of increasing genetic variability as landmasses were uncovered following the glacial period (i.e., the Fuegian archipelago) in contrast with a decrease in genetic diversity associated to island fragmentation (i.e., in the Islas Malvinas/Falkland Islands).

Main Conclusions

We propose that post‐glacial sea level rise and the subsequent isolation across the submerging Patagonian Shelf have driven population fragmentation and recent genetic structure in this species. Our findings advocate for recognising the two identified divergent lineages as distinct conservation units. We highlight the intricate interplay of ecological factors, glacial cycles and population dynamics in shaping the evolutionary trajectory of this unique and threatened raptor species in southern South America.
Energy Availability and Spatial Effect Determine the Multi‐Scale Distributional Patterns of Multi‐Dimensional Diversity of Amphibians in China
Authors: Liao Ziyan , Zhang Wenyan , Guo Zeguang , Qian Qian , He Yuxiao , Xiao Qi , Wu Na , Shi Xiaoqin , Liu Zhidong , Liang Liwen , Fan Huizhong , Chen Youhua
Published: January 2025

Aim

This work focused on the multi‐scale distributional patterns of multi‐dimensional diversity among different groups of amphibians in China and systematically investigated the underlying environmental driving mechanisms by evaluating the performance of multiple ecological hypotheses.

Location

China.

Taxon

Amphibians.

Methods

We examined the effects of different spatial scales on the distribution patterns of taxonomic, functional and phylogenetic diversity of amphibians. Additionally, we assessed the relative importance of eight hypotheses in explaining these multi‐scale diversity patterns using hierarchical partitioning.

Results

The spatial distributional patterns of amphibian taxonomic, functional and phylogenetic diversity exhibited scale dependency. Generally, the explanatory powers of hypotheses‐related covariates increased with larger spatial grain sizes. Across eight spatial grains (ranging from 0.25 to 2 arc‐degree), energy availability and spatial effect emerged as principal determinants for different amphibian groups in China. This was consistent for all species (469 species), as well as endemic, threatened and both endemic and threatened species.

Main Conclusion

Multi‐group biodiversity patterns are characterised by multi‐dimensional components and exhibit multi‐scale dependency. Our study highlights the significant influences of spatial scale on biodiversity pattern and on the explanatory power of ecological hypotheses. These findings provide valuable insights for future conservation planning of amphibians in China.
Instruments for Value Elucidation in Older Adults in Clinical Practice—A Scoping Review
Authors: van den Bosch Geerke , Versteeg Kathelijn , Metselaar Suzanne , Koot Lotte , Burchell George , Geerse Olaf , Stoffels Josephine M. J.
Published: January 2025

Background

To ensure appropriate care for the individual older adult, an ideal treatment should align with patients' values. However, healthcare professionals struggle with how to elucidate patient values effectively. To offer guidance to healthcare professionals, we performed a scoping review, thereby mapping and categorizing instruments specifically developed to elucidate values of older adults in clinical practice.

Methods

A systematic search was conducted from inception up to October 2023 in PubMed, Psychinfo, CINAHL, and Cochrane Library. Articles on instruments clarifying older adults' values in a clinical setting were included. Articles on instruments elucidating patients' wishes, preferences, or goals were excluded.

Results

After screening 7759 eligible studies, we included 37 studies outlining unique instruments. Instruments were subdivided into the following categories, based on the setting in which the instruments were used: “instruments with a general scope,” “health record‐based interventions,” “advance directives,” “advance care planning programs,” and “decision support tools.” Values were made plain in different ways, and instruments promoted different approaches. We further categorized these approaches alongside different axes: “open versus closed,” “process‐oriented versus decision‐oriented,” “confronting versus nonconfronting,” and “explicit versus implicit.” Some instruments focused on establishing a process of deliberation, whereas others focused on achieving treatment decisions.

Conclusion

We found and categorized a large range of instruments, which promoted different ways to elucidate older adults' values. This scoping review serves as an introduction for healthcare professionals to available instruments, which help to clarify patients' values. By categorizing the instruments along different axes of approaching value clarification, we offer healthcare professionals guidance for selecting an appropriate instrument.
Nurse Practitioner–Led Community Urgent Care Services: Actions to Support Growth
Authors: James‐Scotter Miriam , Giacon William Louis , Burwood Nicky , Komene Ebony , Davis Josephine , Adams Sue
Published: January 2025

Aim

To explore the role of nurse practitioners (NPs) in delivering models of acute and urgent care in local communities informing the development of NPs as a solution to providing sustainable and effective healthcare in these settings.

Design

Descriptive qualitative multicase study.

Methods

The study population comprised NPs, clinic managers and general practitioners from NP‐led acute and urgent care clinics across urban and rural Aotearoa New Zealand. Data were gathered from 20 semistructured interviews across seven sites. Data were thematically analysed to identify themes. Clinic‐level operational data relating to the governance, team structures, and service delivery models were also collated and content from these data was integrated into the analysis and findings.

Results

Five key themes were identified: meeting the needs of the community; development of NP‐led acute care services; NPs as part of the healthcare team; training and support systems and supporting junior NPs and NP candidates.

Conclusion

Nurse practitioners have a valuable role to play in delivering acute and urgent care services to local communities. Increasing awareness of the NP role, the prioritisation of community needs and strengthening training and support structures at both a workforce and clinic level were key findings from this research.

Implications for the Profession and/or Patient Care

Findings from this research guided the development of a set of recommendations which consider community, clinic and wider national perspectives and aim to support the future growth of NP‐led community acute/urgent care.

Reporting Method

This research has adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines.

Patient or Public Contribution

The authors have nothing to report.
Correlates Between Temporomandibular Disorder Symptom Severity, Psychological Distress, Well‐Being, and Oral Health‐Related Quality of Life: Insights From Chinese Young Adults
Authors: Yap Adrian Ujin , Lei Jie , Liu Chengge , Huang Zhiwei , Fu Kai Yuan
Published: January 2025

Background

There is limited understanding of how temporomandibular disorder (TMD) symptoms, psychological distress, and well‐being are related to each other and to OHRQoL in Chinese young adults.

Objectives

This study aimed to identify correlations between TMD symptom severity, psychological status, and OHRQoL while also examining factors associated with low OHRQoL.

Methods

Participants, recruited from a major university in the capital city, completed a survey that included demographics, the Chinese versions of the expanded five TMD symptoms (5Ts) screener, Depression, Anxiety, Stress Scales‐21 (DASS‐21), Ryff's Scales of Psychological Well‐being‐18 (SPWB‐18), and Oral Health Impact Profile for TMDs (OHIP‐TMD). Data were analysed using Chi‐square and Kruskal‐Wallis/Mann–Whitney U tests, Spearman's correlation, and logistic regression (α = 0.05).

Results

The study sample consisted of 414 individuals (mean age 22.0 years [SD 2.1], 77.8% female). Among them, 23.4%, 22.2%, 15.7%, and 38.6% had no (NT), intra‐articular (IT), pain‐related (PT), and combined (CT) TMD symptoms, respectively. Significant differences were observed in global TMD severity (CT>IT, PT>NT), global distress (CT>IT, NT), and OHRQoL (CT>IT, PT, NT), but not global well‐being. Global TMD severity was significantly, albeit weakly, correlated with global distress (rs  = 0.32) and global well‐being (rs  = −0.12). Global distress, in turn, showed a significant but weak negative association with global well‐being (rs  = −0.34). Both global TMD severity and global distress exhibited moderate correlations with global OHIP (rs  = 0.63/0.42).

Conclusions

Global TMD severity, incorporating symptom duration, frequency, intensity, and interference, was the main determinant of low OHRQoL in Chinese young adults.
Pathogenicity of Curvularia geniculata Causing Ear Rot in Foxtail Millet (Setaria italica) in China
Authors: Zhu Kangning , Xu Jing , Diao Yulin , Chen Guoqiu , Zhang Wenfei , Wang Kaixi , Zhang Meng , Dou Shuang , Sun Xin , Li Qian , Li Hongyang , Sun Xiaofei , Zhang Haijin
Published: January 2025

Foxtail millet (Setaria italica) an economically important crop globally, particularly in China. In 2021, a foxtail millet ear rot disease was first found in Chaoyang City, Liaoning Province, China. Symptomatic tissues were sampled, and the fungal isolate GZWB008 was identified as Curvularia geniculata based on morphological characteristics and ITS, GAPDH and RPB2 gene sequence analyses. Pathogenicity was confirmed by artificial inoculation, which produced symptoms consistent with those observed in the field. Koch's postulates were fulfilled by re‐isolation of C. geniculata from inoculated symptomatic ears. This is the first report confirming C. geniculata as a causal agent of ear rot in foxtail millet, expanding knowledge of its host range and highlighting its potential threat to millet production.
Simulated retail food environments: A literature review of systems science approaches to advance equity in access to healthy diets
Authors: Mui Yeeli , Winkler Megan R. , Hunt Shanda L. , Gittelsohn Joel , Tracy Melissa
Published: January 2025

As researchers increasingly utilize systems science simulation modeling (SSSM), little is known about how and by whom SSSMs are being leveraged to address inequities in access to healthy diets. We evaluated the extent to which studies (n = 66) employing SSSM to examine retail food environments (RFEs): included three pillars of equity (social position, human capital, socioeconomic and political context) that shape RFEs and access to healthy diets; grounded model design and development in theory; engaged with diverse stakeholders and lived experiences related to RFEs; and translated model findings towards addressing inequities in RFEs. Most studies (n = 58) included some model characteristics related to social position (e.g., age). Characteristics related to human capital (e.g., meal planning skills) were the least integrated fundamental pillar (n = 15). All studies included some characteristics related to socioeconomic and political context; however, we found little to no incorporation of social contexts (e.g., cultural and societal norms). Regarding model design and development, less than one‐third of studies specified theoretical frameworks or engaged with local domain experts and stakeholders. While certain research objectives and, consequently, model types lend themselves better than others to address key pillars that influence RFEs, findings show that models are not fully leveraging SSSMs to analyze the multiple, interacting dimensions – particularly social phenomena – influencing equity in access to healthy diets. Greater attention to engaging stakeholders and the role of human capital and social contexts will likely better equip models to more holistically examine equitable food access, including essential pathways and unintended consequences of programs and policies.
Imagining Coat‐Hangers and Pills: A Qualitative Exploration of Abortion Beliefs and Attitudes in Hostile Policy Contexts in the United States
Authors: Schroeder Rosalyn , Freedman Lori R. , Becker Andréa , Ahlbach Chris , Biggs M. Antonia
Published: January 2025

Objective

We explored awareness of and attitudes about the safety of various methods people use to attempt to end a pregnancy without medical assistance, which we refer to in this study collectively as self‐managed abortion (SMA).

Methods

In 2020, we invited individuals living in eight United States (US) states considered “hostile” to abortion rights or with a history of criminalizing abortions performed outside the formal healthcare system to participate in semi‐structured telephone interviews regarding their attitudes toward these practices. We analyzed coded transcripts for content and themes.

Results

We interviewed 54 individuals. Participants perceived methods of ending a pregnancy on one's own to have a high potential for complications, often evoking “coat hanger” abortions. Participants also frequently referenced methods such as physical trauma, herbs, teas, alcohol, or other drugs. Very few participants reported awareness of medication abortion pills. When asked about the safety of SMA in the context of self‐sourcing these medications, participants considered pills safer and more acceptable than other SMA methods, while still fearing incorrect use and complications. Others believed that SMA could offer greater reproductive autonomy, less stigma, and a safer physical and psychological experience than facility‐based abortion care.

Conclusion

In 2020, most participants perceived SMA as involving unsafe practices and did not include use of medication abortion pills. Future research should document how beliefs and attitudes have been influenced by the expansion in telemedicine provision of medication abortion, the implementation of new state abortion bans, and the promulgation of Shield Laws.
The Role of Political Actors in Realizing Sustainable European Energy Markets: Insights From the Trinational Upper Rhine Region
Authors: Leopold Franziska , Blum Bianca , Schröder Dominik
Published: January 2025

Against the background of the European decarbonization strategy, this study examines the extent to which the expansion of renewable energies can lead to tensions with the social and ecological dimensions of the sustainability concept. The study is based on qualitative interviews with 66 experts conducted in the trinational metropolitan region of the Upper Rhine in Germany, France, and Switzerland. Following a description of the status‐quo in each country, a public choice analysis is used to identify the key actors in the political decision‐making process to determine the extent to which they facilitate or impede the energy‐transition and cross‐border cooperation, as well as group‐specific socio‐environmental‐conflicts. Based on the identified conflicts, eco‐social‐policy recommendations are derived that can also enhance trinational cooperation.
Features and dolomitizing mechanisms in inner platform facies across the Permian–Triassic boundary (External Dinarides, Croatia)
Authors: Aljinović Dunja , Richoz Sylvain , Smirčić Duje , Chen Yanlong , Nestell Galina , Jazvac Ivan , Petrash Daniel A.
Published: January 2025

The strata encompassing the Permian–Triassic boundary interval capture a pivotal period in Earth's history, with significant changes in Phanerozoic Earth system dynamics, culminating in a severe mass extinction. In carbonate platforms, this boundary is marked by a shift from skeletal to microbial carbonate production. Whereas extensive research has focused on the End‐Permian Mass Extinction in open‐marine shelf environments, the transition within inner platform facies remains underexplored due to limited dating options and pervasive dolomitization. This study examines the Permian–Triassic boundary interval at the continuous dolostone, Brušane‐Sy section, in the External Dinarides (Croatia), that retains much of its original fabric. High‐resolution petrography, biostratigraphy and chemostratigraphy (δ13Ccarb and δ13Corg) were utilized to detail sedimentary responses across the boundary. The Upper Permian fine‐crystalline dolostone features well‐preserved cryptomicrobial/bioclastic, peritidal microfacies with calcareous algae and foraminifera. In contrast, the Lower Triassic dolostone, shows a transition to a medium‐crystalline, fabric‐destructive dolostone texture. The transition from fabric‐retentive Permian to fabric‐destructive Triassic dolostone is attributed to two dolomitization processes: (i) Late Permian transgression facilitating aragonite/high Mg‐calcite deposition, later transforming neomorphically into fabric‐retentive dolostone texture due to abundant precursor dolomite nuclei; and (ii) dispersed Early Triassic primary dolomite precipitation later stabilized during shallow burial with decaying microbial mats serving as loci for crystal growth but decreased nucleation. This shift is recorded by a minimal negative δ13Ccarb excursion (≤0.7‰) and a more pronounced shift in Δ13C (δ13Ccarb – δ13Corg; ca 4.6‰). Contrasting with typical open‐marine Permian–Triassic boundary excursions, such isotopic features reflect the localized shift in primary production to photoautotrophy (algae and cyanobacteria) and early dolomitization in the presence of seawater‐derived dissolved inorganic carbon. Understanding these sedimentary and diagenetic dynamics provides crucial insights into environmental changes and biogeochemical cycles affecting Permian–Triassic boundary dolomitization, offering a comprehensive view of the End‐Permian Mass Extinction across a wider range of shallow marine carbonate dominated depositional environments.
The Impact of Organisational Interventions on Student Perceptions of the Learning Environment: A Repeated Cross‐Sectional Study
Authors: Molla Mithu , Servis Mark , Hodgens Tiffany , Akinjobi Zainab , Jain Sharad
Published: January 2025

Background

The learning environment (LE) refers to the social interactions, organisational culture and physical spaces that shape learners' perceptions and learning. With numerous efforts to measure and improve it, there is still a lack of clearly identified, evidence‐based interventions that impact the LE. Our aims were to design LE interventions and measure their effectiveness using a comparison of student responses on the Association of American Medical Colleges Graduation Questionnaire (AAMC GQ).

Approach

Root causes of problems in the LE were identified, and comprehensive interventions were then put in place. Interventions addressed three main categories where problems were identified as follows: faculty development, physician wellness, and the learning climate committee. To evaluate changes postintervention, we utilised a repeated cross‐sectional design.

Evaluation

Deidentified item‐level response data were analysed and organised as a pre‐intervention period (2016–2018) and postintervention period (2021–2023). None of the mistreatment events were statistically significant between the periods, except for “required to perform personal services”. However, perceptions of faculty professionalism improved significantly in the postintervention period for all questions except the hidden curriculum (HC).

Implications

Taken together, our results show that large‐scale interventions may be effective at improving perceptions of faculty professionalism but have limited effect on frequency of mistreatment events. The hidden curriculum failed to show improvement with our interventions and has been identified as an area of further research and ongoing interventions.
Diagnostic Performance of Two Different Techniques to Quantify CMV‐Specific Cell‐Mediated Immunity in Intermediate‐Risk Seropositive Kidney Transplant Recipients
Authors: Fernández‐Ruiz Mario , Nuévalos Marcos , Rodríguez‐Goncer Isabel , García‐Ríos Estéfani , Ruiz‐Merlo Tamara , Redondo Natalia , Trujillo Hernando , González Esther , Polanco Natalia , Caso José María , Aparicio‐Minguijón Eduardo , López‐Medrano Francisco , San Juan Rafael , Andrés Amado , Pérez‐Romero Pilar , Aguado José María
Published: January 2025

Background

Kidney transplant (KT) recipients at intermediate risk for cytomegalovirus (CMV) infection constitute a potential target for individualized prevention strategies informed by the CMV‐specific cell‐mediated immunity (CMV‐CMI). The optimal method for the functional assessment of CMV‐CMI in this group remains unclear.

Methods

We included 74 CMV‐seropositive KT recipients that did not receive T‐cell‐depleting induction and were managed by preemptive therapy. CMV‐CMI was monitored at baseline and months 1, 3, 6, and 12 by intracellular cytokine staining (ICS) and a interferon (IFN)‐γ‐release assay (QuantiFERON‐CMV [QTF‐CMV]). Both methods were compared for discriminative capacity (areas under the receiving operating characteristic curve [auROCs]) and diagnostic accuracy to predict protection against high‐level (≥1000 IU/mL) CMV DNAemia and/or disease.

Results

Eighteen patients (24.3%) experienced high‐level CMV DNAemia or disease. There were no significant differences in the discriminative capacity to predict protection of CMV‐specific CD8+ (auROC: 0.719) and CD4+ T‐cell counts (auROC: 0.664) enumerated by ICS and IFN‐γ production measured by QTF‐CMV (auROC: 0.666). Optimal cutoff values of ≥9.8 CMV‐specific CD4+ T‐cells/µL and ≥5.7 CD8+ T‐cells/µL by ICS yielded excellent specificity (95.7% and 86.9%, respectively) and positive predictive values (PPVs) (>98.0%), but a sensitivity below 60%. A reactive QTF‐CMV (IFN‐γ ≥0.2 IU/mL) provided good sensitivity (81.6%) and PPV (92.5%), at the expense of a poor specificity (22.2%).

Conclusions

The discriminative capacity to predict immune protection against clinically relevant CMV infection among intermediate‐risk KT recipients was comparable for ICS and QTF‐CMV. A selected ICS threshold may provide better specificity than the interpretative cut‐off values currently recommended for QTF‐CMV.

image
Progress towards the elimination of trachoma as a public health problem in four counties of Eastern Equatoria State, Republic of South Sudan
Authors: Ohidor Stephen , Presley Nicholas A. , Sanders Angelia M. , Nute Andrew W. , Gonzalez Tania A. , Bol Yak Yak , Nyibong Albino W. , Weiss Paul , Niquette James , Callahan E. Kelly , Nash Scott D.
Published: January 2025

Background

Trachoma is targeted by the World Health Organization (WHO) for elimination as a public health problem by 2030. Trachoma impact surveys using standardised methodology are recommended to monitor progress towards elimination and to determine eligibility for continued surgery, antibiotics, facial cleanliness, and environmental improvement (SAFE) interventions. From 2007 to 2015, four counties of Eastern Equatoria State, South Sudan, received three to five rounds of mass drug administration with antibiotics. A trachoma impact survey in 2015 indicated all four counties had trachomatous‐inflammation follicular prevalence among children ages 1–9 years above the WHO elimination threshold (range 17.4%–47.6%). Based on these results, the recommended number of years of SAFE interventions were implemented and the counties were subsequently resurveyed.

Methods

Between 2021 and 2023, trachoma impact surveys were conducted in Budi, Kapoeta East, Kapoeta North, and Kapoeta South counties using a two‐stage cluster sample design. Trained and certified graders examined participants for trachoma clinical signs using the WHO simplified grading system to estimate county‐level prevalence.

Results

A total of 12,570 individuals from 3286 households in 116 survey clusters were examined for trachoma. Prevalence of trachomatous‐inflammation follicular among children ages 1–9 years was 5.6% (95% confidence interval [CI]:3.7%–8.3%) in Kapoeta South, 7.4% (CI:5.1%–10.7%) in Budi, 12.3% (CI:7.8%–18.9%) in Kapoeta East, and 18.1% (CI:13.5%–24.0%) in Kapoeta North. Trachomatous inflammation‐intense prevalence among children ages 1–9 years ranged from 0.4% (CI:0.2%–1.0%) in Kapoeta East to 2.1% (CI:1.4%–3.2%) in Kapoeta North, and trachomatous trichiasis in individuals ages ≥15 years ranged from 1.0% (CI:0.5%–2.1%) in Kapoeta North to 1.9% (CI:1.3%–2.8%) in Budi.

Conclusions

As no county reached the WHO elimination thresholds of trachomatous‐inflammation follicular <5% or trachomatous trichiasis <0.2%, SAFE interventions should continue. Furthermore, these districts are classified as having persistent trachoma, based on trachomatous‐inflammation follicular levels remaining >5% after two impact surveys. Compared to results from 2015, the prevalence of trachomatous‐inflammation follicular, trachomatous inflammation‐intense, and trachomatous trichiasis in all counties decreased, indicating that the Republic of South Sudan Ministry of Health's Trachoma Control Program is advancing towards its elimination goal.
Analysis of Exits in Fire Evacuation and Crowd Management in Multi-Functional Sports Halls
Authors: Yaman Muammer
Published: January 2025

Crowd management and fire evacuation for assembly buildings are complex design processes in terms of design and construction. It should be designed as the main purpose of the safety of life and property to route the crowd to the nearest exit without creating congestion. This study aims to investigate the effect of exits in sports halls, which can respond to different functions from assembly buildings, for fire evacuation, and crowd management. In evacuation analyses, the effects of existing and alternative exits on the total evacuation time are investigated through Pathfinder evacuation simulations. For this purpose, a typical college sports hall was considered and possible exits were evaluated. Single and double blocking of exits in scenarios that may occur at different points were examined and total evacuation times were analyzed. In the study, it was found that spectators create congestion in sports halls (density of more than 3 people/m2) and are decisive in total evacuation time. It was determined that an exit at a distance from the spectator area could not provide an effective evacuation. Exits close to the spectator area were found to be effective in reducing the total evacuation time and could reduce the total evacuation time by 30 seconds. In conclusion, it is emphasized that the number of exits and exit locations in multi-functional sports halls should be made with rational and performance-based analysis. The importance of preventing congestion and positioning the exits to direct the crowd in an effective fire evacuation and crowd management is explained.
Water as a Sustainable Infrastructure and Cultural Symbol of City: Bächle in Freiburg im Breisgau
Authors: çatal Sena , Ünver Demirkıran Ece , Kardeş Yağmur Çağılsu , Karaca Ebrike , Cabacı Beyza , Aycı Hilal
Published: January 2025

Water, as an indispensable aspect of life, holds significant importance in ecological, biological, sociological, cultural, and various other perspectives. Humans have always tended to settle near water sources, and water has played a critical role in the development and evolution of human civilization. This article investigates the historical and cultural significance of water, with a specific focus on the 'Bächle' water canal system in the German city of Freiburg. Examining the relationship between water and urban development, this research discusses how water infrastructure can serve as both a cultural symbol and a fundamental element of a city. At the same time, it emphasizes the role of Bächle in preserving Freiburg's cultural heritage and enhancing urban sustainability. Originating as a practical infrastructure component for irrigation and waste disposal in the 12th century, Bächle has transformed into a symbol shaping the city's identity and it cultivates a unique urban experience over time. Beyond its initial function, Bächle contributes to the city's livability, serving as a source of recreation and functioning as a communal space for social interactions. In this context, through an interdisciplinary approach, the research integrates historical analysis, urban planning perspectives, and cultural studies to unravel the multifaceted layers of Bächle's impact on Freiburg's past, present, and future. The research explores how Bächle not only contributes to the practical aspects of urban infrastructure but also plays an important role in improving the quality of life and sustaining the cultural identity of the community. The lessons learned from the Bächle's legacy offer valuable insights into creating resilient and culturally vibrant urban spaces for future generations.
Neighbourhood Satisfaction and Density Perception in Indian Cities of Bhopal and Nagpur
Authors: Mokde Kamble Tanushri , Bahadure Sarika
Published: January 2025

Density is an important urban form component. It is a tool that has been used for guiding the way cities are planned for living. Indian cities have been following high-density living, but some researchers showcase that high-density has negative effects. An investigation is necessary to verify the crowding effect and NH sustainability. The paper aims to find if residents are satisfied with the high-density living in the Indian cities of Bhopal and Nagpur. The study identifies context-specific NH satisfaction indicators using Analytical Hierarchy Process (AHP). Based on indicators, data is collected from differing density neighbourhoods. It uses Descriptive as well as Inferential analysis to arrive at results. Further, sensitivity analysis is made using Aggregated Index (AI). Descriptive analysis found a trend of density variation as per each indicator. Inferential statistics (MANOVA) confirms that public perception about density mostly differs in NHs of varying density. The results show that high density proves to be sustainable for variables like NH quality, Community wellbeing and Social equity.The study discusses certain NH interventions that can be useful in deriving future NH design guidelines and framing housing policies in India. Neighbourhood (NH) satisfaction assessment can comment upon the sustainability in a NH. The method can be a starting point to test the sustainability NHs for Indian cities.
Analyzing the Relationship Between Environmental Variables, Job Demands, Emotional Fatigue, and Job Stress in the Metal Industry of Southern Peninsular Malaysia
Authors: Mohd Said Mohd Azrin , Khamis Nor Kamaliana , Khairulnisan Khairul’Aqil , Mohd Sabri Mohd Anas , Ismail Ahmad Rasdan
Published: January 2025

Occupational environmental stress significantly impacts employees' efficiency, well-being, and safety within the workplace. This study aimed to evaluate such stress in the metal workplace by scrutinizing environmental factors: temperature, relative humidity, noise, and illuminance. This study employed mixed data collection methods, combining both objective and subjective approaches. Four (4) metal workplaces were conveniently selected, and questionnaires with 159 subjective evaluation items were distributed to 60 respondents. The methods involved collecting empirical data on environmental factors. Pearson correlation and regression analysis revealed a strong correlation between occupational environmental factors and both objective physical assessments and subjective evaluations. Temperature data exhibited the highest association, followed by relative humidity, noise, and illuminance. Further, a multivariate regression analysis highlighted a robust positive correlation (r=0.834) and a regression value (R2=0.785) between environmental variables and the job stress level. This study highlights the relationship between job stress levels and their impact on workers in the workplace. It also introduces a new model for predicting occupational environmental stress at work. In conclusion, this research provides valuable insights for stakeholders by ensuring workplaces align with standards that promote employees' well-being, safety, and physical and psychological health. Such findings facilitate the creation of conducive work environments.
Towards a Sustainable Algiers: Analyzing Urban Typologies for Sustainable Cities
Authors: Hamoudi Anis , Emekci Şeyda
Published: January 2025

The rapid urbanization in Algeria has led to a focus on the forms and specifications of urban areas, particularly in Algiers, which necessitates innovative approaches for sustainable development. This study concentrates on Algiers, a city with a unique combination of architectural styles, encompassing various urban layouts, such as traditional Casbah, 19th-century colonial architecture, and modern structures. This study examines the sustainability and livability of each architectural typology through the application of a mixed-method approach that merges qualitative field observations with quantitative data sourced from academic publications. The findings revealed that each typology offers distinct sustainability advantages. These results emphasize the necessity of implementing a balanced urban development strategy that acknowledges historical contexts, while incorporating modern advancements to promote a sustainable future. This study provides essential insights into the relationship between urban typologies and sustainability in Algiers as well as the social impacts of each typology on citizen well-being and social cohesion.
Assessing Daylighting Conditions and Strategies in Residential Workspaces During the COVID-19 Pandemic: A Case Study of Apartment Buildings in Malaysia
Authors: Mousavi Seyed Mohammad , Shokouh Sara , Mohammadi Amin , Hosseini Nasab Shariyeh
Published: January 2025

Incorporating daylighting strategies in buildings is crucial for enhancing visual conditions, energy efficiency, and productivity. Working in an environment without windows or with limited access to daylight can negatively affect performance and lead to eye fatigue, stress, and headaches. The COVID-19 pandemic and the rapid development of IT capabilities have resulted in an increase in home-based workspaces worldwide, including Malaysia. This emerging trend, accelerated by the pandemic, has prompted people to work from their homes. Therefore, it is essential to ensure visual comfort for home workers by implementing effective daylighting strategies in their residential work environments. This study focuses on evaluating daylighting conditions in existing residential apartment buildings (RABs) in Malaysia, particularly considering their transformation into workspaces during the COVID-19 outbreak. The research methodology consists of three sequential steps; selecting and observing case studies, conducting simulation experiments, and administering a questionnaire survey. Hence, it involved observing 10 contemporary RABs in Johor Bahru, recording their facade and layout characteristics, including window shading. Then, simulation experiments were conducted by the IES-VE software to demonstrate indoor daylighting condition. Additionally, a questionnaire survey was conducted from 360 occupants of the selected RABs, utilizing multiple-choice questions and a five-point Likert scale. The collected data was analyzed using descriptive statistics. The results revealed that the lack of external window shading forced residents to rely on internal shading methods. Moreover, excessive tropical sunlight resulted in visual discomfort and glare issues for users. However, occupants predominantly utilized conventional shading options, such as curtains, leading to poorly illuminated indoor environments and increased reliance on artificial lighting for desk-related tasks. The significant findings from this research emphasize the design of flexible spatial layouts with ample open spaces along with the use of efficient internal and external shading devices in RABs, to create well-lit and healthy working environments.