bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Bringing forth’ skills and knowledge of newly qualified midwives in free‐standing birth centres: A hermeneutic phenomenological study
Authors: Stone Nancy Iris , Thomson Gill , Tegethoff Dorothea
Published: December 2023

Aim

To understand and interpret the lived experience of newly qualified midwives (NQMs) as they acquire skills to work in free‐standing birth centres (FSBCs), as well as the lived experience of experienced midwives in FSBCs in Germany who work with NQMs.

Background

In many high‐, middle‐ and low‐income countries, the scope of practice of midwives includes autonomous care of labouring women in all settings, including hospitals, home and FSBCs. There has been to date no research detailing the skills acquired when midwives who have trained in hospitals offer care in out‐of‐hospital settings.

Methods

This study was underpinned by hermeneutic phenomenology. Fifteen NQMs in their orientation period in a FSBC were interviewed three times in their first year. In addition to this, focus groups were conducted in 13 FSBCs. Data were collected between 2021 and 2023.

Findings

Using Heidegger's theory of technology as the philosophical underpinning, the results illustrate that the NQMs were facilitated to bring forth competencies to interpret women's unique variations of physiological labour, comprehending when they could enact intervention‐free care, when the women necessitated a gentle intervention, and when acceleration of labour or transfer to hospital was necessary.

Conclusion

NQMs learned to effectively integrate medical knowledge with midwifery skills and knowledge, creating a bridge between the medical and midwifery approaches to care.

Implications

This paper showed the positive effects that an orientation and familiarization period with an experienced team of midwives have on the skill development of novice practitioners in FSBCs.

Impact

The findings of this study will have an impact on training and orientation for nurse‐midwives and direct‐entry midwives when they begin to practice in out‐of‐hospital settings after training and working in hospital labour wards.

Patient and Public Contribution

This research study has four cooperating partners: MotherHood, Network of Birth Centres, the Association for Quality at Out‐of‐Hospital Birth and the German Association of Midwifery Science. The cooperating partners met six times in a period of 2 ½ years to hear reports on the preliminary research findings and discuss these from the point of view of each organization. In addition, at each meeting, three midwives from various FSBCs were present to discuss the results and implications. The cooperating partners also helped disseminate study information that facilitated recruitment.
TGFA expression is associated with poor prognosis and promotes the development of cervical cancer
Authors: Ma Xiaoxuan , Zheng Jingying , He Kang , Wang Liangjia , Wang Zeyu , Wang Kai , Liu Zunlong , San Zhiqiang , Zhao Lijing , Wang Lisheng
Published: December 2023

Cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) are the second most common cancers in women aged 20–39. While HPV screening can help with early detection of cervical cancer, many patients are already in the medium to late stages when they are identified. As a result, searching for novel biomarkers to predict CESC prognosis and propose molecular treatment targets is critical. TGFA is a polypeptide growth factor with a high affinity for the epidermal growth factor receptor. Several studies have shown that TGFA can improve cancer growth and progression, but data on its impact on the occurrence and advancement of CESC is limited. In this study, we used clinical data analysis and bioinformatics techniques to explore the relationship between TGFA and CESC. The results showed that TGFA was highly expressed in cervical cancer tissues and cells. TGFA knockdown can inhibit the proliferation, migration and invasion of cervical cancer cells. In addition, after TGFA knockout, the expression of IL family and MMP family proteins in CESC cell lines was significantly reduced. In conclusion, TGFA plays an important role in the occurrence and development of cervical cancer. Therefore, TGFA may become a new target for cervical cancer treatment.
Atopic dermatitis: A global health perspective
Authors: Faye Ousmane , Flohr Carsten , Kabashima Kenji , Ma Lin , Paller Amy S. , Rapelanoro Fahafahantsoa Rabenja , Steinhoff Martin , Su John C. , Takaoka Roberto , Wollenberg Andreas , Yew Yik Weng , Postigo Jose A. Ruiz , Schmid‐Grendelmeier Peter , Taïeb Alain
Published: December 2023

The International Society of AD (ISAD) organized a roundtable on global aspects of AD at the WCD 2023 in Singapore. According to the Global Burden of Disease (GBD) consortium, at least 171 million individuals were affected with AD in 2019, corresponding to 2.23% of the world population, with age‐standardized prevalence and incidence rates that were relatively stable from 1990 to 2019. Based on the panel experience, most AD cases are mild‐to‐moderate. Without parallel data on disease prevalence and severity, the GBD data are difficult to interpret in many regions. This gap is particularly important in countries with limited medical infrastructure, but indirect evidence suggests a significant burden of AD in low‐and‐medium resource settings, especially urban areas. The Singapore roundtable was an opportunity to compare experiences in World Bank category 1 (Madagascar and Mali), 3 (Brazil, China) and 4 (Australia, Germany, Qatar, USA, Singapore, Japan) countries. The panel concluded that current AD guidelines are not adapted for low resource settings and a more pragmatic approach, as developed by WHO for skin NTDs, would be advisable for minimal access to moisturizers and topical corticosteroids. The panel also recommended prioritizing prevention studies, regardless of the level of existing resources. For disease long‐term control in World Bank category 3 and most category 4 countries, the main problem is not access to drugs for most mild‐to‐moderate cases, but rather poor compliance due to insufficient time at visits. Collaboration with WHO, patient advocacy groups and industry may promote global change, improve capacity training and fight current inequalities. Finally, optimizing management of AD and its comorbidities needs more action at the primary care level, because reaching specialist care is merely aspirational in most settings. Primary care empowerment with store and forward telemedicine and algorithms based on augmented intelligence is a future goal.
Support matters: How formal and informal institutions shape young Indians' work‐family preferences
Authors: Zumbyte Ieva
Published: December 2023

Objective

This study examines the extent to which young people's future employment preferences in India are influenced concurrently by formal workplace policies and informal caregivers' support.

Background

Scholars have focused on how young individuals' work‐family ideals are shaped by workplace institutions to better understand the persistence of gender inequalities in the labor market. Yet the literature on work‐family policy examines primarily the effects of formal policies, overlooking the role of informal caregivers. Consequently, we know little about the relative influence of formal and informal support on young individuals' work‐family preferences and why one system may be preferred over another.

Method

The study used an original survey‐experimental data from an online sample of young, highly educated and unmarried respondents in India (N = 482) to assess their employment preferences when they have a family and a young child, while conditioning them to formal and informal work‐family support. Logistic regressions examined the relationship between different support types and respondents' employment preferences.

Results

When not conditioned to any support, most women preferred part‐time and most men preferred full‐time employment. Women were twice as likely to prefer full‐time employment with informal support compared to formal support, but men's preferences were not sensitive to either type of support.

Conclusion

The effectiveness of work‐family policies in challenging gendered behaviors depends on the credibility of formal as opposed to informal institutions.
Effect of botulinum toxin type A on muscular temporomandibular disorder: A systematic review and meta‐analysis of randomized controlled trials
Authors: Li Kaiyang , Tan Kenneth , Yacovelli Alexandra , Bi Wei Guang
Published: December 2023

Background

Botulinum toxin type A (BTX‐A) is increasingly used to manage painful temporomandibular disorders (TMD). However, the effect of BTX‐A on muscular TMD remains unclear.

Objective

To assess the efficacy, safety and optimal dose of BTX‐A for treating TMD.

Methods

We conducted systematic literature searches in MEDLINE, Embase, Web of Science, ClinicalTrials.gov and Cochrane Library until March 2023. We extracted data from randomized controlled trials (RCTs) that evaluated the efficacy and safety of BTX‐A in treating muscular TMD. We performed a meta‐analysis using a random‐effects model.

Results

Fifteen RCTs involving 504 participants met the inclusion criteria. BTX‐A was significantly more effective than placebo in reducing pain intensity, as measured on a 0–10 scale, at 1 month (MD [95% CI] = −1.92 [−2.87, −0.98], p < .0001) and 6 months (MD [95% CI] −2.08, [−3.19 to −0.98]; p = .0002). A higher dosage of BTX‐A (60–100 U bilaterally) was associated with a greater reduction in pain at 6 months (MD [95% CI] = −2.98 [−3.52, −2.44]; p < .001). BTX‐A also resulted in decreased masseter muscle intensity (μV) (MD [95% CI] = −44.43 [−71.33, −17.53]; p = .001) at 1 month and occlusal force (kg) at 3 months (MD [95% CI] = −30.29 [−48.22 to −12.37]; p = .0009). There was no significant difference in adverse events between BTX‐A and placebo.

Conclusions

BTX‐A is a safe and effective treatment for reducing pain and improving temporomandibular muscle and joint function in muscular TMD patients. A bilateral dose of 60–100 U might be an optimal choice for treating muscular TMD pain.
Navigating the politics of innovation in family firms: The role of political capital
Authors: Capella Francesca , Manelli Luca , Frattini Federico , Kotlar Josip , Chiesa Vittorio
Published: December 2023

In family firms, innovation poses distinct challenges due to the social complexity resulting from the intertwining of the family and business systems. While prior research has focused primarily on the powerful role of the dominant family coalition in leadership positions, much less attention has been paid to middle managers who must navigate the social complexity in family firms to implement management innovations. Through a multicase study of two highly innovative family firms, we theorize and demonstrate how middle managers engage in coalition building to address the social complexity in family firms when pursuing management innovation by creating a new organizational unit dedicated to managing innovation at the corporate level. Our study shows that middle managers change the social evaluation of the transfer of political capital from the dominant family coalition through enforcement and detachment. Subsequently, they convert, invest, and then mobilize different sources of political capital to gain power through pragmatic persuasion and altruistic evangelizing. Finally, we find that the dominant family coalition employs two distinct modes of political stewardship with respect to family and nonfamily middle managers.
The measurement of fatigue in clinicians within hospital settings: A systematic review of measurement properties
Authors: Walters Stephen John , Dizon Janine , Stern Cindy , Stephenson Matthew
Published: December 2023

Medical staff fatigue leads to accidents and mistakes and puts patient safety at risk. A measure of fatigue in the workplace may help to quantify, predict, and manage fatigue. This review aimed to evaluate instruments used to measure fatigue in medical staff within hospitals. A systematic review following the JBI methodology was undertaken. A search for articles was conducted in 2021. Included articles (all validation studies) were assessed for methodological quality using the COSMIN checklist. Measurement property data was evaluated for Quality of Evidence using GRADE methodology. Ten studies representing five instruments were reviewed: Occupational Fatigue Exertion and Recovery scale (now superseded); Occupational Fatigue Exertion and Recovery scale (15‐item); Multidimensional Fatigue Inventory; Need for Recovery Scale; and the Swedish Occupational Fatigue Inventory. Four instruments show promise for measuring fatigue in hospital medical staff, however, there is limited certainty in the measure property estimates. The Quality of Evidence for measurement properties for all instruments is insufficient. Further validation studies following the COSMIN standards are needed before recommendations for use can be made.
A new hierarchical analysis framework of building heights: Towards a more intuitive understanding of 3D urban structure
Authors: Yang Ling , Zhou Xingyu , Yang Xin , Chen Yang , Zhang Haiping , Na Jiaming
Published: December 2023

Understanding the 3D spatial structure of a city is increasingly essential for addressing various environmental and management issues, surpassing the importance of traditional 2D analysis. However, existing studies neglect the diversity of building height and still lack a clear description of 3D urban structure. This article proposes a new framework to uncover the 3D urban structure. Firstly, kernel density is employed to reveal the hierarchical spatial structure of buildings and the contour tree method is improved to quantitatively measure the spatial diversity and complexity. Then, the 3D urban structure is abstracted by spatial interpolation after feature filtration. Finally, this framework is applied to the central area of Chengdu City, revealing that: (1) Spatial structures of buildings with different heights exhibit significant diversity, location preference, and complexity; and (2) A globally “depression” 3D urban structure with low center—high periphery is obviously identified. This framework provides an effective way to reveal the 3D urban structure in a more intuitive and clearer way from various disordered urban buildings, which can be transferable to other cities and further facilitate sustainable planning and development of cities.
Evaluating the effect of urban flooding on spatial accessibility to emergency shelters based on social sensing data
Authors: Zhu Shaonan , Jiang YiXin , Zhang Jun , Dai Qiang , Yang Xin
Published: December 2023

Urban flooding is a growing source of natural hazards, significantly threatening the safety of sustainable development in cities. The distribution of flood risks is heterogeneous, so it is crucial to allocate emergency resources reasonably. This article develops an analytical framework to evaluate the effect of urban flooding on emergency responses based on social sensing data. Initially, we designed a Weibo search pattern and used natural language processing technologies to get high‐risk flood points. Then, assuming that such high‐risk flood points can disrupt traffic, we assessed urban emergency shelter accessibility after flooding events. Finally, we carried out an evaluation of spatial fairness between population and emergency shelter accessibility through spatial correlation analysis. We analyzed the urban area of Nanjing as a case study, extracting 37 high‐risk flood points from the past 5 years. The results highlight that existing emergency shelters fall short in accommodating the needs of urban residents under disaster conditions. This disparity is notably amplified in high‐risk flood points. By measuring the impact of flooding quantitatively, we expect to promote a more comprehensive management on urban flood risks.
Evaluation of ear, nose, and throat‐screening in liver transplantation candidates: A retrospective cohort study
Authors: Beukman Eline , van der Meer Adriaan J. , Takkenberg R. Bart , Hoed Caroline M. den , Nagtegaal Andries Paul
Published: December 2023

Background

Patients with end‐stage liver disease can be treated with a liver transplantation (LT). Before listing, candidates are subjected to a screening procedure according to the EASL Clinical Practice Guidelines for LT. In our hospital, this includes an ear, nose, and throat (ENT) examination, directed towards the identification of (asymptomatic) infections and head and neck malignancies.

Methods

We retrospectively reviewed all ENT screening examinations in LT candidates from 2007 to 2022. The screening consisted of a visit to the ENT outpatient clinic combined with sinus radiography.

Results

ENT screening was performed in 1099 patients. Sixty‐one cases were identified, either diagnosed with an infection (n = 58, almost exclusively sinusitis) or a neoplasm (n = 3, of which two malignancies). With binary logistic regression, we could not identify significant risk factors for diagnosing sinusitis. 711 patients underwent LT. After LT, two patients developed a novel malignancy of the head and neck area, while 14 patients were diagnosed with sinusitis, two of the latter already showed opacification on sinus radiography during screening. Despite immunosuppressive drugs, no complicated sinusitis was observed.

Conclusion

Sinusitis or a neoplasm was diagnosed in almost 6% in a large cohort of LT candidates. Although almost a third of sinusitis patients were not treated accordingly, we did not observe any complicated sinusitis after LT. A more conservative approach to sinusitis may therefore be justified in LT candidates, especially in asymptomatic cases. At our institution, we aim to refer only those patients with specific ENT complaints

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The influence of the COVID‐19 pandemic on blood donation and supply in China
Authors: Yu Si‐cong , Yao Yun‐tai ,   the Evidence in Cardiovascular Anesthesia (EICA) Group
Published: December 2023

Introduction

During the COVID‐19 pandemic, there was a sharp decline in blood donation which posed a serious threat to the clinical blood supply worldwide. The aim of this study was to evaluate the influence of the COVID‐19 pandemic on blood donation and supply in China on a nationwide level.

Methods

A comprehensive review of the published literature was performed using eight databases including PubMed, Web of Science, Cochrane Library, Ovid, Embase, CNKI, WANFANG, and VIP by searching relevant words combinations.

Results

Twenty‐seven studies were determined to be eligible and included. Among them, 21 studies reported the situation of blood donation during the COVID‐19 pandemic in China. The donation of both whole blood and platelet concentrates declined (with a decline of 5%–86% for whole blood and 3%–34% for platelet concentrates), with this especially evident in February 2020. The COVID‐19 pandemic changed the pattern of blood donation and the composition of blood donors accordingly. Fifteen articles reported the supply of various blood components during the COVID‐19 pandemic. The supply and usage of both packed red blood cell (PRBC) and fresh‐frozen plasma (FFP) decreased (with a decrease of 4%–40% for PRBC and 9%–58% for FFP). The proportion of blood transfusions in different departments changed too. Compared to 2019, there was a decrease in surgical blood transfusions, and an increase in that used in treatments performed in emergency and internal medicine departments.

Conclusion

The COVID‐19 pandemic has led to an overall reduction of blood transfusion activities in most cities in China, in particular blood donations and blood demands.
Treatment of feline intermediate to high‐grade alimentary lymphoma: A retrospective evaluation of 55 cats treated with the VAPC combination chemotherapy protocol (2017–2021)
Authors: Moore Antony Stewart , Frimberger Angela Erica
Published: December 2023

The most commonly utilized protocols to treat lymphoma in cats employ vincristine, cyclophosphamide and prednisone; with additional drugs sometimes used including L‐asparaginase and doxorubicin. Medical records were reviewed for 55 cats with alimentary lymphoma treated with a novel multiagent protocol using prednisolone, L‐asparaginase, doxorubicin, vinblastine instead of vincristine, a higher dosage of cyclophosphamide and oral procarbazine (VAPC protocol). Outcomes evaluated were response to therapy, toxicity and progression‐free survival (PFS). Grade 3 or 4 neutropenia was the most common treatment‐related reason for chemotherapy dosage adjustment, occurring in 8 of 52 cats receiving vinblastine, 7 of 55 cats receiving cyclophosphamide and 1 of 40 cats receiving doxorubicin, but febrile neutropenia was identified in only two cats. Of 38 cats receiving chemotherapy for measurable disease, 26 (68.4%) achieved complete response (CR). Three cats achieved a partial response and 9 cats failed to achieve a remission. There were no identified factors influencing whether a cat was likely to achieve CR. For all 55 cats (including those receiving chemotherapy and surgery), median PFS was 184 days with 1, 2 and 3‐year survival rates of 35.4%, 26.5% and 26.5%, respectively. On multivariate analysis, 40 cats that achieved CR had a median survival time of 341 days (78 days for PR, 45 days for NR); PFS times were also significantly affected by lymphocyte:monocyte L:M ratio (>3.4 = 700 days vs. ≤3.4 = 126 days) and B‐cell versus T‐cell phenotype (220 days vs. 42 days, respectively).
Using the ARIMA/SARIMA Model for Afghanistan's Drought Forecasting Based on Standardized Precipitation Index
Authors: Rezaiy Reza , Shabri Ani
Published: December 2023

Forecasting drought plays a vital role in strategic planning and the management of underground water supply. In this study, we utilized autoregressive integrated moving average (ARIMA) and Seasonal ARIMA (SARIMA) models to predict drought events in Afghanistan, based on the standardized precipitation index (SPI). We used monthly average precipitation data from 1991 to 2015 for model training, while data from 2016 to 2020 were employed for model validation. The results of the statistical analysis, which  encompassed evaluating Mean Absolute Error (MAE), Root Mean Squared Error (RMSE), and Mean Absolute Percentage Error (MAPE), indicated that among the SPI 3, SPI 6, SPI 9, SPI 12, and SPI 24, the SARIMA models applied to the SPI 24 demonstrated the most accurate forecasting performance with RMSE (0.1492), MAE (0.1039), and MAPE (22.3732%) compared to SPI 3, SPI 6, SPI 9, and SPI 12. Subsequently, the ARIMA/SARIMA models were employed to forecast drought events for the upcoming year. It’s noteworthy that this constitutes the first-ever statistical analysis of the drought index in Afghanistan. Therefore, the outcomes of this study can be applied across diverse sectors, including water resource management and environmental precautions.
Neutrosophic Bicubic Bezier Surface ApproximationModel for Uncertainty Data
Authors: Rosli Siti Nur Idara , Zulkifly Mohammad Izat Emir
Published: December 2023

Surfaces and their descriptions are significant in design, physical science, geology, and other natural phenomena. This study introduces a neutrosophic B´ezier surface approximation with a four-by-four control net for the bicubic situation. The neutrosophic notion defines the neutrosophic control net relation. The control net is mixed with the Bernstein basis function to generate a surface blending function and a neutrosophic bicubic B´ezier surface. Finally, the neutrosophic bicubic B´ezier surface is shown using an approximation approach and data points having neutrosophic properties.
Existence and rotatability of the two‐colored Jones–Wenzl projector
Authors: Hazi Amit
Published: December 2023

The two‐colored Temperley–Lieb algebra is a generalization of the Temperley–Lieb algebra. The analogous two‐colored Jones–Wenzl projector plays an important role in the Elias–Williamson construction of the diagrammatic Hecke category. We give conditions for the existence and rotatability of in terms of the invertibility and vanishing of certain two‐colored quantum binomial coefficients. As a consequence, we prove that Abe's category of Soergel bimodules is equivalent to the diagrammatic Hecke category in complete generality.
PHENOTYPIC AND GENETIC DIVERSITY OF ENTEROVIRUSES IN THE REPUBLIC OF BELARUS, 2003-2022
Authors: Paklonskaya N.V. , Amvrosieva T.V. , Bogush Z.F. , Shilova Yu.A. , Koltunova Yu.B. , Dashkevich A.M. , Zapolskaya V.V. , Kishkurno E.P.
Published: December 2023

Enteroviruses (EV) are widespread viral agents that regularly cause epidemic outbreaks of diseases that are characterized by a variety of clinical manifestations. The aim of this work was to study the phenotypic and genotypic diversity of non-poliomyelitis EVs that circulated from 2003 to 2022 in our country during epidemic upsurges and decreases of enteroviral morbidity. It was established that during this period there was a circulation of 44 different types of EVs belonging to the species  Enterovirus B (97.8%), Enterovirus A (1.88%), Enterovirus C (0.9%), Enterovirus D (0.4 %). Among Enterovirus B viruses, Coxsackievirus B5, ECHO 30, and ECHO11 prevailed. During the years of epidemic rises of morbidity, the ECHO 30, ECHO 9 and ECHO 11 viruses were significantly more often identified (p< 0.001), while in the years of decreases Coxsackievirus B1, B2, B3 and B4 were detected more often (p<  0.001). ECHO 6 and Coxsackievirus B5 viruses were registered both during periods of epidemic ups and downs and were characterized by the maximum intratype genetic diversity, significantly greater than ECHO30, ECHO6 and ECHO 11 (p< 0.05). During the observation period, 9 genetic variants of ECHO 30, 6 – of ECHO 9, 3 – of ECHO 11, 6 – of ECHO 6 and 13 – of  Coxsackievirus B5 were identified. An analysis of the genetic diversity of ECHO 30, 9, 11, 6, Coxsackie B5 viruses showed that the upsurges of enteroviral morbidity was accompanied by the maximum number of detected genetic variants  and some of them were new to the country's population.
The data obtained indicate the multifactorial nature of the formation of the epidemic process and a significant contribution to its formation of the genetic diversity of pathogens.
Modeling and Parameter Identification of Spark Plug Deposit Formation Mechanism for Different Fuel/Lubricant Combination
Authors: Kushwaha Garima , Saraswati Samir , Paul Bireswar
Published: December 2023

The identification of model parameters is complex and requires many approximations and laboratory investigations. Here, a novel approach to identifying these parameters is proposed, which uses experimental data, and a parameter estimation method to minimize a cost function made up of errors between the predicted and experimental deposit thickness. Parameters are determined for various ethanol–gasoline mixtures and lubricants. Simultaneously, the thermal and electrical properties of deposits are studied, and this information, coupled with the identified parameters, is utilized to infer potential deposit formation sources, mechanisms, and other elements that will influence the characteristics of the spark plug. It is found that the deposit formation model along with the identified parameters has the potential to reliably estimate the deposit growth with time as good correlations have been observed between measured and predicted spark plug deposit mass for all fuels and lubricants. The thermal and electrical conductivity of the spark plug deposit increases with a high ethanol fraction and high viscous oil, which results in increased chances of side sparking.
Selective strategy of reactive hysteresis loop for coatings on alloy substrates with different moduli
Authors: Si Biao , Sun Linfan , Su Zhiwei , Zhang KaiCe , Guo Jing , Hua Minqi , Zhou Yanwen
Published: December 2023

The structure and properties of nitride films, such as titanium nitride (TiN), depend on the reactive gas (N2) flow rates, which are normally selected according to the reactive hysteresis loops. Film-substrate adhesion depends on the properties of the films and substrates. A selective strategy for the reactive gas flow rate within the hysteresis loop was investigated by characterizing the structure, properties, and failure mechanisms of TiN films on Ti6Al4 V titanium alloy (TC4) and 4Cr5MoSiV1 hot-work die steel (H13). The hysteresis loop of the titanium (Ti) target potential as a function of the N2 flow rate was measured, and flow rates in different sputtering modes were used to prepare TiN films using plasma-enhanced magnetron sputtering. As the N2 flow rate increased from 5 cm3/min, 10 cm3/min, 15 cm3/min to 20 cm3/min, from the metallic mode to the compound mode, the morphologies of the films changed from loose to dense, the phase structures changed from TiN0.3 (002) to TiN (111), (200), and (220), and the nano-hardness and elastic moduli increased. Applying a Rockwell normal load, asymmetric circular cracks appeared and became significant for TiN/TC4 as the N2 flow rate increased to 15–20 cm3/min; cracks were only observed in TiN/H13 at an N2 flow rate of 20 cm3/min. Applying normal and shear scratch stresses, the TiN films peeled off from the TC4, except for TiN, with an N2 flow rate of 10 cm3/min, indicating that the adhesion between TiN and TC4 was weak. No peel-off chips were observed in the scratch morphologies of TiN/H13, indicating excellent adhesion between the films and H13 substrate. Circular cracks appeared in the scratch morphology of TiN0.3, indicating that cohesion had broken within the film. The possible failure mechanism was the large difference in the elastic moduli and hardness of TiN and TC4, which led to TC4 elastic and plastic deformation much earlier than in TiN films. According to numerical simulation, the interfacial tensile stress of TiN/TC4 under a normal load was higher, and the interfacial strain near the indentation edges was larger than that of TiN/H13. Considering the comprehensive properties, a reactive flow rate near the critical point such as 15 cm3/min for TiN/TC4 should be used for the nitride film on a low-hardness and low-modulus substrate; in the compound mode stage, 20 cm3/min for TiN/H13 should be used for the nitride film on a high-hardness and high-modulus substrate.
Modelling sound particle motion in shallow water
Authors: Oppeneer Victor O. , de Jong Christ A. F. , Binnerts Bas , Wood Michael A. , Ainslie Michael A.
Published: December 2023

Fish species and aquatic invertebrates are sensitive to underwater sound particle motion. Studies on the impact of sound on marine life would benefit from sound particle motion models. Benchmark cases and solutions are proposed for the selection and verification of appropriate models. These include a range-independent environment, with and without shear in the sediment, and a range-dependent environment, without sediment shear. Analysis of the acoustic impedance illustrates that sound particle velocity can be directly estimated from the sound pressure field in shallow water scenarios, except at distances within one wavelength of the source, or a few water depths at frequencies where the wavelength exceeds the water depth.
Factors That Influence Meeting the Recommended Weekly Physical Activity Target Among Older People With Physical Multimorbidity: Evidence From 6 Low- and Middle-Income Countries
Authors: Smith Lee , Yon Dong Keon , Butler Laurie , Kostev Karel , Brayne Carol , Barnett Yvonne , Underwood Benjamin R. , Shin Jae Il , Rahmati Masoud , Neufeld Sharon A.S. , Ragnhildstveit Anya , López Sánchez Guillermo F. , Koyanagi Ai
Published: December 2023

Background: There is a scarcity of studies on the association between physical multimorbidity and lower levels of physical activity among older adults from low- and middle-income countries, while the potential mediating variables in this association are largely unknown. Methods: Cross-sectional, community-based, nationally representative data from the World Health Organization Study on global AGEing and adult health were analyzed. Data on 11 chronic physical conditions were collected. Scoring <150 minutes of moderate- to high-intensity physical activity per week was considered low physical activity. Multivariable logistic regression and mediation analysis were done to assess associations and quality of life measures which might influence these associations. Results: Data on 14,585 people aged ≥65 years were analyzed (mean [SD] age 72.6 (11.5) y, maximum age 114 y; 55.0% women). After adjustment for potential confounders, compared with no chronic conditions, ≥3 conditions were associated with a significant 1.59 to 2.42 times higher odds for low physical activity. Finally, mobility mediated the largest proportion of the association between ≥3 chronic physical conditions and low physical activity (mediated percentage 50.7%), followed by activities of daily living disability (30.7%), cognition (24.0%), affect (23.6%), and pain/discomfort (22.0%). Conclusions: Physical multimorbidity was associated with higher odds for low physical activity among older adults residing in low- and middle-income countries. Mobility, disability, cognition, affect, and pain/discomfort explained the largest proportion of this association. Given the universal benefits of regular and sustained participation in physical activity, it would be prudent to implement interventions among older people with physical multimorbidity to increase levels of physical activity. Future studies should assess the impact of addressing the identified potential mediators among people with multimorbidity on physical activity levels.
A Bourdieusian Approach to Pain Management and Health in Professional Cricket
Authors: Read Daniel , Thomas Ivan , Smith Aaron C.T. , Skinner James
Published: December 2023

Painkiller (mis)use in sport presents a range of potential health risks to athletes (e.g., injury exacerbation). There is a lack of qualitative data examining the sociological genesis of variations in attitudes toward painkiller use. Focusing on the concept of physical capital, this article explores how attitudes toward painkiller use among professional cricket players in England are socialized by their workplace. Attitudes toward painkiller (mis)use stem from field-level structures that foster employment vulnerability, ensuring physical capital is precarious and legitimating painkiller (mis)use as a method of protecting economic opportunities with the added benefit of accruing symbolic capital by demonstrating toughness. Based on the findings, this article advocates for a sociologically informed harm-reduction approach to pain management in elite sport.
Supplemental Material: Compositional zoning of the Otowi Member of the Bandelier Tuff, Valles caldera, New Mexico, USA
Authors: Wolff J.A. , al. et
Published: December 2023

File S1: Sample preparation; comparison of results from different laboratories; core samples; volume calculations; accessory phases; Ti-in-quartz thermometry and diffusion; key to chemical data. File S2: Chemical data. File S3: Ti-in-quartz calculations.
5-Alkyloxymethyl Derivatives of 2ʹ-Deoxyuridine Bearing 2,4-Dinitrophenyl and Dansyl Groups: Synthesis and Antibacterial Activity
Authors: Makarov D. A. , Oskolsky I. A. , Jasko M. V. , Solyev P. N. , Vasilyeva B. F. , Demiankova M. V. , Efremenkova O. V. , Kochetkov S. N. , Alexandrova L. A.
Published: December 2023

Condensation of 3ʹ,5ʹ-di-O-acetyl-5-bromomethyl-2ʹ-deoxyuridine with 6-trifluoroacetylaminohexan1-ol yielded 5-(6-trifluoroacetylaminohexyl-1-oxymethyl)-3ʹ,5ʹ-di- O-acetyl-2ʹ-deoxyuridine. Its deblocking with an aqueous alcoholic solution of ammonia gave 5-(6-aminohexyl-1-oxymethyl)-2ʹ-deoxyuridine, and condensation with triazole and 2-chlorophenyl phosphorodichloridate followed by treatment with an aqueous solution of ammonia led to the formation of 5-(6-aminohexyl-1-oxymethyl)-2ʹ-deoxycytidine. The interaction of the obtained compounds with 2,4-dinitrofluorobenzene or N-hydroxysuccinimide esters of N-2,4-dinitrophenylaminohexanoic acid or 5-dimethylaminonaphthalene-1-sulfonyl glycine was used to synthesize DNP- and DNS-derivatives of 2ʹ-deoxyuridine as well as 5-(6-DNP-aminohexanoylaminohexyl-1-oxymethyl)-2ʹ-deoxycytidine. DNP derivatives of 2ʹ-deoxyuridine were shown to inhibit the growth of Micrococcus luteus.
Use of Artificial Intelligence in the Identification and Management of Frailty: A Scoping Review Protocol
Authors: Karunananthan Sathya , Rahgozar Arya , Hakimjavadi Ramtin , Yan Hui , Dalsania Kunal A , Bergman Howard , Ghose Bishwajit , LaPlante Jim , McCutcheon Tess , McIsaac Daniel I , Abbasgholizadeh Rahimi Samira , Sourial Nadia , Thandi Manpreet , Wong Sabrina T , Liddy Clare
Published: December 2023

Introduction

Rapid population ageing and associated health issues such as frailty are a growing public health concern. While early identification and management of frailty may limit adverse health outcomes, the complex presentations of frailty pose challenges for clinicians. Artificial intelligence (AI) has emerged as a potential solution to support the early identification and management of frailty. In order to provide a comprehensive overview of current evidence regarding the development and use of AI technologies including machine learning and deep learning for the identification and management of frailty, this protocol outlines a scoping review aiming to identify and present available information in this area. Specifically, this protocol describes a review that will focus on the clinical tools and frameworks used to assess frailty, the outcomes that have been evaluated and the involvement of knowledge users in the development, implementation and evaluation of AI methods and tools for frailty care in clinical settings.

Methods and analysis

This scoping review protocol details a systematic search of eight major academic databases, including Medline, Embase, PsycInfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Ageline, Web of Science, Scopus and Institute of Electrical and Electronics Engineers (IEEE) Xplore using the framework developed by Arksey and O’Malley and enhanced by Levacet aland the Joanna Briggs Institute. The search strategy has been designed in consultation with a librarian. Two independent reviewers will screen titles and abstracts, followed by full texts, for eligibility and then chart the data using a piloted data charting form. Results will be collated and presented through a narrative summary, tables and figures.

Ethics and dissemination

Since this study is based on publicly available information, ethics approval is not required. Findings will be communicated with healthcare providers, caregivers, patients and research and health programme funders through peer-reviewed publications, presentations and an infographic.

Registration details

OSF Registries (https://doi.org/10.17605/OSF.IO/T54G8).
Diabetes distress as mediators of loneliness and health promotion behaviour: a cross-sectional study
Authors: Zhou Feiyang , Deng Lu , Guo Chunbo , Long Keyu , Xie Linlin , Yang Tingting , Lv Qian
Published: December 2023

Objectives

The purpose of this study was to explore whether diabetes distress mediated the relationship between loneliness and health promotion in older adults with diabetes.

Design

A cross-sectional study.

Setting

The study was conducted at three tertiary hospitals in Changsha, Hunan Province, China.

Participants

The sample included 140 patients with diabetes (65 years and older, mean age 72.6 years, SD=4.6).

Methods

We employed path models to analyse data on diabetes distress, loneliness and health promotion behaviours. We collected diabetes distress, loneliness and health promotion behaviour with self-reported questionnaires including the Diabetes Distress Scale, the University of California at Los Angeles (UCLA) Loneliness Scale and the Elderly Health Promotion Scale from January 2022 to October 2022. Mediation analysis was performed by SPSS V.26.0’s PROCESS macro.

Result

The findings of this study indicated diabetes distress acted as a mediator between loneliness and health promotion behaviour. According to bootstrapping results, the total effect of loneliness on health promotion behaviour was significantly negative (β=−0.312, p=0.006). Loneliness significantly and negatively correlated with diabetes distress (β=−0.043, p<0.001), while diabetes distress significantly and negatively correlated with health promotion behaviours (β=−2.724, p=0.008). Both the indirect effect and the direct effect of loneliness on health promotion behaviour were significant.

Conclusion

Our study illustrated that loneliness was negatively associated with health promotion behaviours, and diabetes distress acted as a mediator in this relationship. It is suggested that healthcare providers should prioritise the identification and management of diabetes distress in older patients with diabetes who experience loneliness to improve health promotion behaviours and optimise disease management outcomes.
South Asian individuals’ experiences on the NHS low-calorie diet programme: a qualitative study in community settings in England
Authors: Dhir Pooja , Maynard Maria , Drew Kevin J , Homer Catherine Verity , Bakhai Chirag , Ells Louisa Jane
Published: December 2023

Background

Existing literature examines barriers to the provision of ethnically diverse dietary advice, however, is not specific to total diet replacement (TDR). There is a lack of literature from the UK, limiting the potential applicability of existing findings and themes to the UK context. This study addresses this gap in research by interviewing participants of South Asian ethnicity who have undertaken the National Health Service (NHS) low-calorie diet programme (LCD) for people with type 2 diabetes living with overweight or obesity. This study explores factors that may affect the uptake and acceptability of its TDR, food reintroduction and weight maintenance stages. This aims to provide rich data that can inform effective tailoring of future programmes with South Asian participants.

Objective

To explore the perspectives of individuals of South Asian ethnicity on an NHS programme using TDR approaches for the management of type 2 diabetes (T2D).

Design

Qualitative study.

Setting

Individuals in the community undertaking the NHS LCD programme.

Participants

Twelve one-to-one interviews were conducted with individuals from a South Asian ethnicity participating in the NHS LCD.

Main outcome measures

Qualitative semistructured interviews conducted through different stages of the programme. Reflexive thematic analysis was used to analyse the transcripts.

Results

Key themes highlighted positive and negative experiences of the programme: (1) more work is needed in the programme for person centeredness; (2) it is not the same taste; (3) needing motivation to make changes and feel better; (4) a mixed relationship with the coach; (5) social experiences; (6) culture-related experiences.

Conclusion

This study provides important experience-based evidence of the need for culturally tailored T2D programmes. Action to address these findings and improve the tailoring of the NHS LCD may improve experience, retention and outcomes on the programme for people of South Asian ethnicity and thereby reduce inequalities.
Automated audit of hospital oxygen use devised during the COVID-19 pandemic
Authors: O'Driscoll Ronan , Bakerly Nawar Diar
Published: December 2023

Background

The British Thoracic Society (BTS) has organised intermittent audits of hospital oxygen use in UK hospitals since 2008. Manual audits are time-consuming and subject to human errors. Oxygen prescribing and bedside observations including National Early Warning Scores (NEWS2 scores) are undertaken within an integrated electronic medical record (EMR) at this hospital.

Methods

The hospital’s Business Information team were commissioned in late 2019 to devise a bespoke automated audit of oxygen prescribing and use. A summary report displays the oxygen saturation alongside the oxygen prescription status of every patient in the hospital except for critical care units which do not use NEWS2. The display has a ‘traffic-light’ colour scheme (green within target range, amber or red if below range or if above range on supplemental oxygen), with a graph showing oxygen use and saturation levels for patients with each prescribed target range. Clinicians can access raw data including oxygen saturation, oxygen device and flow rate for each individual patient.

Results

Over 51 audits involving 34 352 sets of observations, an average of 6.0% involved use of oxygen and 88.6% of these had a valid oxygen prescription. During the first wave of the COVID-19 pandemic in spring 2020, the monthly percentage of observations involving oxygen use increased to a peak of 10.4% followed by a rise to 10.6% during the second wave and 7.4% during the third (Omicron) wave. Oxygen use returned to baseline after each wave.

Conclusions

In hospitals with integrated EMRs, it is possible to automate all fundamental aspects of the BTS oxygen audits and to monitor oxygen use at individual patient level and a hospital-wide level. This could be particularly valuable during major events such as the COVID-19 pandemic. This methodology could be extended to other clinical audits where the audit questions relate to routinely collected EMR data.
Role of palliative care intervention in patients with vulvar cancer: a retrospective study
Authors: Allende Silvia Rosa , Salcedo-Hernandez Rosa , Dominguez Ocadio Georgina , Peña-Nieves Adriana , Isla-Ortiz David , Verástegui Emma L , Cabrera-Galeana Paula
Published: December 2023

Objective

To describe the experience of a Mexican cancer centre in vulvar cancer and the opportunity to incorporate palliative care (PC) during treatment.

Patients and methods

A retrospective study of clinical and sociodemographic characteristics of women with vulvar cancer referred to the PC service (PCS) between 2010 and 2021 is reported. Frequencies were estimated, as well as medians and IQRs, accordingly. Referral time and overall survival were estimated using the Kaplan-Meier method.

Results

125 women with vulvar cancer were seen between 2010 and 2021, but only 42% were seen at PCS, mostly polysymptomatic, after several visits to the emergency room. 89% of the patients seen at PCS died at home.

Conclusions

Vulvar cancer is a rare type of cancer, while squamous cell carcinoma is the most frequent type. At the time of referral, almost half of the patients had severe pain, bleeding, malodor, infection and urinary incontinence. Most of these patients lived in poverty, were poorly educated and had multiple surgeries. PC may play an important role in the care of patients with advanced vulvar cancer, relieving the physical and psychological symptoms, avoiding unnecessary hospitalisation and favouring death at home without pain and other symptoms.