bluuebunny/crossref_metadata_2025 huggingface dataset:
Materialism, the Dark Triad Traits, and Money Management among Undergraduate Students
Authors: Kornienko Dmitriy S. , Balevab Milena V. , Yachmeneva Nadezhda P.
Published: October 2024

Background. Previous studies have assumed that a materialistic value orientation is correlates with personality traits such as honesty, neuroticism, and agreeableness. Less is known about the relationship between features of a materialistic orientation such as acquisition centrality, acquisition as the pursuit of happiness, and possession-defined success, and the Dark Triad traits. This article presents a study on the relationship between materialism, the Dark Triad traits (Machiavellianism, narcissism, and psychopathy), and money management. Objective. The study aimed to investigate whether groups exhibiting various combinations of materialism and Dark Triad traits have disparities in financial control and accountability, which serve as indicators of money management. Design. Questionnaire-based surveys were conducted online, with a total of 442 undergraduate students age 18 to 25 participating. The participants filled out the Short Dark Triad measure, the Material Values Scale, and the Money Management Scale, in addition to providing their demographics. Results. Four combinations of materialistic and Dark Triad traits were revealed (Bright and Dark Materialists and Non-materialists). Bright and Dark Materialists were more self-centered and manipulative than Non-materialists. Strong materialism, paired with the lowest degree of Dark Triad characteristics, resulted in the worst financial management. On the contrary, individuals with low materialistic tendencies in addition to high Dark Triad traits tended to have better ability to managing their finances. Conclusion. It is possible to assume that materialism is a strategy for obtaining riches, positions, and reputation at the cost of others in the case of "dark" personalities. Nevertheless, those with low levels of materialism and low Dark Triad characteristics showed better abilities to handle their finances in terms of control and responsibility.
The Emotional Intelligence of the GPT-4 Large Language Model
Authors: Vzorin Gleb D. , Bukinich Alexey M. , Sedykh Anna V. , Vetrova Irina I. , Sergienko Elena A.
Published: October 2024

Background. Advanced AI models such as the large language model GPT-4 demonstrate sophisticated intellectual capabilities, sometimes exceeding human intellectual performance. However, the emotional competency of these models, along with their underlying mechanisms, has not been sufficiently evaluated. Objective. Our research aimed to explore different emotional intelligence domains in GPT-4 according to the Mayer–Salovey–Caruso model. We also tried to find out whether GPT-4's answer accuracy is consistent with its explanation of the answer. Design. The Russian version of the Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT) sections was used in this research, with questions asked as text prompts in separate, independent ChatGPT chats three times each. Results. High scores were achieved by the GPT-4 Large Language Model on the Understanding Emotions scale (with scores of 117, 124, and 128 across the three runs) and the Strategic Emotional Intelligence scale (with scores of 118, 121, and 122). Average scores were obtained on the Managing Emotions scale (103, 108, and 110 points). However, the Using Emotions to Facilitate Thought scale yielded low and less reliable scores (85, 86, and 88 points). Four types of explanations for the answer choices were identified: Meaningless sentences; Relation declaration; Implicit logic; and Explicit logic. Correct answers were accompanied by all types of explanations, whereas incorrect answers were only followed by Meaningless sentences or Explicit logic. This distribution aligns with observed patterns in children when they explore and elucidate mental states. Conclusion. GPT-4 is capable of emotion identification and managing emotions, but it lacks deep reflexive analysis of emotional experience and the motivational aspect of emotions.
The Features of Modeling Mediation in Digital Support for Formation of Multiplicative Concepts
Authors: Vysotskaya Elena , Yanishevskaya Maria , Lobanova Anastasia
Published: October 2024

Background. The formation of multiplicative concepts of complex structure is a challenge for educational design. Students’ typical mistakes and strategies spontaneously obtained through hands-on trials in solving balance scale problems have been at the center of many studies within this trend. However, the consideration of relevant concept-mediated actions based on Learning Activity Theory (Davydov) remains a relevant problem. Objective. We aimed to develop a feasible framework for digital support of students’ learning actions in this domain. The productiveness of individual and joint forms of work with dynamic objects in a digital environment, mediated with conceptual modeling tools, was compared. Design. The participants were 181 fifth-grade students (11–12 years old). The first group (123 students) was taught a special procedure of modeling, which they then could test during individual computer-supported problem-solving. The second group (58 students) worked in pairs (jointly), using the same procedure. The pre- and post-tests included challenging problems on prediction of the balance state and ways to regain equilibrium. Results. Comparison of the pre- and post-test results of the joint computer-supported activity instruction revealed students’ progress in solving critical tasks as guided by the conceptual modeling procedure of load evaluation instead of “empirical” correlations of weights and distances. The individual computer-supported work, however, failed to overcome the belief of some students in the efficacy of trial-and-error methods as applied to the digital simulation with instant feedback. Conclusion. The special organization of the computer-supported concept-mediated joint activity may promote multiplicative concept formation.
Warhol’s Death and Disaster
Authors: Gage Simone Ophelia
Published: October 2024

In his Death and Disaster series, Andy Warhol’s Byzantine Catholic upbringing and beliefs take shape in his portraits of celebrities and unnamed disaster victims alike. While previous scholarship on the series describes Warhol’s representation of death as consumerist, callous, and contributing to spectacle culture driven by mass media, my work instead focuses on Warhol’s adoption and transformation of the Byzantine iconic tradition. In choosing to appropriate tabloid images of otherwise anonymous fatalities in the Disaster series, Warhol dignifies disaster victims as the secular martyrs of a rapidly modernizing world, where we are often mere casualties sacrificed in the name of industrial progress. Through his utilization of Byzantine visual language, Warhol’s Death and Disaster works venerate victims of tragedy, moving them away from their former lives as tabloid spectacles and instead positioning them as secular icons of the twentieth century—their images memorialized as the saints and martyrs of our time.
The Forgotten Narratives: Mobilization, Recruitment and Wartime Experiences of World War Two African Servicemen from Southern Rhodesia, (Colonial Zimbabwe) c.1939–1945
Authors: Chikumbu Anotida
Published: October 2024

This article discusses the mobilization, recruitment and wartime experiences of Africans who participated in the Second World War. Centred on the accounts of ex-servicemen, their families, and friends, this article argues that some Africans were either hoodwinked or forced to join the imperial forces. Consequently, they began to question their position as colonial subjects in the war. Their experiences revived anticolonial sentiments and abetted the rise of labour activism and mass nationalism in the colony during the war. The bulk of the material for this article was obtained from written family records, oral histories, and archival sources.
Assessment of haemolysis models for a positive-displacement total artificial heart
Authors: Bornoff Joseph , Zaman Shaikh Faisal , Najar Azad , Finocchiaro Thomas , Perkins Ina Laura , Cookson Andrew N , Fraser Katharine H
Published: October 2024

The assessment and reduction of haemolysis within mechanical circulatory support (MCS) remains a concern with regard to device safety and regulatory approval. Numerical methods for predicting haemolysis have typically been applied to rotary MCS devices and the extent to which these methods apply to positive-displacement MCS is unclear. The aim of this study was to evaluate the suitability of these methods for assessing haemolysis in positive-displacement blood pumps. Eulerian scalar-transport and Lagrangian particle-tracking approaches derived from the shear-based power-law relationship were used to calculate haemolysis in a computational fluid dynamics model of the Realheart total artificial heart. A range of power-law constants and their effect on simulated haemolysis were also investigated. Both Eulerian and Lagrangian methods identified the same key mechanism of haemolysis: leakage flow through the bileaflet valves. Whilst the magnitude of haemolysis varied with different power-law constants, the method of haemolysis generation remained consistent. The Eulerian method was more robust and reliable at identifying sites of haemolysis generation, as it was able to capture the persistent leakage flow throughout the entire pumping cycle. This study paves the way for different positive-displacement MCS devices to be compared across different operating conditions, enabling the optimisation of these pumps for improved patient outcomes.
Nigeria's Climate Change Act, conditional and unconditional nationally determined contributions, and the principle of common but differentiated responsibilities
Authors: Noah Izoukumor Afedolor
Published: October 2024

The commitments outlined in Nigeria's Nationally Determined Contribution (NDC) are crucial for fulfilling the country's obligations under the Paris Agreement. The updated NDC reaffirms the Nigerian government's pledge to achieve a 20 per cent unconditional reduction and a 47 per cent conditional reduction in greenhouse gas emissions by 2030. To implement these commitments nationally, the Nigerian government enacted the Climate Change Act of Nigeria in 2021. However, the Climate Change Act does not explicitly incorporate the 20 per cent unconditional and 47 per cent conditional reduction targets from Nigeria's NDC. This article examines the implications of the Climate Change Act not directly recognizing these NDC targets and explores the legal status of NDCs at the national level. The assessment reveals that, despite the absence of explicit recognition in the Climate Change Act, the Nigerian government is legally obligated to achieve 20 per cent unconditional emission reduction by 2030. This is because the 20 per cent unconditional obligation is grounded in the principle of Common but Differentiated Responsibility (CBDR). Conversely, the Nigerian government does not have a legally binding obligation to the 47 per cent conditional emission reduction targets, as achieving this reduction depends on international support.
Visual realism and character identification in science comics: an empirical study testing McCloud’s ‘masking effect’ theory
Authors: Yang Shiyu , Barolo Gargiulo Leonardo , Li Nan , Brossard Dominique
Published: October 2024

Comics have increasingly served as a tool for delivering scientific information to diverse audiences. However, little is known about how visual elements in comics influence their persuasive potential. Inspired by McCloud (1993)’s ‘masking effect’ theory featured in Understanding Comics: The Invisible Art, this study examined how different degrees of realism in comic characters, combined with background details, affected readers’ character identification. The findings suggested that exposure to comics featuring unrealistic, cartoonish characters minimized the gap in character identification between Black and white US participants. Contrary to McCloud’s hypotheses, exposure to comics with less detailed backgrounds resulted in higher character identification across conditions, regardless of character realism. The authors discuss the implications for future research and practice of using comics for public communication of science.
Endogenous pain modulation after sleep restriction in migraine: a blinded crossover study
Authors: Neverdahl Jan Petter , Uglem Martin , Matre Dagfinn , Nilsen Kristian Bernhard , Hagen Knut , Gravdahl Gøril Bruvik , Sand Trond , Omland Petter Moe
Published: October 2024

Background

Patients with migraine are vulnerable to insufficient sleep, but the impact of sleep restriction is largely unknown. In addition, the importance of sleep may be different in patients with migraine who mostly have attack onsets during sleep, so called sleep-related migraine, compared to patients with non-sleep-related migraine. In this study we investigate the effect of sleep restriction on endogenous pain modulation in patients with migraine and healthy controls. We also compared the effect of sleep restriction in sleep-related and in non-sleep-related migraine.

Methods

Measurements were conducted in 39 patients with migraine between attacks and 31 controls, once after habitual sleep and once after two consecutive nights of partial sleep restriction. There were 29 and 10 patients with non-sleep-related and sleep-related migraine respectively. Test stimulus was 2-min tonic noxious heat to the left volar forearm. Temporal summation was calculated as the regression coefficient for rated pain in the late part of this 2-min stimulation. Conditioning stimulus was right hand-immersion in 7 °C water. Conditioned pain modulation was defined as the difference in rated pain with and without the conditioning stimulus and was calculated for temporal summation and mean rated pain for the test stimulus. The effect of sleep restriction on temporal summation and conditioned pain modulation was compared in migraine subjects and controls using two-level models with recordings nested in subjects.

Results

Conditioned pain modulation for temporal summation of heat pain tended to be reduced after sleep restriction in patients with migraine compared to controls (p = 0.060) and, in an exploratory analysis, was reduced more after sleep restriction in sleep-related than in non-sleep-related migraine (p = 0.017). No other differences between groups after sleep restriction were found for temporal summation or conditioned pain modulation.

Conclusion

Patients with migraine may have a subtly altered endogenous pain modulation system. Sleep restriction may have an increased pronociceptive effect on this system, suggesting a mechanism for vulnerability to insufficient sleep in migraine. This effect seems to be larger in sleep-related migraine than in non-sleep-related migraine.
Measuring NOx during periodic technical inspection of diesel vehicles
Authors: Franzetti Jacopo , Selleri Tommaso , Fonseca González Natalia , Melas Anastasios , Gioria Roberto , Suarez-Bertoa Ricardo
Published: October 2024

Background

All light-duty (LD) and heavy-duty (HD) vehicles circulating in the European Union undergo regular checks during mandatory periodic technical inspections (PTI). These inspections promote road safety and environmental protection. Vehicles with defective deNOx aftertreatment systems can result in high emissions of NOx, which is an important air pollutant. The ongoing revision of the “so-called” Roadworthiness Package by the European Commission propose including a new method for measuring NOx from vehicles’ exhaust during PTI (NOx-PTI).

Results

The results obtained showed an increase in NOx emissions, 8 to 28 times, when the selective catalytic reduction (SCR) unit was not working. The applicability of the NOx-PTI idling test procedure to Euro VI HD vehicles was also investigated satisfactorily. Furthermore, methods to warm-up the vehicle’s aftertreatment prior to the NOx-PTI idling test, including standing still free accelerations and urban speed drives, as well as systems conditions before the test, were studied. Five different NOx analysers were assessed against reference equipment to ensure the accuracy of NOx measurements to assess their suitability for PTI purposes. The findings indicate that an urban speed drive is suitable for warming up both LD and HD vehicles. The tested analysers appeared to be suitable for use in PTI.

Conclusions

The high NOx emissions recorded when the SCR unit was not working, and their potential environmental impact, highlight the importance of a PTI test capable of detecting malfunctioning vehicles. The study demonstrated that the idle test procedure, testing conditions, and NOx analysers used were effective in performing a NOx-PTI check on both light- and heavy-duty Diesel vehicles, successfully discriminating between functioning and malfunctioning SCR systems.
Mobilome impacts on physiology in the widely used non-toxic mutant Microcystis aeruginosa PCC 7806 ΔmcyB and toxic wildtype
Authors: Stark Gwendolyn F. , Truchon Alexander R. , Wilhelm Steven W.
Published: October 2024

The Microcystis mobilome is a well-known but understudied component of this bloom-forming cyanobacterium. Through genomic and transcriptomic comparisons, we found five families of transposases that altered the expression of genes in the well-studied toxigenic type-strain, Microcystis aeruginosa PCC 7086, and a non-toxigenic genetic mutant, Microcystis aeruginosa PCC 7806 ΔmcyB. Since its creation in 1997, the ΔmcyB strain has been used in comparative physiology studies against the wildtype strain by research labs throughout the world. Some differences in gene expression between what were thought to be otherwise genetically identical strains have appeared due to insertion events in both intra- and intergenic regions. In our ΔmcyB isolate, a sulfate transporter gene cluster (sbp-cysTWA) showed differential expression from the wildtype, which may have been caused by the insertion of a miniature inverted repeat transposable element (MITE) in the sulfate-binding protein gene (sbp). Differences in growth in sulfate-limited media also were also observed between the two isolates. This paper highlights how Microcystis strains continue to “evolve” in lab conditions and illustrates the importance of insertion sequences / transposable elements in shaping genomic and physiological differences between Microcystis strains thought otherwise identical. This study forces the necessity of knowing the complete genetic background of isolates in comparative physiological experiments, to facilitate the correct conclusions (and caveats) from experiments.
Alpha-adrenergic antagonists and iris dynamics: Challenges and solutions in cataract surgery
Authors: Kaushik Jaya , Sharma Rishi , Goyal Sumit , Dangi Meenu , Jha Rakesh Kumar , Singh Ankita
Published: October 2024

Background

Alpha-1 adrenergic receptor antagonists (α1-ARAs) are frequently used in treatment of Hypertension and symptomatic benign prostatic hypertrophy (BPH). Numerous studies have demonstrated the association between α1-ARAs like Tamsulosin and increased surgical risks for patients undergoing cataract surgery. This study aims to identify and study the effects of α1-ARAs on iris parameters and the subsequent operative challenges encountered during cataract surgery.

Methods

A cross-sectional, prospective study involving 30 patients on α1-ARAs planned for cataract surgery and equal number of age and sex matched controls were subjected to evaluation of changes on iris parameters and subsequent challenges in cataract surgery.

Results

The study group had statistically significant lesser pupil diameter. Iris thickness at sphincter muscle region (SMR) was similar between groups (P = 0.53). Significantly lower values of iris thickness at dilator muscle region (DMR) found in treated subjects (P = < 0.001). There was statistically significant difference between DMR/SMR ratio of two groups (P < 0.001). Multiple regression analysis revealed longer duration of α1-ARAs treatment correlated with reduced DMR/SMR ratio (P = 0.001; r = 0.47).

Conclusion

α1-ARAs have implications for pupil size regulation and surgical procedures involving the eye. Tamsulosin is more potent than alfuzosin in inducing IFIS. Systemic α1-ARAs lower values of DMR thickness, DMR/SMR ratio and reduces pupillary diameter. Therefore, ophthalmologists, primary care physicians, urologists, and patients should be aware of the potential difficulties that these drugs pose for cataract surgery.
Outcome of flexible fixation for acute isolated syndesmotic injuries
Authors: El-Azab Hossam , Hafez Abdel Rhman , Mohamed Mohamed A. , Elsayed Moustafa
Published: October 2024

Background

Management of syndesmotic injuries with screw fixation has potential disadvantages, which may lead to the loss of some of the ankle functions. The use of the suture-button system instead can overcome these disadvantages.

Patients and methods

In a prospective study, 32 patients with acute isolated syndesmotic injuries were treated with a suture-button device. Follow-up was for a minimum of 2 years, regarding the Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, patient satisfaction at 3, 12, and 24 months, and radiological assessment.

Result

A significant improvement regarding pain (VAS during rest 5.6 and during walking 6.1 preoperative improved to 0.1 and 0.2 postoperatively, respectively. (P values were < 0.0001 for both pain during rest and walking) and AOFAS score (improved significantly from 44 ± 7.5 pre- to 99 ± 8.7 points postoperatively (P value was 0.0034). The improved VAS and AOFAS scores of the repaired ankles gradually reached the values of the contralateral uninjured ankle (evaluated at 3,12, and 24 months, postoperatively). Radiographs and CT of both ankles - repaired and healthy ankles - were similar at the 3 months follow-up. Early full weight-bearing and early return to work and sport characterized all patients. There was no need for hardware removal.

Conclusion

Suture-button treatment for acute isolated ankle syndesmotic injuries leads to favorable clinical and radiological outcomes. Postoperative radiographs and CT denoted maintained ankle stability. Patients can do early full weight-bearing and early return to work and sport.
A systematic review on how to diagnose deltoid ligament injuries—are we missing a uniform standard?
Authors: Schrempf Judith , Baumbach Sebastian , Abdelatif Nasef Mohamed N. , Polzer Hans , Böcker Wolfgang
Published: October 2024

Background

Up to now, there is no convincing evidence, that surgical treatment of deltoid ligament injuries, especially in the setting of ankle fractures, does result in improved outcome. One reason could be a missing diagnostic standard. The aim of the current systematic review was to analyze the applied diagnostic strategies for acute deltoid ligament injuries in outcome studies.

Methods

MEDLINE, Scopus, Central, and EMBASE were searched through February 2022 for any original studies addressing diagnostics of acute deltoid injuries. The study was conducted per the PRISMA guidelines. The inclusion criteria were formed according to the PICOS criteria. The data assessed were study type, level of evidence, included fractures, time point and method of diagnosing deltoid ligament layers, differentiation between layers and syndesmotic injuries.

Results

31 studies were included in the final analysis. Most studies (n = 28) based their decision to treat the deltoid ligament injury on radiologic findings only, with stressed radiographs (n = 18) being the most common. The radiographs were applied at one or more time points (preoperative, before ORIF, after ORIF, after ORIF and syndesmotic repair). The most frequently assessed parameter was the Medial Clear Space (MCS, n = 27) with cut-off-values considered pathological ranging between MCS > 1 mm and MCS > 6 mm.

Conclusion

Comparing the 31 studies shows that a standardized method to diagnose deltoid ligament injuries is missing. Further research is needed to establish evidence-based guidelines on how to diagnose acute deltoid ligament injuries.

Trial registration

Prospero ID: CRD42022307112.

Clinical trial number: not applicable.
Coping strategies of intensive care units nurses in alarm management: a qualitative research study
Authors: Lu Shu-Fen , Kuo Yi-Wen , Hung Shih-Hsin , Wu Cheng-Hsueh , Wang Chien-Ying , Chou Shin-Shang , Huang Shu-He
Published: October 2024

Background

Intensive care units are critical environments where various alarm systems play a pivotal role in patient monitoring and safety. Alarm fatigue can lead to slower response times and missed alarms, compromising patient safety and increasing stress and burnout among intensive care unit nurses. Understanding how intensive care unit nurses respond to and manage these alarms is crucial in evaluating their impact on patient care and nursing well-being.

Methods

This descriptive qualitative study explored the experiences of intensive care unit nurses in alarm management. Conducted in the medical and surgical intensive care units of a Northern Taiwan medical center, the study involved 15 nurses. Semi-structured interviews were utilized to investigate the working experiences of ICU nurses in alarm management and to identify their coping strategies for dealing with the constant inundation of medical device alarms. The interviews were transcribed, and content analysis was applied to identify key themes in the responses.

Results

The study revealed five main themes in intensive care unit nurses’ strategies for managing alarms: (1) Mastering alarm signals and acting; (2) Team monitoring for life preservation; (3) Enhancing senses and distinguishing carefully; (4) Learning from the lessons of incidents for vigilant reflection; and (5) Detach alarms’ influence on daily life. These coping strategies are effective in alarm management, safeguarding patients’ lives, enhancing the serenity of the clinical environment, and mitigating the physical and mental exhaustion caused by alarm fatigue.

Conclusions

Intensive Care Unit nurses develop various coping strategies to manage medical device alarms, based on their experience. These strategies are crucial in maintaining patient safety and reducing nurse alarm fatigue. They can also be used for nursing education and clinical training.
Impact of a teat disinfectant based on Lactococcus cremoris on the cow milk proteome
Authors: Addis Maria Filippa , Maffioli Elisa Margherita , Gazzola Alessandra , Santandrea Federica , Tedeschi Gabriella , Piccinini Renata
Published: October 2024

Background

Dairy cow milking practices require cleaning and disinfection of the teat skin before and after milking to ensure the safety and quality of milk and prevent intramammary infections. Antimicrobial proteins of natural origin can be valuable alternatives to traditional disinfectants. In a recent field trial, we demonstrated that a teat dip based on a nisin A-producing Lactococcus cremoris (L) had comparable efficacy to conventional iodophor dip (C) in preventing dairy cow mastitis. Here, we present the differential shotgun proteomics investigation of the milk collected during the trial.

Methods

Four groups of quarter milk samples with low (LSCC) and high somatic cell count (HSCC) collected at the beginning (T0) and end (TF) of the trial were analyzed for a total of 28 LSCC (14 LSCC T0 and 14 LSCC TF) and 12 HSCC (6 HSCC T0 and 6 HSCC TF) samples. Milk proteins were digested into peptides, separated by nanoHPLC, and analyzed by tandem mass spectrometry (LC-MS/MS) on an Orbitrap Fusion Tribrid mass spectrometer. The proteins were identified with MaxQuant and interaction networks of the differential proteins were investigated with STRING. The proteomics data have been deposited to the ProteomeXchange Consortium via the PRIDE partner repository with the dataset identifier PXD045030.

Results

In healthy milk (LSCC), we detected 90 and 80 differential proteins at T0 and TF, respectively. At TF, the Lactococcus group showed higher levels of antimicrobial proteins. In mastitis milk (HSCC), we detected 88 and 106 differential proteins at T0 and TF, respectively. In the Lactococcus group, 14 proteins with antimicrobial and immune defense functions were enriched at TF vs. 4 proteins at T0. Cathelicidins were among the most relevant enriched proteins. Western immunoblotting validation confirmed the differential abundance.

Conclusions

At T0, the proteomic differences observed in healthy milk of the two groups were most likely dependent on physiological variation. On the other hand, antimicrobial and immune defense functions were higher in the milk of cows with mammary gland inflammation of the Lactococcus-treated group. Among other factors, the immunostimulatory action of nisin A might be considered as a contributor.
How post overdose response efforts can address social determinants of health among people who use drugs: perspectives from the New York State Department of Health (NYSDOH) Post Overdose Response Team (PORT)
Authors: Lloyd Danielle , George Nerissa , Grove Donald , Goldberg Rebecca , Clear Allan
Published: October 2024

Individuals who have survived an overdose often have myriad needs that extend far beyond their drug use. The social determinants of health (SDOH) framework has been underutilized throughout the opioid overdose crisis, despite widespread acknowledgment that SDOH are contributors to the majority of health outcomes. Post Overdose Response Teams (PORTs) engage with individuals who have experienced 1 or more nonfatal overdoses and bear witness to the many ways in which overdose survivors experience instability with healthcare, housing, employment, and family structure. Employing a harm reduction model, PORTs are well-positioned to reach people who use drugs (PWUD) and to address gaps in basic needs on an individualized basis, including providing social support and a sense of personal connection during a period of heightened vulnerability. The New York State Department of Health (NYSDOH) PORT program is a harm reduction initiative that utilizes law enforcement data and several public databases to obtain accurate referral information and has been active since 2019 in NYC. This PORT program offers various services from overdose prevention education and resources, referrals to health and treatment services, and support services to overdose survivors and individuals within their social network. This perspective paper provides an in-depth overview of the program and shares quantitative and qualitative findings from the pilot phase and Year 1 of the program collected via client referral data, interviews, and case note reviews. It also examines the barriers and successes the program encountered during the pilot phase and Year 1. The team’s approach to addressing complex needs is centered around human connection and working toward addressing SDOH one individualized solution at a time. Application of the NYSDOH PORT model as outlined has the potential to create significant positive impacts on the lives of PWUD, while potentially becoming a new avenue to reduce SDOH-related issues among PWUD.
Men’s involvement in family planning programs: an exploratory study from Karachi, Pakistan
Authors: Ahmed Jawaria Mukhtar , Abrejo Farina Gul , Gul Xaher , Saleem Sarah
Published: October 2024

Background

In Pakistan, family planning has traditionally been perceived as primarily a women’s concern, resulting in the exclusion of men from relevant initiatives. This situation is further exacerbated by cultural and social barriers that hinder men’s access to family planning services. This study addresses a significant research gap by assessing the extent of family planning service provision for men in urban areas of Karachi. It delves into the exploration of men’s involvement in family planning service delivery, identifies existing gaps in services catering to men, records men’s perceptions of accessibility and acceptability of these services, and ultimately offers recommendations to enhance men’s involvement and strengthen service provision to better meet their needs.

Methods

We employed a qualitative exploratory research design using semi-structured interviews to investigate perceptions regarding family planning service provision to men. This approach involved 25 interviews, comprising eight key informant interviews with stakeholders, eight with service providers, and nine in-depth interviews with married men.

Results

This study highlights the limited engagement of men in family planning programs, primarily due to entrenched sociocultural norms that confine female healthcare providers to serving women, hindering men’s involvement. While national and provincial policies endorse men’s participation, they lack defined roles for male providers. Behavioral and information-sharing barriers at the community level discourage male healthcare providers from collaborating with females. Family planning programs, except for NGO-led vasectomy projects, fail to adequately address men’s needs. Despite policy recognition, implementation remains inadequate. Bridging the men’s involvement gap necessitates more male providers and improved contraceptive stigma combat training. Further research is vital to explore effective methods for involving men in community and service delivery in family planning.

Conclusion

There is a need to change the perception that contraception is solely the responsibility of women, as men’s participation in family planning in Karachi is limited. Engaging men can yield positive health and non-health outcomes. Culturally sensitive services, developed with community input using a couple-centered approach, are crucial for equitable family planning. Further research is needed to explore men’s inclusion strategies in service provision and utilization.
Capturing sources of health system legitimacy in fragmented conflict zones under different governance models: a case study of northwest Syria
Authors: Alkhalil Munzer , Turkmani Rim , Gharibah Mazen , Patel Preeti , Mehchy Zaki
Published: October 2024

Introduction

Legitimacy and trust are crucial for resilient health systems in fragmented conflict zones. This study evaluates the legitimacy of health systems in northwest Syria under different governance models.

Methods

Using a deductive and inductive mixed-methods approach, the research team developed a framework with an index, 4 sub-indices and 18 indicators to assess the legitimacy of health systems using different governance models – top-down, bottom-up, and hybrid – in the context of the response to the earthquake that hit Syria in February 2023. The study includes surveys, workshops, stakeholder consultations, and an expert panel conducted in northwest Syria and online.

Results

The findings indicate that bottom-up health governance model is perceived as the most legitimate, followed by the mixed model, while top-down model is perceived as the least legitimate. This preference is measured across all legitimacy source sub-indices, including legality, justification, consent and performance and across the overall Health System Legitimacy Index (HSLI). However, the hybrid governance approach showed limited superiority at two indicator levels regarding long-term health system response.

Conclusion

This study highlights the importance of considering the legitimacy of the health system in fragmented conflict zones. It helps explain the effectiveness of the bottom-up approach and community-based governance in enhancing trust, cooperative behaviour, health interventions and achieving sustainability. Additionally, the study highlighted the role of legitimate health systems in practising civic virtue and promoting social justice, thus contributing to peace-building efforts. These insights are crucial for policymakers and development donors to strengthen health systems in challenging contexts.
Patients undergoing emergent surgery for type A intramural hematomas or type A aortic dissections have similar outcomes
Authors: Nithikasem Sorasicha , Chakraborty Abhishek , Ikegami Hirohisa , Takebe Manabu , Sunagawa Gengo , Chiricolo Antonio , Chaudhary Ashok , Rahimi Alexander , Agarwala Simran , Russo Mark , Lee Leonard Y. , Lemaire Anthony
Published: October 2024

Objective

Despite key differences in pathological processes, both Intramural Hematomas and Aortic Dissections are Acute Aortic Syndromes repaired with similar surgical technique. The objective of this study was to determine differences in surgical outcomes between patients with Intramural Hematoma versus Type A Aortic Dissection undergoing Ascending Aortic Arch repair.

Methods

This retrospective review of prospectively collected data included all patients with acute Intramural Hematoma or Type A Aortic Dissection who underwent emergent Ascending- or Arch Repair from January 2018 to May 2023 at a single academic institution. Primary outcomes included intraoperative mortality, 30-Day mortality, and postoperative stay. Secondary outcomes included postoperative complications. Outcomes were analyzed using Chi-squared, Fisher’s Exact, and t-tests, with significance set at p < 0.05.

Results

A total of 107 patients were included, 27 of whom (25%) had Intramural Hematoma and 80 (75%) had Type A Aortic Dissection. There were no differences in preoperative characteristics such as age, gender, and comorbidities, and no differences in perioperative characteristics such as case length, cardiopulmonary bypass, aortic cross-clamp, and circulatory arrest times. When comparing postoperative outcomes, there was a higher rate of postoperative pericardial effusions requiring pericardial window in the Intramural Hematoma cohort compared to the Aortic Dissection cohort (15% [n = 4] vs. 3% [n = 2]; p = 0.02). There were no differences in other primary outcomes such as intraoperative mortality, 30-Day mortality, and postoperative length of stay. There were also no differences in the rates of postoperative complications such as bleeding requiring reoperation, cerebrovascular accident, atrial fibrillation, pleural effusion requiring thoracentesis, and surgery-related Emergency Department visits.

Conclusions

Our analysis demonstrates similar outcomes for patients undergoing Ascending Aortic Arch repair between patients with Intramural Hematoma and Type A Aortic Dissection. Despite the higher rate of required postoperative pericardial windows in the Intramural Hematoma cohort, the overall primary outcomes remained comparable. These findings better elucidate the standard of care for patients with acute Intramural Hematoma undergoing Ascending Aortic Arch repair.
Genetic testing in pediatric kidney transplant recipients to promote informed choice and improve individualized monitoring
Authors: Feng Yonghua , Xu Shicheng , Feng Yi , Zhao Na , Xu Linan , Fang Ye , Xu Hongen , Mao Lu , Wang Zhigang , Guo Jiancheng , Feng Guiwen , Rao Jia , Shang Wenjun
Published: October 2024

Background

The growing body of research on kidney disease in children has identified a broad spectrum of genetic etiologies.

Methods

We conducted a prospective study to evaluate the efficacy of an optimized genetic test and subclinical changes in a real-world context before kidney transplantation. All cases involved recipients under the age of 18 who underwent whole exome sequencing (ES) between 2013 and 2022.

Results

The study population included 244 children, with a median age of 13.1 years at transplantation. ES provided a molecular genetic diagnosis in 114 (46.7%) probands with monogenic variants in 15 known disease-causing genes. ES confirmed the suspected clinical diagnosis in 74/244 (30.3%) cases and revised the pre-exome clinical diagnoses in 40/244 (16.4%) cases. ES also established a specific underlying cause for kidney failure for 19 patients who had previously had an unknown etiology. Genetic diagnosis influenced clinical management in 88 recipients (36.1%), facilitated genetic counseling for 18 families (7.4%), and enabled comprehensive assessment of living donor candidates in 35 cases (14.3%).

Conclusions

Genetic diagnosis provides critical insights into the pathogenesis of kidney disease, optimizes clinical strategies concerning risk assessment of living donors, and enhances disease surveillance of recipients.
Avoiding overflow metabolite formation in Komagataella phaffii fermentations to enhance recombinant protein production
Authors: Steimann Thomas , Wegmann Judith , Espinosa Monica I. , Blank Lars Mathias , Büchs Jochen , Mann Marcel , Magnus Jørgen Barsett
Published: October 2024

Background

Komagataella phaffii (K. phaffii), formerly known as Pichia pastoris, is a widely utilized yeast for recombinant protein production. However, due to the formation of overflow metabolites, carbon yields may be reduced and product recovery becomes challenging. This study investigates the impact of oxygen availability, different glucose concentrations and feeding strategies on overflow metabolite formation and recombinant protein production in K. phaffii.

Results

High glucose concentrations in batch fermentation, as applied in literature, lead to substantial ethanol accumulation, adversely affecting biomass yield and product formation. Increasing dissolved oxygen setpoints does not significantly reduce ethanol formation, indicating that glucose surplus, rather than oxygen availability, drives overflow metabolism. Decreasing the initial glucose concentration to 5 g/L and adapting the feeding strategy of the fed-batch phase, effectively mitigates overflow metabolite formation, improving biomass yield by up to 9% and product concentration by 40% without increasing process time.

Conclusions

These findings underscore the importance of a suitable glucose-feeding strategy in K. phaffii fermentation processes and highlight the detrimental effects of overflow metabolites on productivity. By optimizing carbon source utilization, it is possible to enhance fermentation efficiency and recombinant protein production with K. phaffii.
Effects of cognitive training under hypoxia on cognitive proficiency and neuroplasticity in remitted patients with mood disorders and healthy individuals: ALTIBRAIN study protocol for a randomized controlled trial
Authors: Miskowiak Kamilla Woznica , Damgaard Viktoria , Schandorff Johanna Mariegaard , Macoveanu Julian , Knudsen Gitte Moos , Johansen Annette , Plaven-Sigray Pontus , Svarer Claus , Fussing Caroline Bruun , Cramer Katrine , Jørgensen Martin Balslev , Kessing Lars Vedel , Ehrenreich Hannelore
Published: October 2024

Background

Cognitive impairment is prevalent across neuropsychiatric disorders but there is a lack of treatment strategies with robust, enduring effects. Emerging evidence indicates that altitude-like hypoxia cognition training may induce long-lasting neuroplasticity and improve cognition. We will investigate whether repeated cognition training under normobaric hypoxia can improve cognitive functions in healthy individuals and patients with affective disorders and the neurobiological underpinnings of such effects.

Methods

In sub-study 1, 120 healthy participants are randomized to one of four treatment arms in a double-blind manner, allowing for examination of separate and combined effects of three-week repeated moderate hypoxia and cognitive training, respectively. In sub-study 2, 60 remitted patients with major depressive disorder or bipolar disorder are randomized to hypoxia with cognition training or treatment as usual. Assessments of cognition, psychosocial functioning, and quality of life are performed at baseline, end-of-treatment, and at 1-month follow-up. Functional magnetic resonance imaging (fMRI) scans are conducted at baseline and 1-month follow-up, and [11C]UCB-J positron emission tomography (PET) scans are performed at end-of-treatment to quantify the synaptic vesicle glycoprotein 2A (SV2A). The primary outcome is a cognitive composite score of attention, verbal memory, and executive functions. Statistical power of ≥ 80% is reached to detect a clinically relevant between-group difference with minimum n = 26 per treatment arm. Behavioral data are analyzed with an intention-to-treat approach using mixed models. fMRI data is analyzed with the FMRIB Software Library, while PET data is quantified using the simplified reference tissue model (SRTM) with centrum semiovale as reference region.

Discussion

The results will provide novel insights into whether repeated hypoxia cognition training increases cognition and brain plasticity, which can aid future treatment development strategies.

Trial registration

ClinicalTrials.gov, NCT06121206. Registered on 31 October 2023.
Integrating the Memory Support Intervention into the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C): can improving memory for treatment in midlife and older adults improve patient outcomes? Study protocol for a randomized controlled trial
Authors: Milner Anne E. , Hache Rafael Esteva , Oliver Sophia , Sarfan Laurel D. , Spencer Julia M. , Cogan Ashby , Jiang Yimei , Agnew Emma R. , Zieve Garret G. , Martin Jennifer L. , Zeidler Michelle R. , Dong Lu , Carpenter Joseph K. , Varghese Joshua , Bol Kiely , Bajwa Zia , Tighe Caitlan A. , Harvey Allison G.
Published: October 2024

Background

Poor memory for treatment is associated with poorer treatment adherence and poorer patient outcomes. The memory support intervention (MSI) was developed to improve patient memory for treatment with the goal of improving patient outcomes. The aim of this study protocol is to conduct a confirmatory efficacy trial to test whether a new, streamlined, and potent version of the MSI improves outcomes for midlife and older adults. This streamlined MSI is comprised of constructive memory supports that will be applied to a broader range of treatment content. The platform for this study is the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C). We will focus on midlife and older adults who are low income and experiencing mobility impairments.

Methods

Participants (N = 178) will be randomly allocated to TranS-C + MSI or TranS-C alone. Both intervention arms include eight 50-min weekly sessions. Assessments will be conducted at pre-treatment, post-treatment, 6-, and 12-month follow-up (6FU and 12FU). Aim 1 will compare the effects of TranS-C + MSI versus TranS-C alone on sleep and circadian functioning, daytime functioning, well-being, and patient memory. Aim 2 will test whether patient memory for treatment mediates the relationship between treatment condition and patient outcomes. Aim 3 will evaluate if previously reported poor treatment response subgroups will moderate the relationship between treatment condition and (a) patient memory for treatment and (b) treatment outcome. Exploratory analyses will compare treatment condition on (a) patient adherence, patient-rated treatment credibility, and patient utilization of treatment contents, and (b) provider-rated acceptability, appropriateness, and feasibility.

Discussion

This study has the potential to provide evidence for (a) the efficacy of a new simplified version of the MSI for maintaining health, well-being, and functioning, (b) the wider application of the MSI for midlife and older adults and to the treatment of sleep and circadian problems, and (c) the efficacy of the MSI for sub-groups who are likely to benefit from the intervention.

Trial registration

ClinicalTrials.gov NCT05986604. Registered on 2 August 2023.