bluuebunny/crossref_metadata_2025 huggingface dataset:
Why do people go to college? The institutional environment and the educational dispositions of community college students
Authors: Monaghan David B.
Published: January 2024

Empirical educational research nearly universally tacitly assumes that people attend college only in order to improve their likely earnings. Thus, it ignores the immense cultural importance ascribed to education (and particularly higher education) in modern culture, or at least proceeds as if this cultural valorization is irrelevant to individuals’ educational decision-making. I first review how an economistic model of action informs all dominant theories of educational decision-making, and then suggest how institutional theory can provide a richer account of the college transition. Drawing on in-depth interviews with first-time, first-year community college students, I illustrate this approach through a ‘thick description’ of individuals’ emerging educational orientations. I find that attending college reflects both instrumental goals and moralized conceptions of educational attainment. The decision to attend community college was informed by conceptions of college costs, a limited understanding of grant aid, and loan aversion. And I identify three educational dispositions among entering community college students which map onto institutionalized organizational pathways through the community college itself.
Characteristics and Trends in Median Arcuate Ligament Syndrome (MALS) Associated Visceral Artery Aneurysms: A Systematic Descriptive Review of the Literature
Authors: Karanasios Eleftherios , Ragab Zeyad , Cavenagh Harry , Stather Philip , Ali Tariq
Published: January 2024

Introduction: Median Arcuate Ligament Syndrome (MALS) is associated with true aneurysms, mainly of both the pancreaticoduodenal artery (PDA) and gastroduodenal artery (GDA). Although rare, their potential for rupture and adverse clinical outcomes warrants analysis. Prior studies suggest high rupture rates even for smaller aneurysms under 2 cm in this setting. We performed a systematic literature review, synthesising the evidence on visceral artery aneurysms related to MAL syndrome, with a focus on descriptive analyses of aneurysm size, presentation, rupture rates, and management. Methods: Literature search was performed using (Medline, EMBASE, Emcare and CINAHL). Inclusion criteria included true aneurysms secondary to MALS with or without rupture. The cases with pseudoaneurysms, concomitant pathologies eg, pancreatitis, conservatively managed aneurysms and articles with non-granular pooled data were excluded. Cases were assessed according to demographics, clinical presentation, aneurysm diameter, aneurysm rupture and management technique. Results: 39 articles describing 72 patients were identified. Aneurysm diameter in symptomatic patients was not significantly different from asymptomatic patients {21.0 and 22.3 mm respectively, P = .84}. Ruptured aneurysms were overall smaller than non-ruptured at presentation {12.3 mm v 30.8 mm respectively, P = .02}. Patients presented with abdominal pain (75.6%), nausea/vomiting (15.6%), hypotension (33.9%), shock (20.0%) and haemodynamic collapse (8.9%). 56.9% of all cases were managed with an endovascular approach, 19.4% were managed with an open surgical approach, and 23.6% were managed hybrid. Conclusion: This review suggests visceral artery aneurysms associated with median arcuate ligament rupture at variable sizes. Despite inability to clearly correlate size and rupture risk, our data supports prompt intervention irrespective of size, given the adverse outcomes. Further research is critically needed to clarify size thresholds or other predictors to guide management.
3D simulation of warp-knitted double-needle bed creel jacquard fabric based on the stitch layer
Authors: Zhang Yanting , Liu Haisang , Zhang Aijun , Jiang Gaoming
Published: January 2024

Unlike common jacquard fabrics, the warp-knitted double-needle bed creel jacquard fabric has more unique patterns, which allows to knit two-needle stitch structure on both ground guide bars and jacquard bars. It increases the pattern design complexity and has applications in many fields. However, due to the complex jacquard displacement signals and patterns, the actual patterns and structures remains elusive during the design process. Here, we propose a 3D (three-dimensional) simulation method for the warp-knitted double-needle bed creel jacquard fabric. The knitting parameters are established as mathematical models, by which the jacquard displacement signals can be simplified to numbers to combine with the basic chain notations. The spatial structure of the fabric is analyzed and a 3D stitch-layer model is generated. The simulation results show that through this modeling method, all stitches are arranged in an orderly manner at the appropriate layer, making the stitch position clearer and the 3D structure of the fabric easier to be observed.
Cross-sectional insights into exercise physiology knowledge among medical students in Jordan
Authors: Aolymat Iman , Almadani Yara , Albarakat Majd M. , Oleimat Ayah Khleaf , Al-Nsour Mass , E’lemat Marah
Published: January 2024

Objectives:

Exercise physiology is a branch of physiology that studies how physical activity and exercise alter the structure and function of living organisms. Knowledge of exercise physiology is crucial to improve athletic performance, improve people’s ability to cope with extreme circumstances and approach chronic diseases. This research aimed to evaluate the knowledge of future healthcare professionals, namely, the medical students in Jordan regarding exercise physiology.

Methods:

Responses were collected from 524 undergraduate medical students enrolled in clinical clerkship. An online survey that evaluated participants’ basic understanding of various physiological concepts related to physical exercises, such as respiratory exchange ratio, physical fitness, V̇O2 max and exercise at high altitudes was employed in the study.

Results:

63.2% of participants had a poor level of exercise physiology knowledge. Misconceptions regarding V̇O2 max definition (93.3%), application (46.4%), significance (35.6%) and related physiological factors (48.7%) were observed. Students had misconceptions about physical fitness evaluation questions (52.5%, 39%, and 41.8%, respectively). Student proportions of 37%, 41%, 80.3% and 73.1% showed misconceptions about muscle groups and energy systems during training, training prescription variables, respiratory exchange ratio, and high-altitude performance, respectively. Significant differences in knowledge levels were found based on respondent characteristics ( p < 0.05).

Conclusions:

Knowledge of exercise physiology is more than desirable for medical professionals. Therefore, efforts must be made to increase awareness and improve knowledge about basic physiological fundamentals related to exercise physiology among medical students in Jordan, as they represent the backbone of healthcare professionals of the future who will deal with medical conditions related to physical activity and exercise.
Prevalence and determinants of household medicine storage in Vietnam: A community-based cross-sectional study
Authors: Tieu Mai Diep Thi , Nguyen Quynh Nhu , Le Thi Thuy , Le Van Nho , Nguyen Thanh Quang
Published: January 2024

Objectives:

The COVID-19 pandemic has significantly impacted individual health, potentially increasing the demand for home medicine storage. However, inappropriate household medicine storage can lead to drug waste and unnecessary hazards. This study aimed to explore the prevalence of and identify the factors that predict medicine storage in Vietnamese households.

Methods:

A community-based cross-sectional study was conducted with 800 households in Danang, Vietnam. A multi-stage sampling method was applied in this study. The data collection tool was modified from previous studies and consisted of three sections: household head characteristics, household characteristics, and medicine storage practice. Bivariable and multivariable binary logistic regression analyses were used to identify the factors influencing medicine storage at a p-value of less than 0.05.

Results:

Among 800 households surveyed, 71.6% stored medicine. Analgesics-antipyretics were the most common type of medicine stored (80.8%). 90.1% of households obtained their medicines from private pharmacies, 68.1% of households stored medicine for future use and 58.8% had a home medicine cabinet. 9.4% of households did not store medicine in the appropriate packaging and 19.4% of households did not check the expiry date of their medicine. Educational level (AOR = 2.74; 95% CI = 1.84–4.06), income (AOR = 11.38; 95% CI = 1.46–88.79), presence of chronic illnesses (AOR = 12.44; 95% CI = 7.20–21.21), presence of children (AOR = 2.36; 95% CI = 1.56–3.58), presence of healthcare professionals (AOR = 2.14; 95% CI = 1.28–3.56) were predictors of the medicine storage.

Conclusions:

The current study found a high prevalence of household medication storage and some inappropriate storage behaviors. Therefore, attention should be given to develop effective interventions and policies to promote safe and appropriate storage practices.
Effects of Curcuma longa (turmeric) and curcumin on the premenstrual syndrome and dysmenorrhea: A systematic review
Authors: Shabanian Boroujeni Zahra , Heidari-Soureshjani Saeid , Sherwin Catherine MT
Published: January 2024

Premenstrual syndrome (PMS) and dysmenorrhea, in addition to harming the physical and mental health of women, also disrupt their daily life and quality of life. We aimed to investigate the effects and underlying mechanisms of Curcuma longa (turmeric) and curcumin on PMS and dysmenorrhea. PRISMA guideline 2020 was followed for conducting this systematic review. Comprehensive literature searches were conducted across multiple databases, including PubMed, EMBASE, Web of Science, and Scopus. Finally, 17 articles were found after considering the study’s inclusion and exclusion criteria into account. Data were extracted and entered into an Excel file for further investigation and drew the results. Curcuma longa and curcumin affect PMS and dysmenorrhea through various mechanisms. They inhibit the activity of cyclooxygenase-2 (COX-2) and the production of prostaglandins, thus reducing inflammation and pain. Additionally, curcumin’s antioxidant properties protect against oxidative stress, and lipid peroxidation helps maintain hormonal balance, exert analgesic effects, and relieve the symptoms of PMS and dysmenorrhea. They also insert neurotransmitter modulatory properties, such as increased serotonin and dopamine levels, which may contribute to their antidepressant, and sedative effects. Curcuma longa and curcumin indicated promising therapeutic effects in reducing PMS and dysmenorrhea symptoms due to their anti-inflammatory and antioxidant effects. Although, further well-designed clinical trials are needed to establish their efficacy and optimal dosage.
Self-reported Changes in Use of and Attitudes Toward ICT in Three Generations in Sweden During the Early Phase of the COVID-19 Pandemic
Authors: Offerman Jens , Schmidt Steven M. , Iwarsson Susanne , Fristedt Sofi
Published: January 2024

COVID-19 has affected the daily activities of people worldwide. Recommendations introduced to reduce the spread of the virus led to increased use of Information and Communication Technologies (ICT) to meet everyday needs. Such rapid digitalization had not been seen previously and not been possible to study before. Hence, this study aimed to identify and describe self-reported changes in usage of and attitudes toward ICT among three generations in Sweden during the early phase of the COVID-19 pandemic. Additionally, it aimed to identify whether and how belonging to a specific generation was related to these changes. A national cross-sectional survey was conducted in June 2020 with a final sample of N = 3,000, stratified into three generations (30–39, 50–59, and 70–79-year-old persons). A majority reported using digital technology more often than before the pandemic. Compared to the youngest generation, the oldest and middle-aged generations reported that they used digital technology more often than before the pandemic. Our results show which technologies were considered essential for different generations during the early phase of the pandemic. This information can be used to guide policy makers based on knowledge concerning the needs and demands for digital technologies in everyday life among people of different ages.
“They Need to Go in There”: Criminalized Subjectivity among Formerly Incarcerated Black Men
Authors: Couloute Lucius
Published: January 2024

Black people are overrepresented in the American criminal justice system, yet policy-based criminal justice research has historically ignored the perspectives of criminalized Black people. Using interviews with 27 formerly incarcerated Black men, the author helps address this issue by exploring how carceral experiences produce “criminalized subjectivities.” In particular, when explicitly asked about what they would say to powerful state officials about their contact with the criminal justice system, the Black men in this study described a range of practices and policies they viewed as unfair and contradictory. Interviewees discussed: unequal judicial processes, inhumane prison conditions, postimprisonment barriers to reintegration, and the rigged nature of racialized mass criminalization. The author argues that, taken together, their responses constitute a critical perspective urging structural (rather than individual-level) change, rooted in experiences with invisibilization and criminalization.
Using Expert Elicitation to Adjust Published Intervention Effects to Reflect the Local Context
Authors: Gray Jodi , Thynne Tilenka R. , Eaton Vaughn , Larcombe Rebecca , Tantiongco Mahsa , Karnon Jonathan
Published: January 2024

Background. Local health services make limited use of economic evaluation to inform decisions to fund new health service interventions. One barrier is the relevance of published intervention effects to the local setting, given these effects can strongly reflect the original evaluation context. Expert elicitation methods provide a structured approach to explicitly and transparently adjust published effect estimates, which can then be used in local-level economic evaluations to increase their local relevance. Expert elicitation was used to adjust published effect estimates for 2 interventions targeting the prevention of inpatient hypoglycemia. Methods. Elicitation was undertaken with 6 clinical experts. They were systematically presented with information regarding potential differences in patient characteristics and quality of care between the published study and local contexts, and regarding the design and application of the published study. The experts then assessed the intervention effects and provided estimates of the most realistic, most pessimistic, and most optimistic intervention effect sizes in the local context. Results. The experts estimated both interventions would be less effective in the local setting compared with the published effect estimates. For one intervention, the experts expected the lower complexity of admitted patients in the local setting would reduce the intervention’s effectiveness. For the other intervention, the reduced effect was largely driven by differences in the scope of implementation (hospital-wide in the local setting compared with targeted implementation in the evaluation). Conclusions. The pragmatic elicitation methods reported in this article provide a feasible and acceptable approach to assess and adjust published intervention effects to better reflect expected effects in the local context. Further development and application of these methods is proposed to facilitate the use of local-level economic evaluation.

Highlights

Local health services make limited use of economic evaluation to inform their decisions on the funding of new health service interventions. One barrier to use is the relevance of published intervention evaluations to the local setting. Expert elicitation methods provide a structured way to consider differences between the evaluation and local settings and to explicitly and transparently adjust published effect estimates for use in local economic evaluations. The pragmatic elicitation methods reported in this article offer a feasible and acceptable approach to adjusting published intervention effects to better reflect the effects expected in the local context. This increases the relevance of economic evaluations for local decision makers.
Significance of nanoparticles shape for enhanced heat transfer over on elastic sheet
Authors: Ganie Abdul Hamid , Ullah Basharat , Noreen  , Koka Nisar Ahmad , Khan Umar
Published: January 2024

This study analyzes the impact that the shape of nanoparticles has on the rate at which heat is transferred over an elastic sheet, which is one of the most important aspects of thermal management. It addresses the pressing demand for effective heat dissipation and insulation in a variety of industries, including energy systems and electronic devices, among others. The importance of this work rests in the fact that it has the potential to make conventional methods of heat transmission obsolete. By gaining an understanding of how the morphologies of nanoparticles affect their thermal properties, we may pave the way for the development of novel materials and applications, which will ultimately result in increased energy efficiency and high-performance technology. The originality by arguing that the study fills a knowledge gap on how different nanoparticle shapes influence heat transport in elastic sheets. The importance of this property for applications such as electronics and materials research should be emphasized. Within the scope of this study, a nanofluid composed of copper and water is utilized to investigate the movement of heat between the stretching sheets. This objective is supported by the utilization of the Hamilton Crosser Model as a tool. Platelets, cylinders, and blocks are some of the shapes and sizes of the nanoparticles that are utilized in this process. A magnetic field is applied, which changes the thermal properties of the nanofluids that are being used in the process of exchanging heat between two objects. This makes the process go more quickly. A similarity transformation is used to convert the governing equations into a collection of ordinary differential equations (ODEs). By using the shooting method, the boundary value problem can be converted into an initial value problem. This is achievable since the shooting technique is a shooting method. After that, a numerical solution is found for this issue using the RK-4 method. We give visual data that demonstrates how the flow pattern and temperature profile change as a result of a variety of different causes. Plots are provided for both the Nusselt number and the skin friction coefficient. As the inquiry goes on and the values of the key parameters are changed, one thing that happens consistently across all forms of nanoparticles is an increase in the velocity profile. This is a pattern. In addition, the nanofluid that is formed of platelet-shaped nanoparticles (which has a bigger value of shape factor) is shown to have the greatest temperature. This finding demonstrates a clear association between temperature and shape factor.
Naalasite, NaAl(AsO3OH)2⋅H2O, the Al analogue of nafeasite from the Torrecillas mine, Iquique Province, Chile
Authors: Kampf Anthony R. , Möhn Gerhard , Ma Chi , Désor Joy
Published: January 2024

The new mineral naalasite (IMA2023–027), NaAl(AsO3OH)2⋅H2O, was found at the Torrecillas mine, Iquique Province, Chile, where it is a secondary alteration phase associated with anhydrite, juansilvaite, magnesiokoritnigite and a lavendulan-like phase. Naalasite occurs in tightly intergrown aggregates and druses of equant crystals. Crystals are light to medium pink and transparent, with vitreous lustre and white streak. The Mohs hardness is ~3½. The density is 3.19(2) g⋅cm–3. Optically, naalasite is uniaxial (+), with ω = 1.630(3) and ɛ = 1.660(3) (white light). The empirical formula (based on 9 O apfu) is Na0.92Al0.61Fe3+0.39As2O9H4.07. Naalasite is trigonal, space group R32, with cell parameters: a = 8.494(4), c = 26.430(13) Å, V = 1651.5(4) Å3 and Z = 9. The structure, refined to R1 = 3.78% for 641 I > 2σI reflections, is based on a loose 3D framework of alternating AsO3OH tetrahedra and AlO6 octahedra. The structure is topologically equivalent to that of nafeasite and can be regarded as its Al analogue, even though nafeasite is monoclinic with space group C2.
Role of microRNA-4739 in enhancing cisplatin chemosensitivity by negative regulation of RHBDD2 in human cervical cancer cells
Authors: Li Yuling , Zhou Zhengtong , Qu Jinfeng , Gong Peiling , Wei Yuyan , Sun Yaping
Published: January 2024

Background

Cisplatin (DDP) is a widely used chemotherapy drug for advanced cervical cancer (CC), but resistance poses a significant challenge. While miR-4739 has been implicated in tumor development, its specific role in regulating DDP resistance in CC remains unclear.

Methods

We analyzed the expression levels of miR-4739 and RHBDD2 in DDP-resistant and DDP-sensitive CC tissues using quantitative real-time polymerase chain reaction (PCR) and assessed their correlation through Spearman’s correlation analysis. DDP-resistant CC cell lines (HeLa/DDP and SiHa/DDP) were established by gradually increasing DDP concentrations, followed by transfection with miR-4739 mimics, si-RHBDD2, or a RHBDD2 overexpression vector. A series of functional assays, including CCK-8 assay, colony formation, flow cytometry, and transwell assay were performed. The interaction between miR-4739 and RHBDD2 was confirmed by luciferase reporter assay. We examined the protein levels of RHBDD2, P-gP, MRP1, cleaved caspase-3, and E-cadherin through western blot analysis. Moreover, we generated xenograft tumors by injecting stably transfected HeLa/DDP cells into mice to compare their tumorigenesis capacity.

Results

We observed downregulation of miR-4739 and upregulation of RHBDD2 in DDP-resistant CC tissues and cell lines. MiR-4739 was shown to directly bind to RHBDD2 gene sequences to repress RHBDD2 expression in HeLa/DDP and SiHa/DDP cells. Our in vitro and in vivo experiments demonstrated that overexpressing miR-4739 overcame DDP resistance in CC cells by targeting RHBDD2. Furthermore, RHBDD2 overexpression reversed the effects of miR-4739 mimics on drug-resistance-related proteins (P-gP and MRP1) and the expression of cleaved caspase-3 and E-cadherin in HeLa/DDP cells.

Conclusions

In summary, our study revealed that miR-4739 can reverse DDP resistance by modulating RHBDD2 in CC cells.
Fast computation of the eigensystem of genomic similarity matrices
Authors: Hahn Georg , Lutz Sharon M. , Hecker Julian , Prokopenko Dmitry , Cho Michael H. , Silverman Edwin K. , Weiss Scott T. , Lange Christoph
Published: January 2024

The computation of a similarity measure for genomic data is a standard tool in computational genetics. The principal components of such matrices are routinely used to correct for biases due to confounding by population stratification, for instance in linear regressions. However, the calculation of both a similarity matrix and its singular value decomposition (SVD) are computationally intensive. The contribution of this article is threefold. First, we demonstrate that the calculation of three matrices (called the covariance matrix, the weighted Jaccard matrix, and the genomic relationship matrix) can be reformulated in a unified way which allows for the application of a randomized SVD algorithm, which is faster than the traditional computation. The fast SVD algorithm we present is adapted from an existing randomized SVD algorithm and ensures that all computations are carried out in sparse matrix algebra. The algorithm only assumes that row-wise and column-wise subtraction and multiplication of a vector with a sparse matrix is available, an operation that is efficiently implemented in common sparse matrix packages. An exception is the so-called Jaccard matrix, which does not have a structure applicable for the fast SVD algorithm. Second, an approximate Jaccard matrix is introduced to which the fast SVD computation is applicable. Third, we establish guaranteed theoretical bounds on the accuracy (in $$L_2$$

L
2

norm and angle) between the principal components of the Jaccard matrix and the ones of our proposed approximation, thus putting the proposed Jaccard approximation on a solid mathematical foundation, and derive the theoretical runtime of our algorithm. We illustrate that the approximation error is low in practice and empirically verify the theoretical runtime scalings on both simulated data and data of the 1000 Genome Project.
Identification of ARF genes in Cucurbita pepo L and analysis of expression patterns, and functional analysis of CpARF22 under drought, salt stress
Authors: Zhang Ming-jun , Xue Ying-yu , Xu Shuang , Jin Xuan-ru , Man Xing-chu
Published: January 2024

Background

Auxin transcription factor (ARF) is an important transcription factor that transmits auxin signals and is involved in plant growth and development as well as stress response. However, genome-wide identification and responses to abiotic and pathogen stresses of the ARF gene family in Cucurbita pepo L, especially pathogen stresses, have not been reported.

Results

Finally, 33 ARF genes (CpARF01 to CpARF33) were identified in C.pepo from the Cucurbitaceae genome database using bioinformatics methods. The putative protein contains 438 to 1071 amino acids, the isoelectric point is 4.99 to 8.54, and the molecular weight is 47759.36 to 117813.27 Da, the instability index ranged from 40.74 to 68.94, and the liposoluble index ranged from 62.56 to 76.18. The 33 genes were mainly localized in the nucleus and cytoplasm, and distributed on 16 chromosomes unevenly. Phylogenetic analysis showed that 33 CpARF proteins were divided into 6 groups. According to the amino acid sequence of CpARF proteins, 10 motifs were identified, and 1,3,6,8,10 motifs were highly conserved in most of the CpARF proteins. At the same time, it was found that genes in the same subfamily have similar gene structures. Cis-elements and protein interaction networks predicted that CpARF may be involved in abiotic factors related to the stress response. QRT-PCR analysis showed that most of the CpARF genes were upregulated under NaCl, PEG, and pathogen treatment compared to the control. Subcellular localization showed that CpARF22 was localized in the nucleus. The transgenic Arabidopsis thaliana lines with the CpARF22 gene enhanced their tolerance to salt and drought stress.

Conclusion

In this study, we systematically analyzed the CpARF gene family and its expression patterns under drought, salt, and pathogen stress, which improved our understanding of the ARF protein of zucchini, and laid a solid foundation for functional analysis of the CpARF gene.
A hybrid strategy using an ambulance and a helicopter to convey thrombectomy candidates to definite care: a prospective observational study
Authors: Vuorinen Pauli , Setälä Piritta , Ollikainen Jyrki , Hoppu Sanna
Published: January 2024

Background

Mechanical thrombectomy is the treatment of choice for large vessel occlusion strokes done only in comprehensive stroke centres (CSC). We investigated whether the transportation time of thrombectomy candidates from another hospital district could be reduced by using an ambulance and a helicopter and how this affected their recovery.

Methods

We prospectively gathered the time points of thrombectomy candidates referred to the Tampere University Hospital from the hospital district of Southern Ostrobothnia. Primary and secondary transports were included. In Hybrid transport, the helicopter emergency medical services (HEMS) unit flew from an airport near the CSC to meet the patient during transport and continued the transport to definitive care. Ground transport was chosen only when the weather prevented flying, or the HEMS crew was occupied in another emergency. We contacted the patients treated with mechanical thrombectomy 90 days after the intervention and rated their recovery with the modified Rankin Scale (mRS). Favourable recovery was considered mRS 0–2.

Results

During the study, 72 patients were referred to the CSC, 71% of which were first diagnosed at the PSC. Hybrid transport (n = 34) decreased the median time from the start of transport from the PSC to the computed tomography (CT) at the CSC when compared to Ground (n = 17) transport (84 min, IQR 82–86 min vs. 109 min, IQR 104–116 min, p < 0.001). The transport times straight from the scene to CT at the CSC were equal: median 93 min (IQR 80–102 min) in the Hybrid group (n = 11) and 97 min (IQR 91–108 min) in the Ground group (n = 10, p = 0.28). The percentages of favourable recovery were 74% and 50% in the Hybrid and Ground transport groups (p = 0.38) from the PSC. Compared to Ground transportation from the scene, Hybrid transportation had less effect on the positive recovery percentages of 60% and 50% (p = 1.00), respectively.

Conclusion

Adding a HEMS unit to transporting a thrombectomy candidate from a PSC to CSC decreases the transport time compared to ambulance use only. This study showed minimal difference in the recovery after thrombectomy between Hybrid and Ground transports.
Effect of wet clothing removal on skin temperature in subjects exposed to cold and wrapped in a vapor barrier: a human, randomized, crossover field study
Authors: Hagen Linn Therese , Brattebø Guttorm , Dipl-Math Jörg Assmus , Wiggen Øystein , Østerås Øyvind , Mydske Sigurd , Thomassen Øyvind
Published: January 2024

Background

Prehospital care for cold-stressed and hypothermic patients focuses on effective insulation and rewarming. When encountering patients wearing wet clothing, rescuers can either remove the wet clothing before isolating the patient or isolate the patient using a vapor barrier. Wet clothing removal increases skin exposure but avoids the need to heat the wet clothing during rewarming. Leaving wet clothing on will avoid skin exposure but is likely to increase heat loss during rewarming. This study aimed to evaluate the effect of wet clothing removal compared to containing the moisture using a vapor barrier on skin temperature in a prehospital setting.

Methods

This randomized crossover experimental field study was conducted in a snow cave in Hemsedal, Norway. After an initial cooling phase of 30 min while wearing wet clothes, the participants were subjected to one of two rewarming scenarios: (1) wet clothing removal and wrapping in a vapor barrier, insulating blankets, and windproof outer shell (dry group) or (2) wrapping in a vapor barrier, insulating blankets, and windproof outer shell (wet group). The mean skin temperature was the primary outcome whereas subjective scores for both thermal comfort and degree of shivering were secondary outcomes. Primary outcome data were analyzed using the analysis of covariance (ANCOVA).

Results

After an initial decrease in temperature during the exposure phase, the dry group had a higher mean skin temperature compared to the wet group after only 2 min. The skin-rewarming rate was highest in the initial rewarming stages for both groups, but increased in the dry group as compared to the wet group in the first 10 min. Return to baseline temperature occurred significantly faster in the dry group (mean 12.5 min [dry] vs. 28.1 min [wet]). No intergroup differences in the subjective thermal comfort or shivering were observed.

Conclusion

Removal of wet clothing in combination with a vapor barrier increases skin rewarming rate compared to encasing the wet clothing in a vapor barrier, in mild cold and environments without wind.

Trial registration

ClinicalTrials.gov ID NCT05996757, retrospectively registered 18/08/2023.
Comparison of Pocock and Simon’s covariate-adaptive randomization procedures in clinical trials
Authors: Shan Guogen , Li Yulin , Lu Xinlin , Zhang Yahui , Wu Samuel S.
Published: January 2024

When multiple influential covariates need to be balanced during a clinical trial, stratified blocked randomization and covariate-adaptive randomization procedures are frequently used in trials to prevent bias and enhance the validity of data analysis results. The latter approach is increasingly used in practice for a study with multiple covariates and limited sample sizes. Among a group of these approaches, the covariate-adaptive procedures proposed by Pocock and Simon are straightforward to be utilized in practice. We aim to investigate the optimal design parameters for the patient treatment assignment probability of their developed three methods. In addition, we seek to answer the question related to the randomization performance when additional covariates are added to the existing randomization procedure. We conducted extensive simulation studies to address these practically important questions.
Effects of dexmedetomidine combined with etomidate on postoperative cognitive function in older patients undergoing total intravenous anaesthesia: a randomized, double-blind, controlled trial
Authors: Fu Wuchang , Xu Hongchun , Zhao Ting , Xu Jun , Wang Fangjun
Published: January 2024

Background

Etomidate has been advocated for anesthesia in older and critically ill patients because of its hemodynamic stability. Clinical studies have shown that dexmedetomidine has neuroprotective and anti-inflammatory properties and improves postoperative cognitive dysfunction in older patients. The present study was to evaluate the effects of the combination of etomidate and dexmedetomidine with different anaesthesia time on postoperative cognitive function in older patients.

Methods

A total of 132 older patients undergoing ureteroscopic holmium laser lithotripsy were randomly divided into EN group and ED group equally. Patients whose surgery time was less than or equal to 1 h in each group were allocated to short-time surgery group (EN1 group and ED1 group), and whose surgery time was more than 1h were allocated to long-term surgery group (EN2 group and ED2 group). The primary outcome was the score of the Mini-Mental State Examination. The secondary outcomes were State-Trait Anxiety Inventory scores, Riker sedation agitation scores, Zung Self-Rating Depression Scale scores, the memory span for Arabic numerals, the plasma concentrations of S-100 calcium-binding protein B and neuron specific enolase, the time to spontaneous respiration, recovery, and extubation.

Results

The MMSE scores at t2-3 were higher in ED1 and ED2 groups than in EN1 and EN2 groups (p<0.05). Compared with ED1 and ED2 groups, the ZSDS scores, the S-AI scores and the T-AI scores at t1-2 were higher in EN1 and EN2 groups (p<0.05), respectively. The recalled Arabic numbers at t1-3 were higher in ED2 group than in EN2 group (p<0.05). The plasma concentration of S-100β at t1-2 in EN1 group and t1-3 in EN2 group were higher than that in ED1 and ED2 groups (p<0.05), respectively. Compared with ED1 and ED2 groups, the plasma concentrations of NSE were higher at t1-3 in EN1 group and t1-4 in EN2 group (p<0.05), respectively.

Conclusion

The administration of dexmedetomidine could improve postoperative cognitive dysfunction, emergence agitation, depression and anxiety, attenuate the plasma concentrations of S-100β and NSE in older patients undergoing total intravenous anaesthesia with etomidate.

Trial registration

Registration number: ChiCTR1800015421, Date: 29/03/2018.
A retrospective analysis of 20,178 adult neurological infection admissions to United Kingdom critical care units from 2001 to 2020
Authors: Donovan Joseph , Glover Abena , Gregson John , Hitchings Andrew W. , Wall Emma C. , Heyderman Robert S.
Published: January 2024

Background

Neurological infection is an important cause of critical illness, yet little is known on the epidemiology of neurological infections requiring critical care.

Methods

We analysed data on all adults with proven or probable neurological infection admitted to UK (NHS) critical care units between 2001 and 2020 reported to the Intensive Care National Audit and Research Centre. Diagnoses, physiological variables, organ support and clinical outcomes were analysed over the whole period, and for consecutive 5-year intervals within it. Predictors of in-hospital mortality were identified using a backward stepwise regression model.

Results

We identified 20,178 critical care admissions for neurological infection. Encephalitis was the most frequent presentation to critical care, comprising 6725 (33.3%) of 20,178 cases. Meningitis– bacterial, viral or unspecified cases - accounted for 10,056 (49.8%) of cases. In-hospital mortality was high, at 3945/19,765 (20.0%) overall. Over the four consecutive 5-year periods, there were trends towards higher Glasgow Coma Scale scores on admission, longer critical care admissions (from median 4 [IQR 2–8] to 5 days [IQR 2–10]), and reduced in-hospital mortality (from 24.9 to 18.1%). We identified 12 independent predictors of in-hospital death which when used together showed good discrimination between patients who die and those who survive (AUC = 0.79).

Conclusions

Admissions with neurological infection to UK critical care services are increasing and the mortality, although improving, remains high. To further improve outcomes from severe neurological infection, novel approaches to the evaluation of risk stratification, monitoring and management strategies are required.
The effect of nutritional education based on the health action process approach (HAPA) on the pregnancy outcomes among malnourished pregnant mothers
Authors: Razzazi Atieh , Griffiths Mark D. , Alimoradi Zainab
Published: January 2024

Objective

To examine the effectiveness of nutritional education based on the health action process approach (HAPA) on pregnancy outcomes among malnourished pregnant mothers utilizing nutritional support.

Methods

In a randomized controlled trial, 234 malnourished pregnant women under nutritional support from the fourth month of pregnancy participated. Participants were randomly allocated in study groups by the balance block randomization method. Data were collected using a socio-demographic and pregnancy outcomes checklist as well as self-devised questionnaire assessing the constructs of the HAPA model before and three months after the educational intervention. The framework of the educational intervention was based on the constructs of the HAPA and included three one-hour training sessions through lectures, group discussions, ‘question and answer’ sessions, and the use of educational tools. Data were analyzed using analysis of covariance (ANCOVA) and SPSS software.

Results

Pregnancy outcomes including optimal weight gain during pregnancy (p = 0.47), neonate’s birth weight (p = 0.58), gestational age at delivery (p = 0.83), type of delivery (p = 0.48) gestational anemia (p = 0.22), diabetes (p = 0.59) and hypertension (p = 0.29) were not significantly different in the intervention and control groups. The results showed that the educational intervention produced a significant increase in the total score (24 points) in the intervention group. Improvement of scores in the intervention group compared to the control was observed in all of the model constructs except outcome expectation (0.68 decrease). The educational intervention in the present study had a large measure of effect in total (SMD: 2.69, partial eta2: 0.664).

Conclusion

A nutritional education intervention based on the HAPA model for malnourished pregnant women increased behavioral intention and planning for action to have better nutritional behavior. However, the intervention did not change the pregnancy outcomes significantly.

Practice implications

Nutritional education based on the HAPA model can be used to improve nutritional behaviors of malnourished pregnant women.
Psychoeducation for adult ADHD: a scoping review about characteristics, patient involvement, and content
Authors: Pedersen Henrik , Skliarova Tatiana , Pedersen Sindre Andre , Gråwe Rolf W. , Havnen Audun , Lara-Cabrera Mariela L.
Published: January 2024

Background

Psychosocial interventions such as psychoeducation are increasingly being used to treat adult ADHD, both as an alternative and as a supplement to pharmacotherapy. A thorough overview of the literature on psychoeducation for adult ADHD is lacking. The objectives of this scoping review were therefore to identify the characteristics of psychoeducation interventions designed for adults with ADHD, examine how the patient experience or perspective is considered during the intervention’s development and implementation, determine the typical themes covered, and explore how ‘psychoeducation’ is defined in these interventions.

Methods

A comprehensive search was performed to identify records in MEDLINE, Embase, PsycINFO, Web of Science, Cochrane CENTRAL, AMED, and ClinicalTrials.gov. Two or more reviewers were included in every step of the screening process and the final selection of included studies. The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist (Supplementary Material 1) was used to report the results, and the framework developed by Arksey and O’Malley was used as a guide throughout the scoping process.

Results

A total of 2121 records were identified through the literature search. After screening and full-text analysis, ten studies were included for final analysis. Most studies were conducted in Europe and followed a group format. Seven main themes were identified: Information about the diagnosis, treatment options, somatic health and ADHD, the insider perspective, ADHD and social life, coping and psychological skills, and ADHD and work. There was significant overlap in themes covered, but coverage of each theme varied. Themes deemed important by newer research, such as sexuality and gender-specific issues, were missing. Only one intervention involved patients in its development and implementation, and two interventions involved family members. There was variation in how psychoeducation was defined in the included studies, and the implications of this are discussed.

Conclusion

The literature on psychoeducation for adult ADHD is not ready for any systematic effect estimation. Before such estimations are conducted, a shared understanding and definition of psychoeducation are needed. The involvement of end users in the development and delivery of interventions may aid reach this goal but results from this review indicate that such practices are rare.
Global trends and partial forecast of adverse effects of medical treatment from 1990 to 2019: an epidemiological analysis based on the global burden of disease study 2019
Authors: Kong Xin , Tao Xufeng , Li Lu , Zhao Xinya , Ren Jiaqi , Yang Shilei , Chen Xuyang , Xiang Hong , Wu Guoyu , Li Yunming , Dong Deshi
Published: January 2024

Background

The possibility of adverse effects of medical treatment (AEMT) is increasing worldwide, but little is known about AEMT in China. This study analyzed the health burden of AEMT in China in recent years through the Global Burden of Disease Study (GBD) 2019 and compared it with the worldwide average level and those in different sociodemographic index (SDI) regions.

Methods

We calculated the age-standardized rate (ASR) of deaths, disability-adjusted life years (DALYs), years of life lost (YLLs), years lived with disability (YLDs), incidence and prevalence attributed to AEMT in China, worldwide and countries with different sociodemographic indices during 1990–2019 using the latest data and methods from the GBD 2019.

Results

From 1990 to 2019, the global age-standardized death rate (ASDR), DALYs, and YLLs for AEMT showed a significant downward trend and were negatively associated with the SDI. By 2040, the ASDR is expected to reach approximately 1.58 (95% UI: 1.33–1.80). From 1990 to 2019, there was no significant change in the global incidence of AEMT. The occurrence of AEMT was related to sex, and the incidence of AEMT was greater among females. In addition, the incidence of AEMT-related injuries and burdens, such as ASR of DALYs, ASR of YLLs and ASR of YLDs, was greater among women than among men. Very old and very young people were more likely to be exposed to AEMT.

Conclusions

From 1990 to 2019, progress was made worldwide in reducing the harm caused by AEMT. However, the incidence and prevalence of AEMT did not change significantly overall during this period. Therefore, the health sector should pay more attention to AEMT and take effective measures to reduce AEMT.
Spatial multi-criteria decision analysis for the selection of sentinel regions in tick-borne disease surveillance
Authors: Guillot C. , Aenishaenslin C. , Acheson E. S. , Koffi J. , Bouchard C. , Leighton P. A.
Published: January 2024

Background

The implementation of cost-effective surveillance systems is essential for tracking the emerging risk of tick-borne diseases. In Canada, where Lyme disease is a growing public health concern, a national sentinel surveillance network was designed to follow the epidemiological portrait of this tick-borne disease across the country. The surveillance network consists of sentinel regions, with active drag sampling carried out annually in all regions to assess the density ofIxodesspp. ticks and prevalence of various tick-borne pathogens in the tick population. The aim of the present study was to prioritize sentinel regions by integrating different spatial criteria relevant to the surveillance goals.

Methods

We used spatially-explicit multi-criteria decision analyses (MCDA) to map priority areas for surveillance across Canada, and to evaluate different scenarios using sensitivity analyses. Results were shared with stakeholders to support their decision making for the selection of priority areas to survey during active surveillance activities.

Results

Weights attributed to criteria by decision-makers were overall consistent. Sensitivity analyses showed that the population criterion had the most impact on rankings. Thirty-seven sentinel regions were identified across Canada using this systematic and transparent approach.

Conclusion

This novel application of spatial MCDA to surveillance network design favors inclusivity of nationwide partners. We propose that such an approach can support the standardized planning of spatial design of sentinel surveillance not only for vector-borne disease BDs, but more broadly for infectious disease surveillance where spatial design is an important component.