bluuebunny/crossref_metadata_2025 huggingface dataset:
Schizophrenia – new treatments soon
Authors: Hall Jeremy
Published: November 2024

Antipsychotic medications targeting dopamine receptors were identified 70 years ago. Recent clinical trials have shown that agonists of muscarinic acetylcholinergic receptors can improve both psychotic and negative symptoms in schizophrenia. Here, this new approach to the treatment of schizophrenia is reviewed in anticipation of the drugs being licensed clinically.
Unintentional Mediastinal Placement of Thoracic Epidural Catheter Incidentally Discovered on Computed Tomography Imaging: A Case Report
Authors: Nieb Jacob M. , Garcia Tomas Vicente , Chen Liting
Published: November 2024

Thoracic epidural analgesia is commonly used for postoperative analgesia for abdominal and thoracic surgeries. One complication of thoracic epidural catheter placement is a malpositioned catheter, such as in the subarachnoid, subdural, or intrapleural space. We present a case of unintentional posterior mediastinal catheter placement. The catheter produced a sensory level and analgesic benefit and was only identified incidentally on computed tomography (CT) imaging. This case highlights another possible anatomic location for unintentional catheter placement, which may be more common than reported, as it functioned as an epidural catheter by all clinical metrics and would not have been identified without imaging.
Αναζητώντας τις απαρχές της διερευνητικής διδασκαλίας και μάθησης των φυσικών επιστημών στον Αιμίλιο του Ρουσσώ
Authors: Δημοπούλου Γεωργία
Published: November 2024

Στόχος της παρούσας διατριβής είναι να μελετηθεί το έργο του Ρουσσώ Αιμίλιος ή Περί Αγωγής, υπό το πρίσμα των νέων εξελίξεων στον χώρο της σύγχρονης διδακτικής των φυσικών επιστημών. Πιο συγκεκριμένα, εξετάζεται εάν και κατά πόσο το έργο Αιμίλιος ή Περί Αγωγής, εμπεριέχει προτάσεις επιστημονικής εκπαίδευσης, παρόμοιες με αυτές του σύγχρονου κινήματος της Διερευνητικής Διδασκαλίας και Μάθησης στις Φυσικές Επιστήμες (ΔιΔιΜαΦΕ). Πράγματι, στον Αιμίλιο ο Ρουσσώ αντιτίθεται στην παραδοσιακή διδασκαλία. Αντίθετα, παραθέτει παραδείγματα και υποδείξεις για μια «φυσική εκπαίδευση» κατά την οποία το παιδί αλληλεπιδρά καθημερινά με τη φύση, υπό την έμμεση καθοδήγηση ενός παιδαγωγού. Παράλληλα, υπογραμμίζει τη σημασία της εξερεύνησης της φύσης και των μηχανισμών της για την ολόπλευρη διαπαιδαγώγηση του παιδιού. Η εξοικείωση με τις επιστήμες της φύσης φαίνεται ότι, κατά τον Ρουσσώ, θα προσφέρει στον μαθητή σημαντικές γνώσεις για να ανταπεξέλθει στη ζωή: τον μαθαίνει να σκέφτεται, του προσφέρει πρακτικές δεξιότητες, του ανοίγει επαγγελματικούς ορίζοντες, και διαμορφώνει τον χαρακτήρα ενός νέου που αγαπά την έρευνα και τη μάθηση, και φροντίζει για τους άλλους. Με αυτές τις ιδέες ο Ρουσσώ προετοιμάζει το έδαφος για αυτό που σήμερα ονομάζεται επιστημονική εκπαίδευση. Η διατριβή εντοπίζει πολλές από τις ιδέες που εξέφρασε ο Ρουσσώ στο έργο εμβληματικών θεωρητικών της εκπαίδευσης αργότερα, όπως ο Πεσταλότσι, ο Φρέμπελ, ο Χέρμπαρτ, ο Ντιούι, η Μοντεσσόρι, ο Πιαζέ και το κίνημα του εποικοδομισμού, αλλά και ο Βιγκότσκι. Οι παραπάνω προσωπικότητες συνέβαλαν καθοριστικά στη πρόταση της σύγχρονης ΔιΔιΜαΦΕ. Έτσι, η διατριβή αυτή αποτελεί μια μελέτη της ιστορίας ιδεών που διέπουν τη ΔιΔιΜαΦε, ενώ εστιάζει σε μια πτυχή του έργου του Ρουσσώ η οποία δεν έχει μελετηθεί αρκετά, αυτή της επιστημονικής εκπαίδευσης. Φιλοδοξεί με αυτόν τον τρόπο να εδραιώσει τον Ρουσσώ ως έναν από τους προγόνους της ΔιΔιΜαΦΕ. Ιδανικά αυτή η ανάγνωση του Αιμιλίου μπορεί να ανοίξει έναν νέο δίαυλο διαλόγου μεταξύ των προτάσεων του Ρουσσώ για την εκπαίδευση και της διδακτικής των φυσικών επιστημών.
Αξιολόγηση της ερυθροποιητίνης ως δυνητικού biomarker σε παιδιά με σύνδρομο υπνικής άπνοιας
Authors: Καλογρίτσας Νικόλαος
Published: November 2024

Στόχος: Στους ενήλικες με αποφρακτική υπνική άπνοια (ΣΑΑΥ) έχουν καταγραφεί υψηλά επίπεδα ερυθροποιητίνης (EPO) στον ορό αίματος. Ωστόσο υπάρχει έλλειψη σχετικής βιβλιογραφίας σε παιδιά με αποφρακτική υπνική άπνοια (ΣΑΑΥ). Ο κύριος στόχος αυτής της μελέτης ήταν να διερευνήσει την πιθανή χρήση της ερυθροποιητίνης (EPO) ως παιδιατρικού βιοδείκτη του συνδρόμου υπνικής άπνοιας διερευνώντας τη σχέση μεταξύ των επιπέδων της ερυθροποιητίνης (EPO) στον ορό και της παρουσίας αποφρακτικής υπνικής άπνοιας (OSΑ) στον παιδιατρικό πληθυσμό. Υλικά & Μέθοδος: Στα πλαίσια αυτής της έρευνας διενεργήθηκε προοπτική μελέτη σε παιδιά ηλικίας 4-12 ετών τα οποία παραπέμφθηκαν για ολονύκτια πολυκαταγραφική μελέτη ύπνου (PSG). Δημιουργήθηκαν 4 ομάδες βαρύτητας με βάσει τον δείκτη άπνοιας – υπόνοιας (ΑΗΙ). Συγκεκριμένα η πρώτη ομάδα περιλάμβανε 30 παιδιά με ΑΗΙ< 1 που αποτελούσαν την ομάδα ελέγχου, η δεύτερη ομάδα περιλάμβανε 30 παιδιά με ΑΗΙ 1-5 που αποτελούσαν την ομάδα με ηπίου βαθμού άπνοιας- υπόπνοιας και ακολούθως η ομάδα 3 με 30 παιδιά με μετρίου βαθμού άπνοια (ΑΗΙ 5-10) και η ομάδα 4 με 30 παιδιά με σοβαρού βαθμού άπνοια (ΑΗΙ>10). Στη συνέχεια ελήφθησαν πρωινά δείγματα αίματος προκειμένου να μετρηθούν και να συγκριθούν τα επίπεδα της ερυθροποιητίνης (EPO). Τελικά 115 παιδιά συμπεριλήφθηκαν στη μελέτη για ανάλυση. Η ομάδα ελέγχου αποτελούνταν από 29 παιδιά με μέση ηλικία τα 6,93±2,10 και οι ομάδες με αποφρακτική υπνική άπνοια από 86 παιδιά με μέση ηλικία τα 6,78± 2,52. Αποτελέσματα: Οι μέσες τιμές ερυθροποιητίνης (EPO) για το δείγμα ελέγχου και για το δείγμα με αποφρακτική άπνοια ήταν 5,46±2,24 mIU/ml και 8.33±4,10 mIU/ml αντίστοιχα. Συμπεράσματα: Η μελέτη μας έδειξε ότι τα επίπεδα ερυθροποιητίνης (EPO) στον ορό των παιδιών με αποφρακτική υπνική άπνοια (ΣΑΑΥ) ήταν σημαντικά υψηλότερα από τα παιδιά της ομάδας ελέγχου και συσχετίζονται σημαντικά με τον δείκτη άπνοιας – υπόπνοιας. Τα αποτελέσματα αυτά έδειξαν ότι η ερυθροποιητίνη (EPO) μπορεί να θεωρηθεί ως υποψήφιος βιοδείκτης για τα παιδιά με σύνδρομο υπνικής άπνοιας . Δεδομένου ότι αυτή είναι η πρώτη μελέτη πάνω σ’ αυτό το θέμα , χρήζει περαιτέρω έρευνας.
Wiara w egzystencji. Teoretyczny wymiar chrześcijańskiego ideału w pismach pseudonimowych Sorena Kierkegaarda
Authors: Słowikowski Andrzej
Published: November 2024

Przedmiotem książki jest egzystencjalna myśl duńskiego filozofa Sørena Kierkegaarda rozpatrywana jako pewien szczególny projekt antropologiczny, którego zadanie stanowi próba odpowiedzi na pytanie: co to znaczy stawać się i być chrześcijaninem? Nie ma wątpliwości, że dzieło Kierkegaarda w swym najgłębszym rdzeniu ma wymiar chrześcijańskiej antropologii egzystencjalnej, w której centrum stoi jednostka jako niepowtarzalny i wyjątkowy byt ludzki, odkrywający swoją prawdę o sobie tylko w wierze, będącej zawsze indywidualną relacją z Bogiem. Główny zabieg interpretacyjny zastosowany w tej książce polega na tym, by odczytać pisma pseudonimowi Kierkegaarda w taki sposób, aby uwidocznić spójną i przemyślaną antropologię zawartą w jego myśli. To, że nie tworzy on żadnego systemu wiedzy, którego celem byłby obiektywny wykład na temat filozoficznie rozumianej istoty człowieka, jest oczywiste, bezdyskusyjne i konieczne do przyjęcia dla każdego, kto chce na poważnie zajmować się jego dziełem. Nie zmienia to jednak faktu, że aby realizować swój majeutyczny cel, polegający na zachęceniu czytelnika do pogłębiania własnego życia duchowego, Kierkegaard musiał rozwinąć bardzo spójny sposób myślenia o tym, kim u swych podstaw jest człowiek. Dokonał tym samym daleko idącej konceptualizacji fenomenów ludzkiej duchowości, tworząc bardzo głęboko przemyślaną i świetnie skonstruowaną sieć kategorialną. Z jej pomocą starał się uchwycić sens stawania się i bycia chrześcijaninem w ludzkiej egzystencji oraz tak go przedstawić, by rzeczywiście pobudzić czytelnika o refleksji nad sobą.
Wyjaśnianie za pomocą reprezentacji mentalnych. Perspektywa mechanistyczna
Authors: Gładziejewski Paweł
Published: November 2024

Przez dziesięciolecia wydawało się, że teza o reprezentacyjnej naturze umysłu stanowi teoretyczny fundament i spoiwo kognitywistyki. Nauki kognitywne miały „zneutralizować” filozoficzną ideę, że poznanie świata jest zapośredniczone przez wewnętrzne, umysłowe reprezentacje, a następnie wykorzystać ją w próbach dostarczenia naukowego wyjaśnienia zjawisk poznawczych. Dziś powodzenie tego typu projektu podaje się w wątpliwość. Z jednej strony coraz wyraźniej jest widoczny wśród kognitywistów brak konsensusu względem tego, co właściwie znaczy, że pewien system fizyczny – taki jak biologiczny mózg – opiera swoje działanie na wewnętrznych reprezentacjach. Z drugiej strony na popularności zyskują stanowiska antyreprezentacjonistyczne, które postulują wyrzucenie pojęcia reprezentacji z teoretycznego repozytorium nauk o poznaniu. Celem tej książki jest wypracowanie określonych rozstrzygnięć dotyczących natury oraz roli eksplanacyjnej reprezentacji mentalnych w kognitywistyce. Autor rozwija koncepcję wyjaśniania reprezentacyjnego jako wyjaśniania za pomocą mechanizmów poznawczych wykorzystujących wewnętrzne modele-surogaty świata. Broni on tezy, że mechanizmy tego rodzaju spełniają istotną rolę w różnych rejonach współczesnej kognitywistyki, w związku z czym próby pogrzebania reprezentacjonizmu są zdecydowanie pochopne. Autor zmierza także do pokazania, że kognitywistyczne wyjaśnienia za pomocą reprezentacji zasadniczo różnią się od wyjaśnień ludzkich działań za pomocą takich „zdroworozsądkowych” stanów emocjonalnych, jak przekonania, pragnienia, oczekiwania czy intencje. Nasza tak zwana psychologia potoczna okazuje się zatem w znacznym stopniu autonomiczna względem kognitywistycznych ustaleń dotyczących wewnętrznej, mechanistycznej organizacji systemów poznawczych.
Vaccination as an element of health security management - analysis of factors of patient attitudes towards COVID-19 preventive vaccinations based on the opinions of healthcare experts
Authors: Karczmarz Sabina , Owczarczyk Anna , Żuk Paweł , Średziński Leszek , Prusaczyk Artur , Bogdan Magdalena
Published: November 2024

Background: Preventive vaccinations play a significant role in reducing the spread of infectious diseases. They mitigate the course of infectious diseases and limit the occurrence thereof. Thus, they allow maintaining the health security of citizens and are one of the activities that allow for effective population health management. However, even though vaccinations bring significant benefits to the population as a whole, the attitudes of individuals to them raise a number of controversies.
 Objective: The aim of the study was to analyze the characteristics and factors of patient attitudes towards COVID-19 preventive vaccinations based on the opinions of healthcare experts. The study was carried out in the framework of a project "The interdependence of lifestyle and attitudes towards COVID-19 preventive vaccinations", which finished in June 2023.
Method: The research method was an in-depth telephone interview with experts who had previously studied the research problem and the results of quantitative research, and expressed individual opinions on the factors of patient attitudes towards COVID-19 vaccinations. The experts indicated various factors which, in their opinion, can influence patient willingness to be vaccinated against COVID-19. In the research process, four main factors were found: patient social environment and patient experience; patient knowledge and awareness, social impact (message of medical authorities and political decision makers), balance of benefits and risks.
Results: The results obtained in the study and the conclusions drawn show the need for further, in-depth research in patient attitudes towards preventive vaccinations, not only COVID-19 vaccinations.
Appreciative Inquiry in Youth Care in Belgium
Authors: Joly Koen
Published: November 2024

This article is the result of an inspiring session with the team members of De Knoop ("the Button") examining how they "do" appreciative work with youngsters.
Ego to Eco: A Joyous and Enriching Journey
Authors: Heap Nick
Published: November 2024

There is a way to a sustainable future where we live in harmony with nature and each other. The journey will be joyous and enriching. We can get there by doing things we already enjoy! This article is an appreciative reframing of an intractable problem.
Case—Humanitarian Supply Chains and Inventory Management: Planning Medical Supply at the International Committee of the Red Cross
Authors: Thakur-Weigold Bublu , Tilson Vera , Pachamanova Dessislava A. , Mohamad Samah El Sayed
Published: November 2024

Funding: The ETH project with the ICRC was supported by a Humanitarian Action Challenges (HAC) grant within the joint “Engineering Humanitarian Aid” (EHA) program.
Synthesis and Characterization of Li -Zeolite Catalyst for Biodiesel Production from Castor Oil
Authors: Salim Razan Ali , Erwa Ibrahim Yaagoub , Hassan Asmo Abdillahi , Almaleeh Mohammed Alzubair , Eldaim Siddig Osman Abd , Ahmed Abdalwahab , Yasin Sahl
Published: November 2024

This study used lithium-modified Zeolite as a heterogeneous catalyst to make biodiesel from non-edible castor oil. The catalyst was wet impregnated with natural Zeolite and characterized by XRD, FTIR, and SEM. Castor oil was extracted and injected into a GC-MS unit for analysis, and established procedures were used to evaluate chemical properties. The catalyst's performance in the transesterification reaction was examined to determine optimal process conditions and reusability. A catalyst characterization study found that the lithium-modified zeolite catalyst selectively produces methyl esters from castor oil with 4% FFA in a batch process. The maximum biodiesel yield was 92% at 60°C, 60 minutes, 6:1 methanol-to-oil molar ratio, and 1.5% catalyst loading. The catalyst reusability test showed 12.8% degradation after four cycles. Under ideal conditions, biodiesel had a flashpoint of 62°C, kinematic viscosity of 1.24 cSt, and density of 0.81 g/cm3. Fuel properties were compared to ASTM standards to verify compliance. Castor oil is a promising biodiesel source. Zeolite modified with lithium is an effective heterogeneous catalytic transesterification catalyst for methyl ester under milder reaction conditions.
A Review on Climatic Change: Causes, Impacts on Wildfires and Human Health
Authors: Sultan Yara Ezal Deen , Pillai Kanni Raj Arumugam
Published: November 2024

Climate change occurs when climate standards significantly vary, causing environmental and societal problems. Changes in humidity, temperature, and precipitation alter ecosystem balance. Natural causes include volcanic eruptions, rising temperatures, snow melting, and rising sea levels. These changes in climate metrics negatively impact all life forms on Earth, leading to harmful effects on the environment and society. The paper discusses the complex relationship between climate change and wildfires, highlighting the increased global warming caused by deforestation and greenhouse gas emissions. It also discusses the impact of climate change on forest fires and vice versa, aiming to provide a conceptual review of climate issues to improve human health.
The impact of concomitant meniscal surgery on the clinical outcomes of anterior cruciate ligament reconstruction
Authors: Gabr Ayman , Fontalis Andreas , Robinson James , Hage William , O'Leary Sean , Spalding Tim , Haddad Fares S.
Published: November 2024

Aims

The aim of this study was to compare patient-reported outcomes (PROMs) following isolated anterior cruciate ligament reconstruction (ACLR), with those following ACLR and concomitant meniscal resection or repair.

Methods

We reviewed prospectively collected data from the UK National Ligament Registry for patients who underwent primary ACLR between January 2013 and December 2022. Patients were categorized into five groups: isolated ACLR, ACLR with medial meniscus (MM) repair, ACLR with MM resection, ACLR with lateral meniscus (LM) repair, and ACLR with LM resection. Linear regression analysis, with isolated ACLR as the reference, was performed after adjusting for confounders.

Results

From 14,895 ACLR patients, 4,400 had two- or five-year Knee injury and Osteoarthritis Outcome Scores (KOOS) available. At two years postoperatively, the MM repair group demonstrated inferior scores in KOOS pain (β = −3.63, p < 0.001), symptoms (β = − 4.88, p < 0.001), ADL (β = − 2.43, p = 0.002), sport and recreation (β = − 5.23, p < 0.001), quality of life (QoL) (β = − 5.73, p < 0.001), and International Knee Documentation Committee (β = − 4.1, p < 0.001) compared with the isolated ACLR group. The LM repair group was associated with worse KOOS sports and recreation scores at two years (β = − 4.264, p < 0.001). At five years, PROMs were comparable between the groups. At five years, PROMs were comparable between the groups. Participants undergoing ACLR surgery within 12 weeks from index injury demonstrated superior PROMs at two and five years.

Conclusion

Our study showed that MM repair, and to a lesser extent LM repairs in combination with ACLR, were associated with inferior patient-reported outcome measures (PROMs) compared to isolated ACLR at two years postoperatively, while meniscal resection groups exhibited comparable outcomes. However, by five years postoperation, no significant differences in PROMs were evident. Further longer-term, cross-sectional studies are warranted to investigate the outcomes of ACLR and concomitant meniscal surgery.
RESISTINDO À TEMPESTADE: PRÁTICAS DE CONTROLE DE GESTÃO ADOTADAS PELAS PEQUENAS EMPRESAS EM TEMPOS DE PANDEMIA
Authors: Carraro Wendy Beatriz Witt Haddad , Motta Donavan Salaibe , Pinheiro Alan Bandeira
Published: November 2024

Este estudo teve por objetivo identificar as Práticas de Controle de Gestão utilizadas por empresas de pequeno porte em tempos de pandemia de Covid-19, um período de grande instabilidade econômica e desafios sem precedentes O contexto da pesquisa está inserido na crise sanitária global que afetou profundamente as operações empresariais, especialmente entre as pequenas empresas, que precisaram se adaptar rapidamente às novas condições do mercado. A pesquisa utilizou uma abordagem quali-quantitativa, analisando dados de 40 empresas de pequeno porte que participaram de Webworkshops sobre Controles de Gestão. Esses workshops ocorreram ao longo do período da pandemia, fornecendo insights tanto quantitativos quanto qualitativos sobre as práticas adotadas. Esses workshops ocorreram ao longo do período da pandemia, fornecendo insights tanto quantitativos quanto qualitativos sobre as práticas adotadas. Os resultados apontaram que as Práticas de Controle de Gestão mais utilizadas no período da crise sanitária foram: Melhoria Contínua de Produto, na categoria de Estratégia; Redes Sociais e WhatsApp, na categoria de Sistemas de Informações; Análises Financeira, na categoria de Desempenho; e Análise de Gestão dos Custos, para as categorias de Orçamento e Custos. As empresas que utilizam estas práticas apresentaram estabilidade quanto aos gastos e quantidade de colaboradores, aumento de investimento em novos produtos/serviços, além de serem empresas com modelo de gestão centralizado. Esta pesquisa é original, pois analisa a resposta de empresas pouco examinadas na literatura durante um período particular e oferece uma contribuição relevante ao entender como pequenas empresas podem se adaptar e sobreviver em cenários de crise.
AGRESSIVIDADE TRIBUTÁRIA: UMA REVISÃO SISTEMÁTICA DAS PESQUISAS BRASILEIRAS
Authors: Santos Bárbara Barcelos Monteiro , Santos Geovane Camilo dos , Ribeiro Cíntia De Melo de Albuquerque , Pinto Leonardo José Seixas
Published: November 2024

O objetivo deste estudo foi identificar os principais resultados e métricas de agressividade tributária em pesquisas brasileiras. Assim, realizou-se uma Revisão Sistemática da Literatura (RSL) na base SPELL, encontrando-se 36 estudos aderentes a pesquisa. Os resultados indicam predominância masculina nas publicações, sendo o autor mais prolífero é o professor Antonio Lopo Martinez, seguido por outros 7 autores com 2 publicações cada. A instituição de ensino que concentra a maior quantidade dos autores é a Fundação Instituto Capixaba de Pesquisa em Contabilidade, Economia e Finanças (FUCAPE). A principal métrica de agressividade tributária identificada foi Effective Tax Rate (ETR), presente em 28 estudos, seguida pela Book-Tax Differences (BTD) em 16 e ETR cash em 10. Percebe-se que há espaço para desenvolvimento de pesquisas relacionadas a temas recentes como Covid-19, indicadores Environmental, Social and Corporate (ESG) e reforma tributária. A principal contribuição deste estudo é evidenciar aos pesquisadores brasileiros na área de contabilidade e tributação, as principais métricas de agressividade tributária e sugerir caminhos para pesquisas futuras. O estudo também contribui evidenciando que algumas métricas tradicionais, como a ETR e BTD podem não ser as mais ideais para a análise da agressividade tributária no contexto brasileiro, pois a carga tributária tem predominância de tributos sobre o consumo.
Late Medieval Administration and Bookkeeping in The Crown of Aragon: Torralba’s Company
Authors: López Pérez María Dolores , Nassar Sari
Published: November 2024

The attempt to rebuild the socioeconomic reality of the fifteenth-century Crown of Aragon has brought us to all the companies once founded and managed by Joan de Torralba. Linking two main commercial cities of that time — Zaragoza and Barcelona with the forefront financial centres of those days - Italian cities, in particular, Venice, Pisa-Florence, and Genoa — set the company in a unique position. This paper studies two primary components of our business: corporate and financial management. This analysis intends to demonstrate the complexity of management in late medieval companies of the Crown of Aragon, alongside knowledge diffusion and the extent and significance of weaving networks. We have in mind to present how the administration was developing, giving the local colour and regional details, making much of the proper management and contacts through the Mediterranean, employing management and historical analysis. The results reveal that the companies in the Crown of Aragon benefited from their management approach. The position of merchant elites, with the example observed by Joan de Torralba as the executive, was prominent. Hence, the weight of the last centuries of the Middle Ages, considering the West Mediterranean area, was essential in the transition to build a modern-like economic space.
Data-driven complementary indices and metrics for assessing national progress on climate risk and adaptation
Authors: Serrano-Candela Fidel , Estrada Francisco , Raga Graciela , González Salazar Constantino
Published: November 2024

Climate change is a complex, multidimensional issue requiring decision-making and governance supported by extensive data from social and natural systems. Large cross-country datasets are available, and various methods are used to transform this data into information relevant for policy and decision-making. Summary indices provide insights into adaptation, mitigation, vulnerability, and risk, helping track countries’ climate-related ambitions and progress. However, many existing methods for constructing indices do not fully exploit the multivariate structures within the data, leading to potential redundancies and overlaps. We develop a set of complementary, non-overlapping indices using Principal Component Analysis to capture distinct dimensions of societal and climate interactions. These data-driven indices account for underlying data structures, ensuring each provides unique and independent insights. Our analysis includes harmonized country-level datasets, metrics relevant to loss and damage, public perceptions of climate change, and projections of economic damages. The application of these indices is illustrated with dissonance metrics that assess the alignment between a country’s adaptation capacities, societal concerns, and risks. The proposed approach for index construction can be valuable across various policy contexts and for informing climate-related strategies. An online tool is provided to visualize and access the results presented in this paper.
Diagnostic accuracy of a smartphone-based device (VistaView) for detection of diabetic retinopathy: A prospective study
Authors: Shahzad Rida , Mehmood Arshad , Shabbir Danish , Siddiqui M. A. Rehman
Published: November 2024

Background

Diabetic retinopathy (DR) is a leading cause of blindness globally. The gold standard for DR screening is stereoscopic colour fundus photography with tabletop cameras. VistaView is a novel smartphone-based retinal camera which offers mydriatic retinal imaging. This study compares the diagnostic accuracy of the smartphone-based VistaView camera compared to a traditional desk mounted fundus camera (Triton Topcon). We also compare the agreement between graders for DR screening between VistaView images and Topcon images.

Methodology

This prospective study took place between December 2021 and June 2022 in Pakistan. Consecutive diabetic patients were imaged following mydriasis using both VistaView and Topcon cameras at the same sitting. All images were graded independently by two graders based on the International Classification of Diabetic Retinopathy (ICDR) criteria. Individual grades were assigned for severity of DR and maculopathy in each image. Diagnostic accuracy was calculated using the Topcon camera as the gold standard. Agreement between graders for each device was calculated as intraclass correlation coefficient (ICC) (95% CI) and Cohen’s weighted kappa (k).

Principal findings

A total of 1428 images were available from 371 patients with both cameras. After excluding ungradable images, a total of 1231 images were graded. The sensitivity of VistaView for any DR was 69.9% (95% CI 62.2–76.6%) while the specificity was 92.9% (95% CI 89.9–95.1%), and PPV and NPV were 80.5% (95% CI 73–86.4%) and 88.1% (95% CI 84.5–90.9) respectively. The sensitivity of VistaView for RDR was 69.7% (95% CI 61.7–76.8%) while the specificity was 94.2% (95% CI 91.3–96.1%), and PPV and NPV were 81.5% (95% CI 73.6–87.6%) and 89.4% (95% CI 86–92%) respectively. The sensitivity for detecting maculopathy in VistaView was 71.2% (95% CI 62.8–78.4%), while the specificity was 86.4% (82.6–89.4%). The PPV and NPV of detecting maculopathy were 63% (95% CI 54.9–70.5%) and 90.1% (95% CI 86.8–92.9%) respectively. For VistaView, the ICC of DR grades was 78% (95% CI, 75–82%) between the two graders and that of maculopathy grades was 66% (95% CI, 59–71%). The Cohen’s kappa for retinopathy grades of VistaView images was 0.61 (95% CI, 0.55–0.67, p<0.001), while that for maculopathy grades was 0.49 (95% CI 0.42–0.57, p<0.001). For images from the Topcon desktop camera, the ICC of DR grades was 85% (95% CI, 83–87%), while that of maculopathy grades was 79% (95% CI, 75–82%). The Cohen’s kappa for retinopathy grades of Topcon images was 0.68 (95% CI, 0.63–0.74, p<0.001), while that for maculopathy grades was 0.65 (95% CI, 0.58–0.72, p<0.001).

Conclusion

The VistaView offers moderate diagnostic accuracy for DR screening and may be used as a screening tool in LMIC.
Analysis of spatio-temporal evolution and influencing factors of land dividends in China
Authors: Wang Yao , Ling Jiahui
Published: November 2024

This paper explores the classification, formation, measurement, evolution, and influencing factors of land dividends in China.It analyzes the nature of land value dividends and efficiency dividends, examines their spatio-temporal evolution, and investigates influencing factors via a regression model, providing insights for future development. The paper posits that changes in land use patterns primarily contribute to land value dividends, while efficiency dividends stem from improving land use efficiency within existing patterns. Presently, China is transitioning from a phase dominated by land value dividends to one marked by efficiency dividends. In terms of spatio-temporal dynamics, efficiency dividends display a fluctuating upward trajectory, whereas land value dividends and the overall quantity of land dividends demonstrate an initial ascent followed by a gradual decline, with the central region exhibiting the most pronounced changes. The analysis of influencing factors reveals a significant positive correlation between value dividends, the overall quantity of land dividends, and factors such as land transfer and capital investment, while efficiency dividends exhibit a significant positive correlation with urbanization. Consequently, the government should implement measures to sensibly regulate land quantity and layout, promote intensive and efficient land use, activate dormant land resources, and propel the optimization and high-quality development of land dividends.
Development of the Ward Nurses’ Perspective-taking of the Staff Receiving Discharged Patients Scale: An observational study of ward nurses
Authors: Tanaka Shingo , Saiki Masatoshi , Takemura Yukie
Published: November 2024

Introduction

Discharge planning involves coordinating between different care settings. Failed coordination can lead to delayed care at the facilities receiving discharged patients. Nurses who implement discharge planning must consider the circumstances of the staff receiving the discharged patients.

Objective

This study aims to develop a nurses’ perspective-taking scale for measuring the cognitive process of imagining a staff’s situation when receiving discharged patients.

Methods

An online survey was conducted from September to November 2021 with nurses in Japanese acute care hospitals, using a 20-item questionnaire based on interviews and a literature review. Item reduction was conducted based on inter-item correlations, item-total correlations, and exploratory factor analysis. Confirmatory factor analysis was performed. For the exploratory and confirmatory factor analysis, the samples were randomly split in half and tested. Cronbach’s alpha, intraclass correlation coefficients, and correlation coefficients were calculated using both self-developed and pre-existing measures.

Results

The questionnaire was distributed to 1,289 individuals, and 416 valid responses were obtained. Item reduction and exploratory factor analysis resulted in a 10-item scale with two subscales, “imagine-other” (six items), which is imagining the other person’s situation, and “imagine-self” (four items), which is imagining oneself in the other person’s situation. The goodness-of-fit indices were as follows: comparative fit index, 0.95; root mean square error of approximation, 0.08; and standardized root mean squared residual, 0.06. Correlation coefficients with existing scales were 0.38, 0.57, and -0.33. Cronbach’s alpha was 0.89, and the intraclass correlation coefficient was 0.54.

Conclusion

The newly developed scale proved to be reliable, valid, and suitable for use. This scale can measure the degree of perspective-taking by nurses, which can improve collaboration between facilities and the effectiveness of discharge planning.
Social health, activity behaviors, and quality of life among young adult cancer survivors: Protocol for a prospective observational study
Authors: Miller Kimberly A. , Kaslander Jonathan N. , Stal Julia , Belcher Britni R. , Cho Junhan , Freyer David R. , de la Haye Kayla , Milam Joel E. , Piombo Sarah E. , Cairns Maureen , Hewus Micaela , Marin Priscilla , In Gino K.
Published: November 2024

Approximately 85,000 adolescent and young adults (AYAs; age 15–39) are diagnosed with cancer in the United States annually. Experiencing a cancer diagnosis as an AYA can substantially impact social connections and social health. This paper describes the design and protocol of an observational study to prospectively assess social health and its association with physical activity and quality of life among AYAs after a cancer diagnosis. The study uses a longitudinal observational design to prospectively explore the relationships between social health and activity behaviors (physical activity and sedentary time) at four clinically significant timepoints over the course of 12 months among AYAs newly diagnosed with cancer. Patients are recruited at three hospitals and surveyed at each time period. Multiple dimensions of social health are assessed including social support, social roles, loneliness, social anxiety, and social networks. A wrist accelerometer is worn for one week at each assessment period. Change in social network structures will be analyzed using egocentric social network analysis. Structural equation models will be fitted to analyze the relationship between social constructs and physical activity. Findings from this study will address gaps in our understanding of the impact of a cancer diagnosis on multiple dimensions of social health for AYAs and the potential role social factors play in physical activity and quality of life. Understanding these processes will inform age-tailored interventions to improve health and quality of life outcomes for this at-risk population.
Mechanisms of rapid plant community change from the Miocene Succor Creek flora, Oregon and Idaho (USA)
Authors: Schiller Christopher M. , Lowe Alexander J. , Dillhoff Thomas A. , Fields Patrick F. , Riley Abigail M. , Taggart Ralph E. , Schmitz Mark D. , Strömberg Caroline A. E.
Published: November 2024

The fossil record of the U.S. Pacific Northwest preserves many Middle Miocene floras with potential for revealing long-term climate-vegetation dynamics during the Miocene Climatic Optimum. However, the possibility of strong, eccentricity-paced climate oscillations and concurrent, intense volcanism may obscure the signature of prevailing, long-term Miocene climate change. To test the hypothesis that volcanic disturbance drove Middle Miocene vegetation dynamics, high-resolution, stratigraphic pollen records and other paleobotanical data from nine localities of the Sucker Creek Formation were combined with sedimentological and geochemical evidence of disturbance within an updated chronostratigraphic framework based on new U-Pb zircon ages from tuffs. The new ages establish a refined, minimum temporal extent of the Sucker Creek Formation, ~15.8 to ~14.8 Ma, and greatly revise the local and regional chronostratigraphic correlations of its dispersed outcrop belt. Our paleoecological analysis at one ~15.52 Ma locality reveals two abrupt shifts in pollen spectra coinciding with the deposition of thick ash-flow tuffs, wherein vegetation dominated by Cupressaceae/Taxaceae, probably representing a Glyptostrobus oregonensis swamp, and upland conifers was supplanted by early-successional forests with abundant Alnus and Betula. Another ephemeral shift from Cupressaceae/Taxaceae swamp taxa in favor of upland conifers Pinus and Tsuga correlates with a shift from low-Ti shale to high-Ti claystone, suggesting a link between altered surface hydrology and vegetation. In total, three rapid vegetation shifts coincide with ash-flow tuffs and are attributed to volcanic disturbance. Longer-term variability between localities, spanning ~1 Myr of the Miocene Climatic Optimum, is chiefly attributed to eccentricity-paced climate change. Overall, Succor Creek plant associations changed frequently over ≤105 years timespans, reminiscent of Quaternary vegetation records. Succor Creek stratigraphic palynology suggests that numerous and extensive collection of stratigraphically controlled samples is necessary to understand broader vegetation trends through time.
Elevated plasma progranulin levels in the acute phase are correlated with recovery of left ventricular function in the chronic phase in patients with acute myocardial infarction
Authors: Minatoguchi Shingo , Satake Atsushi , Murase Hirotaka , Yoshizumi Ryo , Komaki Hisaaki , Baba Shinya , Yasuda Shinji , Ojio Shinsuke , Tanaka Toshiki , Okura Hiroyuki , Minatoguchi Shinya
Published: November 2024

Background

Progranulin is a secreted glycoprotein that regulates inflammation and wound healing. However, plasma progranulin levels in the acute phase and their clinical significance in patients with acute myocardial infarction (AMI) remain to be elucidated.

Objective

We aimed to investigate the relationship between the increase in plasma progranulin levels in the acute phase and the recovery of left ventricular function in the chronic phase in AMI patients.

Method and result

Eighteen AMI patients were followed up for 6 months. Blood samples were collected from the antecubital vein on day 0 (on admission) and day 7 in the acute phase. The control group consisted of patients without significant coronary artery stenosis, as assessed by cardiac catheterization (n = 16). Plasma progranulin levels were measured by enzyme-linked immunosorbent assay. Echocardiography was performed in the acute (within 7 days) and chronic (6 months) phases of AMI to evaluate left ventricular ejection fraction using the modified Simpson’s method. Plasma progranulin levels in the AMI group on day 0 (69.5 ± 24.6 ng/mL) were similar to those in the control group (84.2 ± 47.1 ng/mL). There was a significant increase in progranulin levels in the AMI group on day 7 (104.2 ± 52.0 ng/mL) compared with day 0. The increase in plasma progranulin levels in the acute phase was positively correlated with the increase in left ventricular ejection fraction between the acute and chronic phases. Among various factors, only plasma progranulin levels were favorably correlated with left ventricular functional recovery in the chronic phase.

Conclusion

The increase in plasma progranulin levels in the acute phase may serve as a predictive biomarker and a contributer for the recovery of left ventricular function in the chronic phase in patients with AMI.
A large-scale evaluation of therapeutic alliance and symptom trajectories of depression and anxiety in blended care therapy
Authors: Wu Monica S. , Wickham Robert E. , Chen Shih-Yin , Varra Alethea , Chen Connie , Lungu Anita
Published: November 2024

This study sought to conduct a large-scale examination (N = 14,951) into the associations between therapeutic alliance and anxiety and depression symptom trajectories within a blended care therapy (BCT) program. Clients receiving blended care services completed weekly outcome measures for anxiety and depression and therapeutic alliance ratings every other therapy session. Using a retrospective, pragmatic study design, latent change score (LCS) analysis captured individual differences in initial therapeutic alliance scores and change in alliance. The LCS variables were specified as predictors of a latent growth curve model describing changes in depression and anxiety symptoms over the course of treatment. Therapeutic alliance scores in the BCT program were generally strong (initial item average = 4.10) and improved over time. Higher initial therapeutic alliance scores and greater initial increases in alliance were associated with steeper declines in anxiety and depressive symptoms at the beginning of therapy. Higher therapeutic alliance (both initial scores and initial increases) was also associated with a deeper symptom trajectory over time, indicating lower anxiety and depressive symptoms overall, as well as sustained decreases in symptoms over time. These results highlight the clinical impact of the working relationship between the provider and the client.
Fasciculation potentials are related to the prognosis of amyotrophic lateral sclerosis
Authors: Ohnari Keiko , Mafune Kosuke , Adachi Hiroaki
Published: November 2024

Some prognostic biomarkers of amyotrophic lateral sclerosis (ALS) have been described; however, they are inadequate for satisfactorily predicting individual patient outcomes. Fasciculation potentials (FPs) on electromyography (EMG) are useful for the early diagnosis of ALS, and complex FPs are associated with shorter survival in ALS. In this study, we investigated the relationship between the proportion of muscles with FPs, biochemical markers, and the prognosis of ALS. 89 Patients with ALS were retrospectively classified into three groups based on the interval from onset to death or tracheostomy (less than 1 year: fast progression; from 1 year to less than 3 years: average progression; 3 years or more: slow progression). We performed statistical analysis of the electrophysiological findings, including the percentage of examined muscles with FPs, and biochemical markers evaluated on admission. Patients with fast ALS progression had a higher percentage of muscles with FPs (93.1% vs. 37.9%, P<0.001) and lower uric acid (UA) levels (male: 4.19 mg/dl vs 5.55 mg/dl, P<0.001; female: 3.71 mg/dl vs 5.41 mg/dl, P<0.001) than patients with slow progression. Survival curves demonstrated a relationship between these factors and the survival time in patients with ALS. Furthermore, UA levels were correlated with the percentage of muscles with FPs. Our electrophysiological findings suggest that ALS presents with multisystem neurological manifestations, and these manifestations differed among the groups classified by disease progression. The percentage of muscles with FPs on EMG and serum UA levels were especially associated with the prognosis of ALS.
Gender gap in faculty promotion
Authors: Czech Agata , Olarreaga Marcelo , Peila Olivia
Published: November 2024

We examine the gender gap in faculty promotion at the University of Geneva. After building a new measure of research quality that has no gender bias (i.e. men and women have, on average, the same level of research quality after we control for disciplines), we find that conditional on research quality, discipline and place where the PhD was obtained, women are 11 percent less likely to get promoted. The gender gap is almost three times larger for promotion from assistant to associate professor, suggesting that the mechanism at play is stronger for junior faculty. The gender gap is explained by the fact that an equal increase in research quality leads to a smaller increase in women’s probability of promotion.
Acupuncture for uremic pruritus: A systematic review and meta-analysis protocol
Authors: Gao Ning , Wang Lei , Wang Weiming , Guo Yufeng
Published: November 2024

Background

Uremic pruritus (UP) or chronic kidney disease-associated pruritus (CKD-aP) is one of the most intractable dermatologic symptom in patients with chronic kidney disease. Several randomized controlled trials (RCTs) have been conducted to investigate the antipruritic effects of acupuncture on UP/CKD-aP and suggested a significant therapeutic effect, while the evidence supporting the application of acupuncture is limited.

Objectives

This study will assess the efficacy and safety of acupuncture for patients with UP/CKD-aP.

Methods

Data Sources: RCTs will be searched in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, the Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, Wanfang Database, VIP Database, the WHO International Clinical Trials Registry Platform portal and www.ClinicalTrials.gov from inception to 31st August 2024. Study eligibility criteria: RCTs in English and Chinese conducted on UP/CKD-aP patients will be included. Participants: Adult patients diagnosed with UP/CKD-aP will be included. Interventions: All acupuncture interventions in the management of UP/CKD-aP will be included, compared with no treatment, placebo or sham acupuncture, or other treatment agents. Outcome measures: The primary outcome will be the change in the severity of itching evaluated by validated scales. Study appraisal and svnthesis methods: If necessary, a meta-analysis will be performed for the pooled therapeutic effect by Review Manager 5.3, or a qualitative descriptive analysis will be presented. The data will be transformed into the risk ratio (RR) for binary data and the mean difference (MD) or standardized MD for continuous data for analysis.

Results

This review will update evidence of RCTs evaluating acupuncture for UP/CKD-aP.

Limitations

Anticipated challenges contain the methodological and clinical heterogeneity in terms of evaluation tools and acupuncture interventions within included studies.

Conclusion and implications

It will benefit patients and impact health-care decision-making regarding the models of care that are feasible for patients.

Trial registration

PROSPERO CRD42021257001.
Predictors of neonatal hypothermia within six hours of birth and exploring preventive practices among post-natal mothers in Kilimanjaro region: Explanatory sequential mixed method protocol
Authors: Daniel Emmanuel , Seif Saada A. , Millanzi Walter C.
Published: November 2024

Background

Neonatal hypothermia is a worldwide problem that can lead to a high impact on neonatal health outcomes if appropriate thermal care measures are not implemented. Tackling neonatal hypothermia from the time of delivery with appropriate thermal care measures will increase neonatal survival and decrease complications related to hypothermia.

Objective

The study aims to determine the predictors of neonatal hypothermia within six hours of birth and explore its preventive practices among postnatal mothers.

Methods

This is a mixed-method sequential explanatory study. The first phase will be a quantitative study with a hospital-based analytical cross-sectional design. 325 neonates and their mothers will be randomly selected through a 4-stage sampling technique. The data will be collected using a structured questionnaire, checklist and documentary review. Descriptive and inferential statistics will be used to analyse the data. The second phase will be a descriptive qualitative study involving postnatal mothers who participated in a quantitative study. The data will be collected via in-depth interviews, and thematic analysis will be used to analyse the data. The findings of quantitative and qualitative studies will be triangulated in the discussion.

Discussion

This study will provide a wide understanding of neonatal hypothermia in the region which will help healthcare providers who are caring for neonates to be informed about the current situation, evaluate the care they provide, and find the best way to adhere to thermal care measures. Moreover, the practices of postnatal mothers will be known, which will help to develop tailored interactions to address this problem.
Consistency between inter-institutional panels using a three-level Angoff-standard setting in licensure tests of foreign-trained dentists in Sweden: A cohort study
Authors: Dalum Jesper , Paulsson Liselotte , Christidis Nikolaos , Andersson Franko Mikael , Karlgren Klas , Leanderson Charlotte , Sandborgh-Englund Gunilla
Published: November 2024

Licensure exams play a crucial role in ensuring the competence of individuals entering a profession, thereby safeguarding the public and maintaining the quality and integrity of the profession. In Sweden, dentists educated outside the European Union seeking to practise dentistry must undergoa re-certification process. The re-certification process includes a theoretical examination where pass marks are set using a three-level Angoff method. This study aimed to determine the consistency of the Angoff ratings using independent panels at two Swedish universities. Two cohorts of panellists were included in the study: one reference and one external. The reference panel was responsible for rating the upcoming theoretical examinations in the proficiency test, which were used to set the pass mark. The external panel, recruited from a dental school at a university in another region in Sweden, provided ratings after the examinations. Three examinations during 2019–2020 were included in this study (267 items in total). There was a strong correlation (ρ ≥ 0.70, p < .001) between the ratings of the two independent panels, with no significant differences in item ratings across the full exams, dental disciplines, and professional qualifications analysed. This suggests that the three-level Angoff method reliably produces similar standards for assessing the competence of the minimally qualified dentist across different institutions. The expectations of the minimally qualified but still acceptable dentist were comparable between the two independent panels across the three theoretical examinations explored. The alignment between the panels indicates valid, reliable standards across institutions, despite the independent syllabi of the two study programmes. However, while there is an alignment, differences in ratings remain. Consequently, involving multiple institutions in future standard-setting processes could help ensure that the standards reflect a broader range of educational practices, supporting the credibility of licensure examinations.