bluuebunny/crossref_metadata_2025 huggingface dataset:
Bridging the Gap: Reducing Health Inequities in Access to Preventive Health Care Services in Rural Communities in the Philippines
Authors: Serafica Reimund , Reyes Andrew T. , Cacciata Marysol C. , Kawi Jennifer , Leyva Erwin William A. , Sy Francisco S. , Evangelista Lorraine S.
Published: August 2024

Introduction:

We used an implementation science framework to investigate perceived health inequities in preventive health care initiatives in rural communities in the Philippines. We also identified health equity–focused quality improvement strategies.

Methods:

Three health care providers and 12 barangay clinic patients were interviewed.

Results:

Patient interviews showed that social determinants of health, respect, and attitudes toward health care providers affected patient empowerment to engage in self-management for noncommunicable diseases (NCDs). Health care providers identified six challenges in managing NCDs: (a) inefficient work processes; (b) staffing shortages; (c) insufficient access to low-cost medications; (d) inadequate primary preventive health education from the schools; (e) health care not considered a priority; and (f) lack of local government support.

Discussion:

Inadequate preventive health care and education intensify health access and resource inequities in rural communities in the Philippines. A multi-sectoral plan may improve rural health infrastructure and education toward improving health care access and decreasing care disparities.
Professional Education or Certificate: The Factors Influencing Child Maltreatment Recognition in China
Authors: Tan Zimin , Wang Ruonan , Lian Bin
Published: August 2024

Purpose: This study examines the influences of social work education and social work certificates on the recognition of child maltreatment and its subtypes among social workers in contemporary China. Method: Data from 3,032 child social workers in the 2019 Chinese Social Work Longitudinal Study were analyzed using t-tests, ANOVA, Pearson correlations, and multiple regression models. Results: Social work education showed no significant association with child maltreatment recognition. Individuals with assistant-level or associate-level professional certificates demonstrated higher levels of recognition of child maltreatment and certain subtypes, including emotional abuse and neglect. Conclusions: Compared to the extensive coverage of child protection in certificate exams that reflects practical needs and policy changes, an overall lack of child social work content in degree programs could lead to long-term consequences on child protection practices and calls for a practice-oriented reorganization of social work degree curricula.
A Scoping Review of the Impact of the COVID-19 Pandemic on Family Wellbeing in Africa
Authors: Chigeza Shingairai , Wilson Fadiji Angelina , Matamela Nyambeni
Published: August 2024

Despite the immense interruptions to relationships and family life during the COVID-19 pandemic, only a few studies explicitly focused on family wellbeing. Therefore, the present study aimed to synthesize current evidence in the African context to provide a state-of-the-art representation of the pandemic's impact on family wellbeing. Using a scoping review, 22 articles on the impact of the COVID-19 pandemic on family wellbeing in Africa were analysed. The results of the study showed a diverse and immense impact of the pandemic on family wellbeing. We noted that there were few studies on this topic and that wellbeing outcomes were measured from a deficit perspective rather than as a positive state of being. The theme of stigma was more pronounced in Western Africa, whereas domestic violence was linked more to Southern African contexts. Furthermore, the economic impact of the pandemic was emphasized in Eastern and Southern African countries than in Ghana and Nigeria in Western Africa. In line with the recommendations from the articles reviewed, a multifaceted policy response is needed to protect family wellbeing. Such interventions need to focus on family functioning, happiness and social wellbeing, and not just reactive and preventative approaches, to promote wellbeing.
Evaluating the Impact of Nurse-led Geriatric Homecare Interventions: A Systematic Review of Randomized Controlled Trials
Authors: Pendet Ni Made Diah Pusparini , Januraga Pande Putu , Wijanadi M. Candra , Gautama Made Satya Nugraha
Published: August 2024

Nurse-led interventions have gained prominence as a promising approach for geriatric care, yet the existing evidence base remains limited. This systematic review aimed to evaluate the impact of nurse-led home care interventions on health outcomes. Adhering to the PRISMA guidelines, we conducted a comprehensive search of PubMed, ScienceDirect, Scopus, ProQuest, and Embase databases from their inception until April 2024. A narrative synthesis was used. Following the screening of 901 studies derived across five electronic databases, nine trials were analyzed in this review. The interventions showed mixed results on quality of life, with significant improvements in some studies but not others. Physical health and performance generally improved, with fewer falls and better functional status in the intervention groups. Mental health outcomes were also mixed. Caregiver burden did not significantly change overall, but some aspects, such as isolation, improved. Hospitalization rates did not significantly differ between groups in most studies, but emergency department visits were lower in the intervention groups. Mortality rates were also similar between groups, but more patients in the intervention groups died at home. Despite the diversity in approaches, nurses played an active and comprehensive role in all programs. These findings highlight the adaptability and flexibility of nurse-led interventions. Further research is needed to refine these interventions, identify their most effective components, and understand how they can be tailored to meet the unique needs of older adults and their caregivers.
Study on the residual stress of simple cubic lattice structure produced by selective laser melting
Authors: Zhao Hongjian , Yang Binghua , Zhang Rui , Tian Yuxuan , Liu Changsheng , Zhan Yu
Published: August 2024

Lattice structures become the focus for scholars to research due to its unique lightweight, high impact resistance and ideal noise reduction. Selective laser melting has become a very effective and convenient method for preparing lattice structures of excellent quality. However, it is imperative to acknowledge that rapid heating and cooling processes inherent to the method can generate excessive residual stresses within the lattice structures, thereby significantly compromising their mechanical properties. To address this issue, the present study seeks to elucidate the patterns and characteristics of distribution of residual stresses and deformations within simple cubic lattice structures, employing a combination of experimental techniques and finite element analysis. The fabrication of these simple cubic lattice structures is accomplished through selective laser melting. The investigation encompasses both two methods, involving X-ray measurements at discrete points on the structure, and finite element simulations to depict the overall stress distribution. The results show that the residual stress and deformation are more likely concentrated on the initial surface to be processed, and residual stress on the substrates is bigger than that on bars. Specifically, the biggest stress concentrates on the Z-bars, up to 1393 MPa. However, in terms of the overall state of stress distribution in the structure, the residual stress on the substrate is slightly higher than that on the lattice structure.
Sovereignty cubed: The Arctic as a territorial and ontological volume
Authors: Wood-Donnelly Corine
Published: August 2024

State sovereignty over space has traditionally been viewed as confined to a bounded land area. However, scholarship in critical cartography, political, and social theory shows this understanding to be flawed. This perspective not only limits understandings of sovereignty density, but also weakens our understanding of the limits of the state. This is particularly evident in the Arctic, where sovereignty discourse often fails to address the complexities of space in connection with authority and legitimacy for decision-making in the region. This article first critically examines Arctic sovereignty, challenging the notion of sovereignty as merely a horizontal area with land or sea boundaries. Instead, it argues that Arctic geopolitics and governance are better understood when sovereignty is considered as a scalar concept encompassing a territorial volume. Second, it contextualises the processes involved in the legitimisation of sovereignty and governance practices across the Arctic, framing this as ontological sovereignty. The article contends that Arctic sovereignty and governance are more comprehensively understood by shifting from a strictly material perspective to an ontological framing, which encompasses control over the nature and existence of Arctic spaces, with implications for future development and understandings of Arctic governance.
Investigation of flexural performance of concrete beams with nonwoven/polymer composites versus steel-rebar reinforcement
Authors: El Messiry Magdi , Elmor Marwa
Published: August 2024

The research investigates the unique characteristics and benefits of using nonwoven fabrics and polymer I cross-section composites in concrete beams. These materials show improved strength, flexibility, and corrosion resistance compared to conventional steel-reinforced beams, offering promising solutions for various construction applications. This study constructed an I-beam structure using a nonwoven polyester fabric/polyester composite cast in a concrete beam. Other designs included woven carbon fabric or Kevlar nonwoven fabric applied to the bottom flange of the I-beam for reinforcement. The flexural behavior of an I-beam polyester nonwoven/polyester composite with Kevlar or carbon-reinforced concrete beams was examined. The comparison between the different samples indicates that: flexural strength: the carbon sheet-reinforced sample exhibits the highest flexural strength, followed by the steel rebar and Kevlar-reinforced samples. The ductility: The steel rebar-reinforced sample shows the highest ductility, indicating better deformation capacity before failure. Carbon sheet reinforcement also provides substantial ductility. Bending stiffness: The highest bending stiffness is observed in the Kevlar-reinforced sample, suggesting a stiffer and less flexible beam. These observations highlight the trade-offs between stiffness, strength, and ductility in reinforced concrete beams. The reinforcement material choice depends on the application-specific requirements, such as the need for higher bending strength, better flexibility, or greater stiffness.
Evaluation of the Effect of Radiosurgery for Target and Non-Target Lesions in Patients with Brain Metastases Using RANO-BM Criteria
Authors: Popov Veselin , Raycheva Gabriela , Graklanov Vasko , Uchikov Petar , Grudeva-Popova Zhanet
Published: August 2024

Objectives

The current therapeutic indications of radiosurgery are constantly expanding. Magnetic resonance imaging (MRI) has an important role in the diagnostic and post-therapeutic period of primary and secondary brain tumor formations.

Methods

A total of 66 patients with verified cancer disease and brain metastases were separated into two groups. The first group includes 34 patients with primary non-small cell lung cancer and the second one 32 patients with other types of primary cancer. All of them received high-dose radiotherapy in 1–5 fractions. The number, size, and location of the treated lesions responded to robotic stereotactic radiosurgery criteria. The Response Assessment Criteria for Brain Metastases (RANO-BM) is an international multidisciplinary group of experts who developed acceptable criteria for assessing brain metastases. Before treatment and on the first, third, sixth month after radiosurgery, a MRI and blood tests were performed.

Results

Treated lesions were separated into four groups depending on the results – complete response, partial response, progressive disease, and stable disease. In both groups of patients, the percentage of complete or partial response had increased in the third and sixth months.

Conclusion

The results give us a reason not to recommend an MRI 1 month after treatment if the patient doesn't have any new neurological symptoms, because there may be a pseudo-progression. MRI results valued by RANO-BM criteria give us a good option to evaluate brain metastases on the third and sixth month after after stereotactic radiosurgery.
Rare neurovascular variants that you probably have not seen before
Authors: Abdalkader Mohamad , Hanz Samuel Z , Raz Eytan , Zedde Marialuisa , Hu Wei , Pascarella Rosario , Qiu Zhongming , Kikano Raghid , Nguyen Thanh N
Published: August 2024

Background

Recognition of neurovascular variants is crucial for safe endovascular and neurosurgical interventions. We aim to review and highlight various uncommon neurovascular variants and anomalies with a discussion of their relevant embryology and pathology.

Methods

A retrospective review of a prospectively maintained neurovascular database was performed to identify uncommon neurovascular variants and anomalies. A pictorial review of these neurovascular findings is provided along with relevant embryological development, clinical significance, and potential pathological associations.

Results

A pictorial review of selected neurovascular variants and anomalies is presented. These entities, divided between intra- and extra-cranial findings, include infra-optic origin of the anterior cerebral artery, meningo-ophtalmic artery, duplicated posterior cerebral artery, duplicate middle cerebral artery (MCA), MCA fenestration, twig-like MCA, pure arterial malformation, corkscrew basilar artery, persistent hypoglossal artery, persistent trigeminal artery and its variants, direct branches from the common carotid and cervical internal carotid arteries (ICA) (ascending pharyngeal artery from the ICA, thyroidal arteries from the CCA/brachiocephalic, arteria thyroidea ima), and extra-cranial carotid fenestration. The angiographic findings of these entities are presented with relevant 3D reconstruction and multimodal cross-sectional imaging correlation when available.

Conclusions

This pictorial review highlights uncommon neurovascular variants and anomalies that neuroradiologists, interventionalists, and neurosurgeons should be aware of for accurate diagnosis and safe interventions.
Numerical study on the efficiency of an electrostatic precipitator having the shape of a truncated cone
Authors: Nejma Chahine , Ben Abdelmlek Khaoula , Ben Nejma Fayçal
Published: August 2024

This paper presents a comprehensive numerical study of a truncated conical precipitator. The main objective was to enhance the efficiency of the precipitator by exploring the influence of several parameters on particle trajectories and the evolution of the collection efficiency. The studied parameters include the cone coefficient ( D), flow velocity, applied voltage, conduit diameter and length, as well as relative permeability. For each parameter, analyses were conducted on the evolution of the collection efficiency for particles with various diameters, ranging from 0.01 to 10 μm. The results obtained from the numerical simulation on COMSOL Multiphysics® indicate that, regardless of the value of D, the precipitator exhibits optimal efficiency in collecting particles with extreme diameters (0.01 and 10 μm) due to the dominance of the electrical force. In contrast, particles with intermediate diameters (0.1–1 μm) present a challenge, as the drag and electric forces are too weak to ensure effective particle collection. The study highlights that a sharper tip at the top of the precipitator significantly enhances its efficiency. Increasing the applied voltage and selecting lower inner radii of the collecting electrode reinforce the electrical force and enhance particle collection. Furthermore, increasing the height of the precipitator directs particle trajectories more effectively toward the collecting electrode. The results provide valuable insights for the design of more efficient precipitators and propose practical guidelines for improving their effectiveness. These contributions are particularly important for air pollution control technologies, offering significant advancements in this field.
Managing cardiovascular risk factors with telemedicine in primary care: A systematic review and meta-analysis of patients with arterial hypertension and type 2 diabetes
Authors: Mihevc Matic , Virtič Potočnik Tina , Zavrnik Črt , Klemenc-Ketiš Zalika , Poplas Susič Antonija , Petek Šter Marija
Published: August 2024

Objectives

To review the effect of telemedicine interventions on cardiovascular risk factors control in people with arterial hypertension (AH), type 2 diabetes (T2D), or both in primary care.

Methods

We conducted a systematic review in February 2024 using PubMed/MEDLINE, Cochrane Library, and EMBASE databases. We included randomised controlled trials from 2010 onwards, lasting ≥3 months, comparing telemedicine to standard care for managing cardiovascular risk factors in adults with AH, T2D, or both.

Results

Among 1803 records, 54 were included. Telemonitoring with teleconsultations showed the best outcomes. For AH, systolic blood pressure decreased by −5.63 mmHg (95% CI −9.13 to −2.13) at 6 months and −5.59 mmHg (95% CI −10.03 to −1.14) at 12 months compared to standard care. For T2D, HbA1c decreased by −0.45% (95% CI −0.90 to 0.00) at 6 months and −0.18% (95% CI −0.41 to 0.05) at 12 months compared to standard care. Blood glucose self-monitoring was as effective as telemonitoring for T2D at 6 months. The effect on diastolic blood pressure, low-density lipoprotein, triglycerides, and body mass index was non-significant.

Discussion

Telemedicine offers short-term benefits but lacks long-term effectiveness. Optimal outcomes require a combined telemedicine approach, health education co-intervention, ≥12-month follow-up, and careful patient selection.
Agent regret and the moral responsibility for the misuse of research results
Authors: Heinrichs Jan-Hendrik , Ergin Aslan Serap
Published: August 2024

An increasing number of research fields must expect that their projects will be classified as susceptible to misuse or otherwise security relevant, even if the reasons or criteria for this classification have not yet been uniformly developed. Research institutions will commonly distribute the obligation to predict and prevent misuse across multiple members and structures including ethics committees. However, cases of misuse occur even in spite of these precautions, raising the question of the type and distribution of responsibility for the resulting harm. This question becomes even more pressing if research ethics committees in their decisions ask researchers to provide a misuse- specific risk assessment or risk mitigation plan and thereby shift back a part of their responsibility on the researchers. While this kind of requirement may be considered as unsatisfactory by researchers, members of research ethics committees or boards and third-party funders, will argue that it fulfils two important functions. On the one hand, it makes use of the best available source for misuse risk-assessment available to most committees; on the other hand, it guarantees that the researchers at least try to take responsibility. If researchers, committee members and others involved discharge their obligation to predict and mitigate misuse risks with due diligence, any backward-looking responsibility they retain is to show agent regret for the results of their work having been misused.
Are occupational therapists in hand therapy working in an occupation-centered way? A cross sectional survey
Authors: Ransby Thea Birch , Jacobsen Nicolaj Schøler , Hansen Alice Ørts
Published: August 2024

Introduction

The dominance of the biomedical approach has previously caused a limited focus on occupation within hand therapy. This study aimed to investigate the rehabilitation offered to patients with a hand-related disorder (HRD) in Denmark including to determine the extent to which occupation-focused and/or occupation-based assessments and interventions are used and to identify barriers against their use.

Methods

A cross-sectional survey with 45 questions was conducted among members of the Danish Association for Hand Therapy. Data were analysed with descriptive statistics. Categorical variables were reported with frequency and percentage, and continuous variables with average and standard deviation.

Results

One hundred and six occupational therapists working as hand therapists ( n = 106) completed the survey. They reported common use of assessments measuring range of motion, pain, edema, and occupational performance. Occupational performance was assessed by non-standardized occupation-focused assessments, such as informal conversations. Exercise, pain management, and occupation-focused informal conversations were reported as the most frequently used interventions. Out of 82 respondents, 74 (91.4%) reported that they used interventions focused on body function and structures to the extent they wanted. Only 41 (50.0%) used occupation-focused or occupation-based interventions to the extent they wanted.

Discussion

Assessments and interventions reporting body function and structure were used most frequently whereas assessments and interventions reporting activity and participation were used to a lesser extent. Occupation-focused assessments and interventions were used more commonly than occupation-based. Hand therapists considered occupation-based assessments and interventions to be important in rehabilitation after HRD, despite using them with few patients. Several barriers were reported regarding the implementation of an occupation-centered approach: habit, workload, time constraints, and setting.
Achondroplasia: Current concept of orthopaedic management
Authors: Mindler Gabriel T , Stauffer Alexandra , Chiari Catharina , Mladenov Kiril , Horn Joachim
Published: August 2024

Achondroplasia, the most common form of inherited disproportionate short stature, is caused by mutations in the fibroblast growth factor receptor 3 gene. The typical clinical features of achondroplasia include short stature, rhizomelic disproportion, joint hyperlaxity, spinal deformity and deformity of the upper and lower limbs. The latter are among the challenges of state-of-the-art orthopaedic treatment plans and significantly contribute to the burden of the disease in individuals with achondroplasia. Multidisciplinary preoperative individual decision-making concerning surgical interventions should be considered. New medical treatments for achondroplasia have been developed and (some) have been approved for clinical use in several countries. While the number of research articles on achondroplasia is increasing rapidly, many unknown or controversial orthopaedic topics remain. Furthermore, in view of new medical developments with improvements in growth and potentially other effects, the timing and algorithms of orthopaedic treatments (e.g. guided growth, limb lengthening and deformity correction) need to be re-evaluated. While standing height is the primary research focus in medical therapy, it is crucial to comprehensively assess orthopaedic parameters in this multifactorial disease. The current treatment of patients with achondroplasia requires specialised multidisciplinary centres with transitional care and individual orthopaedic counselling.
When Avoidance Backfires: Interracial Officer-Citizen Dyads and the Consequences for Fleeing Suspects
Authors: Flexon Jamie L. , D’Alessio Stewart J. , Stolzenberg Lisa
Published: August 2024

Research suggests that Black citizens who experience an elevated fear of law enforcement frequently engage in avoidance strategies, such as fleeing, when confronted by police. There is also strong reason to speculate that this avoidance behavior commonly transpires when the police officer is White. Problematically, this avoidance strategy may place these citizens at an increased risk for officer use of force as the police seek to subdue fleeing suspects. The current study uses data drawn from the Evaluation of Less-Lethal Technologies on Police Use-of-Force project and a series of logistic regression equations and mediation analysis to determine whether Black suspects are more apt to flee from White police officers than other officer-suspect racial dyads and, because of this fleeing behavior, have a greater likelihood of experiencing force. After controlling for a variety of salient factors, results indicate support for this scenario. Policy implications are discussed.

Plain language title

When Avoidance Backfires: Mixed-Race Officer-Citizen Contacts and What Happens When Suspects Run From Police
Comparison of Patient-Reported Outcomes for Immediate Unrestricted Weightbearing Versus Restricted Rehabilitation Protocols After Osteochondral Allograft Transplantation to the Distal Femur
Authors: Prigmore Brian , Haneberg Erik , Elias Tristan , Wiedrick Jack , Ballin Jessica , Cole Brian J. , Yanke Adam B. , Crawford Dennis C.
Published: August 2024

Background:

There is no standardized rehabilitation protocol after osteochondral allograft (OCA) transplantation surgery to the distal femur. The spectrum of recommendations includes restrictions to toe-touch weightbearing (TTWB) for 6 weeks and immediate weightbearing as tolerated (WBAT).

Purpose/Hypothesis:

The purpose of this study was to compare outcomes for immediate unrestricted WBAT to restricted TTWB after OCA transplantation to the distal femur. It was hypothesized that the immediate WBAT protocol would be noninferior to delayed, restricted TTWB.

Study Design:

Retrospective cohort study.

Methods:

A total of 74 patients who underwent press-fit, dowel technique OCA transplantation to the femoral condyle(s) for contained (International Cartilage Repair Society grade 3-4) lesions were identified in the Metrics of Osteochondral Allograft multicenter database: 36 patients (18 women/18 men) who were prescribed TTWB were allocated to the control cohort and 38 patients (21 women/17 men) who were prescribed WBAT were allocated to the test cohort. Baseline characteristics were similar except for larger grafts in test patients (3.4 vs 2.7 cm2; P = .004) and higher body mass index (BMI) in control patients (27.8 vs 24.9 kg/m2; P = .01). Failure rates, final patient-reported outcome (PRO) scores, and PRO score changes from baseline were compared between the cohorts. Multiple regression was used to control for potential confounders and investigate noninferiority using minimal clinically important differences (MCIDs).

Results:

The mean follow-up was 2 years (range, 1-5 years) in both cohorts. Both cohorts showed significant improvement in all PRO scores, with no significant between-group differences in failure rates, final PRO scores, or PRO changes from baseline. There were 3 cases of failure in each cohort (control cohort: allograft revision [n = 2], debridement [n = 1]; test cohort: chondroplasty [n = 2], conversion to total knee arthroplasty [n = 1]). Regression analysis showed that adjusted differences in final PRO scores based on weightbearing protocol were minor and less than MCIDs when controlling for age, sex, graft size, BMI, and allograft location. Analysis of the MCIDs with respect to the lower bounds of the confidence intervals indicated that WBAT was noninferior to TTWB with a reasonable degree of confidence (range, 84.1%-99.9% confidence).

Conclusion:

Results indicated that immediate unrestricted WBAT after OCA transplantation to the distal femur was equally safe and effective compared to restricted TTWB.
“A Future for White Children”: Examining Family Ideologies of White Extremist Groups at the Intersection of Race and Gender
Authors: Johnson Katherine , Ebert Kim
Published: August 2024

Many White Americans believe that racism, racial violence, and hate groups are relics of the past, and yet we have witnessed the resurgence of White extremist groups and overt racism in recent years. This resurgence requires an examination of White extremist ideologies, particularly as they center traditional family values in justifying their extremism. In this study, we utilize a content analysis of the websites of six White extremist organizations to examine ideologies surrounding the family at the intersection of race and gender. Furthermore, we question why these ideologies take shape as they do and the potential implications of espousing family values with a rise in White extremism. Our study addresses the gender gap in existing White extremist research and highlights the need for an intersectional approach in understanding how ideologies differ between a White extremist group specifically for women and those under the leadership of men.
The Benefit of Hearing Aids as Measured by Listening Accuracy, Subjective Listening Effort, and Functional Near Infrared Spectroscopy
Authors: Vaisberg Jonathan M. , Gilmore Sean , Qian Jinyu , Russo Frank A.
Published: August 2024

There is broad consensus that listening effort is an important outcome for measuring hearing performance. However, there remains debate on the best ways to measure listening effort. This study sought to measure neural correlates of listening effort using functional near-infrared spectroscopy (fNIRS) in experienced adult hearing aid users. The study evaluated impacts of amplification and signal-to-noise ratio (SNR) on cerebral blood oxygenation, with the expectation that easier listening conditions would be associated with less oxygenation in the prefrontal cortex. Thirty experienced adult hearing aid users repeated sentence-final words from low-context Revised Speech Perception in Noise Test sentences. Participants repeated words at a hard SNR (individual SNR-50) or easy SNR (individual SNR-50 + 10 dB), while wearing hearing aids fit to prescriptive targets or without wearing hearing aids. In addition to assessing listening accuracy and subjective listening effort, prefrontal blood oxygenation was measured using fNIRS. As expected, easier listening conditions (i.e., easy SNR, with hearing aids) led to better listening accuracy, lower subjective listening effort, and lower oxygenation across the entire prefrontal cortex compared to harder listening conditions. Listening accuracy and subjective listening effort were also significant predictors of oxygenation.
Risk Factors Associated With Drug-Related Side Effects in Children: A Scoping Review
Authors: Toni Esmaeel , Ayatollahi Haleh , Abbaszadeh Reza , Fotuhi Siahpirani Alireza
Published: August 2024

Objective. Children’s vulnerability to drug-related side effects has been highlighted in several studies. However, there is no consensus on the risk factors associated with these side effects. This study aimed to investigate risk factors associated with drug-related side effects in children. Methods. This scoping review was conducted across multiple databases. The search strategy was created with a focus on drug-related side effects, as they are more predictable based on the pre-determined risk factors. Data were collected, and reported narratively. Results. The demographic, health, hospital, and drug-related risk factors may cause drug-related side effects in children. Among them, low age, sex, polypharmacy, length of hospitalization, and medications used for comorbidities may increase the risk. Conclusion. While most of the risk factors might be similar in adults and children, their impact might be different in these 2 groups. Therefore, future studies should identify more details about the impact of the risk factors in children.
Incidental Finding of Arteria Lusoria
Authors: Faraj Chaymae , Essetti Sara , Maslouhi Kaoutar , Allali Nazik , El haddad Siham , Chat Latifa
Published: August 2024

The arteria lusoria or retroesophageal right subclavian artery is the most common malformation of the aortic arch. It may be discovered with some symptoms of airway and/or esophageal compression, such as dyspnea or dysphagia, but in most cases it is an asymptomatic pathology. We report a case of a 3 months old patient diagnosed with Down syndrome who was admitted for pulmonary infection with incidental finding of retrooesophageal right subclavian artery.
A Cross-Sectional Study of Patient Satisfaction Among Immigrants in the Pediatric Outpatient Clinic of Firoozabadi Hospital
Authors: Moslemi Arimi Elahe , Solhi Mahnaz , Eghdami Shayan , Kharghani Moghadam Seyedeh Melika , Mohammadi Mohammad , Fathi Mehrab , Kachuei Maryam
Published: August 2024

Patient satisfaction is important in healthcare as it affects the quality of care and can lower costs in hospitals. This study aimed to measure immigrant satisfaction with outpatient services at Firoozabadi Hospital's pediatric clinic. Data were collected from immigrant patients from January to July 2023. The Patient Satisfaction Questionnaire 18 and the personal information checklist were used in oral interviews with caregivers. The overall satisfaction score was 72.95 out of 90, with a standard deviation of 12.57. Financial issues received the lowest satisfaction scores, while interpersonal manner received the highest ratings. Out of the 241 respondents, 48.6% were completely satisfied, 32.7% were satisfied, 10.6% had no opinion, and 4.4% expressed dissatisfaction. Satisfaction levels were not correlated with income, education, possession of identification documents or health insurance, and length of stay in Iran. Overall, most participants were happy with the outpatient services, but many lacked health insurance. Providing easier access to health insurance for immigrants could help reduce dissatisfaction with expensive medical bills.
Getting to Grips with the Oxysterol-Binding Protein Family – a Forty Year Perspective
Authors: Olkkonen Vesa M. , Ikonen Elina
Published: August 2024

This review discusses how research around the oxysterol-binding protein family has evolved. We briefly summarize how this protein family, designated OSBP-related (ORP) or OSBP-like (OSBPL) proteins, was discovered, how protein domains highly conserved among family members between taxa paved the way for understanding their mechanisms of action, and how insights into protein structural and functional features help to understand their versatility as lipid transporters. We also discuss questions and future avenues of research opened by these findings. The investigations on oxysterol-binding protein family serve as a real-life example of the notion that science often advances as a collective effort of multiple lines of enquiry, including serendipitous routes. While original articles invariably explain the motivation of the research undertaken in rational terms, the actual paths to findings may be less intentional. Fortunately, this does not reduce the impact of the discoveries made. Besides hopefully providing a useful account of ORP family proteins, we aim to convey this message.
Childbearing Women’s Experiences of and Interactions With the Health System in Vietnam: A Critical Interpretive Synthesis
Authors: Lakin Kimberly , Huong Nguyen Thu , Kane Sumit
Published: August 2024

Scholars have long argued that the care experience is shaped by context, and by evolutions in this context. Using Vietnam as a case, we critically interrogate the literature on women’s experiences with maternity care to unpack whether and if it engages with the major social, economic, and health system impacts of the Doi Moi reforms in Vietnam and with what consequences for equity. We conducted a critical interpretive synthesis of this literature in light of the social, economic, and health system transformations driven by the Doi Moi reforms. We offer three critiques: (1) an overwhelming focus on public maternity care provision in rural/mountainous regions of Vietnam, (2) a narrow focus on women’s ethnic identity, and (3) a misplaced preoccupation with women’s limited autonomy and agency. We argue that future research needs to consider the impact of Vietnam’s shift towards market-oriented care provision, and the broader societal and health system changes impacting both rural and urban areas, as well as ethnic minority and Kinh majority populations.
How I treat acute venous thromboembolism in patients with brain tumors
Authors: Leader Avi , Wilcox Jessica A. , Zwicker Jeffrey I.
Published: August 2024

Venous thromboembolism (VTE) is a common complication in patients with brain tumors. The management of acute VTE is particularly challenging due to an elevated risk of intracranial hemorrhage (ICH). Risk of developing ICH on anticoagulation is influenced by a number of factors including tumor type, recent surgery, concomitant medications, platelet counts, and radiographic features. In patients with a heightened risk for ICH, the benefits of anticoagulation need to be balanced against a likelihood of developing major hemorrhagic complications. Management decisions include whether to administer anticoagulation, at what dose, placement of an inferior vena cava filter, monitoring for development of hemorrhage or progressive thrombus, and escalation of anticoagulant dose. This article discusses the complexities of treating acute VTE in patients with brain tumors and outlines treatment algorithms based on the presence or absence of ICH at the time of VTE diagnosis. Through case-based scenarios, we illustrate our approach to anticoagulation, emphasizing individualized risk assessments and evidence-based practices to optimize treatment outcomes while minimizing the risks of hemorrhagic events in patients with brain tumors.
Ide-cel vs standard regimens in triple-class–exposed relapsed and refractory multiple myeloma: updated KarMMa-3 analyses
Authors: Ailawadhi Sikander , Arnulf Bertrand , Patel Krina , Cavo Michele , Nooka Ajay K. , Manier Salomon , Callander Natalie , Costa Luciano J. , Vij Ravi , Bahlis Nizar J. , Moreau Philippe , Solomon Scott , Abrahamsen Ingerid Weum , Baz Rachid , Broijl Annemiek , Chen Christine , Jagannath Sundar , Raje Noopur , Scheid Christof , Delforge Michel , Benjamin Reuben , Pabst Thomas , Iida Shinsuke , Berdeja Jesús , Giralt Sergio , Truppel-Hartmann Anna , Chen Yanping , Zhong Xiaobo , Wu Fan , Piasecki Julia , Eliason Laurie , Dhanda Devender , Felten Jasper , Caia Andrea , Cook Mark , Popa McKiver Mihaela , Rodríguez-Otero Paula
Published: August 2024

Outcomes are poor in triple-class–exposed (TCE) relapsed and refractory multiple myeloma (R/RMM). In the phase 3 KarMMa-3 trial, patients with TCE R/RMM and 2 to 4 prior regimens were randomized 2:1 to idecabtagene vicleucel (ide-cel) or standard regimens (SRs). An interim analysis (IA) demonstrated significantly longer median progression-free survival (PFS; primary end point; 13.3 vs 4.4 months; P < .0001) and higher overall response rate (ORR) with ide-cel vs SRs. At final PFS analysis (median follow-up, 30.9 months), ide-cel further improved median PFS vs SRs (13.8 vs 4.4 months; hazard ratio [HR], 0.49; 95% confidence interval [CI], 0.38-0.63). PFS benefit with ide-cel vs SRs was observed regardless of number of prior lines of therapy, with greatest benefit after 2 prior lines (16.2 vs 4.8 months, respectively). ORR benefit was maintained with ide-cel vs SRs (71% vs 42%; complete response, 44% vs 5%). Patient-centric design allowed crossover from SRs (56%) to ide-cel upon progressive disease, confounding overall survival (OS) interpretation. At IA of OS, median was 41.4 (95% CI, 30.9 to not reached [NR]) vs 37.9 (95% CI, 23.4 to NR) months with ide-cel and SRs, respectively (HR, 1.01; 95% CI, 0.73-1.40); median OS in both arms was longer than historical data (9-22 months). Two prespecified analyses adjusting for crossover showed OS favoring ide-cel. This trial highlighted the importance of individualized bridging therapy to ensure adequate disease control during ide-cel manufacturing. Ide-cel improved patient-reported outcomes vs SRs. No new safety signals were reported. These results demonstrate the continued favorable benefit-risk profile of ide-cel in early-line and TCE R/RMM. This trial was registered at www.ClinicalTrials.gov as #NCT03651128.
Genomic analysis of adult thrombotic microangiopathies in less than 3 days: from rapid to fast genomics to treatment
Authors: Yousfi Nadhir , Mousseaux Cyril , Hamza Abderaouf , Laville Pierre , Mille Marie , Philippe Nicolas , Dancer Marine , Bouder Christophe , Luque Yosu , Rafat Cédric , Mesnard Laurent
Published: August 2024

Using nanopore sequencing, we showed the feasibility and impact of rapid genomic screening for managing thrombotic microangiopathies in 18 prospective cases, achieving diagnoses in <3 days. We compared the results with standard exome sequencing, cost efficiency, and complement blockade initiation.
The use of biostimulants as a key to sustainable hydroponic lettuce farming under saline water stress
Authors: İkiz Boran , Dasgan Hayriye Yildiz , Balik Sibel , Kusvuran Sebnem , Gruda Nazim S.
Published: August 2024

Backround

The utilization of high-quality water in agriculture is increasingly constrained by climate change, affecting availability, quality, and distribution due to altered precipitation patterns, increased evaporation, extreme weather events, and rising salinity levels. Salinity significantly challenges salt-sensitive vegetables like lettuce, particularly in a greenhouse. Hydroponics water quality ensures nutrient solution stability, enhances nutrient uptake, prevents contamination, regulates pH and electrical conductivity, and maintains system components. This study aimed to mitigate salt-induced damage in lettuce grown via the floating culture method under 50 mM NaCl salinity by applying biostimulants.

Results

We examined lettuce’s physiological, biochemical, and agronomical responses to salt stress after applying biostimulants such as amino acids, arbuscular mycorrhizal fungi, plant growth-promoting rhizobacteria (PGPR), fulvic acid, and chitosan. The experiment was conducted in a greenhouse with a randomized complete block design, and each treatment was replicated four times. Biostimulant applications alleviated salt’s detrimental effects on plant weight, height, leaf number, and leaf area. Yield increases under 50 mM NaCl were 75%, 51%, 31%, 34%, and 33% using vermicompost, PGPR, fulvic acid, amino acid, and chitosan, respectively. Biostimulants improved stomatal conductance (58–189%), chlorophyll content (4–10%), nutrient uptake (15–109%), and water status (9–107%). They also reduced MDA content by 26–42%. PGPR (1.0 ml L‒1), vermicompost (2 ml L‒1), and fulvic acid (40 mg L‒1) were particularly effective, enhancing growth, yield, phenol, and mineral content while reducing nitrate levels under saline conditions.

Conclusions

Biostimulants activated antioxidative defense systems, offering a sustainable, cost-effective solution for mitigating salt stress in hydroponic lettuce cultivation.
Optimized deep CNN for detection and classification of diabetic retinopathy and diabetic macular edema
Authors: Thanikachalam V , Kabilan K , Erramchetty Sudheer Kumar
Published: August 2024

Diabetic Retinopathy (DR) and Diabetic Macular Edema (DME) are vision related complications prominently found in diabetic patients. The early identification of DR/DME grades facilitates the devising of an appropriate treatment plan, which ultimately prevents the probability of visual impairment in more than 90% of diabetic patients. Thereby, an automatic DR/DME grade detection approach is proposed in this work by utilizing image processing. In this work, the retinal fundus image provided as input is pre-processed using Discrete Wavelet Transform (DWT) with the aim of enhancing its visual quality. The precise detection of DR/DME is supported further with the application of suitable Artificial Neural Network (ANN) based segmentation technique. The segmented images are subsequently subjected to feature extraction using Adaptive Gabor Filter (AGF) and the feature selection using Random Forest (RF) technique. The former has excellent retinal vein recognition capability, while the latter has exceptional generalization capability. The RF approach also assists with the improvement of classification accuracy of Deep Convolutional Neural Network (CNN) classifier. Moreover, Chicken Swarm Algorithm (CSA) is used for further enhancing the classifier performance by optimizing the weights of both convolution and fully connected layer. The entire approach is validated for its accuracy in determination of grades of DR/DME using MATLAB software. The proposed DR/DME grade detection approach displays an excellent accuracy of 97.91%.
Behavioral, cognitive and emotional determinants of getting vaccinated for COVID-19 and the mediating role of institutional trust among young adults in Cyprus
Authors: Konstantinou Pinelopi , Kyprianidou Maria , Christodoulou Andria , McHugh Louise , Constantinou Marios , Epiphaniou Eleni , Vahey Nigel , Nicolaou Christiana , Middleton Nicos , Karekla Maria , Kassianos Angelos P.
Published: August 2024

Background

Vaccination uptake is a complex behavior, influenced by numerous factors. Behavioral science theories are commonly used to explain the psychosocial determinants of an individual’s health behavior. This study examined the behavioural, cognitive, and emotional determinants of COVID-19 vaccination intention based on well-established theoretical models: Acceptance and Commitment Therapy (ACT), Capability, Opportunity, Motivation, and Behaviour (COM-B) and the Health Belief Model (HBM). Additionally, it examined the mediating role of institutional trust in the relationship between determinants of these models and vaccination intentions.

Methods

A cross-sectional study was conducted from January to May 2022, where university students in Cyprus completed an online survey.

Results

A total of 484 university students completed the online survey, with 23.8% reporting being vaccinated with fewer than three vaccination doses and/or no intention to vaccinate further. Hierarchical logistic regression analysis showed that higher scores in institutional trust, perceived severity, motivation, physical and psychological capability were significantly associated with higher odds of intending to vaccinate. Higher psychological flexibility and not being infected with COVID-19 were also associated with higher odds of vaccination intention, but not in the final model when all determinants were included. Additionally, significant indirect effects of psychological and physical capability, motivation and perceived severity on vaccination intention were found to be mediated by institutional trust.

Conclusions

When tackling COVID-19 vaccination hesitancy, behavioural, cognitive, and emotional aspects should be considered. Stakeholders and policymakers are advised to implement targeted vaccination programs in young people while at the same time building trust and improving their capabilities and motivation towards getting vaccinated.