bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting the Risk of Adverse Neonatal Outcomes in Women With Insulin-Treated Diabetes: Is It Time for a Pregnancy-Specific Glycemic Risk Index (GRI)?
Authors: Citro Fabrizia , Bianchi Cristina , Belcari Tommaso , Galleano Federico , Venturi Caterina , Battini Lorella , Marchetti Piero , Bertolotto Alessandra , Aragona Michele
Published: October 2024

Background:

The Glycemia Risk Index (GRI) describes the quality of glycemic control, emphasizing extreme hypoglycemia and hyperglycemia more than less extreme values. However, a pregnancy-specific GRI (pGRI), tailored to the tighter target glucose range required during pregnancy, has not been established.

Methods:

We retrospectively evaluated clinical, metabolic, and Continuous Glucose Monitoring (CGM) data across pregnancy in women with insulin-treated diabetes, managed between September 2021 and March 2024 at the University Hospital of Pisa. First and second levels of hyperglycemia (TAR1: 140-180 mg/dL, TAR2: >180 mg/dL) and hypoglycemia (TBR1: 63-54 mg/dL, TBR2: <54 mg/dL) were used to calculate the pGRI at each trimester. Logistic regression analysis investigated the association between pGRI and risk of at least one adverse neonatal outcome (among preterm delivery, macrosomia, large for gestational age, small for gestational age, neonatal hypoglycemia, neonatal jaundice, and neonatal intensive care unit admission).

Results:

Of 45 pregnant women, 25 (56%) experienced at least one adverse neonatal outcome. In the third trimester, women with adverse outcomes had significantly higher total TAR (26 [12-32]% vs 10 [4-23]%, P = .018) and lower TIR (71 [64-83]% vs 88 [75-92]%, P = .007). Specifically, the difference was notable in TAR2 (6 [2-15]% vs 1 [0-4]%, P = .004), whereas TAR1 was comparable between the 2 groups. Accordingly, third trimester pGRI was higher in women with adverse neonatal outcomes (38 [18-49]% vs 18 [10-31]%, P = .013) and, at logistic regression, slightly but significantly increased the risk of adverse neonatal outcomes (1.044 [1.004-1.086], P = .024).

Conclusions:

Pregnant women with insulin-treated diabetes reporting adverse neonatal outcomes spent more time in hyperglycemia, particularly in extreme hyperglycemia. Therefore, the level of hyperglycemia should always be assessed during pregnancy. The pGRI, emphasizing extreme hyperglycemia, may be a novel comprehensive tool for assessing the risk of adverse neonatal outcomes.
Corruption, sextortion, gender-based violence: Open challenges for the European Union in harmonising substantive criminal rules
Authors: De Paolis Roberta
Published: October 2024

The TFEU granted the European Union a propulsive function of harmonizing criminal provisions by establishing minimum standards relating to the definition of crimes and penalties concerning impactful forms of criminality. Considering this, the European Commission has proposed two directives on corruption and gender-based violence, nevertheless lacking to enucleate borderline cases such as sextortion, namely that form of corruption in which sex, rather than money, is the currency of the bribe. Sextortion has been recorded in critical sectors such as education, healthcare, and law enforcement, but there are no specific laws regulating it. Consequently, law enforcement agencies pursue a case-by-case approach and prosecute sextortion either as a corruption case or as a gender-based violence case. Such an approach is not devoid of criticalities. On this point, one should consider, for example, the burdens of consent and the evidentiary system regarding sexual coercion or the unfair criminalization of victims since, technically, they are the ones who provide the sexual activity that constitutes the currency of the bribe. To overcome these concerns, this article suggests introducing an autonomous offense specifically designed to criminalize the conduct of those in a position of power demanding or receiving sexual services in exchange for treatments or services to which those who provide the sexual activity are already legally entitled. Placing the sextortion issue at the European level would fit within the current legal basis of the treaties (Article 83(1) and (2) TFEU) and align with current European initiatives in the field of corruption and gender-based violence.
Synthesis of bioplastics and the effects of additives on the mechanical, thermal and biodegradable properties
Authors: Abu Ubaidah Afiq Syazwan , Mohamad Puad Noor Illi , Hamzah Fazlena , Azmi Azlin Suhaida , Ahmad Nor Yusilawati
Published: October 2024

The mounting global concern over the environmental consequences of petroleum-based plastics has prompted significant research into sustainable alternatives, with bioplastics emerging as a forerunning solution. This systematic review elucidates the multifaceted synthesis processes of bioplastics, which are derived from renewable sources such as plant starches, cellulose, and waste materials. The synthesis encompasses stages from raw material selection, pre-treatment, to the incorporation of various additives, with the aim to achieve specific properties in the resultant bioplastics. A substantial focus of this review lies in comprehensively understanding the role of additives, which serve as the pivotal agents in tailoring the mechanical and thermal characteristics of bioplastics. Additives, including cross-linking agents, plasticizers, fillers, compatibilizers, and reinforcement agents, are critically examined for their influence on attributes such as tensile strength, flexibility, thermal stability, and biodegradability. Factors such as intermolecular interactions, hydrogen bonding, and moisture content, play a determining role towards the resultant properties. The prospects for bioplastics are rapidly expanding, signalling a transformative shift in various applications ranging from eco-friendly packaging to advanced biomedical devices. This article serves as a comprehensive guide to both researchers and industry stakeholders, providing deep insights into the synthesis of bioplastics and the transformative role additives play in their functional properties.
Adverse events of topical ocular prostaglandin medications for glaucoma treatment: a pharmacovigilance study based on the FAERS database
Authors: Wu Shi-Nan , Huang Caihong , Wang Yu-Qian , Li Xiang , Zhang Si-Qi , Chen Xiao-Dong , Qin Dan-Yi , Zhu Linfangzi , Wen Jia-Yi , Luo Na-Chuan , Hu Jiaoyue , Liu Zuguo
Published: October 2024

Background:

As prostaglandin medications, crucial in glaucoma treatment, become more widely used, their local adverse events are increasingly observed.

Objectives:

To evaluate the common adverse events of four clinically commonly used prostaglandin F (FP) receptor agonists in the treatment of glaucoma in the Food and Drug Administration Adverse Event Reporting System (FAERS) database.

Design:

We screened and analyzed the generic and brand names of latanoprost, bimatoprost, travoprost, and tafluprost in the FAERS database and summarized and cleaned the baseline information of subjects receiving the above-mentioned drugs.

Methods:

Perform descriptive statistical analysis on the baseline information of subjects using the drugs. Conduct disproportionality analysis of drug-related adverse events. The criteria for positive signals of adverse events are established by simultaneously meeting the thresholds set by four methods: the ratio of reported odds, proportional reporting ratio, Bayesian confidence propagation neural network, and multi-item gamma Poisson shrinker. Additionally, assess the cumulative risk curves for drug-induced time of the aforementioned drugs and use one-way ANOVA to compare differences in drug-induced time across different groups.

Results:

The study included 1567 latanoprost, 1517 bimatoprost, 696 travoprost, and 82 tafluprost subjects. Adverse events mainly affected eye disorders, with significant issues in iris hyperpigmentation, ocular pemphigoid, corneal endothelial cell loss, periorbital fat atrophy, corneal irritation, eyelash growth, and ocular hyperemia. The time to onset varied among drugs, with latanoprost showing the longest (mean days = 344.37) and bimatoprost the shortest duration (mean days = 155.65; p < 0.001).

Conclusion:

Although signal detection analysis based on the FAERS database cannot establish a definitive causal relationship, our study found that FP receptor agonists used in glaucoma can cause various adverse events. Assessing their clinical suitability and potential side effects is crucial for providing personalized treatment and ensuring medication safety.
An integrative systematic review of nurses’ involvement in medication deprescription in long-term healthcare settings for older people
Authors: Vaismoradi Mojtaba , Mardani Abbas , Crespo Manuel Lillo , Logan Patricia A. , Sak-Dankosky Natalia
Published: October 2024

Background:

Deprescription of medications for older people in long-term care settings is crucial to enhance medication safety by reducing polypharmacy and minimizing related adverse events. Nurses as the member of the multidisciplinary healthcare team can support deprescription initiatives, but there is a gap in comprehensive knowledge about their roles.

Objectives:

To investigate the role and contribution of nurses in deprescribing medications within the multidisciplinary pharmaceutical care context of long-term healthcare for older people.

Design:

A systematic review utilizing an integrative approach was performed.

Methods:

Multiple databases were searched, including PubMed (covering MEDLINE), Scopus, CINAHL, ProQuest and Embase, focusing on studies published in English from 2014 to 2024. The preliminary search yielded 4872 studies, which were then refined to 32 qualitative and quantitative studies chosen for data analysis and narrative synthesis. Thematic comparisons and analysis led to the creation of meaningful categories integrating the studies’ findings to meet the review’s objective.

Results:

The review findings were classified into categories: ‘necessity and benefits of deprescribing’, ‘multidisciplinary collaboration for deprescribing’, ‘nurse role in deprescribing’, ‘identified challenges to deprescribing’, ‘involvement of older people and families in deprescribing’. They illustrated and exemplified various aspects of nurses’ roles and contributions in deprescription initiatives within the multidisciplinary pharmaceutical care team, such as support for reducing doses, discontinuing medications or transitioning to safer alternatives, as well as factors influencing this process.

Conclusion:

The main dimensions of nurses’ roles and contributions in deprescription initiatives encompass monitoring, communicating and educating. Challenges to nurses’ active participation in deprescribing, such as the need for increased knowledge, confidence and inclusion in team discussions, should be addressed through education, training and changing attitudes. These steps are essential for improving the safety of medication deprescribing in long-term care settings.

Trial registration:

The review was registered under PROSPERO ID: CRD42023486484, and can be accessed at crd.york.ac.uk/PROSPERO/display_record.php?RecordID=486484
Autonomous road hazard detection and avoidance system using deep reinforcement learning for intelligent vehicles
Authors: Swathi S , Vinayagam S Sakthi , Sujin JS , Duraisamy Baskar
Published: October 2024

Road hazards significantly contribute to fatalities in traffic accidents. As the number of vehicles on the road increases, the risk of accidents rises, especially under adverse weather conditions that impair visibility and road conditions. In such scenarios, it is crucial to alert approaching vehicles to prevent further collisions. Detecting humans or animals on the road is essential to minimize fatalities in traffic accidents. Accurate detection and estimation of road hazards are vital for ensuring safety and enhancing the driving experience. Current deep learning methods for road condition monitoring are often time-consuming, costly, inefficient, labor-intensive, and require frequent updates. Therefore, there is pressing need for more flexible, cost-effective, and efficient process to detect road conditions, particularly road hazards. In this work, we present a road hazard detection and avoidance system for autonomous driving using deep reinforcement learning (DRL) to address traffic congestion and safety issues in complex road conditions. We utilize GoogLeNet for feature extraction, which extracts deep features from the given images. Subsequently, we design a modified compact snake optimization (MCSO) algorithm for feature optimization, addressing data dimensionality issues. Additionally, we introduce geometric deep reinforcement learning (GDRL) for hazard detection and tracking in complex road environments, improving the accuracy and robustness of visual detection. The proposed MCSO + GDRL model is validated using a self-made open access dataset with 5607 samples from car recorders and the KITTI dataset for autonomous driving training.
In silico prediction of some pharmacokinetic, safety, biological activity and molecular docking studies of 1-piperazine indole hybrid with nicotinic amide and nicotinic acid and their analogues
Authors: Mitku Melese Legesse , Dagnaw Abera Dessie , Geremew Derso Teju , Anagaw Yeniewa Kerie , Worku Minichil Chanie , Limenh Liknaw Workie , Tadesse Yabibal Berie , Ergena Asrat Elias
Published: October 2024

Background:

In silico predictions are now being utilized in drug discovery and design to assess the physicochemical, pharmacokinetics, and safety properties of compounds at the beginning of the drug discovery process. This early evaluation of the physicochemical, pharmacokinetics, and safety properties of compounds helps the researchers to invest their time and resources only in the best prospective lead compounds by eliminating compounds with a low chance of success.

Objective:

The purpose of this study was to explore a promising lead compound designed from 1-piperazine indole hybrid with nicotinic amide and nicotinic acid analogs targeted on Trypanosoma brucei phosphofructokinase for Trypanosomiasis activity by using in silico predictions strategy.

Results:

The physicochemical, safety, pharmacokinetic, and biological activity properties of those molecules were predicted by using ADMETlab 2.0, ACD labs Chem Sketch software version 14.0, Molinspiration software, and MolPredictX online tool. Our results indicate that several promising candidates exhibit favorable characteristics. Based on Molinspiration software both nicotinic acid and nicotinic amide derivatives showed higher kinase inhibitor activity and all nicotinic acid derivatives revealed enzyme inhibitors and GPCR ligand activity. According to the MolPredictX online tool, the most biologically active derivatives were NA-4, NA-11, and NAD-11.

Conclusion:

Overall, our findings offer valuable insights into the potential efficacy and safety of these compounds. It appears that almost all of the compounds have successfully passed the pharmacokinetic evaluations and integration of nicotinic acid into indole appears to be more beneficial than nicotinic amide regarding certain biological activities.
How do gender stereotypes about leadership positions change in the face of a crisis?
Authors: Itzkovitch-Malka Reut
Published: October 2024

This study explores how a crisis situation affects voter bias towards women leaders. In an era of global pandemics, frequent climate disasters, economic recessions, and violent conflicts, this question is especially timely. Using an experimental research design, fielded prior the 2019 Israeli elections, we simulate a crisis in one of three policy areas. One typically regarded as masculine (defense), another as feminine (education), and a third with mixed perceptions (finance). We examine whether the framing of a crisis in one of these policy areas changes voters’ gender stereotypes regarding the suitability of women or men for the relevant ministerial positions. We then interact the crisis condition with voters’ gender baseline preference to see how their predispositions towards men and women in politics moderate the effect of a crisis on gender stereotypes. We find that while men are generally regarded as better suited to serve as Ministers of Defense and women to serve as Ministers of Education, a crisis situation increases the perceived suitability of men for both ministerial roles. Thus, a crisis situation strengthens the conventional notion of men as the most competent leaders. These effects are more pronounced among voters whose gender baseline preferences align with existing gender stereotypes.
Designing feelings into lower-limb prostheses – A kansei engineering approach to understand lower-limb prosthetic cosmeses
Authors: Ramstrand Nerrolyn , Riveiro Maria , Eriksson Lars , Ceder Michael
Published: October 2024

Introduction: This study aimed to quantify the relationship between prosthetic users’ emotional response to prosthesis aesthetics and specific product properties. Methods: Words representing prosthesis users’ emotional response (Kansei) to different aesthetic designs of prostheses were identified via interviews and mood boards. A group of experts consolidated the words into thematic groups, each represented by a single, high-level ‘Kansei’ word. 53 lower limb prosthesis users completed a questionnaire, rating their perception of 13 aesthetic designs using the ‘Kansei’ words. Quantification Theory Type 1 was applied to explore the relationship between words and product properties. Sub-analyses assessed for differences based on sex, age and level of extroversion. Results: 5 high-level Kansei words were identified (‘Natural’, ‘Technological’, ‘Cool’, ‘Unique’ and ‘Functional’). The Kansei word ‘Natural’ had a strong association with realistic looking prostheses while the words ‘Technological’, ‘Cool’ and ‘Unique’ were strongly associated with expressive designs which incorporate hard, colourful covers. The word ‘Functional’ was not a reliable predictor of product properties. No major differences were observed within sub-grouped categories. Conclusion: Kansei words identified in this study can be used to help guide clients in their aesthetic design choices and to assist designers in achieving the desired response from their products.
Social Investment Through A Collaborative Village Festival: The Case of Farmers’ Village Festival in Jogjakarta
Authors: Najiyati Sri , Prihadyanti Dian , As’adhanayadi Bilal , Danarti Danarti , Mardiana Mardiana , Dewi Rukmini Nugroho , Febriyandi Y. S. Febby , Muhtar Muhtar
Published: October 2024

Villages require innovative Social Investment (SI) to improve human resource competencies and social capital to promote long-term community welfare. A festival can be a potential tool for SI. A Collaborative Village Festival (CVF), despite the occurrence of problems and challenges of common festivals and the limited available literature in the area, can be a potential variant of SI programs. This research aims to analyze the implementation of CVF and its success factors and identify the benefits of CVF as a tool for SI, especially for developing Human Capital (HuCap) and Social Capital (SoCap). Based on the results of a single case study, CVF, characterized as a multi-program and multi-stakeholder, has a role in developing HuCap and activating SoCap in several aspects. CVF also serves as a tool for multi-investment, which, in this case, is an eco-sociocultural investment. Several factors should be considered in designing and executing CVF to obtain greater benefits. The multi-stakeholder collaboration created through CVF forms a unique hexa-helix pattern, leading to a new variation of the helix model. This research provides practical contributions concerning festival management to optimize the SI-related benefits, which can encourage rural development.
Does the Expansion of Local Government Debt Affect the ESG Performance of Enterprises? Evidence From China
Authors: Li Feifei , Xue Ruile , Wang Songying , Du Mingyue
Published: October 2024

As an important fiscal policy of local governments, local government borrowing has an increasingly prominent impact on micro-enterprises. However, there is still a lack of effective verification on whether local government debt (LGD) will affect the Environmental, Social, and Corporate Governance (ESG) performance of enterprises. This paper uses micro data of Chinese listed companies from 2011 to 2020 and LGD data at the prefecture-level city layer to test the impact and mechanism of the expansion of LGD on corporate ESG performance by establishing panel regression models and mediating effect models. The results show that the expansion of LGD significantly reduces the ESG performance of local enterprises and presents a long-term inhibitory effect. The mechanism analysis indicates that the expansion of LGD suppresses corporate ESG performance by crowding out corporate credit resources, reducing government fiscal subsidies to enterprises, thereby worsening corporate cash flow. Furthermore, the negative impact of LGD expansion on corporate ESG performance is more pronounced in non-state-owned enterprises, those with high leverage, high industry competition, high technological intensity, low marketization, and low financial development levels. Furthermore, the expansion of LGD mainly reduces corporate social and environmental responsibility but has no significant impact on internal governance. The inhibitory effect of LGD on ESG is not caused by publicly issued urban investment bonds but stems from non-publicly issued debts. This paper extends the research on the microeconomic consequences of LGD to the field of corporate ESG, providing insights for comprehensively assessing the risks of LGD and promoting the construction of corporate ESG.
Longitudinal Links Between Identity Development and the Vision of One’s Adult Life in Emerging Adulthood
Authors: Janowicz Kamil , Piotrowski Konrad , Bakiera Lucyna
Published: October 2024

Our longitudinal study aimed to investigate relationships between identity development and the vision of one’s adult life (VOAL) in emerging adults. In the first measurement, 299 emerging adults aged 17 to 27 participated, and 177 participated in the second measurement (9-10 months later). Participants were asked to complete the Dimensions of Identity. Development Scale and write about their envisioned future adult life. Written answers about the VOAL were coded by trained judges to allow for quantitative analyses. The results indicated that both identity exploration and commitment were related to the structure of the emerging adults’ VOAL and their subjective attitudes toward the possessed VOAL but in different ways. We also observed that changes in identity processes over time turned out to be related to changes in the VOAL. Our results suggest the presence of a reciprocal relationship between identity development and thinking about the future in emerging adults.
Reconstructing Psychopathology: A Data-Driven Reorganization of the Symptoms in the Diagnostic and Statistical Manual of Mental Disorders
Authors: Forbes Miriam K. , Baillie Andrew , Batterham Philip J. , Calear Alison , Kotov Roman , Krueger Robert F. , Markon Kristian E. , Mewton Louise , Pellicano Elizabeth , Roberts Matthew , Rodriguez-Seijas Craig , Sunderland Matthew , Watson David , Watts Ashley L. , Wright Aidan G. C. , Anna Clark Lee
Published: October 2024

In this study, we reduced the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-5) to its constituent symptoms and reorganized them based on patterns of covariation in individuals’ ( N = 14,762) self-reported experiences of the symptoms to form an empirically derived hierarchical framework of clinical phenomena. Specifically, we used the points of agreement among hierarchical principal components analyses and hierarchical clustering as well as between the randomly split primary ( n = 11,762) and hold-out ( n = 3,000) samples to identify the robust constructs that emerged to form a hierarchy ranging from symptoms and syndromes up to very broad superspectra of psychopathology. The resulting model had noteworthy convergence with the upper levels of the Hierarchical Taxonomy of Psychopathology (HiTOP) framework and substantially expands on HiTOP’s current coverage of dissociative, elimination, sleep–wake, trauma-related, neurodevelopmental, and neurocognitive disorder symptoms. We also mapped some exemplar DSM-5 disorders onto our hierarchy; some formed coherent syndromes, whereas others were notably heterogeneous.
Nutritional Assessment Based on Mid-upper Arm Circumference Among Tribal Preschool Children of Three Distinct Ecological Zones of India
Authors: Kshatriya Gautam Kumar , Roy Pijush Kanti , Chanak Mahua , Biswas Saheli , Bose Kaushik
Published: October 2024

Undernutrition among infants and children retards the physical and cognitive growth and increases susceptibility to infections and diseases. Educational attainment and productivity of children get adversely affected by undernutrition, NFHS (2019–2020) and IIPS (2021) found the prevalence of undernutrition indicators to be high among the under-five children of the nation and tribal children to be in a more vulnerable condition. Mean mid-upper arm circumference (MUAC) is a quick, simple and precise screening tool to use in large-scale community-based nutritional programme. The present study aimed to assess the prevalence of undernutrition based on MUAC among three tribes of three distinct ecological zones of India, namely Bhil Tribe (Desert ecology), Dhodia tribe (Coastal ecology) and Kinnaura tribe (Himalayan ecology). The present cross-sectional study consists of 985 tribal children (509 boys and 476 girls) belonging to the age group 0–1 through 5+ years (below six years). Z-score was computed using WHO (2006) recommended age and sex-specific cutoff points for MUAC and the prevalence of undernutrition was assessed for children of below five years of age. MUAC has been found to have significant age difference among all communities ( p < .001). Prevalence of undernutrition was found to be the highest among the Bhil tribe, the one residing in the desert ecology (41.03%) followed by Dhodia (18.06%) and Kinnaura tribe (12.16%). Among Bhil and Kinnaura children, prevalence of undernutrition was higher among the girls, while the Kinnaura boys manifested higher prevalence of undernutrition in comparison to their counterpart. Significant ( p < .01) sex difference in undernutrition prevalence was found only in case of Bhil tribe (boys: 33.33%, girls: 48.02%). The prevalence of undernutrition significantly differs among the tribes of three distinct ecological zones ( p < .001). The nutritional status of the tribal children, particularly that of the Bhil children, was unsatisfactory. To improve the nutritional wellbeing of the tribal population of the nation, studies at regular intervals focusing on the causes responsible for nutritional status are needed.
Household Economy and its Relation to  Household Head and Women: A Study  Among the Tangkhuls in Kangpokpi District, Manipur
Authors: Mashangva Barnabas
Published: October 2024

The household economy is the collective sociocultural of managing resources and economic activities within households or families. A household economy is a fundamental unit of analysis in anthropological studies of economic systems, as it provides insights into how people manage their livelihoods within different cultural contexts. The present study attempted to investigate the relationship between household income and the role of household heads and women in income generation in the context of the Tangkhul of Kangpokpi District, Manipur. Using a mixed methods approach, including surveys, interviews and focus group discussions, the study examines the economic practices of households engaged in shifting cultivation and how household heads and women contribute to income generation. The finding reveals the significant contribution of women to household economic activities and the interplay between gender roles and household heads in the Tangkhul community. The Tangkhul is a patriarchal society, although women enjoy substantial freedom and play an important role in family and community life. The study highlights the need for a more detailed understanding of economic practices and the role of gender in shaping household income in rural communities. The insight gained from this research can inform policies and interventions aimed at livelihood and reducing poverty in rural areas.
What Drives Actual Buying Behaviour for Organic Food Consumers?: Insights from SOBC Framework in Emerging Economies
Authors: Anand Arpan , Jangra Sapna , Gupta Anjali , Tewary Tavishi
Published: October 2024

This research article responds to the question of what influences consumers’ continuous purchase intention, leading to actual buying behaviour (ABB) for organic food. Specifically, the study examines the relationship between information related to organic food, environmental concerns, perceived value, food safety concerns and perceived barriers with consumers’ attitudes regarding organic food, which eventually affects their purchase intention and leads to ABB. Utilizing the stimulus–organism–behaviour–consequence (SOBC) theory, an empirical investigation is conducted to explore the influence of satisfaction, outcome and belief on organic food cognitive dissonance. A structured questionnaire was used to capture satisfaction, outcome, belief, cognitive dissonance and demographic variables. The questionnaire was developed based on a 5-point Likert scale from the northern part of India, and its validity and reliability were assessed through a pilot study. Responses collected from 356 active organic food consumers were analyzed utilizing advanced partial least squares (PLS) methodology, with cognitive dissonance serving as the dependent variable and satisfaction, result and belief acting as the independent factors. The findings indicate that information concerning organic food, perceived value, food safety concerns and organic food awareness have a significant positive influence on consumers’ attitudes towards organic food, which further positively affects their purchase intention. However, no significant association was found between environmental concerns and perceived barriers with consumers’ attitudes for organic food, which suggests that these antecedents may not be strong drivers of consumer behaviour in this context. The study provides intriguing strategic inputs for organic food producers and marketers.
Renal Vein Thrombosis as an Initial Presentation for Systemic Lupus Erythematosus in a 32-Year-Old Sudanese Male: A Case Report in Palestine
Authors: Abu Lehia Ayah , Itbaisha Adham , Abu-Hilal Lila H. , Hamamdah Abdullah , Darras Adeeb , Shawar Abdullatif
Published: October 2024

Systemic lupus erythematosus (SLE) is a complex autoimmune disease known for its diverse clinical presentations, and one severe complication is lupus nephritis (LN), which significantly contributes to morbidity and mortality. While LN often presents within the first 5 years of SLE diagnosis, renal vein thrombosis (RVT) is a rare vascular complication with a high risk of mortality and morbidity. This case report discusses the rare occurrence of RVT as the initial presentation of SLE in a 32-year-old Sudanese male patient, currently working in Palestine, presenting with flank pain, hematuria, fever, and lower limb edema. The case details the patient’s symptoms, examination findings, and extensive laboratory and imaging workup leading to the diagnosis. This report highlights the rare association between RVT and SLE, emphasizing the importance of maintaining a high index of suspicion for SLE in patients with multisystem involvement, especially in males, where the diagnosis may be overlooked due to its lower prevalence. Early recognition can improve patient outcomes and reduce the risk of complications. Further research is needed to better understand the connection between RVT and SLE and to develop more effective treatment strategies.
Impact of Artificial Intelligence on Fashion Education for Future Jobs
Authors: Kohli Japjee Kaur
Published: October 2024

In the twenty-first century, artificial intelligence (AI) will change the way organizations conduct their daily operations. In addition, cutting-edge digital technologies like AI, Internet of things, augmented reality/virtual reality, cloud computing, robotics and big data will have a significant impact on the nature of future jobs. This revolutionary influence may be seen in the fashion industry across a wide variety of specialities, including design, sampling, production, quality and inspection, packaging and labelling, marketing, advertising and sales. This transformation also highlights the necessity for upgrading the fashion curriculum to include the essential and desired skills and competencies to enable students to apply such digital technology for future jobs. The purpose of this study is to examine the future skill and competence needs that will need to be linked with the curriculum of the Bachelor’s degree in Fashion Design programme for the use of AI in the fashion sector. The present research employs qualitative approaches. Skills for future jobs are identified through the literature and verified by employers. The findings reveal that skills and competencies imparted through the current curriculum are insufficient to work in the digital world, and a relook into the curriculum is required to produce an AI-savvy workforce.
Focusing on the Non-cognitive: Developing Civic Reasoning Through Emotions of Race and Power
Authors: Jones Brittany L. , Halvorsen Anne-Lise
Published: October 2024

This study explores how the intersection of race and emotions, or racialized emotions, influenced Black high school students’ civic reasoning. Drawing from the students’ photo-elicitation and focus group interviews, we found that racialized emotions not only informed how students conceptualized civic engagement during the Civil Rights Movement but also shaped their civic participation and their critiques of legal systems and other democratic processes. These findings highlight the significant role that racialized emotions had on students’ civic reasoning, suggesting that the intersection of race and emotions is not just a peripheral aspect of civic education but rather a central component. We contend that ignoring emotions in civics instruction, standards, and curriculum not only diminishes students’ learning experiences but can also be harmful and inauthentic. To address this issue, we offer strategies for educators on how to center students’ racialized emotions in their civics instruction.
Estimating the Racial Wealth Gap in Brazil
Authors: Sue Christina A. , Rivas Salvador , Wainer Jacques
Published: October 2024

Brazil is at the forefront of research and policies aimed at redressing racial inequality in Latin America. However, there is a paucity of scholarship on Brazilian racial inequality in wealth. The lack of research is largely a by-product of data limitations. In this study, we analyze the best publicly available data on various indicators of wealth, controlling for multiple factors. We find a tiered system with White households having the most wealth, followed by mixed-race households, and then Black/Brown households. We find that White Brazilian families have approximately 1.5 to 2 times the wealth of Black/Brown families, which is similar to the U.S. Black-White gap for comparable measures, with the notable exception of homeownership. Our findings provide novel insights into racial wealth inequality in Brazil that may inform the study of wealth in countries where data on wealth are limited and/or where traditional measures (e.g., homeownership) are not suitable indicators of wealth.
Behavioral public policy bodies: New developments & lessons
Authors: Naru Faisal
Published: October 2024

The field of behavioral public policy (BPP) has grown rapidly in the past 10 years, as is indicated by the rising numbers of BPP bodies that routinely apply insights and methods from behavioral science to improving the effectiveness and efficiency of public policy. This article reports on a count showing that between 2018 and 2024, the number of BPP bodies grew worldwide from 201 to 631 and increased on all continents. The article also summarizes results from a survey that asked representatives from 10 BPP bodies that varied by locale, political and cultural environment, and longevity to describe their group’s mission, functions, policy areas, challenges, and lessons for others. Common challenges include setting expectations, sustainability, and bridging the research–policy gap. Results from both the global analysis and the survey highlight that being in an “ecosystem” that includes outside advisors with experience in applying behavioral science and running local programs can enhance efficacy. Other lessons from the survey include the importance of focusing on solving problems rather than on applying a particular kind of intervention, being multidisciplinary (for example, by involving people with expertise in project management), designing for scale, presenting data in the context of a larger narrative, and formalizing operating procedures.
Reducing Waiting Times in Diabetes Care: A Value Stream Mapping and OPA-Fuzzy-TOPSIS Analysis
Authors: Mishra Vinaytosh
Published: October 2024

Healthcare systems are inherently complex, and service delivery requires patient customization. Chronic care requires patients to spend significant time in the clinic for proper care. Long waiting times in healthcare facilities contribute to patient dissatisfaction and poor adherence to medical regimes. This study presents a method for analyzing non-value-added activities in the service supply chain and offers a prescriptive framework to minimize them. The method used to analyze the current and future state is value stream mapping, while stakeholder analysis was performed to understand the power and interest of stakeholders. Finally, this study uses the ordinal priority approach (OPA) and Fuzzy-TOPSIS to prioritize the action points for achieving the future state in the case organization. To illustrate the approach suggested in this study, a case of a diabetes speciality clinic was used. This study’s findings suggest hiring paramedical staff and clubbing diabetes education in medical nutrition therapy can reduce waiting time without affecting quality. The study further suggested that using multimedia in diabetes education is an effective strategy for reducing waiting times. Thus, this study provides a descriptive and prescriptive approach for analysis and improving healthcare service delivery. The findings of this study are useful for healthcare administrators and health policymakers.
“Huanglianjiedu Decoction” Against Pancreatic Adenocarcinoma Proliferation of by Downregulating the PI3K/AKT/mTOR and MAPK/ERK1/2 Signaling Pathways
Authors: Dong, MD Shu , Xu, MD Panling , Yang, MD Peiwen , Jiao, MD Juying , Cheng, MD, PhD Chien-shan , Chen, MD, PhD Lianyu
Published: October 2024

Background

Huanglianjiedu decoction (HLJDD) is a classical Traditional Chinese Medicine (TCM) prescription with thousand years of clinical use against various malignancies, including pancreatic adenocarcinoma (PAAD). However, its potential bioactive component and molecular mechanism remains unclear.

Aims

This study is to inspect the HLJDD mechanisms of action against PAAD via integrated computational and pharmacochemistry strategy, in vivo and in vitro experiments to validate associated targets and pathways.

Methods

A PAAD xenograft model was established by subcutaneous injecting Panc02 cells into C57BL/6 mice. Ultra-high performance liquid chromatography with tandem mass spectrometry (UHPLC-MS/MS) was engaged to determine constituents of HLJDD and assessed for pharmacokinetic scheme using the TCM Systems Pharmacology Platform (TCM-SP). Differentially expressed genes (DEGs) of PAAD was retrieved from the transcriptome dataset GSE43795, followed by recognizing overlapping targets the oncogenes and target genes of PAAD and HLJDD, respectively. Putative signaling pathways of HLJDD in treating PAAD were enriched using KEGG and GO analyses. The anti-PAAD effects of HLJDD was assessed in vivo and in vitro, besides, the potential mechanism was validated using immunoblotting and immunohistochemical assays.

Results

HLJDD significantly suppressed the growth of transplanted PAAD tumors, constrained PAAD progression, and induced apoptosis and S-phase arrest. Seventy-five active components meeting the drug-likeness criteria and 278 target genes of HLJDD were identified. KEGG analysis indicated that the top three enriched pathways were cancer, AGE-RAGE signaling, and IL-17 signaling pathways. Disease enrichment analysis highlighted immune, pharmacological, and cancer-related diseases as the top three categories. A total of 47 potential target genes were identified. Immunoblotting revealed that HLJDD inhibited PI3K and MAPK-related signaling pathways, while immunohistochemical staining confirmed that HLJDD suppressed the expression of phosphorylated MAPK and ERK1/2.

Conclusion

HLJDD inhibited PAAD in vitro and in vivo via the modulation of multiple mechanisms, including regulation of PI3K/AKT/mTOR and MAPK/ERK1/2 signaling pathways.
Cross-cultural adaptation and psychometric evaluation of the Emergency Medical Services Safety Attitudes Questionnaire in the Brazilian context
Authors: Camargo Fernanda Silva Oliveira , Massago Miyoko , Bonfim Samile , Dutra Amanda de Carvalho , Oliveira Araújo Edilaine Aparecida de , Oliveira Márcia Rosângela Neves de , Pujals Constanza , Gurgel Sanderland José Tavares , Radovanovic Cremilde Aparecida Trindade , Vissoci João Ricardo Nickenig , de Andrade Luciano
Published: October 2024

Background

Ensuring patient safety is essential to prevent and minimize adverse events, and pre-hospital services play a vital role in the healthcare network, serving as the starting point for quality care. This study aimed to adapt the Emergency Medical Services Safety Attitudes Questionnaire to the Brazilian context and evaluate its psychometric properties.

Methods

Beaton and colleagues’ guidelines were used as a reference. Construct validity was evaluated by confirmatory factor analysis (CFA) based on the responses of 93 participants. Questions with reverse scoring were excluded in a further CFA.

Results

The content validity index was 0.99, and Cronbach's alpha was 0.90. The initial CFA resulted in a Tucker–Lewis index (TLI) of 0.95 and a comparative fit index (CFI) of 0.951. After the exclusion of reverse-coded questions (Q4 and Q9), TLI increased to 0.96 and CFI to 0.97.

Conclusions

The adapted instrument demonstrated good content, face, and construct validity, confirming its suitability for evaluating patient safety in prehospital services in Brazil. It can guide adjustments in care protocols, contributing to the safety and effectiveness of prehospital care while aligning with patient-centered best practices.
Comparing visual estimation and hematocrit change in the assessment of blood loss among women undergoing cesarean delivery in a tertiary facility in northern Uganda
Authors: Edilu Robert , Sanvu Aaron , Ecuut James , Odong Alban , Bongomin Felix , Nantale Ritah , Ayikoru Jackline , Arwinyo Baifa , Ojara Sande , Pebolo Pebalo Francis
Published: October 2024

Background:

Cesarean section poses a fourfold risk for postpartum hemorrhage (PPH), necessitating accurate blood loss estimation to enable timely interventions. However, the conventional visual estimation method often leads to underestimation, resulting in undiagnosed PPH even in our setting, Uganda. Yet, the quantitative standard techniques remain underutilized.

Objective:

We compared visual and calculated blood loss among women undergoing cesarean delivery at Gulu Regional Referral Hospital in northern Uganda.

Design:

We employed a cross-sectional study design.

Methods:

We enrolled pregnant women scheduled for cesarean section and determined both calculated and visually estimated blood loss. Data analysis involved using Pearson’s moment correlation coefficient to compare the two methods and logistic regression to determine the factors associated with PPH.

Results:

We included 105 participants, most were primigravida ( n = 100, 43%), aged 15–24 years ( n = 100, 52%), with term gestation ( n = 100, 75%). The mean visual estimated blood loss (vEBL) was 235.3 ± 123.7 ml (interquartile range (IQR) 50–600 ml), while the calculated estimated blood loss (cEBL) was 435.0 ± 1328.2 ml (IQR −11,182.1–2226.7 ml). Visual estimation underestimated blood loss in 90% of cases ( n = 100), and 21% ( n = 21) had undiagnosed PPH (>1000 ml blood loss). None of the respondents had PPH (>1000 ml blood loss) following vEBL. There was a small positive correlation between both methods (vEBL and cEBL; r = 0.1165; p = 0.2482). Women aged >35 years were 1.60 times more likely to experience PPH than their counterparts aged 25–34 years (adjusted odds ratio (AOR): 1.60; 95% CI: 1.11–2.30, p < 0.011). Chorioamnionitis increased the risk of PPH by 2.2 times (AOR: 2.20; 95% CI: 1.20–4.05, p < 0.012).

Conclusion:

The visual estimation technique significantly underestimated blood loss in up to 90% of cases, particularly during emergency cesarean sections. Among the 21% of cases diagnosed with PPH based on calculated blood loss, advanced maternal age and chorioamnionitis were notable contributing factors. Routine hemoglobin and hematocrit testing in obstetric care can be effectively utilized to objectively assess blood loss, aiding in the accurate diagnosis and management of PPH. Implementing these measures, even in resource-constrained settings, can significantly reduce the morbidity and mortality associated with PPH.

Trial registration:

Not applicable.
Exploring challenges to the uptake of sexual and reproductive health services among lesbian and bisexual women in Bulawayo, Zimbabwe: a qualitative enquiry
Authors: Khozah Methembe Yotamu , Nunu Wilfred Njabulo
Published: October 2024

Background:

Reproductive healthcare is essential for all people, including lesbian and bisexual women. However, lesbians and bisexual women are among society’s most marginalised and excluded members.

Objective:

This study aimed to explore the challenges faced by lesbian and bisexual women in accessing Sexual and Reproductive Health (SRH) Services in Bulawayo, Zimbabwe.

Design:

An exploratory, descriptive qualitative study was conducted on two populations that included eight participants identified through the Voice of the Voiceless organisation in Bulawayo and 10 key informants and probed the challenges faced by lesbians and bisexual women when accessing SRH services.

Methods:

Data were gathered through 10 key informant interviews and 1 focus group discussion (FGD; with 8 participants). The interviews and FGDs were recorded, transcribed verbatim, coded and thematically analysed.

Results:

The themes that emerged included the uptake of SRH services among lesbians and bisexual women, the challenges faced by lesbians and bisexual women when accessing SRH services, and strategies to aid the uptake of SRH services by lesbians and bisexual women. The findings showed that the uptake of SRH services was generally low and was influenced by factors such as clinical settings. The challenges mentioned included stigma and the unavailability of specific lesbian and bisexual women’s services. By contrast, the most frequent strategies included affirmative training for healthcare providers and improved clinical settings to become friendly and inclusive.

Conclusion:

There is an imperative for targeted SRH services that address the distinct needs of lesbians and bisexual women, in line with the 95-95-95 strategy and Sustainable Development Goals target 3.7. The observed low uptake of these services can be attributed to several systemic barriers, including inadequate training of health providers, negative attitudes and lack of inclusive policies. Enhancing the sensitivity of health facilities, strengthening links to sexual health education and implementing supportive legal frameworks are essential steps to improve SRH outcomes in this population. These findings elucidate critical gaps within the current healthcare system and present significant opportunities for policymakers to formulate evidence-based strategies to ensure equitable access to SRH services, thereby advancing public health objectives.