bluuebunny/crossref_metadata_2025 huggingface dataset:
Sefer Yeṣirah’s Dating, Geographic Provenance and the Open Question of Its Composer’s Religious Affiliation and Identity
Authors: Zinner Samuel
Published: December 2023

In 2018, Weiss has ended centuries of speculation about the enigmatic Hebrew Sefer Yeṣirah’s dating and geographical provenance, demonstrating with a high level of confidence (specifically on the basis of Sefer Yeṣirah’s Syriac grammarian loanwords) a seventh-century C.E. Syrian origin. Weiss and others have also shown that Sefer Yeṣirah’s closest parallels are in Syriac Christian grammarian and theological sources. Given that abundant evidence points to a Rabbinic form of Judaism present in ancient Syria, the theory of a Jewish composer is odd because of the text’s non-Rabbinic character. Similarly, the theory of a Syriac Christian or “Jewish-Christian” author is odd in view of the text’s composition in Hebrew instead of Syriac. It remains for future research to solve this final enigma of the religious identity of Sefer Yeṣirah’s composer.
Seventy-Two and The One Nation
Authors: Nicolaus Peter , Rodziewicz Artur
Published: December 2023

The current article sheds light on the symbolism of the number 72 in Yezidism and briefly outlines its roots in ancient Mesopotamian religions, Judaism, Christianity, and Islam. Furthermore, it highlights the link between 72 nations and 72 genocides in Yezidi perception.
Tétouan et la littérature généalogique à l’époque de Mawlāy Ismāʿīl. Motivations et caractéristiques de deux enquêtes de vérification des généalogies
Authors: Dahia Bilal
Published: December 2023

This article looks at the phenomenon of the writing of Cherifian genealogies, which came to the fore in Morocco in general, and in northern Morocco in particular, with the emergence of the Alawite dynasty. The case of Tétouan, which was the center of the governors of northern Morocco at the time, will be studied, examining the city’s relationship to the phenomenon of Sherifism. The article examines the reason for the emergence of works specializing in chorfa genealogies at the time of Mawlāy Ismāʿīl in Tetouan. We’ll see how attempts were made to distinguish the chorfa as a noble class distinct from the masses in certain tribes, particularly among the Banī ʿArūs and the Banī Ḥassān, and their consequences, including the phenomenon of the “so-called chorfa” (al-mutašarrifah) since the 15th century. This phenomenon was at the origin of the genealogical registration movement in the Alawite period. In this study, we will examine two examples of the oldest treatises on the genealogy of the chorfa in Tétouan, these are Dawaʿī al-ṭarab fī -ẖtisāri ansāb al-ʿarab written by Ibn al-ʿĀfiyah al-Zaǧnī, and Šaḏar al-ḏahab fī ẖayr nasab written by Ibn Raḥmūn al-Ḥasanī. These two books share very similar characteristics in terms of the nature of the content, based on literal transmission and data collection in the first instance, with very limited scope for discussion and analysis. In conclusion, we will discuss the degree of success they achieved in combating the mutašarrifah phenomenon in northern Morocco.
Right-Moving Supercell Tornadogenesis during Interaction with a Left-Moving Supercell’s Rear-Flank Outflow
Authors: Edwards Roger , Thompson Richard L.
Published: December 2023

On the local afternoon of 29 May 2012, a long-lived, right-moving (RM) supercell formed over northwestern Oklahoma and turned roughly southeastward. For >3 h, as it moved toward the Oklahoma City, Oklahoma, metro area, this supercell remained nontornadic and visually high-based, producing a nearly tornadic gustnado and a swath of significantly severe, sometimes giant hail up to 5 in. (12.7 cm) in diameter. Meanwhile, a left-moving (LM) supercell formed over southwestern Oklahoma about 100 mi (161 km) south-southwest of the RM storm, and moved northeastward, with a rear-flank gust front that became well defined on radar imagery as the LM storm approached southern and central parts of the metro. The authors, who had been observing the RM supercell in the field since genesis, surmised its potential future interaction with the LM storm’s trailing gust front about 1 h beforehand. We repositioned to near the gust front’s extrapolated collision point with the RM mesocyclone, in anticipation of maximized tornado potential, then witnessed a small tornado from the RM mesocyclone immediately following its interception of the boundary. Synchronized radar and photographic images of this remarkable sequence are presented and discussed in context of more recent findings on tornadic supercell–boundary interactions, with implications for operational utility.

Significance Statement

Supercells—well-organized, rotating thunderstorms mainly found in midlatitudes—commonly produce the largest hail, along with damaging gusts and most tornadoes. In radar imagery and photographs, we show the characteristics and merger of two supercell types: left-moving and right-moving, with respect to winds aloft. As the left-moving storm’s trailing gust front interacted with the right-mover’s mesocyclone, the latter strengthened quickly, soon producing a tornado. Observed evolution of these storms supports idealized numerical and conceptual models for supercell behavior and interactions with storm-scale boundaries, and may be useful in short-fused tornado forecast and warning operations.
Designing the Intelligent Organization: Six Principles for Human-AI Collaboration
Authors: Kolbjørnsrud Vegard
Published: December 2023

This article presents principles and practical guidelines for how managers can succeed in growing the intelligence of their organizations by harnessing the complementary strengths of humans and artificial intelligence (AI). Organizational intelligence is the ability of collectives of intelligent human and digital actors to solve problems and adapt. Six principles for human-AI collaboration in organizations are explored—addition, relevance, substitution, diversity, collaboration, and explanation—and how they play out in leading organizations is discussed. Finally, practical guidelines are outlined for how leaders can enable their organizations to successfully make the change.
I Trends on Democratic Erosion: The Role Of Agency And Sequencing
Authors: Kneuer Marianne
Published: December 2023

Democratic erosion has become the main path of movement away from democracy since 1990. Distinct from abrupt breakdowns like coups d’état, executive coups, military defeat, or foreign invasions, the erosion of democratic systems occurs as a gradual and incremental process, driven by legally elected incumbents and by legal means (or by upholding the façade of legal means). These incumbents are change agents who deliberately and actively endeavor to dismantle the democratic rules of the game. This text addresses some still unsolved but highly relevant conceptual issues in the ongoing research of democratic erosion: the delineation between democratic erosion and loss of democratic quality and the delineation between democratic erosion and autocratization. Moreover, the article focuses on two main features of democratic erosion — agency and incrementality — and suggests a model for the sequencing of democratic erosion.
Marijuana Message Channels, Health Knowledge, Law Knowledge, and Confidence in Knowledge as Risk and Protective Factors of Marijuana Use among College Students
Authors: Park Sung-Yeon , Joa Claire Youngnyo , Yun Gi Woong , Constantino Nora
Published: December 2023

Marijuana use among U.S. college students is the highest since the mid-1980s. Because knowledge about marijuana and confidence in the knowledge are related to changing marijuana laws and marijuana-related messages ubiquitous in college students’ information environment, we examined their relationships with use. The Structural Equation Modeling method was used to analyze the relationships using survey responses from 249 college students in an adult-use marijuana legal state. Marijuana health knowledge was related to less use, and law knowledge was related to more use. Both relationships were mediated by perceived risk. Confidence in knowledge was related to more use directly as well as indirectly via lower peer disapproval and lower perceived risk. Among various marijuana message channels, peers were the most influential, contributing to lower health knowledge and higher confidence in knowledge.
Book review: Ashok Pankaj, Inclusive Development Through Guaranteed Employment: India’s MGNREGA Experiences
Authors: Saxena K. B.
Published: December 2023

Ashok Pankaj, Inclusive Development Through Guaranteed Employment: India’s MGNREGA Experiences, Springer, 2023, 313 pp., ₹10,115.00, ISBN 9789811574429 (Hardcover).
Preparatory labor for chemical fertilizer: Rural modernity and the practices of South Korean farmers in the 1960s
Authors: Lee Juyoung
Published: December 2023

This article examines preparatory labor practices that South Korean farmers had to undertake to use chemical fertilizers in the 1960s. Preparatory labor, such as learning about and acquiring fertilizers, that came prior to the use of chemical fertilizer in the field was mundane and often invisible. However, it was this logistical and emotional labor that was essential for the maintenance of South Korea’s chemical fertilizer system. In the system, which was part of the government’s efforts to establish rural modernity through increased crop productivity, the state looked down on farmers as the subject of edification. Nevertheless, the farmers were crucial maintainers of the state-led agricultural reform, realizing the government’s vision of modernity. To reveal the hidden relationship between farmers, technology, and the state, this article extensively uses diaries written by two farmers – Yoon Heesoo from Daecheon Village and Shin Kwonsik from Daegok Village. By doing so, this article aims to shed light on the voices of farmers and their roles in the agricultural reform of 1960s South Korea and, more broadly, of the Green Revolution.
Creativity During Threat to Organizational Survival: The Influence of Employee Creativity on Downsizing Survival Selection
Authors: Halinski Michael , Boekhorst Janet A. , Allen David , Good Jessica R. L.
Published: December 2023

Although research consistently shows that employee creativity contributes to positive outcomes for teams and organizations, we have limited insight into how employee creativity shapes the outcomes of those employees who demonstrate such creativity, particularly in the context of environmental uncertainties. Drawing from event system theory and threat rigidity theory, we argue that under a threat to organizational survival, incremental creativity has a positive, and radical creativity has a negative, indirect effect on downsizing survival selection via manager evaluations of employee job performance. Study 1 uses a unique three-wave, three-source field study ( n1 = 186) to provide support for our hypotheses. Studies 2 and 3 use experimental data ( n2 = 410, n3 = 565) involving different scenarios of threats to organizational survival (i.e., organization’s innovation failure, competitor’s successful innovation) that provide further support for the hypothesized effects of radical creativity on manager evaluations of employee job performance. Post-hoc analyses reveal novel insights into how managers’ creativity preferences can influence their evaluation of the job performance of employees who demonstrate incremental creativity during threatening events.
Understanding Health, Subjective Aging, and Participation in Social Activities in Later Life: A Regional Finnish Survey
Authors: Vaartio-Rajalin Heli , Snellman Fredrik , Gustafsson Ylva , Rauhala Auvo , Viklund Emilia
Published: December 2023

To understand health and well-being in later life, it is vital to consider the meaning of subjective aging. This study aimed to explore how perceived health, self-perceptions of aging, and participation in social activities relate to each other among older persons in the Bothnia region and Åland islands in Finland. Data were analyzed using Spearman’s and polychoric correlation and multinomial logistic regression analyses. The perceived good health and the younger physical, psychological, and social dimensions of subjective age were found to be associated with each other and with participation in social activities outside one’s home.
Thrombolytics in Cardiac Arrest from Pulmonary Embolism: A Systematic Review and Meta Analysis
Authors: Feltes Jordan , Popova Margarita , Hussein Yasir , Pierce Ayal , Yamane David
Published: December 2023

Background

During cardiopulmonary resuscitation, intravenous thrombolytics are commonly used for patients whose underlying etiology of cardiac arrest is presumed to be related to pulmonary embolism (PE).

Methods

We performed a systematic review and meta-analysis of the existing literature that focused on the use of thrombolytics for cardiac arrest due to presumed or confirmed PE. Outcomes of interest were return of spontaneous circulation (ROSC), survival to hospital discharge, neurologically-intact survival, and bleeding complications.

Results

Thirteen studies with a total of 803 patients were included in this review. Most studies included were single-armed and retrospective. Thrombolytic agent and dose were heterogeneous between studies. Among those with control groups, intravenous thrombolysis was associated with higher rates of ROSC (OR 2.55, 95% CI = 1.50–4.34), but without a significant difference in survival to hospital discharge (OR 1.41, 95% CI = 0.79–2.41) or bleeding complications (OR 2.21, 0.95–5.17).

Conclusions

Use of intravenous thrombolytics in cardiac arrest due to confirmed or presumed PE is associated with increased ROSC but not survival to hospital discharge or change in bleeding complications. Larger randomized studies are needed. Currently, we recommend continuing to follow existing consensus guidelines which support use of thrombolytics for this indication.
The “Dark Side” of Climate Action Planning
Authors: Swanson Kayleigh
Published: December 2023

We are increasingly seeing the unintended social consequences of climate action planning as urban efforts to be climate-responsive create uneven exposure to climate risks and contribute to new forms of gentrification and displacement. I use Yiftachel’s four dimensions of planning control as a framework to explore the circumstances in which planning emerges as an oppressive activity in the context of climate change. I argue that seemingly progressive mitigation and adaptation actions are accompanied by a “dark side” that can advance regressive outcomes despite the positive intentions of planners.
The Inner Dynamics of Moral Economies: The Case of Waste Management
Authors: Sosna Daniel
Published: December 2023

This article examines the internal dynamics and relationality of moral economies. It focuses on labor relations to understand how people find balance between collective moral frameworks and individual everyday acts. Drawing on ethnographic research among Czech landfill workers during the neoliberalization of the waste industry in the 2010s, the article explores two spheres of waste management: the informal scavenging of landfill workers and the management of wastewater. Salvaging things via scavenging and management of wastewater provides two arenas for analyzing the ways people reason about the good, dignity, and justice while following their own goals. Using inspirations from the scholarship on moral economy and everyday ethics, the author argues that these two theoretical directions may benefit from the respective strengths of each other’s approaches: a capacity to recognize patterns of moral reasoning behind struggles for dignity in an unequal world versus an actor-oriented situational sense of ethics growing from everyday life on the ground. The article points at a scalar reshaping of moral economies and brings attention to a morality that does not reflect only direct transactions but also more imaginative relations to distant others.
Overlooked and Undeserving: Older People in Narratives of Return in Post-1989 East Germany
Authors: Hachmeister Maren
Published: December 2023

The German right-wing populist party “Alternative for Germany” (AfD) opposes diverse family lifestyles by promoting the return to a family model of father, mother, and children. This “Narrative of Return” paves the way for the party’s anti-gender, anti-childlessness, and anti-immigration agendas. This article examines how narratives about families as promoted by the AfD reflect or address experiences of the post-socialist transformation in East Germany. It turns out that Narratives of Return (NoR) overlook the elderly as acting individuals and disregard the ways they engage with their families and how they continue to organize their lives autonomously in old age. NoR instead depict older people as an anonymous group of supposedly undeserving pensioners, who benefit from society and family without having any function in them. However, discourses on care for the family can be traced down to a micro-level that confirms how care for the family is, in fact, care for older people. The article presents two selected life stories of advanced-age East Germans to substantiate this claim. The life stories reveal that older people themselves believe in various notions of family, despite being served with NoR in the recent past. Experiences in the former German Democratic Republic (GDR) even seem to prevent older people from again falling for totalizing schemes that order and prescribe uniform (family) experience. Consequently, it is not to be expected that NoR will succeed in closing discourses on care for the family easily.
Narrative(s) of Return and the Gendered Memory Politics of Post-1989 Transformation: Populist Familism, Catholic Fundamentalism, and Liberal Feminism in Poland
Authors: Wawrzyniak Joanna , Sikorska Małgorzata
Published: December 2023

This article has two main objectives. First, it proposes an analytical framework for how to explore “narratives of return” as policy proposals and tools of memory politics. Second, it reveals coexisting versions of “return” advocated by three Polish political actors: the populist right-wing Law and Justice party (“Return” to the Nation), Catholic activists (“Return” to Religion), and representatives of liberal feminism (“Return” to Women’s Rights). The case material consists of four policy proposals relating to either family or women’s reproductive rights. The article shows that all analyzed political narratives of return have used some variation of the discourse on victimhood, and all of them mean to terrify and raise fear. The policy proposals draw on Polish collective memory and, specifically, on the politics of memory of the post-1989 transformation.
The Treaty of Brest-Litovsk and the Repatriation of East Prussian Deportees from Simbirsk during World War I
Authors: Perrin Charles
Published: December 2023

This article assesses whether the repatriation of civilian prisoners of war, most of whom were East Prussian deportees, from Simbirsk to Germany between April and June of 1918, was carried out according to the terms of the Treaty of Brest-Litovsk. Simbirsk, which was home to more East Prussian deportees than any other internment site in Russia, is particularly well-suited for a case study of the repatriation of civilian prisoners from Russia during World War I because the correspondence and memoirs of those who were involved in the repatriation still exist and are accessible outside Russia. The article concludes that the repatriation of civilian prisoners of war interned in Simbirsk was not carried out according to the terms of the Treaty of Brest-Litovsk—at least not according to how the treaty was interpreted by the German and Russian governments—and identifies several reasons why this was the case. This case study may have policy implications for the current war in Ukraine, which has also been characterized by the deportation of civilians from Russian-occupied territory to Russia, although on a much larger scale. If the war in Ukraine ends in a negotiated settlement between Ukraine and Russia, the repatriation of Ukrainian deportees will be an important part of that settlement. The article offers several recommendations for the Ukrainian officials who would be responsible for negotiating such a settlement to avoid chaotic evacuations similar to what happened in Simbirsk during World War I.
New Validated Tool to Diagnose Breastfeeding Dysfunction
Authors: Agarwal Rajeev , Eddis-Finbow Mars , Tam Jodie , Broatch Jennifer , Bussey Kimberly J.
Published: December 2023

Background:

Breastfeeding behaviors and experiences exist on a continuum. What differentiates normal from dysfunctional is defined by frequency and severity. No current validated tool addresses the subjective experience of dyads with a predictive score that can be followed over time.

Research Aim:

To create and validate a self-report tool to assess breastfeeding and evaluate its ability to predict risk of breastfeeding dysfunction.

Methods:

This study used a cross-sectional design to determine the validity of a novel instrument to assess breastfeeding dysfunction. We gave the initial questionnaire to 2085 breastfeeding dyads. We assessed content validity by comparison with other tools. We used exploratory factor analysis with varimax rotation for concept identification and Cronbach’s alpha for internal consistency. We employed logistic regression to assess the tool’s ability to differentiate between normal breastfeeding and breastfeeding dysfunction.

Results:

Factor analysis mapped 17 questions to four concepts to create a score (FLIP; flow, latch, injury [to the nipple], and post-feed behavior). Internal consistency and reliability of the scores in these concepts were acceptable (Cronbach’s alpha ≥ 0.087 for all measures). A logistic regression model that controlled for infant age, with a breastfeeding dysfunction risk classification threshold of 60%, yielded a correct classification of 88.7%, with 93.1% sensitivity, 64.6% specificity, and a 6.5% false positive rate.

Conclusions:

The FLIP score was determined to be a valid and reliable instrument for quantifying the severity of breastfeeding dysfunction in children under 1 year old. Further studies will assess its usefulness in the management of breastfeeding dysfunction.
‘Rocking the establishment’: Subculture, authenticity and the populist radical right in Sweden
Authors: Schiller Melanie
Published: December 2023

This article uses the recent rise of populist radical right discourses in society as a cultural and political phenomenon to explore the role of popular music in constructing these discourses, with a focus on the Sweden Democrats (SD) and musician Peter Jezewski. By examining Jezewski’s direct collaborations with the SD and his song ‘My Land’, the article uncovers how popular music culture participates in the construction of populist discourses of ‘the people’ in nativist terms. The article contends that certain subcultural styles in popular music resonate strongly with populist discourses of a ‘silenced majority’ in need of a strong populist leader and as such contribute to the construction of the ‘people’ versus ‘elite’ antagonism beyond the political realm. The case study of Jezewski’s song and music video emphasises how nostalgic rock culture enables populist articulations by aligning with populist radical right anti-establishment, preservationist−nativist discourses and the performative construction of ‘the people’. Drawing on cultural studies resources, the article hence investigates the practices that bring ‘a people’ into existence through cultural tropes and mechanisms to better comprehend the links between articulations of populism, popular culture and subcultural performances of counter-hegemonic resistance.
Justice and reconciliation: Responses to critics in Anthropological Theory
Authors: Mamdani Mahmood
Published: December 2023

This response seeks to distinguish further between perpetrators and beneficiaries. It links this distinction to two different forms of violence, criminal and political. The overall argument focuses on the relation between political and social justice.
Update in Progress: Cognitive Phenotypes in Temporal Lobe Epilepsy
Authors: Sarkis Rani A.
Published: December 2023

[Box: see text]
Sources of Well-Being for Hispanic Women Who Have Experienced Intimate Partner Violence: A Scoping Review
Authors: Baeza María José , De Santis Joseph P. , Cianelli Rosina , Metheny Nicholas , Villegas Natalia , Iriarte Evelyn
Published: December 2023

Purpose: This review sought to identify and integrate available evidence on various sources of Hispanic women's well-being following intimate partner violence (IPV). Methods: The review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Four peer-reviewed databases were reviewed for studies published between 2007 and 2022. The inclusion criteria include being an original research, quantitative and/or qualitative data, Hispanic women as a separate group for analysis, well-being as an outcome variable (quantitative) or phenomenon of interest (qualitative), and published in English or Spanish. Results: A total of 2,292 records were identified, and nine articles were included in the final review. Findings revealed that ensuring safety and opportunities for women's children, separating from violent partners, and obtaining a job were related to increased well-being. Other findings revealed that peer support, self-empowerment, and leadership skills were associated with interpersonal, psychological, and community well-being, respectively. Economic and occupational well-being was linked to education and financial independence. Conclusions: This scoping review advances the exploration of well-being among Hispanic women who have experienced IPV. This knowledge can be used to inform post-IPV support for Hispanic women and highlight areas for intervention development to promote well-being.
Mallet Hallux Injury Fixed With Extension Blocking Pin Technique: A Case Report
Authors: Giro Margaret E. , Quazi Nawreen , Elder Waters Michael , Lee Wonyong
Published: December 2023

Mallet hallux injuries are relatively rare, and management can range from conservative treatment to surgical fixation. Only a few cases of surgically treated are reported, and there is no consensus on the superiority of one technique to others in surgical treatment. We reviewed various options for surgical fixation of Mallet hallux injury and presented a case of mallet hallux injury treated with Kirschner wires with an extension blocking technique.

Level of Evidence: V
The meaning of attachment: Cruel intensions
Authors: Brasdefer Thomas
Published: December 2023

In this commentary, I address some of the assumptions of a geography focused on teleological promises. Ben Anderson presented attachment as a kind of relation with special endurance and significance, differentiating it from relations which may be entangled. As a result, the power of attachments lies in one's aspirations: they may turn abstract objects into proximal objects. I am responding to two emphases of the concept: on meaning and on sensuous attachment. I revisit Anderson and subsequent commentaries by Cockayne and Ruez, Coleman, Rose and Zhang plumbing their shared theoretical roots in Lauren Berlant and Michel Foucault for connective tissue. I refer casually to the rich literature in analytic philosophy on meaning. Caveat lector that there exists a lengthy debate on ‘belief–desire’ in philosophy and psychology about whether these affects alone may cause human action or if they need an external object: how can we know what we want if we do not know about it? For lack of space and geography, I will not cover this topic, and furthermore I am not bridging the chasm between analytic and continental philosophy; but both present methodological difficulties to attachment-as-placemaking.
Intention to use digital mental health solutions: A cross-sectional survey of university students attitudes and perceptions toward online therapy, mental health apps, and chatbots
Authors: Gbollie Elton Fayiah , Bantjes Jason , Jarvis Lucy , Swandevelder Sonja , du Plessis Jean , Shadwell Richard , Davids Charl , Gerber Rone , Holland Nuhaa , Hunt Xanthe
Published: December 2023

Background

Globally, the high prevalence of mental disorders among university students is a growing public health problem, yet a small minority of students with mental health problems receive treatment. Digital mental health solutions could bridge treatment gaps and overcome many barriers students face accessing treatment. However, there is scant evidence, especially in South Africa (SA), relating to university students’ use of and intention to use digital mental health solutions or their attitudes towards these technologies. We aim to explore university 2students attitudes towards and perceptions of digital mental health solutions, and the factors associated with their intention to use them.

Methods

University students from four SA universities ( n = 17 838) completed an online survey to assess experience with, attitudes and perceptions of, and intentions to use, digital mental health solutions. We conducted an exploratory factor analysis to identify factors underlying attitudes and perceptions, and then used multivariate ordinal regression analysis was used to investigate the factors’ association with students’ intention to use digital mental health solutions.

Results

Intention to use digital mental health solutions was high, and attitudes towards and perceptions of digital mental health solutions were largely positive. Importantly, our analysis also shows that 12.6% of users were willing to utilise some form of digital mental health solutions but were unwilling to utilise traditional face-to-face therapies. The greatest proportion of variance was explained by the factor ‘Attitudes towards digital technologies’ utility to improve student counselling services, provided they are safe’.

Conclusion

SA university students are already engaging with digital mental health solutions, and their intention to do so is high. Certain attitudes and perceptions, particularly concerning the utility, effectiveness, and safety, underlie willingness to engage with these solutions, providing potential targets for interventions to increase uptake.
The role of digital health in revolutionizing healthcare delivery and improving health outcomes in conflict zones
Authors: Ahmed Sirwan Khalid , Hussein Safin , Chandran Deepak , Islam Md. Rabiul , Dhama Kuldeep
Published: December 2023

The provision and planning for healthcare delivery in conflict is a pressing imperative. Healthcare within these environments is naturally complex, given the entanglement of affected populations, militaries and oft-deteriorating public services. The field of digital health, placed at the intersection of healthcare and technology, has the power to revolutionize healthcare delivery and improve health outcomes worldwide. Its impact is particularly significant in conflict zones, where it can address the unique challenges faced by these regions. Violence, damaged infrastructure, restricted mobility, forced migration, and overstretched healthcare facilities are all hallmarks of conflict zones that demand novel approaches to addressing them. Health care delivery is being revolutionized by the introduction of digital health technology in conflict zones, which are improving access, emergency response capacities, health information management, and mental health assistance. Doctors and aid organizations can more easily overcome challenges and reach out to underserved populations in these regions because to digital technological improvements. Recent decades have seen a shift in the nature of conflict, and with it, a corresponding shift in the range of digital health solutions available to address geographical, epidemiological, and clinical gaps. The purpose of this letter is to inquire into the application of digital health in conflict zones and its potential to lessen the pressing healthcare needs of affected communities.
Leadership Development Elements Contained in the Life Stories of Leadership Members
Authors: Loci Sokol , Peterlin Judita
Published: December 2023

Life stories are considered an inexhaustible source of information, which serves for the development of leadership elements and is a determining factor for raising the awareness of leadership members to understand the nature and existence of personal values, which then leadership members can use in a process of decision-making. We aim to bring insights into the process of collaborative decision-making and its linkage with personal past experiences divided into four life-story aspects. We used a semi-structured interview with managers positioned in the top hierarchical line in the organization, and we used the critical incident technique to prepare the questionnaire. We analyzed our empirical data by using the qualitative thematic method of analysis. The main finding is that valuable leadership development elements are contained in the life stories. The new insight is also that life stories are a new path to influence and develop the awareness of the values and purpose of a leadership member.
A Linked Population-Based Analysis of Severe Lower Extremity Traumas in Ontario
Authors: Kim Stephanie M. , McClure Andrew , Reid Jennifer , Dubois Luc , Lawendy Abdel-Rahman , Simpson Andrew M.
Published: December 2023

Background: Successful management of open tibial fractures often requires a multidisciplinary approach. Previous literature has shown that admission to a trauma centre and coordinated management of early bony fixation and soft-tissue reconstruction improve patient outcomes. The objective of this study was to describe patients who had open tibial fractures in Ontario and analyse their outcomes. Method: Linked population-based administrative data pertaining to patients who had open tibia fractures between the years 2009 and 2020 were examined. Demographic information, admission location, timing of soft-tissue reconstruction, and complication rates were collected. Results: 4240 patients were identified. The mean age was 47, and the majority were males. One-third of the patients were admitted to a trauma centre. This group were more likely to have an Injury Severity Score >15, and associated neurovascular injuries of the leg. When outcomes were compared over 1 year, the trauma centre group was more likely to undergo limb amputation, but also more likely to have a soft-tissue reconstruction. The average time to soft-tissue reconstruction was 20 days. Patients receiving care in a trauma centre were more likely to have an external fixation, plastic surgery consults, and longer hospital stay. There were no differences in the odds of infection, malunion or nonunion, and 30-day mortality. Conclusions: These findings provide a comprehensive examination of the clinical course for patients experiencing open tibia fractures in Ontario. Future studies can help facilitate coordinated efforts between different specialties to expedite care and improve overall outcomes.
What Benefits Might a Family Expect From Using Spiritual Coping Mechanisms When Providing Care for People With Schizophrenia? Literature Review
Authors: Rohmi Faizatur , Yusuf Ah , Fitriasari Rizky , Agustinus Hardiyanto
Published: December 2023

Introduction

Caring for people with schizophrenia has consequences, one of which is stressors during care. Families as caregivers often using coping strategies that involve relationships with self, others, or the transcendent/God or nature and also may include religious/spiritual practices.

Objectives

This literature review aims to identify the benefit of using spiritual coping as used by a family schizophrenia caregiver. The variable is spiritual coping.

Methods

This literature review method used PRISMA methodology for systematic reviews. Search was conducted in March 2017, updated in August 2022 and submitted in April 2023 for the publication process, limited to English by using electronic databases: Scopus, ScienceDirect, Sage, ProQuest, and PubMed.

Results

Fifteen studies were included in this review. Two synthesized findings emerged: spiritual coping strategies used by family caregivers give positive effects for family.

Conclusion

When the stress or crisis phase is experienced while caring for people with schizophrenia, the family who acts as a caregiver reveals the meaning of life they have and that they feel hopelessness and helplessness. In an effort to overcome the family's burden as caregivers, they often use spiritual coping, which is important to increase the caregiver's wellbeing.
Engaging with communities in rural, coastal and low-income areas to understand barriers to palliative care and bereavement support: reflections on a community engagement programme in South-west England
Authors: Hansford Lorraine , Wyatt Katrina , Creanor Siobhan , Davies Jennie , Horne Gillian , Lynn Amanda , McCready Sheena , Pearce Susie , Peeler Anna , Rhys Ann , Sallnow Libby , Harding Richard
Published: December 2023

Background:

England’s South-west Peninsula is largely rural, has a high proportion of over 65s, and has areas of rural and coastal deprivation. Rural and low-income populations face inequities at end of life and little is known about the support needs of rural, coastal and low-income communities.

Objectives:

To understand how to foster community support for dying and grieving well, a regional, multi-sectoral research partnership developed a community engagement programme to explore experiences of seeking support, issues important to people and the community support they valued. This article shares what people told us about the role that communities can play at end of life, and reflects on learning from our process of engaging communities in conversations about dying.

Design and methods:

A programme of varied community engagement which included: the use of the ‘Departure Lounge’ installation and four focus groups with interested individuals in a range of community settings; the co-creation of a ‘Community Conversation’ toolkit to facilitate conversations with individuals with experience of end-of-life care and their carers with Community Builders; a focus group with Community Builders and a storytelling project with three bereaved individuals.

Results:

People valued community support at the end of life or in bereavement that offered connection with others, peer support without judgement, responded to their individual needs and helped them to access services. Creative methods of engagement show potential to help researchers and practitioners better understand the needs and priorities of underserved populations. Collaboration with existing community groups was key to engagement, and contextual factors influenced levels of engagement.

Conclusion:

Local community organizations are well placed to support people at end of life. This work highlighted the potential for partnership with palliative care and bereavement organizations, who could offer opportunities to develop people’s knowledge and skills, and together generate sustainable solutions to meet local need.
Positive Association Between the Immunogenetic Human Leukocyte Antigen (HLA) Profiles of Multiple Sclerosis and Brain Cancer
Authors: James Lisa M , Georgopoulos Apostolos P
Published: December 2023

Previous research has documented elevated risk of brain cancer in patients with multiple sclerosis (MS). Separately, human leukocyte antigen (HLA) has been implicated in protection or susceptibility for both conditions. The aim of the current study was to assess a possible role of shared immunogenetic influence on risk of MS and brain cancer. We first identified an immunogenetic profile for each condition based on the covariance between the population frequency of 127 high-resolution HLA alleles and the population prevalence of each condition in 14 Continental Western European countries and then evaluated the correspondence between MS and brain cancer immunogenetic profiles. Also, since each individual carries 12 HLA alleles (2 × 6 genes), we estimated HLA protection and susceptibility for MS and brain cancer at the individual level. We found that the immunogenetic profiles of MS and brain cancer were highly correlated overall ( P < .001) and across all 6 HLA genes with the strongest association observed for DRB1, followed by DQB1 and HLA-A. These findings of immunogenetic overlap between MS and brain cancer are discussed in light of the role of HLA in the immune system response to viruses and other foreign antigens.
Glutaminase Upregulation As a Mechanism of Chemotherapy Resistance in High-Risk Leukemia
Authors: Nalesnik Gregory Harrison , Dovat Sinisa , Bogush Daniel , Schramm Joseph
Published: December 2023

Many types of cancers are characterized by elevated glutamine consumption. Glutaminase is a therapeutic target to arrest cancer cell development. Ikaros (IKZF1) is a DNA-binding, zinc finger protein that functions as a transcriptional regulator and a tumor suppressor in leukemia. Ikaros activity is essential for normal hematopoiesis and immune development and is expressed at high levels in most hematopoietic cells. Deletion of IKZF1 leads to the downregulation and upregulation of many important genes and is a predictor of poor outcomes in leukemia. We hypothesize that upregulation of glutaminase in cancer cells with IKZF1 deletion may be a mechanism whereby high-risk leukemias convey chemotherapy resistance. Conversely, Ikaros may help keep healthy hematopoietic cells in-check by preventing over-expression of glutaminase.

To test this hypothesis, we exposed two lines of B-ALL cells to the allosteric and selective glutaminase inhibitor BPTES. One cell line had IKZF1 intact (Nalm-6 scramble) and one had IKZF1 deleted via a CRISPR knockout (Nalm-6 IK KO). Treatments were done in triplicate with an exposure time of 72 hours. WST-1 viability assay was used to obtain an IC50 value for each cell line. Leukemia cells with IKZF1 knocked out had a two-fold higher IC50 than cells with IKZF1 intact. This indicates that IKZF1 deletion may convey chemotherapy resistance by upregulating glutaminase and implies that strategies targeting glutaminase may improve treatment outcomes in high-risk leukemia patients.
Deep Learning for Morphology-Based, Bone Marrow Cell Classification
Authors: Sun Shenghuan , Cleave Jacob , Wang Linlin , Lucas Fabienne , Brown Laura , Spector Jacob , Boiocchi Leonardo , Baik Jeeyeon , Zhu Menglei , Ardon Orly , Lu Chuanyi M. , Dogan Ahmet , Goldgof Dmitry , Carmichael Iain , Prakash Sonam , Butte Atul , Goldgof Gregory Mark
Published: December 2023

The morphological classification of cells in bone marrow aspirate (BMA) is central to the diagnosis of hematologic diseases, including leukemias. Despite being a critical task, its monotonous, time-consuming nature and dependency on highly skilled clinical experts makes it prone to human error. Such errors can lead to delays and misdiagnoses that negatively impact patient care. To counter these challenges, we curated an expansive dataset of more than 40,000 hematopathologist consensus-annotated single-cell images, extracted from BMA whole slide images (WSIs), each annotated into one of 23 distinct morphologic classes.

We then utilized this data to develop DeepHeme, a convolutional neural network classifier designed for bone marrow cell typing tasks. DeepHeme achieves state-of-the-art performance in both the breadth of differentiable classes and accuracy across these classes. By comparing its performance to that of individual hematopathologists from three premier academic medical centers, using our gold standard consensus-labelled images, we found our AI algorithm either matched or surpassed the average performance across all classes. In addition, we integrated DeepHeme with internally developed region classifier and cell detection algorithms, culminating in a comprehensive diagnostic pipeline for whole slide cell differential.

We next tested DeepHeme on slides from an external hospital system at a major cancer center to evaluate the generalizability of our model, a necessary precondition to widespread application. DeepHeme demonstrated a high level of generalizability, evidenced by a decrease of only 4% in the mean F-1 score, from 0.89 to 0.85, across all 23 cell classes. Lastly, to improve access to the DeepHeme algorithm results and encourage further real-world generalizability testing, we developed a web application that allows scientists and clinicians to test the DeepHeme algorithm on either test images from our study or their own user-uploaded aspirates.
Mitochondrial Damage-Associated Molecular Patterns (DAMPs) Contribute to the Development of Murine Antibody-Mediated Transfusion-Related Acute Lung Injury (TRALI)
Authors: Marcoux Genevieve , Rebetz Johan , Moore Ellen , Cederholm Hilma , McGauran David , Johansson Karl , Semple John W
Published: December 2023

Transfusion-related acute lung injury (TRALI) is potentially life-threatening and has been ranked as the leading cause of transfusion-related fatalities since its description in the 1980s. With a 5 to 14% mortality rate, symptoms range from mild dyspnea, cough and fever to full-blown respiratory failure and severe hypoxemia, which usually occurs within 6 hours from the transfusion. To date, the pathogenesis is not fully understood, but it appears that TRALI requires two hits in order to be initiated; the first-hit is the patient's clinical condition often reflected by a state of inflammation while the second hit is the transfusion itself. Several published articles have shown that mitochondrial damage-associated molecular patterns (mtDAMPs) including extracellular mitochondria and mitochondrial DNA (mtDNA) are elevated in stored transfusion products that have been linked to adverse transfusion reactions. Using an in vivo murine model of TRALI where injection of a monoclonal anti-MHC class I antibody (34-1-2s) into LPS-primed BALB/c mice causes significant lung edema, we explored the possibility of whether mitochondria and mtDAMPs could act as first hits in TRALI induction. Mitochondria were prepared from mouse livers by differential centrifugation and purified on a density gradient. Intravenous injections of only mitochondria (2.5 x 10 8 per mouse) prior to injection with 34-1-2s caused TRALI characterized by significantly elevated lung wet/dry ratios (Figure 1A), temperature loss and lung neutrophil accumulation. In contrast, however, intraperitoneal injections of mitochondria did not prime as a first hit for 34-1-2s-induced TRALI suggesting that the route of the mitochondrial first hit is important in determining whether TRALI proceeds (Figure 1A.). Using a TLR9 agonist (ODN2395) to mimic mtDNA as a first hit, we also observed 34-1-2s-induced TRALI induction, and this could be prevented by the administration of a specific TLR9 antagonist (ODN4084F) 2h before the ODN2395 injection (Figure 1B). Of interest, the TLR9 antagonist was not sufficient to prevent TRALI induced by the iv whole mitochondria first hit, indicating that other mtDAMPS are also involved in the priming of the mice for TRALI. This study suggests that mitochondria and at least mtDNA can act as a first hit in antibody-mediated TRALI via stimulation of recipient TLR9 and that the first hit route maybe important in stimulating TRALI. Further investigations are underway to identify other mtDAMPS (such as N-formyl peptides) or a combination of DAMPs that are important for the first hit. Inhibition of mitochondrial DAMPS may be a potential therapy for transfusion recipients suffering from TRALI.