bluuebunny/crossref_metadata_2025 huggingface dataset:
Students’ Perspective on Undergraduate Research Experiences in Indonesian Dental Schools
Authors: Idrus Erik , Wahono Nieka A. , Yanuar Rezon , Wimardhani Yuniardini S. , Puspitawati Ria , Amir Lisa R.
Published: May 2024

Undergraduate (UG) research is considered as an essential part of dental education. Numerous dental schools have included required course‐based undergraduate research in their curricula. However, the implementation of UG research courses in the curriculum may vary between dental schools. In the present study, we aimed to evaluate student perspectives on UG research in the curriculum of Indonesian dental schools. A total of 203 participants from 10 dental schools returned the questionnaire. The participants were clinical students of the dentistry profession program who completed their undergraduate dentistry program from 2017 to 2022. The majority of study participants favored UG research in the curriculum of the undergraduate dentistry study program. Less than 20% participants perceived UG research experiments were not important in dental education. Factors that influenced these perceptions included the availability of adequate time to complete the course and sufficient support from research supervisors. Recommendations for improvement included providing an adequate time to complete UG research and adequate supervision to guide students to understand the conceptual background information of the research topics, designs, and scientific communication of data interpretation. Regular monitoring of students’ performance and progress would ensure completion of UG research courses in a timely manner. In conclusion, although UG research as a compulsory course in the Indonesian dental curriculum was well received by the students, overcoming the challenges is essential for the improvement of the research environment for undergraduate dental students.
Hyperlipidemia Is Not Related to Semen Quality, but to Serum Testosterone Levels
Authors: Bi Jiajie , Ma Jing , Yang Chaoju , Li Yuanjing , Liu Xuan , Tie Yanqing , Wang Shusong
Published: May 2024

Background. Currently, there are few studies on the effects of hyperlipidemia on semen parameters and serum hormones in men. In this study, we divided the study subjects into two groups of normal and hyperlipidemia according to the criteria, and observed the differences between semen parameters and serum reproductive hormones in hyperlipidaemic men and normal men, to explore the potential associations between the indicators. Materials and Methods. Eight hundred eighty five men attending infertility clinics in six hospitals from September 2016 to June 2017 were selected. Their lipid levels, semen parameters, and serum reproductive hormone levels were tested, and a total of 480 men with normal lipids and 405 men with hyperlipidemia were selected according to the criteria, and the relationship between semen quality, serum reproductive hormones, lipids and semen parameters, and serum hormones was statistically analyzed. Results. There was no significant difference in semen parameters between hyperlipidaemic men and normal men (P  > 0.05), serum testosterone levels were significantly lower in hyperlipidaemic men (P  < 0.05), and there was a negative correlation between triglycerides (TG) and testosterone in the blood (P  < 0.05).Conclusion. Hyperlipidemia does not affect male semen parameters, and changes in testosterone in hyperlipidaemic men may be related to triglycerides.
Enhancing Presurgical Infant Orthopedic Appliances: Characterization, Mechanics, and Biofilm Inhibition of a Novel Chlorhexidine-Halloysite Nanotube-Modified PMMA
Authors: Al Ansari Nadia , Abid Mushriq
Published: May 2024

Objectives. This in vitro study aimed to develop a novel nanocomposite acrylic resin with inherent antimicrobial properties. This study evaluated its effectiveness against microbial biofilm formation, while also assessing its physical and mechanical properties. Methods. Polymethylmethacrylate (PMMA) was modified with four different concentrations of chlorhexidine halloysite nanotubes (CHX-HNTs): 1%, 1.5%, 3%, and 4.5 wt.% by weight, along with a control group (0 wt.% CHX-HNTs). The biofilm inhibition ability of the modified CHX-HNTs acrylic against Candida albicans, Staphylococcus aureus, Streptococcus pneumoniae, and Streptococcus agalactiae was assessed using microtiter biofilm test. In addition, ten samples from each group were then tested for flexural strength, surface roughness, and hardness. Statistical analysis was performed using one-way ANOVA and Tukey’s test for comparison (P<0.05). Results. CHX-HNTs effectively reduced the adhesion of Candida albicans and bacteria to the PMMA in a dose-dependent manner. The higher the concentration of CHX-HNTs, the greater the reduction in microbial adhesion, with the highest concentration (4.5 wt.%) showing the most significant effect with inhibition rates ≥98%. The addition of CHX-HNTs at any tested concentration (1%, 1.5%, 3%, and 4.5 wt.%) did not cause any statistically significant difference in the flexural strength, surface roughness, or hardness of the PMMA compared to the control group. Conclusions. The novel integration of CHX-HNT fillers shows promising results as an effective biofilm inhibitor on acrylic appliances. This new approach has the potential to successfully control infectious diseases without negatively affecting the mechanical properties of the acrylic resin. Clinical Relevance. The integration of CHX-HNTs into presurgical infant orthopedic appliances should be thoroughly assessed as a promising preventive measure to mitigate microbial infections. This evaluation holds significant potential for controlling infectious diseases among infants with cleft lip and palate, thereby offering a valuable contribution to their overall well-being.
Applying a Human Rights‐Based Approach to Formal Care and Support Provided in the Home: A Narrative Review
Authors: Kelly Yvonne , Gannon Judy , Bassul Carolina , Williams Michelle , Morrissey David , McKee Joyce , Keyes Laura M. , O’Rourke Niamh , Flynn Rachel
Published: May 2024

Providing formal care and support in the home has many benefits. Applying a human rights‐based approach places the person and their human rights at the centre of all that a health and social care service does. There is a paucity of evidence on how to apply a human rights‐based approach in practice when providing homecare. Increasing knowledge and understanding of human rights will empower health and social care practitioners to protect and promote human rights in formal homecare. The aim of this narrative review was to identify and describe human rights‐based approaches in homecare, in order to promote awareness and understanding of a human rights‐based approach. Five bibliographic databases were searched. Primary research studies pertaining to the delivery of formal homecare that included a human rights‐based approach were eligible for inclusion. Sixteen articles were identified for inclusion. Quality appraisal and data extraction were conducted on included studies. A deductive framework analysis was used and concepts of a human rights‐based approach that emerged from the literature as relevant to homecare were as follows: dignity and respect, autonomy, equality, participation, and communication. We found that homecare planning and delivery requires the integration of human rights, using approaches, such as person‐centred care, partnerships in decision‐making, supporting independence, and acknowledging a person’s beliefs and cultures, in everyday practice. Findings from this review can support and enable service providers to apply human rights in everyday practice, ultimately for the benefit of people using homecare services.
Li-Fraumeni Syndrome With Six Primary Tumors—Case Report
Authors: Stojiljković Dejan , Cvetković Ana , Jokić Andrej , Mirčić Dijana , Mihajlović Sanja , Krivokuća Ana , Crnogorac Marija Đorđić , Glisic Lazar
Published: May 2024

Li-Fraumeni syndrome (LFS) is a cancer predisposition syndrome associated with a high, lifetime risk of a broad spectrum of cancers caused by pathogenic germline TP53 mutations. Numerous different germline TP53 mutations have been associated with LFS, which has an exceptionally diverse clinical spectrum in terms of tumor type and age of onset. Our patient has developed six asynchronous tumors to date: a phyllode tumor of the breast, a pheochromocytoma, a rosette-forming glioneuronal tumor (RGNT), an adrenocortical carcinoma (ACC), a ductal carcinoma of the breast, and a thymoma. The occurrence of such a number of rare tumors is sporadic even among in the population of patients living with cancer predisposition syndromes. In this instance, the omission of pretest genetic counseling and thorough family tree analysis prior to selecting the test led to the oversight of an underlying TP53 likely pathogenic mutation (classified as Class 4). This emphasizes the necessity for such counseling to prevent overlooking crucial genetic information. Neglecting this step could have had profound implications on the patient’s treatment, particularly considering the early onset and occurrence of multiple tumors, which typically raise suspicion of a hereditary component. The implications for family members must be considered.
Preliminary Exploration of Potential Active Ingredients and Molecular Mechanisms of Yanggan Yishui Granules for Treating Hypertensive Nephropathy Using UPLC-Q-TOF/MS Coupled with Network Pharmacology and Molecular Docking Strategy
Authors: Yang Fan , Zhang Kailun , Dai Xiaohua , Jiang Weimin
Published: May 2024

Hypertensive nephropathy (HN) is a prevalent complication of hypertension and stands as the second primary reason for end-stage renal disease. Research in clinical settings has revealed that Yanggan Yishui Granule (YGYSG) has significant therapeutic effects on HN. However, the material basis and action mechanisms of YGYSG against HN remain unclear. Consequently, this study utilized a comprehensive method integrating ultraperformance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS), network pharmacology, and molecular docking to delineate the active ingredients and potential therapeutic mechanisms of YGYSG for treating HN. Firstly, sixty distinct components were recognized in total as potential active ingredients in YGYSG by UPLC-Q-TOF/MS. Subsequently, the mechanisms of YGYSG against HN were revealed for the first time using network pharmacology. 23 ingredients played key roles in the complete network and were the key active ingredients, which could affect the renin-angiotensin system, fluid shear stress and atherosclerosis, HIF-1 signaling pathway, and AGE-RAGE signaling pathway in diabetic complications by regulating 29 key targets such as TNF, IL6, ALB, EGFR, ACE, and MMP2. YGYSG could treat HN through the suppression of inflammatory response and oxidative stress, attenuating the proliferation of renal vascular smooth muscle cells, lessening glomerular capillary systolic pressure, and ameliorating renal dysfunction and vascular damage through the aforementioned targets and pathways. Molecular docking results revealed that most key active ingredients exhibited a high affinity for binding to the key targets. This study pioneers in clarifying the bioactive compounds and molecular mechanisms of YGYSG against HN and offers scientific reference into the clinical application.
Computational Evaluation of the Structural, Topological, and Solvent Effects on the Nonlinear Optical Properties of 1-Methylurea Butanedioic Acid Crystal
Authors: Tasheh Stanley Numbonui , Nkungli Nyiang Kennet , Tsapi Charly Tedjeuguim , Ajifac Dodo Lydie , Ghogomu Julius Numbonui
Published: May 2024

In silico investigation of the effects of a molecule’s framework and surroundings on its nonlinear optical (NLO) response is still an active topic of study in the fields of photonics and optoelectronics. NLO materials play a crucial role in modern photonics and optoelectronic technologies. Presented here is a comprehensive theoretical analysis of the structural, topological, and NLO features of 1-methylurea butanedioic acid (MUBA) alongside solvent effects (water, DMSO, and benzene) using the DFT method at the B3LYP(D4)/6–311++G(d,p) level. Geometric and infrared parameters were calculated and compared with experimental values. The analysis using atoms in molecules (AIM) and the independent gradient model (IGM) reveals the presence of two noncovalent intermolecular interactions: N4–H16⋯O12 and O6–H25⋯O3, which stabilize the crystal structure. The natural bond orbital (NBO) analysis reveals that the LP(1)N4 ⟶ π∗(C2-O3) interaction is the most stabilizing and is enhanced in solvent environments. NLO data show that the first (βtot) and second (γ) hyperpolarizability values of MUBA are approximately 0.6–1.1 and 8.3–17.0 times higher than those of urea. In addition, the quadratic and cubic responses of MUBA are significantly reduced and increased, respectively, in solvent environments. Based on its NLO susceptibilities, MUBA exhibits SHG, EOPE, OKE, and EFISHG properties, suggesting its potential application in the production of optoelectronic devices and optical limiting. This study enhances our understanding of the factors influencing the NLO behaviour of organic crystals, providing valuable insights for designing materials with enhanced NLO characteristics. The implications extend to industries such as telecommunications and computing, where faster data transmission rates are in high demand.
Polyphasic Approach and Potential Cyanotoxin Production by Planktothrix from the Río Grande de Comitán and Montebello Lakes National Park, Southern Mexico
Authors: Carmona Jiménez Javier , Caro Borrero Angela , Sánchez-Salas Aída Isabel , Becerra-Absalón Itzel , Cirés Gómez Samuel , Quesada del Corral Antonio , Perona Urizar Elvira , Ortíz Suárez David , Mazari-Hiriart Marisa
Published: May 2024

The development of anthropic activities during recent years has led to an increase in nutrient fluxes in the Río Grande de Comitán and Montebello Lakes National Park, Mexico. In turn, this has modified the dynamics of the biotic community, specifically favoring the presence of cyanobacteria tolerant to contamination. The continual and massive presence of Planktothrix species (spp.) in the system suggests a potential detrimental impact for economic issues and human health. In this study, we identify the morphological and molecular characteristics of Planktothrix populations from seven tropical (1,380–1,740 masl, 23.0–25.5°C) and calcareous lakes and two ponds from a water treatment plant. We also assess the ecological drivers that could be related to the presence of cyanotoxins in the system. The ecological preferences, morphology, 16S rRNA structure, and 16S‐23S rRNA internal transcribed spacer found evidence for three species: P. agardhii distributed in neutral to slightly basic water (pH = 7.7–8.7), and P. spiroides and Planktothrix sp. in alkaline waters (pH = 9.1). The presence of the mcyE gene and its validation by liquid chromatography confirmed the presence of two microcystin variants (MC‐RR and MC‐LR) in at least three populations of P. agardhii. These microcystins put the health of the ecosystem and its inhabitants at risk, a condition that should be addressed and resolved with a water management and detoxification strategy in the basin.
Efficacy of Normalising Serum Zinc Level for Patients with Olfactory Dysfunction and Zinc Deficiency
Authors: Tanaka Hirotaka , Mori Eri , Yonezawa Nagomi , Sekine Rumi , Nagai Monami , Tei Masayoshi , Otori Nobuyoshi
Published: May 2024

Introduction: Zinc deficiency may worsen the severity of olfactory dysfunction; however, the relationship between serum zinc levels and therapeutic effects on olfactory dysfunction remains uncertain. This study investigated the relationship between normalising serum zinc levels and the therapeutic effects on olfactory dysfunction. Methods: Forty-two patients diagnosed with post-infectious, post-traumatic, and idiopathic olfactory dysfunction, with serum zinc levels <70 μg/dL, were included in the study. All patients were treated with mecobalamin, tokishakuyakusan, and polaprezinc. The patients were divided into 2 groups: the zinc-normalised (≥70 μg/dL) and zinc-deficient (<70 μg/dL) groups, based on their post-treatment serum zinc levels. Olfactory test results were compared in each of the 2 groups. Results: The patients were treated for a median of 133 days. The zinc-normalised group had significantly better results in all olfactory tests (detection/recognition thresholds of the T&T olfactometer, odour identification test (Open Essence), Visual Analogue Scale for olfactory dysfunction, and self-administered odour questionnaire). In contrast, only the self-administered odour questionnaire showed a significant improvement in the zinc-deficient group, with no significant differences observed in the other olfactory tests. When comparing the changes in the olfactory test scores between the 2 groups, significant differences were observed in the detection/recognition thresholds of the T&T olfactometer test and Open Essence results. Conclusion: These findings suggest that patients with olfactory dysfunction may have difficulty improving their olfactory function if they also have zinc deficiency. Furthermore, normalisation of zinc deficiency may contribute to the improvement of olfactory dysfunction with general treatment.
Association of Performance on Multiple Cognitive Domains with Sarcopenia among Middle-Aged and Older Adults
Authors: Wu Yafei , Wang Zongjie , Fang Ya
Published: May 2024

Introduction: The relationship between cognitive function and subsequent sarcopenia remains unclear. Therefore, this study aimed to examine the associations of performance on multiple cognitive domains with sarcopenia in the middle-aged and older adults. Methods: This longitudinal analysis (wave 2011–2013) included 2,934 participants from the CHARLS study. Sarcopenia was defined by the Asian Sarcopenia Working Group 2019 criteria. Cognitive function was measured by the Chinese version of the Mini-Mental State Examination (MMSE). Three interpretable techniques, namely SHapley Additive exPlanations (SHAP) and two built-in methods (coefficients of logistic regression and Gini importance of random forest), were used to assess the relationship between MMSE, its components (orientation, attention, episodic memory, and visuospatial ability) and sarcopenia. In addition, the association of MMSE score and its components with sarcopenia was further validated using stepwise regression. Results: All interpretable methods showed that MMSE score was important predictors of sarcopenia, especially the SHAP (MMSE score ranked top one). For its components, episodic memory, visuospatial ability, and attention showed high predictive value compared with orientation. Stepwise regression analyses showed that MMSE score and its components of episodic memory and visuospatial ability were correlated with sarcopenia, with their odds ratios of 0.93 (95% CI: 0.91–0.96, p < 0.001), 0.87 (95% CI: 0.82–0.93, p < 0.001), and 1.32 (95% CI: 1.05–1.65, p = 0.016), respectively. Conclusions: Better cognitive function especially episodic memory and visuospatial ability was negatively associated with incident sarcopenia among community middle-aged and older adults.
Real-World Risk of Severe Cytopenias in Multiple Myeloma Patients Sequentially Treated with Immunomodulatory Drugs
Authors: Barberio Julie , Lash Timothy L. , Nooka Ajay K. , Naimi Ashley I. , Patzer Rachel E. , Kim Christopher
Published: May 2024

Introduction: Most multiple myeloma (MM) patients experience cytopenias, likely driven by both disease and treatment-related factors. Immunomodulatory agents (IMiDs), which form the backbone of most anti-myeloma regimens, are known to cause higher grade cytopenias. In this context, the impact of sequential IMiD treatments on cytopenia risk is unknown. Methods: We evaluated the cumulative risks of severe cytopenias following second line of therapy (LOT) initiation in 5,573 MM patients in the Flatiron Health database. Patients for whom both LOTs 1 and 2 contained IMiDs were considered “sequentially exposed”; those for whom neither contained IMiDs were “never exposed.” Results: For the neutropenia outcome, compared to the never exposed, the sequentially exposed had the highest 1-year risk (risk difference [RD] 12%), followed by those only recently exposed during LOT 2 (RD 8%), then by those with only past exposure during LOT 1 (RD 5%). A similar pattern was observed for leukopenia, but no meaningful differences were observed for anemia or thrombocytopenia. The associations between sequential exposure, versus never, with neutropenia and leukopenia were even stronger among those with a recent cytopenia history. Conclusion: Results suggest that sequential exposure to IMiDs is a risk factor for higher grade cytopenias. These findings have profound clinical implications in choosing newer LOTs with potential risks of cytopenia.
Performance of Thyroid Fine-Needle Aspiration Biopsy in a Low- and Middle-Income Country
Authors: Conradie Wilhelmina , Baatjes Karin , Luvhengo Thifhelimbilu , Buitendag Johannes , Razack Rubina , Davies John , Crabbia Fabio , Afrogheh Amir , Lübbe Jeanne
Published: May 2024

Introduction: The 6 categories of the Bethesda System for Reporting Thyroid Cytology (TBSRTC) with associated risk of malignancy (ROM) provide evidence-based clinical management guidelines. This study aimed to determine the ROM and accuracy of FNAB in South Africa (SA). Methods: Thyroid specimens from 3 pathology laboratories registered between January 2015 and December 2019 were considered for inclusion. ROM was obtained per TBSRTC category by cytohistological correlation and dividing the total number of specimens with malignant histology by the total number of cases operated. Accuracy was calculated based on the Bethesda category and eventual malignant histology. Results: Seventeen thousand seven hundred and seventy-three histology and 4,791 cytology cases were identified. Of the 4,791 cytology cases, 931 (19%) underwent surgery. More than a third (333, 35.8%) of cases were confirmed as malignant following histological assessment, with the majority being benign (584, 62.7%). The ROM for the nondiagnostic and benign categories was 24.3% and 20.5%. The highest ROM was for category VI (91.5%), followed by categories V (69.5%), IV (51.9%), and III (38.8%). Thyroid FNAB had a sensitivity of 73%, specificity of 74%, and overall accuracy of 74%. Conclusion: Bethesda categories II and IV have a relatively higher ROM in SA compared to findings from other developed countries. The diagnostic accuracy of thyroid FNAB in SA and the high rate of nondiagnostic diagnoses (38%) require further investigation. A national thyroid registry could provide location-specific data to aid the implementation of appropriate local policies and national guidelines for practicing thyroid surgeons.
Hepatic Oxygenation Changes and Symptomatic Intradialytic Hypotension
Authors: Ookawara Susumu , Ito Kiyonori , Sasabuchi Yusuke , Ueda Yuichiro , Morino Junki , Kaneko Shohei , Mutsuyoshi Yuko , Kitano Taisuke , Hirai Keiji , Morishita Yoshiyuki
Published: May 2024

Introduction: Clinical studies on differences among changes in cerebral and hepatic oxygenation during hemodialysis (HD) in patients with and without intradialytic hypotension (IDH) are limited. We investigated changes in intradialytic cerebral and hepatic oxygenation before systolic blood pressure (SBP) reached the nadir during HD and compared these differences between patients with and without symptomatic IDH.
Methods: We analyzed data from 109 patients with (n=23) and without (n=86) symptomatic IDH who were treated with HD. Cerebral and hepatic regional oxygen saturation (rSO2), as a marker of tissue oxygenation and circulation, was monitored during HD using an INVOS 5100c oxygen saturation monitor. Changes in cerebral or hepatic rSO2 when SBP reached the nadir during HD were compared between the groups of patients.
Results: The cerebral rSO2 before HD in patients with and without symptomatic IDH was 49.7 ± 11.2% and 51.3 ± 9.1% (p = 0.491). %Changes in cerebral rSO2 did not significantly differ between the two groups from 60 min before the SBP nadir during HD. Hepatic rSO2 before HD in patients with and without symptomatic IDH were 58.5 ± 15.4% and 57.8 ± 15.9% (p = 0.869). The %changes in hepatic rSO2 were significantly lower in patients with symptomatic IDH than in those without throughout the observational period (p < 0.001). We calculated the area under the receiver operating characteristic curve (AUC) and estimated cut-off values for changes in hepatic rSO2 as a symptomatic IDH predictor. The predictive ability at 5 and 40 min before symptomatic IDH onset was excellent, with AUCs and cut-off values of 0.847 and 0.841, and -10.9% and -5.0%, respectively.
Conclusions: Hepatic oxygenation significantly decreased more in patients with symptomatic IDH before its onset, than in those without symptomatic IDH, whereas changes in cerebral oxygenation did not differ. Evaluating changes in hepatic oxygenation during HD might help to predict symptomatic IDH.
Heathfield Down: An Alternative Location for the Battlefield of Hastings, 1066
Authors: Welshman Rebecca , Coleman Simon
Published: May 2024

The exact location of the Battle of Hastings remains a question of debate. We identify previously unknown 18th and 19th-century sources that locate the battle near Old Heathfield in East Sussex, ten miles north-west of Battle Abbey, on land once known as Heathfield Down and ‘Slaughter Common’. We analyse the relevance of the haran apuldran (‘Hoar Apple Tree’) in the ‘D’ text of the Anglo-Saxon Chronicle as an original name for the battlefield and discuss the survival of this name in medieval deeds concerning a nearby place ‘Horeapeltre’. We consider the military and cultural reasons why the battle might have taken place near here and show that the haran apuldran was probably a military assembly point. Heathfield Down was a likely conflict area due to its communication links, topography and strategic location, and Harold being stationed here could explain why he was taken by surprise, according to English sources.
The Impacts of Community-Driven Development Program in Conflict-Affected Regions: Evidence from Cambodia
Authors: Jung Jaehyun , Kim Taejong , Kim Booyuel
Published: May 2024

This study evaluates the effects of the Cambodia Rural Development Program, specifically focusing on income generation and social capital. By employing a difference- in-differences framework and propensity score matching, the study finds a statistically significant positive impact on income, primarily driven by increased engagement in regular income-generating activities. However, the study also finds that the program has a limited effect on village-level collective actions, social cohesion, and perceived safety while inadvertently discouraging financial contributions to community projects. Additionally, trust between villagers and government officials remains unchanged. Heterogeneous analyses reveal the ineffective participation of trauma-experienced subgroups, highlighting the need for tailored approaches in conflict-affected regions.
Whose Ideas Matter? The Changing Meaning of Health Protocols in Indonesia’s Border Management Policies in the Pandemic Era
Authors: Yazid Sylvia , Karman Mireille Marcia
Published: May 2024

The COVID-19 pandemic affected border management policies by introducing health protocol norms for foreigners entering the country. Although public rhetoric often emphasized the importance of preventing an increase in imported cases, the implementation of health protocols in Indonesian border management policy varied from long quarantine periods during the advent of the pandemic to the easing of border control during the Omicron spike. This paper is focused on the international and domestic dynamics that affected the meaning and implementation of health protocols in Indonesia’s border management policies. It was found that, although international health norms served as initial guidance for health protocols at the start of the pandemic, their influence faded over time as they did not align with the national agenda, which prioritized economic growth. Therefore, after successfully adapting to the pandemic, the president and his elite circle redefined health protocols to favor the economic recovery process.
The Risk of the Revelatory State
Authors: Ballantyne Lucinda
Published: May 2024

Patients enter states that in their spontaneity and deep interiority have qualities of the revelatory. I propose we recognize such a state as a clinical event: The person is in a state of intense internal receiving of self. We might think of it as a state of internal communication happening as the person speaks. The person feels real to herself. Her relation to her mind in this revelatory moment is easily intruded on—even by ventures of play. When the state is gone, it is gone. I single out this clinical moment from moments that are cocreated and happening within an analytic third. I argue that in the revelatory moment, a patient builds capacities to be present for pain, desire—for raw experiences ordinarily difficult to access. The state makes a strict demand on the analyst. I see it as a moment of object usage—that is, it is a moment of risk with the analyst. This moment challenges and deepens our understanding of Winnicott’s usage formulation.
The Operators Model of Psychoanalytic Clinical Reasoning
Authors: Polipo Niccolò Fiorentino , Willemsen Jochem , Kallai Delphine
Published: May 2024

In this paper, the authors develop a model of psychoanalytic clinical reasoning as the inferential process by which analytic therapists are able to arrive at an understanding of the clinical material. Starting from Bion’s theory of functions, the authors propose that a “function” can be thought of as a condition-action sequence that analytic therapists implicitly use to respond to certain configurations of elements in the material by executing conceptual or reflective operations. To investigate the main families of functions that are used by analytic therapists in everyday practice, the authors used an interpersonal process recall procedure based on supervision sessions from a theoretically heterogeneous group of participants. A consensual procedure was developed to identify operations, spell out the underlying functions, and group functions into families. Twelve families of functions were identified that appear to be used by analytic therapists regardless of their schools of thought. The authors call them the “operators” of psychoanalytic clinical reasoning. According to the operators model, the process of psychoanalytic clinical reasoning consists in the chaining together of operations using functions from different families. A specific collection of “clinical reasoning styles” seems to be interwoven in this process. Different avenues open up for research, clinical practice, and training.
Property, Materiality, Proximity: The Analytic Frame and In-Person Work
Authors: Wilson Mitchell
Published: May 2024

In-person meeting offers psychologically usable material—signifiers that serve as day’s residue—that cannot be duplicated or substituted for in remote ways of working. Questions of materiality, the history and specificity of location, and bodily proximity all are key aspects of the psychoanalytic frame, as Bleger’s classic formulations attest. The COVID-19 pandemic has changed the choreography of engagement between analyst and patient: the ghostly dust in the frame enters the room. As Bleger says, with ghosts so rustled, nonprocess has a chance to become process. Two clinical examples highlight these points about materiality and in-person working. The final section of the paper extends Bleger’s description to tackle the perplexing situation of patients who hesitate to return to the office. Issues of “ghosting,” vanishing, disappearing are discussed, and linked to the constitutive absence that grounds any meaningfully structured presence. This constitutive absence is evoked by the prospect of the return to in-person analytic work. A final clinical example is used to illustrate this disturbing and irreducible fact about human interaction when two bodies are together in a room to discuss, over time, the life of one of the participants.
Am I Safe at My Educational Place? Creating Secure and Sustainable Urban Learning Spaces Through Green Infrastructure and Ecological Education
Authors: Ma Wenbo , Khan Ali Junaid , Fayyaz Sana , Curle Samantha , Gigauri Iza
Published: May 2024

Green infrastructure has become a critical part of society for environmental sustainability. Students studying in public urban spaces seem less satisfied with their living standards and environmental conditions. This research aims to determine the impact of perceived danger in urban public spaces, green infrastructure, and ecological education on student satisfaction. Additionally, this study considers the moderating effects of ecological education and green infrastructure. Data were collected from 350 students at public schools and colleges. The Partial Least Squares Structural Equation Modeling (PLS-SEM) method was used for data analysis. The study found a significant direct relationship between perceived danger in urban public spaces, green infrastructure, ecological education, and student satisfaction. Moreover, the moderating effects of green infrastructure and ecological education are significant in increasing student satisfaction. This research is based on a novel idea and contributes a newly developed model to the body of knowledge on student satisfaction and ecological education. The research has both theoretical and practical implications for improving student satisfaction through ecological education and green infrastructure. The limitations of this research are described, along with future directions to guide researchers in their future studies.
Frustration–Aggression Nexus in Framing the Expanding Banditry Economy in Northwest Nigeria: Evidence From Communal-Level Perception in Zamfara State, 2011–2024
Authors: Obi Kelechukwu Charles , Iwuoha Victor Chidubem , Aniche Ernest Toochi , Asogwa Kenneth Chinedu
Published: May 2024

Recent studies on armed banditry in Zamfara have commented on climate change, weak security infrastructure, and setbacks in socio-economic developments. The communal-level issues in the threat such as farmland allocation, vigilantism, and local intelligence provision have largely remained understudied. This study exploits the gap to explain armed banditry. A mixed method of data collection and qualitative descriptive method of data analysis were adopted. Using frustration–aggression analysis as explanatory tool, the paper concludes that wholesale farmland transaction, rudimentary communal vigilantism, and bandits’ concealed alliance formation with some traditional leaders for intelligence and benefits sharing are key factors that aided banditry. Tackling these three basic communal-level banditry nuances requires absolute political will to re-assess and implement the extant policies on grazing reserves and pastoralist mobility.
Rhetorical Strategies and Appraisal Markers in Online Civic Engagement of the Yoruba Nation Secessionist Agitation on Nairaland
Authors: Akano Richard Damilare
Published: May 2024

This study examines rhetorical strategies and appraisal markers in the engagement of the Yoruba Nation (YN) secessionist agitation in Nairaland. Adopting the appraisal framework and Fairclough’s notions of intertextuality and interdiscursivity as a theoretical anchorage, analysis unveils historical and biblical allusion, proverbs and adages, rhetorical questions, code alternation and pidgin as prominent rhetorical practices and intertextual and interdiscursive resources that index cognitive positioning and ideological evaluations of the agitation and related social actors. While the anti-YN participants express negativity and ideological dissociation from the secessionist course, the pro-YN participants express positivity, solidarity and ideological alignment with the separatist agitation. As the secessionist movement generates concerns about ethnic synergy and national integration, participants take advantage of a heterogeneous virtual space to influence other online participants’ ideological positions on whether to sustain patriotic spirit to strive continually towards Nigeria’s nationhood or to join the vociferous call for the nation’s geo-ethnic dismemberment and ultimately secession.
Caste, Merit, and Technical Education in India
Authors: Ranjan Priya
Published: May 2024

Ajantha Subramanian, The Caste of Merit: Engineering Education in India, Harvard University Press, 2019, 374 pp., GBP 22.02, ISBN 978-0-6749-8788-3 (Hardback).

Anna Ruddock, Special Treatment: Student Doctors at the All India Institute of Medical Sciences, Stanford University Press, 2021, 282 pp., GBP 11.69, ISBN 978-1-5036-2825-0 (Paperback).
Mental Health, Suicidality, Health, and Social Indicators Among College Students Across Nine States in India
Authors: Cherian Anish V. , Armstrong Gregory , Sobhana H. , Haregu Tilahun , Deuri Sonia P. , Bhat Shrinivasa U. , Aiman Agnieta , Menon Vikas , Cherian Anil V. , Kannappan Yamini , Thamby Tinu , John Soyuz , Pavithra V. A. , Tesia Sonali S. , Gosh Sujit , Hanjabam Shukhdeba S. , Gangmei John Gaingamlung , Kiran Manisha , Nriame Veronica , Ravindra R. M.
Published: May 2024

Background:

The prevalence of mental health issues among youth is significantly high globally. This article presents findings from a survey that examined psychological distress, suicidal thoughts and behaviors, and health and social indicators among college students in India.

Methods:

The study recruited 8,542 students from 30 universities spanning nine Indian states, utilizing a questionnaire that included the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) to measure depression and anxiety symptoms. It also examined the prevalence of suicidal thoughts, attempts, non-suicidal self-injury, and other health and social factors.

Results:

Findings indicate that 18.8% and 12.4% of students had considered suicide over their lifetime and in the past year, respectively, with 6.7% having attempted it at some point in their lives. Among those with lifetime suicidal thoughts, more than one-third (38.1%) reported having previously disclosed these thoughts to someone, with friends being the most common confidants. Furthermore, one-third (33.6%) of participants reported moderate to severe symptoms of depression, and one-quarter (23.2%) reported moderate to severe symptoms of anxiety.

Conclusions:

The study revealed a significant prevalence of depressive and anxiety symptoms, as well as suicidal thoughts and attempts among college students in India. The study underscores the critical need for interventions aimed at improving mental health and supporting this demographic.
Extracorporeal life support after surgical repair for acute type a aortic dissection: A systematic review and meta-analysis
Authors: Sá Michel Pompeu , Jacquemyn Xander , Hess Nicholas , Brown James A. , Caldonazo Tulio , Kirov Hristo , Doenst Torsten , Serna-Gallegos Derek , Kaczorowski David , Sultan Ibrahim
Published: May 2024

Background

The use of extracorporeal life support (ECLS) in patients after surgical repair for acute type A aortic dissection (ATAAD) has not been well documented.

Methods

We performed a systematic review and meta-analysis to assess the outcomes of ECLS after surgery for ATAAD with data published by October 2023 in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and the Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines. The protocol was registered in PROSPERO (CRD42023479955).

Results

Twelve observational studies met our eligibility criteria, including 280 patients. Mean age was 55.0 years and women represented 25.3% of the overall population. Although the mean preoperative left ventricle ejection fraction was 59.8%, 60.8% of patients developed left ventricle failure and 34.0% developed biventricular failure. Coronary involvement and malperfusion were found in 37.1% and 25.6%, respectively. Concomitant coronary bypass surgery was performed in 38.5% of patients. Regarding ECLS, retrograde flow (femoral) was present in 39.9% and central cannulation was present in 35.4%. In-hospital mortality was 62.8% and pooled estimate of successful weaning was 50.8%. Neurological complications, bleeding and renal failure were found in 25.9%, 38.7%, and 65.5%, respectively.

Conclusion

ECLS after surgical repair for ATAAD remains associated with high rates of in-hospital death and complications, but it still represents a chance of survival in critical situations. ECLS remains a salvage attempt and surgeons should not try to avoid ECLS at all costs after repairing an ATAAD case.
“I’d Like Accessibility Analysis to Help Us Shape the Future”: Transportation Practitioners and Accessibility Measurement
Authors: Rowangould Dana , Karner Alex , Levine Kaylyn , Alcorn Louis
Published: May 2024

Transportation agencies are becoming increasingly interested in measuring accessibility, or the ease with which people can reach desired destinations. In part, the concept is attractive because it reflects the primary purpose of a transportation system—to connect people to the opportunities they value. Academic researchers have identified a wide range of accessibility measures that vary widely in their interpretability, data requirements, parameters, multimodalism, and relevance to different areas of transportation planning and decision making. At the same time, new data and tools that facilitate and improve accessibility measurement are proliferating. Despite the promise of access measures, the landscape is vast and expanding, which can be difficult for practitioners to navigate. In fact, the use of accessibility in practice is relatively limited, with only a small share of U.S. transportation agencies using these measures. In this paper, we draw from 45 interviews with transportation professionals and a follow-up survey to determine how U.S. transportation practitioners currently use accessibility measures, barriers to accessibility measurement, and opportunities to use accessibility measures moving forward. Our results point to a wide range of technical capacities and accessibility applications across agencies, a suite of considerations that influence whether and how accessibility measures are used, a desire among many practitioners to increase their use of accessibility, and barriers to doing so. We close with reflections on opportunities to expand and improve the use of accessibility measurement in practice to strengthen transportation decision making.
Improving the mechanical performance of railway concrete sleepers using recycled materials: An experimental and numerical study
Authors: Wang Jun , Siahkouhi Mohammad , Du Yunchang , Huang Gang , Han Xiaodong , Jing Guoqing
Published: May 2024

This paper explores the use of three waste materials available in vast quantities, including waste tires, glass bottles and bamboo furniture, in the manufacture of railway sleepers. Mechanical properties of recycled concrete have been studied to establish an optimal mix suitable for concrete railway sleeper manufacturing. Thus, 5%, 10%, 15% and 20% recycled rubber sands (RRS) by volume of fine aggregate are used instead of 30# and 60# mesh sizes of fine aggregate. Moreover, 20%, 40%, 60%, 80% and 100% of aggregate volume are replaced by recycled glass aggregate (RGA) particles. Furthermore, different percentages of recycled bamboo fibers (RBF) have been used as 1%, 2% and 3% by volume of concrete. According to the optimal concrete mixtures of RRS, RGA and RBF, twelve concrete railway sleepers are manufactured and tested for middle and rail seat bending strengths. Results show that ref. sleeper has almost 16% and 24% lower strengths than RGA sleeper in middle and rail seat, respectively, while ref. sleeper have higher strengths by 16% and 13%, and 18% and 7% than RRS sleeper (M60-R5) and RBF sleeper (B2) in middle and rail seat, respectively. The FEM results show that the ([Formula: see text]) of the RGA sleeper is the minimum ratio by 1.11 and 1.13 for rail seat and middle of sleeper, respectively, which is the best performance. In RBF sleeper FEM model, Bamboo fiber can only bear 5% and 8% of total stress in middle and rail seat, respectively, due to low mechanical properties of fibers.
Vibration characteristics of a cylindrical sandwich shell with an FG auxetic honeycomb core and nanocomposite face layers subjected to supersonic fluid flow
Authors: Amirabadi Hossein , Darakhsh Arashk , Sarafraz Mirsalman , Afshari Hassan
Published: May 2024

In this paper, the flutter analysis is studied for a cylindrical sandwich shell subjected to external supersonic fluid flow. The sandwich shell consists of a re-entrant auxetic honeycomb (AH) core made of functionally graded materials (FGMs) which is covered with two polymeric face layers enriched with either carbon nanotubes (CNTs), graphene nanoplatelets (GNPs), or graphene oxide powders (GOPs). The volume fraction (percentage) of the ceramic phase in the functionally graded auxetic honeycomb (FGAH) core varies from zero at the inner surface to one at the outer one based on either power-law function (P-FGM), exponential function (E-FGM), or sigmoid function (S-FGM). It is assumed that the nanofillers are distributed uniformly inside the face layers. The first-order shear deformation theory (FSDT) and the piston theory are employed to provide the mathematical models of the shell and the aerodynamic pressure, respectively. The governing equations and boundary conditions are derived via Hamilton’s principle. An exact solution is performed in the circumferential direction via harmonic trigonometric functions (sine and cosine) and an approximate solution is performed in the axial direction utilizing the differential quadrature method (DQM). The natural frequencies and corresponding damping ratios are attained through the presented semi-analytical solution and the impacts of several factors on the natural frequencies and the critical aerodynamic pressure of the shell are examined. These factors the type of the FGM, the material index, and inclined angle of the cells in the FGAH core, the thickness of the FGAH core, the type and mass fraction of the nanofillers in the nanocomposite face layers, and boundary conditions.
COVID-19, Internal Transitions and Vulnerable Citizens: Narratives of the Migrant Crisis in India during the Pandemic
Authors: Krishna Niyathi R. , Sivakumar P. , Subramani Supriya , Rajan S. Irudaya
Published: May 2024

This article illustrates how the state’s response to the COVID-19 pandemic led to an internal migrant crisis in India, making the country realise the presence of physical borders within itself. Through a narrative analysis of the chronicles of internal migrant workers and the migrant crisis published in print media during the first wave of COVID-19, this article elucidates how internal borders within a country became impermeable, affecting the rights and well-being of vulnerable citizens, who were labelled ‘disease carriers’. The discrimination and othering faced by migrants aggravated during this period, making them more prone to fall through the cracks of the crisis. Although mobility restrictions were important public health tools to mitigate the spread of COVID-19 infections, they undoubtedly exacerbated the pre-existing socio-economic inequities and vulnerabilities. Problematising these aspects of the migrant crisis during the pandemic, this article proposes migration policies and governance through effective public communication, inclusive decisions and human rights as a way forward.