bluuebunny/crossref_metadata_2025 huggingface dataset:
Computational study on the impact of gasoline-ethanol blending on autoignition and soot/NOx emissions under low-load gasoline compression ignition conditions
Authors: Kalvakala Krishna C. , Singh Harsimran , Pal Pinaki , Pulpeiro Gonzalez Jorge , Kolodziej Christopher P. , Aggarwal Suresh K.
Published: October 2024

In the present work, computational fluid dynamics (CFD) simulations of a single-cylinder gasoline compression ignition (GCI) engine are performed to investigate the impact of gasoline-ethanol blending on autoignition, nitrogen oxide (NOx), and soot emissions under low-load conditions. In order to represent the test gasoline (RD5-87), a four-component toluene primary reference fuel (TPRF)+ethanol (ETPRF) surrogate (with 10% ethanol by volume; E10) is employed. A three-dimensional (3D) engine CFD model employing finite-rate chemistry with a skeletal kinetic mechanism (including NOx sub-mechanism), adaptive mesh refinement (AMR), and hybrid method of moments (HMOM) is adopted to capture the in-cylinder combustion phenomena and soot/NOx emissions. The engine CFD model is validated against experimental data for three gasoline-ethanol blends: E10, E30 and E100, with varying ethanol content by volume. Model validation is carried out for a broad range of start-of-injection (SOI) timings (−21, −27, −36, and −45 crank angle degrees (°CA) after top-dead-center (aTDC)) with respect to in-cylinder pressure, heat release rate, combustion phasing, NOx and soot emissions. For relatively later injection timings (−21 and −27 °CA aTDC), E30 yields higher amount of soot than E10; while the trend reverses for early injection cases (−36 and −45 °CA aTDC ). On the other hand, E100 yields the lowest amount of soot among all fuels irrespective of SOI timing. Further, E10 shows a non-monotonic trend in soot emissions with SOI timing: SOI-36>SOI-45>SOI-21>SOI-27, while soot emissions from E30 exhibit monotonic decrease with advancing SOI timing. NOx emissions from various fuels follow a trend of E10>E30>E100. On the other hand, NOx emissions increase as SOI timing is advanced for all fuels, with an anomaly for E10 and E100 where NOx decreases when SOI is advanced beyond −36 °CA aTDC. Detailed analysis of the numerical results is performed to investigate the soot/NOx emission trends and elucidate the impact of chemical composition and physical properties on autoignition and emissions characteristics.
Guided structure learning of DAGs for count data
Authors: Nguyen Thi Kim Hue , Chiogna Monica , Risso Davide , Banzato Erika
Published: October 2024

In this paper, we tackle structure learning of directed acyclic graphs (DAGs), with the idea of exploiting available prior knowledge of the domain at hand to guide the search of the best structure. In particular, we assume to know the topological ordering of variables in addition to the given data. We study a new algorithm for learning the structure of DAGs, proving its theoretical consistency in the limit of infinite observations. Furthermore, we experimentally compare the proposed algorithm to several popular competitors, to study its behaviour in finite samples. Biological validation of the algorithm is presented through the analysis of non-small cell lung cancer data.
Navigating who I was and who I am online: How people with dementia use social media platforms to support identity
Authors: Talbot Catherine V , Roe Daisy , Brunner Melissa
Published: October 2024

A diagnosis of dementia can have a powerful impact on identity, and social media platforms offer promising avenues for identity expression and reconciliation. Addressing limited research in this area, we used semi-structured interviews to explore how 10 people with dementia used social media to navigate their identity. Our thematic analysis produced four themes, showing how social media platforms afford unique opportunities for self-expression, visibility, and association, thereby empowering users to maintain their sense of self, challenge stereotypes, and foster community connections. Additionally, social media facilitated a multifaceted and holistic sense of identity beyond the confines of diagnosis. While there were concerns about online self-disclosure, sharing experiences of dementia had therapeutic benefits, aiding in acceptance and adjustment. Participants also leveraged social media to establish continuity between their pre- and post-diagnostic selves, providing a sense of stability amid uncertainty. With the increasing prevalence of social media use among people with dementia, proactive measures by healthcare professionals, policymakers, technology developers, and carers are required to cultivate online experiences that are safe, supportive, and inclusive of people with dementia.
Cough-induced vertebral artery dissection: A case report and literature review
Authors: Khalid A , Summerbell A , Jha P , Abdelhafiz AH
Published: October 2024

Spontaneous vertebral artery dissection (VAD) is common after minor neck trauma or abrupt neck manipulation, which may result in stroke. However, violent cough is a less recognised cause of VAD. Only a few cases are reported in the literature. We review the literature and report a case of a 62-year-old man who presented with a headache and neck pain following a period of intermittent coughing, which led to VAD and a cerebellar ischaemic stroke. He responded well to medical treatment and made a full recovery. Therefore, VAD should be considered in the differential diagnosis for patients presenting with neck pain and headache after episodes of violent coughing.
Restaurants as Environments for Healthy Eating: Factors That Contribute to Restaurant-Based Healthy Eating Program Adoption
Authors: Knapp M. , Moore T. , Lederer A. , Kimball M. , Quantz Y. , Fuster M. , Myers L. , Johnson C.
Published: October 2024

Purpose. This study identified restaurant manager/owner factors that may contribute to adoption of a restaurant-based healthy eating program, Eat Fit. Findings may be used to engage restaurants in efforts to increase access to and availability of healthy foods, promote healthy food choices, and work toward improving diet and lowering obesity and chronic disease risk in the community. Methods. Cross-sectional survey data were collected from restaurant managers/owners interested in partnering with Eat Fit. Variables included restaurant manager/owner beliefs, perceived staff knowledge/skills, support, self-efficacy, outcome expectancies, and barriers and facilitators to implementation. Results. Forty-nine managers/owners participated. Most managers/owners held positive beliefs about offering healthy food items in restaurants (83.7%). Most agreed that restaurants could influence eating behaviors (83.7%) and that restaurants have a responsibility to offer healthy options (77.6%). Most managers/owners perceived high levels of support (83.7%) and were confident in their ability (95.9%) to implement the Eat Fit program. The most cited barriers were customer preference, ingredient availability, staff knowledge, and operational challenges. The most common reasons for involvement in the program were a desire to increase access to healthy food, to entice customers looking for healthier food, a belief that restaurants should offer healthy food, and opportunities to market through Eat Fit. Conclusions. This research contributes to knowledge about beliefs and perceptions of restaurant manager/owners. Efforts to engage restaurants should focus on benefits of offering healthy food and the role restaurants can play in promoting health. Furthermore, programs may benefit from enhanced restaurant staff training, customer-targeted marketing, and educational efforts.
Recruitment and Retention of Latinx Teachers Is Top Priority: So Why Are New Teachers Saying ¡Adiós!?
Authors: Neumann Natasha , Somoza-Norton Andrea , Lopez Lorraine
Published: October 2024

Veronica Perez, a Latinx teacher, contemplates her career path while Jodie Sanders, an elementary principal, faces staffing challenges. Jodie navigates the Rios Unified School District under the oversight of Maria Zarate, Human Resources Director, aiming for diversity. However, Zarate’s efforts encountered resistance. Their experiences shed light on hurdles in recruiting Latinx educators. The three educators’ perspectives provide a glimpse into the gaps and opportunities districts and schools may face in attracting Latinx teachers. This case study explores the complexities, disconnects, and layers of understanding around diversity, equity, and inclusion district initiatives among teachers and leaders, with the goal of recruiting and retaining Latinx educators.
Addressing Inequity in Special Education Referrals: Integrating General and Special Education Strategies in School Leadership
Authors: Ripma Tye A. , DeMatthews David E. , Voulgarides Catherine K.
Published: October 2024

This case highlights the moral and ethical dilemmas that principals and educators confront when making decisions about special education classification and placement, particularly in the context of racial disproportionality. These decisions are complex, influenced by the requirements of the Individuals with Disabilities Education Act (IDEA) and the sociocultural and historical contexts that school leaders work within. In addition, the case delves into the relationship between general education instruction and special education referral processes in the context of a multi-tiered system of supports, exploring the delicate balance principals must maintain between adhering to special education laws and exercising professional judgment.
Observable, but Not Unobservable Health Numbers are Associated With Self-Reported Health: NHANES 2017-2020
Authors: DeDonno Michael , Objio Bella-Christina , Crowder Alexis
Published: October 2024

Objective: Present study explored the influence of self-reported health on diff between observable and unobservable health factors. Method: Data obtained through the 2017-2020 pre-pandemic dataset of the National Health and Nutrition Examination Survey (NHANES). A series of analyses of covariance were conducted with self-reported health as the independent variable, and measures of blood pressure, waist-to-hip ratio, fasting glucose and total cholesterol as dependent variables. Family income served as a covariate. Results: Results revealed significant differences in self-reported health and blood pressure, waist-to-hip ratio, and fasting glucose. Individuals who rated their health excellent or very good tended to have better health numbers than those who rated their health as fair or poor. No statistically significant difference was found with self-reported health and cholesterol. Conclusion: It is possible that health numbers that can be observed (or assessed) at home, without a health care professional, may be more aligned with how individuals perceive their own health. Health care professionals may want to further help patients recognize their own health status. The use of wearable technologies may provide added health information resulting in more accurate perception of health. A more accurate perception of a patient’s own health may aid health care professionals in further improving patient care.
Numerical exploration of radiative heat transfers in a magneto bioconvection Maxwell fluid passing through a spinning disk
Authors: Algehyne Ebrahem A , Alamrani Fahad Maqbul , Lone Showkat Ahmad , Ali Farhan , Saeed Anwar , Khan Arshad
Published: October 2024

When applied to a rotating disk, Maxwell nanofluids have a wide range of applications in various fields. They provide increased heat transfer efficiency in cooling systems, which is essential for preserving the ideal operating temperatures of spinning gears like disk brakes and turbines. Furthermore, Maxwell nanofluids in microfluidic devices provide improved fluid manipulation and control, improving performance in applications such as microscale pumps and lab-on-a-chip systems. This article has numerically examined the magneto-bio-convection flow of Maxwell, which includes nanofluid, past a disk surface based on these applications. We present the model equations in PDE format, then shift them to ODEs using the appropriate variables. We utilize the bvp4c approach to obtain numerical solutions to the modeled equations. We also take into account the effects of thermal radiation, heat sources, Brownian motion, thermophoresis, chemical reactivity, and activation energy. We find that a higher stretching/shrinking variable has enhanced the radial velocity profile, while simultaneously diminishing the axial and angular velocity field. While the velocity profiles in the axial direction and redial direction have reduced with larger magnitude of Maxwell fluid variable. The thermal distributions have risen due to higher magnetic, Brownian motion, thermophoresis, heat sources, and thermal radiation components. Thermophoresis, magnetic and thermal radiation, heat sources, and Brownian motion all contribute to an increase in heat transfer rates.
Optimizing outcomes in drug-resistant mesial temporal lobe epilepsy patients undergoing stereoelectroencephalography-guided radiofrequency thermocoagulation
Authors: Jean Stéphane , Jiang Rifeng , Dai Yihai , Chen Weitao , Liu Weihong , Deng Donghuo , Tagu Panashe Tevin , Wei Xiaoqiang , Chen Shan , Fang Xinrong , Song Shiwei
Published: October 2024

Background:

Mesial temporal lobe epilepsy (MTLE) epileptiform discharges have been reported to arise from the hippocampus or the extrahippocampal medial temporal cortex, such as the amygdala, and then propagate to the temporal lobe cortex. The surgical ablation of which of these structures would result in a better postoperative outcome is debatable.

Objective:

To assess the possible factors that might have influenced the postoperative outcome of a group of drug-resistant mesial MTLE patients who underwent stereoelectroencephalography (SEEG)-guided radiofrequency thermocoagulation (RFTC).

Design:

Single-center, retrospective.

Methods:

The present study utilized a pre- and postoperative gray matter voxel-by-voxel ablation mapping comparison approach, along with a white matter mapping of longitudinal changes in the native space technique, to evaluate the association between the post-SEEG implantation signal recordings (obtained from clinically relevant electrode contacts used during RFTC) and the post-RFTC ablation volume of the different selected regions of interest (ROIs).

Results:

The study included 22 patients (12 men and 10 women, mean age 28.86 ± 14.04 years). Sixteen patients (72.72%) were seizure-free (SF), and six patients (27.27%) were non-SF. Five patients (22.72%) experienced mild side effects following RFTC. The post-RFTC follow-up period varied from 12 to 48 months, with an average of 24.17 ± 9.86 months. The SF group was associated with a higher number of implanted electrode contacts in the amygdala that were used during RFTC, a larger preoperative volume of the amygdala; a larger ablation volume of both the amygdala and rhinal cortex. The ablation volume of the white matter was statistically similar between both groups.

Conclusion:

This study provides valuable insights into the significance of the amygdala and rhinal cortex as ROIs in the preoperative evaluation of patients with MTLE. Future implantation scheme plans should consider evaluating the preoperative volume of these ROIs. Additionally, increasing the number of electrode contacts implanted within these regions might be beneficial to capture more clinically relevant signals and enhance their ablation volume.
Cutaneous manifestations of deep mycoses in Nigeria: a systematic review
Authors: Bassey Thelma E. , Okekemba Ikechukwu , Egbara Walter O. , Owai Promise , Okafor Love E. , Elem David E. , Edim Geraldine L. , Onukak Asukwo , Ekeng Bassey E.
Published: October 2024

Background:

Deep mycoses are serious fungal diseases commonly associated with the immunocompromised but can also present in the immunocompetent following severe exposure to fungal pathogens. Included in this group are subcutaneous and systemic fungal infections.

Objectives:

Reviews highlighting skin involvement in patients with deep mycosis in the Nigerian setting are sparse in the literature. This systematic review summarized the clinical presentation, risk factors, and diagnosis of deep mycosis presenting with cutaneous manifestations in Nigerians.

Design:

This was a systematic review conducted following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines.

Data sources and methods:

PubMed, Google Scholar, and the African Journal Online database were searched from inception to February 2024 to identify published articles from Nigeria on deep mycoses with cutaneous manifestations. We included single case reports and case series on cutaneous involvement in deep fungal infections in Nigeria. Review articles, guidelines, meta-analyses, animal studies, and fungal studies not relating to the Nigerian setting were excluded.

Results:

We identified 16 well-documented articles on deep cutaneous mycoses published in Nigeria over the past six decades which amounted to 137 cases; 102 (74.5%) cases were reported before the year 2000, while the remainder were published within the past two decades. The 137 cases were majorly histoplasmosis ( n = 87, 63.5%) and eumycetoma ( n = 19, 13.9%) and predominant risk factors, farming ( n = 13, 9.5%) and diabetes mellitus ( n = 3, 2.2%), The diagnosis of cases was predominantly via histopathology ( n =131, 95.6%) with a few cases diagnosed by fungal culture ( n = 15, 10.9%), and antigen assay ( n = 1, 0.7%) respectively. Twenty-one (15.3%) were clinically diagnosed as cancers including a case of carcinoma of the skin, and one each (0.7%) as skin tuberculosis or neurofibromatosis but all histologically confirmed as deep cutaneous mycoses.

Conclusion:

The decline of reports on deep cutaneous mycoses in recent times suggests neglect or a low index of suspicion from attending clinicians. This is further buttressed in the misdiagnosis of cases as other clinical entities. Ensuring a histological diagnosis of skin lesions, especially in at-risk patients will mitigate these gaps.
Plaque-like cutaneous mucinosis associated with pain: A case report
Authors: Bregvadze Kakha , Mekokishvili Lally
Published: October 2024

Plaque-like cutaneous mucinosis (PCM) is a rare atypical subtype of Lichen myxedematosus, characterized by hyperpigmented plaques typically found on the midline trunk. We report the case of a 26-year-old woman with a 1-year history of painful, pruritic, hyperpigmented plaques over her spine. Physical examination revealed soft plaques in the midline of the back, and histopathology showed dermal mucin deposition, consistent with PCM. The presented case is notable as the first reported instance of PCM presenting with lesional pain. We propose that mechanical stress, likely due to repeated friction at the site of spinous processes, contributed to the development of pain. The fact that pain lessened after the use of a lumbar support pillow and gaining weight supports our hypothesis. Our case demonstrates the importance of considering PCM in the differential diagnosis of hyperpigmented plaques and highlights the need for further research to elucidate its underlying pathogenesis and optimize treatment strategies.
Socioeconomic and gender disparities in depression among elderly Chinese individuals
Authors: Tang Yixuan , Li Yi
Published: October 2024

The positive relationship between socioeconomic status (SES) and health is well established in Western societies. However, while research mainly focuses on SES measures such as education and income, these measures may not completely capture the characteristics of social stratification in China. In the socio-historical context of China, for example, the work unit sector is a crucial SES factor. Yet, few health studies have paid attention to unique SES factors in China. Furthermore, women generally report worse mental health than men, but it is unclear whether this gender gap could be influenced by SES. In this article, using data from the China Health and Retirement Longitudinal Study, we (1) expand SES measures to explore the impact of the work unit sector and use other SES measures, including Communist Party of China (CPC) membership and hukou (household registration) status, to examine the relationship between SES and depression and (2) investigate whether SES could modify the relationship between gender and depression. We find that all the SES measures negatively predict the depression symptoms of elderly individuals. We also find that women on average report higher depressive symptom scores than men. However, the gender differences in depressive symptom scores are smaller among elderly individuals with higher SES than among those with lower SES. We demonstrate that the work unit sector and CPC membership are crucial SES factors affecting the mental health of elderly Chinese individuals. Moreover, we show that the gender gap in depression could vary by SES, suggesting that women might benefit more from obtaining higher SES.
Economic Stress and Healthcare Adherence: The Influence of Job Insecurity and Income Adequacy
Authors: Patterson Jack , Watson Gwendolyn Paige , Baker Anna , Sinclair Robert R. , Jones Karyn
Published: October 2024

This study investigated the influence of economic stressors on the relationship between healthcare adherence attitudes and intentions. The data were collected through two time points, three months apart, from 442 US workers recruited through Amazon’s Mechanical Turk. Multiple regression analysis was used to test the model with perceived income inadequacy and job insecurity as moderators of the adherence attitudes-intentions relationship. The model controlled for adherence intentions at Time 1 (T1), medical illness history, and medical illness recency. The results confirmed the healthcare adherence attitudes-intentions relationship, and supported the hypothesis that economic stressors were negatively correlated with healthcare adherence attitudes and intentions. Job insecurity moderated this relationship and perceived income inadequacy was negatively associated with healthcare intentions across time. The findings highlight the importance of considering economic stress as a social determinant in interventions aimed at improving adherence. Research is needed to understand the mechanisms underlying the relationship between economic stress and healthcare adherence.
The Effects of Past Behavioral Bias on Mutual Fund Investors Intention: Examining the Moderating Impact of Knowledge
Authors: Yuvaraj D. , Venugopal Pulidindi
Published: October 2024

This study aims to understand individual behavioral intentions toward mutual fund investors using the theory of planned behavior (TPB). Financial knowledge is used as a moderating variable to test the relationship between the antecedents of investment intention. Convenience sampling was used to obtain 236 samples. Statistical analyses were performed using the SPSS and AMOS software. The research discovered that subjective norms and perceived behavioral control had a substantial impact on individuals’ intention to invest. Financial knowledge is positively moderated by the antecedents of investment intentions. This study suggests that following the initial phases of decision-making, investors seek information from a variety of sources, including feedback from family and friends, podcasts, social media, and prior experiences. Marketers and financial advisors should educate investors of all ages and education groups on where and how to select and build portfolios of mutual funds in financial markets.
Reliability and Validity of an Ultrasound-Derived Measure for Axial Patellofemoral Alignment
Authors: Greenberg Elliot M. , Barnes Megan , Lawrence J. Todd , Brown Naomi , Williams Brendan
Published: October 2024

Background:

Axial extensor mechanism alignment is routinely assessed in patients with patellofemoral instability.Although many of these assessments are described using magnetic resonance imaging, it is plausible that ultrasound (US) imaging could be utilized to provide similar information in a more cost-effective and time-efficient manner.

Purpose:

To (1) describe and assess the reliability of a novel measure of extensor mechanism alignment of the patellofemoral joint using musculoskeletal US and (2) establish the construct validity of this measure through comparison of patients with and without patellar instability.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

Patients with (n = 24; 14.2 ± 3.1 years; 83% female) and without (n = 26; 14.7 ± 2.8 years; 69% female) a clinical history of patellofemoral instability (PFI) participated. Extensor mechanism alignment was assessed bilaterally on US, measuring the distance between the midpoint of the patellar tendon to the lateral trochlear ridge (MPT-LTR). Interrater reliability of the measurements was assessed using the intraclass correlation coefficient (ICC), with a minimum of 1 week between measurements for test-retest reliability. Differences between limbs were assessed using paired-samples t tests, and between-group differences were compared using independent-samples t tests.

Results:

Patients with PFI demonstrated a significantly smaller MPT-LTR distance than healthy controls on both their involved (8.1 ± 3.6 vs 12.6 ± 2.6 mm) and uninvolved (8.9 ± 3.4 vs 12.9 ± 2.4 mm) limbs ( P < .001 for both), indicating greater lateralization of the patellar tendon relative to the trochlea. There were no differences found between limbs for either patients with PFI ( P = .26) or controls ( P = .46). Interrater reliability was good (ICC = 0.785; 95% confidence interval [CI], 0.579-0.890), and test-retest reliability (n = 8) was excellent (ICC = 0.958; 95% CI, 0.790-0.992).

Conclusion:

The US-based MPT-LTR distance demonstrated good-to-excellent reliability. When compared with controls, the MPT-LTR distance was smaller in patients with PFI, indicating greater lateralization of the extensor mechanism.
Politics without principle: Potential borders and the ethics of anti-trafficking online
Authors: Mendel Jonathan , Sharapov Kiril
Published: October 2024

Anti-trafficking has been spreading in a novel way, with moral certitude (where human trafficking is deemed uniquely wrong, and this wrongness is taken as a founding principle for anti-trafficking action) accompanied by little or no accountability. This moral certitude drives anti-trafficking networks to spread across borders, just as it is assumed that trafficking will. The paper critiques this certitude and spread of anti-trafficking by developing ideas around borders, potential, and ethics. Massumi (2007) analyses the move to a potential politics, which prioritises what “[c]ould have, would have” happened and acts against this potential as if it is a ground for certitude. After Massumi, this paper argues that online anti-trafficking practice relies on potential borders: borders between legal and illegal, and the borders between states, are increasingly blurred by action against what might potentially be trafficking. Following Campbell (1993: 3-4) we critique the claims to “moral certitude” and principle in anti-trafficking and argue for deeper ethical engagement with the needs of others. Rather than the spread of anti-trafficking through potential borders, we argue that exploitation should be challenged through an ethical response to those marginalised by capitalism today. Against the unprincipled politics of the anti-trafficking industry, we advance a politics without principle that foregrounds our ethical obligation to respond to others.
Anti-VEGF Monotherapy vs Anti-VEGF and Steroid Combination Therapy for Diabetic Macular Edema: A Meta-analysis
Authors: Grad Justin , Hatamnejad Amin , Dadak Rohan , Sodhi Simrat , Pattathil Niveditha , Choudhry Netan
Published: October 2024

Purpose: To compare the safety and efficacy of antivascular endothelial growth factor (anti-VEGF) monotherapy vs anti-VEGF and steroid combination therapy in treatment-naïve and treatment-resistant patients with diabetic macular edema (DME). Methods: A systematic literature search was conducted from January 2005 to December 2022. Sixteen randomized control trials (RCTs) published in English that reported the efficacy or safety of monotherapy and combination therapy in patients with DME were included. Results: The 16 RCTs included 1166 eyes. Monotherapy was associated with a significantly better best-corrected visual acuity (BCVA) at the final follow-up (weighted mean difference [WMD], −0.04 logMAR; 95% CI, −0.07 to −0.02; P = .002; I2 = 0%). No significant differences were observed in the change in BCVA between groups at the final observation. Monotherapy was associated with a significantly smaller change in retinal thickness at the final follow-up (WMD, 37.63 μm; 95% CI, 11.67-63.60; P = .005; I2 = 78%) and with a significantly lower risk for intraocular pressure–related adverse events (AEs) (risk ratio, 0.27; 95% CI, 0.15-0.46; P ≤ .001; I2 = 0%). The risk for cataract-related AEs was not significantly different between groups ( P = .06). The results in treatment-naïve patients were similar. In treatment-resistant patients, the change in retinal thickness at the final follow-up was similar between groups ( P = .14), but the risk for cataract-related AEs was significantly lower in the monotherapy group in 2 RCTs (risk ratio, 0.09; 95% CI, 0.01-0.66; P = .02; I2 = 0%). Conclusions: The changes in BCVA were similar despite combination therapy being associated with greater changes in retinal thickness. However, increased complications were seen with combination therapy. Most results in treatment-naïve patients and treatment-resistant patients were similar.
COVID-19 vaccination in children aged 5–11: a systematic review of parental barriers and facilitators in Western countries
Authors: Davey Stephanie A. , Gaffiero Daniel
Published: October 2024

Background:

Parental decision-making regarding vaccination, particularly for coronavirus-19 (COVID-19) where significant debate surrounds children aged 5–11, is influenced by various factors. Understanding the motivations behind parents’ vaccination choices for their children is crucial for maintaining vaccine uptake, in line with the National Health Service United Kingdom vaccination strategy.

Objectives:

The present systematic review aims to identify the barriers and facilitators affecting parents’ decisions to vaccinate children aged 5–11 against COVID-19 in Western countries.

Data sources and methods:

The first search was conducted using PsychINFO, MEDLINE and Google Scholar in June 2023 with an additional follow-up search a year later in June 2024 for full-text papers focusing on COVID-19 vaccine decision-making among parents or caregivers of children aged 5–11. The language of the included studies was set as English and originating from Western countries specifically examining barriers and facilitators to COVID-19 vaccination, excluding children with chronic conditions. The risk of bias was independently assessed by both authors using the JBI Checklist for Prevalence Studies, with disagreements resolved through discussion.

Results:

A total of four cross-sectional questionnaire studies involving a total of 5,812 participants from Western countries (the United States and Europe) were included in the present review. Only 46.35% of parents intended to vaccinate their children aged 5–11 against COVID-19. The primary barriers identified were concerns about side effects and distrust in institutions. Key facilitators included recommendations from healthcare professionals and parents’ own COVID-19 vaccination status. Demographic factors including ethnicity and gender showed mixed influence.

Conclusion:

Persistent concerns about side effects and institutional distrust have reduced parental intention to vaccinate their children. However, healthcare professionals play an important role in increasing vaccine uptake through recommendations to their patients. Future interventions should focus on equipping healthcare professionals with the necessary tools to effectively promote vaccination and address parental concerns about side effects.
Requirements for Design Methods from Circular Design to Support the Product Development of Products for the Circular Economy in SMEs
Authors: Tellez Nitzling Daniel , Kokoschko Björn , Schabacker Michael
Published: October 2024

Against the backdrop of increasing ecological challenges, in connection with excessive use of resources, a rethinking of the current mode of operation of the economy and consumers is required. The circular economy, which describes a system in which products, components, and materials are preserved in recurring cycles, is seen as a counter-design to the currently dominant form of economy. The development of circular products plays a central role in the development of both consumer and capital goods. Design methods from circular design—a part of circular economy—form the basis for the development of circular products. Therefore, this contribution identifies and investigates evaluation criteria for the optimal selection of these design methods for use in small and medium-sized enterprises (SMEs). It is shown that design methods shall promote circular development of a product and focus on a systemic consideration of the product context along the entire product life cycle as well as closing technical and biological cycles. The contribution formulates evaluation criteria that address the assessment of the applicability, integrability in SMEs, and circularity of a design method and thus provide a basis for the evaluation of design methods from circular design. Product developers in SMEs are thus provided with a set of criteria to support them in product development for the circular economy.
Holistic Approach to the Indian Higher Education System in Design and Sustainability
Authors: Sachdeva Heena , Agarwal Garima
Published: October 2024

Sustainability is a need of the hour as we have very limited resources that are to be restored or utilized carefully. One way toward sustainability is through higher education, with awareness, possible ways of using it, and a change in thought process which will lead to minimal wastage of resources. Design decisions based on sustainability are more than using natural resources that are biodegradable. One of the main strategies of green design is to follow the ‘waste hierarchy’. Green materials are designed to be reusable and recyclable, and they degrade naturally at the end of their life, reducing the environmental footprint of the product. In point of fact, design has the power to stoke and encourage innovation. It can also contribute to the shaping of the world on a variety of levels, from materials to products, product service systems, social organizations, and socio-technical systems. Eco-design is a comprehensive and holistic approach to planning activities that emphasizes the welfare of people and the environment as the final design. ‘It focuses on resource efficiency and the use of environmentally friendly materials to develop products and processes’ (Manzini, 2020, Design, When Everybody Designs). Sustainability for design is sometimes referred to as a lifetime configuration approach since it gathers data on the full life cycles of products and their effects on the environment and living beings. The aim of the paper is to be unambiguous as to why sustainable systems should be included in higher education. An endeavor, additionally, had been to summarize the government policies in order to raise awareness for the next generation. Further, data is collected from respondents who belong to the education system for understanding the importance of sustainability in education. From the gathered information, it was observed that every person unconsciously considers sustainability in their day-to-day lives. However, with mindfulness and plan training there will be an impact on the general public for a better future.
Mindful Wealth Management: Thematic Integration and Analysis of Mindfulness in Financial Decision-Making
Authors: Garad Askar
Published: October 2024

Purpose: This paper explores the influence of mindfulness on financial decision-making, aiming to develop a comprehensive framework that integrates psychological and behavioral finance perspectives. It addresses gaps in current literature, including the limited exploration of personality traits like openness and conscientiousness and the role of mindfulness across generations. Study Design: The research employs a conceptual analysis based on a comprehensive literature review, synthesizing insights from psychology, finance, and neurobiology. The study also examines the intersection of mindfulness and emerging financial technologies such as robo-advisors and cryptocurrencies. Findings: The study identifies how mindfulness influences financial behaviors, particularly in risk aversion, cognitive flexibility, and emotional regulation. It highlights generational differences in financial decision-making and mindfulness’s role in navigating digital financial environments. Contributions: This paper introduces a revised conceptual framework that expands the understanding of mindfulness in financial decision-making. It includes new dimensions, such as personality traits, generational differences, and the interaction between mindfulness and digital finance. Implications: The findings provide actionable insights for financial advisors, practitioners, and policymakers. Recommendations include the integration of mindfulness-based strategies tailored to individual traits and generational needs, as well as mindfulness training in leadership development programs to foster ethical and resilient decision-making.
Scan of the postgraduate educational environment domains questionnaire: a reliable and valid tool for the evaluation of educational environment in postgraduate medical education
Authors: Seyedhassan Sadrian , Mahsa Moosavi , Jeyran Ostovarfar , Mitra Amini , Rezvan Ghaderpanah , Sedigheh Mokhtarpour
Published: October 2024

Background

The educational environment plays a critical role in shaping learners’ perceptions and experiences in medical education. Evaluating and enhancing the quality of this environment is essential for the continuous improvement of medical training programs. The Scan of the Postgraduate Educational Environment Domains (SPEED) is a concise instrument that assesses three domains of the educational environment. This study aimed to translate the SPEED questionnaire into Persian and evaluate its validity and reliability in the context of postgraduate.

Methods

A cross-sectional study was conducted with 200 first and second-year medical residents. The Persian translation of the SPEED questionnaire was assessed for content validity, and confirmatory factor analysis was performed to evaluate its structural validity. Cronbach’s alpha coefficient was calculated to assess internal consistency reliability.

Results

The Persian-translated SPEED questionnaire demonstrated satisfactory content validity, with all items exceeding the minimum acceptable values for content validity ratio and index. Confirmatory factor analysis indicated an acceptable fit for the 3-dimensional structure of the SPEED instrument. Internal consistency reliability analysis showed high reliability for the content, atmosphere, and organization domains.

Conclusion

The Persian-translated version of the SPEED questionnaire is a valid and reliable tool for assessing the domains of the educational environment in postgraduate medical education.
Risk of suicide in patients with atrial fibrillation receiving different oral anticoagulants: a nationwide analysis using target trial emulation framework
Authors: Li Brian Meng-Hsun , Yang Avery Shuei-He , Cheng Michael Chun-Yuan , Huang Huei-Kai , Lai Edward Chia-Cheng
Published: October 2024

Background

The suicide risk in patients with atrial fibrillation receiving novel oral anticoagulants or warfarin has not been evaluated in real-world practice. Moreover, reducing vitamin K levels may increase the suicide risk, underscoring the importance of selecting appropriate oral anticoagulants to prevent unintended outcomes. Therefore, we aimed to evaluate the association between different types of oral anticoagulants and the risk of attempted and completed suicide among patients with atrial fibrillation.

Methods

This nationwide study retrieved data from Taiwan's National Health Insurance Research Database from 2012 to 2020. This study included patients with atrial fibrillation aged 20 years and older who newly received oral anticoagulant treatment, and who had no contraindications for NOACs and no history of suicide-related events. The main outcomes were suicide-related outcomes, including attempted suicide and completed suicide. This study employed the target trial emulation framework to improve the causal inference for the observed association. 

Results

A total of 103,768 (71.74%) patients taking NOACs and 40,877 (28.26%) patients taking warfarin were included in this study. Compared to those receiving warfarin, patients receiving NOACs were associated with a lower risk of suicide-related outcomes (HR, 0.82; 95% CIs, 0.69–0.96).

Conclusions

The findings of this cohort study suggested that patients receiving NOACs were associated with a lower risk of suicidal attempts but similar risk of complete suicide, compared to those receiving warfarin. Considering the risk of suicide, NOACs could be the preferred anticoagulants for patients with atrial fibrillation.
Infant feeding knowledge among women living with HIV and their interaction with healthcare providers in a high-income setting: a longitudinal mixed methods study
Authors: Moseholm Ellen , Aho Inka , Mellgren Åsa , Johansen Isik S , Katzenstein Terese L , Pedersen Gitte , Storgaard Merete , Weis Nina
Published: October 2024

Background

Recent changes in the infant feeding guidelines for women living with HIV from high-income countries recommend a more supportive approach focusing on shared decision-making. Limited information is available on the infant feeding knowledge of women living with HIV and how healthcare providers engage with them in this context. This multicenter, longitudinal, mixed methods study aims to get a comprehensive and nuanced understanding of infant feeding knowledge among women living with HIV of Nordic and non-Nordic origin living in Nordic countries, and their interaction with healthcare providers regarding infant feeding planning.

Methods

Pregnant women living with HIV in Denmark, Finland, and Sweden were recruited in 2019–2020. The Positive Attitudes Concerning Infant Feeding (PACIFY) questionnaire was completed in the 3rd trimester (T1), three (T2), and six (T3) months postpartum. Women who completed the quantitative survey were also invited to participate in qualitative semi-structured interviews at T1 and T3. Results from the survey and interviews were brought together through merging to assess for concordance, complementarity, expansion, or discordance between the datasets and to draw meta-inferences.

Results

In total, 44 women living with HIV completed the survey, of whom 31 also participated in the interviews. The merged analyses identified two overarching domains: Knowledge about breastfeeding in the U = U era and Communications with healthcare providers. The women expressed confusion about breastfeeding in the context of undetectable equals untransmittable (U = U). Women of Nordic origin were more unsure about whether breastfeeding was possible in the context of U = U than women of non-Nordic origin. Increased postpartum monitoring with monthly testing of the mother was not seen as a barrier to breastfeeding, but concerns were found regarding infant testing and infant ART exposure. Infant feeding discussions with healthcare providers were welcome but could also question whether breastfeeding was feasible, and many participants highlighted a need for more information.

Conclusions

Healthcare providers caring for women living with HIV must have up-to-date knowledge of HIV transmission risks during breastfeeding and engage in shared decision-making to optimally support infant feeding choices.
Integrated serum pharmacochemistry, 16S rDNA sequencing, and metabolomics to reveal the material basis and mechanism of Shouhui Tongbian capsule against diphenoxylate-induced slow transit constipation in rats
Authors: Yang Jiaying , Xiao He , Yao Jingchun , Zhang Pin , Yi Bojiao , Fang Zhengyu , Guo Na , Guan Yongxia , Zhang Guimin
Published: October 2024

Background

Slow transit constipation (STC) is highly prevalent and has rising incidence. Shouhui Tongbian capsule (SHTB) is a traditional Chinese Medicine formula with extensive and highly efficacious usage in STC treatment, however, its mechanism of action, especially the regulation of microbiome and lipid metabolites, remains unclear.

Methods

After quality control of SHTB using LC‒MS to obtain its material basis, we tried to elucidate the cohesive modulatory network of SHTB against STC using hyphenated methods from microbiomics, lipidomics, mass spectrometry imaging (MSI) and molecular methods.

Results

SHTB could repair intestinal barrier damage, reduce systemic inflammation and increase intestinal motility in a diphenoxylate-induced STC rat model. Based on 16S rDNA sequencing results, SHTB rehabilitated the abnormal changes in Alloprevotella, Coprococcus, Marvinbryantia, etc., which were associated with STC symptoms. Meanwhile, microbial functional prediction showed that lipid metabolism was improved with SHTB administration. The differential lipids, including fatty acids, lysophosphatidylcholine, phosphatidylcholine, sphingomyelin triglyceride and ceramide, that are closely related to STC disease and SHTB efficacy. Furthermore, SHTB significantly reversed the abnormal expression of these key target enzymes in colon samples, including CTP-phosphocholine cytidylyltransferase, CTP-phosphoethanolamine cytidylyltransferase, phosphatidic acid phosphatase, acid sphingomyelinase etc.

Conclusions

Combined analysis demonstrated that SHTB reducing lipid accumulation and recovery of intestinal microbial homeostasis was the critical mechanism by which SHTB treats STC.