bluuebunny/crossref_metadata_2025 huggingface dataset:
AUKUS and India's Indo-Pacific Strategy
Authors: Behera Laxman Kumar
Published: September 2023

The rollout of AUKUS represents a tectonic shift in the geopolitical rivalry between China and other Indo-Pacific nations. The coming together of three major democratic countries in a strategic technology pact to counter the authoritarian China in the Indo-Pacific could not have come at a more opportune time for India, which is facing increasing Chinese hostility on its northern land borders and strategic encirclement in South Asia and the Indian Ocean Region (IOR). This article discusses AUKUS's potential impacts on India and examines India's Indo-Pacific strategy, its participation in the Quad, and its naval strategy. I argue that, on balance, AUKUS's benefits for India far outweigh its costs.
Management Implications of the COVID-19 Pandemic: A Scoping Review
Authors: Bolino Mark C. , Henry Sarah E. , Whitney Jacob M.
Published: September 2023

On March 11, 2020, the World Health Organization declared COVID-19 a global pandemic, and organizational life around the world changed dramatically overnight. In response, there has been a flurry of management research that seeks to understand the wide-ranging implications of this crisis. In this article, we summarize a scoping review of 69 articles that focused on management issues during the pandemic to understand how it affected individuals, teams, leaders, organizations, and society at large. We also identify and discuss the theoretical perspectives that were prominent in these investigations. We conclude by identifying directions for future inquiry with a mind toward research questions that are likely to be relevant in a postpandemic workplace and note some implications for management scholarship as well.
From Iron Cage to Glass House: Repurposing of bureaucratic management and the turn to openness
Authors: Brandtner Christof , Powell Walter W. , Horvath Aaron
Published: September 2023

Although many contemporary organizations face institutional pressures to embrace open organizing principles, some defer or decline the call. We examine how existing bureaucratic practices shape organizations’ initial steps towards openness to explain variation in substantive openness in the practice of management. Scrutinizing the assumption that bureaucratic organizations operate behind closed doors, we study the turn to openness in a single metropolitan area with heterogeneous management practices and shared calls for greater transparency and inclusion. Econometric analyses paired with in-depth interviews reveal that more bureaucratic organizations first encountered such ideals of openness because they were quicker to use digital communication tools. How open organizations are managed results from the repurposing of existing practices in pursuit of openness. The turn to openness can be understood as a transformation of existing bureaucratic management instead of de-novo adoption of new practices. Our study illuminates how bureaucratic management counterintuitively enables some organizations to become more open, and offers support for repurposing as a mechanism of change in the transformation of an organizational field.
Challenging the dominant work ethic: Work, naps, and productivity of location-independent workers
Authors: Kesküla Eeva
Published: September 2023

This paper critiques the centrality of work in capitalist societies and looks at people who have abandoned their location-bound jobs for the lifestyle of a digital nomad. Five months of fieldwork in Thailand during the first wave of the COVID-19 pandemic revealed that digital nomads aspired to have autonomy over their work, including reducing their work time. However, pursuing their ideal meant negotiating the desire to minimise labour hours on the one hand and guilt about not fitting the hegemonic values of hard work on the other. Digital nomads try to overcome the dominant work ethic in their talk about working productively. While these digital nomads generally spoke of ‘productivity’ in terms of autonomy and efficiency, concerns over ‘appearing lazy’ shifted the register to mainstream concepts of productivity, such as ‘hard work’. Drawing on philosophers of work and the need to take utopias seriously, this article proposes that even if small-scale and individualised, digital nomads’ attempts to reorganise their working lives are an important critique of work, especially in post-COVID trends toward more remote working.
Guidelines of the International Headache Society for Controlled Clinical Trials in Idiopathic Intracranial Hypertension
Authors: Mollan Susan P. , Fraser Clare L. , Digre Kathleen B. , Diener Hans-Christoph , Lipton Richard B. , Juhler Marianne , Miller Neil R. , Pozo-Rosich Patricia , Togha Mansoureh , Brock Kristian , Dinkin Marc J. , Chan Carmen K. M. , Tassorelli Cristina , Sinclair Alex J. , Terwindt Gisela M. , Jensen Rigmor H.
Published: September 2023

The quality of clinical trials is essential to advance treatment, inform regulatory decisions and meta-analysis. With the increased incidence of idiopathic intracranial hypertension and the emergence of clinical trials for novel therapies in this condition, the International Headache Society Guidelines for Controlled Clinical Trials in Idiopathic Intracranial Hypertension aims to establish guidelines for designing state-of-the-art controlled clinical trials for idiopathic intracranial hypertension.
“Let's Call a Spade a Spade. My Barrier is Being a Black Student”: Challenges for Black Undergraduate Nursing Students in a Western Canadian Province
Authors: Luhanga Florence , Maposa Sithokozile , Puplampu Vivian , Abudu Eunice
Published: September 2023

Background

We need more understanding of experiences that hinder or promote equity, diversity, and inclusion of Black students in undergraduate nursing programs to better inform their retention and success.

Purpose

To explore documented experiences of Black undergraduate nursing students, review barriers affecting their retention and success, and suggest evidence-based strategies to mitigate barriers that influence their well-being.

Methods

We used a focused qualitative ethnography for recruiting Black former and current students (N = 18) in a Western Canadian province's undergraduate nursing programs via purposive and snowball sampling. Most participants were female, 34 years or younger, with over 50% currently in a nursing program. Five participants later attended a focus group to further validate the findings from the individual interviews. Descriptive statistics were used to describe participant characteristics; we applied a collaborative constant comparison and thematic analysis approach to their narratives.

Results

Challenges influencing Black students’ retention and success fell into four main interrelated subthemes: disengaging and hostile learning environments, systemic institutional and program barriers, navigation of personal struggles in disempowering learning environments, and recommendations to improve the delivery of nursing programs. Participants also recommended ways to improve diversity and mitigate these barriers, such as nursing programs offering anti-oppression courses, platforms for safe/healthy dialogue, and more culturally sensitive learning-centered programs and responsive supports.

Conclusions

The study findings underscore the need for research to better define nursing program conditions that nurture safe, learning-centred environments for Black students. A rethink of non-discriminatory, healthy learning–teaching engagements of Black students and the mitigation of anti-Black racism can best position institutions to promote equity, diversity, and inclusion of Black students.
Experimental and numerical investigation on 2.5-dimensional nature-inspired infill structures under out-plane quasi-static loading
Authors: Ashok Dara , Bahubalendruni M V A Raju , Mhaskar Atharva , Choudhary Vishal , Balamurali Gunji , Turaka Shesahiah
Published: September 2023

The 2.5-dimensional (2.5D) infill structures are gaining more attention due to their better energy absorption capabilities and lightweight. The additive manufacturing eases the fabrication of these structures and made them accessible for industrial and transport applications. The present work is focused on enhancing energy absorption capability, and mean crush force (MCF) for a novel nature-inspired 2.5D infilled structure through nature-inspired 2.5D geometries. Six nature-inspired geometries are considered for a comparative analysis with the proposed novel snowflake-inspired 2.5D infilled structure to sustain under quasi-static out-plane loading. These structures are cylindrical shells filled with different infill configurations and maintained at constant volume. The structures are fabricated using three-dimensional printing through the digital light processing technique with photopolymer resin and tested under compressive out-plane quasi-static loading conditions. Numerical simulations were performed by ANSYS and compared with experimental results to corroborate the reliability. The effect of infill configurations and supported ribs on the crushing behaviour is discussed in detail. The results reveal a significant improvement in MCF, specific energy absorption, and confined crushing deformation for the proposed lightweight 2.5D infill structures.
A Study and Analysis of Entrepreneurial Intention Among Postgraduate Students in Noida, Uttar Pradesh
Authors: Medayil Mohan Alex , Balakumar R. S.
Published: September 2023

This article investigates the influence of entrepreneurial intention (EI) among postgraduate students in Noida, Uttar Pradesh, with entrepreneurial orientation and business intention with the mediating impact of new business ventures. Study participants come from both private and public universities in Noida, Uttar Pradesh, and the study is composed of 450 students. The survey was developed, responses were collected from postgraduate students and descriptive analysis was used for the study. The findings indicate that social identities are positively and significantly related to EI among postgraduate students to start new ventures. The results also show that entrepreneurial and business intentions are key mediators that affect the relationship between entrepreneurship orientation and business intention. These results have significant scientific and practical implications. Fostering students’ development is a priority for universities and policymakers. Entrepreneurial business intention extends an entrepreneurial sense to become an entrepreneur and influence them to start their new venture. A contribution to this field is the study of entrepreneurial orientation among postgraduate students in Noida, Uttar Pradesh, and investigates the influence of EI among them.
An entropy-based failure prediction model for the creep process
Authors: Shirazi Zohreh , Mohammadi Bijan
Published: September 2023

The creep process is a life-limiting degradation mechanism for many parts. Consequently, it should have been considered throughout the design process. This study aimed to assess the creep curve of Inconel 718 by designing a fixed blade profile. The finite element model has been done using ABAQUS software. The temperature distribution of the vane was calculated to assess the thermal stress on the vane. For temperature analysis, the film subroutine code was written. The creep life prediction model was evaluated using creep subroutine. This model included an entropy model based on the Boltzmann theory and continuum damage mechanics. Stress and temperature were applied at a range from 100 to 900 MPa and from 620 to 800°C, respectively. Finally, an accumulation damage parameter was computed. In this investigation, all three parts of the creep curve can be achieved simultaneously. There was good agreement between the simulations performed on a vane based on this method and the samples studied in previous research.
Combination of Nicorandil and Beta-Adrenergic Receptor Blockers in Patients with Coronary Artery Disease: A Real-World Observational Study
Authors: Cheng Jia , Qiu Lin , Zhang Zixuan , Li Na , Shu Hongyang , Xiao Zhichao , Zhou Ning
Published: September 2023

Background

The effect of combined nicorandil and beta-adrenergic receptor blockers (BBs) compared with that of BBs alone on long-term clinical outcomes in patients with coronary artery disease (CAD) remains undetermined.

Methods

A multicenter retrospective cohort study was performed. Adult patients who had been hospitalized for CAD and treated for angina with a combination of nicorandil and BBs or BBs alone were included. The effect of different treatments on the cumulative incidence of major adverse cardiovascular event (MACE) and their components within a follow-up duration of 2.5 years were analyzed using Kaplan–Meier survival curves. An inverse probability of treatment weighting (IPTW) method was used to adjust for the possible effect of confounding factors.

Results

A total of 137,714 patients were screened, of whom 16,912 individuals (mean age: 61.5 years, men: 67.1%) were successfully enrolled. Among the enrolled participants, 4669 received the combined treatment of nicorandil and BBs, while 12,243 received BBs alone. After IPTW, the results demonstrated that the combined treatment was associated with a significantly reduced incidence of MACE (hazard ratio [HR] 0.79, 95% conidence interval [CI] 0.72-0.87) and stroke (HR 0.48, 95% CI 0.42-0.54) but not of MI (HR 1.03, 95% CI 0.92-1.15) or all-cause mortality (HR 0.93, 95% CI 0.64-1.37). Sensitivity analyses revealed similar results.

Conclusions

A combined antiangina treatment of nicorandil and BBs may be more effective than treatment of BBs alone in reducing the long-term incidence of MACE in patients with CAD.
Tribological performance evaluation of organic polymer as additives in vegetable oil using steel materials
Authors: Opia Anthony Chukwunonso , Abdollah Mohd Fadzli Bin , Kameil Abdul Hamid Mohd , Syahrullail Samion , Ali Audu Ibrahim , Mama Stanly Chinedu , Saleh Abdelgade Agilah , Sule Ahmed , Johnson Charles N
Published: September 2023

An investigation on lubricating oil rheological behavior and tribological effect on sliding contact was conducted. The study employed organic polymer Eichhornia Crassipes carboxymethyl cellulose (EC-CMC) polymer as additive in corn oil (CO) and sunflower oil (SFO). The experiment was performed using high frequency reciprocating rig (HFRR). Analysis on viscosity behavior was done with three samples of EC-CMC concentration (0.5 wt.%, 1 wt.%, and 1.5 wt.%) under 100 ml volume of base CO and SFO samples. Rheological studies on the polymer concentrations show good results with 0.5 wt.%, 1 wt.%, and 1.5 wt.%, but indicated optimal on 1 wt.% EC-CMC especially from temperature beyond 100°C for the two selected lubricants. Under friction and wear analysis, the test was conducted using 1 wt.% EC-CMC. The base lubricants CO and SFO yielded coefficient of friction and wear scar diameter of 0.087, 11.2 × 10−6 mm3/N/m and 0.080, 10.5 × 10−6 mm3/N/m, respectively. During the testing, the use of 1 wt.% EC-CMC blended SFO gives lower coefficient of friction than CO both at base state and inclusion with additive. This yielded COF reduction by 22.5% and 13.8% for 1 wt.% EC-CMC + SFO and 1 wt.% EC-CMC + CO, respectively, but gives better reduction under SAE-5W-30. The analysis concluded that application of 1 wt.% concentration of EC-CMC in base oil lubricant for both SFO and CO significantly enhanced the properties. The utilization of this sustainable product certainly will contribute in solving global pollution challenges.
Dynamic response of epoxy foam structures reinforced with aramid layers subjected to low-velocity impact
Authors: Boutros Lara , Navarro Pablo , Marguet Steven , Tawk Issam , Ferrero J. F
Published: September 2023

This study investigates the impact response of epoxy foam structures reinforced with aramid woven fabrics through drop weight tests. These structures are not classical sandwich panels as the fabrics are blended into the epoxy foam. The number of aramid plies and their location are varied, and the influence of the foam density is studied. Low-velocity drop weight tests are conducted. The load–displacement curves, the morphology of damage, the indentation, and the back face signature are analyzed. Results reveal that increasing the number of aramid layers in the middle of the structure reduces the crack propagation and increases the peak load. In addition, adding one layer of aramid at the back face prevents the crack propagation. Finally, the use of several foam densities, with the higher density at the impact face leads to an improved protection capacity.
New Resilience for the New Normal: Online Students’ Early Strategies for Course Persistence at the Beginning of the COVID-19 Pandemic
Authors: Graham Kate , Stuart George , McAdie Tina
Published: September 2023

Student attrition is now a global problem in Higher Education with most institutions experiencing high volumes of early exiting students. However, student resilience has yet to be adequately explored, particularly among the increasing online student population, as a possible mechanism to reduce attrition rates. In the present study, online, undergraduate students were asked two qualitative, open-ended questions to elicit their subjective understanding of resilience in the context of their university study. Thematic analysis identified that health-, work-, and relationship-related experiences were the top-three stressful experiences described by students. Academic management, self-care, and positive psychology techniques were the most common student coping strategies. The findings suggest a highly individualized conceptualization of what might predict retention or attrition. Findings are discussed in the context of assisting online, undergraduate students to utilize their resilience to persist in university.
Do the Right Thing the Right Way! How Ethical Leaders Increase Employees Creative Performance
Authors: Wadei Kwame Ansong , Asaah Jenkins Atarisigna , Amoah-Ashyiah Ambrose , Wadei Bernice
Published: September 2023

This study presents a moderated mediation model of leadership influences by examining the effects of ethical leadership on employee creative performance, using data from 342 employees matched with their supervisors in small and medium organizations in Ghana. The study revealed that creative self-efficacy mediated the positive relationship between ethical leadership and employee creative performance from the SPSS macro-PROCESS analysis. Additionally, job autonomy was identified as a situational moderator in the ethical leadership and employee creative self-efficacy relationship. Thus, the relationship between ethical leadership and employee creative self-efficacy was stronger as the job autonomy level rose. Finally, the theoretical contributions, practical implications as well as limitations, and future research directions were also discussed.
Neo-emotions: An Interdisciplinary Research Agenda
Authors: Cottingham Marci D.
Published: September 2023

Emotion research that attends to the cultural dynamics of affective life remains underdeveloped. I outline an agenda for an understudied phenomenon that can orient emotion researchers to the situated, cultural practices of affective life: Neo-emotions. Neo-emotions, when situated within macro-level processes and cultural events, illustrate the constrained yet creative practices that social actors use to address the disconnect between one's emotional vocabulary and dynamic environment. As such, neo-emotions are analytically rich cultural practices that can be empirically explored through sociological, anthropological, historical, and psychological inquiry. I discuss a range of neo-emotions, including doomscrolling, eco-grief, and Black joy, their social antecedents (digitalization, disasters/crises, and social movements) and methodological implications for an interdisciplinary agenda.
Comprehensive geriatric assessment in older vascular patients in a tertiary hospital
Authors: Shi Min Chau Christine , Lin Huimin , Li Fuyin , Villan Sigaya Kenneth
Published: September 2023

Background

Comprehensive Geriatric Assessment (CGA) is a validated multidomain assessment of an older person’s myriad issues that has shown positive medical outcomes in surgical settings. However, there is paucity of evidence in older Vascular inpatients.

Objectives

To determine if a Geriatric Liaison Service using CGA improves medical outcomes in older Vascular inpatients in Singapore.

Methods

This is a quality improvement prospective cross-sectional study. Vascular patients aged ≥65 years admitted between November 2018 to October 2019 were referred to the Vascular-Geriatric Service (VGS) at the surgeon’s discretion if they had acute medical issues, cognitive concerns, or functional decline. Patients admitted under Vascular Surgery during the preceding year but not referred to VGS were used as control. A pre- and post-analysis was conducted for outcomes of medical complications, while a multivariate analysis was done to look at LOS, 30-day unplanned medical readmissions and 30-day mortality rates.

Results

Patients had significantly lower rates of pneumonia (2.2% vs 10.8%, p = .021) and delirium (1.1% vs 18.3%, p < .001) post-VGS compared to pre-VGS. VGS decreased the odds of 30-day mortality by 79% as compared to the control group (OR = 0.21, 95% CI: 0.05-0.86, p = .030). The intervention group had increased risk of a longer hospital stay by 48% as compared to control (RR: 1.48 95% CI: 1.11 to 1.97, p = .008).

Conclusions

VGS was associated with reduction in some medical complications, and 30-day mortality in older frail Vascular inpatients with multimorbidity.
Congestive Heart Failure in an Adolescent With a Ruptured Sinus of Valsalva Aneurysm
Authors: Jawahar Aravinth P. , Issa Bayan , Porayette Prashob , Karimi Mohsen , Beasley Gary S.
Published: September 2023

Sinus of Valsalva aneurysm (SVA) is an abnormal dilatation of the aortic root located between the aortic valve annulus and the sinotubular junction and is rare in the pediatric population. This case report describes a unique case of a 16-year-old adolescent patient admitted with progressive heart failure symptoms and diagnosed with a ruptured noncoronary SVA. He underwent surgical repair of the SVA with autologous pericardial patches and had an uncomplicated postoperative course. A genetic workup revealed an underlying 22q11.2 deletion that is infrequently associated with SVA.
COVID-19 Vaccine Acceptance Among Healthcare Students in Vietnam, Based on Health Belief Model
Authors: Tieu Mai Diep Thi , Thuy Pham Thi
Published: September 2023

Introduction

Healthcare students have a high risk of acquiring COVID-19 while practicing in medical facilities, and their health-related decisions might considerably impact the people around them. In the circumstance of many people refusing vaccination, the delay in accepting the COVID-19 vaccine by this group could be a barrier to providing effective immunity to the entire population against the COVID-19 pandemic.

Objective

The study aimed to assess the prevalence of vaccination acceptance and the factors influencing COVID-19 vaccine acceptance among Vietnamese healthcare students.

Methods

A web-based cross-sectional study was conducted among 384 respondents. The chi-square, Fisher's exact, and Mann–Whitney tests were used to assess the association between independent and dependent variables. Binary logistic regression analysis was used to identify the potential determinants of COVID-19 vaccine acceptance. Variables with p values of less than .05 at the 95% confidence interval were considered significant variables.

Results

Out of 384 participants, 91.7% accepted COVID-19 vaccination. Nurse and midwife (odds ratio [OR] = 6.81, confidence interval [CI] = 2.02–22.94, p < .01), perceived normal health status (OR = 15.22, CI = 2.74–84.66, p < .001), perceived good health status (OR = 149.00, CI = 11.08–2003.42, p < .01), COVID-19 infection among relatives or friends (OR = 4.19, CI = 1.77–9.95, p < .01) were predictors for the COVID-19 vaccine acceptance. Participants were less likely to accept COVID-19 vaccination if they reported greater perceived barriers (OR = 0.80, CI = 0.69–0.93, p < .01).

Conclusion

The current study offers helpful information on the factors influencing vaccine acceptance based on the Health Belief Model. The findings could benefit policymakers in establishing effective campaigns to improve the acceptance rate of the COVID-19 vaccine among healthcare students and shorten the time required to achieve herd immunity.
Effect of a Commercial NCLEX-RN Preparation Product on First Time Pass Rates
Authors: Lewis Lisa Scandale , Willingham Tonya , Myers John , Hatch Daniel
Published: September 2023

Introduction

Passing the National Council Licensure Exam-Registered Nurse (NCLEX-RN) is the entry into the profession for nurses, and rates of passing the exam on the first attempt are used as an important outcome measure for schools, students, and accrediting agencies.

Objective

This study was conducted in order to investigate if a commercial NCLEX-RN test preparation product impacted first time pass rates.

Methods

Data were collected from 688 students from six institutions who were taking the NCLEX-RN for the first time. The intervention group (n = 396) received a 6-month subscription to a commercial product with which to prepare for the NCLEX-RN, and was compared to the control group (n = 292) to test for differences in demographics and test pass rates.

Results

The intervention group was more likely to be younger than 25 years of age (n = 160, 55.8% vs. n = 76, 34.6%; p < .001) when compared with the control group. No other significant differences in demographics or NCLEX-RN pass rates were observed between the groups.

Conclusion and Recommendations

This study failed to demonstrate a change in the likelihood of passing NCLEX-RN on the first attempt in a group of students who used a commercial test preparation product. We recommend that instructor-guided use of a test-preparation product, along with other interventions to support test success, be considered in creating an individualized plan for nursing students preparing for NCLEX-RN.
Patients’ Perception Towards Quality of Nursing Care and Associated Factors at Agaro General Hospital, Southwest Ethiopia: A Cross-Sectional Study
Authors: Yesuf Mohammed , Abdu Mehd
Published: September 2023

Introduction

Quality care is currently on the agenda of policy-makers at national and international levels. Patient-centeredness is considered an integral component of healthcare quality dimensions in addition to its effectiveness and safety. This indicates that healthcare should be viewed from a patient's perspective.

Methods and Materials

An institution-based cross-sectional study was conducted with a total sample size of 422 using systematic random sampling among patients admitted to the Agaro General Hospital. SPSS software version 25.0 was used to enter and analyze the data. The relationship between the dependent variable and covariates was determined using multivariable binary logistic regression analysis.

Results

A total of 405 patients participated in this study with a response rate of 96.0%. The overall percentage of positive perception was 76.3%. Clients aged 31–40 years were more likely [AOR: 2.191, 95% CI: 1.033–4.645, p-value: .041] and clients aged ≥ 51 years were less likely to perceive positively [AOR: 0.490, 95% CI: 0.271–0.886, p-value: .018]. Patients who had paid for receiving care were more likely to perceive it positively [AOR: 3.046, 95% CI 1.043–8.896, p-value: .042]. The odds of positive perception towards the quality of nursing care were higher among patients who thought the hospital cost was medium [AOR: 3.066, 95% CI: 1.286–7.311, p-value: .012], low [AOR: 13.859, 95% CI: 2.245–85.562, p-value: .005], and uncertain [AOR: 6.116, 95% CI: 1.988–18.809, p-value: .002].

Conclusion and Recommendations

Most patients had a positive perception of the quality of nursing care. Being elderly and feeling towards hospital costs have a negative influence whereas having paid for the treatment has a positive influence on the patients’ perception of nursing care. Hence the need increases with age, and healthcare providers should pay great attention while providing care for elderly patients.
“Dear Manager, now I know what you expect”: Examining availability ambiguity in two studies
Authors: Heissler Clara , Ohly Sandra , Kern Marcel
Published: September 2023

In the present study, we introduce the concept of availability ambiguity and propose that it extends our understanding of the consequences of availability expectations after hours beyond the absolute level perceived by employees. Thus, we investigated how the level and ambiguity of supervisors’ availability expectations contribute to ICT communication satisfaction, detachment, work-home interference, and exhaustion. Furthermore, we test the effectiveness of a training for supervisors aimed at encouraging them to be transparent about their availability expectations by making explicit agreements with their team. In cross-sectional Study 1, data from 235 individuals showed that availability ambiguity predicted detachment and work-home interference beyond the effect of availability expectations. This finding underscores the need for clear agreements, which was addressed in an intervention tested in the two-wave Study 2. Results from 62 subordinates at T1 and 33 at T2 belonging to 17 different supervisors who participated in the training indicated an increase in explicit agreements and a decrease in availability ambiguity, but no decrease in levels of availability expectations or emotional exhaustion and no increase in ICT communication satisfaction, detachment, or work-life balance. Taken together, our studies show that the ambiguity of availability expectations is a unique stressor that needs to be and can be targeted.
Characterizing end-of-life communication in families
Authors: Horning Melanie A. , Bowen Mary Elizabeth
Published: September 2023

Background:

The chronic disease course can be uncertain, contributing to delayed end-of-life discussion within families resulting in missed opportunity to articulate wishes, increased decisional uncertainty, and delayed hospice care. Consistent with the Family Communication Patterns Theory (FCPT), family communication patterns may affect the quality and timing of end-of-life discussion, hospice utilization, and the experience of ‘a good death.’

Objective:

To assess how families’ conversation and conformity orientation (spontaneity of conversation and hierarchical rigidity) form four family communication patterns (consensual, pluralistic, protective, and laissez-faire) and may be associated with the number and timing of end-of-life discussions.

Design:

A cross-sectional study.

Methods:

Family members of loved ones who died from chronic illnesses while in hospice ( n = 56) completed online surveys including a modified Revised Family Communication Pattern instrument (RFCP) and the Chronic Illness Rating Scale (CIRS). Additional survey questions assessed the number and timing of end-of-life discussions and timing of hospice enrollment. IBM SPSS version 26 was used for descriptive analysis.

Results:

Most families (42.9%) were pluralistic, reporting communication styles with high conversation and low conformity orientation; (39.29%) were protective, reporting low conversation and high conformity orientation. Pluralistic families had more end-of-life conversations than did protective families.

Conclusion:

Study findings suggest that there may be a relationship between family communication pattern type and inclination toward end-of-life discussion. This first step supports future research regarding whether the FCPT can be used to predict which families may be at increased risk for ineffective or delayed end-of-life discussion. Additional variables to consider include the timing of hospice enrollment and the quality of the dying experience. Clinicians may ultimately use findings to facilitate earlier identification of and intervention for families who are at risk for poor end-of-life communication and outcomes.
Delayed intracranial hemorrhage after head trauma seems rare and rarely needs intervention—even in antiplatelet or anticoagulation therapy
Authors: Bergenfeldt Henrik , Forberg Jakob Lundager , Lehtinen Riikka , Anefjäll Ebba , Vedin Tomas
Published: September 2023

Background

Traumatic brain injury causes morbidity, mortality, and at least 2,500,000 yearly emergency department visits in the USA. Computerized tomography of the head is the gold standard to detect traumatic intracranial hemorrhage. Some are not diagnosed at the first scan, and they are denoted “delayed intracranial hemorrhages. ” To detect these delayed hemorrhages, current guidelines for head trauma recommend observation and/or rescanning for patients on anticoagulation therapy but not for patients on antiplatelet therapy. The aim of this study was to investigate the prevalence and need for interventions of delayed intracranial hemorrhage after head trauma.

Methods

The study was a retrospective review of medical records of adult patients with isolated head trauma presenting at Helsingborg General Hospital between January 1, 2020, and December 31, 2020. Univariate statistical analyses were performed.

Results

In total, 1627 patients were included and four (0.25%, 95% confidence interval 0.06–0.60%) patients had delayed intracranial hemorrhage. One of these patients was diagnosed within 24 h and three within 2–30 days. The patient was diagnosed within 24 h, and one of the patients diagnosed within 2–30 days was on antiplatelet therapy. None of these four patients was prescribed anticoagulation therapy, and no intensive care, no neurosurgical operations, or deaths were recorded.

Conclusion

Traumatic delayed intracranial hemorrhage is rare and consequences mild and antiplatelet and anticoagulation therapy might confer similar risk. Because serious complications appear rare, observing, and/or rescanning all patients with either of these medications can be debated. Risk stratification of these patients might have the potential to identify the patients at risk while safely reducing observation times and rescanning.
ΔPSap4#5 surface-functionalized abiraterone-loaded nanoparticle successfully inhibits carcinogen-induced prostate cancer in mice: a mechanistic investigation
Authors: Al Hoque Ashique , Dutta Debasmita , Paul Brahamacharry , Kumari Leena , Ehsan Iman , Dhara Moumita , Mukherjee Biswajit , Quadir Mohiuddin , Kaipparettu Benny Abraham , Laha Soumik , Ganguly Shantanu
Published: September 2023

Prostate cancer (PCa) is one of the fatal illnesses among males globally. PCa-treatment does not include radiotherapy. Chemotherapy eventually causes drug resistance, disease recurrence, metastatic advancement, multi-organ failure, and death. Preclinical data on PCa-induced by carcinogens are truly scarce. Although some data on xenograft-PCa in animals are available, they mostly belonged to immuno-compromised animals. Here, we developed ΔPSap4#5 aptamer surface-functionalized abiraterone-loaded biodegradable nanoparticle (Apt-ABR-NP) to investigate its targeting ability to prostate-specific membrane antigen (PSMA) in carcinogen-induced PCa mice and the therapeutic efficacy of the formulation. Aptamers are called synthetic monoclonal antibodies for their target specificity. However, they are devoid of the toxicity problem generally associated with the antibody. Abiraterone is a testosterone and androgen inhibitor, a new drug molecule that shows good therapeutic efficacy in PCa. The developed nanoparticles were physicochemically characterized and used for various in vitro and in vivo investigations. Nanoparticles had an average size of 149 nm with sustained drug release that followed Korsmeyer–Peppas kinetics. In vitro investigation showed that Apt-ABR-NP produced 87.4% apoptotic cells and 95.3% loss of mitochondrial membrane potential in LNCaP cells after 48 h of incubation. In vivo gamma scintigraphy, live imaging, and biodistribution studies in prostate cancer animal models showed the predominant targeting potential of Apt-ABR-NP. Histopathological investigation showed the remarkable therapeutic efficacy of the formulation. The pharmacokinetic study showed an increased biological half-life and enhanced blood residence time of Apt-ABR-NP. Apt-ABR-NP therapy can thus minimize off-target cytotoxicity, reduce drug loss due to site-specific delivery, and deliver abiraterone in a sustained manner to the organ of interest. Thus, the present study brings new hope for better therapeutic management of PCa in the near future.

Graphical Abstract
Nomogram for the prediction of crescent formation in IgA nephropathy patients: a retrospective study
Authors: Lin Zaoqiang , Feng Liuchang , Zeng Huan , Lin Xuefei , Lin Qizhan , Lu Fuhua , Wang Lixin , Mai Jianling , Fang Pingjun , Liu Xusheng , Tan Qinxiang , Zou Chuan
Published: September 2023

Background

The 2017 Oxford classification of immunoglobulin A nephropathy (IgAN) recently reported that crescents could predict a worse renal outcome. Early prediction of crescent formation can help physicians determine the appropriate intervention, and thus, improve the outcomes. Therefore, we aimed to establish a nomogram model for the prediction of crescent formation in IgA nephropathy patients.

Methods

We retrospectively analyzed 200 cases of biopsy-proven IgAN patients. Least absolute shrinkage and selection operator(LASSO) regression and multivariate logistic regression was applied to screen for influencing factors of crescent formation in IgAN patients. The performance of the proposed nomogram was evaluated based on Harrell’s concordance index (C-index), calibration plot, and decision curve analysis.

Results

Multivariate logistic analysis showed that urinary protein ≥ 1 g (OR = 3.129, 95%CI = 1.454–6.732), urinary red blood cell (URBC) counts ≥ 30/ul (OR = 3.190, 95%CI = 1.590–6.402), mALBU ≥ 1500 mg/L(OR = 2.330, 95%CI = 1.008–5.386), eGFR < 60ml/min/1.73m2(OR = 2.295, 95%CI = 1.016–5.187), Serum IgA/C3 ratio ≥ 2.59 (OR = 2.505, 95%CI = 1.241–5.057), were independent risk factors for crescent formation. Incorporating these factors, our model achieved well-fitted calibration curves and a good C-index of 0.776 (95%CI [0.711–0.840]) in predicting crescent formation.

Conclusions

Our nomogram showed good calibration and was effective in predicting crescent formation risk in IgAN patients.
The translation process of the culturally sensitive active aging scale for community-dwelling older adults in Pakistan
Authors: Bibi Rashida , Yan Zhang , Zeb Akhter , Anwar Nasir , Mian Nasar , Khan Roheeda Amanullah
Published: September 2023

Background

The assessment of active aging levels in Pakistani older adults is crucial yet; research tools are scarce in the local language. Therefore, this study aims to translate and validate the English version of an Active Aging Scale into a cross-culturally sensitive Urdu version to assess active aging levels in Pakistani older adults.

Methods

To translate and validate the scale, we used the ISPOR (International Society for Pharmacy Economic and Outcome Research) standards. Reliability, concurrent validity, construct validity, convergent validity, and discriminatory validity were checked on a total sample of 160 community-dwelling older adults. After two weeks, the test–retest reliability was examined. AMOS version 23 and SPSS version 23 were used to analyze the data.

Results

The average content validity index for clarity was 0.91 and relevancy was 0.80. The total variance in the pilot study of all items secured > 0.3 variances except for two items scored < 0.30 that were omitted before the validity and reliability test. The remaining items explained 65.46% of the overall variation and had factor loadings ranging from 0.46 to 0.90 in the principal factor analysis (PFA). The confirmatory factor analysis of the Active Aging Scale revealed that the model fit was good with a Chi-square value (418.18 (DF = 2.2) which is less than 3.00. This is further evidenced by the root mean square error of approximation (RMSEA) of 0.042, goodness of fit index (GFI) of 0.92, adjusted goodness of fit index (AGFI) of 0.94, and comparative fit index (CFI) values of 0.92 and 0.96 (unstandardized and standardized, respectively). The scale’s Cronbach’s alpha coefficient was 0.88, indicating dependability and its test–retest reliability with the significance of (P. < 0.05).

Conclusion

The Urdu version of the Active Aging Scale was successfully translated and validated in a culturally sensitive manner, and can be used to evaluate the effectiveness of various active aging interventions for older adults in Pakistan.
The direct disease burden of COVID-19 in Belgium in 2020 and 2021
Authors: Devleesschauwer Brecht , Willem Lander , Jurčević Jure , Smith Pierre , Scohy Aline , Wyper Grant M. A. , Pires Sara Monteiro , Van Goethem Nina , Beutels Philippe , Franco Nicolas , Abrams Steven , Van Cauteren Dieter , Speybroeck Niko , Hens Niel , De Pauw Robby
Published: September 2023

Background

Burden of disease estimates have become important population health metrics over the past decade to measure losses in health. In Belgium, the disease burden caused by COVID-19 has not yet been estimated, although COVID-19 has emerged as one of the most important diseases. Therefore, the current study aims to estimate the direct COVID-19 burden in Belgium, observed despite policy interventions, during 2020 and 2021, and compare it to the burden from other causes.

Methods

Disability-adjusted life years (DALYs) are the sum of Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) due to disease. DALYs allow comparing the burden of disease between countries, diseases, and over time. We used the European Burden of Disease Network consensus disease model for COVID-19 to estimate DALYs related to COVID-19. Estimates of person-years for (a) acute non-fatal disease states were calculated from a compartmental model, using Belgian seroprevalence, social contact, hospital, and intensive care admission data, (b) deaths were sourced from the national COVID-19 mortality surveillance, and (c) chronic post-acute disease states were derived from a Belgian cohort study.

Results

In 2020, the total number of COVID-19 related DALYs was estimated at 253,577 [252,541 − 254,739], which is higher than in 2021, when it was 139,281 [136,704 − 142,306]. The observed COVID-19 burden was largely borne by the elderly, and over 90% of the burden was attributable to premature mortality (i.e., YLLs). In younger people, morbidity (i.e., YLD) contributed relatively more to the DALYs, especially in 2021, when vaccination was rolled out. Morbidity was mainly attributable to long-lasting post-acute symptoms.

Conclusion

COVID-19 had a substantial impact on population health in Belgium, especially in 2020, when COVID-19 would have been the main cause of disease burden if all other causes had maintained their 2019 level.
The Dunning–Kruger effect: subjective health perceptions on smoking behavior among older Chinese adults
Authors: Jia Zhike , Li Shubin , Luo Zhihua , Tong Minjun , Gao Tianyue
Published: September 2023

Background

The intrinsic damage and external hazards of smoking are major risk factors for poorer health and are recognized as a global health issue of concern in geriatric health. This study aims to assess the Dunning–Kruger effect through the influence of subjective health perceptions on smoking behavior in older adults.

Methods

This study used data from the 2018 Chinese Longitudinal Healthy Longevity Survey (N = 9,683) provided by the Center for Healthy Aging and Development Studies at Peking University. A binary logistic model was used to examine whether the Dunning–Kruger effect affects smoking behavior in older adults, and a linear probability model was used as a commentary baseline model for logistic regression to prevent measurement bias. In addition, a mediating analysis was used to examine the mechanisms through which the Dunning–Kruger effect occurs.

Results

Older adults often overestimated their current health status and underestimated the health risks of smoking, causing the Dunning–Kruger effect to arise from their inadequate self-perceived health (i.e., older adults are more likely to smoke when they have better self-rated health or when hypertension, cardiopathy, stroke, and diabetes have little or no impact on their daily lives). These observations can be explained by the older adults’ subjective health perceptions arising from their ingenuous understanding of their health, which indirectly influences their smoking behavior to some extent.

Conclusion

Older adults’ self-perceived health was associated with smoking behavior. Public health institutions should improve older adults’ health perceptions so that they objectively understand their own health status.
The impacts of knowledge and attitude on behavior of antibiotic use for the common cold among the public and identifying the critical behavioral stage: based on an expanding KAP model
Authors: Wang Qianning , Wu Yuanyang , Wang Dan , Lai Xiaoquan , Tan Li , Zhou Qian , Duan Lixia , Lin Rujiao , Wang Xi , Zheng Feiyang , Yu Tiantian , Wang Lu , Fan Si , Wang Yanting , Zhang Xinping , Liu Chenxi
Published: September 2023

Background

This study aims to explore the impacts of knowledge and attitude on the behavior of antibiotic use during the treatment of the common cold based on the expanding KAP model, and then identify the critical behavioral stage.

Methods

A cross-sectional study was conducted on 815 public from 21 community health centers (CHCs) in Chongqing, China. Based on the expanding KAP model, a self-administered questionnaire was designed to measure knowledge, attitude, multi-stage behavior, and perceived threat, in which multi-stage behavior was divided into pre-use antibiotic behavior, during-use antibiotic behavior, and post-use antibiotic behavior. A structural equation model was used to examine the model fit and the direct, indirect, mediating effects, and moderating effect of the variables.

Results

The expanding KAP showed good model fit indices with χ²/df = 0.537, RMSEA = 0.033, CFI = 0.973, GFI = 0.971, NFI = 0.934, TLI = 0.979. Knowledge had a positive effect on attitude (β = 0.503, p < 0.05), pre-use antibiotic behavior (β = 0.348, p < 0.05), during-use antibiotic behavior (β = 0.461, p < 0.001), and post-use antibiotic behavior (β = 0.547, p < 0.001). Attitude had a positive effect on during-use antibiotic behavior (β = 0.296, p < 0.001), and post-use antibiotic behavior (β = 0.747, p < 0.001). The mediating effect of attitude was positive among knowledge, during-use antibiotic behavior (β = 0.149, p < 0.05), and post-use antibiotic behavior (β = 0.376, p < 0.001). Perceived threat also had a positive moderating effect between knowledge and post-use antibiotic behavior (β = 0.021, p < 0.001).

Conclusions

Knowledge, attitude and perceived threat had different effects on different stages of antibiotic behavior. The critical behavioral stage prioritized the post-use antibiotic behavior and during-use antibiotic behavior over pre-use antibiotic behavior.