bluuebunny/crossref_metadata_2025 huggingface dataset:
Challenges to Cardiovascular Health Among Female U.S. Veterans and Future Implications: A Scoping Review
Authors: Batie Carolyn M , Axon Robert N , Pope Charlene
Published: January 2025

Introduction

Cardiovascular disease (CVD) is the leading cause of death for women in the United States, and U.S. female Veterans have higher rates of CVD compared to civilian women. With an increasing number of women joining the military, the number of female Veterans is expected to rise; therefore, providing appropriate cardiovascular care must be a top priority for the DoD and the Veterans Health Administration (VHA). This scoping review will answer the question: “Among U.S. female Veterans, what are the challenges faced in cardiovascular health, and what are potential future implications and interventions?” We designed this scoping review to identify common themes and gaps in the literature, guide further investigations, and contribute to developing targeted interventions and policies to enhance cardiovascular outcomes among female Veterans.

Materials and Methods

On May 1, 2024, a modified PRISMA-ScR search was performed using the following online databases: PubMed, CINAHL, and OVID. The inclusion criteria included U.S. female Veterans, CVD, and data collected from VHA database sources. Results from any literature source published in the past 10 years and written in English were considered. The search identified 107 studies. Two independent reviewers screened titles and abstracts and then performed full-text reviews.

Results

We identified 34 studies assessing challenges to cardiovascular care among female Veterans in areas of racial/ethnic and gender-specific disparities regarding the prevalence of nontraditional CVD risk factors, access to health care services, awareness and knowledge of CVD risk factors, and willingness to receive cardiovascular care. The review also identified potential areas for improvement initiatives in education, peer support, and future research.

Conclusions

This review highlighted 3 main challenges female Veterans face in accessing CVD care from the VHA: perceived barriers, unique risk factors, and gender/racial disparities. It emphasized the need for improved CVD research, screening, education, and social support for female Veterans. The authors propose two main strategies to address these challenges: (1) pre-transition education from the DoD and (2) enhanced CVD training in the VHA. Cardiovascular disease risk factor recognition and prevention education should occur in military settings, allowing medical providers in DoD clinics to engage female service members in discussions and screenings before transitioning to VHA care. The VHA should educate providers on the barriers female Veterans face, the identification of nontraditional risk factors, and existing health care disparities. Additionally, it should continue to support successful initiatives focused on improving CVD care for female Veterans, such as the Women’s Health Research Network, the Quality Enhancement Research Initiative, and the Enhancing Mental and Physical Health of Women through Engagement and Retention program.
Randomized Controlled Trials in Social Work
Authors: Solomon Phyllis , Zhang Anao , Tham Suzanne
Published: January 2025

Randomized controlled trial (RCT) is terminology more commonly employed in the medical arena but has been increasingly used in the behavioral and social sciences. This is because RCTs employ experimental designs to determine the efficacy of interventions, which is extremely important to social work practice. An RCT retains the key features of an experimental design. A primary characteristic is participants’ random or chance allocation to the experimental intervention or the control condition for comparison. This allocation process minimizes participants’ differences between these conditions. In social work, the control condition is often standard treatment or what is considered the acceptable standard of care for achieving the desired outcome, rather than nothing or a placebo, which is common in medical interventions. Furthermore, these true experimental designs require random assignment after a pretest of the outcome assessment normally using a psychometrically sound or objective measure of the outcome and a minimum of two conditions, experimental and control, although the study may have more than one experimental or control condition. RCTs are important to building a base of evidence for social work practice, as the experimental design inherently controls for most biases or threats to the internal validity of the design and, therefore, increases confidence in making causal statements concerning the effectiveness of the experimental intervention. For these reasons, RCTs are considered the “gold standard” of research because they have high internal validity, enabling causal findings. However, they have limited external validity. External validity is best achieved through replication of the RCT. Due to the need for empirically based practice, primarily in the health-care arena, there have been several new innovations in the standard experimental design or RCT, such as pragmatic RCTs aimed at determining the effectiveness of interventions in real-world clinical practice and step-wedge designs, where exposure to the intervention occurs over a period of time.
Saiyid Aḥmad of Rai Bareli
Authors: Nizami Moin Ahmad
Published: January 2025

Saiyid (also Sayyid) Aḥmad (b. 1786–d. 1831) was the founder of a religio-political movement, at times remembered as the Mujahidin movement, that combined religious reform with an armed struggle in early-19th-century North India. He was born in the town of Rai Bareli, near Lucknow, to a religious family that had strong connections with the Naqshbandi Sufi order. He went to Delhi for education in 1804 and became a disciple of Shāh ʿAbd al-ʿAzīz (d. 1824; son of Shāh Walī Allāh). ʿAbd al-ʿAzīz initiated him in the Chishtī, Naqshbandī, and Qādirī orders and entrusted him to his younger brother Shāh ʿAbd al-Qādir (d. 1813) for further education. Later, in 1812, Saiyid Aḥmad joined the Afghan ruler of Tonk (in Rajasthan), Nawāb Āmir Khān (b. 1768–d. 1834), and served as a soldier, eventually becoming his close confidant. In 1817, when the Nawāb signed a treaty with the British, Saiyid Aḥmad left his services and went to Delhi. He established himself as a religious leader and a Sufi guide and founded the Ṭarīqa-i Muḥammadiya (Path of the Prophet), a Sufi order emphasizing strict observance of Sharia. He received active support from the family of Walī Allāh, particularly from Shāh Ismāʿīl (d. 1831) and Shāh ʿAbd al-Ḥayy (d. 1828), the nephew and son-in-law of ʿAbd al-ʿAzīz, respectively. Between 1817 and 1821, Saiyid Aḥmad made extensive tours of the countryside towns of the Gangetic basin and made full use of the networks of scholarship that connected the religious families of such towns. Accompanied by his closest followers, Saiyid Aḥmad urged people to denounce “heretical religious innovations” (bidʿat), preached absolute oneness of God, and stressed a reform of social practices. In 1821, along with some 753 disciples, he set out on a pilgrimage to Mecca via Calcutta. On his return in 1823, he spent a few years collecting funds and seeking support for jihad, which began with his migration to the northwest in 1826. He assumed the title of Amīr al-muʾminīn (Leader of the Believers), and the Mujahidin clashed with the Sikhs in the Peshawar region. In the battle at Balakot in 1831, Saiyid Aḥmad died fighting along with his closest companion, Shāh Ismāʿīl. The Mujahidin movement, however, outlived Saiyid Aḥmad. When the East India Company annexed Punjab in 1849, the Mujahidin came into direct conflict with them. They remained active throughout the 1850s and it was only in the 1860s, after a series of trials, that the British managed to bring an end to the flow of money and men to the frontier.
Arya Samaj
Authors: Bhargav Vanya Vaidehi
Published: January 2025

Founded in 1875 by Dayanand Saraswati (b. 1824–d. 1883), the Arya Samaj (the Society of Nobles), became one of the most influential Hindu socio-religious reform movements in north India in the twentieth century, gaining widespread popularity in Punjab and the United Provinces. The Arya Samaj was born of Hinduism’s encounter with British colonialism and Christianity, which sparked multiple efforts to redefine Hinduism in accordance with Abrahamic conceptions of religion. Responding to colonial-missionary criticisms of Hinduism for its polytheism, excessive ritualism, idolatry, and caste system, the Samaj redefined Hinduism as a simplified monotheism, free of idol-worship and the notion of hereditary castes. The Arya Samaj’s efforts to reform Hinduism brought it into conflict with self-proclaimed “orthodox” Sanatanist Hindus, who defended idol-worship, Brahmin-led ritualism, and hereditary caste hierarchy as integral to Hinduism. The Samaj’s central message was “Back to the Vedas”; it saw itself as reviving the original Hinduism supposedly found in the Vedas. Whether the Samaj advocated Hindu “revival” or “reform”—terms often standing in for conservatism and progressivism, respectively—has been a matter of debate among historical actors and scholars. Education has been vital to Arya Samajist agenda, with disagreements even contributing to the Samaj’s split in 1893. The two factions, the College faction and the Gurukul faction, were named after the educational institutions they supported: the Dayanand Anglo-Vedic (DAV) College and Gurukul Kangri, respectively. The DAV College aimed to provide a balanced Western and Vedic education, becoming the center of a vast educational network. Less influential, Gurukul Kangri formed the core of a smaller network invoking the traditional gurukul education, and strongly prioritized Sanskrit and Vedic studies. Samajist reform involved the education of women and “Untouchable” and “low” castes. Arya Samaj’s caste-related reformism entailed efforts to admit low-castes into caste Hindu society by investing them with the sacred thread. The Samaj also aimed to convert low-caste Muslims and Christians to Vedic truth and caste Hindu society. These conversions challenged the caste hierarchy, but were driven by Hindu majority-making, entailed attacks on Islam and Christianity, and contributed communal conflict in the 1920s. Indeed, the Samaj’s relationship to Hindu nationalism is the subject of scholarly debate, with many arguing that it laid ground for the later Hindu nationalism represented by the Hindu Mahasabha, V.D. Savarkar, and the Rashtriya Swayamsevak Sangh. Apart from Hindu nationalism, scholars have highlighted the Samaj’s entanglement in anti-colonial national politics.
Gendering Disasters
Authors: Walmsley Olivia , Roberts Jessica , Le Masson Virginie , Acciari Louisa , Yadav Punam , Fordham Maureen
Published: January 2025

Gender norms and stereotypes, socially and culturally structured gender roles, and power relations affect our understanding of a disaster scenario. In examining disasters and conflict through a gender and feminist lens, questions such as “Who is at risk?” and “Who is affected by a catastrophe and why?” can be answered. For more than four decades, gender and disaster scholars have documented how individuals’ social identities shape their experiences of disasters, their vulnerabilities, and their capacities to respond and recover. “Intersectionality” and its tenets argue that people’s identities are not limited to the sum of their different identity categories (their gender(s), age, ethnicity, religion, class and/or caste background, sexual orientation and many other characteristics). It is therefore essential when examining the multifaceted experience of disasters to question the very notion of disaster, and its relation to broader, structural inequalities. Resources outlined in this bibliography address a range of social identities and expand the traditional binary approach to examining “gender” in disaster scenarios. This bibliography also aims to promote references that may be less often cited or less visible, especially those coming from the Global South. Such plurality of voices and perspectives is important to address existing gaps in knowledge, policy, and practice. Indeed, without a more systematic gender and intersectional lens, populations and territories that are considered to be more “vulnerable” will continue to disproportionately suffer from the effects of disasters, while being given little space to share their own knowledge and solutions. Resources in this bibliography provide evidence, information, and recommendations to a wide audience including students, scholars, practitioners, and policymakers. Gendering Risk and Resilience offers insight into how intersectional aspects of identity impact capacities and vulnerability. Gender, Disasters, and Access to Resources shows how access to resources is determined by a range of geographic and social factors. Gender, Humanitarianism, and Displacement examines power relations in contexts of humanitarian intervention and forced migration. Disasters, Discrimination, and Rights spotlights discrimination impeding access to rights and how to combat it. The bibliography also addresses Sexual and Reproductive Health in Disaster Contexts, and how livelihoods and reproductive work are impacted by disasters in Care and Livelihoods in Times of Crisis. Gender and Violence is addressed, as well as Agency, Voice, and Power. Decolonizing Gender and Disaster focuses on the racial-political implications of disaster work. Gendering Methodologies in Disaster Risk Reduction looks at data collection, management, and storage through a feminist lens.
Crisis Bargaining
Authors: Fanlo Abby
Published: January 2025

Crisis bargaining occurs when two parties negotiate to determine the distribution of a disputed good, and the failure to reach an agreement on this issue results in war. Thus, much of the international relations scholarship on crisis bargaining is an effort to explain the onset of war. Traditional neorealist and neoliberalist theories of international politics imply that understanding war requires attention to the factors that make it difficult to reach a settlement short of conflict, but using a noncooperative bargaining model to develop theories about the causes of war was not commonplace until the 1980s and 1990s. During this time, scholars in the rationalist tradition, including Robert Powell, James Morrow, and James Fearon, offered important contributions to a general understanding of bargaining failure and war onset. In particular, Fearon developed the now canonical bargaining model of war to describe the two main conditions under which bargaining would break down into inefficient conflict: information asymmetries and commitment problems. Fearon’s work opened the door for other scholars to identify ways that states overcame information and commitment problems, including by sending credible signals of resolve, developing sound reputations, or employing certain bargaining strategies. Success in crisis bargaining is not simply identifying an acceptable settlement and avoiding war, however. States also seek to emerge victorious from crises, by either coercing their opponents into making concessions or by deterring following through on threats. Therefore, scholars have explored the factors that explain successful coercion in crisis bargaining, in addition to identifying the correlates of peace overall. Of course, many of the factors that facilitate a peaceful crisis outcome overall also explain which side gets a more favorable settlement, including the ability of states to signal resolve effectively. Nevertheless, understanding peace and understanding crisis victory are distinguishable efforts—and they are discussed separately in this article. These topics have been studied via formal and empirical analyses. In the 1980s and 1990s, most research on crisis bargaining employed formal models to support their arguments, sometimes accompanied by case studies to illustrate their validity in the real world. As the theories developed, however, so did serious efforts to empirically test them, via rigorous econometric methods and survey experiments. Given the challenges of empirically evaluating theories in which core explanatory variables are inherently unobservable, however, empirical analyses in this field face significant challenges.
Venezuelan Politics and Foreign Policy
Authors: Smilde David , Robertson Dustin
Published: January 2025

Through most of its existence, Venezuela’s place in international relations has exceeded what might be expected from a mid-sized state on the global periphery. Simón Bolívar’s continental independence drives began in Venezuela and this regional leadership has long been a central element of Venezuelan national sentiment. Venezuela’s location at the northern edge of South America and the southern edge of the Caribbean gave it strategic importance to the powers of the Global North in the nineteenth century. Venezuela’s vast oil reserves made its geopolitical importance soar in the middle of the twentieth century. And Venezuela’s 1958 democracy resisted the collapse of other second-wave democracies and became a reference point for the region, as a Cold War counterpoint to Cuba. These elements: regional leadership, location, oil, and democracy have run through Venezuelan politics and foreign policy throughout its existence as a country, despite dramatic shifts in policies and allies in recent decades. This bibliography focuses not on foreign policy toward Venezuela but on Venezuela’s foreign policy, dipping into Venezuela’s politics to the degree that it is necessary for understanding its foreign policy.
Web3 and Communication
Authors: Mentanko Jennifer , Brody Ann , Swartz Lana , Chow-White Peter A.
Published: January 2025

The term “Web3” has become a catchall term for the “next” Internet paradigm. This third phase of the Internet is characterized by blockchains, cryptocurrencies, non-fungible tokens (NFTs), and decentralized autonomous organizations, among other disruptive technologies. Defining Web3—sometimes termed as Web 3.0—is not a simple task. The Internet’s development is often divided into three different stages: Web 1.0, the read-only web; Web 2.0, the interactive web; and Web3. While this ontology can be helpful to understand the web’s evolution, rather than situating Web3 as a linear progression from Web 2.0, the development of Web3 should be understood as a complex relationship between web developments, human negotiations, and social contexts. The definition and meaning of Web3 becomes even murkier, as it is often used interchangeably with concepts such as blockchain, the “web of value,” the “token economy,” and the “metaverse,” particularly after Facebook’s rebrand to Meta. In addition, the term “Metaverse” has multiple meanings. The Metaverse is an, often branded, virtual, three-dimensional and immersive platform, while a metaverse (lowercase m) is a specific metaverse site, just like the web and its individual websites. Scholars often use metaverse to describe the broader, more generalized and sometimes theoretical concept of an immersive, virtual world. Throughout this entry, you will likely notice the shifting semiotics of Web3, which is an indication that this disruptive innovation is still being researched and developed and has yet to reach rhetorical closure. This shift from Web 2.0 to Web3 is not only technical, but also philosophical. Theoretically, Web3 is a response to our increasingly centralized Internet, characterized by online conglomerates, data silos, and algorithms that make it difficult for individual users to maintain authority when they are only valued for their data. Web3 allows individual users to own their own web content and data through the decentralization of decision-making authority based on trust in computations, rather than institutions. Social scientists have recently started investigating Web3 and its potential economic, political, and sociocultural impact and its affordances and constraints for everyday users engaging with the web. For communication scholars, Web3 redefines how we connect, share information, exchange value, and form online communities. The research presented in this article will help scholars define Web3 and its associated technologies, and better understand how this new Internet paradigm has the potential to change industries, value creation and exchange, and everyday online interactions.
Object-Based Teaching and Learning in the University with Anthropological Museum Collections
Authors: Bell Joshua , Greene Candace , Richardson Sarah
Published: January 2025

Teaching with objects is a recently revived trend in anthropology, seeking to put theory and things together. Anthropology began in museums, and museum collections were once an integral part of education in the field. (See the separate Oxford Bibliographies article “Museum Anthropology.”) But by the mid-twentieth century, they had parted company, and few anthropologists received any training involving objects. In recent decades, anthropology has reconnected with the material world, engaging with both materials cared for in museums and objects circulating more widely. There is now a substantial literature concerned with theory and practice, driven by two related fields of interest: museum anthropology and material culture. This situation can be a challenge for instructors, who may lack models or be uncertain how to access resources. This bibliography is focused on applying method and theory to the use of objects in teaching anthropology. We have organized the bibliography into a section on theories of objects with subsections focused on key aspects which have had wide-ranging implications—specifically that of biographical approaches to objects and two sections each on the dynamics of collecting and materiality. Similarly, under methods we have organized the bibliography to deal with sources specifically focused on using museum collections for teaching, the object-ness of other media, issues in pedagogy, problems and pitfalls, and ethics. In bringing other types of media into this bibliography we are hoping to widen the discussion around teaching and push for the applicability of the core principles advocated in this domain to wider materials. Too often, working with museum collections gets relegated to a sideline within anthropology, when the lessons provided through such engagements have profound implications for understanding objects in general, helping address the ongoing colonial legacies of the discipline, and forging new collaborative relationships with communities whose heritage is in museums. The sources here present object-based learning as a core teaching strategy rather than an occasional enrichment activity. They are intended to serve university faculty who wish to incorporate objects into courses relating to the critical analysis of museums, the history of anthropology, new materialism, the ethnography of world cultures, visual anthropology, and related topics. This bibliography is oriented to the use of culturally produced objects and does not cover the use of human remains or derivative representations. Such materials present unique challenges and require distinct protocols including close consultation with members of descendent communities.
Assessing the effect of AEB-P system with adaptive control strategy from the perspective of pedestrian head injury risk
Authors: Lu Ying , Qin Xinpeng , Sun Yongduo , Xie Junping
Published: January 2025

With the continuous development of vehicle intelligence technology and active safety technology, the autonomous emergency braking pedestrian (AEB-P) system has emerged as a crucial element of contemporary automotive active safety systems. However, there are still some deficiencies in the control strategies utilized by the current AEB-P system. It is imperative to design an AEB-P system that can adapt the safety threshold and control strategy in real-time based on the current driving conditions. The objective of this paper is to propose an AEB-P system with an adaptive control strategy and analyze its effectiveness from the perspective of pedestrian head injuries. Initially, an algorithm for adaptive collision time threshold model is proposed, and the AEB-P control strategy integrating this threshold is designed. Subsequently, a finite element model of human head is developed to predict pedestrian head injuries in pedestrian-vehicle collision (PVC) scenarios with AEB-P intervention. Additionally, a simplified finite element model of PVC is established, and real PVC scenarios are reconstructed to assess the effectiveness of various AEB-P control strategies in mitigating pedestrian head injuries. The results demonstrate that the conventional control strategy is ineffective in reducing the risk of pedestrian head injuries at medium to high speeds. Conversely, the AEB-P system, which incorporates an adaptive control strategy, proves to be effective in decreasing the risk of pedestrian head injuries. Overall, the AEB-P system with adaptive control strategy enhances pedestrian safety notably, particularly in scenarios where PVCs are inevitable.
Characterisation of virulence of Puccinia coronata f. sp. avenae in Australia in the 2023 growing season
Authors: Nguyen Duong T. , Henningsen Eva , Lewis David , Mago Rohit , Sperschneider Jana , Stone Eric A. , Dodds Peter , Figueroa Melania
Published: January 2025

Crown rust caused by the basidiomycete fungus Puccinia coronata f. sp. avenae (Pca) results in significant crop losses worldwide. Genetic solutions to protect against this disease require disease resistance gene discovery and introduction of resistance genes into elite germplasm by breeders. To inform disease resistance breeding activities, it is paramount to monitor changes of virulence in the Pca population and link those to genotypes of the pathogen. In 2023, a collection of 37 Pca isolates from diverse regions in Australia were gathered and their infection types across a commonly used set of oat differential lines determined to assign virulence pathotypes. We compared those virulence phenotypes to data collected in previous collections. While some of the virulence phenotypes had been reported in 2022, our analysis detected new virulence or an increase in frequency for virulence on some resistance genes. Notably, some of the frequency increases in virulence were recorded in Western Australia (WA), a region of interest due to its role in oat production for milling.
Take Charge of Your Professional Network of Colleagues to Succeed in Academic Medicine
Authors: Nemeth Attila , Deshpande Neha , Zhang Yilin , Singh Mamta
Published: January 2025

Instead of relying on a single, dyadic mentor for career advice, we suggest creating and intentionally cultivating a professional network of colleagues (PNC) to guide your academic career. There are four archetypes to help clinician educators succeed in academic medicine: a traditional mentor, a sponsor, a coach, and a connector.1 However, these roles are not discrete, and overlap occurs. For example, some mentors are great sponsors. In fact, a clinician educator’s PNC is akin to a board of directors in the business world. A board of directors determines the direction and strategic plan of a company,2 while a PNC helps a clinician educator strategically navigate academia and provides career guidance.

It can be challenging to create a PNC. To choose membership for your PNC, we propose taking an active and self-reflective role. Ask where you see yourself in the future and perform a personal value assessment.3 Then, brainstorm with your PNC on how to achieve your goals. Use the Accreditation Council of Graduate Medical Education’s Clinician Educator Milestones to develop valuable skills in academia,4 build your professional identity, and target areas for professional development. We present our strategy for using and maintaining a PNC below.
Assessing Data Adequacy in Qualitative Research Studies
Authors: Sims Danica , Cilliers Francois
Published: January 2025

When undertaking qualitative research studies, researchers often use the concept of data saturation to justify sufficient sampling to cease data collection and analysis. We argue that this reveals a positivist perspective that is incompatible with qualitative research,1 which is instead based on constructivist, interpretivist, or other perspectives. Instead, we recommended the concepts of information power,
2
conceptual depth,
3 and theoretical sufficiency,
1,4,5 with data adequacy considered during research design and evaluated iteratively throughout the sampling, data collection, and analysis processes. The table below provides guidelines for when more, or less, data are needed to justify cessation of data collection and analysis. Both researchers and readers can use the criteria for assessing data adequacy.
The Shadow Economy of Effort: Unintended Consequences of Pass/Fail Grading on Medical Students’ Clinical Education and Patient Care Skills
Authors: Warm Eric , Hirsh David A. , Kinnear Benjamin , Besche Henrike C.
Published: January 2025

The shift to pass/fail grading in undergraduate medical education was designed to reduce medical students’ stress. However, this change has given rise to a “shadow economy of effort,” as students move away from traditional didactic and clinical learning to engage in increasing numbers of research, volunteer, and work experiences to enhance their residency applications. These extracurricular efforts to secure a residency position are sub-phenomena of the hidden curriculum. Medical schools do not officially require all the activities students need to be most competitive for residency selection; therefore, students, as rational actors, participate in the activities they think will most help them succeed.

Here, the authors frame residency application and selection as a complex adaptive system (CAS), which self-organizes without centralized control or hierarchical intent. Individuals in a CAS operate in environments marked by volatility, randomness, and uncertainty—all of which are abundant in the residency selection process. Outcomes in such systems, like the development of a shadow economy, are novel, emergent, and cannot always be anticipated. To address these challenges, the authors suggest the need for deep understanding of the system’s elements, interrelationships, and dynamics, including feedback loops and emergent properties. Optimizing the results of a CAS requires incentivizing outcomes over activities, ensuring open information flow, and engaging in continuous monitoring and evaluation.

The current pass/fail era and resultant shadow economy of effort risk creating a triple harm by devaluing clinical excellence, burning out medical students, and potentially producing superficial, or worse inauthentic, academic and community work. Medical educators must optimize residency application and selection for cooperative outcomes and design incentives to ensure the outputs of medical education align student, institutional, patient, and societal goals. Without a set of predictive “answers,” the authors suggest a process of determining actions to advance this ultimate aim and reduce harm.
Studies on Shielding and Activation Levels in a Concrete-Iron-Concrete Sandwich Structure Wall in the CMUH Proton Therapy Facility
Authors: Fang Po-Wen , Hsieh Ying-I , Shiau An-Cheng , Sheu Rong-Jiun
Published: January 2025

The shielding performance and activation susceptibility of a sandwich wall in the proton therapy facility of China Medical University Hospital were investigated in an integrated manner using FLUKA Monte Carlo simulations. The 2-m-thick partition wall between two adjoining treatment rooms had a three-layered structure, which comprised a 0.2-m-thick iron layer sandwiched between two layers of 0.9-m-thick concrete. In comparison with that of a concrete wall of the same thickness, the shielding performance of the concrete-iron-concrete wall was marginally better, further reducing the transmitted dose rate by approximately a factor of 2 against secondary neutrons generated through proton bombardment. This study also investigated radioactivity levels from long-lived radionuclides (3H, 22Na, 54Mn, 55Fe, 60Co, 134Cs, 152Eu, and 154Eu) that are primarily induced in concrete or iron by neutrons. The specific activities of 54Mn, 55Fe, and 60Co in the middle iron layer were considerably higher (by factors of 75, 25, and 5, respectively) than those in the neighboring concrete. However, as for clearance levels, the index value of the iron layer was lower than that of the neighboring concrete because of the presence of fewer types of long-lived radionuclides in iron. Under irradiation scenarios considered in this study, the residual activity levels of the sandwich wall do not exceed those of a full-concrete wall, and the indexes at various depths estimated at 5 years cooling following a 20-y operational period comply with clearance criteria.
Trauma-Related Shame
Authors: Laughlin Lisa M.
Published: January 2025

Background

Feelings of shame after interpersonal assault directly impact survivor well-being. Although the concept of trauma-related shame has been well defined and applied in psychology, the direct application to nursing care for victims of sexual assault is unclear.

Objective

The aim of this study was to perform an interdisciplinary concept analysis to clarify and synthesize the concept of trauma-related shame as it relates to interpersonal assault.

Method

A multidisciplinary literature search was conducted using the term “trauma-related shame.” Article titles and abstracts were reviewed for significance to interpersonal assault. Rodgers' evolutionary method of concept analysis was used to identify attributes and related concepts and also clarify the contextual basis of trauma-related shame.

Results

The search resulted in 150 articles, 15 of which met the specified inclusion criteria. Fourteen of the selected articles were research studies, and one was a systematic review. A thematic analysis was used, and two attributes were identified: self-devaluation and self-isolation. An experience of trauma, fear, multivictimization, preexisting shame, low self-esteem, stigmatized events, and negative reactions from others were identified as antecedents. Finally, when reviewing for consequences, anxiety, depression, posttraumatic stress disorder, acute stress disorder, distress, poor health outcomes, social withdrawal, and suicidal tendencies were identified as common themes.

Conclusion

This concept analysis is a first step in the further development and implementation of trauma-related shame in nursing. It will be vital to the provision of holistic care for the profession to conduct research and publish literature related to shame for survivors of interpersonal traumatic events.
Exploring the mechanism of Pujin oral liquid in the treatment of preterm white matter injury using network pharmacology and molecular docking
Authors: Gong Xing-Ruo , You Xiao-Rui , Guo Mei-Ran , Ding Xue-Ying , Ma Bing-Xiang
Published: January 2025

We aimed to elucidate the pharmacological mechanisms of Pujin oral liquid in treating preterm white matter injury (PWMI). The Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform was used to identify Pujin oral liquid’s active ingredients and predict their targets. The known targets related to treating PWMI were identified from the GeneCards, Online Mendelian Inheritance in Man, DisGeNet, PharmGKB, and CTD databases. A drug–disease intersecting protein–protein interaction network using a STRING database was built; gene ontology function and Kyoto Encyclopedia of Genes and Genomes signaling pathway enrichment analyses were performed on common target genes using the Metascape database. Molecular docking of the active ingredients and key targets was validated using the AutoDock Vina software. In total, 470 Pujin oral liquid targets and 13,290 disease targets were screened from multiple databases, and Venn analysis identified 407 common targets. Protein–protein interaction analysis showed that Pujin oral liquid may impact SRC, MAPK3, MAPK1, TP53, STAT3, AKT1, PIK3R1, JUN, RELA, CTNNB1, and ESR1. Moreover, gene ontology functional analysis revealed processes such as the response to inorganic substances, cellular response to organic cyclic compounds, response to xenobiotic stimuli, regulation of system processes, and protein phosphorylation. The main signaling pathways were neuroactive ligand–receptor interaction and the cGMP–PKG, JAK–STAT, and cAMP signaling pathways. Molecular docking showed that the active ingredients’ small molecules bond strongly to target proteins. The therapeutic effect of Pujin oral liquid on PWMI is multifaceted, involving multiple targets and pathways. Its clinical application in treating preterm white matter injuries is promising.
An updated meta-analysis of the efficacy and safety of robot-assisted laparoscopy hepatectomy and laparoscopic hepatectomy in the treatment of liver tumors
Authors: Niu Fuyong , Wang Yefei , Bai Zhiyuan , He Zhiqiang , Wang Hailin , Li Furong
Published: January 2025

Background:

To compare the efficacy and safety of robot-assisted laparoscopic hepatectomy (RALH) with laparoscopic hepatectomy (LH) in the treatment of liver tumors.

Methods:

A comprehensive search of English-language literature was conducted in PubMed, Embase, Web of Science, and the Cochrane Library from January 2000 to June 2024. Studies comparing RALH and LH for liver tumors were identified, and after qualitative evaluation, a meta-analysis was performed using Stata 16.0 software.

Results:

After applying inclusion and exclusion criteria, 42 articles were included, including 29,969 patients, with 5673 in the RALH group and 24,296 in the LH group. The meta-analysis showed that compared with the LH group, surgery time was longer in the RALH group (MD = 55.33; 95% CI: 34.84–75.83; P < .001), the conversion to open surgery rate was higher (RR = 1.04; 95% CI: 1.03–1.05; P < .001), the total cost was higher (MD = 0.43; 95% CI: 0.14–0.73; P = .004), and the tumor diameter was larger (MD = 0.37; 95% CI: 0.24–0.49; P < .001). Additionally, the R1 resection rate was higher in the RALH group (RR = 1.04; 95% CI: 1.03–1.06; P < .001). However, there were no significant differences between the groups in terms of intraoperative transfusion rate, hepatic hilar occlusion rate, postoperative complications, postoperative hospital stay, mortality rate, malignancy rate, or R0 resection rate (P > .05).

Conclusion:

Based on current evidence, RALH is safe and effective, although it is associated with higher total costs, increased blood transfusion rates, and longer operative times. However, there were no significant differences between RALH and LH in terms of other outcome indicators, suggesting that both procedures offer similar surgical efficacy and safety. Further clinical randomized controlled trials are needed to confirm these findings.
Assessment of occupational risks in nurses in Spain: Preliminary psychometric analysis of the ISTAS_Enfermería scale
Authors: Narbona-Gálvez Ángela , Allande-Cussó Regina , Ruiz-Frutos Carlos , Ayuso-Murillo Diego , Fontán-Vinage Guadalupe , García-Iglesias Juan Jesús , Navarro-Abal Yolanda , Fagundo-Rivera Javier , Climent-Rodríguez José Antonio , Gómez-Salgado Juan
Published: January 2025

To adapt and evaluate the psychometric properties of the SUSESO/ISTAS21 questionnaire for nurses in Spain. Cross-sectional study for the cross-cultural adjustment and psychometric validation of the COPSOQ-ISTAS21 scale. Descriptive analyses were conducted, and data was correlated. A confirmatory factor analysis was performed, thus assessing the reliability and criterion validity. The sample consisted of 2757 Spanish nurses. The exploratory factor analysis identified a 5-factor structure with 15 items, which explained 63.6% of the variance. The factors were named: Support at work; Job satisfaction; Work-related emotional well-being; Job insecurity; and Double presence. The internal consistency of the questionnaire, measured by Cronbach alpha and McDonald omega coefficient, was adequate, with values of 0.764 and 0.741, respectively. The results of the confirmatory factor analysis indicated a good model fit. Three levels of psychosocial risk (low, intermediate, and high) were identified based on percentiles and quartiles of mean scores. The adapted version of the SUSESO/ISTAS21 questionnaire showed reliable psychometric properties in Spanish nurses, making it a valid and robust tool for assessing psychosocial risks in this group.
Lung cancer palindromia due to the deficiency of vital energy and blood syndrome treated by TCM herbs: A case report
Authors: Sun Xiaomeng , Tan Dongyang , Miao Jiarui , Wang Chang , Xu Yi , Yuan Fei , Fan Xu
Published: January 2025

Rationale:

Lung cancer is a common primary malignant tumor of lung in clinic, which leads the world in both new cancers and new cancer deaths. At present, surgical treatment, radiotherapy and chemotherapy are commonly used in the treatment of lung cancer. However, due to the strong occultness of the diseases and the possibility of recurrence, the best treatment opportunity is often missed. Immunotherapy, which is the main method of lung cancer, but the treatment efficiency and survival are not satisfactory, most patients will have local recurrence or distant metastasis. Traditional Chinese medicine has a targeted effect on the treatment of lung cancer with small adverse reactions, and has a positive impact on alleviating the adverse reactions of radiotherapy and chemotherapy and prolonging the life span of patients. More and more attention should be paid to the research of lung cancer treatments.

Patient concerns:

Patients with lung tumors, which had been surgically removed in the past. This time, the tumor occurred again, and the patient could not tolerate another surgical treatment. Other targeted treatments are not available due to financial and body constraints.

Diagnoses:

The case was diagnosed as invasive adenocarcinoma of the upper lobe of the right lung.

Interventions:

The patient received early surgical treatment, and then changed to traditional Chinese medicine (TCM) decoction treatment. The treatment principle of Chinese medicine is mainly to tonify healthy Qi and blood, enhancing the immunity of the body.

Outcomes:

After nearly 2 years of TCM decoction treatment, the recurrent tumor has shrunk significantly. No discomfort such as fatigue, fever or weight loss. During this period, the patient did not receive western medical treatment such as surgery and chemotherapy, which did not affect normal life. It also proves that Chinese medicine is effective.

Lessons:

This case report confirms that traditional Chinese medicine is safe and effective in the treatment of lung cancer, improving the ability of strengthening the health, driving away evil, and fighting cancer. TCM herbs can block the lesion of new blood vessels, anticancer metastasis, prevent recurrence after surgery, which is worth promoting. In clinical practice, the individual treatment of patients and the symptomatic treatment according to different syndromes should be attached great importance.
Improving Antibiotic Use in Argentine Pediatric Hospitals: A Process Evaluation Using Normalization Process Theory
Authors: Roberti Javier , Jorro-Barón Facundo , Ini Natalí , Guglielmino Marina , Rodríguez Ana Paula , Echave Cecilia , Falaschi Andrea , Rodríguez Viviana E , García-Elorrio Ezequiel , Alonso Juan Pedro
Published: January 2025

Introduction:

In the pediatric setting, overprescribing of antibiotics contributes to the rise of multidrug-resistant organisms. Antimicrobial stewardship programs (ASPs) are recommended to optimize antibiotic use and combat resistance. However, the implementation of ASPs in low- and middle-income countries faces several challenges. This study aimed to evaluate the implementation process of a multifaceted ASP in 2 pediatric hospitals in Argentina.

Methods:

A qualitative study was conducted in two large public children’s hospitals in Argentina, using semistructured interviews with 32 healthcare providers at the beginning and end of the ASP implementation. The study was guided by the normalization process theory.

Results:

The intervention faced challenges, including limited understanding of its objectives, confusion with existing practices, and insufficient commitment from senior staff. Although junior staff were more receptive, communication barriers with external staff and workload concerns hindered broader adoption. Infectious disease specialists primarily led implementation, with limited involvement of other staff, particularly in training activities. Despite these challenges, participants reported improvements, such as the development of standardized antibiotic guidelines, better interdisciplinary collaboration, and improved communication. However, organizational support and resistance to new practices remained barriers.

Conclusions:

This study highlights the importance of organizational context and staff commitment in ASP implementation. Tailored strategies that address the specific challenges of low- and middle-income countries are needed to effectively implement ASPs.
Hepcidin modifies the relationship between anemia, erythrocyte indices, and neurocognitive performance in virally suppressed people with HIV
Authors: Tavasoli Azin , Okwuegbuna Oluwakemi K. , Tang Bin , Iudicello Jennifer E. , Kallianpur Asha R. , Ellis Ronald J. , Letendre Scott L.
Published: January 2025

Objective:

Neurocognitive (NC) impairment in people with HIV (PWH) is associated with erythrocyte indices, which may serve as indicators of iron metabolism, inflammation, and related factors. Erythropoiesis requires iron, regulated by a multifaceted system of peptide hormones, including hepcidin. This study postulated that hepcidin might modify the relationship between erythrocyte indices and NC performance in PWH.

Methods:

Plasma hepcidin and erythrocyte indices were quantified in 88 virally-suppressed PWH who underwent comprehensive NC assessments. Global NC performance was summarized by global T-scores. Associations of global T-scores with anemia and erythrocyte indices were determined in univariable analyses. To examine the influence of hepcidin on the relationship between NC performance and erythrocyte indices, we evaluated interactions between these covariates in relation to global T-scores and then performed stratified analyses.

Results:

In multivariable analyses, hepcidin detectability interacted with age (p = 0.007) and mean corpuscular volume (MCV) (p = 0.031) in relation to the global T-score. Interactions between anemia and erythrocyte indices on global T-scores were significant (anemia x MCV, p = 0.008; anemia x MCH, p = 0.011). Stratified analyses identified that lower global T-scores were associated with older age (p = 0.001) and higher MCV (p = 0.0046) and mean corpuscular hemoglobin (MCH, p = 0.026) only when hepcidin was undetectable. Among the anemic, worse global T-score was associated with higher MCV (p = 0.001) and MCH (p = 0.002).

Conclusion:

Findings suggest that iron-related factors (hepcidin, anemia, MCV, MCH) and age influence neurocognitive health. This cross-sectional study underscores hepcidin as an effect modifier in the associations of erythrocyte indices, anemia, and age with neurocognitive function in PWH.