bluuebunny/crossref_metadata_2025 huggingface dataset:
Limits of Intelligibility: A Critique of The Legal Discourse on Intersexuality in Kerala
Authors: Das Parvathy , Mathew Reju George
Published: August 2024

Intersex infants and individuals are subjected to inhuman violations, such as intrusive medical procedures and discriminating practices, all over the world. In India, it is a direct violation of the fundamental rights bestowed upon citizens. The article looks critically at the introduction of a third category, ‘intersex’/‘cannot be identified’, in birth and death registrations in Kerala. By locating the discourse within larger global discourses on intersexuality in general, and around gender minorities and sex minorities in India in particular, it argues that the legal recognition of intersexuality through the introduction of the third category but without other structural changes is a superficial attempt at fulfilling the imperatives of inclusion and recognition of intersex individuals as citizens with fundamental rights. A holistic approach that considers the legal, sociocultural and economic dimensions is required for the well-being of intersex infants and individuals.
Bullying within specialist medical training in Australia: Analysis of the medical training survey, 2020–2023
Authors: Wilkes Fiona A , Munindradasa Ashvini , Maguire Paul A , Anderson Katrina , Looi Jeffrey CL
Published: August 2024

Objective

Bullying is common in medical specialist training in Australia. To understand bullying rates across medical specialist training programs, we analyse the recent Medical Training Survey, administered by the Medical Board of Australia to all registered medical practitioners.

Methods

Medical Training Survey data were extracted and averaged from 2020 to 2023.

Results

Many speciality trainees reported personally experiencing or witnessing bullying. This was lowest in general practice (13% personally experienced and 15% witnessed) and highest in obstetrics and gynaecology (27% and 41%). The highest rate of bullying by supervisors was in surgery: 60% of surgical trainees stated that when they were bullied it was by their supervisor. Within psychiatry, 22% of trainees had personally experienced bullying and 32% of trainees had witnessed bullying. When they were bullied, the perpetrator was less commonly a supervisor (40%). In all specialities, there was a very low percentage of bullying which was reported, and was identified as having a satisfactory outcome: the most satisfactory outcomes (13%) were in general practice.

Conclusion

Current rates of bullying for medical specialist trainees, the reluctance to report, as well as the lack of satisfactory outcomes, is of grave concern for Australian healthcare. This requires urgent attention at a systems level.
Pursuing a Deep Ecology of Rural Volunteerism: An Extended Conceptual Framework for Sustainable Social Service Delivery and Community Development
Authors: Chadwick Kelsey
Published: August 2024

Rural communities face challenges related to poverty, isolation, and lack of service accessibility. In settings where funding and staffing fall short, volunteerism can provide a solution to increase social service delivery in remote areas; however, rural volunteer recruitment and retention remain major barriers to program sustainability. While theoretical approaches in systems and ecological thought have been historically essential in studying rural volunteerism, this article seeks to propose deep ecological theory as an immersive extension of the conceptual framework that considers the synergistic whole in addition to analysis of the elements and their relationships to one another. Implications for social work include a deeper examination of rural processes for enhanced program design, service delivery, and community development through volunteerism.
Fractionalization of Forchheimer’s correction to Darcy’s law in porous media in large deformations
Authors: Gunda Sachin , Giammarini Alessandro , Ramírez-Torres Ariel , Natarajan Sundararajan , Barrera Olga , Grillo Alfio
Published: August 2024

This work presents a theoretical and numerical study of the flow of the interstitial fluid saturating a porous medium, principally aimed at modeling a bio-mimetic material and assumed to experience a dynamic regime different from the Darcian one, as is typically hypothesized in biomechanical scenarios. The main aspect of our research is the conjecture according to which, for a particular mechanical state of the porous medium, the fluid exhibits two types of deviation from Darcy’s law. One is due to the inertial forces characterizing the pore scale dynamics of the fluid. This aspect can be resolved by turning to the Forchheimer correction to Darcy’s law, which introduces non-linearities in the relationship between the fluid filtration velocity and the dissipative forces describing the interactions between the fluid and the solid matrix. The second source of discrepancies from classical Darcy’s law emerges, for example, when pore scale disturbances to the flow, such as obstructions of the fluid path or clogging of the pores, result in a time delay between drag force and filtration velocity. Recently, models have been proposed in which such delay is described through constitutive laws featuring fractional operators. Whereas, to the best of our knowledge, the aforementioned behaviors have been studied separately or in small deformations, we present a model of fluid flow in a deformable porous medium undergoing large deformations in which the fluid motion obeys a fractionalized Forchheimer’s correction. After reviewing Forchheimer’s formulation, we present a fractionalization of the Darcy–Forchheimer law, and we explain the numerical procedure adopted to solve the highly non-linear boundary value problem resulting from the presence of the two considered deviations from the Darcian regime. We complete our study by highlighting the way in which the fractional order of the model tunes the magnitude of the pore pressure and fluid filtration velocity.
Travelers With Disabilities: How Online Information Search Reduces Uncertainty About Service Accessibility in Hospitality and Tourism
Authors: Park Hyekyung , Park Eunhye , Costa Rui , Lee Minwoo
Published: August 2024

Despite the significant number of travelers with disabilities and their substantial contribution to the tourism and hospitality industry, there has been a lack of research exploring the necessary services required by travelers with disabilities during their travels. Therefore, this study aims to identify accessibility issues encountered by travelers with disabilities during their travels and to examine the impact of these issues on their behavior in reducing uncertainty within the online travel community. To achieve the research objectives, the present study performed an integrated approach that combines text analytics and robust regression analysis. The findings of this study provide guidelines for tourism and hospitality management to reduce the perceived uncertainty experienced by travelers with disabilities, thereby promoting the accessibility of tourism and hospitality services.
Optimizing efficiency of a ship’s two-magnet energy harvesting device using the Cuckoo search algorithm
Authors: Chiu Min-Chie , Cheng Ho-Chih
Published: August 2024

Establishing an energy harvesting device to supply sustainable energy to deep sea sensors is a challenging task due to the complex subsea marine phenomenon. To overcome this, we propose a two-magnet KMC energy harvester hanging on the cabin of the ship with a spherical bearing. The magnets connected with springs move vertically up and down when the ship is periodically actuated by surface waves, generating electricity to power the deep sea sensors through a cable. We present a case study using wave speed (Uow = 2.0 m/s), wave amplitude (Ho = 0.4 m), and wave length (λ = 4.0 m) to demonstrate the efficacy of the two-magnet energy harvester. Before optimizing the energy harvester, a sensitivity analysis is conducted on the electrical power with respect to marine parameters and the energy harvester’s geometric parameters. To maximize the electrical power, we adopt a Cuckoo Search Algorithm as an optimizer. By using the objective function of root-mean-square electrical power in conjunction with the Cuckoo Search, we obtain optimal electrical power. Simulations reveal that the energy harvester produces 0.1497 Watts of power.
“It is a lovely gift to get from the public health nurse”: Public health nurse perspectives on involvement in an infant book gifting scheme
Authors: Egan Suzanne M , Moloney Mary , Pope Jennifer , Hoyne Clara , Breatnach Deirdre
Published: August 2024

The benefits of book gifting schemes for infants, parents and families, are well documented. While book gifting schemes operate around the world, and are delivered in different ways (e.g., postal services, local libraries, maternity hospitals and community centres), little is known about the benefits and challenges for those involved in delivering the schemes. This mixed methods study, based on a book gifting scheme in Ireland, reports findings from public health nurses (PHNs) regarding their involvement in an infant book gifting scheme. PHNs incorporated the delivery of an infant book gifting pack, and information leaflets about reading with infants, into their regular infant developmental health checks at 3 months and at 7-9 months. The findings from over 300 developmental checks indicate that participating PHNs were positive overall regarding their involvement in the scheme. Despite their heavy workload, in general, PHNs reported they had sufficient time available during the health checks to incorporate the book gifting. They highlighted the benefit of the scheme for parents and infants but also for PHNs themselves and their professional practice. The present paper discusses the findings in the context of ecological systems theory, notably, the role of the PHN in supporting infants and parents, and considers the implications of the findings for the delivery of infant book gifting schemes.
Novel Vaginal Cerclage Assisted Laparoscopic Cervico-Sacropexy Technique for Uterovaginal Prolapse
Authors: Aydın Serdar , Çekiç Sebile Güler
Published: August 2024

Aim

Laparoscopic hysteropexy is a complicated procedure that requires specialized surgical skills, including precise dissection and suturing. The aim is to describe the technical considerations for performing a new, feasible, and minimally invasive technique to correct apical and concurrent apical and anterior vaginal wall defects.

Method

A retrospective analysis was conducted on 70 consecutive women who underwent surgery for stage ≥3 uterovaginal prolapse. As a part of the technique, an anterior 2-cm long transverse incision was made at the anterior cervicovaginal junction, and the bladder was dissected through blunt and sharp dissection to the level of the isthmus. A posterior colpotomy was performed. A polypropylene tape was inserted into the cervical connective tissue, and the free arms of the tape were inserted into the peritoneum via the posterior colpotomy. Two arms of the tape were passed from the tunnel parallel and medial to a right sacrouterine fold, then fixed to the anterior longitudinal ligament via the laparoscopic route.

Results

The tape can be inserted into the cervix in a median of 15 min, and the laparoscopy procedure can be completed in 24 min. No mesh erosion or long-term complications occurred. At a 1-year control, there were no cases of recurrence.

Conclusions

This novel cervico-sacrocolpopexy technique is a feasible and safe, minimally invasive way to correct apical or multicompartment defects, with a short operation time and an anatomical result that mimics the normal sacrouterine ligament.
Using multistate models with clinical trial data for a deeper understanding of complex disease processes
Authors: Therneau Terry M , Ou Fang-Shu
Published: August 2024

A clinical trial represents a large commitment from all individuals involved and a huge financial obligation given its high cost; therefore, it is wise to make the most of all collected data by learning as much as possible. A multistate model is a generalized framework to describe longitudinal events; multistate hazards models can treat multiple intermediate/final clinical endpoints as outcomes and estimate the impact of covariates simultaneously. Proportional hazards models are fitted (one per transition), which can be used to calculate the absolute risks, that is, the probability of being in a state at a given time, the expected number of visits to a state, and the expected amount of time spent in a state. Three publicly available clinical trial datasets, colon, myeloid, and rhDNase, in the survival package in R were used to showcase the utility of multistate hazards models. In the colon dataset, a very well-known and well-used dataset, we found that the levamisole+fluorouracil treatment extended time in the recurrence-free state more than it extended overall survival, which resulted in less time in the recurrence state, an example of the classic “compression of morbidity.” In the myeloid dataset, we found that complete response (CR) is durable, patients who received treatment B have longer sojourn time in CR than patients who received treatment A, while the mutation status does not impact the transition rate to CR but is highly influential on the sojourn time in CR. We also found that more patients in treatment A received transplants without CR, and more patients in treatment B received transplants after CR. In addition, the mutation status is highly influential on the CR to transplant transition rate. The observations that we made on these three datasets would not be possible without multistate models. We want to encourage readers to spend more time to look deeper into clinical trial data. It has a lot more to offer than a simple yes/no answer if only we, the statisticians, are willing to look for it.
Electronic Glycemic Management System Improved Glycemic Control and Reduced Complications in Patients With Diabetes Undergoing Coronary Artery Bypass Surgery: A Randomized Controlled Trial
Authors: Câmara de Souza Alexandre Barbosa , Toyoshima Marcos Tadashi Kakitani , Cukier Priscilla , Lottenberg Simão Augusto , Bolta Paula Mathias Paulino , Lima Eduardo Gomes , Serrano Júnior Carlos Vicente , Nery Marcia
Published: August 2024

Background:

In-hospital hyperglycemia poses significant risks for patients with diabetes mellitus undergoing coronary artery bypass graft (CABG) surgery. Electronic glycemic management systems (eGMSs) like InsulinAPP offer promise in standardizing and improving glycemic control (GC) in these settings. This study evaluated the efficacy of the InsulinAPP protocol in optimizing GC and reducing adverse outcomes post-CABG.

Methods:

This prospective, randomized, open-label study was conducted with 100 adult type 2 diabetes mellitus (T2DM) patients post-CABG surgery, who were randomized into two groups: conventional care (gCONV) and eGMS protocol (gAPP). The gAPP used InsulinAPP for insulin therapy management, whereas the gCONV received standard clinical care. The primary outcome was a composite of hospital-acquired infections, renal function deterioration, and symptomatic atrial arrhythmia. Secondary outcomes included GC, hypoglycemia incidence, hospital stay length, and costs.

Results:

The gAPP achieved lower mean glucose levels (167.2 ± 42.5 mg/dL vs 188.7 ± 54.4 mg/dL; P = .040) and fewer patients-day with BG above 180 mg/dL (51.3% vs 74.8%, P = .011). The gAPP received an insulin regimen that included more prandial bolus and correction insulin (either bolus-correction or basal-bolus regimens) than the gCONV (90.3% vs 16.7%). The primary composite outcome occurred in 16% of gAPP patients compared with 58% in gCONV ( P < .010). Hypoglycemia incidence was lower in the gAPP (4% vs 16%, P = .046). The gAPP protocol also resulted in shorter hospital stays and reduced costs.

Conclusions:

The InsulinAPP protocol effectively optimizes GC and reduces adverse outcomes in T2DM patients’ post-CABG surgery, offering a cost-effective solution for inpatient diabetes management.
SH003 Induces DR5-Mediated Caspase-Dependent Apoptosis of NSCLC Through Inhibition of AKT Survival Pathway
Authors: Kim Ji Hye , Kang Sooyeon , Lee Gyu-Ri , Ko Seong-Gyu
Published: August 2024

Background

Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is well known to selectively induce apoptotic cell death in cancer cells, not in normal cells, with death receptors (DRs)—DR4 and DR5. In consequence of this specialty, this cytokine and its receptors are considered for candidates of target therapy in clinic. SH003, a new traditional medicine-based polyherbal preparation, consists of Astragalus membranaceus (Am), Angelica gigas (Ag) and Trichosanthes kirilowii Maximowicz (Tk). In this study, we investigated whether SH003 can induce apoptosis through DRs in non-small-cell lung cancer (NSCLC) cells.

Methods

Cell proliferation and cytotoxicity were measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), clonogenic assay, and, trypan blue exclusion staining, protein expression by western blot analysis, and apoptosis by fluorescence-activated cell sorting analysis.

Results

We found that SH003-induced apoptosis in NSCLC cells through several mechanisms. First of all, MTT and colony formation assay confirmed the growth-inhibitory effect of SH003 in H460 cells. Second, SH003 upregulated the expression of DR4 and DR5. Third, it activated caspase-8, caspase-7, and caspase-3 cascades, which are essential for DR-mediated extrinsic apoptosis. The effect of SH003-induced apoptosis was significantly abolished by inhibition of caspases enzymes. And also, SH003 cleaved caspse-9. Fourth, SH003 reduced AKT kinase phosphorylation, and overexpression of AKT abrogated the caspase-dependent apoptosis by SH003. Fifth, SH003 inactivated ERK, but, constitutive ERK expression did not completely reduce SH003-mediated growth inhibition and apoptosis.

Conclusions

SH003 potentiates caspase-dependent apoptosis of NSCLC through the upregulation of DRs, activation of caspase cascades and downregulation of AKT cell survival pathways.
Chondrocyte Response to Fresh Autologous Conditioned Serum Versus Freeze-Dried Allogenic Conditioned Serum
Authors: Credille Kevin , Elias Tristan J. , Allahabadi Sachin , Wang Zachary , Hakimiyan Arnavaz , Chubinskaya Susan , Cole Brian J. , Frisbie David , Yanke Adam B.
Published: August 2024

Objective

To investigate the cytokine release profile and histological response of human cartilage after exposure to autologous conditioned serum (ACS) and freeze-dried allogenic conditioned serum (FD-CS).

Design

Cartilage explants were collected from 6 patients undergoing total knee arthroplasty. ACS and FD-CS were created from patient serum samples. Cartilage samples were divided into 6 groups: (1) untreated control, (2) ACS, (3) FD-CS, (4) untreated interleukin (IL)-1β (5 ng/ml), (5) IL-1β + ACS, and (6) IL-1β + FD-CS. After 12 days, cartilage samples were analyzed with glycosaminoglycan (GAG) concentration normalized to wet weight while comparing cytokine concentrations, and histological scoring.

Results

There was a significant decrease in pathology scoring for ACS ( P = 0.0368) and FD-CS ( P = 0.0368) in the IL-1β injury groups compared with the untreated IL-1β insult group. ACS and FD-CS significantly mitigate the IL-1β induced increase in basic fibroblast growth factor (bFGF) ( P = 0.0009 and P = 0.0002, respectively). FD-CS showed a significant decrease in IL-1β concentration in the presence of IL-1β insult compared with the untreated IL-1β group ( P < 0.0001). ACS-treated samples had significantly higher concentration of tumor necrosis factor (TNF)-α independent of IL-1β when compared with samples not treated with biologics ( P = 0.0053).

Conclusions

Explanted osteoarthritic cartilage responds favorably and equivalently to treatment with ACS and FD-CS from a histological perspective. Both ACS and FD-CS were able to mitigate the IL-1β-induced increases in bFGF and FD-CS lowered IL-1β concentration while increasing interleukin-1 receptor antagonist (IL-1Ra) concentration. Although the cytokine profile of cartilage tissue explants treated with FD-CS appears to be different than that of ACS, this difference does not seem to affect biologic activity of FD-CS.
Perceptual ripening of oranges
Authors: Gegenfurtner Karl R.
Published: August 2024

We present a practical example for the phenomenon of color assimilation. We describe the advances in research on color assimilation from von Bezold, to Albers and Munker, and provide a compelling example of the recently described “Confetti-illusion” by Novick. Our research introduces a novel aspect by showing how unripe and greenish looking oranges can be perceived as ripe and vibrantly colored when viewed through an orange net. These findings highlight the significant implications of color assimilation in everyday consumer environments, offering a fresh perspective on how visual perception can be manipulated.
Mauri Hono: A Mauri sensory methodology
Authors: Apiti Ariana , Kora Aorangi , Tassell-Matamua Natasha , Moriarty Te Rā , Matamua Nathan , Lindsay Nicole , Dell Kiri , Pomare Pikihuia , de la Torre Parra Lorena , Baikalova Nadia
Published: August 2024

Within a Māori cultural context, the manifestation of mauri instilled in all living things, both animate and inanimate gives life. Previous research suggests Māori can experience somatic exchanges of energy such as mauri from both other people, as well as within the natural environment. Accordingly, Mauri Hono: A Mauri Sensory Methodology provides a foundation to understanding knowledge by tuning into our senses and using mauri states to help elicit meaning about ourselves and our relationships with natural environments when immersed in those environments. In this study, four key phases of the methodology are detailed; Rongo, Mōhio, Mārama and Mātau and applied to a case study which sought to understand how Māori draw meaning from their experience of being immersed in a natural environment. Ten participants undertook a hīkoi (walk) within a national forest park of regenerating, native, bush. Findings revealed the importance of tuning into one’s senses and having the time and space to interpret different experiences. Furthermore, Mauri Hono, as a Māori methodology is predicated on the belief that experiential knowledge aids in providing a more complete understanding of phenomena than theoretical knowledge alone. It further highlights that whilst knowledge can come into fruition within the timeframe of the project, there is opportunity for insights to arise afterwards, comprising various layers of knowing.
Does Repetitive Transcranial Magnetic Stimulation of Alzheimer’s Patients Improve Cognition or Depression or Both?
Authors: Saha Chandan , Dastgheib Zeinab , Lithgow Brian , Moussavi Zahra
Published: August 2024

Repetitive transcranial magnetic stimulation (rTMS) is used clinically to treat major depression and has more recently been applied as a potential treatment for Alzheimer’s disease (AD). Given that the rTMS treatment protocols for AD are similar to those used for depression, we investigated whether the AD participants’ cognition change after rTMS was, in part, due to a change in depressive level. Twenty-eight participants of an rTMS treatment study for AD participated in this study. We collected cognitive measures to partition them into 2 groups of subjects with marked or moderate responses (n = 13) and those with responses of small or none (n = 15). Besides, we recorded pre and post Electrovestibulography (EVestG) signals, and 2 EVestG features targeting depression were calculated from the averaged field potential curve (FPave) and low-frequency modulation of the recorded firing pattern (33-interval histogram [IH33]), respectively. We then compared these features in the above-mentioned cognitive-wise response groups. The FPave and IH33 depression-related features showed no substantial difference between pre- and post-treatment in either group in response to rTMS treatment. The change in these EVestG depression features of the AD participants was also poorly correlated with Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) change with treatment. This study’s results demonstrate that cognitive improvement post rTMS is not predominantly a result of an improvement in depression.
Association of the dietary inflammatory index with sarcopenic obesity and frailty in older adults
Authors: Jung Sukyoung , Lee Yunhwan , Kim Kirang , Park Sohyun
Published: August 2024

Objectives

This study examined whether a higher dietary inflammatory index (DII®) is associated with the risk of sarcopenic obesity (SO) and frailty among Korean older adults.

Methods

A total of 950 participants aged 70–84 years, who completed the baseline nutrition survey of the Korean Frailty and Aging Cohort Study, were included in the analysis. The DII, quantifying the dietary inflammatory potential, was calculated using 23 foods and nutrients as assessed by a 24-h dietary recall. SO was defined as the coexistence of sarcopenia (dual-energy X-ray absorptiometry-measured appendicular skeletal muscle mass index of < 7.0 for males; <5.4 for females) and abdominal obesity (waist circumference of ≥ 90 cm for males; ≥85 cm for females). Frailty status was assessed using the Fried frailty index (range, 0–5), a simple tool for defining frailty that consists of three or more of five frailty items. Multinomial logistic regression models were used to estimate odds ratios (ORs) with 95% confidence intervals (CIs), adjusting for confounders.

Results

The prevalence of SO and frailty was 9.8% and 10.8%, respectively. The DII was significantly higher in the frail group (2.7) compared to the robust and SO groups (2.0 vs. 1.8) (P < 0.001). Among nutrients and foods included in the DII, the frail group exhibited lower vitamin E, niacin, vitamin B6, energy, and protein intakes than the robust and SO groups. Multivariable-adjusted OR (95% CI) for frailty versus robust (comparing DII tertile 3 to tertile 1) was 2.3 (1.1–4.8; P-trend = 0.02). However, no significant association was observed between the DII and SO (OR, 1.1; 95% CI, 0.5–2.1; P-trend = 0.6).

Conclusions

A higher DII score was associated with increased odds of frailty but not with SO in Korean older adults, suggesting that proinflammatory diets have a greater impact on frailty than that on SO in the older population.
Children’s screen time and psychosocial symptoms at 5 years of age – the role of parental factors
Authors: Niiranen Janette , Kiviruusu Olli , Vornanen Riitta , Kylliäinen Anneli , Saarenpää-Heikkilä Outi , Paavonen E. Juulia
Published: August 2024

Background and objectives

Electronic media (e-media) has become a universal part of young children’s daily lives. Previous studies have found an association between increased screen time and children’s psychosocial symptoms. We investigated whether parents’ psychological distress and parenting style dimensions explain the association between children’s screen time and psychosocial symptoms. Moreover, we investigated whether parents’ mental well-being and parenting style dimensions moderate this association.

Methods

We used data from the Finnish CHILD-SLEEP birth cohort study. Parents and the child were assessed when the child was 5 years old (N = 671). The measure of screen time included program viewing from TV and other devices. Child’s psychosocial problems and parents’ depression, stress and parenting style dimensions were assessed by self-reports.

Results

A high level of screen time in children was associated with attention and concentration difficulties, hyperactivity and impulsivity symptoms as well as internalizing and externalizing symptoms among 5-year-olds. For the most part, the associations remained significant despite controlling for parents’ mental health, parenting style dimensions and multiple background factors, especially associations relating to attention and concentration difficulties and hyperactivity symptoms were robust. Maternal stress and depression moderated the association between children’s screen time and psychosocial symptoms, indicating a more pronounced association among stressed or depressed mothers.

Conclusion

There is an independent association between children’s screen time and psychosocial symptoms which is especially pronounced among those children whose mothers had poorer mental well-being. In clinical practice, the length of screen time should be inquired already at a young age and parents should be offered guidance to reduce the possible ill effects of excessive screen time, as well as help with their own mental health problems.
Impact of virtual reality on peri-interventional pain, anxiety and distress in a pediatric oncology outpatient clinic: a randomized controlled trial
Authors: Reitze Alicia , Voigt Marie , Klawonn Frank , Dusch Martin , Grigull Lorenz , Mücke Urs
Published: August 2024

Purpose

Pain and anxiety-inducing interventions have a major impact on pediatric patients. Pain reduction by virtual reality (VR) during port and vein punctures is well studied. This study investigates peri-interventional reduction of pain, anxiety and distress using VR compared to the standard of care (SOC) in a pediatric oncology outpatient clinic.

Methods

In a randomized, controlled cross-over design, patients aged 6–18 years experience potentially painful interventions accompanied by VR. Observational instruments include NRS, FPS-r, BAADS, mYPAS-SF, PedsQL and SSKJ3-8R. All patients undergo two observations: SOC (A) and VR (B) in a randomized order. In addition, parents and staff are interviewed. Specific conditions for VR in an outpatient clinic setting derived from interprofessional focus group discussion are being explored.

Results

Between July 2021 and December 2022 57 eligible patients were included and randomized to the orders A/B (n = 28) and B/A (n = 29). Thirty-eight patients completed both observations. Characteristics in both groups did not differ significantly. More than half of the patients had no previous experience with VR, 5% decided to discontinue VR prematurely. Peri-interventional pain, anxiety and distress were significantly reduced by VR compared with SOC. 71% of patients and 76% of parents perceived punctures with VR to be more relaxed than previous ones. 95% of patients perceived fun with VR goggles. Detailed questionnaires on individual stress and anxiety were returned from 26 of 38 patients. Focus group discussion with staff yielded evidence for successful implementation of VR in an outpatient clinic.

Conclusions

The present study shows that VR can be used for peri-interventional reduction of pain, anxiety, and distress in the special environment of a pediatric outpatient clinic. Specific conditions must be met for successful implementation. Further studies are needed to identify particularly susceptible patients and to illuminate alternatives for distraction that are feasible to implement with limited resources.

Trial registration number

(ClinicalTrials.gov ID): NCT06235723; 01/02/2024; retrospectively registered. This study adheres to the standard checklist of CONSORT guidelines.
Patient with Herlyn–Werner–Wunderlich syndrome and endometriosis achieves successful full-term pregnancy (40 weeks and 6 days): a case report
Authors: Oliveira Juliana Vieira Queiroz Almeida , Philip Chris Elizabeth , Pereira Thayná Andreza Ribeiro , Garcia Gabriela Martins Perez , Villamil Quésia Tamara Mirante Ferreira
Published: August 2024

Introduction

Herlyn–Werner–Wunderlich syndrome , a rare Müllerian ducts congenital disease, is characterized by a diphtheritic uterus, blind hemivagina, and ipsilateral renal agenesis. Diagnosis is at young age by ultrasound and magnetic resonance imaging, and the prognosis is good. Usually, complications evolve endometriosis and secondary pelvic inflammation.

Case report

A 40-year-old female patient, Brazilian, white, primigravida, diagnosed at 30 years with a didelphic uterus on ultrasound, and 4 years later, with a left ovarian endometrioma, multiple ovarian cysts, and left renal agenesis on magnetic resonance imaging. Subsequently, due to dyspareunia and a feeling of swelling, the patient underwent transvaginal ultrasound with bowel preparation, and a hematocolpos was found and Herlyn–Werner–Wunderlich syndrome was suspected; 10 years after the diagnosis she had a planned pregnancy. She presented frequent contractions following the 15th week of pregnancy and fortunately there were no complications or premature labor. Labor was inducted at 40 weeks and 6 days without progress and a cesarean section was indicated and performed without complications. Herlyn–Werner–Wunderlich syndrome often goes unnoticed, leading to inadequate treatment. Individuals with Herlyn–Werner–Wunderlich syndrome commonly face fertility issues, such as high miscarriage rate (21–33%), and obstetric complications, such as spontaneous abortions (40% risk), intrauterine growth restriction, postpartum hemorrhage, increased fetal mortality, preterm delivery (21–29%), and elevated rates of cesarean sections. In addition, there is higher susceptibility of developing endometriosis, especially with hemivaginal obstruction, and pelvic adhesions.

Conclusion

Early diagnosis enables timely treatment and, consequently, fewer complications. Still, when these factors are absent, vaginal birth may still be possible. The true prevalence and incidence of complications related to Herlyn–Werner–Wunderlich syndrome are still unknown.
Violence during transition: accounts of gender-affirming care in South Africa’s public health system
Authors: Kukard Dylan
Published: August 2024

Despite constitutional protections afforded to the LGBTQ+ community, South Africa remains a society violent towards gender minorities. With public healthcare over-burdened, this system of care remains particularly unresponsive to the needs of transgender people who seek to affirm their gender medically. With a narrative design, this research explored the experiences of transgender people of violence through their access to gender-affirming care. This study troubled the notion of violence from a social determinant of health to situate it as an unexplored mechanism of meaning-making in the South African context. Using gatekeepers aligned with LGBTQ+ support groups, 15 volunteer participants recollected their accounts through semi-structured interviews. Using this undirected talk, the narrative analysis found that gaps in care become a key point in the narrative trajectory of participants shaping their decision-making around experiences of interpersonal violence and for personal advocacy with healthcare professionals. Similarly, the clinic was narrated as a site of violence both symbolically through invasive bodily examinations and structurally as a place for perpetrators of anti-transgender violence to target transgender patients. Transition in this context can be seen as a mode to understand several competing violence/s where the body is treated as a site for physical, psychological and structural harm.
The Short Forms of Readings in the Ordo Lectionum Missae (1969/1981): Origins, Analysis, and Proposals (Part II)
Authors: Hazell Matthew P.
Published: August 2024

ABSTRACT: The lectionary of the post-Vatican II Roman Rite provides optional short forms for a number of readings. However, no specific guidelines for their use are given, there is no real attempt to explain why they are provided, and the extent of their use seems to go beyond “certain rather long texts” ( Praenotanda , no. 80). Furthermore, these short forms and what is omitted in them have received very little scholarly attention. This article attempts to remedy this by examining the process of the lectionary reform as detailed in the documentation of the Consilium ad exsequendam , as well as analysing each of the Sunday Gospel readings in Tempus per annum that have been assigned optional short forms. To conclude, some recommendations for a future editio typica of the lectionary are given.
Boosting Customer Growth: The Impact of Service Excellence and Product Quality at Bank Muamalat KCP Gowa, South Sulawesi
Authors: Wati Mirna , Mustamin Asyraf , Supriadi Supriadi , Nur Awal
Published: August 2024

Service excellence and product quality are two factors that can affect customer satisfaction. Customer satisfaction will drive customers' growth. For example, customers who are satisfied with the services or products offered will promote Islamic banking products/services to others, which will affect the growth in the number of customers. The purpose of this study was to determine the effect of service excellence and product quality on customer growth at Bank Muamalat KCP Gowa. The number of samples in this study were 100 respondents, using a quantitative approach. The data collection technique used a questionnaire, and the sample calculation technique used the slovin formula. The results of this study indicate that the sig. value of 0.000 < 0.05 and the t-count value of 5.146> t-table 1.983 for the service excellent variable and the value of 0.008 t-table 1.983 for the product quality variable. Furthermore, the value of 0.000 < 0.05 and F count of 40.856 > F table of 3.090 were obtained. The implication of this research shows the excellent service quality enhances customer growth, as well as the high product quality improves customer growth. The excellent service and product quality provided will create satisfaction for customers to recommend to others and support the growth of the number of customers at Bank Muamalat KCP Gowa.
CHLORARACHNION REPTANS: PRIMER REGISTRO PARA LA COSTA , ATLANTICA COLOMBIANA
Authors: Zamora Ana Sofía , Schnetter Reinhard
Published: August 2024

Se registra por primera vez Chlorarachnion reptans (filum Chlorarachniophyta) para la flora colombiana. Se comentan los principales caracteres de esta especi
ASPECTOS MORFOMETRICOS Y TEORICOS DE UN EMBALSE TROPICAL DE ALTA MONTAÑA: REPRESA LA FE, EL RETIRO, COLOMBIA
Authors: Hernani T. Alejandra , Ramírez R. John J.
Published: August 2024

Se describen las características batimétricas y morfométricas de la represa La Fe y las predicciones de carácter teórico derivadas del análisis de los parámetros morfométricos y los elementos de forma. El valor del índice de desarrollo de perímetro (F = 2,25) corresponde al de un sistema medianamente dendrítico. El índice de desarrollo de volumen (Dv = 1,05) muestra un cuenco de forma cónica ligeramente convexa y con puntos de inflexión (SCx-micro). Los valores de la profundidad relativa (Dr = 2,07%) y el fetch efectivo (Lr = 5,9 x 10·3 km) corresponden a un cuerpo de agua con una pista de acción reducida para el viento y una profundidad considerable en el punto de muestreo. Se predice que el embalse La Fe es un cuerpo de agua térmicamente estable, con penetración de luz y alotrofia considerables, de productividad baja, mezcla restringida sólo a los primeros metros de la columna de agua y zona litoral ampliamente desarrollada.
APROXIMACION DE LA POTENCIA ASINTOTICA DE LA PRUEBA DEL RANGO SIGNADO DE WILCOXON
Authors: Aranda S. Moisés , Corzo S. Jimmy
Published: August 2024

Se estudia la potencia de la prueba del rango signado de Wilcoxon para muestras de una subfamilia simétrica de la distribución lambda generalizada. Se muestra que para un rango de valores del parámetro λ4 de la subfamilia, tanto la potencia como la consistencia de la prueba de RSW son funciones monótonas no decrecientes dentro del rango especificado de valores λ4.
Escaneo científico sobre técnica del insecto estéril (TIE)
Authors: Cárdenas Solano Leidy Johanna , Contreras Pedraza Carlos Alberto
Published: August 2024

La técnica del insecto estéril (TIE) ha emergido como una herramienta fundamental en el control de plagas, especialmente en la gestión de la mosca de la fruta del Mediterráneo (Ceratitis capitata), una de las plagas más devastadoras para la agricultura a nivel global. La TIE consiste en la cría y liberación de grandes cantidades de insectos estériles, que compiten con las poblaciones silvestres, reduciendo gradualmente la capacidad reproductiva de la plaga y, por ende, su densidad poblacional. El análisis de la ecuación de búsqueda TITLE-ABS-KEY (("Mediterranean fruit fly" OR "Ceratitis capitata" OR wiedemann OR "Diptera W/2 Tephritidae") AND ("Sterile W/2 Insect Techn*" OR sit)) revela una vasta colección de investigaciones enfocadas en la aplicación de la TIE en Ceratitis capitata según la base de consulta de Scopus®. Los estudios han documentado numerosos aspectos de la TIE, desde los métodos de irradiación y cría masiva hasta las estrategias de liberación y monitoreo en campo. Además, se han explorado las interacciones entre la TIE y otros métodos de control integrado de plagas (IPM), destacando su papel en la sostenibilidad agrícola. En este contexto, el objetivo de este escaneo científico es proporcionar una visión comprensiva de los avances, desafíos y perspectivas futuras de la TIE en el manejo de la mosca de la fruta del Mediterráneo, subrayando su relevancia como componente clave en los programas de control de plagas a nivel mundial
Personalized Medicine: How to Evaluate Health Information Online (Preprint)
Authors: Ozmizrak Pinar
Published: August 2024

UNSTRUCTURED

You may have come across the term “personalized medicine” before, but what is it? Genetic testing has become commonplace for investigating ancestry and disease risk. There are a myriad of genetic tests available for sale online claiming to offer meal plans and exercise routines tailored to your genetic code. After all, what could be more personalized than DNA? As health information has become more accessible online, another question arises: what information is reliable and what is not? This open educational resource explores 6 questions that can be used by anyone to evaluate the trustworthiness of online health information: Who runs the website? What is the website about? Where are the sources of health information? When was the website last updated? Why was the website made? How is the website funded? Asking these questions is key for the public and medical professionals alike.
Зохиолч Сормууниршийн Дашдооровын дэлгэцийн урлагт эзлэх байр суурийн асуудалд /“Их замын эхэнд” киноны жишээн дээр/
Authors: Byambasuren Khishigsukh ,   National University of Mongolia
Published: August 2024

This paper, in addition to elucidating the contributions of the folk writer Sormuunirshiin Dashdoorovyn to 20th-century Mongolian cinematic art, will also discuss the value, significance, historical context, artistic thought, character imagery, and character portrayal in the feature-length artistic film “At the Beginning of the Great Road”. In the film ‘At the Beginning of the Great Road’, Mongolian lifestyle is vividly and expansively portrayed. n the movie “At the Beginning of the Great Road”, the director deeply understood the Mongolian customs depicted by the screenwriter and showcased this in his cinematic art, making the work a perfect whole.
Manejo clínico del melasma en la población femenina. Una revisión de la literatura
Authors: Ruilova Torres Stefanie Pauleth ,   Universidad Técnica de Machala Ecuador, Rogel Narváez Yarelys Paulette , Briones Morales Víctor Euclides , Ramírez Vera Jessenia Elizabeth ,   Universidad Técnica de Machala Ecuador,   Universidad Técnica de Machala Ecuador,   Médico General, Machala, Ecuador.
Published: August 2024

El melasma es un trastorno común, caracterizado por áreas hiperpigmentadas en zonas fotoexpuestas, principalmente en el rostro. Afecta mayoritariamente a mujeres en edad fértil, llegando al 40% en Asia y al 30% en Latinoamérica. Los factores etiológicos incluyen la exposición a radiación UV, predisposición genética y hormonal. Además del impacto estético, el melasma afecta la calidad de vida y está asociado con ansiedad y depresión. Se realizó una revisión bibliográfica en bases de datos como Scielo, Redalyc y Science Direct, centrada en estudios del periodo 2019-2024. Los tratamientos principales incluyen agentes despigmentantes tópicos como hidroquinona, retinoides, ácido azelaico, ácido kójico y ácido tranexámico. La hidroquinona es eficaz en reducir la pigmentación al inhibir la tirosinasa, aunque puede causar irritación. Los retinoides y el ácido azelaico ayudan en la renovación celular y reducen la inflamación, mientras que el ácido tranexámico presenta buenos resultados tanto tópicos como orales. Tratamientos emergentes como tiamidol y cisteamina ofrecen alternativas viables. Los peelings químicos y terapias láser se utilizan en casos más severos. Sin embargo, el melasma es una condición crónica y recurrente, requiriendo tratamientos personalizados y expectativas realistas sobre los resultados.
Strategi Integrated Marketing Communication Mossa Coffee untuk Meningkatkan Brand Awareness
Authors: Luturmas Natan , Vanel Zon , Huwae George Nicholas
Published: August 2024

Dalam era persaingan bisnis yang semakin ketat dan munculnya berbagai coffee shop di Indonesia Mossa Coffee diharapkan mampu bersaing dengan kompetitor lainnya. Namun, untuk bertahan dan sukses dalam pasar yang kompetitif ini, Mossa Coffee perlu mengembangkan Brand Awareness yang kuat dan berkelanjutan. Penelitian ini bertujuan untuk menginvestigasi dan menganalisis efektifitas strategi Integrated Marketing Communication (IMC) dalam meningkatkan Brand Awareness  Mossa Coffee. Penelitian ini menggunakan pendekatan kualitatif dengan metode deskriptif. Data akan dikumpulkan melalui wawancara mendalam, dokumentasi, dan survey terhadap masyarakat yang datang mengunjungi Mossa Coffee. Data akan dianalisis secara deskriptif untuk mengidentifikasi praktik terbaik dan hambatan yang dihadapi oleh Mossa Coffee dalam upaya meningkatkan Brand Awareness-nya. Hasil dari penelitian ini diharapkan akan memberi wawasan mendalam tentang bagaimana strategi IMC diterapkan dan memengaruhi Brand Awareness  Mossa Coffee. Penelitian ini akan membantu menggambarkan praktik dan tantangan yang dihadapi oleh Mossa Coffee dalam upaya membangun Brand Awareness yang kuat. Temuan penelitian ini memiliki potensi untuk menjadi panduan bagi pemilik Mossaa Coffee dan praktisi pemasaran dalam memperbaiki strategi mereka.
Acceptance and Use of Regional Government Information Systems Using the UTAUT2 Model
Authors: Ni Luh Putu Ika Satia Devi  , Dodik Ariyanto
Published: August 2024

Acceptance and use of information systems by local governments is a crucial aspect in increasing the efficiency, transparency and accountability of public services. However, the implementation of this technology often faces various challenges, both from a technical and non-technical side. The UTAUT2 model has proven to be a powerful framework for understanding user behavior in adopting information technology. This research aims to determine the factors that influence the acceptance and use of Regional Government Information Systems using the UTAUT2 model. The samples in this research were accounting and budgeting operators in each OPD with a sample size of 147. The data collection technique in this research was by distributing questionnaires via Google Form. The data analysis used is SEM-PLS analysis. The results of this study indicate that performance expectations have no effect on behavioral intentions. Effort expectations, facilitating conditions, confidence in using SIPD, habits have a positive influence on behavioral intentions. Behavioral intentions, performance expectations, effort expectations, facilitating conditions, confidence in using SIPD have a positive influence on usage behavior. Habits have no effect on usage behavior. The implications of this research are From a practical perspective, the results of this research can help local governments in designing more effective strategies to increase the adoption of information technology among employees and the community.