bluuebunny/crossref_metadata_2025 huggingface dataset:
Calling on Queer Asians: Richard Fung’s Orientations (1984)
Authors: Kim Liz
Published: October 2024

This article considers Richard Fung’s Orientations (1984) as a work of early pan-Asian community organization and self-recognition for lgbtq+ Asian North Americans. Located between the founding of the community as a part of the legacy of Third World Liberation Front and aids activism starting in the mid-1980s, the video was made at a key juncture when visibility and self-affirmation were the main objectives for Asian North American queer communities. The autoethnographic documentary, which has received less scholarly attention than Fung’s video works addressing Asian diasporic sexualities and postcolonial subjectivity, marks an important turning point for the historiography of Asian lgbtq+ groups in North America and for the understanding of Fung’s oeuvre over the past four decades.
Autonomy and Reflexivity
Authors: Ktenas Yannis
Published: October 2024

The paper examines the way in which Castoriadis’s political positions on autonomy and heteronomy relate to his philosophical analysis of the alienation of society from its institutions and the attribution of the origin of its laws to an extra-social source. In this context, autonomy is closely related to the possibility of reflexivity, construed as a critical interrogation of the meaning and content of institutions and laws, which allows to bring to the fore the socially created character of each institution, and, therefore, the possibility of its deliberate and collective change. However, the fact that something is a social product does not automatically entail that it can be modified at will. It is against this background that this piece raises some questions about autonomy and heteronomy in the modern world and explores possible limitations of Castoriadian reflexivity, while attempting to seek answers to these questions through Castoriadis’s work.
Perioperative Observation and Nursing of a Child with Facial Venous Malformation Treated with Interventional Embolization
Authors: Wu Shuixiang , Zhou Yan , Yang Yujuan , Han Jian , Zhu Xiaowen
Published: October 2024

Background: Venous malformations (VMs) are a rare disease with an incidence of only about 1/10,000 in children, but VMs can expand as the child grows, appearing more in shallow skin areas such as the neck of the head, can cause discomfort or degradation, and therefore, can seriously affect the physical and mental health of the child. There are numerous treatment options for VMs, and interventional embolosclerotherapy has become the clinically preferred treatment for VMs due to its many advantages. Case Presentation: We summarize the perioperative care experience of a 10-year-old child with severe right facial malformation diagnosed as facial venous malformation (VMs) who underwent interventional embolization during hospitalization. After 14 days of careful treatment and nursing by medical staff, the child was discharged successfully. Discussion: The key points of our perioperative care for this patient include paying attention to the mental health of the child and providing psychological support; strengthening health education and paying attention to the prevention of falls; preoperative preparation; intraoperative care; observation of the condition; pain assessment and care; strengthening discharge guidance; and doing a good job in continuous nursing. Conclusion: For the nursing of the child with facial venous malformations, it is necessary to pay attention not only to their physiological care but also to their psychological care to help them recover as soon as possible.
Ensuring Quality and Consistency in OPC-53 Cement Testing: A Comprehensive Proficiency Testing Evaluation
Authors: Vashishtha Shwet
Published: October 2024

The proficiency testing (PT) program is a critical part of quality assurance in laboratories, especially within industries like construction where cement testing is essential. This study provides a comprehensive evaluation of the fifth PT scheme for Ordinary Portland Cement (OPC) grade 53, conducted by the Nodal Laboratory. The key parameters assessed in this program were standard consistency, compressive strength, and soundness using the Le-Chatelier method. Twenty-four laboratories participated, and their performance was analyzed using advanced statistical methods, adhering to ISO 17043:2010 and ISO 13528:2015 standards. The results showed that most laboratories performed satisfactorily, with only one outlier identified in the soundness test. This paper covers all aspects of the PT program, from sample preparation to the distribution of materials, as well as the homogeneity and stability tests conducted on the samples. Statistical evaluation was carried out using Z-scores, which allowed the laboratories to be ranked according to their performance in each parameter. This method highlights discrepancies and provides a clear framework for participating laboratories to improve their testing procedures. Proficiency testing is essential for maintaining high standards in laboratory performance. It helps standardize testing methods across multiple laboratories, ensuring that OPC-53 cement meets strict quality and performance specifications. The program enables laboratories to identify performance gaps and take corrective actions, ensuring the reliability and accuracy of results. Participation in PT programs is a step toward continuous improvement, keeping laboratories aligned with international standards, ultimately benefiting the broader construction industry by ensuring the structural integrity of buildings and infrastructure. This study underscores the importance of regular PT participation. It not only provides a benchmark for laboratory performance but also ensures compliance with ISO standards. This fosters the consistent quality of cement used in large-scale construction, reducing the risk of structural failures and contributing to long-term safety and durability. The findings demonstrate the positive impact of PT programs on overall testing accuracy and laboratory reliability, emphasizing their role in advancing best practices in the construction industry.
Penalized Likelihood Estimation for Current Status Data with Informative Censoring
Authors: Faisal Alhassan , Iddi Samuel , Nortey Ezekiel , Doku-Amponsah Kwabena
Published: October 2024

Current status data occurs when failure time of subjects in a survival study is only known to be either less or greater than the censoring time. Thus, the failure time is either left – or right – censored. Analyzing data of this structure under the Cox Proportional Hazards model with dependent censoring assumption can be challenging. To address this, a Penalized Maximum Likelihood Estimation (PMLE) approach was proposed. The unknown baseline cumulative hazard functions for both the failure time and the censoring time were estimated using splines. The advantage of penalized approach over unpenalized method is that that the desired smoothness level of the functions are controlled by their respective penalty terms. The possible dependence between the failure and censoring times was accounted for using the gamma-frailty model. An easy to implement hybrid computational algorithm is proposed to estimate the PMLEs and the Bayesian technique was employed for the estimation of the variances of the parameters. Extensive simulation studies were conducted to assess the statistical properties of the PMLEs. It was observed that the realized estimators were not only consistent, asymptotically normal and efficient, but also, were robust to the number of knots chosen, the proportion of dependent censoring used and the frailty distribution employed. The proposed PMLE method was further applied to real data obtained from tumorigenicity experiment.
Isolated Intracranial Rosai-Dorfman Disease: A Diagnostic Challenge
Authors: Patel Harsh , Singh Preeti , Kumar Abhaya
Published: October 2024

Rosai-Dorfman disease (RDD) is a benign condition characterized by abnormal proliferation of white blood cells called histiocytes and an uncommon biological process called emperipolesis, in which a living cell penetrates inside another living cell. Central nervous system involvement in RDD is extremely rare. We report one such rare case of 47-year- old man who presented with right sided focal seizure from 1 year. MRI Brain showed a dural based lesion. On the basis of clinical presentation and radiological findings initial diagnosis made was of en plaque meningioma. Gross total resection of lesion was performed. Initial histopathological diagnosis was of IgG4 related HPM. Post surgery there was significant improvement in patients clinical condition. Intensity of seizure episodes were reduced. However due to persistence of right sided focal seizures, tissue blocks were reviewed and diagnosis of intracranial Rosai-Dorfman disease was made. Upon which further hematologist opinion was taken and whole body PET CT was done which showed solitary uptake in brain. It was observed that characteristic feature of RDD emperipolesis is sometimes masked by storiform fibrosis and lymphocytic infiltration leading to misdiagnosis. Therefore close follow up is required, in case of persistence of symptoms tissue blocks should be reviewed and possibility of intracranial Rosai-Dorfman disease should be considered while dealing with dural based lesions.
Challenges in Understanding the Mole Concept Among Level 200 Students in Science Colleges of Education in Ghana
Authors: Owusu Michael , Assem Humphrey , Ossei-Anto Theophilus , Ansah Frank
Published: October 2024

This study investigates challenges in understanding the mole concept among pre-service teachers in Ghanaian Colleges of Education. Chemistry education is fundamental for fields such as medicine and engineering, yet students often face difficulties due to inadequate foundational knowledge and ineffective teaching methods. The mole concept is crucial for grasping various chemical phenomena, but its complexity frequently results in significant learning challenges. This study employs a mixed-method explanatory design, combining quantitative diagnostic tests and qualitative interviews with 1,211 pre-service teachers from six selected colleges. The study identifies key challenges in learning the mole concept, including difficulties in translating word problems into equations, determining mole ratios, deriving empirical and molecular formulae, and understanding the relationship between stoichiometric coefficients and moles. The analysis categorizes these challenges into comprehension, transformation, process skills, and encoding errors, with process skills and transformation challenges being the most prevalent. Findings reveal that many students struggle to solve problems without formulae, highlighting a lack of conceptual understanding. Interviews with pre-service teachers confirm quantitative data, indicating that students often rely on rote memorization rather than conceptual grasp. The study concludes that improvements in teaching methods are needed, emphasizing the importance of understanding over memorization and recommending small group collaborative learning. Contributions include filling empirical gaps in the literature regarding pre-service teachers’ challenges and suggesting practical recommendations for enhancing chemistry education.
Device to Measure, Monitor and Control Variables for Agricultural Purposes
Authors: Quevedo-Nolasco Abel , Aguado-Rodriguez Graciano-Javier
Published: October 2024

The measurement of meteorological variables is important for decision-making in the field. Accurate data can help farmers optimize their activities to improve food production. Traditional methods of monitoring variables can be expensive or complex for small-scale farmers to use. This indicates a need for low-cost and user-friendly devices. Currently, there is technology for developing these types of devices, which could be useful to automate processes based on variable monitoring and improve food production. Due to this, a device based on the Arduino MegaTM board was developed to monitor air temperature, relative humidity, rain, and soil moisture. In addition, equipment was developed to be controlled based on a rain gauge. The device has a TFT touch screen for easy-user interaction and 4 menus for information display (summary, floor, date-time and manual equipment control). The program of the device required more lines of code (59.65%) to establish user-device interaction compared to its internal processes (18.66%) and variable declarations (21.68%). A container was 3D printed to house all the integrated circuits and the device was tested under both indoor (Jun-10, 2024 to July-17, 2024) and outdoor (Jul-22, 2024 to Aug-18, 2024) conditions. Under indoor conditions, a 3% difference was found in the temperature measurements taken under the same conditions (using DS18B20 and MLX90614 sensors). Under outdoor conditions it was found that the air temperature decreased by an average of 2.33°C when increasing the height from 8ft to 16ft and the relative humidity decreased by an average 3.48% when increasing the height from 8ft to 16ft. There was a 3.4% difference in total rain measured by the rain gauges. Finally, the developed device performed adequately during the two months of testing in both conditions, measuring variables and controlling equipment (the equipment went from waiting mode to rain harvesting mode 92 times).
The Role of Agricultural Inputs on Crop Productivity: The Case of Zigam Woreda
Authors: Bekele Assefa
Published: October 2024

In spite of the importance of agriculture in Ethiopia, it is characterized by low productivity and has been unable to produce sufficient quantities of output to feed the country’s population. In light of this various development strategies has been undertaken to improve the performance of agriculture. Intensification of agriculture through the use of new agricultural technologies has been emphasized over the last three decades. This study attempted to examine the contribution of agricultural input for crop productivity. The data for the study was collected from 91 sample farmers. This study was the study used both primary and secondary data. In this study researcher was used simple random sampling techniques. This research was use cross sectional approach and econometric method of data analysis to investigate the role of age, sex, land size, labor force, fertilizer, improved seed, extension service, and access to credit, education level and pesticides for crop production by collecting data from the household. In econometric method of data analysis researcher was used ordinary least square (OLS) Model. The econometric result show that land size, labor force, improved seed, fertilizer, credit service, extension service and education level have positive and significant effect on crop production. However, pesticide has a negative and significant impact on crop production. From the explanatory variables, education level has a higher coefficient. This indicates education level is more significant for crop production. According regression result R2 is 0.97, which implies 97% of output function is explained by the selected ten (10) explanatory variables. The policy implication is that to reduce farmers resistant to use farm inputs and to create knowledge about the optimal input use educate and training of farmers is necessary.
Examination of the Management of State Land by Local Authorities in the Context of Unauthorized Settlement: A Study of Forest No. 31 in Kabwe, Located in Zambia's Central Province
Authors: Silumbwe Evance , Mubanga Mpundu
Published: October 2024

Excision National Forest No. 31, Illegal Settlement, State Land, Local Area Plan and Encroachment
Farmers' Perceptions and Practices in Managing Vegetable Pests and Pesticide Use in the Upper Blue Nile Basin, Ethiopia: In the Case of the Koga Irrigation System
Authors: Mitku Geteneh , Abebaw Yinebeb
Published: October 2024

This experiment was carried out to assessment of farmers’ perceptions, knowledge, and current management practices on the major pests among vegetable growers in the Koga irrigation system, Ethiopia. Understanding the farmers’ awareness and pest management is essential for designing a research agenda, and awareness creation. The survey was carried out from November 2020 to March 2021 in Koga irrigation, with a total of 63 vegetable growers. A semi-structured questionnaire was used. Almost all farmers in the study area overwhelmingly depend on pesticides to control the pests on their vegetable crops. Profenofos, Dimethoate, and Lambda-cyhalothrin were dominantly and commonly used insecticides in the study area with different trade names for more than two vegetables. There are two common and widely used fungicides named Metalaxyl-M 68 %WG and Mancozeb regarding disease control. The farmers used wrong application techniques, inappropriate spraying, wrong storage practices, and protective measure of pesticides. This wrong perception and practice could be associated with their limited knowledge about pesticides and related activities. Hence, it is recommended that government or non-governmental organizations should focus to improve the misuse and misperception of farmers in pesticide use, including personal and environmental protection through education and community intervention.
Farmers' Awareness of Land Degradation and Adoption of Soil and Water Conservation Practices in Hidebu Abote, Ethiopia
Authors: Ararsa Feyisa , Debele Chala
Published: October 2024

In Ethiopia, land degradation is a serious problem that affects both overall economic growth and agricultural output. Even while nutrient depletion, soil erosion, and deteriorating soil quality are serious issues, many land conservation initiatives today neglect to consider the expertise of farmers and local requirements. This study's primary goal was to evaluate farmers' knowledge of land degradation and their practice of soil and water conservation techniques in Ethiopia's Hidebu Abote. Data were gathered through focus groups, key informant interviews, household surveys, secondary data analysis, and focus groups. According to the findings, over 75% of the participants were aware of the factors that contribute to land degradation, such as poverty, rocky terrain, bad farming techniques, overgrazing, overcultivation, and soil erosion. Farmers used techniques such as contour farming, fallowing, fanyajuu, cut-off drains, soil bunds, and manure application in addition to more modern methods of conserving water and soil. The adoption of soil and water conservation methods by farmers was impacted by several factors such as age, gender, size of family, educational background, NGOs' incentives, farm size, land tenure, and distance from homestead. The study indicates that encouraging farmers to manage and conserve their land should be the priority for any policy or program aiming at land resource management and soil conservation. Policymakers and development professionals can use the findings as guidance to create efficient interventions to alleviate land degradation in the research area and other comparable contexts.
Impact of Energy Consumption from Renewable Energy Sources on Economic Growth: Evidence from Nigeria
Authors: Orisa Ebube , Ibe Anthony , Nteegah Alwell
Published: October 2024

This study examines the impact of renewable energy consumption and electricity tariff on the economy of Nigeria. The study considers the casual relationship and vector decomposition between various renewable energy sources (solar, hydro and biomass), electricity price and Gross domestic product (GDP) using an unrestricted vector error correction model (VECM). In addition, other robust econometric techniques were applied to the time series of GDP, electricity price and energy consumption from renewable energy sources from 1980 to 2021. The findings indicated a 1% increase in biomass consumption causes increase in GDP by 0.14% in the long-run. Mixed result in the short-run with the difference in the log value of the current lag of solar and bio electricity consumption having positive impact on GDP. The coefficient of the Error Correction Model (ECM) was negative (-0.49) and statistically significant indicating that short-run change from the long-run equilibrium is corrected by 49% annually. Unidirectional causality from GDP to solar electricity consumption. Solar, hydro, biomass and electricity price explain 1.4%, 0.4% 2.2% & 12% respectively of fluctuations in GDP in the long-run. The study results demonstrates that regulations need to be put in place to control the adverse effect of consuming biomass on the environment which could cause mixed impact on gross domestic product in the short run whereas, policies to foster development of solar projects could impact positively on GDP and alleviate the electricity supply deficiency in Nigeria.
Modified CANDU Reactor MCR as an Early-Deployable Nuclear Workhorse
Authors: Knorr Jürgen , Kerber Albert
Published: October 2024

Safe, simple and soon deployable are the imperatives for each SMR concept today. Only this SMR has the potential to become a nuclear workhorse in the fight against climate change if it is available soon, in large numbers and deployable worldwide. Therefore the assessment of the usefulness of an SMR concept must not only relate to the reactor itself. Only a holistic view of the entire nuclear fuel cycle with the given SMR as the central part between the front-end and back-end can lead to viable decisions. The IAEA lists more than 120 SMR concepts in its Handbook 2022. Time pressure is forcing us to critical selection of a promising reactor concept and to combine innovative solutions with tried and established technical and administrative networks. Against this background, the Modified CANDU Reactor (MCR) is proposed as additional SMR design. The MCR has two obvious modifications compared to the well-known and globally proven CANDU design: a) spherical fuel elements (pebbles) with ceramic cladding b) vertical arrangement of the pressure tubes. Intended for the generation of heat and electricity close to the consumer, the construction of a plant with MCR is preferably carried out underground close to the surface. The Herrenknecht VSM-shaft-tunnel technology is planned for the construction of the structures. For the transportation of irradiated fuel elements, (extended) interim storage and final disposal, technologies are proposed (Initial Barrier; TRIPLE C) that have already been published elsewhere. In order to provide a basis for further scientific and technical discussions, an attempt was made to incorporate the MCR concept into the existing CANDU SMR TM design. The resulting combined “overlapping” concept has not yet been discussed with the CANDU developing and operating countries. The authors hope for a fruitful discussion and are looking for future cooperation with the CANDU SMR TM manufacturer (CANDU Energy Inc. Canada), as well as with the countries that traditionally use CANDU reactors (China, India, South Korea) and Norway in future maybe too.
Management of Acquired Aural Atresia and Stenosis: A Case Series
Authors: Yang Runqin , Zhao Yu , Li Rui , Zhang Changmin , Du Miaomiao , Wang Wenyue , Liu Xiaoxiao , Zha Dingjun , Han Yu
Published: October 2024

Background: Acquired aural atresia and aural stenosis have high recurrence rates, which are challenging for ear, nose, and throat surgeons. This study aimed to discuss the management of acquired aural atresia and aural stenosis to obtain favorable outcomes. Methods: Four representative cases of different etiologies are presented, and a related literature review was conducted. Results: Four patients aged 11 to 63 years were included in this study. Every patient with long-term follow-up (≥1 year) achieved favorable outcomes via pre- and postoperative management. Conclusion: Prevention in clinical practice is conducive to decreasing the incidence of acquired aural stenosis and aural atresia. Surgical techniques and postoperative management determine operative success. External auditory canal support is indispensable, and local corticosteroid injections in the early stage are beneficial for the management of restenosis.
A novel continuum damage evolution model based on the concept of damage driving force for unidirectional composites
Authors: Yu Tianhong , Qi Wenxuan , Sitnikova Elena , Li Shuguang
Published: October 2024

A novel damage evolution model for unidirectional (UD) composites is established in this paper in the context of continuum damage mechanics (CDM). It addresses matrix cracking and it is to be applied along with the damage representation established previously. The concept of damage driving force is employed based on the Helmholtz free energy. It is shown that the damage driving force can be partitioned into three parts, resembling closely three conventional modes of fracture, respectively. A damage evolution law is derived accordingly based on the newly obtained expressions of the damage driving force. The fully rationalised Tsai-Wu criterion is employed in the model for predicting the initiation of matrix cracking damage and fibre failure, assisted with the rationalised maximum stress criterion for identifying the damage modes. A mechanism is introduced to describe the unloading behaviour as a part of the proposed model. The predictions were validated against experimental results, showing good agreement with the experiments and demonstrating the capability and effectiveness of the proposed model.
Whose Side Are We On? Toward an Emancipatory Ethic in Critical Arts-Based Research
Authors: Bagley Carl , Castro-Salazar Ricardo
Published: October 2024

The renowned U.S. sociologist Howard S. Becker, writing in 1969, posed the ethical question: Whose side are we on? In the context of continued structural inequalities in the distribution of power and wealth and individual and institutional oppression, in terms of class, race, gender, disability, and sexual orientation, this question remains as important as ever. The article, in advocating a robustly partisan approach, offers an emancipatory ethical framework continuum and an empirical example, from the authors’ critical arts-based research with undocumented Mexican Americans, to support and inform critical researchers, committed to working with oppressed groups against discrimination and for social justice.
Effects of a Training Program to Improve Co-Teaching and Collaboration Skills for In-Service Teachers of Special and General Education
Authors: Alsudairy Nouf Abdullah
Published: October 2024

Although co-teaching is increasingly recognized as a valuable approach in inclusive education, comprehensive studies that examine the impact of targeted professional development on enhancing teachers’ capabilities in this area are lacking. The limited research on this topic fails to provide clear evidence of the effectiveness of such training programs and their potential benefits for special education and general education teachers. Addressing this issue, this study investigates the effectiveness of a proposed professional development training program designed to elevate co-teaching and collaboration skills among in-service teachers. A one-group quasi-experimental design was used, and a convenience sampling of 32 female teachers, comprising 16 special education and 16 general education teachers, participated in the program consisting of 14 intensive sessions. Pre- and post-intervention assessments, comprising a co-teaching test and a collaboration skills scale, were administered. Results demonstrate significant benefits of the training program, with participants showcasing improved performance in the co-teaching post-test and collaboration scale. Special education teachers notably outperformed their general education counterparts in co-teaching skills. However, the analysis did not reveal any statistically significant differences between teachers of students with learning disabilities and teachers of general education regarding their performance on the collaboration skills scale. The study concludes with recommendations and future research directions, offering insights to further advance co-teaching practices and collaboration skills among educators.
Enhancing Science Affinities of Ethnic Minority High School Students Through Online Interactions with Cultural Role-Models of Scientists and Engineers During the COVID-19 Pandemic: A Case Study
Authors: Yoon Jiyoon , Koo Katie
Published: October 2024

This case study aims to investigate the effectiveness of an online science enhancement program in retaining ethnic minority students in science by providing them with opportunities to interact with cultural role-models of scientists and engineers during the COVID-19 pandemic. The study draws on foundational theories of identity formation and attitudes towards science, as well as research on growth mindsets, to increase students’ participation in science and assess the program’s effects, while also collecting data to develop a new theory. The findings indicate that the online enhancement program successfully facilitated the formation of science identities among the 12 ethnic minority high school students, enhanced their interest in science, and fostered positive attitudes towards science during the pandemic. Moreover, the online interactions with cultural role-models of scientists and engineers supported the students’ science learning and reinforced their science identity. This study also provides guidelines for future research on designing online enrichment programs to enhance ethnic minority students’ science affinities.
Is CRP-Albumin Ratio an Indicator for Wound Infection in Children Exposed to Severe Burns? A Retrospective Cohort Study
Authors: Bülbül Serap Samut , Ceylan Alper , Görgün Selim
Published: October 2024

Background. In the early stages of severe burn cases, an increase in serum C-reactive protein (CRP) level and a decrease in serum albumin level can be observed. Objective. This study aimed to investigate whether the CRP/albumin ratio at the time of hospital admission in children exposed to severe burns would be an indicator for bacterial growth at the wound site. Method. A total of 137 pediatric patients who were treated in our hospital’s burn center due to third-degree burns of 30% or more of their body between January 2019 and October 2023 were included in the study. Results. The mean age was 3.69 ± 4.16 years. CRP/albumin ratio was found to be an independent risk factor for culture positivity (odds ratio: 1.162; P = .01). Conclusion. High CRP/albumin ratio in children with severe burns may provide important information about the development of wound colonization or infection, most likely due to prolonged hospital stay.
Gender, Power, and Nonpreferred Contraceptive Use in the United States: Results from a National Survey
Authors: Burke Kristen Lagasse , Lindberg Laura Duberstein
Published: October 2024

Power dynamics in social interactions likely affect individuals’ ability to use their preferred contraception, yet research has primarily emphasized financial barriers. Using data from a national survey of people assigned female at birth, we apply a social-ecological framework to assess a broader range of factors shaping nonpreferred use. Over one-quarter of respondents were not using their preferred method; among them, nearly half preferred vasectomy, condoms, or withdrawal. Partner disagreement was the most common reason for nonpreferred use and was associated with experiencing partner contraceptive coercion. Black women, who face structural racism in the health care system, were more likely to attribute their nonpreferred use to a provider’s recommendation. These findings demonstrate how gender and power shape contraceptive use despite the preferences of those at risk of pregnancy, highlighting the need for cultural, policy, and health care shifts to resolve contraceptive preference-use discordance and increase gender equity in the responsibility of pregnancy prevention.
Willingness to be present throughout patient death via medical aid in dying in a national sample of interdisciplinary US hospice clinicians: a content analysis of rationales
Authors: Becker Todd D. , Cain Cindy L. , Cagle John G. , Davitt Joan K. , Kusmaul Nancy , Sacco Paul
Published: October 2024

Background:

Although medical aid in dying (MAID) legalization continues to expand across the United States, limited research has elucidated attitudes toward its clinical provision, especially in terms of clinician presence.

Objective:

The objective of the current study was to explore attitudes toward presence throughout a patient’s death via MAID in hospice physicians, nurses, social workers, and chaplains. Aims included (1) characterizing willingness to be present throughout patient death via MAID and (2) describing rationales for willingness.

Design:

We employed a cross-sectional design.

Methods:

A national convenience sample of interdisciplinary hospice clinicians in the United States ( N = 413) completed a self-administered, mixed-method survey via Qualtrics. A quantitative item assessing participants’ willingness (no, unsure, yes) to be present throughout a patient’s death via MAID preceded a qualitative probe inquiring about their rationales behind their previous response. Quantitative responses were characterized through frequencies and percentages. Qualitative responses within each resulting quantitative subsample were content analyzed for surface-level meaning using inductive coding.

Results:

Participants who were willing to be present ( n = 305 [74%]) attributed their willingness to personal support, definitions of quality clinical care, and values from their professional training. Some engaged in boundary setting, describing particular conditions under which they would be willing to be present. Those who were unwilling ( n = 63 [15%]) noted personal objections to the concept of MAID, personal objections to MAID participation, and perceptions of MAID’s misalignment with healthcare. Those who were unsure ( n = 45 [11%]) premised their responses on ambivalence and a lack of experience, both of which precluded formulating a definitive position.

Conclusion:

Although three-quarters of participants were willing to be present during MAID, qualitative responses revealed great nuance within and across quantitative subsamples. Hospice clinicians would benefit from greater professional guidance and support pertaining to MAID.
Global outcomes and prognosis for relapsed/refractory mature T-cell and NK-cell lymphomas: results from the PETAL consortium
Authors: Han Jessy Xinyi , Koh Min Jung , Boussi Leora , Sorial Mark , McCabe Sean M. , Peng Luke , Singh Shambhavi , Eche-Ugwu Ijeoma Julie , Gabler Judith , Fernandez Turizo Maria J. , MacVicar Caroline T. , Garg Aditya , Disciullo Alexander , Chopra Kusha , Lenart Alexandra , Nwodo Emmanuel , Barnes Jeffrey , Koh Min Ji , Miranda Eliana , Chiattone Carlos , Stuver Robert , Horwitz Steven M. , Merrill Mwanasha , Jacobsen Eric , Manni Martina , Civallero Monica , Skrypets Tetiana , Lymboussaki Athina , Federico Massimo , Kim Yuri , Kim Jin Seok , Cho Jae Yong , Eipe Thomas , Shet Tanuja , Sridhar Epari , Shetty Alok , Saha Saswata , Jain Hasmukh , Sengar Manju , Van Der Weyden Carrie , Prince Henry Miles , Hamouche Ramzi , Murdashvili Tinatin , Foss Francine , Gentilini Marianna , Casadei Beatrice , Zinzani Pier Luigi , Okatani Takeshi , Yoshida Noriaki , Yoon Sang Eun , Kim Won-Seog , Panchoo Girisha , Mohamed Zainab , Verburgh Estelle , Alturas Jackielyn Cuenca , Al-Mansour Mubarak , Ford Josie , Cabrera Maria Elena , Ku Amy , Bhagat Govind , Ma Helen , Sawas Ahmed , Kariya Khyati Maulik , Iwasaki Makoto , Bhanushali Forum , O’Connor Owen A. , Marchi Enrica , Shen Changyu , Shah Devavrat , Jain Salvia
Published: October 2024

Variances in global access to drugs and treatment practices make it challenging to understand the benefit of contemporary therapies in patients with relapsed and refractory (R/R) mature T-cell and natural killer–cell lymphomas (MTCL and MNKCL). We conducted an international retrospective cohort study of 925 patients with R/R MTCL and MNKCL. In peripheral T-cell lymphoma–not otherwise specified and anaplastic lymphoma kinase–negative anaplastic large cell lymphoma (ALK– ALCL), patients with relapsed lymphoma demonstrated a superior median overall survival (OS) relative to refractory from the time of second-line treatment. We identified several independent predictors of OS for R/R lymphoma including age >60 years, primary refractory disease, histological subtype other than angioimmunoblastic T-cell lymphoma (AITL), extranodal sites >1, Ki67 ≥40%, and absolute lymphocyte count less than the lower limit of normal. A multivariable model incorporating these formed the basis for a prognostic index for R/R TCL, in which patients are stratified into low-risk (0-1 risk factor), intermediate-risk (2-3 risk factors), or high-risk (≥4 risk factors) groups, which were associated with 3-year OS of 57.14%, 23.3%, and 7%, respectively. Patients received either a "novel" single agent (SA; 35%) or cytotoxic chemotherapy (CC; 60%) for their second-line treatment. Higher progression-free survival was observed with SA over CC for the entire cohort with a higher 3-year OS in AITL and ALK– ALCL. Among the SA, small-molecule inhibitors demonstrated OS advantage relative to CC in AITL. Our results highlight continued efficacy of novel drugs globally and the potential of a new prediction model in informing heterogeneous prognosis within the R/R population of MTCL and MNKCL.
Experiences of lifestyle changes among Thai older adults six months after applying the Plan-Do-Study-Act (PDSA) cycle
Authors: Wongsala Manothai , Rosendahl Sirpa , Anbäcken Els-Marie , Manasatchakun Pornpun , Holmgren Jessica
Published: October 2024

Background

Thai older adults are valuable resources in their society. The Thai health service system is challenged when it comes to ensuring that older Thai adults can continue to live healthy and independent lives in society. It is of great value to support independence and improve older people’s active ageing. Promoting lifestyle changes by applying the Plan-Do-Study-Act cycle (PDSA cycle), at group meetings in a municipality context, is a way of focusing on active ageing. This study aims to describe older adults´ experiences of lifestyle change six months after finishing group meetings applying the PDSA cycle.

Methods

A qualitative approach with individual interviews and a qualitative content analysis were used with 12 Thai older adults who participated in the meetings applying the PDSA cycle.

Results

Six months after finishing applying the PDSA cycle, some older adults kept their individual goals and were influenced by their family surroundings. They also formulated additional goals. Three categories and six sub-categories emerged: Keeping individual goals, influenced by the surroundings, and formulation of additional goals were the overall categories.

Conclusions

These Thai older adults showed that they had the ability to make lifestyle changes with the support of the PDSA cycle, but not all maintained their planned activities after six months. The question is how healthcare professionals and the surroundings, may further support and motivate these people to maintain these changes based on their own preferences in a sustainable way.
Sex differences in contextual fear conditioning and extinction after acute and chronic nicotine treatment
Authors: Keady Jack V. , Hessing Marissa C. , Songrady Judy C. , McLaurin Kristen , Turner Jill R.
Published: October 2024

Background

Chronic cigarette smokers report withdrawal symptomology, including affective dysfunction and cognitive deficits. While there are studies demonstrating sex specific withdrawal symptomology in nicotine-dependent individuals, literature examining the underlying biological mediators of this is scant and not in complete agreement. Therefore, in this study, we evaluated the sex specific effects of nicotine and withdrawal on contextual fear memory, a hippocampally dependent aspect of cognition that is disrupted in nicotine withdrawal.

Methods

Male and female B6/129F1 mice (8–13 weeks old) were used in all experiments. For the acute nicotine experiment, mice received intraperitoneal saline or nicotine (0.5 mg/kg) prior to contextual fear conditioning and test. For the chronic nicotine experiment, mice received nicotine (18 mg/kg/day) or saline for 11 days, then underwent contextual fear conditioning and test. Following the test, mice underwent minipump removal to elicit withdrawal or sham surgery, followed by the fear extinction assay. Bulk cortical tissue was used to determine nicotinic acetylcholine receptor levels via single point [3H]Epibatidine binding assay. Gene expression levels in the dorsal and ventral hippocampus were quantified via RT-PCR.

Results

We found that female mice had a stronger expression of contextual fear memory than their male counterparts. Further, following acute nicotine treatment, male, but not female, subjects demonstrated augmented contextual fear memory expression. In contrast, no significant effects of chronic nicotine treatment on fear conditioning were observed in either sex. When examining extinction of fear learning, we observed that female mice withdrawn from nicotine displayed impaired extinction learning, but no effect was observed in males. Nicotine withdrawal caused similar suppression of fosb, cfos, and bdnf, our proxy for neuronal activation and plasticity changes, in the dorsal and ventral hippocampus of both sexes. Additionally, we found that ventral hippocampus erbb4 expression, a gene implicated in smoking cessation outcomes, was elevated in both sexes following nicotine withdrawal.

Conclusions

Despite the similar impacts of nicotine withdrawal on gene expression levels, fosb, cfos, bdnf and erbb4 levels in the ventral hippocampus were predictive of delays in female extinction learning alone. This suggests sex specific dysfunction in hippocampal circuitry may contribute to female specific nicotine withdrawal induced deficits in extinction learning.
Sex dimorphism and tissue specificity of gene expression changes in aging mice
Authors: Zhu Dantong , Arnold Matt , Samuelson Brady A. , Wu Judy Z. , Mueller Amber , Sinclair David A. , Kane Alice E.
Published: October 2024

Background

Aging is a complex process that involves all tissues in an organism and shows sex dimorphism. While transcriptional changes in aging have been well characterized, the majority of studies have focused on a single sex and sex differences in gene expression in aging are poorly understood. In this study, we explore sex dimorphism in gene expression in aging mice across three tissues.

Methods

We collected gastrocnemius muscle, liver and white adipose tissue from young (6 months, n = 14) and old (24 months, n = 14) female and male C57BL/6NIA mice and performed RNA-seq. To investigate sex dimorphism in aging, we considered two levels of comparisons: (a) differentially expressed genes between females and males in the old age group and (b) comparisons between females and males across the aging process. We utilized differential expression analysis and gene feature selection to investigate candidate genes. Gene set enrichment analysis was performed to identify candidate molecular pathways. Furthermore, we performed a co-expression network analysis and chose the gene module(s) associated with aging independent of sex or tissue-type.

Results

We identified both tissue-specific and tissue-independent genes associated with sex dimorphism in aged mice. Unique differentially expressed genes between old males and females across tissues were mainly enriched for pathways related to specific tissue function. We found similar results when exploring sex differences in the aging process, with the exception that in the liver genes enriched for lipid metabolism and digestive system were identified in both females and males. Combining enriched pathways across analyses, we identified amino acid metabolism, digestive system, and lipid metabolism as the core mechanisms of sex dimorphism in aging. Although the vast majority of age-related genes were sex and tissue specific, we identified 127 hub genes contributing to aging independent of sex and tissue that were enriched for the immune system and signal transduction.

Conclusions

There are clear sex differences in gene expression in aging across liver, muscle and white adipose. Core pathways, including amino acid metabolism, digestive system and lipid metabolism, contribute to sex differences in aging.
Comparison of facilities with and without additional medical fees for nutrition support team activity during the COVID-19 pandemic
Authors: Futamura Akihiko , Koseki Takenao , Iida Junichi , Suzuki Akito , Muroi Nobuyuki , Myotoku Michiaki , Maki Hiroki , Mizutani Kazuhisa , Ogino Hikaru , Taniguchi Yasuki , Higashi Keiichiro , Usui Masanobu
Published: October 2024

Background

This study aimed to clarify the effectiveness of nutrition support team (NST) facilities for preventing central line-associated bloodstream infection (CLABSI).

Methods

We retrospectively analyzed the incidence of CLABSI as well as the presence or absence of additional medical fees for NST activity between 2019 and 2021, including the period before and after the COVID-19 pandemic. Subsequently, we performed between-group comparisons of the CLABSI incidence. CLABSI rates were compared based on cumulative per 1000 catheter uses during the relevant period.

Results

Among 47 facilities that were registered for participation, there were 34 and 13 facilities with and without additional medical fees for NST activity (NST and non-NST groups, respectively). The CLABSI incidence rate was significantly lower in the NST group 0.96 [0.28–1.73] than in the non-NST group 1.25 [075–6.10] (p < 0.05). Before the pandemic, the NST group had a lower CLABSI rate per 1000 catheter uses than the non-NST group 2019: 0.70 [0.12–1.26] vs 2.10 [0.62–5.97]. During the pandemic, the CLABSI incidence showed no significant between-group difference 2020: 0.99 [0.51–1.61] vs 1.01 [0.80–4.16]; 2021: 1.24 [0.44–2.35] vs 1.96 [1.23–5.31]; however, the CLABSI rates in the NST group remained low.

Conclusion

During the COVID-19 pandemic, the incidence of CLABSI was lower in the NST group than in the non-NST group, indicating the effectiveness of NST in preventing the occurrence of CLABSI.