bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of epidural steroid injections for the management of spinal malignancy-related pain.
Authors: Lim Dongsik , Chang Minhye , Kim Sunmin , Kim Yu Jung , Nahm Francis Sahngun , Lee Pyung Bok , Choi Eun Joo
Published: June 2024

e24052

Background: Spinal malignancy-related pain is common in cancer patients. There are several treatment options from systemic steroid injection to surgical treatment. Epidural steroid injection (ESI) is one of commonly performed treatment. The purpose of this study is to assess the effect of ESI in spinal malignancy-related pain. Methods: We retrospectively reviewed our cases who was diagnosed with spinal metastatic cancer, and received ESI from January 2021 to December 2022. The primary outcome was pain intensity (Visual Analogue Scale score, 0-10) at baseline, 1, 3 and 6 months after ESI. Patients with a pain reduction of more than 50% at 1 month after ESI were classified as success group (S), and others were classified as failure group (F). The secondary outcomes were change of MEDD (morphine equivalent daily dose, mg/day) at same time points. Also, each patient’s demographic data, ECOG, history of previous radiotherapy, and survival duration following ESI. Results: Totally 135 patients were enrolled, and 80 patients were analyzed. Of the 80 patients, 47 and 33 patients were classified into the S and F group, respectively (Table 1). Patients who had previous radiotherapy was 68.1% in S group, but only 48.5% in F group (p = 0.04). The 80% of group S survived over 6 months, compared to 39% of group F (p < 0.001). There were significant differences in VAS scores between S and F groups at all-time points during the follow-up period (P < 0.001) and MEDD was significantly lower in the S group at 1 (p = 0.02) and 3 months (p < 0.01). Conclusions: This study demonstrates that ESI effectively reduce pain and opioid use in patients with spinal malignancy-related pain. Given the observed survival periods, it can be inferred that earlier intervention with ESI is more likely to yield beneficial outcomes. [Table: see text]
The impact of cannabidiol (CBD) on aromatase inhibitor (AI)-associated musculoskeletal symptoms (AIMSS).
Authors: Fleege Nicole Margo Grogan , Miller Elise , Kidwell Kelley M. , Scheu Kelly L. , Kemmer Kathleen A. , Boehnke Kevin , Henry Norah Lynn
Published: June 2024

e24060

Background: Although treatment with an AI for 5-10 years decreases 10-year breast cancer (BC) mortality by about 40%, up to 25% of patients will stop treatment early because of treatment-related, intolerable joint and muscle pain and stiffness, called AIMSS. Only acupuncture, duloxetine, and exercise have been shown to reduce AIMSS. While the exact underlying mechanism is unknown, it is thought to be due in part to ongoing systemic inflammation. CBD has anti-nociceptive and anti-inflammatory properties, making it a potential treatment option for AIMSS. Methods: Women with stage 0-3 hormone receptor-positive BC experiencing AIMSS (defined as worst joint pain ≥4/10 during prior 7 days that developed or worsened since starting AI therapy) were eligible for enrollment in this single arm, single center phase 2 open label clinical trial (NCT04754399). Patients received an FDA-approved formulation of CBD (Epidiolex), titrated over 4 weeks from 25 mg BID to 100 mg BID and then continued at maximum tolerated dose for a total of 15 weeks. Patient-reported outcomes (PRO) data were collected serially, including the Brief Pain Inventory (BPI) and the PROMIS Profile 29+2 v2.1. The primary endpoint was the number of CBD-treated patients with at least a 2-point reduction (minimal clinically important difference) in worst pain from baseline to 15 weeks. Statistical analysis was completed using paired t-tests and linear mixed models. Results: Of 39 eligible patients (Table 1), 11 discontinued participation early due to patient discretion (n = 6) or adverse event (n = 5). There were no grade 3-4 toxicities. Analyzing data from all 39 patients, there was an improvement in BPI worst pain (0-10 scale) of 0.13 per week of treatment after baseline (p < 0.001), resulting in an average improvement in worst pain of 1.95 at the end of 15 weeks. Of the 28 patients who completed the study, 17 (60.7%) reported a ≥2-point improvement in BPI worst pain between baseline and week 15. There was a significant improvement in PROMIS T score at week 15 in both physical function (2.34, p = 0.01) and ability to participate in social roles and activities (2.71, p = 0.02). Conclusions: Treatment with CBD was associated with an improvement in joint pain for a subset of patients. Additional analyses are ongoing to further investigate the impact of CBD on AIMSS and to explore which patients are most likely to benefit from treatment with CBD. Clinical trial information: NCT04754399 . [Table: see text]
The role of shared decision-making in cancer pain management: Insights from a systematic review.
Authors: Monteiro Andrea L , Yousef Andro , Sweiss Karen , DiDomenico Robert , Sharp Lisa K.
Published: June 2024

e24078

Background: Effective pain management in cancer care is crucial for patient quality of life. Shared decision-making (SDM) interventions are increasingly recognized for their potential to improve patient outcomes by facilitating patient engagement in care decisions. This systematic review synthesizes evidence on the impact of SDM interventions in cancer pain management. Methods: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted a comprehensive search across multiple databases, including PubMed, EMBASE, Scopus, CINAHL, PsycINFO, Web of Science, and the Cochrane Library. The search also extended to grey literature sources such as conference proceedings, dissertations, and unpublished reports to ensure a thorough coverage of the subject matter. Our search strategy employed a combination of MeSH terms and keywords related to 'decision making,' 'patient participation,' 'pain management,' and 'cancer.' This strategy was tailored to each database's unique syntax and search operators. Results: Ten studies, including six pilot and feasibility studies and four randomized controlled trials (RCTs) and Preintervention-Postintervention studies, were systematically reviewed. The interventions implemented diverse SDM strategies ranging from digital tools and personalized education to clinical decision support systems, targeting key aspects of pain management and patient-provider communication. Frequent intervention components included patient-reported outcome dashboards, symptom management support, and educational resources for pain management. The Tailored Education and Coaching (TEC) intervention notably increased pain-specific patient communication by 31%, while the PAINRelieveIt intervention did not significantly impact analgesic adherence but effectively reduced pain misconceptions among caregivers. Some interventions, like the Carevive CPS, showed high patient involvement in SDM (94.1%) and compliance with quality oncology practice initiative metrics (98%). However, the effectiveness of these interventions varied, with some showing no significant impact on primary pain outcomes. The variability in measured outcomes such as pain intensity, analgesic adherence, and patient satisfaction indicates a context-dependent effectiveness of SDM interventions, highlighting the importance of personalized approaches and the role of implementation strategies in influencing patient engagement and intervention success. Conclusions: SDM interventions in cancer pain management are diverse in structure and impact. Some interventions show promise in improving communication and reducing misconceptions, but their direct effect on pain outcomes varies.
Utilization of palliative care for geriatric veterans with newly diagnosed stage 3 and 4 pancreatic cancer.
Authors: Panjrolia Ekta , Tannous Toufic , Resendes Natasha M. , Islam Raiyan , Hammel Iriana M.
Published: June 2024

e24082

Background: Locally advanced and metastatic pancreatic cancer continues to be difficult to treat with high mortality. For stage 3 and stage 4 pancreatic cancer, there remains no meaningful advances in treatment and standard of care heavily relies on a palliative approach. Yet, there remains reports that early use of palliative care (PC) may be underutilized despite palliative care being mainstay of treatment. We sought to further characterize which factors may play a role in PC referral within the geriatric veteran population. Methods: This retrospective cohort study included veterans who were diagnosed and treated for pancreatic cancer within the Veterans Integrated Services Network (VISN) 8 which includes Veterans Affairs medical facilities in Florida, southern Georgia, Puerto Rico and the U.S. Virgin Islands. Demographic data such as age, sex, race, ethnicity and branch of service and treatment data such as chemotherapy and PC use were pulled from the electronic medical record. We conducted a chart review to determine stage and ECOG status at the time of diagnosis. Of this cohort, 99 veterans were identified who met the criteria of 65 years of age or older at the time of newly diagnosed stage 3 or stage 4 pancreatic cancer. Statistical analyses were conducted using GraphPad Prism 10.1.2 software and analyses consisted of t-test, Mann-Whitney, chi-squared, multiple regression model and odds ratio. Results: The mean age for veterans who did not receive PC was 74.66 years and veterans who did receive PC mean age was 74.79, revealing no statistically significant difference (p = 0.9205). The median ECOG for veterans who did and did not receive PC was 1 (p = 0.6609). Chemotherapy use in the PC and no PC groups did not differ with about 49% of veterans in the no PC group receiving chemotherapy and 42% of veterans received PC and chemotherapy (p = 0.5329). Furthermore, sex, race, ethnicity, stage 3 vs 4, and branch of military service were not found to be statistically significant between the PC and no PC groups. We found no statistically significant relationship between frequency of PC utilization (p = 0.4450) with age (OR = 1.001; 95% CI 0.9331-1.072), ECOG score (OR = 1.059; 95% CI 0.7425 – 1.504) or chemotherapy use (OR = 0.7353; 95% CI 0.2936 – 1.821). The OR for age, ECOG and chemotherapy use all cross 1.0 demonstrating that these independent variables do not have a correlation with PC utilization. Conclusions: Between geriatric veterans with newly diagnosed stage 3 and stage 4 pancreatic cancer who did and did not receive PC, there appears to be no statistically significant difference in ECOG status, age, ethnicity, use of chemotherapy or branch of military service. Our data demonstrates that otherwise prognostic features such as age and ECOG did not differ in veterans who did and not receive PC regardless of chemotherapy use, however overall more PC referrals are still needed within this patient population.
Assessing our adherence to bone protection standards in metastatic prostate cancer in the largest Irish center: Are we falling behind?
Authors: Aslam Razia , Hadi Danial , Shah Syed Muhammad Bilal , Barron Emma
Published: June 2024

e24145

Background: Prostate cancer ranks as the second most prevalent cancer in men globally, often necessitating androgen deprivation therapy (ADT) as part of its treatment. While ADT effectively diminishes testosterone levels, a vital factor in prostate cancer cell growth, it concurrently poses a notable side effect – an accelerated rate of bone loss. This heightened bone loss elevates the vulnerability of patients to osteoporosis and fractures. The optimization of bone health entails early identification of patients susceptible to osteoporosis and fractures, the implementation of preventative measures, and prompt interventions to mitigate bone loss and fracture risks. Methods: The audit aims to evaluate adherence to established guidelines, such as those outlined by the National Comprehensive Cancer Network (NCCN) and the European Society for Medical Oncology (ESMO), concerning the assessment and optimization of bone health. A retrospective analysis was performed on the medical records of prostate cancer patients who underwent Androgen Deprivation Therapy (ADT) at St James Hospital in Dublin. Pertinent data, encompassing patient demographics, duration of ADT, documentation of bone health assessment, frequency of Bone Mineral Density (BMD) testing, utilization of preventive measures (e.g., calcium and vitamin D supplementation), and any interventions for bone health optimization (such as bisphosphonate therapy and denosumab), was systematically collected. Results: A comprehensive review encompassed 57 patients, revealing that 38 patients (67%) exhibited metastatic disease. Among them, 42 patients (74%) presented with castrate-sensitive disease. Out of the total, 24 patients (42%) underwent a baseline Dual-Energy X-ray Absorptiometry (DEXA) scan. Results indicated that 12 patients were diagnosed with Osteoporosis, 9 with Osteopenia, and 3 with normal Bone Mineral Density (BMD). At baseline, 26 patients (46%) initiated Calcium and Vitamin D supplements, while 12 patients (21%) commenced Bisphosphonates/Denosumab based on DEXA scan outcomes. Notably, 8 (14%) patients experienced a skeletal/bone-related event which is much higher than reported in literature. Conclusions: The findings are intended to guide healthcare professionals in optimizing bone health strategies, with the ultimate goal of improving patients' quality of life and minimizing the risk of fractures and related complications. Identified areas for improvement in clinical practices will be addressed by implementing recommended recommendations, aiming to enhance patient care, decrease the risk of osteoporosis and fractures, and overall improve patient outcomes. A re-audit is planned to monitor ongoing adherence to guidelines and assess the impact of interventions implemented as a result of this study.
Central Bank Communication with the General Public: Promise or False Hope?
Authors: Blinder Alan S. , Ehrmann Michael , de Haan Jakob , Jansen David-Jan
Published: June 2024

Central banks are increasingly reaching out to the general public to motivate and explain their monetary policy actions. One major aim of this outreach is to ensure accountability and create trust; another is to guide inflation expectations. This article surveys a rapidly growing literature on central bank communication with the public, rather than with the financial markets. We first discuss why such communication matters and is more challenging than communicating with expert audiences. Then we turn to methods: How do central banks try to reach the public, and do they succeed? Next, and importantly, we survey the empirical evidence on the extent to which this new outreach affects inflation expectations. On balance, we see some promise in the potential to inform the public better, but many challenges along the way. (JEL D83, D84, E31, E52, E58, G53)
Plagues upon the Earth: Disease and the Course of Human History
Authors: Rhode Paul W.
Published: June 2024

Paul W. Rhode of University of Michigan and NBER reviews “Plagues upon the Earth: Disease and the Course of Human History” by Kyle Harper. The EconLit abstract of this book begins: “Explores the ways that human history has shaped disease ecology and pathogen evolution and how disease ecology and pathogen evolution have shaped human history in turn, detailing how the emergence, incidence, and consequences of disease in both individuals and populations are inseparable from a wider array of social and environmental factors.”
Monetary Policy and Its Unintended Consequences
Authors: Levin Andrew T.
Published: June 2024

Andrew T. Levin of Dartmouth College and NBER reviews “Monetary Policy and Its Unintended Consequences” by Raghuram Rajan. The EconLit abstract of this book begins: “Details how monetary adventurism can have unintended effects and promotes policy that is moderate and focused on combating high inflation and financial instability.”
The Crisis of Democratic Capitalism
Authors: Elmendorf Doug
Published: June 2024

Doug Elmendorf of Harvard University reviews “The Crisis of Democratic Capitalism” by Martin Wolf. The EconLit abstract of this book begins: “Promotes the argument that economic disappointment is one of the chief explanations for the rise of left- and right-wing populism in high-income democracies, focusing on what can be done to restore the relationship between capitalism and democracy.”
Consent as a rational choice
Authors: Φωκά-Καβαλιεράκη Παναγούλα
Published: June 2024

Η συναίνεση αποτελεί θεμελιώδη έννοια της πολιτικής και ηθικής φιλοσοφίας και μια ακρογωνιαία λίθο για τις κοινωνικές επιστήμες, όπως η οικονομία και το δίκαιο. Η γνήσια συναίνεση υποτίθεται ότι δίνεται από ορθολογικά άτομα, επομένως η ορθολογικότητα είναι ίσως η πιο σημαντική προϋπόθεση για οποιαδήποτε συναινετική δραστηριότητα. Εάν θεωρήσουμε τη συναίνεση ως μια εκούσια επιλογή μεταξύ διαθέσιμων εναλλακτικών, τότε η γνήσια συναίνεση είναι μια ορθολογική επιλογή. Καθώς εξετάζουμε το ζήτημα της ανθρώπινης ορθολογικότητας, διερευνούμε τις διάφορες πτυχές της έννοιας της ορθολογικότητας, τις θεωρίες που έχουν προταθεί και τα στοιχεία που έχουν καταγραφεί από κοινωνικούς και συμπεριφορικούς επιστήμονες στον τομέα της λήψης αποφάσεων και της επίλυσης προβλημάτων. Για τους σκοπούς της ανάλυσής μας χρησιμοποιούμε μια οικονομική προσέγγιση και ακολουθούμε τη συζήτηση της οικονομικής ορθολογικότητας μέσα στο ευρύτερο πλαίσιο της συμπεριφοράς λήψης αποφάσεων. Παρουσιάζουμε επίσης μια σειρά προκαταρκτικών πειραμάτων όπου αναφέρουμε την παρουσία μιας γνωστικής πλάνης (Intellectual and Moral Attribution Bias). Όταν οι συμμετέχοντες καλούνται να αξιολογήσουν τη δική τους συμπεριφορά και αυτή των άλλων, για το ίδιο θέμα, τείνουν να αποδίδουν ορθολογικά κίνητρα στον εαυτό τους και ανορθολογικά ή ανήθικα κίνητρα στους άλλους, υποδεικνύοντας έτσι ότι οι άνθρωποι έχουν προκατάληψη κατά της ορθολογικότητας και της αυθεντικότητας της συναίνεσης των άλλων. Παρουσιάζουμε περαιτέρω την κριτική της αξιωματικής και εργαλειακής θεωρίας της ορθολογικής επιλογής από τη συμπεριφορική οικονομική επιστήμη και συζητάμε τα ζητήματα του κοινωνικού σχεδιασμού και της ατομικής συναίνεσης στον ιδιωτικό και δημόσιο τομέα. Στη συνέχεια προχωράμε στην παρουσίαση στοιχείων από άλλες κοινωνικές, συμπεριφορικές και ψυχολογικές επιστήμες που είναι επικριτικές απέναντι στα ευρήματα και τις υποθέσεις των συμπεριφορικών επιστημών. Ωστόσο, η συναίνεση, ακόμη και όταν πληροί την προϋπόθεση της ορθολογικότητας και της επαρκούς πληροφόρησης, δεν μπορεί ποτέ να είναι ανεπιφύλακτη. Αυτό, όμως, δεν σημαίνει ότι η ύπαρξη περιορισμών ισοδυναμεί με εξαναγκασμό. Για να διακρίνουμε μεταξύ εξαναγκασμένης συναίνεσης και συναίνεσης μεταξύ δύσκολων - αλλά επιθυμητών - επιλογών, ξεκινάμε τη διατριβή παρουσιάζοντας ένα εύχρηστο κριτήριο.
Διερεύνηση των μοτίβων δεσμού παιδιών με διαταραχή αυτιστικού φάσματος (ΔΑΦ) με τη μητέρα και τον πατέρα τους και εφαρμογή μιας συμπεριφορικής - αναλυτικής παρέμβασης για τη βελτίωση του δεσμού
Authors: Στεφανάκη Αρετή
Published: June 2024

Ο συναισθηματικός δεσμός βρέφους-γονιού αποτελεί μέρος της εξελικτικής διαδικασίας του ατόμου και αναπτύσσεται από τη βρεφική ηλικία, ακολουθώντας συγκεκριμένες ηλικιακές φάσεις ανάπτυξης. Παλαιότερες έρευνες, υποστήριζαν ότι οι ελλειμματικές κοινωνικές, επικοινωνιακές και συναισθηματικές δεξιότητες των παιδιών με Διαταραχή Αυτιστικού Φάσματος (ΔΑΦ) εμποδίζουν την ικανότητα τους να συνάψουν δεσμό με τα πρόσωπα φροντίδας (American Psychiatric Association, 1980 • Kanner, 1943). Πλήθος σύγχρονων ερευνών καταδεικνύουν τόσο την ικανότητα των παιδιών με ΔΑΦ να αναπτύσσουν δεσμό με τους γονείς τους όσο και τις δυσκολίες αξιολόγησης της ποιότητας δεσμού αυτών των παιδιών. Σκοπός της παρούσας έρευνας ήταν η ποιοτική διερεύνηση των μοτίβων δεσμού τεσσάρων αγοριών με ΔΑΦ, ηλικίας 2 έως 4 ετών, με τη μητέρα και τον πατέρα τους και η αξιολόγηση της αποτελεσματικότητας ενός Νατουραλιστικού Συμπεριφορικού-Αναλυτικού μοντέλου εκπαίδευσης γονέων, με στόχο τη βελτίωση της ποιότητας δεσμού των παιδιών με ΔΑΦ με τους γονείς τους. Οι στόχοι της έρευνας αποσκοπούσαν στη βελτίωση και την ενδυνάμωση τριών κατηγοριών αντιδράσεων: α) των ατομικών χαρακτηριστικών των παιδιών με ΔΑΦ, που δυσχεραίνουν τη σύναψη ασφαλούς δεσμού, β) των γονικών συμπεριφορών που διευκολύνουν τη σύναψη ασφαλούς δεσμού και γ) των συμπεριφορών αλληλεπίδρασης παιδιού με ΔΑΦ-γονιού, με σκοπό την ποιοτική αναβάθμιση της σχέσης τους. Στη συγκεκριμένη έρευνα, αξιοποιήθηκε ο πειραματικός σχεδιασμός με πολλαπλές γραμμές βάσης ανά κατηγορία αντιδράσεων ως καταλληλότερος για τη μέτρηση των συμπεριφορών ανά δυάδα παιδιού με ΔΑΦ-γονιού. Η ανάλυση των αποτελεσμάτων της έρευνας επιβεβαίωσε, αφενός τα ευρήματα προηγούμενων ερευνών σχετικά με την ικανότητα των παιδιών με ΔΑΦ να συνάπτουν οργανωμένα μοτίβα δεσμού με τα πρόσωπα φορντίδας του και συγκεκριμένα να κατηγοριοποιούνται στον ασφαλή τύπο δεσμού-Β και αφετέρου, κατέδειξε σημαντικά οφέλη και στα τρία επίπεδα των στοχεύσεων της έρευνας. Επιπλέον, τα αποτελέσματα γενικεύτηκαν σε νέα ερεθίσματα και σε νέες κατηγορίες αντιδράσεων και διατηρήθηκαν σε βάθος χρόνου. Τα ευρήματα της συγκεκριμένης έρευνας τονίζουν την ανάγκη και τη σπουδαιότητα σχεδιασμού μοντέλων εκπαίδευσης γονέων πρώιμης παρέμβασης, με πυρήνα τον συναισθηματικό δεσμό και απώτερο στόχο τη συστηματική και συστημική προσέγγιση των αναγκών των παιδιών με ΔΑΦ και των οικογενειών τους.
Φεμινισμός και Πορνογραφία: Η σεξουαλική βία και η απάντηση του Φεμινισμού
Authors: Κοβός Νικόλαος
Published: June 2024

Στις μέρες μας η πορνογραφία και το υλικό που εμπεριέχεται σε αυτήν είναι τόσο διαδεδομένα, όπου αμέτρητοι άνθρωποι ανά τον κόσμο μπορούν να έχουν πολύ εύκολη πρόσβαση σε αυτό οποιαδήποτε στιγμή της ημέρας το επιθυμήσουν, είτε δωρεάν είτε καταβάλλοντας ένα μικρό χρηματικό αντίτιμο. Ωστόσο, όπως κάθε παγκόσμιο φαινόμενο έτσι και η ραγδαία αύξηση θέασης πορνογραφικού υλικού ελλοχεύει ορισμένους κινδύνους. Στο παρόν άρθρο θα αναλυθεί ένα από τα σημαντικότερα προβλήματα του φαινομένου αυτού, δηλαδή η προβολή σκηνών βίας (λεκτικής και μη) κυρίως από το ανδρικό προς το γυναικείο φύλο, το οποίο δημιουργεί εσφαλμένες αντιλήψεις στους ανθρώπους σχετικά με το σεξ. Επιπρόσθετα θα εξεταστούν διεξοδικά και ορισμένες οπτικές επ’ αυτού διαφόρων φεμινιστριών φιλοσόφων, με στόχο την εύρεση μιας επιθυμητής πρότασης για τον περιορισμό του προβλήματος.
Στρεσογόνοι παράγοντες, επαγγελματική εξουθένωση και ανθεκτικότητα στο επάγγελμα του εκπαιδευτικού: Διερεύνηση των μεταξύ τους σχέσεων και του ρόλου των δημογραφικών χαρακτηριστικών
Authors: Γεωργίου Ευθυμία , Κάμτσιος Σπυρίδων
Published: June 2024

Σκοπός της έρευνας ήταν η μελέτη της επίδρασης των στρεσογόνων παραγόντων στην επαγγελματική εξουθένωση των εκπαιδευτικών καθώς επίσης και η πιθανή σχέση ανάμεσα στην ανθεκτικότητα και στην επαγγελματική εξουθένωση. Ταυτόχρονα, οι στρεσογόνοι παράγοντες στο επάγγελμα του εκπαιδευτικού, η επαγγελματική εξουθένωση και η ανθεκτικότητα εξετάζονται σε συνάρτηση με δημογραφικά χαρακτηριστικά. Στην έρευνα συμμετείχαν 844 εκπαιδευτικοί από την πρωτοβάθμια και δευτεροβάθμια εκπαίδευση της Κύπρου και Ελλάδας. Οι συμμετέχοντες συμπλήρωσαν τα παρακάτω ερωτηματολόγια: (1) Ερωτηματολόγιο Επαγγελματικής Εξουθένωσης, (2) The Greek Hardiness Resilience Gauge και (3) Ερωτηματολόγιο Πηγών Επαγγελματικής Έντασης. Τα αποτελέσματα της έρευνας καταδεικνύουν ότι τα υψηλά επίπεδα επαγγελματικής εξουθένωσης σχετίζονται με χαμηλά επίπεδα ανθεκτικότητας και ότι οι τρεις διαστάσεις της ανθεκτικότητας (πρόκληση, δέσμευση, έλεγχος) μειώνουν την επιρροή των στρεσογόνων παραγόντων στην επαγγελματική εξουθένωση. Αναδείχθηκαν, επίσης, διαφορές στις μεταβλητές της μελέτης λόγω της επιρροής συγκεκριμένων δημογραφικών χαρακτηριστικών. Τα αποτελέσματα της μελέτης συζητώνται στο πλαίσιο της σύγχρονης βιβλιογραφίας.
IVUS and iFR: A Powerful duo for uncovering intermediate lesions in coronary artery disease
Authors: Samaras Antonios , Konstantinou Thrasivoulos , Sdogkos Evangelos , Vogiatzis Ioannis
Published: June 2024

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Risk Factors for Postoperative Chylothorax Occurrence Following Pediatric Congenital Heart Surgery
Authors: Nguyen Tran-Chau , Hoang Thao-Vy , Nguyen Ha-Giang , Culbertson Casey
Published: June 2024

Objectives: Chylothorax, a rare but potentially life-threatening complication post congenital heart surgery, warrants early identification of risk factors to implement preventive strategies and timely interventions. This study aims to determine risk factors associated with chylothorax occurrence at our cardiac intensive care unit.
Methods:  We conducted a nested case-control study involving 2042 children who underwent congenital heart surgery at Nhi Dong 1 hospital (Ho Chi Minh City, Vietnam) from Feb 25th, 2015, to October 12th, 2019. Among these, 38 chylothorax cases were matched by sex and year of surgery to 76 randomly selected control patients. Univariate analysis and logistic regression were performed to identify independent factors associated with chylothorax occurrence after congenital heart surgery.
Results: Neonatal cardiac surgery, RACHS-1 risk category ≥ 3, aortic arch repair, the arterial switch operation, prolonged bypass time (median 160 mins vs 87 mins) and aortic clamp time (median 89.5mins vs 51 mins), delayed sternal closure and unexpected reoperation were all associated with postoperative chylothorax occurrence on univariate analysis. Additionally, body weight < 4.5 kg (p=0.027), postoperative dysrhythmias (p=0.004), and high volume of chest tube output (> 10% of total expected blood volume) within the first 6 postoperative hours after cardiac intensive care unit admission (p=0.014) emerged as independent risk factors for postoperative chylothorax occurrence with odds ratios and 95% confident interval of 2.78 (1.12-6.87), 3.38 (1.29-8.86) & 3.82 (1.55-9.39), respectively. These factors served as predictors of postoperative chylothorax occurrence with a sensitivity of 42.1%, specificity of 90.8%, positive predictive value of 69.6% and a negative predictive value of 75.8%.
Conclusions: High chest tube output within the first 6 postoperative hours, postoperative dysrhythmias, and body weight of < 4.5kg at surgery significantly increase the risk of postoperative chylothorax in our institution.
Keywords: Postoperative chylothorax, chylothorax post pediatric cardiac surgery, pediatric chylothorax
Fertility Decline in Iceland, 2013-2022: Trends and Structures
Authors: Jónsson Ari Klængur
Published: June 2024

Iceland is one of the Western countries that have experienced an unexpected fertility decrease in the 2010s. In this study, the aggregate Icelandic fertility decline is dissected to explore which fertility components are the main drivers behind the decline since 2010 in order to better understand whether the development is associated with compositional changes or linked to changes such as increased propensities of childlessness and decreased propensities to have another child. As such, it contributes empirical evidence to ongoing theorisation within current fertility debates. Official administrative register data are analysed by means of event-history analysis. Findings are presented as parity-specific birth risks and in the form of Kaplan-Meier estimates of synthetic period-based cohorts of women and men progressing to parity one over calendar years. In terms of results, we find that the fertility decline was concentrated around first births, and the decline can principally be attributed to women under the age of thirty. Propensities to remain childless have increased slightly since 2013, while there were no declines in the intensities to have a second and a third child. Hence, the development in Iceland appears to be driven by clear postponement of parenthood but not altered childbearing behaviour in terms of propensities to have a second and a third child. Results do not necessary contradict theories under the umbrella of the gender-relations framework, but they highlight the importance of exploring other factors impacting the transition to parenthood, such as perceived global and welfare uncertainties. Socioeconomic differentials in first-birth fertility and factors affecting postponement and ultimate childlessness should be explored further, as well as short-term developments in higher-order birth intensities during adverse circumstances, such as the 2008 economic crisis and the Covid-19 pandemic, during which periods the third-birth intensities increased.
Assessment of physical fitness among people over 60 years of age
Authors: Ciesielski Jakub , Perkowski Radosław
Published: June 2024

Introduction: An ageing of population is becoming more and more common. With age, the functionality and efficiency of the body decreases. As a result, the time spent by seniors on physical activity is shortened and physical fitness decreases. For this reason, the physical fitness of seniors should be regularly checked and they should be encouraged to take up physical activity. There are many proven and reliable tests used to assess physical fitness.             Materials and methods: The study group consisted of 40 people (31 women and 9 men), aged 60-78 years. The tests used in following study were: the SPPB questionnaire, handgrip strength test, and arm and calf circumference measurements. An attempt was made to find sociodemographic factors that could influence the level of physical fitness. It was checked whether physical fitness and physical activity depend on age, gender and BMI. It was checked how much time older people spend on physical activity during the day and week. The study confirmed that physical fitness decreases with age.             Results: Tests and interviews have shown that people who spend more than 60 minutes a day on physical activity achieve higher scores on the SPPB questionnaire. These results were applicable to both women and men. Studies in a larger and more diverse population would need to be repeated in order to further confirm these results and draw more conclusions.
Semaglutide in the Treatment of Diabetes and Associated Obesity
Authors: Makuch Rafal , Chrościcka Alicja , Gała Kamil , Czajka Andrzej , Lenard Paweł , Kucharski Adam , Michalska Sara , Pilarski Konrad , Dewicka Martyna , Wawrzyniak Alicja Maria
Published: June 2024

Introduction and objective: Diabetes represents one of the most significant healthcare challenges of the 21st century. The disease is frequently asymptomatic, with patients often remaining undiagnosed for extended periods and failing to seek assistance from healthcare professionals. A sedentary lifestyle, excessive caloric intake, and a lack of physical activity contribute to the development of obesity, which in turn leads to carbohydrate metabolism disorders. In this study, we will examine the relationship between diabetes and obesity, and discuss the drug semaglutide, which is used to treat type 2 diabetes and also promotes weight loss.
Review methods: Review and summary of research studies available in open-source format on Google Scholar, PubMed.
Abbreviated description of the state of knowledge: Numerous clinical studies have demonstrated the efficacy of semaglutide in improving lipid profiles and promoting weight loss. This effect is believed to be mediated by the drug's ability to slow gastric emptying. It is evident that semaglutide, a glucagon-like peptide-1 (GLP-1) analogue, exerts a beneficial effect on carbohydrate parameters and helps to delay the occurrence of complications associated with diabetes.
Summary: A review of clinical reports and conducted studies indicates that semaglutide has the potential to enhance parameters that directly or indirectly impact the quality of life of patients with diabetes. However, the utilisation of the aforementioned pharmaceutical is associated with adverse effects, which may impede patient-physician collaboration and potentially precipitate the development of new health complications in patients. One of the effects of semaglutide treatment is a reduction in appetite, which contributes to weight loss. This property of the drug makes it suitable for use in patients with excessive body weight.
Violencia político electoral tras la firma del acuerdo de paz en Santander. Un análisis de las elecciones generales de 2018 y regionales de 2019
Authors: Alipios Cruz Merchán Camilo , Bonilla Ovallos Maria Eugenia , Perez Guevara Nadia Jimena
Published: June 2024

Este artículo caracteriza la violencia política en los procesos electorales de 2018 y 2019 en el departamento de Santander, tras la firma del Acuerdo de Paz en Colombia, a partir de dos dimensiones analíticas: 1) violencia contra políticos y/o candidatos, líderes y periodistas y; 2) delitos electorales en contextos de violencia armada. Los resultados evidencian que la violencia político electoral en el departamento aumentó en las elecciones regionales de 2019, la “amenaza” es el hecho victimizante más recurrente, las principales víctimas son los líderes y las lideresas sociales y la corrupción al sufragante es el delito electoral más denunciado en zonas de influencia de los grupos armados que continúan activos en el post acuerdo.
Digital government and the handling of sensitive data in the execution of public policies: challenges and possibilities
Authors: Oselame Graf Júlia , Muller Bitencourt Caroline
Published: June 2024

The research aims to investigate the characteristics and risks associated with the handling of sensitive data in the implementation of public policies within the digital government model. To achieve this, a hypothetical-deductive method and bibliographic and documentary procedures are employed, proposing an interdisciplinary discussion on technological advancement, data protection, transparency, and public policies. The justification revolves around the importance of a comprehensive, cohesive system that genuinely protects sensitive personal data, considering the need to keep pace with technological developments and maintain a minimum level of security in the digital age at both national and international levels. There is no doubt that the judicious and strategic use of data has the potential to drive substantial improvements in policy evaluation, decision-making, and the relationship between government and citizens. However, dealing with personal data also means addressing risks with responsibility, transparency, and respect for individual rights.
El invento de Diego de Pantoja (1571-1618) para el aprendizaje del chino mediante partituras musicales
Authors: Ramos Ignacio , García Benito Rubén
Published: June 2024

Diego de Pantoja (1571-1618), jesuita español, contribuyó decisivamente al desarrollo de la transcripción de los caracteres chinos en letras latinas, junto con su indicación de los tonos. Se trata de una versión primitiva del pinyin, un método actual que es clave para el aprendizaje del chino. Su original contribución reside en el uso que hizo del pentagrama musical para facilitar el correcto aprendizaje de los tonos chinos. A pesar de la importancia de su invención, este aspecto de la obra de Pantoja no ha podido ser claramente dilucidado hasta la fecha, tal vez debido a la escasez de fuentes históricas y a su deficiente interpretación. Nuestro estudio analiza meticulosamente fuentes primarias de los periodos Ming y Qing para explorar e interpretar los perfiles básicos del método de transcripción musical creado por Pantoja, y de su relevancia en la historia del diálogo intercultural Oriente-Occidente.
La adenda et corrigenda del Grupo de Puebla al Foro de São Paulo: mantener la promesa política tras el desplome del socialismo del siglo XXI
Authors: timana kure Carlos
Published: June 2024

La conquista del poder por la izquierda ha tenido un carácter internacional desde su génesis en el siglo XIX. Esta aproximación colaborativa permite contextualizar lo que significó el Foro de São Paulo a finales del siglo XX para la izquierda latinoamericana tras la desintegración de la URSS. Por lo que se analiza al Socialismo del siglo XXI como su principal producto, explicando las circunstancias que permitieron su surgimiento en Venezuela, así como su proceso de expansión y crisis, que se vería acentuada por la muerte de los líderes históricos de la izquierda latinoamericana. Finalmente, se presenta al Grupo de Puebla como una respuesta a la iniciativa articuladora de la derecha en América Latina, el Grupo de Lima, indicando por medio de ello los elementos de continuidad y disrupción con el Foro de São Paulo, sirviendo como instancia articuladora de la izquierda en la región.
La Revolución Bolivariana: un proyecto refundacional paradigmático de la izquierda revolucionaria iberoamericana
Authors: Martínez-Meucci Miguel Ángel
Published: June 2024

La Revolución Bolivariana es el proceso político iniciado en Venezuela a finales del siglo XX por Hugo Chávez y perpetuado en el siglo XXI por Nicolás Maduro. Por originalidad, longevidad, impacto interno e influencia exterior, es uno de los proyectos refundacionales más relevantes de la izquierda revolucionaria iberoamericana tras finalizar la Guerra Fría. Sus múltiples rasgos han propiciado diversas caracterizaciones desde la ciencia política. Se ofrece aquí una aproximación general al respecto, mediante una periodización que permite apreciar la evolución en el tiempo del movimiento y régimen chavista; una breve exposición del socialismo bolivariano como propuesta retórico-ideológica; una descripción sucinta del giro desarrollado en política exterior por parte del gobierno venezolano tras asumir la condición de estado revolucionario; y una caracterización general del chavismo-madurismo como movimiento y régimen político, concluyendo que sus rasgos y tendencias totalitarias son las que mejor definen su naturaleza en términos globales.
La evolución de la figura materna en las películas sobre el conflicto irlandés
Authors: Martínez Álvarez Josefina
Published: June 2024

Los cineastas han definido unos estereotipos femeninos y maternos en aquellos filmes dedicados a la violencia política irlandesa desde 1926. La fuerte retórica nacionalista de estas películas ha mantenido casi inmutables los atributos de las madres como mímesis de la patria. Al iniciarse los Procesos de Paz en 1996 y tras la firma de los Acuerdos de Viernes Santo de 1998, directores y guionistas han enriquecido sus narrativas para mostrar la presencia de las mujeres en la esfera pública. La producción de estas películas, realizada en tres países diferentes, Irlanda, Gran Bretaña y Estados Unidos, ha determinado los modelos de la maternidad en consonancia con el imaginario colectivo de los diferentes públicos, influyendo a su vez en la construcción del relato sobre el conflicto armado y las mujeres.
Generalidades teóricas y metodológicas de la gestión del conocimiento en los programas de Derecho e Ingeniería de Sistemas y Telecomunicaciones, Universidad de Manizales
Authors: Montoya Escobar Mónica Cecilia , González Carreño Camilo , Gallego Henao Luz Eliana , Serna Martínez Sandra Lucía , Vega Omar Antonio , Correa Díaz Ana María
Published: June 2024

Así las cosas, en este capítulo se desarrollarán el componente teórico y metodológico que fueron la base y ruta de este estudio
Effects of school-based interventions on blood pressure in obese children: metanalysis
Authors: Wiggers Ester , Costa Gabriel Peinado , Ribeiro Evelyn Helena Corgosinho , Costa Eduardo Caldas , Trapé Átila Alexandre , Guerra Paulo Henrique
Published: June 2024

Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA), a systematic review with metanalysis was conducted to identify and summarize the effects of school-based physical activity interventions that sought to control and / or reduce blood pressure (systolic and diastolic) in children and / or adolescents with overweight and / or obesity. In September 2022, potential studies were searched in five electronic databases (Pubmed, Scielo, Scopus, Sportdiscus, and Web of Science) and in reference lists. Randomized controlled trials conducted in schools with interventions involving physical activity and assessment of systolic and diastolic blood pressure in children and adolescents aged 6 to 19 years with overweight and / or obesity were considered for synthesis. The risk of bias was assessed using an adapted version of the Effective Public Health Practice Project tool (EPHPP). Metanalysis was developed from the random model. Four studies were included. For systolic blood pressure, a summary effect of -0.10 (95% CI: -0.39; 0.19; I2 = 0%) was observed. For diastolic pressure, the metanalysis indicated -0.33 (95% CI: -0.62; -0.04; I2 = 11%). Considering the promising effects on diastolic blood pressure, we suggest the development of more school-based interventions based on physical activity practice for overweight and / or obese populations, which may also add environmental elements, longer duration, multicomponent approaches, and parent / guardian involvement to their strategies.
Coordinating Charging Request Allocation Between Self-Interested Navigation Service Platforms
Authors: Guillet Marianne , Schiffer Maximilian
Published: June 2024

Current electric vehicle market trends indicate an increasing adoption rate across several countries. To meet the expected growing charging demand, it is necessary to scale up the current charging infrastructure and to mitigate current reliability deficiencies, for example, due to broken connectors or misreported charging station availability status. However, even within a properly dimensioned charging infrastructure, a risk for local bottlenecks remains if several drivers cannot coordinate their charging station visit decisions. Here, navigation service platforms can optimally balance charging demand over available stations to reduce possible station visit conflicts and increase user satisfaction. Although such fleet-optimized charging station visit recommendations may alleviate local bottlenecks, they can also harm the system if self-interested navigation service platforms seek to maximize their own customers’ satisfaction. To study these dynamics, we model fleet-optimized charging station allocation as a resource allocation game in which navigation platforms constitute players and assign potentially free charging stations to drivers. We show that no pure Nash equilibrium guarantee exists for this game, which motivates us to study VCG mechanisms both in offline and online settings, to coordinate players’ strategies toward a better social outcome. Extensive numerical studies for the city of Berlin show that by coordinating players through VCG mechanisms, the social cost decreases on average by 42% in the online setting and by 52% in the offline setting.

History: Accepted by David Alderson, Area Editor for Network Optimization: Algorithms & Applications.

Supplemental Material: The online appendix is available at https://doi.org/10.1287/ijoc.2022.0269 .
Timing Is Everything: An Imprinting Framework for the Implications of Leader Emotional Expressions for Team Member Social Worth and Performance
Authors: Levitt Jacob S. , Coutifaris Constantinos G. V. , Green Paul I. , Barsade Sigal G.
Published: June 2024

Leader emotional expressions have profound implications for team members. Research has established that how frequently leaders express positive and negative emotional expressions shapes team member performance through conveying critical social-functional information about team member social worth. Yet, this social-functional approach to emotions has not fully considered how the timing of leader emotional expressions during a team’s lifecycle can also shape the information conveyed to individual team members about their social worth. In this paper, we integrate the social-functional approach to emotions with imprinting theory to propose that the temporal context of leader emotional expressions has performance implications for individual team members through two distinct facets of social worth: respect and status. Specifically, our imprinting framework explains how positive leader emotional expressions during the early team phase have the most beneficial performance implications through imprinting respect in individual team members. We then propose that these positive implications are amplified by more-frequent-than-average negative leader emotional expressions during the midpoint phase. When filtered through earlier positive expressions, negative emotional expressions during the midpoint phase may signal opportunities for respect and status gains rather than respect and status losses. We find general support for our model in a preregistered four-wave longitudinal archival study of 9,968 team members on 234 consulting teams at a leading professional services company and a four-wave longitudinal field study at a NCAA Division 1 sports program including 245 student-athletes and 86 coaches on 20 varsity teams. Our work highlights that the temporal context of leader emotional expressions is an important performance predictor through social worth.

Supplemental Material: The online appendix is available at https://doi.org/10.1287/orsc.2023.17390 .
The Effect of Ultrasound-guided Central Venous Catheterization on Complications and Success Rate in Critically Ill Children: A Multicenter Study
Authors: Emeksiz Serhat , Kendirli Tanıl , Yıldızdaş Dinçer , Yaman Ayhan , Ödek Çağlar , Boşnak Mehmet , Bayraktar Süleyman , Ağın Hasan , Anıl Ayşe Berna , Kutlu Nurettin Onur , Arslan Gazi , Bayrakçı Benan , Kalkan Gökhan , Dursun Oğuz , Sevketoglu Esra , Azapağası Ebru , Perk Oktay , Yılmaz Hayri
Published: June 2024

Objective: The aims of this study were to compare the results of ultrasound (US) guidance and the landmark (LM) technique for central venous catheter (CVC) placement in pediatric intensive care units (PICUs) as performed by clinicians.

Material and Methods: The patients were divided into two groups according to the technique used: an LM group (459 patients) and a US-guided group (200 patients). We evaluated the success rate, the number of attempts, and the complication rates based on each patient’s age and weight.

Results: The time required for the successful placement of the CVC was significantly different between the two groups: 10.9±10.8 min in the LM group and 8.1±7.6 min in the US-guided group (p=0.012). Additionally, the average number of attempts for successful catheterization was 1.8±0.8 in the US-guided group; and 2.5 ± 1.4 in the LM group (p=0.024). A total of 115 (17.3%) complications were noted: 24 (3.6%) in the US-guided group and 91 (13.7%) in the LM group (p=0.014). The frequency of complications decreased as the age and weight of the patients increased. When the inserted catheters used by ultrasound were evaluated, 59.5% of them were placed by clinicians who had ultrasound training while 40.5% were inserted by clinicians who did not have ultrasound training. There was no significant difference in the complication rate, number of punctures, and success rates between the ultrasound-trained and untrained clinicians (p=0.476).

Conclusion: This is the largest multicenter study comparing the US-guided vs. LM technique for CVC placement in children. We believe that the US-guided CVC procedure is more safe and takes less time than the LM technique. Also, point-of-care ultrasound is useful, beneficial, and easily available for pediatric intensivists.