bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating the influence of groundwater on the in-situ behaviour of Poisson's ratio using downhole array data
Authors: He Hong-Jun , Miao Yu , Shi Yang
Published: November 2024

Poisson's ratio is a commonly used parameter in geotechnical engineering research. Although most studies on its dynamic behaviour have been performed using laboratory tests, which are not necessarily representative of the anticipative soil behaviour in practice, especially nonlinear behaviour. By contrast, the in-situ studies using seismic data are limited and inadequate. Hence, in this study, we first performed the in-situ estimations of Poisson's ratios at various strains for seven research cases by applying seismic interferometry to seismic data from three seismic downhole arrays. Then, we proposed a proxy named equivalent water content, Weq, which was calculated by using site information and used to evaluate the influence of groundwater. Finally, by calculating the Weq for each research case, the in-situ dynamic behaviours of Poisson's ratio and the ratio between compression and shear wave velocities were investigated for sites with low shear stiffness and high water content. It was found that there were significant relationships between the proposed proxy and the in-situ behaviours of Poisson's ratio and the ratio between compression and shear wave velocities. The small-strain Poisson's ratio and the ratio between small-strain compression and shear wave velocities increased with Weq at the change rates, which gradually decreased and increased, respectively. The nonlinear variation of Poisson's ratio at each shear strain decreased with increases in Weq and shear modulus ratio at the change rates, which gradually decreased and increased, respectively. By constructing an analysis model, three formulae were further proposed to describe the above relationships, which can be utilized to build the empirical equations for preliminarily estimating the small-strain Poisson's ratio, the ratio between small-strain compression and shear wave velocities and the nonlinear variation of Poisson's ratio without requiring compression wave velocity.
Crustal and uppermost mantle structure of the Iranian Makran subduction zone from ambient noise and earthquake surface wave tomography
Authors: Mehrdar Ali , Motaghi Khalil , Ghods Abdolreza , Sobouti Farhad , Priestley Keith , Pachhai Surya , Shabanian Esmaeil , Zarunizadeh Zahra , Zeynaddini-Meymand Reza , El-Hussain Issa
Published: November 2024

The Makran subduction zone is a distinctive segment within the Alpine–Himalayan system, where one of the final remnants of the once-expansive Neo-Tethys Ocean is being subducted beneath the Eurasian Plate. Limited seismic data has left several questions unanswered about the structure of the subducting oceanic lithosphere, the transition from the wide and thick Makran accretionary prism to the Zagros Collision Zone, variations in sedimentary cover thickness along and perpendicular to the accretionary prism, and fluctuations in the thickness of sedimentary cover within the fore-arc Jaz Murian Depression (JMD). In this study, we utilize ambient-noise and earthquake surface wave tomography within a period range of 5–50 s to construct a high-resolution 3-D shear-wave velocity model down to a depth of 60 km for the Iranian Makran and northern Oman. Using a new data set from 65 seismic stations located in southeastern Iran and northern Oman, our analysis reveals a sharp velocity contrast within the oceanic lithosphere of the Gulf of Oman, just north of Muscat, with abnormally low-velocity oceanic lithosphere extending westward from this contrast, revealing subduction of a segmented oceanic lithosphere beneath the Makran. Our study finds no lithospheric-scale seismic velocity contrast along the Zendan-Minab-Palami fault, as usually thought as a transition boundary between the Zagros and Makran. Our velocity model shows that the wide accretionary prism of western Makran consists of two zones: a southern low-velocity zone associated with younger sediments and a northern high-velocity zone corresponding to older sediments. A considerable thinning of the sedimentary cover is observed east of longitude 59°E within the coastal Makran tectono-stratigraphic unit, aligning with the structural trend of the Pan-African Semail Gap Fault observed both onshore and offshore Oman. Additionally, a thick sedimentary basin is located beneath the eastern section of the JMD, with the thickness decreasing towards the west.
Development partner influence on domestic health financing contributions in Senegal: a mixed-methods case study
Authors: Federspiel Frederik , Borghi Josephine , Mbaye Elhadji Mamadou , Jensen Henning Tarp , Martinez Alvarez Melisa
Published: November 2024

Sustainable and equitably contributed domestic health financing is essential for improving health and making progress towards Universal Health Coverage (UHC) in low- and middle-income countries. In this study, we explore the pathways through which development partners influence the combination of domestic health financing sources in Senegal. We performed a qualitative case study that comprised 32 key stakeholder interviews and a purposive document review, supplemented by descriptive statistical analysis of World Health Organization and Organization for Economic Cooperation and Development data on health financing sources in Senegal. We developed a novel framework to analyse the different mechanisms and directions of development partner influence on domestic health financing contributions. We identified development partner influence via four mechanisms: setting aims and standards, lobbying/negotiation, providing policy/technical advice, and providing external financing. Overall, development partners worked to increase tax-based government contributions and expand Community-Based Health Insurance (CBHI), which is seemingly equity enhancing. Fungibility and intrinsic equity issues related to CBHI may, however, limit equity gains. We encourage stakeholders in the health financing sphere to use our framework and analysis to unpack how development partners affect domestic health financing in other settings. This could help identify dynamics that do not optimally enhance equity and support progress towards UHC to help achieve more coherent policy-making across all domains of development partner activities in support of UHC. Future research should investigate the role of international creditors, lending, and loan conditionalities on domestic health financing in recipient countries, including equity implications.
Industry influence on public health policy formulation in the UK: a complex systems approach
Authors: van den Akker Amber , Fabbri Alice , Bertscher Adam , Gilmore Anna B , Knai Cecile , Cavill Nick , Rutter Harry
Published: November 2024

Unhealthy commodity industries (UCIs) such as tobacco, alcohol, gambling, ultra-processed food and beverage producers are known to influence policy-making to advance their interests, often to the detriment of public health goals. This study mapped the complex system underpinning UCI’s influence on public health policy formulation in the UK and identified potential interventions to shift the system towards being able to better attain public health goals. We conducted a participatory systems mapping workshop with ten experts to build a causal loop diagram (CLD) and identify potential interventions to address UCI’s influence on public health policy development. The resulting CLD depicts a highly interconnected and reinforcing system driving UCI’s involvement in public health policy formulation across five thematic areas. Among the most connected elements were the ‘dominance of market mechanisms’, ‘perception of partnership as good governance principle’, ‘industry involvement lending perceived legitimacy to the policy formulation process’, ‘industry is seen as part of the solution’ and ‘industry ties to policy-makers’. Participants identified a total of 22 interventions within this system. Analysis of the CLD and interventions identified the potential for two key paradigmatic changes in this complex system: de-normalizing the perception of unhealthy commodity industry actors as legitimate stakeholders in policy formulation; and prioritizing public health and wellbeing objectives over profit and economic gain. In order to shift the system towards better attaining public health goals, interventions should reinforce each other and be supportive of these two key paradigmatic shifts.
A thematic analysis of tobacco industry responses to the Scottish Government’s consultation on e-cigarette regulation
Authors: Hamilton Billie , Ponsford Ruth , Hartwell Greg
Published: November 2024

E-cigarette use is increasing rapidly across the world. Governments have begun to tighten regulation principally to prevent uptake by young people and non-smokers. As tobacco industry ownership of the e-cigarette market grows, it is important to be aware of how industry is seeking to influence the regulation of e-cigarettes. Using thematic analysis, this research examines the explicit arguments and implicit tactics used in responses from the tobacco industry and linked organizations to Scotland’s 2022 consultation ‘Vaping Products—Tightening Rules on Advertising and Promoting’. The themes that emerged in the analysis were compared to tactics and arguments identified in past research on the tobacco industry to look for continuations and divergences. While the research finds continuation of historic arguments and tactics being used in the submissions, it also highlights important novel tactics and framings employed by tobacco industry actors, including incorporating outdated data and calling for UK-wide policy despite this being a devolved issue. Policymakers must remain alert to the strategies being used by the tobacco industry, so they are able to prioritize public health rather than the interests of industries that put profit before health.
Addressing the commercial determinants of mental health: an umbrella review of population-level interventions
Authors: Tompson Alice , Alkasaby Muhammed , Choudhury Tahrima , Dun-Campbell Kate , Hartwell Greg , Körner Katherine , Maani Nason , van Schalkwyk May C I , Petticrew Mark
Published: November 2024

There is increasing evidence that commercial determinants impact mental health. Addressing the commercial determinants may therefore be a way of improving population-level mental health. This umbrella review aimed to provide an overview of evidence in this field and identify knowledge gaps. Five databases (MEDLINE, Embase, PsycINFO, Scopus and Cochrane Library) were searched on the 18/19 of July 2022. Eligible papers were systematic reviews published after 31 December 2011. No geographical limits were applied. Eligible interventions were those that targeted the behaviours or products of commercial actors. Ineligible interventions included individual behaviour change interventions, such as those seeking to educate consumers. Included mental health outcomes were anxiety, depression, self-harm and suicide, whilst surrogate outcomes included product consumption. Industry involvement and the quality of included reviews (critical components of A MeaSurement Tool to Assess systematic Reviews - AMSTAR 2) were assessed. A narrative synthesis was used to compare the findings by industry, and a typology of interventions was developed. Eight reviews with mental health outcomes were included, each with multiple methodological weaknesses. There is some evidence that reducing the availability of alcohol or pesticides may lower suicide rates. Despite the known links, no evidence on the mental health impacts of population-level interventions tackling the social media, tobacco, gambling and ultra-processed foods industries were located. All gambling reviews were identified as having links to industry. Future high-quality evaluations of commercial determinants interventions developed specifically with the aim of achieving positive mental health outcomes and/or that evaluate mental health outcomes and are free from industry links are needed.

PROSPERO ref. number CRD42022346002.
Adverse effects of antidepressants and monitoring practices in adult patients at a psychiatric outpatient department of Tikur Anbessa Specialized Hospital: a cross-sectional study
Authors: Muhammed Oumer Sada , Hassen Minimize , Tages Haneal
Published: November 2024

Background

Available studies showed that antidepressants (ATDs) and antipsychotics are most frequently associated with adverse effects (AEs), which account for ~90% of all AEs in the psychiatry department. These AEs can range from mild to serious or potentially lethal events and pose a significant threat to the physical and mental well-being of patients leading to decreased quality of life, reduced drug adherence, and increased healthcare costs.

Objective

This study aimed to assess the prevalence of self-reported ATD-related AEs among patients attending the psychiatric outpatient department (OPD) at Tikur Anbessa Specialized Hospital (TASH), Ethiopia, and examine current monitoring practices and corrective measures undertaken.

Method

A hospital-based cross-sectional study was conducted in the psychiatric OPD of TASH from 1 April 2023 to 30 May 2023. Descriptive analysis was done to summarize the quantitative data. Logistic regression analysis was performed to identify predictors of occurrence of ATD-related AEs.

Results

The overall prevalence of self-reported ATD-related AEs was 51.3%. The two most reported classes of ATDs were selective serotonin reuptake inhibitors (52.8%) and tricyclic ATDs (47.2%). Across all the utilized ATDs, sedation (46.2%), dry mouth (31.4%), constipation (21.8%), and sexual dysfunction (18.6%) were the most frequently exhibited AEs. Alas, roughly 60.3% of patients have never been asked by healthcare providers about their AEs. When AEs occurred, only 21.2% of patients consulted healthcare professionals for genuine guidance and support. Old age (odds ratio (OR) = 2.84, 95% confidence interval (CI) 1.09–7.40), duration of treatment of >1 year (OR = 2.17, 95% CI 1.07–4.43), daily ingestion of more than five pills (OR = 3.82, 95% CI 0.99–14.76), presence of asthma (OR = 3.45, 95% CI 1.02–11.68), and taking other psychotropic agents (OR = 2.92, 95% CI 1.40–6.07) were significantly associated with the occurrence of ATD-related AEs.

Conclusion

This study unveiled a high prevalence of AEs among patients taking ATDs. Advanced age, long treatment duration, daily ingestion of more than five pills, presence of asthma, and taking other psychotropic medications were predictors of ATD-related AE occurrence.
Impact of Multicohort Human Papillomavirus Vaccination on Cervical Cancer in Women Below 30 Years of Age: Lessons Learned From the Scandinavian Countries
Authors: Nygård Ståle , Falkenthal Thea Eline Hetland , Sture Tina , Lynge Elsebeth , Elfström Miriam , Nygård Mari
Published: November 2024

In Scandinavia, human papillomavirus (HPV) vaccination programs started in 2007–2008 in Sweden and Denmark with HPV vaccination offered to multiple cohorts of young girls, while in Norway this was offered to a single cohort only. Interestingly, in Sweden and Denmark, cervical cancer incidence in young women decreased markedly from 2017 to 2018, while in Norway a steady increase was seen until 2020. As the 3 countries are very similar in other factors important for cervical cancer incidence rates, like cervical cancer screening, the observed difference is most likely due to differences in the multicohort vaccination.
skycurtains: model-agnostic search for stellar streams with Gaia data
Authors: Sengupta Debajyoti , Mulligan Stephen , Shih David , Raine John Andrew , Golling Tobias
Published: November 2024

We present skycurtains, a data-driven and model-agnostic method to search for stellar streams in the Milky Way galaxy using data from the Gaia telescope.skycurtains is a weakly supervised machine learning algorithm that builds a background enriched template in the signal region by leveraging the correlation of the source’s characterizing features with their proper motion in the sky. The minimal model assumptions in the skycurtains method allow for a flexible and efficient search for various kinds of anomalies such as streams, globular clusters, or dwarf galaxies directly from the data. We test the performance of skycurtains on the GD-1 stream and show that it is able to recover the stream with a purity of 75.4 per cent which is an improvement of over 10 per cent over existing machine learning-based methods while retaining a signal efficiency of 37.9 per cent.
Single-stranded DNA with internal base modifications mediates highly efficient knock-in in primary cells using CRISPR-Cas9
Authors: Kanke Karen L , Rayner Rachael E , Bozik Jack , Abel Eli , Venugopalan Aparna , Suu Ma , Nouri Reza , Stack Jacob T , Guo Gongbo , Vetter Tatyana A , Cormet-Boyaka Estelle , Hester Mark E , Vaidyanathan Sriram
Published: November 2024

Single-stranded DNA (ssDNA) templates along with Cas9 have been used for knocking-in exogenous sequences in the genome but suffer from low efficiency. Here, we show that ssDNA with chemical modifications in 12–19% of internal bases, which we denote as enhanced ssDNA (esDNA), improve knock-in (KI) by 2–3-fold compared to end-modified ssDNA in airway basal stem cells (ABCs), CD34 + hematopoietic cells (CD34 + cells), T-cells and endothelial cells. Over 50% of alleles showed KI in three clinically relevant loci (CFTR, HBB and CCR5) in ABCs using esDNA and up to 70% of alleles showed KI in the HBB locus in CD34 + cells in the presence of a DNA-PKcs inhibitor. This level of correction is therapeutically relevant and is comparable to adeno-associated virus-based templates. The esDNA templates did not improve KI in induced pluripotent stem cells (iPSCs). This may be due to the absence of the nuclease TREX1 in iPSCs. Indeed, knocking out TREX1 in other cells improved KI using unmodified ssDNA. esDNA can be used to modify 20–30 bp regions in primary cells for therapeutic applications and biological modeling. The use of this approach for gene length insertions will require new methods to produce long chemically modified ssDNA in scalable quantities.
Socioeconomic Variation in Tobacco Smoking Among the Adult Population in Ireland
Authors: Valentelyte Gintare , Sheridan Aishling , Kavanagh Paul , Doyle Frank , Sorensen Jan
Published: November 2024

Introduction

Differences in smoking prevalence across socioeconomic groups are a major driver of health inequalities. Although smoking prevalence continues to decline across most developed countries, socioeconomic inequalities in smoking still persist. While Ireland is among a small number of countries with a tobacco-endgame goal set to achieve a smoking prevalence of 5% by 2025, the challenge this presents by socioeconomic status is uncharted.

Aims and Methods

We analyzed how differences in smoking status across various socioeconomic groups have changed over time in the adult population in Ireland. We used cross-sectional smoking data from the national population-based Healthy Ireland Survey for 2015–2022 (n = 52 494). Educational attainment and area-based deprivation were used as socioeconomic indicators. Socioeconomic differences and changes in inequality over time were identified using the relative index of inequality (RII). Multinomial logistic regression was used to analyze the association between socioeconomic status and daily smoking, occasional smoking, former smoking, and never smoking with adjustment for sex, age, and survey year.

Results

We observed the highest daily smoking rates among the least educated (OR = 11.62; 95% CI = 9.91, 13.63) and individuals living in the most deprived areas (OR = 4.23; 95% CI = 3.55, 5.04). Additionally, we identified significant relative smoking inequalities over the observation period continued to increase, among the least educated (RII = 2.86, 95%CI = 2.63, 3.09) and individuals living in the most deprived areas (RII = 2.64, 95% CI = 2.36, 2.93)

Conclusions

Despite generally reducing smoking prevalence, socioeconomic inequalities continue to widen among the smoking population in Ireland.

Implications

As the tobacco endgame deadline of 2025 is fast approaching, this study highlights the urgent need to consider potential effects across the lowest socioeconomic status groups when implementing equity-oriented tobacco control policies.
Impact of Hispanic Ethnicity on Adolescent Tobacco Use Estimates in the United States
Authors: Mantey Dale S , Perez Adriana , Wilkinson Anna V , Clendennen Stephanie L , Montgomery LaTrice , Harrell Melissa B
Published: November 2024

Introduction

National estimates of tobacco use are reported by racial category after excluding all individuals who identify as Hispanic (e.g., non-Hispanic [NH], Black, and NH-White). In this study, we assess the impact of excluding Hispanics from racial categories on national estimates of youth tobacco use in the United States.

Aims and Methods

We pooled four years of Youth Risk Behavioral Surveillance Survey (YRBSS) data (2015–2021). Participants were n = 60 327 high school students (9–12th grade). We report the prevalence of past 30-day (current) use of cigarettes, cigars, smokeless tobacco, and electronic cigarettes, stratified by racial category: (1) American Indian/Alaskan Native (AI/AN); (2) Asian; (3) Black; (4) Native Hawaiian/Other Pacific Islander (NHOPI); (5) White; (6) multiracial; and (7) unspecific. Within racial category, we compared the prevalence for each product between NH and Hispanic youth; comparisons controlled for sex, grade, and year.

Results

Descriptively, the majority of AI/ANs (75.6%) and Pacific Islanders (58.9%) identified as Hispanics, as did a minority of multiracial (20.6%), White (14.6%), Black (8.2%), and Asian (7.9%) youth. Prevalence estimates were significantly greater for all four tobacco products among Hispanic-Asian and Hispanic-Black youth, relative to their NH counterparts. Conversely, tobacco use was lower among Hispanic-White youth relative to NH-Whites.

Conclusions

Systematically removing Hispanics from classification within each racial category results in an underestimation of tobacco use among Asian and Black youth, an overestimation of tobacco use among White youth, and unstable estimates among AI/AN and NHOPI youth. These findings challenge the utility of the “race/ethnicity” variable in the study of youth in the United States.

Implications

Findings highlight the need to reconsider the operationalization of “race/ethnicity” which currently excludes Hispanics from each racial category. Hispanic ethnicity appears to function as a “within-group” difference; the study of these within-group differences may provide unique insights into tobacco use disparities.
From Smoking to Vaping: The Motivation for E-cigarette Use at the Neurobiological Level—A Functional Magnetic Resonance Imaging Study
Authors: Grundinger Nadja , Andreas Marike , Lohner Valerie , Schneider Sven , Mons Ute , Vollstädt-Klein Sabine
Published: November 2024

Introduction

Electronic cigarettes (e-cigarettes) are considered a potential aid for smoking cessation. This study investigates the neurobiological mechanisms underlying the motivational properties of e-cigarettes compared to tobacco cigarettes and provides insights into their addictive potential and implications for smoking cessation.

Aims and Methods

The study included 47 daily e-cigarette users, the majority of whom were former smokers (n = 43), and 28 nicotine-naïve participants as controls. Among the e-cigarette users, 32 individuals currently used e-cigarettes exclusively, while 15 also used tobacco cigarettes (dual users). Functional magnetic resonance imaging was used to examine anticipatory brain activation to reward-predictive stimuli for money, e-liquid, or tobacco cigarettes, as well as the instrumental response to obtain each reward.

Results

Exclusive e-cigarette users demonstrated increased activation in limbic regions, for example, the nucleus accumbens, during the anticipation of e-liquid and money over tobacco cigarettes. Prefrontal regions showed greater activation during the anticipation of money compared to e-liquid or tobacco cigarettes. Dual users showed greater activation for money compared to tobacco cigarettes in the hippocampal limbic system. No significant differences were observed in the anticipation of e-liquid and tobacco cigarettes among dual users.

Conclusions

E-cigarettes are perceived as equally rewarding as money, highlighting their addictive potential. Among exclusive e-cigarette users, money and e-liquid have stronger motivational properties than tobacco cigarettes (even among former smokers), suggesting that e-cigarettes may be an effective tool for tobacco cessation. The comparable appeal of e-liquid and tobacco cigarettes among dual users may suggest that a complete switch to e-cigarettes may be more effective for smoking cessation.

Implications

It is important to understand the motivational properties of e-cigarettes, particularly compared to traditional tobacco products. E-cigarettes with little or no addictive potential might not be effective as a substitute for tobacco cigarettes; however, a high addictive potential would, conversely, pose a risk to nonsmokers. Our data suggest that e-cigarettes have a sufficiently high addictive potential to make them an attractive alternative for smokers, especially if they switch completely from tobacco to e-cigarettes.
The 1970s: Neoconceptualism and the Future of Tort Law
Authors: White G Edward
Published: November 2024

For those inclined to adopt a cyclical view of history, the course of scholarship in tort law over the past hundred years might furnish a source of stimulation. We have seen, emerging in the late nineteenth century and cresting in the early twentieth, impulses toward the conceptualization of the subject of Torts and the espousal of overarching theories of tort law; and then, beginning in the early years of the twentieth century and becoming dominant in the 1930s and 1940s, a reaction against conceptualism, an atomizing of the subject of Torts, and a resistance to comprehensive theorizing. One can also see, beginning irregularly in the 1960s and gaining considerable momentum in the 1970s, the rebirth of conceptualist perspectives. Literature that can fairly be called neoconceptualist has begun to dominate recent Torts scholarship, and while the theoretical offerings of contemporary scholars bear little resemblance as manifestos of social policy to the offerings of Holmes and his nineteenth-century contemporaries, they represent a distinct break with the intellectual assumptions of the Realists and the consensus thinkers of the 1950s. Comprehensive, abstract, generalized theory has reappeared in Torts literature.
Melodic Techniques
Authors: Maler Anabel
Published: November 2024

Theories of melody are based on the notion that musical melodies involve pitches and the intervals between pitches; however, sign language music does not necessarily involve sounding pitch. This chapter argues that the concept of melody is still useful for understanding and analyzing sign language music, when melody is understood in terms of common melodic competence within a given culture: in other words, what everybody sings. It provides a fundamental definition of sign language melody as involving the directed, purposeful movement of the body through the signing space, which uses movements and holds to create dynamic, kinetic lines. Using ten different signed performances of “The Star-Spangled Banner,” the chapter explores the elements that characterize signing melodic behavior, as well as the elements that define a melodic signing voice. The chapter closes with an extended analysis of Rosa Lee Timm’s interpretation of the song “Blown Away,” revealing how a signer’s melodic lines can shape the form of a song, and provides a framework for understanding sign language polyphony.
Reorienting the Collection
Authors: Martelli Francesca K. A.
Published: November 2024

Chapter 3 looks to the heart of ad Fam., where we find a strange anomaly in the collection’s pattern of authorship, which elsewhere consists largely of letters penned by Cicero to other people: Fam. 8 reverses this pattern insofar as it consists entirely of letters penned by someone else to him. This chapter traces what it means to find the other side of a correspondence systematically represented within this central book. It shows how the evacuation of the Ciceronian author from this central point in the collection is complemented by a striking metaphor that emerges within Fam. 8: Caelius’s repeated references to the games that he is beholden to host as a newly elected aedile, and comparison of the feud unfolding between Caesar and Pompey to a spectacle entertainment, evoke, for imperial readers, the anachronistic image of the amphitheatre. This image provides a suggestive metaphor for the kinds of spectacle that the letters afford once assembled and published in the new medium of the codex, which imposes a concrete form on the ad Fam. that resembles the amphitheatre, and which makes the letters available for a wider readership, much as the arena facilitates mass entertainment in the imperial age.
Data Ethics and the Power of Data
Authors: César Caballero Reinoso
Published: November 2024

César Caballero Reinoso provides his perspective as both a practitioner and a generator of data who spanned analytical and policy roles both in and out of government. A former director of the Colombian census bureau (DANE) and a pollster, Caballero reflects on the importance of data and decision-making transparency and standing one’s ground in the face of seduction by—and pressure from—powerful political actors. Caballero describes how he set and adhered to clear moral standards and redlines which he would not cross, even while coping with risks as extreme as death threats, among other forms of retaliation. When he decided to quit his government position to avoid compromising his values, he started a survey company and continued to follow his ethical north star. Working with his employees, he veered into “partnered engagement” by developing an inclusionary and participatory process for them to collectively decide on their preferred research topics and policy engagement approaches. Caballero’s experience also serves as a source of inspiration: if he could make responsible engagement choices under such real-world and personal pressures, then scholars facing less intense dynamics during their research and engagements can do so as well.
Motive, Belief and Desire
Authors: Strawson P. F. , Dancy Jonathan
Published: November 2024

Lecture 5 discusses the question: what is a motive? Motivation is a combination of belief and desire. A moral theory must say more about motivation. Start from the familiar antitheses good/bad and right/wrong. The desire to do the right, the rightness-desire, can occur with incompatible desires. If goodness is to be the ultimate ethical concept, it must include the idea of obligation as part of its meaning: if justice is good, we ought to be just. So both approaches require that the desire to do what one ought is part of ethical motivation.
The Epistemological Question
Authors: Strawson P. F. , Dancy Jonathan
Published: November 2024

Lecture 11 addresses the question of how we come to have the ideas expressed by ‘good’, ‘right’, and so on. They are defined in terms of the fundamental moral experiences of guilt, approval, and disapproval. Strawson distinguishes between real and verbal knowledge: real knowledge requires experience of obligation, guilt, approval, disapproval. General moral knowledge is based on experience; but there are always exceptions to moral generalisations, except to the rule that what I feel morally obliged to do is right. General moral propositions should be of the form: ‘acts of this type tend as such to be right/wrong’. Strawson discusses Broad on the materially right and the formally right. Objections to moral intuitionism are presented: (1) the absence of introspective evidence, (2) fallibility argument, (3) connection between moral concepts, (4) motivation argument, (5) subjective duty argument, (6) necessary connexion, (7) exceptions and tendencies to be right.
Selvester Score as a Predictor of Left Ventricular Systolic Function Recovery in ST-Segment Elevation Myocardial Infarction (STEMI) Patients with Reduced Ejection Fraction after Revascularization; MUST Egypt
Authors: Tamara Ahmed Fathy , Hamid Ibrahim Ibrahim Abdel , Tantawy Mahmoud Ahmed , Abdel Fattah Alaa Ahmed
Published: November 2024

Background

Ischemic heart disease is the most common contributor to left ventricular dysfunction. The extent of left ventricular (LV) function varies considerably among patients with extensive coronary disease. Clinical, demographic, and angiographic characteristics differ among patients and are predictive of LV ejection fraction has not been determined. Early identification, preferably in the emergency department (ED), of patients at the highest risk for developing left ventricular (LV) dysfunction could serve to inform the use of certain therapies.

Objective

To assess the correlation between the Selvester score and the myocardial dysfunction by echocardiography to predict left ventricular dysfunction improvement in patients with anterior STEMI and reduced EF.

Patients and Methods

This prospective observational study was done on 54 patients with acute anterior STEMI with LVSD. All patients were subjected to full history taking a full general examination Further, reperfusion strategy, twelve lead surface ECG, and echocardiography data were performed for all patients.

Results

The difference in the Selvester Score on discharge and after three months showed no statistically significant correlation with LV dysfunction improvement. The studied patients demonstrated a cut-off point of ≥ 7 for the Selvester Score at discharge, the ROC analysis revealed a sensitivity of 85.71% and a specificity of 100.00%. The positive predictive value (+PV) is 100.0%, while the negative predictive value (-PV) is 79.2%.

Conclusion

Our findings may aid in the clinical management of patients with anterior STEMI in the early stages of their hospitalization. A high Selvester score at hospital admission can predict non-improvement of EF but can't be used alone as a follow-up after 3 months as a predictor of function improvement without Echocardiography.
Comparison of Sample Adequacy and Diagnostic Yield of Auto-Aspiration and Manual Aspiration Techniques in Ebus-TBNA
Authors: Elfattah Nevine Abd , Mohamed Mohamed , Emam Wael , Kandil Mahmoud
Published: November 2024

Background

The manual aspiration technique involving high suction force is a new method for EBUS-TBNA. However, its application in EBUS-TBNA has been controversial, and consensus guidelines do not answer this specific question.

Aim of the Work

This study aimed to compare the diagnostic yield and sample volume of EBUS- TBNA using standard auto-aspiration and novel manual aspiration techniques.

Patients and Methods

48 patients with undiagnosed mediastinal lymphadenopathy or centrally located lung tumors were randomized in a 1:1 manner into 2 equal groups regarding aspiration technique: Group 1 underwent EBUS-TBNA with standard auto-aspiration technique, and Group 2 underwent EBUS-TBNA with novel manual aspiration technique. Diagnostic yield and sample volume were compared between the two groups.

Results

The manual aspiration group showed significantly better diagnostic yield (p = 0.039), with a diagnosis in 91.7% of patients compared to 62.5% in the auto-aspiration group. The manual aspiration group also had a significantly higher sample volume (p < 0.001), with a mean sample volume of 12.80±1.20 mm3 compared to 9.76±1.31 mm3 in the auto-aspiration group.

Conclusion

The manual suction sampling technique via EBUS-TBNA achieved a higher sample volume and diagnostic yield than the auto suction sampling technique. Therefore, we suggest using manual suction sampling technique in the EBUS-TBNA procedure as it appears to be a promising, easy, no-cost, and safe technique variation. This study adds useful information to the technique of EBUS-TBNA and has potential practice-changing implications.
The Value of Rapid On-Site Evaluation during Conventional and Endobronchial Ultrasound Needle Aspiration in Diagnosis of Mediastinal Lymphadenopathy and Lung Cancer
Authors: AbdelDayem Aya , ELMaraghi Ashraf , Ali Maryam , Samy Fatma , Magdy Omnya
Published: November 2024

Background

ROSE EBUS-TBNA is a useful technique that has revolutionized the field of pulmonology. Developed initially for detecting metastasis in lung cancer patients, it is currently used in the diagnosis of sarcoidosis, tuberculosis (TB), and lymphoma. ROSE, which has been a game changer for the pathologists, helps to act as a guide for assessing the adequacy and accuracy of the sample and aid in rapid decision-making.

Aim of the Work

The aim of the study was to evaluate the value of ROSE during EBUS-TBNA and C.TBNA in the diagnosis of mediastinal lymphadenopathy and lung cancer.

Patients and Methods

Our study was a prospective study where we studied 60 cases were divided into two equal groups ROSE group and Non-ROSE group underwent either Conventional TBNA or EBUS TBNA

Results

The total diagnostic yield of Conventional and EBUS TBNA in both groups were 83.3% (50/60 cases). 28 cases (46.7%) positive for malignancy, 22 cases (36.6%) were positive for benign lesion, and 10 cases (16.6%) were not conclusive. Regarding diagnostic accuracy, it was higher in ROSE group than non-ROSE group (100% in ROSE group vs. 66.7% in non-ROSE group)

Conclusion

ROSE during Conventional or EBUS-TBNA improve diagnostic accuracy of mediastinal lesions by excluding suspicious or nondiagnostic specimens and can reduce unnecessary punctures or eliminate the need for additional bronchoscopic procedures when reaching to preliminary diagnosis
Molecular Detection of Helicobacter pylori Clarithromycin Resistance in Stool Samples
Authors: Kassem Névine Nabil , Kamel Eman Mohammed , Saber Sally Mohammed , Elsayed Engy Yousry , Mohamed Menna Allah Samir , Abdelhalim Rania Mohamed
Published: November 2024

Background

Helicobacter pylori is a spiral-shaped bacterium that grows in the digestive tract. Helicobacter pylori infection has a very high prevalence, and may be present in more than half of the world’s population. In developing countries, children are very commonly infected. Helicobacter pylori may be passed from person to person through direct contact. Risk factors for Helicobacter pylori infection are related to living in crowded conditions without a reliable supply of clean water.

Aim of Work

The aim of the present study is to detect point mutations associated with Helicobacter pylori clarithromycin resistance in stool samples using real- time PCR to help clinicians in proper management of H. pylori infected patients.

Methodology

This cross-sectional study included fifty patients with symptoms consistent with Helicobacter pylori infection who attended the endoscopy unit of the Hepatology, Gastroenterology, and Infectious Disease Department, Ain Shams University Hospitals from December 2019 till May 2020.

Results

The results revealed high resistance rate of clarithromycin (46%), of which A2143G was (28%) and A2142G was (18%). There was no significant difference between clarithromycin resistance detection among males and females. There was no statistically significant correlation between Clarithromycin resistance and age.

Conclusion

This study revealed increase rate of clarithromycin-resistant H. pylori (46%) and was mainly associated with the A2143G point mutation. A2142G point mutation was also detected. There was no significant association between age and gender of the patients with clarithromycin resistance. clarithromycin- containing H.pylori eradication therapy might not be recommended as empirical therapy in Egypt.
A Clinicodemographic Analysis of Egyptian Females Condyloma Accuminata Patients
Authors: Lotfi Ranya Adel , El-Husseiny Rania Mahmoud , Sayed Ahmed Selem Eman Ibrahim
Published: November 2024

Background

Human papillomavirus (HPV) is the most common viral infection of the reproductive tract in women and men. Although most HPV infections resolve spontaneously, persistent infections can lead to precancerous lesions and cancer of the cervix, vagina, vulva, anus and penis. HPV related cancers accounted for an estimated 4.5% of all cancers worldwide in 2012.

Objective

To describe the patients’ demographic features, clinical presentations, sexual aspects, and possible risk factors of codyloma accuminata among female patients treated at Dermatology, venereology and Andrology outpatient clinics of Ain Shams University hospitals and Al-Houd Al-Mrsoud hospital, Cairo, Egypt.

Patients and Methods

This prospective cross sectional clinical study was conducted on 500 female patients aged above 18 years old with condyloma accuminata.

Results

Most of the studied patients (71.2%)gave a history of no condom use, (13.7%) of patients gave history of occasional condom use while the rest 7.5% weren’t sexually active. Most of the patients (61.3%) gave a history of cryotherapy, (8.6%) patients gave a history of chemical cautery, (4.5%) patients gave a history of electro surgery and (2.1%) patients gave a history of immunotherapy. Among the studied patients those had chemical cautery as a treatment modality had the highest recurrence rate.

Conclusion

The main risk factors for condyloma accuminata are young age, unprotected sexual intercourse, multiple sex partners and lower socioeconomic and educational levels. Smoking or alcohol together with immunosuppressive medications and chronic diseases as well as other STDs are possible risk factors. History of medical intervention as laser hair removal of genital area, colonoscopy and vaginal ultrasound could play a role in condyloma accuminata transmission in non-sexual active women. Condyloma accuminata occurred in more than one genital sites in relation to laser hair removal of genital areas compared to mostly one site in sexual transmission.
Evaluation of Local Injection of Adipose-Tissue Derived Stromal Vascular Fraction in Localized Scleroderma
Authors: Zu El-Fakkar Nehal Mohamed , Diab Heba Mahmoud , Ahmed Soltan Marwa Yassin , Elsayed Shereen Bendary , Monem Abo Zeid Asmaa Abd El , Hussein Shabaan Engy Amr Hussein
Published: November 2024

Background

Localized scleroderma (LoS) is a rare connective tissue disease affectig children and adults. It comprises a spectrum of sclerotic diseases that primarily affect the skin. Treatment of morphea is a challenge, several immunotherapies that specifically target cytokine or fibrosis signaling pathways, are under investigation and no treatment till now is considered gold standard. Among the most promising therapeutic approaches for fibrosing diseases are Adipose Stem Cells (ASCs). The scientific basis for studying ASCs treatment potential is their potent immunosuppressive, pro-angiogenic, and antifibrotic activities.

Materials and Methods

20 patients suffering from morphea lesions were injected by ASCs locally. Follow up and assessment were done through validated clinical scoring, durometer measurement of skin hardness and histopathological measurements of dermal collagen thickness and density.

Conclusion

ASCs are promising therapeutic option and tool in addressing skin fibrosing diseases.
COVID-19 Pandemic-Induced Changes in Hospital-Based Pattern of Skin Diseases in Gharbia Governorate, Egypt
Authors: Abdel Fattah Nermeen Samy , El-Khateeb Ekramy Ahmed , Waheb Hassan Fatma Safwat
Published: November 2024

Background

Introduction: The COVID-19 pandemic, declared by the World Health Organization in 2020, prompted numerous restrictions and changes in healthcare practices globally. In Egypt, measures such as curfews, the closure of public places, and the suspension of schools and universities were implemented. These changes had significant implications for healthcare delivery, including dermatology services.

Aim of the Work

This study aimed to investigate the effect of the COVID-19 pandemic on the pattern of skin diseases in Egypt.

Patients and Methods

Data from 20,509 patients (14,353 in the pre-COVID year and 6,156 during the COVID year) were analyzed at Samanod Hospital, Gharbia Governorate, Egypt. Information on date, age, sex, and diagnoses was collected from dermatology clinic registry files for both pandemic and pre-pandemic years.

Results

A substantial decrease in patient attendance at dermatology clinics was observed during the COVID-19 pandemic, with numbers dropping by over 50%. Age and sex distribution of patients were also influenced, with teenagers and adults showing an increase in attendance, while younger children presented less frequently. Although female patients remained predominant during the pandemic, the female-to-male ratio slightly favored males. All disease groups and subgroups demonstrated a decline in patient numbers during the pandemic compared to the pre-COVID year. Infections increased relative to hypersensitivity, with bacterial and fungal infections remaining the most common subgroups. COVID-19-related dermatoses did not significantly increase, except for herpes zoster, which showed a relative increase. Some dermatoses demonstrated significant relative increases during the pandemic, including impetigo, furunculosis, warts, abscesses, and herpes zoster, while others showed declines, such as acne, candidiasis, tinea capitis, urticaria, herpes simplex, pityriasis alba, pityriasis rosea, tinea corporis, xerosis, and chilblains.

Conclusion

The COVID-19 pandemic had a substantial impact on the pattern of skin diseases in Egypt, affecting patient demographics and disease prevalence. Infection-related dermatoses remained prevalent, with bacterial and fungal infections being the most common subgroups. Although minimal changes were observed in some diseases, especially COVID-related dermatoses, the overall pattern of dermatoses was preserved compared to the previous year. This study underscores the need for healthcare systems to adapt to changing disease patterns during pandemics, ensuring adequate medications, supplies, and medical team training to provide effective care. Further community-based studies are necessary to validate the findings and address potential disparities between hospital-based and community-based disease prevalence.
Assessment of Serum Brain-Derived Neurotrophic Factor Level and Its Relation to Psychiatric Morbidity in Vitiligo Patients and the Effect of Vitiligo on the Quality of Life
Authors: El-Kordy Nourhan Mohamed , Saleh Hanan Mohamed , Ahmed Soltan Marwa Yassin , Moneim Mahmoud Dalia Abdel
Published: November 2024

Background

Vitiligo is a chronic skin disorder with depigmentation of skin patches. Vitiligo exerts a huge burden on the psychiatric health and quality of life of affected patients. Several factors contribute to the pathogenesis of psychiatric morbidity in vitiligo patients, of which neurotrophins as Brain-derived neurotrophic factor (BDNF) was identified.

Aim of the Study

The aim of the present study is to assess serum levels of BDNF and their possible relation to the effect of vitiligo on the quality of life and with psychiatric comorbidities in vitiligo cases.

Patients and Methods

A cross-sectional case control study was conducted and included 50 patients suffering from vitiligo and 50 apparently healthy controls. All included participants were subjected to full history taking, complete general examination and full dermatological assessment and scoring of vitiligo using VETI and VIDA scores. After that, assessment of subjects’ psychiatric condition and quality of life was performed. Estimation of serum BDNF level was done using ELISA assay.

Results

BDNF level revealed significantly lower levels in cases compared to controls irrespective of the disease extent or vitiligo activity. The effect of vitiligo on psychiatric health and quality of life was marked as 76% of vitiligo cases had depressive symptoms in comparison to only 42% of controls. In addition, the physical health, social relations and environmental aspects showed significantly lower scores in patients compared to controls.

Conclusion

BDNF serum levels were lower in vitiligo cases. These levels are not related to either the vitiligo disease characteristic or the psychological burden of vitiligo on the patients' life.