bluuebunny/crossref_metadata_2025 huggingface dataset:
Liberal/Individualized Versus Materialist/Structuralist Approaches to Addressing Social and Health Inequalities: Education and Income as Social Determinants of Health
Authors: Ervin Avery , Raphael Dennis
Published: January 2025

Background: While consensus exists that the sources of health inequalities are social inequalities brought on by the experience of qualitatively different living and working conditions, means of addressing these conditions continue to be the subject of dispute. Whether to emphasis education or income as a social determinant of health is one such example of differing views on the sources of these inequalities and the means of addressing them. These different emphases are often justified through the narrow examination of the magnitude of statistical relationships between educational attainment and income with health outcomes.

Purpose: We offer a broader view, seeing these differing emphases as indicative of contrasting views of the nature of society and means of responding to these inequalities with emphasis on education representing a liberal reformist view of the issue while an emphasis on income representing a materialist structuralist view.

Research design and study sample: We examine, the validity of this hypothesis through an analysis of content of five representative publications that consider educational attainment as a social determinant of health and five that do so for income.

Analysis and results: We find that the emphasis on education as a social determinant of health focuses on the attributes of the individual and is generally accepting of the structures and processes of the existing economic and political order. In contrast, an emphasis on income – when placed within a materialist analysis – views existing systems as inequitably distributing income and other resources thereby requiring their reform or transformation.

Conclusion: Considering evidence of deteriorating living and working conditions for many in Canada and elsewhere, we see the latter emphasis as more useful for understanding and addressing these disturbing developments.
Knowing and doing in dialogue
Authors: Leitner Helga
Published: January 2025

In this commentary, I first discuss my sympathies with Robert Lake's On resisting the seduction of theory, namely the dangers of overemphasizing theory and his plea to extend knowledge production beyond the academy. I then critique his omission of substantial work in and beyond geography already practicing his proposed move from knowing to doing, his dismissal of the possibility of progress in theoretical debates, his inattention to theoretical work that has attempted to take complexity seriously and the dualism separating theory from practice that is a leitmotif of his argument.
Registration and Convolutional Multidimensional Attention Module for Few-Shot Anomaly Detection
Authors: Xie Xin , Xiong Shenping , Zheng Wenbin , Cai Tijian
Published: January 2025

Aiming at the shortcomings of most current anomaly detection models, such as low detection accuracy and poor generalization performance, this paper proposes a few-shot anomaly detection model based on a convolutional multidimensional attention module to achieve feature registration (abbreviated as RCM-FSAD), which enhances the model’s perception of the overall image perception ability, using spatial transformer network to obtain the spatial transformation features of the image, improving the sensitivity of the relevant features, so that the whole model learns the commonality between the categories, and enhancing the generalization ability of the model. The spatial transformations and local structures of the input data are captured by deformable convolutional networks v2 to ensure the spatial invariance of the input data. The model is trained with only normal samples to accomplish anomalous regions’ localization and anomaly detection. On the challenging MVTec AD dataset, the unsupervised model not only improves the anomaly detection accuracy but also shows better generalization compared to current state-of-the-art unsupervised anomaly detection methods.
The 12th IJCAR Automated Theorem Proving System Competition—CASC-J12
Authors: Sutcliffe Geoff
Published: January 2025

The CADE ATP System Competition (CASC) is the annual evaluation of fully automatic, classical logic, automated theorem proving (ATP) systems—the world championship for such systems. CASC-J12 was the 29th competition in the CASC series. Nineteen ATP systems competed in the various divisions. This paper presents an outline of the competition design and a commentated summary of the results.
Dioscin pretreatment ameliorates ferroptosis in cardiomyocytes after myocardial infarction via inhibiting endoplasmic reticulum stress
Authors: Wu Chang , Shen Xueping , Lou Pan , Song Dongyan
Published: January 2025

Background

Myocardial infarction (MI) remains a leading cause of mortality globally, often resulting in irreversible damage to cardiomyocytes. Ferroptosis, a recently identified form of regulated cell death driven by iron-dependent lipid peroxidation, has emerged as a significant contributor to post-MI cardiac injury. The endoplasmic reticulum (ER) stress response has been implicated in exacerbating ferroptosis.

Methods

Here, we investigated the potential of Dioscin, a natural compound known for its diverse pharmacological properties, in mitigating ferroptosis in cardiomyocytes following MI by targeting ER stress.

Results

In animal models subjected to MI, administration of Dioscin notably improved cardiac function, reduced infarct size by approximately 24%, and prevented adverse remodeling, highlighting its therapeutic potential. Through in vitro and in vivo models of MI, we demonstrated that Dioscin treatment significantly attenuates ferroptosis in cardiomyocytes, as evidenced by a decrease in lipid peroxidation by about 19% and preserved mitochondrial integrity. Moreover, Dioscin exerted its protective effects by inhibiting ER stress markers, such as the phosphorylation levels of PERK and eIF2α proteins, and the expression levels of BIP and ATF4 proteins, thus disrupting the ER stress-mediated signaling cascade associated with ferroptosis.

Conclusion

Overall, our findings suggested that Dioscin holds promise as a therapeutic agent against post-MI cardiac injury by mitigating ferroptosis via the suppression of ER stress. Further investigations into the precise molecular mechanisms and clinical translation of Dioscin’s cardioprotective effects are warranted, offering a potential avenue for novel therapeutic interventions in MI-related cardiac complications.

Graphical Abstract
Is the treatment of ankle osteoarthritis changing over time in Italy? Analysis of temporal trends for fusion and arthroplasty in a population-based study from 2001 to 2022 on the National Hospital Discharge Record database
Authors: Cuccu Adriano , Samaila Elena Manuela , Ciminello Enrico , Alfieri Montrasio Umberto , Cortese Fabrizio , Ceccarelli Stefania , Falcone Tiziana , Torre Marina
Published: January 2025

Background

Treatment of ankle osteoarthritis by total ankle replacement (TAR) is increasing worldwide. The aim of the study was to present the overall temporal trends of TAR throughout 22 years (2001–2022) in Italy, analyzing the distributions of hospitals by volume of activity and patients by age and sex, drawing on the National Hospital Discharge Record database. Furthermore, as a secondary aim, we compared these trends with those of ankle fusions.

Materials and methods

International Classification of Diseases, 9th Revision, Clinical Modification (ICD9-CM) codes of interest were identified to browse the Italian National Hospital Discharge Record database. Surgical volumes, trends over time, classes of hospital activity volume, sex and age of patients, and population incidence rates were described. The statistical significance of time series trends was assessed by the Cox–Stuart test with randomness as a null hypothesis.

Results

20,248 ankle procedures (total ankle replacements 8853 and ankle fusions 11,395) were extracted from 231,601,523 admissions registered nationally from 2001 to 2022. The yearly total number of TARs significantly increased almost tenfold from 96 to 996 (p < 0.05), while the number of fusions exhibited a stationary behavior (p > 0.05). The increased trend in TAR procedures was concentrated mostly in the North of Italy, with predominantly males between 55 and 64 years of age. The analysis of the number of procedures performed on inhabitants by region and that performed by all the hospitals in the region showed a different pattern across Italy.

Conclusions

The substantial increase in TARs may be owing to improved implant designs and innovative surgical technologies, which allow the treatment of more severe cases and deformities, previously untreated or treated by a fusion. This trend highlights the need to invest in implementing high quality registries by promoting surgeons’ participation in data collection.

Level of evidence: population based study, level 1 evidence.
Modeling and simulation of distribution and drug resistance of major pathogens in patients with respiratory system infections
Authors: Yang Li , Liang Ermin , Gao Yali
Published: January 2025

Background

Respiratory tract infections (RTIs) are one of the leading causes of morbidity and mortality worldwide. The increase in antimicrobial resistance in respiratory pathogens poses a major challenge to the effective management of these infections.

Objective

To investigate the distribution of major pathogens of RTIs and their antimicrobial resistance patterns in a tertiary care hospital and to develop a mathematical model to explore the relationship between pathogen distribution and antimicrobial resistance.

Methods

Five hundred patients with RTIs were included in the study and 475 bacterial strains were isolated from their respiratory specimens. Antimicrobial susceptibility testing and analysis of influencing factors were performed. A mathematical model was developed to simulate the relationship between pathogen distribution and drug resistance.

Results

The most common pathogens were Streptococcus pneumoniae (30%), Haemophilus influenzae (20%), Pseudomonas aeruginosa (15%), Staphylococcus aureus (10%) and Klebsiella pneumoniae (10%). The distribution of pathogens varied according to age group and type of RTIs, with higher proportions of Pseudomonas aeruginosa and Staphylococcus aureus in hospital-acquired and ventilator-associated pneumonia. Isolated pathogens showed high and increasing rates of resistance to commonly used antibiotics. Model simulations suggest that a shift in the distribution of pathogens toward more resistant strains may lead to a significant increase in overall resistance rates, even if antibiotic use patterns remain unchanged.

Conclusion

This study emphasizes the importance of regular monitoring of respiratory pathogen distribution and antimicrobial resistance patterns and the need for a comprehensive approach to managing RTIs, including implementation of antibiotic stewardship programs, infection control measures, and development of new therapies.
Methodological considerations for estimating indirect costs in children and adolescents with chronic conditions: a scoping review
Authors: Kitschen Anne , Asegu Lulseged M. , Sauerland Dirk
Published: January 2025

Background

In children and adolescents, the prevalence of chronic diseases, e.g., obesity, asthma, and attention-deficit/hyperactivity disorder (ADHD), has increased in the last decades. These diseases have negative effects on patients and their families and pose a significant economic burden. Indirect costs related to caregivers’ lost workdays or children’s and adolescents’ missed education are likely to be high. However, there are no guidelines for measuring and valuing indirect costs in this population. Thus, this scoping review aims to examine methods in published articles, compare these approaches, and analyze benefits and shortcomings.

Methods

The systematic literature search was conducted in Medline, PsycINFO, Embase, NHS EED, and the HTA Database considering all articles from inception until 16 October 2024. Two researchers independently screened title, abstract, and full text. Cost-of-illness studies (COIs) reporting indirect costs for obesity, asthma, or attention-deficit/hyperactivity disorders (ADHD) in children and adolescents up to 24 years were included. Only studies published in English or German were considered. Methodological characteristics, measurement of indirect costs, cost components, data source, and costing methods were extracted.

Results

The literature search revealed 45 studies. Thirty-two articles on asthma, eight on ADHD, and five on obesity were included. While all studies included absenteeism, only a few assessed and valued unpaid work (31.1%) or presenteeism (13.3%). Overall, 88.9% of the studies considered indirect costs for caregivers. Additionally, 51.1% considered productivity losses for children and adolescents, with 47.8% of these studies assigning a monetary value to these losses. The largest share of studies (53.3%) considered indirect costs by measuring and valuing caregivers’ lost work time.

Discussion

In conclusion, various methodologies were used to consider indirect costs for chronic diseases in children and adolescents, underlining the need for standardization. This scoping review presents methodologies for incorporating indirect costs in COIs and other types of economic evaluations, which focus on children and adolescents and adopt a societal perspective. These indirect costs include both paid and unpaid activities, as well as absenteeism and presenteeism, not only for caregivers but also for children and adolescents themselves.
Institutional, neighborhood, and life stressors on loneliness among older adults
Authors: Tsuchiya Kazumi , Thierry Amy Danielle , Taylor Harry Owen
Published: January 2025

Background

Loneliness is a public health epidemic in the United States (US), with older adults being vulnerable to experiencing loneliness. Predictors of loneliness are less understood among racial/ethnic groups of US older adults, and few studies have included perceived institutional discrimination (PID), stressful life events (SLE), and perceived neighborhood characteristics (PNC) as antecedent stressors of loneliness in diverse older adult samples. Our study assessed the relationship between these stressors and loneliness among specific racial/ethnic groups of older adults.

Methods

We used the Health and Retirement Study data (n = 9,904) to examine whether PID, SLE, and PNC were associated with loneliness. Loneliness was measured using the 11-item UCLA Loneliness Scale. PID included unfairly not hired for a job, unfairly prevented from moving into a neighborhood, and unfairly treated by the police. SLE included moving to a worse neighborhood/residence, being robbed or burglarized, and unemployed/looking for a job. PNC were measured as discohesion and disorder. Lagged multivariate linear regression models regressed loneliness (2014/2016 HRS waves) on PID, SLE and PNC (2010/2012 HRS waves) measured as cumulative totals and individual items. Models were stratified by Black (BOAs), Hispanic/Latinx (HOAs), and White (WOAs) older adults.

Results

Cumulative totals of PID, SLE, and neighborhood discohesion were associated with loneliness among BOAs while only discohesion was associated with loneliness among HOAs. Cumulative totals for PID, SLE, and PNC were associated with loneliness among WOAs. Individual stressors predicting loneliness for BOAs were moving to a worse residence and being robbed/burglarized. For HOAs, being prevented from moving to a neighborhood was associated with greater loneliness while being robbed/burglarized was associated with less loneliness. Individual stressors predicting greater loneliness for WOAs were being unfairly not hired for a job, receiving unfair treatment during police encounters, and moving to a worse residence.

Conclusions

Our study finds racial/ethnic variation in psychosocial stressors predicting loneliness four years later. Nevertheless, neighborhood discohesion was the most salient stressor and was associated with greater loneliness across all racial/ethnic groups. Future research and interventions should consider the differing stress appraisal processes across groups and to support the development of resources and policies to ameliorate loneliness among diverse older adults.
Game-thinking; utilizing serious games and gamification in nursing education – a systematic review and meta-analysis
Authors: Nylén-Eriksen Mats , Stojiljkovic Marko , Lillekroken Daniela , Lindeflaten Katrin , Hessevaagbakke Elisabeth , Flølo Tone Nygaard , Hovland Olav Johannes , Solberg Ada Marie Svarstad , Hansen Sylvia , Bjørnnes Ann Kristin , Tørris Christine
Published: January 2025

Background

The digital shift in higher education is moving from teacher-focused models to active learning with digital technologies, including the integration of game-based learning strategies. We aim to identify, assess, and summarize the findings of evidence and determine the effectiveness of game-thinking on learning outcomes in nursing education.

Methods

A comprehensive search for relevant literature was conducted between April and May 2022 Seven databases ERIC, Scopus, ProQuest Education Source, MEDLINE, CINAHL, Web of Science, and Embase were utilized to locate original, peer-reviewed papers published in English. The review was conducted and reported in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines.

Results

Overall, 3302 studies were initially screened based on their titles and abstract. From this selection 281 studies were then assessed for full-text eligibility. In the end, 70 studies, consisting of 27 Randomized Controlled Trials (RCTs) and 43 Quasi-experimental studies were included in the review. These studies encompassed data from a total of 8348 participants. The results from the narrative synthesis of the results revealed consistencies across the included studies and their findings. The meta-analysis suggested that game-thinking could be beneficial in nursing education, notably improving students’ academic achievement (Pooled ES = 0.99, [95%CI 0.53, 1.44]). The most significant effect of game-thinking on academic achievement was observed in the academic knowledge performance of nursing students (Pooled ES = 1.06, [95%CI 0.55, 1.57]), followed by academic skill performance (Pooled ES = 0.54, [95%CI 0.06, 1.03]).

Conclusions

The systematic review and meta-analysis provide evidence supporting the effectiveness of game-thinking in nursing education. The findings highlight the potential of game-based learning in enhancing nursing education through knowledge acquisition, albeit with a nuanced effect on skill development. As nursing education continues to adapt to the digital era, integration of game-thinking strategies could serve as a valuable method for creating engaging and effective learning experiences for nursing students.
Factors affecting the prolongation of mechanical ventilation in patients after cardiac surgery
Authors: Kermani Mahdieh Sharifzadeh , Dehesh Tania , Pouradeli Shiva , Esmaili Bahareh Soltani
Published: January 2025

Background

This study aimed to investigate the major predictive factors associated with prolonged mechanical ventilation(PMV) following cardiac surgery.

Methods

This retrospective, cross-sectional, descriptive-analytical study was conducted from September 2021 to March 2022, involving 244 patients who underwent cardiac surgery. PMV was defined as mechanical ventilation for more than 24 h. Potential risk factors before, during, and after surgery were examined and recorded. Logistic regression analysis was performed to assess the relationship between demographic, clinical variables, and prolonged mechanical ventilation. A significance level of 0.05 was used for data analysis.

Results

The study population consisted of 68.4% male and 31.6% female patients, with 86.9% undergoing CABG surgery. PMV was observed in 13.1% of the patients. The findings revealed that the incidence of postoperative pneumonia increased the likelihood of PMV by more than 7 times [OR = 7.24, 95% CI=(5.12,8.14), P-value = 0.001]. Similarly, respiratory failure was associated with a 7.5-fold increase in the odds of PMV [OR = 7.56, 95% CI=(4.48,8.77), P-value = 0.042]. Drainage of one liter of blood on the first postoperative day increased the risk of PMV by 2.2 times [OR = 2.21, 95% CI=(1.98,2.46), P-value = 0.032], and the use of epinephrine was associated with a 2.73-fold increase in the odds [OR = 2.73, 95% CI=(2.24,3.11), P-value = 0.022]. Risk of PMV in the patients who had cardiac dysfunctin increased by more than 2 times.[OR = 2.58, 95%; CI = (1.33.2.87); P-value = 0.042]. In the patients need an Intra Aortic Balloon Pump(IABP) risk of PMV increased by more than 2 times. (OR = 2.74,95%,CI = 1.36,5.47: Pvalue = 0.03). The risk of PMV in the patients who had cerebrovascular accident(CVA) increased by more than three times [OR = 3.75, 95% CI = 1.26,4.84; P-value = 0.044]. For each unit increase in Euro Score 2 the chance of PMV increased by 1.38 TIMES. Furthermore ICU Mortality had a significant relationship with PMV.(Pvalue < 0.001).

Conclusion

The study identified postoperative complications, such as pneumonia, respiratory failure, high drainage, need to an IABP, higher EURO Score 2, Cardiac dysfunction, CVA and the use of epinephrine, as independent risk factors for PMV following cardiac surgery.
Avascular necrosis in pediatric rheumatic diseases: an Italian retrospective multicentre study
Authors: Taietti Ivan , Zini Federico , Conti Emilio Amleto , Cristini Enrica , Borzani Irene , Ramponi Giulia , Bracaglia Claudia , Pecoraro Raffaele , Papa Riccardo , Tibaldi Jessica , Pastore Serena , Simonini Gabriele , Cattalini Marco , Meini Antonella , Marino Achille , Lanni Stefano , Minoia Francesca , Filocamo Giovanni
Published: January 2025

Background

Atraumatic avascular necrosis (AVN) is a severe condition that may complicate the course of rheumatic diseases and contribute to long-term damage. However, there is a lack of evidence on this rare event in pediatric rheumatology. The aim of our study was to evaluate the occurrence of avascular necrosis in the context of rheumatologic diseases in Italy and to describe the main demographic and clinical features of AVN patients, with a particular focus on treatment background.

Methods

All centres part of the Italian Society of Pediatric Rheumatology were invited to participate in a retrospective case collection of children with rheumatic diseases complicated by a pediatric-onset AVN. Demographic, clinical, laboratory and imaging data were recorded, together with outcome and treatment background, particularly steroid exposure. Population collected was further evaluated according to the different underlying rheumatologic disease and to the time of AVN onset.

Results

Fourteen patients (SLE = 7; JIA = 4; others = 3) were collected from 7 centres. Females were predominantly affected (71%) with a median age at AVN diagnosis of 14.3 years. Multifocal involvement was mostly reported (93%), mainly involving femoral heads (44%) and knees (28%). All patients had a severe rheumatologic background and received systemic glucocorticoids with a median cumulative prednisone equivalent dose of 457.5 mg/kg. In all patients but one imaging showed persistence of abnormalities, despite the complete resolution of symptoms in 6 of them. Bisphosphonates were the most used therapeutic approach; orthopedic surgery was required in 2 cases.

Conclusions

Despite its rarity, AVN may be a severe complication of pediatric rheumatic diseases. Active monitoring is crucial to promptly identify patients and to prevent long-term damage. Prospective large sample studies are required to better understand the impact of steroid exposure and its complex interplay with other potential contributing factors.
TAD-SIE: sample size estimation for clinical randomized controlled trials using a Trend-Adaptive Design with a Synthetic-Intervention-Based Estimator
Authors: Lala Sayeri , Jha Niraj K.
Published: January 2025

Background

Phase-3 clinical trials provide the highest level of evidence on drug safety and effectiveness needed for market approval by implementing large randomized controlled trials (RCTs). However, 30–40% of these trials fail mainly because such studies have inadequate sample sizes, stemming from the inability to obtain accurate initial estimates of average treatment effect parameters.

Methods

To remove this obstacle from the drug development cycle, we present a new algorithm called Trend-Adaptive Design with a Synthetic-Intervention-Based Estimator (TAD-SIE) that powers a parallel-group trial, a standard RCT design, by leveraging a state-of-the-art hypothesis testing strategy and a novel trend-adaptive design (TAD). Specifically, TAD-SIE uses synthetic intervention (SI) to estimate individual treatment effects and thereby simulate a cross-over design, which makes it easier for a trial to reach target power within trial constraints (e.g., sample size limits). To estimate sample sizes, TAD-SIE implements a new TAD tailored to SI given that using it violates assumptions under standard TADs. In addition, our TAD overcomes the ineffectiveness of standard TADs by allowing sample sizes to be increased across iterations without any condition while controlling significance level with futility stopping. Our TAD also introduces a hyperparameter that enables trial designers to trade off between accuracy and efficiency (sample size and number of iterations) of the solution.

Results

On a real-world Phase-3 clinical RCT (i.e., a two-arm parallel-group superiority trial with an equal number of subjects per arm), TAD-SIE obtains operating points ranging between 63% to 84% power and 3% to 6% significance level in contrast to baseline algorithms that get at best 49% power and 6% significance level.

Conclusion

TAD-SIE is a superior TAD that can be used to reach typical target operating points but only for trials with rapidly measurable primary outcomes due to its sequential nature. The framework is useful to practitioners interested in leveraging the SI algorithm for their study design.
Quantifying impacts of two ENSO patterns on South China sea summer monsoon onset
Authors: Zhang Lianyi , Lin Junshu , Chen Zesheng , Shi Yanping , Du Yan
Published: January 2025

The onset of the South China Sea (SCS) Summer Monsoon (SCSSM) is usually in May, strongly influencing the beginning of the wet season over the surrounding regions, such as South China and the Philippine Islands. The onset date is significantly affected by the El Niño-Southern Oscillation (ENSO), which manifests as two major types: the Eastern-Pacific (EP) and Central-Pacific (CP) patterns. However, the impacts of these patterns on the SCSSM onset await quantification. Here, using a novel statistical metric, binary combined linear regression, we find a dominant role of the CP pattern rather than the EP pattern, as a moderate CP El Niño/La Niña tends to cause SCSSM onset delay/advance by around 4.7/5.1 days in its decaying year. The anomalous SST structure of CP El Niño leads to persistent anomalous anti-cyclonic winds over the western North Pacific from April to June, suppressing the local convection and impeding the SCSSM winds. In comparison, the EP El Niño impact decays quickly in May and hardly affects the SCSSM onset. This, hence, weakens the relationship between the SCSSM onset and ENSO. These results help improve the SCSSM onset prediction by involving diverse ENSO impacts.
History of the Organisation for Economic Co-operation and Development (OECD) test guidelines for non-animal test methods in Japan
Authors: Kojima Hajime
Published: January 2025

The number of alternatives to animal tests (non-animal test methods) for human health developed globally account for more than 40% of the test methods in the Organisation for Economic Co-operation and Development (OECD) Guidelines for the Testing of Chemicals (TGs). Within the TGs, the National Institute of Health Sciences (NIHS) has standardized 16 OECD TGs for human health, implemented four major revisions, and developed one test method for the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use (ICH) S10 guidelines on photosafety. This review describes trends in the OECD and Japan that mainly focus on international standardizations of non-animal test methods for human health. Drawing from this experience, I hope Japan will advance new approach methodologies for detecting systemic toxicity, which are in global demand.
Postoperative symptom changes following uterine artery embolization for uterine fibroid based on FIGO classification
Authors: Nozaki Yoshimi , Takeuchi Shiori , Arai Masafumi , Kuwatsuru Yoshiki , Toei Hiroshi , Okada Shingo , Kato Hitomi , Saito Naoko , Nobushima Takamichi , Murakami Keisuke , Kitade Mari , Kuwatsuru Ryohei
Published: January 2025

Background

Classifying uterine fibroid using the International Federation of Gynecology and Obstetrics (FIGO) classification system assists treatment decision-making and planning. This study aimed to study whether different fibroid locations influence clinical outcomes following uterine artery embolization (UAE).

Methods

This is a retrospective cohort study of patients who underwent UAE for symptomatic uterine fibroid between December 2016 and January 2023 at our hospital. Changes in mean fibroid volume were compared based on MR images. Menstrual pain, excessive flow symptoms, and treatment satisfaction before UAE and 6 months after UAE were compared.

Results

A total of 149 premenopausal patients (mean age 45.7 ± 2.7 years) were included for analysis (FIGO 2/3, n = 57; FIGO 4–7, n = 92). Baseline menstrual pain, fibroid, and uterine volume before UAE were comparable between the two FIGO groups (p > 0.05). The menstrual flow index was higher for the FIGO 2/3 group (mean ± SD [min–max]: 9.4 ± 1.4 [4–10] vs 8.0 ± 2.3 [0–10], p < 0.001). Six months after UAE, the improvements in menstrual flow index (mean ± SD]: -3.7 ± 2.6 vs -2.6 ± 2.2, p = 0.035), fibroid volume (mean ± SD: -54.7 ± 21.7% vs -39.8 ± 16.2%, p < 0.001), and uterine volume (mean ± SD: -38.2 ± 16.3% vs -31.1 ± 11.6%, p = 0.008) in the FIGO 2/3 group were significantly higher than the FIGO 4–7 group. Both groups had comparable improvements in menstrual pain index (-2.1 ± 2.6 vs -1.8 ± 2.5, p = 0.008) and 88% of the patients were satisfied or very satisfied overall.

Conclusion

UAE treatment satisfaction was high for patients with fibroids at different FIGO stages. UAE treatment outcomes were better for patients with fibroids affecting the endometrium (FIGO 2/3).

Level of evidence

3B, Retrospective observational study.
Physical activity, fatigue severity, and health-related quality of life of community-dwelling stroke survivors: a cross-sectional study
Authors: Odetunde Marufat Oluyemisi , Makinde Ayomide Felix , Jimoh Olamide Mary , Mbada Chidozie Emmanuel , Niyi-Odumosu Faatihah , Fatoye Francis
Published: January 2025

Background

Physical inactivity among stroke survivors (SSV) may result from fatigue, physical disabilities, and psychosocial factors, all of which adversely affect health-related quality of life (HRQL). Studies on combined interactions among physical activity (PA), fatigue severity (FS), and HRQL in SSV are scarce. This study was aimed to determine the relationships among PA, FS, and HRQL in community-dwelling SSV and to predict the association with selected socio-demographic and clinical variables.

Methods

This analytical cross-sectional correlation study involved 102 consented community-dwelling SSV. Respondents were purposively recruited from physiotherapy outpatient clinics of selected secondary and tertiary hospitals in southwest Nigeria. PA, FS, and HRQL of the SSV were assessed using the Stroke Physical Activities Questionnaire (SPAQ), Fatigue Severity Scale (FSS), and Stroke-Specific Quality-of-Life (SS-QoL) scale, respectively. Information on respondents’ socio-demographic and clinical characteristics was also collected. Data were analyzed using descriptive and inferential statistics at p < 0.05 significance level.

Results

Respondents’ mean age was 59.98 ± 11.59 years. The majority were females (52.9%), had ischemic stroke (72%), and with right-side weakness (54%) of over 6 months (80%). Respondents’ mean scores on SPAQ, FSS, and SS-QoL scales are 1867.47 ± 1817.93 MET min/week, 31.94 ± 11.29, and 156.47 ± 26.62, respectively. There were no significant associations between selected socio-demographic/clinical variables and physical activity levels except in gender (χ
2 = 6.737; p = 0.034), fatigue severity except in side of affectation (χ
2 = 5.839; p = 0.054), and HRQL except in level of education (χ
2 = 23.497; p = 0.001) and side of affectation (χ
2 = 7.389; p = 0.007). There was a moderate and significant correlation (R = 0.426; p < 0.05) among PA, FS, and HRQL. Regression analysis revealed no significant associations with the socio-demographic/clinical variable except the side of affectation for HRQL, low (R = 0.223) level of prediction of socio-demographic/clinical variables for PA (F 8, 93 = 0.607; p > 0.05), and fair (R = 0.326) level of prediction for FS (F 8, 93 = 1.386; p > 0.05).

Conclusion

Moderate correlations among fatigue severity, physical activity, and health-related quality of life in stroke survivors suggested that enhancing one domain can benefit others, while the limited predictive ability of socio-demographic and clinical variables highlighted the need to consider cultural and psychological factors in post-stroke outcomes.
Clearing the path for whole-mount labeling and quantification of neuron and vessel density in adipose tissue
Authors: Rauchenwald Thomas , Benedikt-Kühnast Pia , Eder Sandra , Grabner Gernot F. , Forstreiter Sebastian , Lang Michaela , Sango Roko , Eisenberg Tobias , Rattei Thomas , Haschemi Arvand , Wolinski Heimo , Schweiger Martina
Published: January 2025

White adipose tissue (WAT) comprises a plethora of cell types beyond adipocytes forming a regulatory network that ensures systemic energy homeostasis. Intertissue communication is facilitated by metabolites and signaling molecules that are spread by vasculature and nerves. Previous works have indicated that WAT responds to environmental cues by adapting the abundance of these ‘communication routes’; however, the high intra-tissue heterogeneity questions the informative value of bulk or single-cell analyses and underscores the necessity of whole-mount imaging. The applicability of whole-mount WAT-imaging is currently limited by two factors – (1) methanol-based tissue clearing protocols restrict the usable antibody portfolio to methanol-resistant antibodies and (2) the vast amounts of data resulting from 3D imaging of whole-tissue samples require high computational expertise and advanced equipment. Here, we present a protocol for whole-mount WAT clearing, overcoming the constraints of antibody-methanol sensitivity. Additionally, we introduce TiNeQuant (for ‘tissue network quantifier’) a Fiji tool for automated 3D quantification of neuron or vascular network density, which we have made freely available. Given TiNeQuants versatility beyond WAT, it simplifies future efforts studying neuronal or vascular alterations in numerous pathologies.
One Man, One Vote
Authors: Pancs Romans , Sharma Tridib
Published: January 2025

In the United States, electoral districts must be equipopulous. This requirement is known as the one man, one vote doctrine. We propose welfare-based justifications for this requirement under the economic view, according to which voters care about the policy, and under the political view, according to which voters care about representation. Both justifications assume that the districter is partisan. If the districter is benevolent, one man, one vote is harmless under the economic view but may reduce voter welfare under the political view by as much as the reduction from K to √K districts would. (JEL D71, D72)
Scoring Strategic Agents
Authors: Ball Ian
Published: January 2025

I introduce a model of predictive scoring. A receiver wants to predict a sender’s quality. An intermediary observes multiple features of the sender and aggregates them into a score. Based on the score, the receiver makes a decision. The sender prefers “higher” decisions, and she can distort each feature at a privately known cost. I characterize the scoring rule that maximizes decision accuracy. This rule underweights some features to deter sender distortion, and overweights other features so that the score is correct on average. The receiver prefers this scoring rule to full disclosure because it mitigates his commitment problem. (JEL C72, D82, D83)
Οι επιπτώσεις του κόστους διαβίωσης στην ποιότητα ζωής των ασθενών με κυστική ίνωση
Authors: Δαϊναβάς Δημήτριος
Published: January 2025

Η κυστική ίνωση (ΚΙ) οδηγεί σε βλάβη πολλαπλών βασικών οργάνων και συστημάτων στο ανθρώπινο σώμα. Αρκετοί ερευνητές έχουν εκτιμήσει την Ποιότητα Ζωής (ΠΖ) σε ασθενείς με ΚΙ σε σχέση με ψυχοκοινωνικούς, δημογραφικούς και / ή κλινικούς παράγοντες ενώ ελάχιστες μελέτες υπάρχουν σχετικά με την καταγραφή κόστους που να σχετίζονται με τη νόσο. Ο σκοπός της παρούσης προοπτικής μελέτης είναι η διερεύνηση του κόστους διαβίωσης των ασθενών με ΚΙ, η εκτίμηση της Σχετιζόμενης με την Υγεία Ποιότητα Ζωής (ΣΥΠΖ) τους και κυρίως η διερεύνηση της επίδρασης του κόστους διαβίωσης στη ΣΥΠΖ τους. Για τη συλλογή των δεδομένων χρησιμοποιήθηκαν τρία εργαλεία, καθώς και φόρμα καταγραφής των δημογραφικών στοιχείων. Το πρώτο ερωτηματολόγιο χρησιμοποιείται για την Εκτίμηση της Μεταβολής του Κόστους Διαβίωσης Ασθενών. Για την εκτίμηση της ΣΥΠΖ χρησιμοποιήθηκαν δύο εργαλεία. Το πρώτο εργαλείο είναι η ελληνική έκδοση του Short Form Questionnaire-36 (SF-36). Το δεύτερο εργαλείο το οποίο χρησιμοποιήθηκε για την εκτίμηση της ΣΥΠΖ του πληθυσμού στόχου είναι η ελληνική έκδοση του Cystic Fibrosis Quality of Life (CFQoL). Οι ασθενείς κατά τη διάρκεια της μελέτης συμπλήρωσαν τα δύο ερωτηματολόγια, ώστε να αποτυπωθεί το κόστος διαβίωσής τους και οι επιπτώσεις του στη διαμόρφωση της ΠΖ. Το αμφίπλευρο επίπεδο στατιστικής σημαντικότητας ορίστηκε ίσο με 0,05. Η ανάλυση των δεδομένων πραγματοποιήθηκε με το IBM SPSS 21.0.H ΚΙ έχει σημαντικό αντίκτυπο στην ΠΖ των ασθενών ανεξαρτήτως ηλικίας. Η πορεία της νόσου και το κόστος για τη θεραπεία επηρεάζει την καθημερινότητα των ασθενών με ΚΙ και έχει σημαντικό αντίκτυπο στην κοινωνικοποίηση και τη ψυχολογία τους. Η ΣΥΠΖ συσχετίστηκε άμεσα με τη φυσική κατάσταση και σε μικρότερο βαθμό, με την αυτοαναφερόμενη φυσική δραστηριότητα. Η εκτίμησή του μέσου ετήσιου κόστους σχετίζεται με το εκάστοτε σύστημα υγειονομικής ασφάλισης και τις τιμές των φαρμάκων. Υπάρχει ανάγκη για συνεχή παρακολούθηση της ΠΖ των ασθενών με ΚΙ παράλληλα με την εισαγωγή νέων ή τη βελτίωση των υφιστάμενων μεθόδων θεραπείας.
Frameworks and tools for the development and assessment of skills and competences of educators
Authors: Σπυροπούλου Ναταλία
Published: January 2025

H παρούσα διατριβή διερευνά τρόπους υποστήριξης των εκπαιδευτικών στην ανάπτυξη των απαραίτητων δεξιοτήτων και ικανοτήτων για την επιτυχημένη εφαρμογή της εκπαίδευσης STEAM , μέσω της δημιουργίας του STEAMComp Edu, του πρώτου πλαισίου ικανοτήτων που έχει σχεδιαστεί ειδικά για εκπαιδευτικούς. Βασισμένο σε ανάλυση και έρευνα υφιστάμενων μοντέλων εκπαιδευτικών ικανοτήτων και των αναγκών και προκλήσεων της εκπαίδευσης STEAM, το πλαίσιο διαμορφώθηκε μέσα από αναλύσεις και έρευνες, υιοθετώντας μια προσέγγιση που βασίζεται στην κοινότητα, εμπλέκοντας ενεργά τους εκπαιδευτικούς στην ανάπτυξη και επικύρωσή του. Οι απόψεις και οι εμπειρίες των εκπαιδευτικών αποτέλεσαν κεντρικό στοιχείο στον καθορισμό των ικανοτήτων που απαιτούνται για την αποτελεσματική διδασκαλία STEAM. Η έρευνα υπερβαίνει την ανάπτυξη του πλαισίου, εξετάζοντας τις πρακτικές εφαρμογές του, όπως ο σχεδιασμός προγραμμάτων επαγγελματικής ανάπτυξης, εκπαιδευτικών πόρων, ενός εργαλείου αυτοαξιολόγησης και επαγγελματικών προφίλ για τους εκπαιδευτικούς. Το πλαίσιο και τα συνοδευτικά εργαλεία του δεν αποσκοπούν μόνο στη βελτίωση των επαγγελματικών πρακτικών των εκπαιδευτικών, αλλά ωφελούν και ένα ευρύ φάσμα ενδιαφερόμενων μερών. Οι εκπαιδευτικοί οργανισμοί μπορούν να το χρησιμοποιήσουν για την καθοδήγηση της επιμόρφωσης και της επαγγελματικής ανάπτυξης των διδασκόντων, οι υπεύθυνοι χάραξης πολιτικής μπορούν να το εντάξουν σε ευρύτερες στρατηγικές εκπαιδευτικής πολιτικής, ενώ οι ερευνητές μπορούν να εξετάσουν τις εφαρμογές του για τη βελτίωση των μεθόδων διδασκαλίας. Αντιμετωπίζοντας το χάσμα μεταξύ των τρεχουσών διδακτικών ικανοτήτων και των απαιτήσεων της σύγχρονης, διεπιστημονικής εκπαίδευσης STEAM, η έρευνα στοχεύει να ενδυναμώσει τους εκπαιδευτικούς, προσφέροντάς τους τα μέσα για να υλοποιούν καινοτόμες και αποτελεσματικές διδακτικές πρακτικές, συμβάλλοντας ουσιαστικά στη βελτίωση της ποιότητας της εκπαίδευσης στον 21ο αιώνα.
Μεθοδολογία αξιολόγησης και αξιολογητική προσέγγιση μιας μελέτης εκτίμησης περιβαλλοντικής επικινδυνότητας των δραστηριοτήτων μιας μεγάλης βιομηχανικής εγκατάστασης στην περιοχή της λεκάνης απορροής του Ασωπού ποταμού
Authors: Παναγόπουλος Ι. , Καραγιάννης Α. , Καραγιάννης Ν. , Καρκάντζος Ι. , Κατσιμέντος Κ. , Γκουβαλιάς Γ. , Καρούκη Ε.
Published: January 2025

Στο Άρθρο αυτό παρουσιάζεται μια μεθοδολογία αξιολόγησης και η σχετική αξιολογητική προσέγγιση μιας Προκαταρκτικής Μελέτης Προσανατολισμού Εκτίμησης Επικινδυνότητας μιας πλήρους κλίμακας βιομηχανικής μονάδας παραγωγής και συντήρησης αεροσκαφών στη περιοχή της λεκάνης απορροής του Ασωπού Ποταμού. Η Δυνατότητα Ρύπανσης και η σχετική επικινδυνότητα της μονάδας αποδίδεται στην εκπομπή επικίνδυνων και μη επικίνδυνων αερίων, υγρών και στερεών αποβλήτων και κατηγοριοποιείται ως: ΚΑΝΟΝΙΚΗ ΛΕΙΤΟΥΡΓΙΑ, ΑΤΥΧΗΜΑΤΙΚΈΣ ΑΠΟΡΡΙΨΕΙΣ, ΣΤΑΔΙΑΚΕΣ ΑΠΟΡΡΙΨΕΙΣ, ΠΡΟΤΕΡΕΣ ΚΑΤΑΣΤΑΣΕΙΣ, ΡΥΠΑΝΣΗ CURRENT OPERATIONS-NEW CONDITIONS, SUDDEN AND ACCIDENTAL ΣΤΗΝ ΙΔΙΟΚΤΗΣΙΑ ΚΑΙ ΕΚΤΟΣ ΙΔΙΟΚΤΗΣΙΑΣ ΤΗΣ ΕΓΚΑΤΑΣΤΑΣΗΣ. Η εκτίμηση της επικινδυνότητας στηρίζεται σε μια Ανάλυση Περιβαλλοντικής Επικινδυνότητας {Environmental Risk Analysis (ERA)}, σε συμφωνία με τη σχετική Εθνική και Ευρωπαϊκή νομοθεσία, τις αρχές της βιώσιμης ανάπτυξης και τις ειδικές διατάξεις που αφορούν τη απορροής του Ασωπού Ποταμού. Οι στόχοι της ERA είναι η ταυτοποίηση περιοχών μεγάλης διακινδύνευσης στην ιδιοκτησία της εγκατάστασης και η πρόταση μέτρων ελάττωσης της διακινδύνευσης σε περιοχές που η επικινδυνότητα δεν είναι αποδεκτή. Η ιδιομορφίες της τοποθεσίας και των διεργασιών της εγκατάστασης, η απογραφή των εκπομπών σε συνδυασμό με διενεργηθέν πρόγραμμα μετρήσεων εδάφους και η σχετική νομοθεσία ήταν τα δεδομένα εισόδου της Ανάλυσης Περιβαλλοντικής Επικινδυνότητας (ERA). Συνολικά, η αξιολογητική προσέγγιση έδειξε ότι η Προκαταρκτική Μελέτη Προσανατολισμού Περιβαλλοντικής Ευθύνης {First-time Preliminary Orientation Environmental Liability Study (POELS)} αποτελεί ένα καλής ποιότητας προκαταρκτικό πρόγραμμα αντιμετώπισης των νομικών θεμάτων Περιβαλλοντικής Ευθύνης.
Η εφαρμογή της θεωρίας της αλλαγής στην αξιολόγηση δημόσιων πολιτικών και αναπτυξιακών προγραμμάτων
Authors: Ιωάννου Δήμητρα
Published: January 2025

Το άρθρο πραγματεύεται το θέμα της αξιολόγησης στη βάση της θεωρίας της αλλαγής, η οποία συνίσταται στο σχεδιασμό και την αξιολόγηση δράσεων αναφορικά με μεσοπρόθεσμους και μακροπρόθεσμους στρατηγικούς στόχους. Προσεγγίζει βασικά ερωτήματα ως προς το ρόλο της αξιολόγησης στη διαμόρφωση δημόσιων πολιτικών και στην επίτευξη των επιδιωκόμενων στόχων τους. Γίνεται αναφορά στις επιδράσεις της θεωρίας της αλλαγής, οι οποίες μπορεί να έχουν ουσιαστικό αντίκτυπο σε όλα τα επίπεδα της παρέμβασης, από την υλοποίηση μιας δράσης ή ενός ολοκληρωμένου προγράμματος, ως τη χάραξη στρατηγικών σχεδίων ανάπτυξης. Αντιμετωπίζει την αξιολόγηση ως μια διαρκή διαδικασία ανατροφοδότησης των συστημάτων λήψης αποφάσεων, μέσω της διάκρισης του προσδοκώμενου από το πραγματικό ή το δυνητικά εφικτό, μέσα από τη δυναμική της κριτικής θεωρίας και της μελέτης των επιπτώσεων κάτω από το πρίσμα των αντικειμενικών συνθηκών μέσα στις οποίες υλοποιούνται οι αναπτυξιακές παρεμβάσεις, και η οποία μπορεί να συμβάλλει καταλυτικά στην οικοδόμηση εφικτών, ευπροσάρμοστων και αυτοσυντηρούμενων αναπτυξιακών σχεδίων και μεταρρυθμίσεων.
The Use of Sequential Multiple Assignment Randomized Trials (SMARTs) in Physical Activity Interventions: Protocol for a Systematic Review
Authors: Whiston Aoife , Kidwell Kelley M , O'Rielly Siobhán , Walsh Cathal , Forbes John , Walsh Jane , Liam Glynn , Robinson Katie , Hayes Sara
Published: January 2025

Introduction Adaptive interventions involve a sequence of treatments tailored to individual responses, requiring multiple treatment decisions throughout an individual’s treatment pathway. Effective management of many chronic health conditions requires interventions adapted to individual performance. Physical activity (PA) is central to risk reduction therapies for chronic conditions. PA interventions are complex, multidimensional, and tailored to individual responses over time, requiring flexible study designs. However, PA intervention evidence is dominated by standard trial designs for non-adaptive interventions. A sequential, multiple assignment, randomised trial (SMART) design was developed to build adaptive interventions. SMARTs are factorial designs with sequential settings. Despite their potential for developing flexible interventions, SMARTs are relatively new in PA research. This review examines the state of SMART designs in PA interventions, focusing on study characteristics, design, and analysis methods. Methods and analysis A systematic review of SMARTs, wherein the intervention consisted of a PA intervention, will be conducted (June 2023). The following electronic databases were searched: PubMed, Embase, PsychINFO, CENTRAL, and CINAHL. The reference lists of all the identified studies will be reviewed to identify additional studies for inclusion. The titles and abstracts were independently screened by two review authors for selection. Any disagreement regarding inclusion was resolved by discussion or by referral to a third assessor. The methodological quality was assessed using the Cochrane Risk of Bias 2 tool. This review will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Ethics and dissemination As this systematic review will only collect secondary data, ethical approval is not required. These findings will be disseminated through academic conferences and peer-reviewed journals.